Tag: Top Hit Stories

Chlorhexidine Disinfectant May Perform Best in Killing Bone Tumor Cells After Surgery

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Newswise — October 28, 2022 – The widely used disinfectant chlorhexidine gluconate (CHG) appears to be the most effective irrigation solution for use as part of the surgical treatment of bone tumors, suggests an experimental study in The Journal of Bone & Joint Surgery. The journal is published in the Lippincott portfolio in partnership with Wolters Kluwer.

Of the various solutions used to eliminate remaining tumor cells after surgery, a 0.05% CHG solution appears to be most effective in killing cultured bone tumor cells, according to the laboratory study by Matthew J. Thompson, MD, of the University of Washington, Seattle, and colleagues.

CHG shows highest cytotoxicity against chondrosarcoma and giant cell tumors

Some patients with bone tumors undergo a surgical procedure called intralesional curettage. In this procedure, the tumor is scraped away while preserving as much healthy bone as possible. A common adjuvant treatment is to irrigate the operative area of the bone with some kind of chemical solution. This irrigation is performed to reduce the number of remaining cells that could potentially lead to tumor recurrence and reseeding.

Several different solutions have been used for irrigation of the tumor bed, including saline, ethanol, and various disinfectants. Dr. Thompson and colleagues performed a series of experiments to determine which of these solutions has the greatest cytotoxic (cell-killing) effects against bone tumor cells.

The experiments used cultures of two types of bone tumors: giant cell tumor, a benign but aggressive tumor; and chondrosarcoma, a type of bone cancer. Tumor cell cultures were treated with one of six different solutions – sterile water, 0.9% saline, 70% ethanol, 3% hydrogen peroxide, 0.05% CHG, and 0.3% povidone-iodine. Cytotoxicity was compared for the different treatments.

Of the six treatments, only CHG had cell-killing effectiveness equivalent to a control solution with 100% cytotoxicity, and this outcome was observed regardless of the treatment period (i.e., 2 minutes or 5 minutes).

None of the other solutions approached the cell-killing effectiveness of CHG. Only two solutions (sterile water and hydrogen peroxide) were superior to a control treatment with low cytotoxicity. The other three solutions tested – saline, ethanol, and povidone-iodine – showed little or no cytotoxicity.

Chlorhexidine is a familiar disinfectant with various medical uses, including as a topical antiseptic agent before surgery. The researchers write, “[CHG] is commonly used and readily available, with demonstrated in vivo safety in other surgical applications and a lower predicted toxicity compared with some currently used agents.”

The new study shows that CHG is highly effective in killing bone tumor cells – at least under laboratory conditions. “Therefore, the use of a 0.05% CHG solution clinically could serve as a potential chemical adjuvant during intralesional curettage of chondrosarcoma and [giant cell tumors],” Dr. Thompson and coauthors conclude.

The researchers emphasize that further studies will be needed to evaluate the outcomes of CHG irrigation in patients undergoing surgery. Dr. Thompson comments: “We believe it is important to continue to explore better ways to achieve durable local control of benign aggressive tumors like giant cell tumor of bone, which are associated with a high risk of local recurrence when treated with conventional extended intralesional curettage.”

Read [Cytotoxic Effects of Common Irrigation Solutions on Chondrosarcoma and Giant Cell Tumors of Bone]

DOI: 10.2106/JBJS.22.00404

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About The Journal of Bone & Joint Surgery

The Journal of Bone & Joint Surgery (JBJS) has been the most valued source of information for orthopaedic surgeons and researchers for over 125 years and is the gold standard in peer-reviewed scientific information in the field. A core journal and essential reading for general as well as specialist orthopaedic surgeons worldwide, The Journal publishes evidence-based research to enhance the quality of care for orthopaedic patients. Standards of excellence and high quality are maintained in everything we do, from the science of the content published to the customer service we provide. JBJS is an independent, non-profit journal.

About Wolters Kluwer

Wolters Kluwer (WKL) is a global leader in professional information, software solutions, and services for the clinicians, nurses, accountants, lawyers, and tax, finance, audit, risk, compliance, and regulatory sectors. We help our customers make critical decisions every day by providing expert solutions that combine deep domain knowledge with advanced technology and services.

Wolters Kluwer reported 2021 annual revenues of €4.8 billion. The group serves customers in over 180 countries, maintains operations in over 40 countries, and employs approximately 19,800 people worldwide. The company is headquartered in Alphen aan den Rijn, the Netherlands.

Wolters Kluwer provides trusted clinical technology and evidence-based solutions that engage clinicians, patients, researchers and students in effective decision-making and outcomes across healthcare. We support clinical effectiveness, learning and research, clinical surveillance and compliance, as well as data solutions. For more information about our solutions, visit https://www.wolterskluwer.com/en/health and follow us on LinkedIn and Twitter @WKHealth.

For more information, visit www.wolterskluwer.com, follow us on Twitter, Facebook, LinkedIn, and YouTube.

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October 28, 2022
Medical Physicist Consults with Patients Can Help Reduce Anxiety and Increase Satisfaction with Radiation Care
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Newswise — SAN ANTONIO, October 23, 2022 — Meeting with a medical physicist who can explain how radiation therapy is planned and delivered reduces patient anxiety and increases patient satisfaction throughout the treatment process, according to a new study published today in the International Journal of Radiation Oncology • Biology • Physics. Findings of the randomized, prospective phase III clinical trial also will be presented at the American Society for Radiation Oncology (ASTRO) Annual Meeting.

“This study is a wake-up call for medical physicists that there are new ways we can add value to patient care,” said Todd F. Atwood, PhD, lead author of the study and an associate professor and Senior Associate Division Director of Transformational Clinical Physics at the University of California, San Diego. “It illustrates how care teams can partner more effectively with patients as they make their treatment decisions and navigate the radiation therapy process.”

Medical physicists work with radiation oncologists to ensure complex treatment plans are properly tailored to each patient. They also develop and direct quality control programs to make sure treatments are delivered safely, including performing safety tests on the equipment used in a patient’s treatment.

The new findings suggest that medical physicists also can supplement patient education and potentially improve patient outcomes by reducing patients’ treatment-related stress. “Patients increasingly want to be more involved with their care,” said Dr. Atwood. “They are looking for more information. Typically, they start by searching online, but what they’re finding is either non-specific or just too complex. They have unanswered questions, which often lead to confusion, stress and anxiety.”

Prior studies have shown patient-related stress can negatively impact outcomes after radiation therapy. Dr. Atwood and his colleagues hope that by reducing stress and anxiety related to their treatment, this approach may also contribute to better patient outcomes.

In this study, researchers randomized 66 patients seeking external beam radiation therapy into two treatment arms: one that would receive Physics Direct Patient Care (PDPC) prior to – and throughout – radiation treatment, and one that did not receive PDPC radiation therapy. Patients had different types of primary cancer, most commonly breast, gynecologic or prostate cancer, and most were receiving radiation therapy for the first time.

In addition to traditional care, during which patients only discuss their treatment with their radiation oncologist, the PDPC group received two consultations prior to treatment with a medical physicist who explained the technical aspects of their care – how treatment is planned and delivered, how the radiation therapy technology works and “everything that goes into keeping them safe during treatment,” said Dr. Atwood. The medical physicist remained a resource for patients if additional questions arose at any point throughout the treatment process.

Before interacting with patients, the five medical physicists participating in the study completed a patient communication training program that included radiation oncology specific lectures, role playing exercises, simulated patient interactions and analysis, and supervised physician-patient consults that included an analysis of those interactions.

Changes in treatment-related anxiety, overall satisfaction with treatment and satisfaction with their understanding of the technical aspects of care were measured over the course of treatment using patient-reported questionnaires.

Patients who received medical physicist consults had significant improvements in anxiety and both satisfaction metrics, compared to those who received treatment without the additional consults. Anxiety did not differ between the groups at baseline or following the simulation appointment, but it was lower, on average, for patients who got the medical physicist consults after the first treatment (30.2 vs. 37.6, on a 60-point inventory, p=0.027). By the end of treatment, however, the difference in average anxiety scores was no longer significant.

To look more deeply at differences in anxiety between the groups, researchers looked specifically at the number of patients who reported high anxiety levels throughout treatment. While there were no significant differences in the proportion of high-anxiety patients at baseline, after the simulation appointment or after the first treatment, a substantial difference emerged by the end of treatment (12.5% vs. 38.9% reporting high anxiety, p=0.047).

While the consults were beneficial for patients generally, Dr. Atwood said they may be particularly useful to patients who are more prone to anxiety. Among those receiving the additional consults, over the course of treatment, the percentage of patients reporting high anxiety levels dropped by more than half, from 31.3% to 12.5%.

The greatest difference between the groups was seen in how satisfied patients were with their understanding of the technical aspects of their care. While there was no difference between the groups at baseline, the group that received an additional consult at the simulation appointment immediately expressed greater satisfaction with their technical understanding of care (6.2 vs. 5.1 on a 7-point scale, p=0.005). Technical satisfaction scores climbed for both groups throughout treatment, but they remained significantly higher for patients receiving additional consults, reaching 6.6 out of seven for that group, compared to 5.5 for the standard care group (p=0.002).

Overall satisfaction was also significantly higher after the first treatment for patients who received physics consults (6.7 vs. 6.0 on a 7-point scale, p=0.014). While satisfaction rose for both groups following the first treatment, it remained significantly higher for the consult group until the end of treatment (6.9 vs. 6.2, p=0.001).

Dr. Atwood said he was excited to see how long the benefits of supplemental consultation endured. “It has a lasting impact,” he said. “We’ve thought medical physics consults had great potential for years, but now we have a clearer understanding of how they positively impact the patient experience.”

While other members of the care team could also be called upon to provide patients with a deeper understanding of their care, Dr. Atwood said he believes medical physicists were uniquely suited to the role because they were so familiar with the science driving the technology being used.

“People don’t realize how personalized this therapy actually is. Medical physicists work behind the scenes to make sure this personalized treatment is both safe and effective. Our study indicates that there also can be a patient-facing role that will allow medical physicists to add more value to the patient experience” he said.

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Attribution to the American Society for Radiation Oncology (ASTRO) Annual Meeting is requested in all coverage.

See this study presented:
- Examining the impact of direct patient care for medical physicists: A randomized prospective phase III trial (Abstract 7)
- News Briefing: Monday, October 24, 9:00 a.m. Central time. Details here.
- Scientific Presentation: Clinical Trials Session, Sunday, October 23, 10:20 a.m. Central time, Henry B. Gonzalez Convention Center. Details here; email [email protected] for access.
- Journal Citation: Atwood TF, Brown DW, Murphy JD, et al. Examining the Effect of Direct Patient Care for Medical Physicists: A Randomized Prospective Phase III Trial [published online ahead of print, 2022 Oct 24]. Int J Radiat Oncol Biol Phys. doi:10.1016/j.ijrobp.2022.05.014
ABOUT ASTRO

The American Society for Radiation Oncology (ASTRO) is the largest radiation oncology society in the world, with nearly 10,000 members who are physicians, nurses, biologists, physicists, radiation therapists, dosimetrists and other health care professionals who specialize in treating patients with radiation therapies. For information on radiation therapy, visit RTAnswers.org. To learn more about ASTRO, visit our website and media center and follow us on social media.
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October 23, 2022
Telemedicine reduces odds of no-show clinic visits by more than two-thirds for surgical patients
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Key takeaways
- Telemedicine significantly lowers likelihood of no-show clinic visits among surgical patients and follow-up care during the post-surgery period.
- Telemedicine is a convenient tool that can help improve healthcare for all patients, successfully increasing access among vulnerable populations.
Newswise — SAN DIEGO: Surgical patients who use telehealth services are much more likely to show up for their initial clinic visit or follow-up appointment during the post-surgery period than those who rely on in-person visits only. Research findings were presented at the Scientific Forum of the American College of Surgeons (ACS) Clinical Congress 2022. During the early months of the COVID pandemic, when everything shut down, telemedicine became an effective tool to reach patients. Building on those successes, more hospitals and clinics are implementing telehealth technology into their patient care practices.

Telehealth consists of an at-home interactive video and audio telecommunications system, allowing real-time connection between patients, nurses, and doctors. One major benefit to patients is that they avoid the trouble of travel to and from an appointment at a distant hospital or clinic.

“Low access to transportation is the number one reason for patient no-show visits.* Telemedicine is a feasible way for us to reach out to patients who would otherwise have a lot of barriers to access the healthcare system,” said lead study author Connie Shao, MD, a general surgery resident at the University of Alabama Birmingham.

“Maintaining routine healthcare such as clinic visits helps prevent emergent visits, which are typically at a point in time when a patient’s condition is much worse. Staying engaged with the healthcare system with timely care before and after surgery improves quality care, reduces costs for the patient, and helps ensure our patients are able to maintain a higher level of health.”

Even so, little is known about telemedicine use among surgical patients.

About the study

For this analysis, researchers evaluated the association between telemedicine use and patient no-show visits. They looked at data collected from seven clinics at the University of Alabama Birmingham among a diverse population of patients, with an average age of 60, undergoing all types of surgery between January 2018 and December 2021.

Researchers divided the patients into three categories:
1. a historical control of in-person visits from January 2018 to March 2020
2. a contemporary control of in-person visits from March 2020 to December 2021
3. a contemporary group of patients scheduled for telemedicine visits between March 2020 to December 2021
March 2020 was the start of the COVID-19 pandemic and, with that, a ramping up of telemedicine appointments. The three groups were compared for no-show visits.

Key findings
- Of the 553,475 total visits, 11.3% were no-shows.
- Most clinic visits were in the historical control (54.1%), compared with contemporary control (41.5%), and telemedicine visits—which included audio only and video (4.4% for both types).
- The no-show rate was highest among in-person appointments (11.7%) compared to telemedicine visits (2.5%).
- Telemedicine was effective at reducing no-show visits. Of the small group of telemedicine visits, a multivariable adjusted analysis found a reduction in odds by 79% of no-show visits.
- No-show visits were also less common among older patients, those insured with Medicare, and the historical in-person visits from January 2018 to March 2020, compared with the contemporary in-person visits from March 2020 to December 2021.
- Disparities in no-show visits exist. For all visits, male patients were 12% more likely to not complete the appointments than women. Black patients, compared with white patients, were 68% more likely to be no-shows, and Asian patients were 32% more likely to be no-shows.
- Compared with private insurance, Medicaid patients were twice as likely to not complete the appointment. And patients from counties with a higher Social Vulnerability Index were 13% more likely to not complete the appointment.
Addressing the digital divide for patients

“Hopefully with the convenience of telemedicine now, the only bridge that we have to cross is the digital divide. We’ve partnered with a grassroots community program to train people in our community, especially older and more vulnerable people, on how to use telemedicine,” Dr. Shao said. “We can help keep these patients engaged in the healthcare system without having to take up their entire day to come and see us in the hospital.”

Giving all patients the option to use telehealth services may be of great benefit to surgical patients in the future. Dr. Shao is also developing best practice guidelines for the use of telemedicine for different surgical specialties during the post-surgery period.

“Telemedicine interventions such as training patients and offering more low-tech options, such as audio only, especially for patients who live far away, is an easier option. Some care is better than no care. And it’s far better for us to get some information at a telemedicine visit to take care of our patients in a timely interval than to wait to see the patient later on when they are sicker and have to be admitted to a hospital,” Dr. Shao said. “There is a time and place to use telemedicine. It certainly is an intervention worth considering to reduce no-show visits and to improve quality care across the board.”

The main limitation of the study is that the populations that are using telehealth technology are more likely, in general, to show up for a clinic visit (patients with better health literacy and access to the healthcare system disproportionately benefit from telemedicine). Future studies that incorporate telemedicine training into patient visits will eliminate this confounding.

The study was supported by the ACS and the University of Alabama Birmingham Health Services and Outcomes Research Group.

Study coauthors are Marshall C. McLeod, PhD; Andy Hare, BS; Isabel C. Marques, MD; Lauren Gleason, MD, MSPH; Burkely P. Smith, MD; Eric L. Wallace, MD, FACS; and Daniel I. Chu, MD, FACS.

Citation: Shao C, et al. Telemedicine Associated with Decreased No-show Visits among Surgical Specialties, Scientific Forum, American College of Surgeons Clinical Congress 2022.

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* Mieloszyk RJ, Rosenbaum JI, Hall CS, et al. Environmental Factors Predictive of No-Show Visits in Radiology: Observations of Three Million Outpatient Imaging Visits Over 16 Years, J Am Coll Radiol, 2016; 16 (4,B) 554-559.

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About the American College of Surgeons
The American College of Surgeons is a scientific and educational organization of surgeons that was founded in 1913 to raise the standards of surgical practice and improve the quality of care for all surgical patients. The College is dedicated to the ethical and competent practice of surgery. Its achievements have significantly influenced the course of scientific surgery in America and have established it as an important advocate for all surgical patients. The College has more than 84,000 members and is the largest organization of surgeons in the world. “FACS” designates that a surgeon is a Fellow of the American College of Surgeons.
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American College of Surgeons (ACS)

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October 16, 2022
Opening the eye of the storm

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Newswise — For the first time, high-energy muon particles created in the atmosphere have allowed researchers to explore the structures of storms in a way that traditional visualization techniques, such as satellite imaging, cannot. The detail offered by this new technique could aid researchers modeling storms and related weather effects. This could also lead to more accurate early warning systems.

It’s hard not to notice the number of stories in the news about heavy storms in different parts of the world, often attributed to climate change. Weather prediction and early warning systems have always been important, but with increased storm activity it seems especially so these days. A team of researchers, led by Professor Hiroyuki Tanaka from Muographix at the University of Tokyo, offer the world of meteorology a novel way of detecting and exploring tropical cyclones using a quirk of particle physics that takes place above our heads all the time.

“You’ve probably seen photographs of cyclones taken from above, showing swirling vortices of clouds. But I doubt you’ve ever seen a cyclone from the side, perhaps as a computer graphic, but never as actual captured sensor data,” said Tanaka. “What we offer the world is the ability to do just this, visualize large-scale weather phenomena like cyclones from a 3D perspective, and in real time too. We do this using a technique called muography, which you can think of like an X-ray, but for seeing inside truly enormous things.”

Muography creates X-ray-like images of large objects, including volcanoes, the pyramids, bodies of water, and now, for the first time, atmospheric weather systems. Special sensors called scintillators are joined together to make a grid, a little like the pixels on your smartphone’s camera sensor. However, these scintillators don’t see optical light, but instead see particles called muons which are created in the atmosphere when cosmic rays from deep space collide with the atoms in the air. Muons are special because they pass through matter easily without scattering as much as other types of particles. But the small amount they do deviate by as they pass through solid, liquid, or even gaseous matter, can reveal details of their journey between the atmosphere and the sensors. By capturing a large number of muons passing through something, an image of it can be reconstructed.

“We successfully imaged the vertical profile of a cyclone, and this revealed density variations essential to understanding how cyclones work,” said Tanaka. “The images show cross sections of the cyclone which passed through Kagoshima Prefecture in western Japan. I was surprised to see clearly it had a low-density warm core that contrasted dramatically with the high-pressure cold exterior. There is absolutely no way to capture such data with traditional pressure sensors and photography.”

The detector the researchers used has a viewing angle of 90 degrees, but Tanaka envisages combining similar sensors to create hemispherical and therefore omnidirectional observation stations which could be placed along the length of a coastline. These could potentially see cyclones as far away as 300 kilometers. Although satellites already track these storms, the extra detail offered by muography could improve predictions about approaching storms.

“One of the next steps for us now will be to refine this technique in order to detect and visualize storms at different scales,” said Tanaka. “This could mean better modeling and prediction not only for larger storm systems, but more local weather conditions as well.”

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Journal article: Hiroyuki K.M. Tanaka, Jon Gluyas, Marko Holma, Jari Joutsenvaara, Pasi Kuusiniemi, Giovanni Leone, Domenico Lo Presti, Jun Matsushima, László Oláh, Sara Steigerwald, Lee F. Thompson, Ilya Usoskin, Stepan Poluianov, Dezső Varga, Yusuke Yokota. “Atmospheric Muography for Imaging and Monitoring Tropic Cyclones”. Scientific Reports.

About The University of Tokyo
The University of Tokyo is Japan’s leading university and one of the world’s top research universities. The vast research output of some 6,000 researchers is published in the world’s top journals across the arts and sciences. Our vibrant student body of around 15,000 undergraduate and 15,000 graduate students includes over 4,000 international students. Find out more at www.u-tokyo.ac.jp/en/ or follow us on Twitter at @UTokyo_News_en.

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October 7, 2022
Sleep mode makes Energy Internet more energy efficient

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Newswise — A group of scientists in Nagoya University, Japan, have developed a possible solution to one of the biggest problems of the Internet of Energy, energy efficiency. They did so by creating a controller that has a sleep mode and only procures energy when needed.

Widespread generation of electricity based on renewable energy has become necessary to combat the climate crisis. One solution to realize society’s electrification needs is the Internet of Energy, which would operate like the information Internet, except that it would consist of energy linked by smart power generation, smart power consumption, smart interconnection, and cloud sharing.

When information is sent over the Internet, it is divided into transmittable units called ‘packets’, which are tagged with their destination. The energy Internet is based on a similar concept. Information tags are added to power pulses to create units called ‘power packets’. On the basis of requests from terminals, these are then distributed over networks to where they are needed. However, one problem is that since the packets are sent sporadically, the energy supply is intermittent. Current solutions, such as storage batteries or capacitors, complicate the system and reduce its efficiency.

An alternative solution is what is known as ‘sparse control’, where the terminal’s actuators are active part of the time and are in sleep mode for the rest of the time. In sleep mode, they do not consume fuel or electricity, leading to efficient energy saving and reducing environmental and noise pollution. Although sparse control has been used with a single actuator, it does not necessarily provide good performance when multiple actuators are used. The problem of determining how to do this for multiple actuators is called the ‘maximum turn-off control problem’.

Now, a Nagoya University research group, led by Professor Shun-ichi Azuma and Doctoral student Takumi Iwata of the Graduate School of Engineering, has developed a model control scheme for multiple actuators. The model has an awake mode, during which it procures and controls the necessary power packets for when they are needed, and a sleep mode. The research was published in the International Journal of Robust and Nonlinear Control.

“We can see our research being useful in the motor control of production equipment,” explains Professor Azuma. “This research provides a control system configuration method based on the assumption that the energy supply is intermittent. It has the advantage of eliminating the need for storage batteries and capacitors. It is expected to accelerate the practical application of the power packet type energy Internet.”

This research was supported by Japan Science and Technology Agency Emergent Research Support Program and Grant-in-Aid for Scientific Research from the Ministry of Education, Culture, Sports, Science and Technology of Japan.

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October 7, 2022
Students in Rwanda confound pandemic predictions and head back to school

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Newswise — New data from Rwanda, and some of the first published on how COVID-19 has impacted school attendance in the Global South, suggest that a widely-predicted spike in drop-out rates has “not materialised”.

Ever since the pandemic forced schools around the world to close, analysts, academics and teachers have been warning that many students in poorer countries might not return. According to some estimates, more than 10 million school-age students are at risk of dropping out worldwide. There have been particular concerns about marginalised groups such as the very poorest children and girls.

The new study, which used enrolment data from 358 Rwandan secondary schools, collected both before and after the closures, found that rather than undergoing a sharp fall, student numbers actually rose when schools reopened. The cause appears to have been a combination of existing students returning, and the enrolment of other pupils who were out of school before the pandemic began.

Researchers say that this may represent an emerging trend, because as-yet unpublished results from other sub-Saharan countries, such as Ethiopia and Malawi, similarly show no steep fall in numbers.

Despite this, a more gradual, long-term decline in the numbers of children in school may be underway. The research tracked enrolment past the point where schools reopened in Rwanda, and up to May 2021. By that stage, some students did appear to be dropping out of the system. This was particularly true of those from marginalised groups.

The research was undertaken by a team from the University of Cambridge and the East African research and data collection firm, Laterite, and was carried out for the Mastercard Foundation’s Leaders in Teaching Initiative.

Professor Pauline Rose, Director of the Research for Equitable Access and Learning (REAL) Centre, at the Faculty of Education, University of Cambridge, said: “Given the seriousness of the impact of COVID-19, I wouldn’t have been surprised if enrolment rates had halved when schools reopened. We are still developing a comprehensive picture of the situation across Sub-Saharan Africa, but the impact on drop-outs appears far less extreme than initially feared.”

“It is important we continue to monitor the situation. There was clearly real enthusiasm for schools to reopen at first, but there are now signs that some children may potentially be disappearing from the system.”

Schools in Rwanda closed in March 2020 and did not reopen until November, when they did so on a staggered basis. The research collected aggregate enrolment data from before the pandemic, in February 2020, and a year later, in February 2021.

This showed that after schools reopened, enrolment rates rose in the Secondary 1 and Secondary 4 year groups: natural entry points into the Rwandan system because they mark the start of lower and upper secondary school respectively. Enrolment rose by 7% at the Secondary 1 level, and 11% at Secondary 4, in February 2021. Numbers remained steady in the other year groups.

Crucially, the Rwanda Basic Education Board decided to make all students return to the year group that they were previously in when schools reopened. This means that the Secondary 1 and 4 year groups comprised the same cohorts across 2020 and 2021. The rise in numbers was therefore almost certainly due to students who had previously dropped out re-joining their cohort in February 2021.

The study also gathered both enrolment and assessment data from a sample of 2,800 students in the Secondary 3 year group, which it followed up to May 2021.

By that stage, researchers found, some students had started to drop out. About 89% of the entire sample group were still in school by May 2021, but the figure was lower among girls, and particularly among students who were over the ‘expected’ cohort age because they had been kept back an additional year or more. The overage group were also disproportionately likely to come from less-wealthy backgrounds.

“Keeping track of these children is really important,” Mico Rudasingwa, Research Associate at Laterite said. “By the time they reach adolescence, those from the poorest backgrounds in particular are in danger of dropping out early to support with income generating activities for the household.”

The sample group of students also took a learning assessment, in the form of a numeracy test, in February 2020, and again in May 2021 – two terms after their return to school. The results were measured using a ‘latent ability score’ – given as a figure between 0 and 1 – which takes into account not only how many questions they got right, but how difficult those questions were. The average score rose from 0.47 in the first test to 0.52 in the second. Over 90% of the schools in the sample group recorded an average improvement in numeracy scores.

Although positive, these results should be treated with caution, as there is no counterfactual evidence available about how much their test results might have improved had the school closures never occurred. The learning levels of some groups also improved more than others. Boys generally outperformed girls by about 0.02 points on the latent ability scale, while overage students again lagged behind their peers, by about 0.03 points.

The study also collected teacher retention data by tracking 1,700 teachers in science, technology, engineering and maths (STEM) subjects before and after the closures. Around 94% of STEM teachers returned to their classes in early 2021, and almost half the schools surveyed saw an overall increase in STEM teachers through new recruitment. The report describes this low turnover rate as ‘encouraging’.

The full report is available on the REAL Centre website.

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October 7, 2022
Study reveals main target of SARS-CoV-2 in brain and describes effects of virus on nervous system

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Newswise — A Brazilian study published in the journal PNAS describes some of the effects infection by SARS-CoV-2 can have on the central nervous system. A preliminary version (not yet peer-reviewed) posted in 2020 was one of the first to show that the virus that causes COVID-19 can infect brain cells, especially astrocytes. It also broke new ground by describing alterations in the structure of the cortex, the most neuron-rich brain region, even in cases of mild COVID-19.

The cerebral cortex is the outer layer of gray matter over the hemispheres. It is the largest site of neural integration in the central nervous system and plays a key role in complex functions such as memory, attention, consciousness, and language.

The investigation was conducted by several groups at the State University of Campinas (UNICAMP) and the University of São Paulo (USP), all funded by FAPESP. Researchers at the Brazilian Biosciences National Laboratory (LNBio), D’Or Institute (IDOR) and the Federal University of Rio de Janeiro (UFRJ) also contributed to the study.

“Two previous studies detected the presence of the novel coronavirus in the brain, but no one knew for sure if it was in the bloodstream, endothelial cells [lining the blood vessels] or nerve cells. We showed for the first time that it does indeed infect and replicate in astrocytes, and that this can reduce neuron viability,” Daniel Martins-de-Souza, one of the leaders of the study, told Agência FAPESP. Martins-de-Souza is a professor at UNICAMP’s Biology Institute and a researcher affiliated with IDOR.

Astrocytes are the most abundant central nervous system cells. Their functions include providing biochemical support and nutrients for neurons; regulating levels of neurotransmitters and other substances that may interfere with neuronal functioning, such as potassium; maintaining the blood-brain barrier that protects the brain from pathogens and toxins; and helping to maintain brain homeostasis.

Infection of astrocytes was confirmed by experiments using brain tissue from 26 patients who died of COVID-19. The tissue samples were collected during autopsies conducted using minimally invasive procedures by Alexandre Fabro, a pathologist and professor at the University of São Paulo’s Ribeirão Preto Medical School (FMRP-USP). The analysis was coordinated by Thiago Cunha, also a professor in FMRP-USP and a member of the Center for Research on Inflammatory Diseases (CRID).

The researchers used a technique known as immunohistochemistry, a staining process in which antibodies act as markers of viral antigens or other components of the tissue analyzed. “For example, we can insert one antibody into the sample to turn the astrocytes red on binding to them, another to mark the SARS-CoV-2 spike protein by making it green, and a third to highlight the virus’s double-stranded RNA, which only appears during replication, by turning it magenta,” Martins-de-Souza explained. “When the images produced during the experiment were overlaid, all three colors appeared simultaneously only in astrocytes.”

According to Cunha, the presence of the virus was confirmed in five of the 26 samples analyzed. Alterations suggesting possible damage to the central nervous system were also found in these five samples.

“We observed signs of necrosis and inflammation, such as edema [swelling caused by a buildup of fluid], neuronal lesions and inflammatory cell infiltrates,” he said.

The capacity of SARS-CoV-2 to infect brain tissue and its preference for astrocytes were confirmed by Adriano Sebolella and his group at FMRP-USP using the method of brain-derived slice cultures, an experimental model in which human brain tissue obtained during surgery to treat neurological diseases such as drug-refractory epilepsy, for example, is cultured in vitro and infected with the virus.

Persistent symptoms

In another part of the research, conducted in UNICAMP’s School of Medical Sciences (FCM), 81 volunteers who had recovered from mild COVID-19 were submitted to magnetic resonance imaging (MRI) scans of their brains. These scans were performed 60 days after diagnostic testing on average. A third of the participants still had neurological or neuropsychiatric symptoms at the time. They complained mostly of headache (40%), fatigue (40%), memory alterations (30%), anxiety (28%), loss of smell (28%), depression (20%), daytime drowsiness (25%), loss of taste (16%) and low libido (14%).

“We posted a link for people interested in participating in the trial to register, and were surprised to get more than 200 volunteers in only a few days. Many were polysymptomatic, with widely varying complaints. In addition to the neuroimaging exam, they’re being evaluated neurologically and taking standardized tests to measure performance in cognitive functions such as memory, attention and mental flexibility. In the article we present the initial results,” said Clarissa Yasuda, a professor and member of the Brazilian Research Institute for Neuroscience and Neurotechnology (BRAINN).

Only volunteers diagnosed with COVID-19 by RT-PCR and not hospitalized were included in the study. The assessments were carried out after the end of the acute phase, and the results were compared with data for 145 healthy uninfected subjects.

The MRI scans showed that some volunteers had decreased cortical thickness in some brain regions compared with the average for controls.

“We observed atrophy in areas associated, for example with anxiety, one of the most frequent symptoms in the study group,” Yasuda said. “Considering that the prevalence of anxiety disorders in the Brazilian population is 9%, the 28% we found is an alarmingly high number. We didn’t expect these results in patients who had had the mild form of the disease.”

In neuropsychological tests designed to evaluate cognitive functioning, the volunteers also underperformed in some tasks compared with the national average. The results were adjusted for age, sex and educational attainment, as well as the degree of fatigue reported by each participant.

“The question we’re left with is this: Are these symptoms temporary or permanent? So far, we’ve found that some subjects improve, but unfortunately many continue to experience alterations,” Yasuda said. “What’s surprising is that many people have been reinfected by novel variants, and some report worse symptoms than they had since the first infection. In view of the novel virus, we see longitudinal follow-up as crucial to understand the evolution of the neuropsychiatric alterations over time and for this understanding to serve as a basis for the development of targeted therapies.”

Energy metabolism affected

In IB-UNICAMP’s Neuroproteomics Laboratory, which is headed by Martins-de-Souza, experiments were performed on brain tissue cells from people who died of COVID-19 and astrocytes cultured in vitro to find out how infection by SARS-CoV-2 affects nervous system cells from the biochemical standpoint.

The autopsy samples were obtained via collaboration with the group led by Paulo Saldiva, a professor at the University of São Paulo’s Medical School (FM-USP). The proteome (all proteins present in the tissue) was mapped using mass spectrometry, a technique employed to identify different substances in biological samples according to their molecular mass.

“When the results were compared with those of uninfected subjects, several proteins with altered expression were found to be abundant in astrocytes, which validated the findings obtained by immunohistochemistry,” Martins-de-Souza said. “We observed alterations in various biochemical pathways in the astrocytes, especially pathways associated with energy metabolism.”

The next step was to repeat the proteomic analysis in cultured astrocytes infected in the laboratory. The astrocytes were obtained from induced pluripotent stem cells (iPSCs). The method consists of reprogramming adult cells (derived from skin or other easily accessible tissues) to assume a stage of pluripotency similar to that of embryo stem cells. This first part was conducted in the IDOR laboratory of Stevens Rehen, a professor at UFRJ. Martins-de-Souza’s team then used chemical stimuli to make the iPSCs differentiate into neural stem cells and eventually into astrocytes.

“The results were similar to those of the analysis of tissue samples obtained by autopsy in that they showed energy metabolism dysfunction,” Martins-de-Souza said. “We then performed a metabolomic analysis [focusing on the metabolites produced by the cultured astrocytes], which evidenced glucose metabolism alterations. For some reason, infected astrocytes consume more glucose than usual, and yet cellular levels of pyruvate and lactate, the main energy substrates, decreased significantly.”

Lactate is one of the products of glucose metabolism, and astrocytes export this metabolite to neurons, which use it as an energy source. The researchers’ in vitro analysis showed that lactate levels in the cell culture medium were normal but decreased inside the cells. “Astrocytes appear to strive to maintain the energy supply to neurons even if this effort weakens their own functioning,” Martins-de-Souza said.

As an outcome of this process, the functioning of the astrocytes’ mitochondria (energy-producing organelles) was indeed altered, potentially influencing cerebral levels of such neurotransmitters as glutamate, which excites neurons and is associated with memory and learning, or gamma-aminobutyric acid (GABA), which inhibits excessive firing of neurons and can promote feelings of calm and relaxation.

“In another experiment, we attempted to culture neurons in the medium where the infected astrocytes had grown previously and measured a higher-than-expected cell death rate. In other words, this culture medium ‘conditioned by infected astrocytes’ weakened neuron viability,” Martins-de-Souza said.

The findings described in the article confirm those of several previously published studies pointing to possible neurological and neuropsychiatric manifestations of COVID-19.

Results of experiments on hamsters conducted at the Institute of Biosciences (IB-USP), for example, reinforce the hypothesis that infection by SARS-CoV-2 accelerates astrocyte metabolism and increases the consumption of molecules used to generate energy, such as glucose and the amino acid glutamine. The results obtained by the group led by Jean Pierre Peron indicate that this metabolic alteration impairs the synthesis of a neurotransmitter that plays a key role in communication among neurons (more at: agencia.fapesp.br/37383/).

Unanswered questions

According to Martins-de-Souza, there is no consensus in the scientific literature on how SARS-CoV-2 reaches the brain. “Some animal experiments suggest the virus can cross the blood-brain barrier. There’s also a suspicion that it infects the olfactory nerve and from there invades the central nervous system. But these are hypotheses for now,” he said.

One of the discoveries revealed by the PNAS article is that the virus does not use the protein ACE-2 to invade central nervous system cells, as it does in the lungs. “Astrocytes don’t have the protein in their membranes. Research by Flávio Veras [FMRP-USP] and his group shows that SARS-CoV-2 binds to the protein neuropilin in this case, illustrating its versatility in infecting different tissues,” Martins-de-Souza said.

At UNICAMP’s Neuroproteomics Laboratory, Martins-de-Souza analyzed nerve cells and others affected by COVID-19, such as adipocytes, immune system cells and gastrointestinal cells, to see how the infection altered the proteome.

“We’re now compiling the data to look for peculiarities and differences in the alterations caused by the virus in these different tissues. Thousands of proteins and hundreds of biochemical pathways can be altered, with variations in each case. This knowledge will help guide the search for specific therapies for each system impaired by COVID-19,” he said.

“We’re also comparing the proteomic differences observed in brain tissue from patients who died of COVID-19 with proteomic differences we’ve found over the years in patients with schizophrenia. The symptoms of both conditions are quite similar. Psychosis, the most classic sign of schizophrenia, also occurs in people with COVID-19.”

The aim of the study is to find out whether infection by SARS-CoV-2 can lead to degeneration of the white matter in the brain, made up mainly of glial cells (astrocytes and microglia) and axons (extensions of neurons). “We’ve observed a significant correspondence [in the pattern of proteomic alterations] associated with the energy metabolism and glial proteins that appear important in both COVID-19 and schizophrenia. These findings may perhaps provide a shortcut to treatments for the psychiatric symptoms of COVID-19,” Martins-de-Souza pondered.

Marcelo Mori, a professor at IB-UNICAMP and a member of the Obesity and Comorbidities Research Center (OCRC), the study was only possible thanks to the collaboration of researchers with varied and complementary backgrounds and expertise. “It demonstrates that first-class competitive science is always interdisciplinary,” he said. “It’s hard to compete internationally if you stay inside your own lab, confining yourself to the techniques with which you’re familiar and the equipment to which you have access.”

The article has 74 authors. The experiments were conducted by three postdoctoral fellows: Fernanda Crunfli, Victor C. Carregari and Veras.

OCRC, CRID and BRAINN are Research, Innovation and Dissemination Centers (RIDCs) funded by FAPESP. The Foundation also supported the study via funding for seven other projects: 20/04746-0, 17/25588-1, 19/00098-7, 20/04919-2, 20/05601-6, 20/04860-8, and 19/11457-8.

About São Paulo Research Foundation (FAPESP)

The São Paulo Research Foundation (FAPESP) is a public institution with the mission of supporting scientific research in all fields of knowledge by awarding scholarships, fellowships and grants to investigators linked with higher education and research institutions in the State of São Paulo, Brazil. FAPESP is aware that the very best research can only be done by working with the best researchers internationally. Therefore, it has established partnerships with funding agencies, higher education, private companies, and research organizations in other countries known for the quality of their research and has been encouraging scientists funded by its grants to further develop their international collaboration. You can learn more about FAPESP at www.fapesp.br/en and visit FAPESP news agency at www.agencia.fapesp.br/en to keep updated with the latest scientific breakthroughs FAPESP helps achieve through its many programs, awards and research centers. You may also subscribe to FAPESP news agency at http://agencia.fapesp.br/subscribe

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Fundacao de Amparo a Pesquisa do Estado de Sao Paulo

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September 30, 2022
Another monkey virus could be poised for spillover to humans

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Newswise — An obscure family of viruses, already endemic in wild African primates and known to cause fatal Ebola-like symptoms in some monkeys, is “poised for spillover” to humans, according to new University of Colorado Boulder research published online Sept. 30 in the journal Cell.

While such arteriviruses are already considered a critical threat to macaque monkeys, no human infections have been reported to date. And it is uncertain what impact the virus would have on people should it jump species.

But the authors, evoking parallels to HIV (the precursor of which originated in African monkeys), are calling for vigilance nonetheless: By watching for arteriviruses now, in both animals and humans, the global health community could potentially avoid another pandemic, they said.

“This animal virus has figured out how to gain access to human cells, multiply itself, and escape some of the important immune mechanisms we would expect to protect us from an animal virus. That’s pretty rare,” said senior author Sara Sawyer, a professor of molecular, cellular and developmental biology at CU Boulder. “We should be paying attention to it.”

There are thousands of unique viruses circulating among animals around the globe, most of them causing no symptoms. In recent decades, increasing numbers have jumped to humans, wreaking havoc on naïve immune systems with no experience fighting them off: That includes Middle Eastern Respiratory Syndrome (MERS) in 2012, Severe Acute Respiratory Syndrome coronavirus (SARS-CoV) in 2003, and SARS-CoV-2 (the virus that causes COVID-19) in 2020.

For 15 years, Sawyer’s lab has used laboratory techniques and tissue samples from wildlife from around the globe to explore which animal viruses may be prone to jump to humans.

For the latest study, she and first author Cody Warren, then a postdoctoral fellow at the BioFrontiers Institute at CU, zeroed in on arteriviruses, which are common among pigs and horses but understudied among nonhuman primates. They looked specifically at simian hemorrhagic fever virus (SHFV), which causes a lethal disease similar to Ebola virus disease and has caused deadly outbreaks in captive macaque colonies dating back to the 1960s.

The study demonstrates that a molecule, or receptor, called CD163, plays a key role in the biology of simian arteriviruses, enabling the virus to invade and cause infection of target cells. Through a series of laboratory experiments, the researchers discovered, to their surprise, that the virus was also remarkably adept at latching on to the human version of CD163, getting inside human cells and swiftly making copies of itself.

Like human immunodeficiency virus (HIV) and its precursor simian immunodeficiency virus (SIV), simian arteriviruses also appear to attack immune cells, disabling key defense mechanisms and taking hold in the body long-term.

“The similarities are profound between this virus and the simian viruses that gave rise to the HIV pandemic,” said Warren, now an assistant professor in the College of Veterinary Medicine at The Ohio State University.

The authors stress that another pandemic is not imminent, and the public need not be alarmed.

But they do suggest that the global health community prioritize further study of simian arteriviruses, develop blood antibody tests for them, and consider surveillance of human populations with close contact to animal carriers.

A broad range of African monkeys already carries high viral loads of diverse arteriviruses, often without symptoms, and some species interact frequently with humans and are known to bite and scratch people.

“Just because we haven’t diagnosed a human arterivirus infection yet doesn’t mean that no human has been exposed. We haven’t been looking,” said Warren.

Warren and Sawyer note that in the 1970s, no one had heard of HIV either.

Researchers now know that HIV likely originated from SIVs infecting nonhuman primates in Africa, likely jumping to humans sometime in the early 1900s.

When it began killing young men in the 1980s in the United States, no serology test existed, and no treatments were in the works.

Sawyer said there is no guarantee that these simian arteriviruses will jump to humans. But one thing is for sure: More viruses will jump to humans, and they will cause disease.

“COVID is just the latest in a long string of spillover events from animals to humans, some of which have erupted into global catastrophes,” Sawyer said. “Our hope is that by raising awareness of the viruses that we should be looking out for, we can get ahead of this so that if human infections begin to occur, we’re on it quickly.”

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University of Colorado Boulder

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September 30, 2022
Exploring Europa Possible with Silicon-Germanium Transistor Technology

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Newswise — Europa is more than just one of Jupiter’s many moons – it’s also one of most promising places in the solar system to look for extraterrestrial life. Under 10 kilometers of ice is a liquid water ocean that could sustain life. But with surface temperatures at -180 Celsius and with extreme levels of radiation, it’s also one of the most inhospitable places in the solar system. Exploring Europa could be possible in the coming years thanks to new applications for silicon-germanium transistor technology research at Georgia Tech.

Regents’ Professor John D. Cressler in the School of Electrical and Computer Engineering (ECE) and his students have been working with silicon-germanium heterojunction bipolar transistors (SiGe HBTs) for decades and have found them to have unique advantages in extreme environments like Europa.

“Due to the way that they’re made, these devices actually survive those extreme conditions without any changes made to the underlying technology itself,” said Cressler, who is the project investigator. “You can build it for what you want it to do on Earth, and you then can use it in space.”

The researchers are in year one of a three-year grant in the NASA Concepts for Ocean Worlds Life Detection Technology (COLDTech) program to design the electronics infrastructure for upcoming Europa surface missions. NASA plans to launch the Europa Clipper in 2024, an orbiting spacecraft that will map the oceans of Europa, and then eventually send a landing vehicle, Europa Lander, to drill through the ice and explore its ocean. But it all starts with electronics that can function in Europa’s extreme environment.

Cressler and his students, together with researchers from NASA Jet Propulsion Lab (JPL) and the University of Tennessee (UT), demonstrated the capabilities of SiGe HBTs for this hostile environment in a paper presented at the IEEE Nuclear and Space Radiation Effects Conference in July.

Europa’s Challenge

Like Earth, Jupiter also has a liquid metal core that generates a magnetic field, producing radiation belts of high-energy protons and electrons from the impinging solar wind. Unfortunately, as a moon of Jupiter, Europa sits squarely in those radiation belts. In effect, any technology designed for Europa’s surface would not only need to be able to survive the cold temperatures but also the worst radiation encountered in the solar system.

Fortunately, SiGe HBTs are ideal for this hostile environment. The SiGe HBT introduces a nanoscale Si-Ge alloy inside a typical bipolar transistor to nano-engineer its properties, effectively producing a much faster transistor while maintaining the economy-of-scale and low cost of traditional silicon transistors. SiGe HBTs have the unique ability to maintain performance under extreme radiation exposure, and their properties naturally improve at colder temperatures. Such a unique combination makes them ideal candidates for Europa exploration.

“It’s not just doing the basic science and proving that SiGe works,” Cressler said. “It’s actually developing electronics for NASA to use on Europa. We know SiGe can survive high levels of radiation. And we know it’s remains functional at cold temperatures. What we did not know is if it could do both at the same time, which is needed for Europa surface missions.”

Testing the Transistors

To answer this question, the GT researchers used JPL’s Dynamitron, a machine that shoots high-flux electrons at very low temperatures to test SiGe in Europa-type environments. They exposed SiGe HBTs to one million Volt electrons to a radiation dose of five million rads of radiation (200-400 rads is lethal to humans), at 300, 200, and 115 Kelvins (-160 Celsius).

“What had never been done was to use electronics like we did in that experiment,” Cressler said. “So, we worked literally for the first year to get the results that are in that paper, which is in essence definitive proof that what we claimed is, in fact, true—that SiGe does survive Europa surface conditions.”

In the next two years, the GT and UT researchers will develop actual circuits from SiGe that could be used on Europa, such as radios and microcontrollers. Yet more importantly, these devices could then be seamlessly used in almost any space environment, including on the moon and Mars.

“If Europa is the worst-case environment in the solar system, and you can build these to work on Europa, then they will work anywhere,” Cressler said. “This research ties together past research that we have done in my team here at Georgia Tech for a long time and shows really interesting and novel applications of these technologies. We pride ourselves on using our research to break new innovative ground and thereby enable novel applications.”

Citation: J.W. Teng, G.N. Tzintzarov, D. Nergui, J.P. Heimerl, Y. Mensah, J.P. Moody, D.O. Thorbourn, L. Del Castillo, L. Scheick, M.M. Mojarradi, B.J. Blalock, and J.D. Cressler, “Cryogenic Total-Ionizing-Dose Response of 4th-Generation SiGe HBTs using 1-MeV Electrons for Europa-Surface Applications,” IEEE Nuclear and Space Radiation Effects Conference, July 2022.

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The Georgia Institute of Technology, or Georgia Tech, is one of the top public research universities in the U.S., developing leaders who advance technology and improve the human condition.

The Institute offers business, computing, design, engineering, liberal arts, and sciences degrees. Its more than 46,000 students, representing 50 states and more than 150 countries, study at the main campus in Atlanta, at campuses in France and China, and through distance and online learning.

As a leading technological university, Georgia Tech is an engine of economic development for Georgia, the Southeast, and the nation, conducting more than $1 billion in research annually for government, industry, and society.

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Georgia Institute of Technology

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September 30, 2022
Better Asthma and COPD Drugs with Fewer Side Effects Are Within Reach

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Rockville, Md. (September 29, 2022)—Bronchodilators, the most common type of asthma-fighting drug, inhibits contractions of airway smooth muscle that are induced by stimulating receptors on the muscle’s surface. New research highlights a novel mechanism for the drugs and will aid in the development of better medications for the treatment of asthma and chronic obstructive pulmonary disease (COPD). The findings are detailed in a new article by researchers from Dundalk Institute of Technology in Ireland and Queen’s University in Northern Ireland.

Asthma and COPD are common lung disorders—caused by excessive constriction of the airways—that make breathing difficult. Bronchodilators, also known as beta-adrenoceptor agonists, relax airway smooth muscle and open the airways to make breathing easier. These drugs bind to beta-adrenoceptors located on airway muscle cells and cause them to relax.

Constriction of the airways is regulated in the nerves, which release a chemical called acetylcholine. This chemical causes the airways to constrict and narrow. For patients with COPD, the constrictor effects of acetylcholine are enhanced. It has been long known that beta-adrenoceptor agonists could reverse the constricting effects of acetylcholine on airway smooth muscle, but it has not been fully clear how this occurs. It is important to understand how these medications work to assist with future development of more effective drugs with fewer side effects.

Read the full article, “M2 muscarinic receptor-dependent contractions of airway smooth muscle are inhibited by activation of β-adrenoceptors,” published ahead of print in Function. Contact APS Media Relations or call 301.634.7314 to schedule an interview with a member of the research team.

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American Physiological Society (APS)

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September 30, 2022
Liver Cancer: Excessive Alcohol Use and Other Risks

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Newswise — New Brunswick, N.J., October 1, 2022 – The liver is one of the most important organs in the body. It removes toxins from the blood and regulates the levels of chemicals. It excretes a product called bile which helps you digest fat. It makes clotting factors and stores sugar that the body uses for energy. Many may associate poor liver health with increased alcohol consumption but does that mean that drinking alcohol causes liver cancer? Mariam F. Eskander, MD, MPH, surgical oncologist at Rutgers Cancer Institute of New Jersey, the state’s leading cancer center only National Cancer Institute (NCI)-designated Comprehensive Cancer Center, together with RWJBarnabas Health, and assistant professor of surgery at Rutgers Robert Wood Johnson Medical School whose clinical expertise includes liver tumors, shares more information on this topic.

Q: What is the relationship between excessive alcohol use and liver cancer?

Heavy alcohol use is toxic to the liver. Alcohol abuse can cause irreversible damage to the liver called cirrhosis, and cirrhosis is the biggest risk factor for the development of hepatocellular carcinoma, the most common type of liver cancer. Other risk factors are chronic hepatitis B or C and nonalcoholic fatty liver disease, which can also lead to cirrhosis. Smoking is another risk factor.

Q: What are ways to lower liver cancer risk?

Take care of your liver! This means avoiding excessive alcohol intake, maintaining a healthy weight, and not smoking.

Q: Are there any early signs or symptoms of liver cancer?

Unfortunately, there are not any early signs of liver cancer. However, patients may present with abdominal pain, weight loss, nausea or vomiting, and yellowing of the skin or eyes.

Q: Is liver cancer hereditary?

Generally, no. There are some genetic conditions that increase the risk of developing liver cancer but they are not common. These include hereditary hemochromatosis and alpha-1 antitrypsin deficiency.

Q: Should people who have liver cancer abstain from drinking alcoholic beverages?

Yes, people who have liver cancer should avoid drinking alcohol. It can worsen liver function and limit treatment options. It can also increase the risk of developing another type of cancer.

Q: What should I do if I think I’m at risk for liver cancer?

Talk to your primary care physician about your specific risk factors and actions you can take to lower your risk. People with cirrhosis should also see a liver specialist to improve their liver health and get regular ultrasound screenings for liver cancer.

At Rutgers Cancer Institute, the Liver Cancer and Bile Duct Cancer Program is the state’s only multidisciplinary health care group focused on liver and bile duct tumors. Learn more about our Liver Cancer and Bile Duct Cancer Program.

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Rutgers Cancer Institute of New Jersey

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September 30, 2022