Thursday, November 03, 2022

NCCN working with Medlive to advance high-quality cancer care in China and worldwide

United States-based National Comprehensive Cancer Network enters strategic cooperation agreement with Chinese medical information website to publish and translate evidence-based expert consensus guidelines for cancer care now available at nccnchina.org.cn

Business Announcement

NATIONAL COMPREHENSIVE CANCER NETWORK

PLYMOUTH MEETING, PA, UNITED STATES [November 2, 2022] — The National Comprehensive Cancer Network® (NCCN®)—an alliance of leading cancer centers in the United States—is announcing a new collaboration with Medlive to share NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) in China at nccnchina.org.cn. NCCN Guidelines® are the recognized standard for clinical direction and policy in cancer management and the most thorough and frequently-updated clinical practice guidelines available in any area of medicine.

The current library of 84 evidence-based, expert consensus practice guidelines cover 97% of cancer cases affecting patients—with specific treatment recommendations for nearly every type of cancer, plus supportive care and prevention—and are updated at least once-a-year. There are also 65 patient-focused versions of the guidelines for patients and caregivers. All are now available at quicker in-country download speeds with a one-step registration process, also via guide.medlive.cn/NCCN on computer or the Medlive APP on smartphone. These resources will also be translated into Chinese in the future.

“We are committed to making sure providers and patients have access to the most up-to-date standards in cancer care around the world,” said Robert W. Carlson, MD, Chief Executive Officer, NCCN. “At NCCN, we believe that everyone worldwide should benefit from the rapidly expanding knowledge on how to treat cancer most effectively; and we work tirelessly to make that happen. We are proud to collaborate with Medlive on this important project.”

Although NCCN is a U.S.-based organization, NCCN resources are accessed and utilized throughout the world. Nearly half of the 1.5 million registered users viewing NCCN Guidelines at NCCN.org or via the Virtual Library of NCCN Guidelines® app are located outside of the U.S. China is currently the third-highest country for clinical practice guideline downloads, with more than 400,000 per year. This new in-country platform for guidelines is expected to increase that number significantly.

“We are happy to introduce a new home for NCCN resources in China here on our Medlive platform, providing doctors with faster access to NCCN Guidelines,” said Tian Lixin, President, Medlive. “This collaboration will help oncologists in China to reference the widely-recognized NCCN Guidelines, so all patients can receive high-quality, effective, and efficient treatment according to the latest evidence-based expert consensus standards.”

“Both NCCN and Medlive recognize the importance of collaboration and mutual learning,” said Xin Jiangtao, Vice President, Medlive. “We are pleased to use this platform for knowledge sharing between oncology circles in Asia and the United States, ultimately improving care for patients everywhere.”

The collaboration will focus on providing the full English-language library of NCCN Guidelines on Medlive’s platform (in addition to their longtime home at NCCN.org), with Chinese translations to follow in the near future. The new website specifically for NCCN on Medlive was first announced on June 15, 2022 with a live conference hosted by Medlive. The full broadcast is available on-demand at class.medlive.cn/class/live/close/68550.

Visit NCCN.org/global to learn more about NCCN’s work to improve cancer outcomes around the world. Join the conversation online with the hashtag #NCCNGlobal.

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About the National Comprehensive Cancer Network

The National Comprehensive Cancer Network® (NCCN®) is a not-for-profit alliance of leading cancer centers devoted to patient care, research, and education. NCCN is dedicated to improving and facilitating quality, effective, equitable, and accessible cancer care so all patients can live better lives. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) provide transparent, evidence-based, expert consensus recommendations for cancer treatment, prevention, and supportive services; they are the recognized standard for clinical direction and policy in cancer management and the most thorough and frequently-updated clinical practice guidelines available in any area of medicine. The NCCN Guidelines for Patients® provide expert cancer treatment information to inform and empower patients and caregivers, through support from the NCCN Foundation®. NCCN also advances continuing educationglobal initiativespolicy, and research collaboration and publication in oncology. Visit NCCN.org for more information and follow NCCN on Facebook @NCCNorg, Instagram @NCCNorg, and Twitter @NCCN

500 million year-old fossils reveal answer to evolutionary riddle

Peer-Reviewed Publication

UNIVERSITY OF OXFORD

Artist's reconstruction of Gangtoucunia aspera 

IMAGE: CAPTION: ARTIST'S RECONSTRUCTION OF GANGTOUCUNIA ASPERA AS IT WOULD HAVE APPEARED IN LIFE ON THE CAMBRIAN SEAFLOOR, CIRCA 514 MILLION YEARS AGO. THE INDIVIDUAL IN THE FOREGROUND HAS PART OF THE SKELETON REMOVED TO SHOW THE SOFT POLYP INSIDE THE SKELETON. RECONSTRUCTION BY XIAODONG WANG. view more 

CREDIT: RECONSTRUCTION BY XIAODONG WANG.

An exceptionally well-preserved collection of fossils discovered in eastern Yunnan Province, China, has enabled scientists to solve a centuries-old riddle in the evolution of life on earth, revealing what the first animals to make skeletons looked like. The results have been published today in Proceedings of the Royal Society B.

The first animals to build hard and robust skeletons appear suddenly in the fossil record in a geological blink of an eye around 550-520 million years ago during an event called the Cambrian Explosion. Many of these early fossils are simple hollow tubes ranging from a few millimetres to many centimetres in length. However, what sort of animals made these skeletons was almost completely unknown, because they lack preservation of the soft parts needed to identify them as belonging to major groups of animals that are still alive today.

The new collection of 514 million year old fossils includes four specimens of Gangtoucunia aspera with soft tissues still intact, including the gut and mouthparts. These reveal that this species had a mouth fringed with a ring of smooth, unbranched tentacles about 5 mm long. It’s likely that these were used to sting and capture prey, such as small arthropods. The fossils also show that Gangtoucunia had a blind-ended gut (open only at one end), partitioned into internal cavities, that filled the length of the tube.

These are features found today only in modern jellyfish, anemones and their close relatives (known as cnidarians), organisms whose soft parts are extremely rare in the fossil record. The study shows that these simple animals was among the first to build the hard skeletons that make up much of the known fossil record. 

According to the researchers, Gangtoucunia would have looked similar to modern scyphozoan jellyfish polyps, with a hard tubular structure anchored to the underlying substrate. The tentacle mouth would have extended outside the tube, but could have been retracted inside the tube to avoid predators. Unlike living jellyfish polyps however, the tube of Gangtoucunia was made of calcium phosphate, a hard mineral that makes up our own teeth and bones. Use of this material to build skeletons has become more rare among animals over time.

Corresponding author Dr Luke Parry, Department of Earth Sciences, University of Oxford, said: ‘This really is a one-in-million discovery. These mysterious tubes are often found in groups of hundreds of individuals, but until now they have been regarded as ‘problematic’ fossils, because we had no way of classifying them. Thanks to these extraordinary new specimens, a key piece of the evolutionary puzzle has been put firmly in place.’

The new specimens clearly demonstrate that Gangtoucunia was not related to annelid worms (earthworms, polychaetes and their relatives) as had been previously suggested for similar fossils. It is now clear that Gangtoucunia’s body had a smooth exterior and a gut partitioned longitudinally, whereas annelids have segmented bodies with transverse partitioning of the body.

The fossil was found at a site in the Gaoloufang section in Kunming, eastern Yunnan Province, China. Here, anaerobic (oxygen-poor) conditions limit the presence of bacteria that normally degrade soft tissues in fossils.

PhD student Guangxu Zhang, who collected and discovered the specimens, said: ‘The first time I discovered the pink soft tissue on top of a Gangtoucunia tube, I was surprised and confused about what they were. In the following month, I found three more specimens with soft tissue preservation, which was very exciting and made me rethink the affinity of Gangtoucunia. The soft tissue of Gangtoucunia, particularly the tentacles, reveals that it is certainly not a priapulid-like worm as previous studies suggested, but more like a coral, and then I realised that it is a cnidarian.’

Although the fossil clearly shows that Gangtoucunia was a primitive jellyfish, this doesn’t rule out the possibility that other early tube-fossil species looked very different. From Cambrian rocks in Yunnan province, the research team have previously found well-preserved tube fossils that could be identified as priapulids (marine worms), lobopodians (worms with paired legs, closely related to arthropods today) and annelids.

Co-corresponding author Xiaoya Ma (Yunnan University and University of Exeter) said: ‘A tubicolous mode of life seems to have become increasingly common in the Cambrian, which might be an adaptive response to increasing predation pressure in the early Cambrian. This study demonstrates that exceptional soft-tissue preservation is crucial for us to understand these ancient animals.’

Caption: Fossil specimen (left) and diagram (right) of Gangtoucunia aspera preserving soft tissues, including the gut and tentacle. 

Close up photograph of the mouth region of Gangtoucunia aspera showing the tentacles that would have been used to capture prey.


Fossil specimen of Gangtoucunia aspera preserving soft tissues, including the gut and tentacles (left and middle). The drawing at the right illustrates the visible anatomical features in the fossil specimens. 

CREDIT

Luke Parry and Guangxu Zhang.


Notes:

For media enquiries contact Dr Caroline Wood, University of Oxford: caroline.wood@admin.ox.ac.uk

Images of the fossils and an artistic reconstruction of a living Gangtoucunia aspera are available at the following file: https://drive.google.com/drive/folders/10NTzaKWMbQa_iP1LQgzO3Vos2mFVQHeN?usp=sharing Images can be used if credited.

The paper ‘Exceptional soft tissue preservation reveals a cnidarian affinity for a Cambrian phosphatic tubicolous enigma’ will be published in Proceedings of the Royal Society B on 2 November at https://royalsocietypublishing.org/doi/10.1098/rspb.2022.1623.To view the manuscript before this, contact Dr Caroline Wood, University of Oxford: caroline.wood@admin.ox.ac.uk

About the University of Oxford

Oxford University has been placed number 1 in the Times Higher Education World University Rankings for the seventh year running, and ​number 2 in the QS World Rankings 2022. At the heart of this success are the twin-pillars of our ground-breaking research and innovation and our distinctive educational offer.

Oxford is world-famous for research and teaching excellence and home to some of the most talented people from across the globe. Our work helps the lives of millions, solving real-world problems through a huge network of partnerships and collaborations. The breadth and interdisciplinary nature of our research alongside our personalised approach to teaching sparks imaginative and inventive insights and solutions.

Through its research commercialisation arm, Oxford University Innovation, Oxford is the highest university patent filer in the UK and is ranked first in the UK for university spinouts, having created more than 200 new companies since 1988. Over a third of these companies have been created in the past three years. The university is a catalyst for prosperity in Oxfordshire and the United Kingdom, contributing £15.7 billion to the UK economy in 2018/19, and supports more than 28,000 full time jobs.

About the University of Exeter 

The University of Exeter is a Russell Group university that combines world-class research with high levels of student satisfaction. Exeter has over 30,000 students and sits within the Top 15 universities in The Guardian University Guide 2023, and in the top 150 globally in both the QS World Rankings 2022 and THE World University Rankings 2023. In the 2021 Research Excellence Framework (REF), more than 99% of our research was rated as being of international quality, and our world-leading research impact has grown by 72% since 2014, more than any other Russell Group university.

COVID-19 case investigation, contact tracing in New York City

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK

About The Study: Researchers describe the establishment, scaling, and maintenance of Trace, New York City’s COVID-19 contact tracing program and provide data on outcomes during its first 17 months.

Authors: Kathleen Blaney, M.P.H., R.N., of the New York City Department of Health and Mental Hygiene in Queens, New York, is the corresponding author.

  To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamanetworkopen.2022.39661)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

mbed this link to provide your readers free access to the full-text article This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2022.39661?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=110222

 

Estimating savings opportunities from therapeutic substitutions of high-cost generic medications

JAMA Network Open

Peer-Reviewed Publication

JAMA NETWORK

About The Study: In this analysis of the top 1,000 generics in Colorado’s all-payer claims database in 2019, researchers identified 45 high-cost products that had lower-cost therapeutic alternatives of same clinical value. Overall, high-cost generics were 15.6 times more expensive than their therapeutic alternatives (median values). If the lower-cost alternatives had been used, total spending would have been reduced by 88%. Substitution of high-cost generics may provide a simple pathway to offer the same therapeutic benefit at lower cost to patients and insurers.

Authors: Mariana P. Socal, M.D., Ph.D., of the Johns Hopkins Bloomberg School of Public Health in Baltimore, is the corresponding author.

  To access the embargoed study: Visit our For The Media website at this link https://media.jamanetwork.com/

(doi:10.1001/jamanetworkopen.2022.39868)

Editor’s Note: Please see the article for additional information, including other authors, author contributions and affiliations, conflict of interest and financial disclosures, and funding and support.

Embed this link to provide your readers free access to the full-text article This link will be live at the embargo time http://jamanetwork.com/journals/jamanetworkopen/fullarticle/10.1001/jamanetworkopen.2022.39868?utm_source=For_The_Media&utm_medium=referral&utm_campaign=ftm_links&utm_term=110222

 

Why fish look down when they swim

Quirky behavior helps fish estimate swimming direction and speed, simulations show

Peer-Reviewed Publication

NORTHWESTERN UNIVERSITY

Zebrafish swimming with patterns 

VIDEO: WATCH A ZEBRAFISH SWIM ALONG WITH SHIFTING PATTERNS, PROJECTED ONTO THE BOTTOM OF ITS TANK. THIS EXPERIMENT PROVIDED EVIDENCE THAT FISH TAKE VISUAL MOTION CUES FROM BELOW. view more 

CREDIT: TOD THIELE/UNIVERSITY OF TORONTO

Just as you might look down at the sidewalk as you walk, fish look downward when they swim, a new study by a Northwestern University-led international collaboration has confirmed.

The study is the first to combine simulations of zebrafish’s brain, native environment and spatially-varying swimming behavior into one computational model. By analyzing this model, the researchers concluded that this quirk — looking down while swimming forward — is an adaptive behavior that evolved to help the fish self-stabilize, as when swimming against a current.

As water moves, fish are constantly trying to self-stabilize in order to stay in place — rather than getting swept away in a moving stream. Focusing on other fish, plants or debris might give the fish a false sensation that it’s moving. The stable riverbed below them, however, gives fish more reliable information about their swimming direction and speed. 

“It’s similar to sitting on a train car that isn’t moving. If the train next to yours starts to pull to away from the station, it can trick you into thinking you are moving too,” said Northwestern’s Emma Alexander, who led the study. “The visual cue from the other train is so strong that it overrides the fact that all of your other senses are telling you that you are sitting still. That’s exactly the same phenomenon that we are studying in fish. There are many misleading motion cues above them, but the most abundant and reliable signals are from the bottom of the river.”

The study will be published Nov. 2 in the journal Current Biology.

Alexander is an assistant professor of computer science in Northwestern’s McCormick School of Engineering, where she runs the Bio Inspired Vision Lab.

The researchers collected video data a forested stream with a sandy substrate and low-to-medium flow.

CREDIT

E. Alexander/Northwestern University

Going ‘back to the source’

To conduct the research, Alexander and her collaborators focused on zebrafish, a well-studied model organism. But, although many laboratories have tanks full of zebrafish, the team wanted to focus on the fish’s native environment in India.

“It was recently discovered that fish respond to motion below them more strongly than motion above them. We wanted to dig into that mystery and understand why,” Alexander explained. “Many zebrafish that we study grow up in lab tanks, but their native habitats shaped the evolution of their brains and behaviors, so we needed to go back to the source to investigate the context for where the organism developed.”

Armed with camera equipment, the team visited seven sites across India to gather video data of shallow rivers, where zebrafish naturally live. The field team encased a 360-degree camera inside a waterproof diving case and attached it to a remotely-controlled robotic arm. Then, they used the robotic arm to plunge the camera into the water and move it around.

“It allowed us to put our eyes where the fish eyes would be, so it’s seeing what the fish see,” Alexander said. “From the video data, we were able to model hypothetical scenarios where a simulated fish moved arbitrarily through a realistic environment.”

‘Wait for me!’

Back in the lab, the team also tracked zebrafish’s motions inside a ball of LEDs. Because fish have a large field of view, they do not have to move their eyes to look around like people do. So, the researchers played motion stimuli across the lights and watched the fishes’ responses. When patterns appeared on the bottom of the tank, the fish swam along with the moving patterns — more evidence that the fish were taking their visual cues from looking downward.

“If you play a video with moving stripes, the fish will move along with the stripes,” Alexander said. “It’s like they are saying ‘wait for me!’ In the behavioral experiment, we counted their tail beats. The more they wagged their tails, the more they wanted to keep up with the moving stripes.”

The team then abstracted data from its videos and combined it with data from how motion signals get encoded into the fish’s brain. They fed the datasets into two pre-existing algorithms used for studying optic flow (or the movement of the world across our eyes or camera lenses). 

Ultimately, they discovered that in both scenarios — in the wild and in the lab — zebrafish look down when swimming forward. The researchers concluded that fish look down to understand their environment’s motion and then swim to counteract it — to avoid being swept away.

“We tied everything together into a simulation that showed that, in fact, this is an adaptive behavior,” said Alexander, who led the computational part of the study. “The water surface is constantly moving, and other fish and plants are moving by. Fish are better off omitting that information and focusing on the information below them. Riverbeds have a lot of texture, so fish are seeing strong features they can track.”

Building better robots

Not only does this information gives some insight into fishes’ behavior, it could also inform designs for artificial vision systems and sophisticated bio-inspired robots.

“If you were making a fish-inspired robot and you just looked at its anatomy, you might think ‘the eyes are pointing sideways, so I’m going to point my cameras sideways,’” Alexander said. “But it turns out that the eyes are pointing sideways because they are balancing several tasks. We think they point sideways because it’s a compromise — they look upward to hunt and downward to swim.”

The study, “Optic flow in the natural habitats of zebrafish supports spatial biases in visual self-motion estimation,” was supported by the Human Frontier Science Program Young Investigator grant (HSFP RGY0079), the National Institutes of Health (grant number NIH EY003176) and the Werner Reichardt Centre for Integrative Neuroscience (grant number EXC307).

Permanent daylight savings time results in fewer car accidents with animals

Peer-Reviewed Publication

CELL PRESS

The practice of moving our clocks forward, resulting in a later sunset, reduces night-time associated car accidents with deer by 16 percent. Researchers developed a model, publishing November 2 in the journal Current Biology, that demonstrates the benefits that permanent daylight savings time has, not only in saving animal lives but also in reduction of collision costs and human injuries. 

“We saw these huge, abrupt shifts in human activity associated with the timing of sunrise and sunset, so it got us thinking if humans are responding to clock time, whereas animals are responding to the daylight time, does that then create more opportunities for human wildlife conflict?” says first author Calum Cunningham (@CalXCunningham), a biologist from the University of Washington School of Environmental and Forest Sciences.

Using data from 23 state agencies from the US Department of Transportation, Cunningham’s team analyzed 1,012,465 deer-vehicle collisions and 96 million hourly traffic observations across the United States. Their analysis showed that collisions are 14 times more frequent 2 hours after sunset than before. Even more striking, the rate of deer-vehicle collisions increased by 16 percent the week following the change to standard time. 

Taking these numbers, the researchers were able to predict that if daylight savings time became year-round it would prevent 36,550 deer deaths, 33 human deaths, 2,054 human injuries, and $1.19 billion in collision costs annually. The data on car collisions is most likely vastly underreported, and these numbers are likely to be much larger than stated.  

“It surprised me how striking this pattern was, of how much more likely deer are to get struck in the hour or two after darkness," says Cunningham. “This one-hour shift in human activity could have such a significant effect.” 

### 

Current Biology, Cunningham et al, “Permanent daylight saving time would reduce deer-vehicle collisions” https://www.cell.com/current-biology/fulltext/S0960-9822(22)01615-3 

Current Biology (@CurrentBiology), published by Cell Press, is a bimonthly journal that features papers across all areas of biology. Current Biology strives to foster communication across fields of biology, both by publishing important findings of general interest and through highly accessible front matter for non-specialists. Visit: http://www.cell.com/current-biology. To receive Cell Press media alerts, contact press@cell.com.  

LINUS PAULING WAS RIGHT

Vitamin C may hold the key to improve efficacy of dendritic cell-derived anticancer cell therapies

Peer-Reviewed Publication

JOSEP CARRERAS LEUKAEMIA RESEARCH INSTITUTE

The Ballestar Lab 

IMAGE: THE MEMBERS OF THE BALLESTAR LAB. view more 

CREDIT: JOSEP CARRERAS LEUKAEMIA RESEARCH INSTITUTE

Researchers from the Epigenetics and Immune Disease Lab at the Josep Carreras Leukaemia Research Institute has recently shown that vitamin C improves the immunogenic properties of dendritic cells, in vitro. Results recently made public show that treating the cells with vitamin C leads to a more consistent activation of genes involved in the immune response, mainly through DNA demethylation, a kind of epigenetic reprogramming. This discovery may be useful to generate more potent dendritic cell-based therapies in the future.

Since the onset of anticancer cell therapies, those that use living cells to find and eliminate tumors, many types of immune cells have been used. The best-known cell therapies use lymphocytes, as in the highly successful CAR-T therapies. Recently, dendritic cells have attracted the scientists’ attention thanks to its ability to uptake and present antigens (small parts of a pathogen or a cancer cell) to the T-lymphocytes and induce an antigen-specific potent immune activation. On this regard, loading dendritic cells with specific antigens to create immune memory constitute the so-called DC-vaccines.

To study dendritic cells in the lab, researchers differentiate them from monocytes (also an immune cell) using a particular set of molecular signaling. This differentiation is accomplished through a complex set of gene activation processes in the nucleus, mostly thanks to the activity of the chromatin remodeling machinery spearheaded by the TET family of demethylases, proteins that act upon the DNA epigenetic marks.

Vitamin C was known to interact with several TET proteins to enhance its activity, but the specific mechanism was still poorly understood in human cells. In a recent publication at the prestigious journal Nucleic Acids Research, a team lead by Dr. Esteban Ballestar hypothesized that treating monocytes in vitro while differentiating into dendritic cells, would help the resulting cells be more mature and active.

The results obtained by Octavio Morante-Palacios, first author of the publication, José Luis Sardina (also from the Josep Carreras Leukaemia Research Institute) and Eva Martínez-Cáceres, Head of Immunology of the Germans Trias i Pujol Research Institute, show that vitamin C treatment triggers an extensive demethylation at NF- kB/p65 binding sites compared with non-treated cells, promoting the activity of genes involved in antigen presentation and immune response activation. Also, vitamin C increases the communication of the resulting dendritic cells with other components of the immune system and stimulates the proliferation of antigen-specific T cells.

Actually, the researchers proved that vitamin C-stimulated dendritic cells loaded with antigens specific for the SARS-CoV-2 virus were able to activate T cells in vitro more efficiently than non-treated cells, showing the superiority of DC-vaccines treated with vitamin C.

Overall, these new findings support the hypothesis that treating monocyte-derived dendritic cells with vitamin C may help generate DC-vaccines with higher performance. After consolidating these results in preclinical models and, hopefully, in clinical trials, a new generation of cell therapies based on dendritic cells may be used in the clinic to fight cancer more efficiently.

Reference article:

Octavio Morante-Palacios, Gerard Godoy-Tena, Josep Calafell-Segura, Laura Ciudad, Eva M Martínez-Cáceres, José Luis Sardina, Esteban Ballestar. “Vitamin C enhances NF-κB-driven epigenomic reprogramming and boosts the immunogenic properties of dendritic cells”. Nucleic Acids Research, 2022; gkac941, https://doi.org/10.1093/nar/gkac941