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Massive, rapid production of vaccines to fight COVID-19 will require firms to share know-how not just about what to make, but how to make it, write Nicholson Price and colleagues in this Policy Forum. They cite the recent approval granted by the U.S. Department of Justice to six pharmaceutical firms to exchange "technical information" on manufacturing processes related to monoclonal antibody (mAb) candidates as an example - one that might pave the way for standardizing manufacturing of biologics going forward. As the world rushes to identify safe and effective vaccines and therapeutics to counter the COVID-19 epidemic, attention is turning to the next step: manufacturing these products at enormous scale. This might require, in some cases, companies to make products originally developed by other firms, in which case they may need to know that company's manufacturing methods. For myriad reasons, however, patents on products like vaccines often fail to disclose necessary manufacturing information. "[M]aintaining pervasive secrecy for manufacturing COVID-19 vaccines during the pandemic could cause dramatic failure," Price and colleagues argue. They say that relevant information for quick and effective scale-up must be readily available. Especially when the products that will ultimately be made at scale are as-yet unidentified, broader efforts to ensure their eventual scalability should be a focus. The authors acknowledge that transferring knowledge may not be trivial, including in cases where knowledge has not been codified. However, several entities might facilitate this type of knowledge transfer, they say, including existing international organizations and national governments.

What The Study Did: Researchers investigated an association between the duration of diabetes and recent weight loss with subsequent risk of pancreatic cancer in this observational study.

Authors: Chen Yuan, Sc.D., of the Dana-Farber Cancer Institute and Harvard Medical School in Boston, 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/jamaoncol.2020.2948)

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

Smoking is strongly linked to lower use of cancer screening services by women, and more advanced disease once cancer is diagnosed, reveals research published in the online journal BMJ Open.

Tobacco use is falling in many parts of the world, but it's falling less rapidly among women than it is among men. And lung cancer remains the leading cause of cancer death among women, say the researchers.

The evidence also suggests that women underuse cancer screening services, so the researchers wanted to find out if lower take up of these services might be linked to active smoking.

They drew on survey responses from 89,058 women who had gone through the menopause and were taking part in the nationally representative Women's Health Initiative Observational Cohort (WHI-OS) study.

Among the 89,058 participants, more than half (53%) had never smoked; 41% were ex-smokers; and 6% were active smokers, although nearly half (49.5%) had stopped smoking by the time of the last data collection.

Their health and use of cancer screening services were tracked for an average of nearly 9 years, during which time 7054 cases of breast cancer, 1600 cases of bowel cancer, and 61 cases of cervical cancer were diagnosed.

Former smokers were more likely than non-smokers to regularly attend cancer screening appointments. But current smokers were significantly less likely to do so.

"Concern for personal health is the most common reason given for smoking cessation among former smokers, and may explain why this health-conscious population seeks cancer screening more frequently than never smokers," suggest the researchers.

"On the contrary, smokers are overly optimistic about their health and consistently underestimate the magnitude of their cancer risk," they add.

Compared with women who had never smoked, current smokers were 45% less likely to get screened for breast cancer, 47% less likely to get screened for cervical cancer, and 29% less likely to get screened for bowel cancer.

And the higher the daily tally of cigarettes smoked among both former and current smokers, the less likely were these women to use cancer screening services.

Failure to regularly attend screening appointments was also associated with more advanced disease at diagnosis, with current smokers nearly 3 times as likely to be diagnosed with late stage breast cancer, and more than twice as likely to be diagnosed with late stage bowel cancer as those who had never smoked.

This is an observational study, and as such, can't establish cause. Participants included only postmenopausal women and relied on subjective reporting, note the researchers.

Nevertheless, they conclude: "Active smoking is associated with decreased use of breast, colorectal, and cervical cancer screening services in a dose dependent manner.

"Additionally, while cancer screening is important for avoiding late-stage presentation in patients of all smoking statuses, active smokers without appropriate screening have significantly higher odds of being diagnosed with advanced breast or colorectal cancer."

Doctors should emphasise the importance not only of giving up smoking, but also of making use of cancer screening services in this group of high risk women, they advise.

For cancer patients receiving radiation treatment during a surge in COVID-19 cases, adhering to the stay-at-home orders of quarantine is not always an option. The daily hospital trips potentially increase exposure, which is especially dangerous because cancer patients are at high risk for COVID-19 mortality. The option to delay radiation therapy until COVID-19 cases flatten could help cancer patients minimize exposure to the virus by staying home. A new study by investigators from Brigham and Women's Hospital found that for men with unfavorable intermediate-risk or high-risk localized prostate cancer, who are receiving radiation and hormone therapy, delaying radiation while remaining on hormone therapy is unlikely to impact survival. Their results are published in JAMA Oncology.

"Using a large database of patients with prostate cancer, we validated that the timing of starting radiation could be flexible," said Vinayak Muralidhar, MD, a resident in the Department of Radiation Oncology at the Brigham. "Our data suggest that patients can wait for COVID-19 cases to go down before starting radiation. Or, if there's a chance a surge is coming, they could consider undergoing radiation a little earlier than planned and complete it before the surge arrives."

"Our hope is that our study helps patients and providers make decisions about the timing of treatment," said Edward Christopher Dee, a fourth-year student at Harvard Medical School who was the first author of the study. "These decisions may allow patients to decrease their risk of exposure to COVID-19. Our findings may also provide reassurance to patients and providers who choose to delay treatment."

Radiation therapy is used for patients with localized prostate cancer and is given with 6-to-36 months of androgen deprivation therapy, or hormone therapy. Based on preclinical data, these two types of therapy are typically timed so that patients receive radiation treatment after two months of hormone therapy. However, two trials looking at this sequence of therapy showed that within a small window, exact timing of starting radiation relative to starting hormone therapy did not affect the outcome. The Brigham investigators wanted to validate the findings of these two relatively small trials in a cohort of over 63,000 cases of localized prostate cancer in the National Cancer Database. With this type of data set, the team recognizes there could be unmeasured differences between the patients that were not accounted for but explain the findings.

The cases were separated into four groups based on when radiation was started relative to hormone therapy. For cases of intermediate and high-risk disease, there was no difference in overall survival among the four groups.

"The findings are reassuring to patients and allow us to come up with a flexible radiation schedule for prostate cancer that ensures their safety," said Muralidhar. "The results have important implications for patients in areas experiencing a surge in COVID-19 cases who can opt to wait for a safer time to come in and initiate treatment. In the future, we can also look at other types of cancers and treatments and see how delaying therapy has an impact on survival."

Every year, 1.1 million new cases of blood cancers are diagnosed worldwide. Presently, chemotherapy remains the most common and effective course of treatment. However, the emergence of more aggressive forms of leukemia in adults prompts a need for early detection and new therapeutic approaches to achieve better clinical outcomes.

In a novel step forward, researchers from the Cancer Science Institute of Singapore (CSI Singapore) at the National University of Singapore (NUS) have identified covalently closed circular RNAs (circRNAs) from key genes involved in leukemia development and provided greater understanding of their roles in haematological malignancies.

Mutations in additional sex combs-like 1 (ASXL1) gene, an epigenetics remodeler, have been found in acute myeloid leukemia (AML), chronic myelomonocytic leukemia (CMML) and myelodysplastic syndrome (MDS), and are associated with poor overall survival. Recently, the ASXL1 gene locus was shown to undergo alternative splicing to produce circRNAs. While previous studies on circRNAs have primarily been focused on understanding the origins of these non-coding RNAs, the CSI Singapore research group led by Assistant Professor Sudhakar Jha investigated the role of circRNAs in modulating the epigenetics landscape and the effects on differentiation in hematopoietic development and leukemogenesis.

The findings of the study were published in the prestigious scientific journal Haematologica in July 2020.

New mechanism responsible for leukemia development

CircRNAs have been shown to have higher stability, are abundant, and highly conserved compared to linear RNAs. In addition, they can be detected in extracellular vesicles, exosomes and blood plasma thereby highlighting their potential as non-invasive biomarkers. Through RNA sequencing, the research team uncovered circRNA isoforms from the ASXL1 gene locus.

The team's analysis made inroads into understanding the role of circASXL1-1 in leukemia. Their data show that depletion of circASXL1-1 led to decreased H2AK119 ubiquitination (H2AK119ub) and this was through BRCA-1 associated protein 1 (BAP1) activity, a deubiquitinating enzyme and an important epigenetic regulator in leukemia. Furthermore, Asst Prof Jha and Dr Shweta Pradip Jadhav, a Research Fellow in his team, found that circASXL1-1 binds to BAP1 to regulate its catalytic activity.

"This work has provided insights into a new mechanism for the regulation of H2AK119ub levels in hematopoietic progenitors - via interaction of circASXL1-1 and BAP1," explained Asst Prof Jha.

Tapping on the newly established understanding, the research team aims to identify genes involved in myeloid differentiation program of haematopoietic stem cells (HSCs). These genes can in turn be targeted to restore the normal course of differentiation in leukemia or to help induce apoptosis of immature and abnormally differentiated cells. The epigenetic signature identified could thus pave the way for future therapeutic developments of "epi-drugs".

Moving forward, the research team intends to generate data supporting the use of circASXL1-1 in antisense therapy for malignant and non-malignant blood disorders using the newly acquired knowledge. More importantly, findings from this study will lay the foundation for the development of new RNA-based therapeutics for leukemia.

QUT researchers have used nationwide cancer mapping statistics to develop a new mathematical model so health professionals can further question patterns relating to the disease.

Epidemiologists use disease atlases to identify disease prevalence and mortality rates and QUT researchers say data could be expanded by including factors such as remoteness to investigate health inequalities.

QUT PhD student Farzana Jahan is the lead author of a study, published in the Royal Society Open Science, that used a statistical approach to reveal patterns of cancer incidence according to the "remoteness".

The study, which drew upon the Australian Cancer Atlas, considered cancers from geographical regions including major cities, inner regional, outer regional and remote areas.

Cancers having higher incidence in remote areas were head and neck, liver, lung, oesophageal for males and females and cervical and uterine cancers for females.

While in major cities, cancers more likely to have greater incidence include brain, myeloma, non-Hodgkin lymphoma, pancreatic, stomach, thyroid cancer for both sexes, kidney cancer for males, leukaemia, and ovarian cancer for females.

Some cancers more likely to occur in regional areas included bowel, melanoma for both males and females, kidney cancer for females, leukaemia, and prostate cancer for males.

Ms Jahan said the research was an attempt to create a method by which any available disease maps or summary disease measures can be further modelled to "unmask new insights about health and medical issues" without having to go back to the individual health records.

"Our research provides a method for further analysing information that goes beyond the scope of disease summaries," Ms Jahan said.

Dr Susanna Cramb, a biostatistician and epidemiologist based at QUT's Faculty of Health and who co-authored the study, said disease atlases are helpful for showing patterns but rarely adjusted for anything beyond age and population size.

"People might be interested in considering whether for instance the distance to the nearest radiotherapy facility affects survival, or the proportion of workers with high sun exposure is associated with melanoma incidence," Dr Cramb said.

"Comparing socioeconomic associations with certain cancer types and with other countries worldwide is another potential area to investigate.

"This study unlocks data from sources like the Cancer Atlas to explore and refine research hypotheses."

Diabetes mellitus and gout are ranked among the most common metabolic disorders in Western industrialised countries: According to figures published by the World Health Organization (WHO), around 60 million Europeans suffer from diabetes (2) and 18 million Europeans suffer from gout (3). "Gout is increasingly being linked to unfavourable cardiovascular, renal and metabolic complications, and now amputation risks", says EULAR president Professor Iain B. McInnes from Glasgow, Scotland, Great Britain. In a current study, Brian Lamoreaux, MD, MS from Lake Forest/USA showed how high the risk of amputations of outer limbs is by evaluating 190 million data sets from a patient database.

The research team divided the patients into four groups according to their medical records: patients with gout; patients with diabetes; patient with both gout and diabetes; and patients with neither disease. Afterwards, they compared how many patients from each group required an amputation of the outer limbs. The amputation rate of patients suffering from neither of those diseases was 0.03 percent. By contrast, the amputation rate of patients with gout rose to 0.16 percent. For people suffering only from diabetes, the value trebled to 0.46 percent. "Patients suffering from either gout or diabetes have a significantly increased risk of an amputation. In patients with both diseases, this effect is further amplified", says Dr. LaMoreaux. According to the results of his study, the amputation rate among patients with both diabetes and gout is 0.77 percent, compared to 0.03 percent in the control group.

Professor John Isaacs, Chair of the Scientific Programme Committee of EULAR, emphasises that these results are of highest relevance for daily clinical practice: "The more we know about the risks, complications and complications of diabetes and gout, the more specifically we can inform patients and optimize therapeutic strategies to possibly prevent serious surgeries such as amputations". According to the expert, the loss of a part of the body is particularly hard for many people, furthering the urgency to properly manage both conditions.

The number of deaths globally due to smokeless tobacco has gone up by a third in 7 years to an estimated 350,000 people, a new study suggests.

The research, from the University of York, comes at a time when there are concerns that spitting - a behaviour common among those who chew tobacco - is likely to transmit the COVID-19 virus.

The researchers - who are part of an international group called ASTRA - are calling for governments and public health bodies to regulate the production and sale of smokeless tobacco. They say a ban on spitting in public places will also discourage smokeless tobacco use and may reduce the transmission of COVID-19.

Dr Kamran Siddiqi, from the Department of Health Sciences and Hull York Medical School, said: "The study has come at a time when COVID-19 is affecting almost all aspects of our lives. Chewing tobacco increases saliva production and leads to compulsive spitting.

"There are concerns that spitting - a behaviour common among those who chew tobacco- is likely to transmit the virus to others.

"In acknowledgement of this, India for example, has already taken a positive step by banning spitting in public places to reduce the transmission of COVID-19."

The study, which was funded by the National Institute of Health Research, estimates that in 2017 alone smokeless tobacco resulted in more than 90,000 deaths due to cancers of the mouth, pharynx and oesophagus and accounted for more than 258,000 deaths from heart disease. Millions more have their lives shortened by ill health due to the effects of chewing tobacco-based products, the study reveals.

Researchers compiled the figures using data from 127 countries and extracted from the 2017 Global Burden of Disease Study and surveys such as Global Adult Tobacco Survey. The results are published in BMC Medicine.

Dr Siddiqi said South and South-East Asia continues to be a hotspot with India accounting for 70%, Pakistan for 7% and Bangladesh for 5% of the global disease burden due to smokeless tobacco.

Dr Siddiqi added: "Smokeless tobacco is used by almost a quarter of tobacco users and most of them live in India, Pakistan and Bangladesh. In the UK, South Asian communities also consume smokeless tobacco products which too needs to be regulated just like cigarettes."

"We have an international policy in the form of the World Health Organisation's Framework Convention for Tobacco Control, to regulate the supply and demand of tobacco products. We need to apply this framework to smokeless tobacco with the same rigor as it is applied to cigarettes."

A software based on artificial intelligence (AI), which was developed by researchers at the Eye Clinic of the University Hospital Bonn, Stanford University and University of Utah, enables the precise assessment of the progression of geographic atrophy (GA), a disease of the light sensitive retina caused by age-related macular degeneration (AMD). This innovative approach permits the fully automated measurement of the main atrophic lesions using data from optical coherence tomography, which provides three-dimensional visualization of the structure of the retina. In addition, the research team can precisely determine the integrity of light sensitive cells of the entire central retina and also detect progressive degenerative changes of the so-called photoreceptors beyond the main lesions. The findings will be used to assess the effectiveness of new innovative therapeutic approaches. The study has now been published in the journal "JAMA Ophthalmology".

There is no effective treatment for geographic atrophy, one of the most common causes of blindness in industrialized nations. The disease damages cells of the retina and causes them to die. The main lesions, areas of degenerated retina, also known as "geographic atrophy", expand as the disease progresses and result in blind spots in the affected person's visual field. A major challenge for evaluating therapies is that these lesions progress slowly, which means that intervention studies require a long follow-up period. "When evaluating therapeutic approaches, we have so far concentrated primarily on the main lesions of the disease. However, in addition to central visual field loss, patients also suffer from symptoms such as a reduced light sensitivity in the surrounding retina," explains Prof. Dr. Frank G. Holz, Director of the Eye Clinic at the University Hospital Bonn. "Preserving the microstructure of the retina outside the main lesions would therefore already be an important achievement, which could be used to verify the effectiveness of future therapeutic approaches."

Integrity of light sensitive cells predicts disease progression

The researchers were furthermore able to show that the integrity of light sensitive cells outside areas of geographic atrophy is a predictor of the future progression of the disease. "It may therefore be possible to slow down the progression of the main atrophic lesions by using therapeutic approaches that protect the surrounding light sensitive cells," says Prof. Monika Fleckenstein of the Moran Eye Center at the University of Utah in the USA, initiator of the Bonn-based natural history study on geographic atrophy, on which the current publication is based.

"Research in ophthalmology is increasingly data-driven. The fully automated, precise analysis of the finest, microstructural changes in optical coherence tomography data using AI represents an important step towards personalized medicine for patients with age-related macular degeneration," explains lead author Dr. Maximilian Pfau from the Eye Clinic at the University Hospital Bonn, who is currently working as a fellow of the German Research Foundation (DFG) and postdoctoral fellow at Stanford University in the Department of Biomedical Data Science. "It would also be useful to re-evaluate older treatment studies with the new methods in order to assess possible effects on photoreceptor integrity."

Physical activity destinations more than 500 metres from home may encourage older people to engage in physical activity. Outdoor mobility facilitating parks, walking trails, and public services at greater distances increased physical activity, according to a study conducted at the Faculty of Sport and Health Sciences of the University of Jyväskylä.

"Older people reporting attractive destinations more than 500 metres away were more physically active than those who did not report any destination or reported such destinations only closer to home," says senior researcher Erja Portegijs.

Physical activity is important for maintaining health and function in old age. A home neighbourhood offering attractive destinations may thus help older people to maintain an active life. Research commonly assumes that only the near-home environment is meaningful for older adults' mobility and physical activity.

Nearly 200 men and women from Central Finland between the ages of 79 and 94 participated in this study. On an internet-based map, participants noted any outdoor mobility facilitating destinations they perceived.

With this new method, we obtained unique information about older adults' spatial mobility. Such a method has not been used in populations of this advanced age before.

Similar map-based data are increasingly used in city planning. However, older adults are typically underrepresented in such internet surveys.

"Research in representative samples of older populations is therefore important," Portegijs explains. "In our study, we provided technical assistance to enable the participation of those with limited IT skills as well."

Senior researcher Portegijs was also involved in a European-wide study among older adults of six European countries (Germany, Italy, the Netherlands, Spain, Sweden, and the United Kingdom). The results show that it is useful to have multiple destinations such as public services, places to sit, and parks in the neighbourhood. Reporting many of these types of destinations was associated with higher physical activity.

"These results support the idea that diversity and quality aspects of neighbourhood destinations are important to support older adults' physical activity," Portegijs says.

During the COVID-19 pandemic, social distancing and stay-at-home orders have been enacted throughout the world to stop disease transmission and keep people safe. But for those who experience intimate partner violence (IPV), being quarantined with an abuser means that home may be the most dangerous place for a person to be. In recent years, radiologists have been making a concerted effort to help identify injuries associated with IPV. In a new study published in Radiology, a team led by investigators at Brigham and Women's Hospital assessed the incidence, pattern and severity of injuries related to IPV in patients at the Brigham during the spring of 2020. When they compared IPV injuries from 2020 to injuries over the previous three years, they found an alarming increase in physical injuries associated with IPV.

"Despite a decrease in our overall imaging volume, we encountered severe physical injuries related to IPV in the Emergency Department during the COVID-19 pandemic," said the principal investigator and the corresponding author Bharti Khurana, MD, director of Trauma Imaging Research and Innovation Center at the Brigham. "Radiologists and other health care providers should proactively participate in identifying IPV victims and reach out to vulnerable communities as an essential service during the pandemic and other crisis situations."

Khurana and colleagues examined data collected from March 11 to May 3, 2020. They reviewed radiology reports and images and graded them for IPV based on objective signs of abuse. The team developed a grading system based on the location of physical injuries and the depth of injuries. The team then compared injuries seen in the spring of 2020 to data from the same span of time in the previous three years.

The team found 26 cases in which victims sustained physical IPV in the spring of 2020, compared to 20 in 2019, 7 in 2018 and 15 in 2017. The team also looked at the severity of abuse, finding five such cases in 2020 compared to one case each year in the preceding three years. The researchers looked at both superficial and deep injuries, such as injuries from strangulation, stab injuries, burns or use of weapons such as knives, guns and other objects that can cause injury to the deep internal organs. The number of deep injuries during the pandemic was 28 compared to a total of 16 deep injuries during the previous three years.

Overall, a total of 62 IPV victims of all types (physical and non-physical abuse) were identified in 2020; 104 in 2019; 106 in 2018; and 146 in 2017. The larger percentage of severe physical abuse seen during the pandemic may suggest that victims reached out for health care services in later stages of abuse due to fear of COVID-19.

The team's study is retrospective, observational and limited to data from a single institution, thus additional studies are needed to better understand patterns of physical IPV across the U.S. and in other countries during the pandemic.

"Overall, we saw a lower number of IPV victims with a greater number of deep injuries and signs of physical abuse, and this suggests to us that victims may be so fearful of COVID-19 that they aren't reaching us until the abuse is severe," said Khurana. "We know that high-risk physical abuse and severe physical injuries are highly associated with homicide. Even in the middle of a pandemic, we need to recognize the signs of IPV and find opportunities to help patients in need."

Infections in humans caused by the hepatitis B virus (HBV) represent a major public health problem. Despite the availability of effective protective vaccines, more than 250 million individuals worldwide are chronically infected according to WHO estimates. HBV infection is associated with cirrhosis, liver failure and hepatocellular carcinoma, responsible for approximately a million deaths every year. To date there is no specific treatment to completely eliminate the virus and provide a cure for chronic HBV infection. Strikingly, however, about 1% of individuals with chronic HBV infection, known as natural controllers, are capable of recovering spontaneously. To improve our understanding of the antibody response conferring protection against HBV infection, scientists from the Institut Pasteur and Inserm, in collaboration with the Roche Innovation Center in Switzerland, produced and characterized human monoclonal antibodies specific to viral envelope antigens, referred as HBsAg, from blood memory B cells isolated from HBV vaccinees and natural controllers.

Hepatitis B is one of the major human diseases: it is estimated that 2 billion people have been infected with the virus and more than 250 million are chronic carriers capable of transmitting the virus over many years. Chronic carriers are exposed to a high risk of death from liver cirrhosis or liver cancer, diseases that claim around a million lives every year (see our fact sheet).

There are no drugs available to treat acute hepatitis and improve the chances of recovery. But some rare patients, known as natural controllers, undergo seroconversion - they develop antibodies against the virus that can be detected in the blood, conferring protection against the disease similarly to vaccination. In response to HBV infection, specific antibodies produced by immune cells called B lymphocytes recognize HBsAg, some of which being able to block viral infection (neutralization) and propagation by destroying infected liver cells (hepatocytes). Thus, such antibodies appear to play a crucial role in eliminating HBV and protecting against infection.

New therapeutic avenue for the treatment of hepatitis B virus

To investigate the antibody response involved in the protection against HBV infection and analyze in details the properties of the antibodies directed against the virus, the laboratory of Humoral Immunology (Institut Pasteur / INSERM U1222), in collaboration with the Roche Innovation Center in Switzerland, scientists from the units led by James Di Santo and Pierre Charneau (Institut Pasteur), and the teams led by Stanislas Pol (Cochin Hospital) and Camille Sureau (French Blood Transfusion Institute (INTS)), produced and characterized about a hundred human monoclonal antibodies specific to the HBV surface antigens (HBsAg) expressed by memory B cells isolated from the blood of vaccinees and individuals cured of chronic infection (natural controllers). "The study shows that vaccinees and natural controllers are capable of generating a wide array of antibodies targeting different regions of HBsAg" explains Hugo Mouquet, Head of the Humoral Immunology Laboratory at the Institut Pasteur and investigator for the study. The vast majority of anti-HBsAg antibodies produced in controllers are neutralizing and capable of reacting with different HBV subtypes circulating worldwide. Apart from their neutralizing ability in vitro at low concentrations, the antibody candidates tested in mouse models of HBV infection led in vivo to a substantial drop in viremia - the level of viral particles in the blood for a given virus. Importantly, the passive administration of the broadly neutralizing antibody Bc1.187, isolated from a controller subject, into infected mice led to a drastic decrease of viremia and in some mice, to a long-term post-therapy control of the infection.

"The neutralizing antibodies directed against HBsAg thus appear to play a key role in the natural control of infection in chronically infected patients," continues Hugo Mouquet. The antibody Bc1.187 represents a highly promising therapeutic tool for the treatment of patients with chronic HBV infection and/or an alternative to the polyclonal immunoglobulins used in some indications to prevent transmission of the virus in humans.

If we can harness it, quantum technology promises fantastic new possibilities. But first, scientists need to coax quantum systems to stay yoked for longer than a few millionths of a second.

A team of scientists at the University of Chicago's Pritzker School of Molecular Engineering announced the discovery of a simple modification that allows quantum systems to stay operational--or "coherent"--10,000 times longer than before. Though the scientists tested their technique on a particular class of quantum systems called solid-state qubits, they think it should be applicable to many other kinds of quantum systems and could thus revolutionize quantum communication, computing and sensing.

The study was published Aug. 13 in Science.

"This breakthrough lays the groundwork for exciting new avenues of research in quantum science," said study lead author David Awschalom, the Liew Family Professor in Molecular Engineering, senior scientist at Argonne National Laboratory and director of the Chicago Quantum Exchange. "The broad applicability of this discovery, coupled with a remarkably simple implementation, allows this robust coherence to impact many aspects of quantum engineering. It enables new research opportunities previously thought impractical."

Down at the level of atoms, the world operates according to the rules of quantum mechanics--very different from what we see around us in our daily lives. These different rules could translate into technology like virtually unhackable networks or extremely powerful computers; the U.S. Department of Energy released a blueprint for the future quantum internet in an event at UChicago on July 23. But fundamental engineering challenges remain: Quantum states need an extremely quiet, stable space to operate, as they are easily disturbed by background noise coming from vibrations, temperature changes or stray electromagnetic fields.

Thus, scientists try to find ways to keep the system coherent as long as possible. One common approach is physically isolating the system from the noisy surroundings, but this can be unwieldy and complex. Another technique involves making all of the materials as pure as possible, which can be costly. The scientists at UChicago took a different tack.

"With this approach, we don't try to eliminate noise in the surroundings; instead, we "trick" the system into thinking it doesn't experience the noise," said postdoctoral researcher Kevin Miao, the first author of the paper.

In tandem with the usual electromagnetic pulses used to control quantum systems, the team applied an additional continuous alternating magnetic field. By precisely tuning this field, the scientists could rapidly rotate the electron spins and allow the system to "tune out" the rest of the noise.

"To get a sense of the principle, it's like sitting on a merry-go-round with people yelling all around you," Miao explained. "When the ride is still, you can hear them perfectly, but if you're rapidly spinning, the noise blurs into a background."

This small change allowed the system to stay coherent up to 22 milliseconds, four orders of magnitude higher than without the modification--and far longer than any previously reported electron spin system. (For comparison, a blink of an eye takes about 350 milliseconds). The system is able to almost completely tune out some forms of temperature fluctuations, physical vibrations, and electromagnetic noise, all of which usually destroy quantum coherence.

The simple fix could unlock discoveries in virtually every area of quantum technology, the scientists said.

"This approach creates a pathway to scalability," said Awschalom. "It should make storing quantum information in electron spin practical. Extended storage times will enable more complex operations in quantum computers and allow quantum information transmitted from spin-based devices to travel longer distances in networks."

Though their tests were run in a solid-state quantum system using silicon carbide, the scientists believe the technique should have similar effects in other types of quantum systems, such as superconducting quantum bits and molecular quantum systems. This level of versatility is unusual for such an engineering breakthrough.

"There are a lot of candidates for quantum technology that were pushed aside because they couldn't maintain quantum coherence for long periods of time," Miao said. "Those could be re-evaluated now that we have this way to massively improve coherence.

"The best part is, it's incredibly easy to do," he added. "The science behind it is intricate, but the logistics of adding an alternating magnetic field are very straightforward."

Because cancer is easier to successfully treat when it's caught early, a major goal in cancer research is to develop new ways to find tumors at early stages, before they start to spread. One approach that's being studied are liquid biopsies. These tests aim to find and diagnose cancer anywhere in the body by detecting biomarkers -- materials that tumors shed into the bloodstream -- in a blood sample.

In a study published August 13, 2020, in Cell by a team of collaborators from Memorial Sloan Kettering and Weill Cornell Medicine, researchers report that tiny packages of materials released by tumors, called EVPs (extracellular vesicles and particles), may serve as biomarkers for detecting a number of different types of cancer in the early stages.

"One of the holy grails in cancer medicine is to diagnose an early cancer in a patient based on a blood test," says MSK surgeon William Jarnagin, Chief of the Hepatopancreatobiliary Service and co-senior author of the study. "This research is a proof-of-principle study; much more work is needed before it can be used as a screening tool. But ultimately, it would be fantastic if we could use this approach to find cancer in someone before they had symptoms."

A Different Type of Biomarker

Much of the previous work on liquid biopsies has focused on the detection and analysis of cancer genes that are released by cancer cells into the blood. Some of these liquid biopsies, including MSK-ACCESS, are already approved as a tool for monitoring treatment and matching patients who have cancer with the appropriate targeted therapy. Using liquid biopsies as a screening tool to detect previously undiagnosed cancer is still experimental.

The new study focuses not on analyzing genes but instead examining proteins contained in EVPs. David Lyden, a physician-scientist at Weill Cornell and the paper's other senior author, studies EVPs in his lab and is a pioneer in the field. He has found that tumors may release EVPs as a way to prepare other parts of the body to receive cancer cells when they spread.

The researchers say that one potential advantage of focusing on proteins in EVPs rather than cancer genes is that it allows them to also characterize different types of cells found in the area around a tumor -- called the tumor microenvironment. In addition, it could help them detect changes in other tissues, such as immune organs, which also contribute to EVP proteins that are seen in the blood.

Using Machine Learning to Process Data

The current study looked at whether EVPs might be useful in screening. It employed blood and tissue from people who were known to have cancer as well as some samples from cell lines and mouse models. The research included samples from 18 different cancers, including breast, colon, and lung, which came primarily from MSK. There was a comparison group of samples from people who didn't have cancer.

A computational biology approach was used to match particular EVP protein signatures with certain types of cancer. "The amount of information that comes from this kind of study is monumental -- it's a huge amount of data," Dr. Jarnagin says. "You really need high-throughput computer programs and machine learning to be able to sort through it all."

Once the computing method was established, the team found that the computer could identify different types of cancer from the samples with a sensitivity of 95% (meaning that it found the cancer in 95% of cases) and a specificity of 90% (meaning that 10% of the cancers it identified turned out to be false positives).

"Even if this test became standard, we still would have to do CT and MRI scans to confirm where the tumor was located," Dr. Jarnagin says. "But if you use a blood test to find who might be at risk of having a certain type of cancer, it would be a huge advance because we could target investigations to these high-risk patients."

He adds that if this type of liquid biopsy is shown to be effective for clinical use, it's likely to also be useful in monitoring the treatment response in people already diagnosed with cancer. It may also be a good tool to monitor people after treatment to determine whether their cancer has come back when it's still too small to show up on a scan.

Next Steps for Validating Findings

Using liquid biopsies to detect cancer is a much bigger challenge than using them to monitor cancers that are already known. For now, the team is focused on the next step: validating that their lab findings with EVPs will work with additional patients. Part of the validation process will involve testing this method in those who don't have cancer but have an increased risk due to a strong family history or a known mutation in one of the BRCA genes, for example. Standard diagnostic methods will be used as a comparison in the validation process.

Dr. Jarnagin explains that in the future, liquid biopsies are likely to be especially important for diagnosing cancers that don't currently have established screening methods, including liver and pancreatic cancers.

"These cancers are rarely detected early and treating them as soon as possible could result in better patient outcomes," says Dr. Lyden, who is a member of the Sandra and Edward Meyer Cancer Center and the Gale and Ira Drukier Institute for Children's Health at Weill Cornell Medicine.

AUSTIN, Texas -- We hear a lot about fake news, but do we know it when we see it?

Research from The University of Texas at Austin has found that although Facebook users may be too quick to believe or share misinformation, flagging fake news can make a significant difference. In fact, the study, published online today by Information Systems Research, shows that platforms can reduce the extent to which their users fall for and spread fake news articles by deploying a better designed fake news flag.

The new paper studied what tools would help Facebook users spot fake news. Lead author Tricia Moravec, an assistant professor in the McCombs School of Business, and her two co-authors, Antino Kim and Alan R. Dennis of Indiana University, found that two simple interventions, especially when combined, had a strong effect on helping people discern real from fake news.

The first intervention the researchers tested was a stop sign icon. The second was a strong statement, "Declared Fake by 3rd Party Fact-Checkers." Each intervention was effective, but when combined, they were almost twice as powerful, the study says.

"Ideally, we would see Twitter and especially Facebook use some type of flag for misinformation with a brief statement to nudge people to think more critically," Moravec said.

Twitter has begun using labels and warning messages. Facebook uses technology and fact-checkers to identify false information and moves the information lower in the News Feed so it's less likely to be seen. Facebook also says that people who repeatedly share false news will see their distribution reduced and their ability to advertise removed.

"Twitter has been doing a much better job than Facebook at managing misinformation, since they actively flag misleading information," Moravec said. "It is a good step that Facebook is taking to at least demote misinformation and punish repeat offenders, but based on the misinformation I have seen about COVID-19 on Facebook, I do not think their efforts are effective in managing misinformation on their platform."

Moravec said that the proliferation of fake news on social media worsened during the 2016 election and has accelerated during the COVID-19 pandemic, feeding confusion and misinformation about matters that can have life-and-death consequences. As sharply divided Americans face the November presidential election amid warnings of interference from Russia and other countries, stopping the threat of fake news takes on greater urgency, she said.

The researchers focused on social media because that's where more than 60% of adults get their news, with Facebook being the world's most-used platform.

Moravec and her two colleagues conducted several studies to see what would have the biggest impact on getting people to avoid spreading fake news. First, they tested the stop sign icon and fake news statement for one second and five seconds. One second is enough time to elicit an automatic gut reaction, while five seconds can capture the effect of critical thinking. That was accompanied by "awareness training," which was a brief announcement explaining the warnings.

They then tested the stop sign and statement together with users being trained partway through the study. Finally, to better understand the training's effect, some participants received training, and others did not. The researchers found that the combination of the stop sign, statement and awareness training had the biggest impact.

Although Facebook in December 2016 started flagging fake news with an icon combined with a brief warning statement, it stopped doing so about a year later. Facebook did not do awareness training on the meaning of the warning and the statement, which said, "Disputed by 3rd Party Fact-Checkers," and that may have made the tool less effective, Moravec said.

She believes Facebook abandoned the fake news flag too soon and needs to try again, possibly using the system she and her team tested.

"How much could it have helped if Facebook had a flag on false COVID-19 information?" she asked. "Even if it didn't work for everyone, at least getting some people to change or critically consider some health information is progress."