The Missing Link: Improving Cancer Outcomes Through a Structured Nutritional Quality Improvement Program

This study evaluated the nutrition improvement program (NIP) in China. A difference-in-differences model with propensity score matching was employed to diagnose the explicit effects of the NIP on the physical and mental health of students in rural areas, followed by a sensitivity analysis to validate the reliability of the results. Our findings suggest that the NIP improved the physical and mental health of students under compulsory education in rural areas. It was also found that NIP was more beneficial to students with financial difficulties, left-behind children in rural areas and children with one or more siblings. Based on our results, we suggest the government to implement NIP to narrow the health gap between urban and rural children.

first_page settings Order Article Reprints Font Type: Arial Georgia Verdana Font Size: Aa Aa Aa Line Spacing:    Column Width:    Background: Open AccessAbstract Improving Cancer Outcomes through Electrochemical Biosensing of Early Diagnosis/Prognosis Biomarkers in Human Biopsies † by José Manuel Pingarrón 1,*, Susana Campuzano 1, Rebeca Magnolia Torrente-Rodríguez 1, Víctor Ruiz-Valdepeñas Montiel 1, Eva Vargas 1 and Rodrigo Barderas 2 1 Departamento de Química Analítica, Facultad de CC. Químicas, Universidad Complutense de Madrid, 28040 Madrid, Spain 2 Departamento de Bioquímica y Biología Molecular I, Facultad de CC. Químicas, Universidad Complutense de Madrid, 28040 Madrid, Spain * Author to whom correspondence should be addressed. † Presented at the 5th International Symposium on Sensor Science (I3S 2017), Barcelona, Spain, 27–29 September 2017. Proceedings 2017, 1(8), 759; https://doi.org/10.3390/proceedings1080759 Published: 29 November 2017 (This article belongs to the Proceedings of Proceedings of the 5th International Symposium on Sensor Science (I3S 2017)) Download Download PDF Download PDF with Cover Download XML Versions Notes Cancer is the second leading cause of death after cardiovascular diseases and responsible for over 8 million deaths worldwide. Although substantial progress has been made in the prevention and treatment of different cancer types, its incidence and prevalence is increasing in recent years. Therefore, the development of efficient, simple, quantitative and disposable devices with short response times, low cost, and that are suitable to perform decentralized and reliable determination of early diagnosis cancer biomarkers could help to reduce cancer mortality due to its detection at early stages, when the disease can be efficiently treated and cured in more than 90% of cancer patients.Within this context, the main characteristics of novel biosensing scaffolds for the determination of cancer related-miRNAs [1,2,3] and autoantibodies [4] against tumor associated antigens (TAAs), relevant biomarkers considered for both early diagnosis and prognosis, will be presented. The developed methodologies, based on the coupling of attractive bioreceptors and bioassay formats, functionalized magnetic microcarriers, and electrochemical detection at disposable transducers, have demonstrated practical applicability for the accurate determination of the endogenous concentration of the target analytes in solid (fresh and FFPE breast human tissues) and liquid (human serum from colorectal and ovarian cancer patients) biopsies.The developed easy handling single- or multiplexed platforms, readily applied to the determination of other biomarkers, provided results in agreement with conventional methodologies but with lower cost and in remarkably shorter times. These interesting features make them suitable alternatives in the implementation of user-friendly and affordable devices, particularly attractive to perform routine determinations in both clinical and basic research settings to improve cancer diagnosis and prognosis. ReferencesTorrente-Rodríguez, R.M.; Ruiz-Valdepeñas Montiel, V.; Campuzano, S.; Farchado-Dinia, M.; Barderas, R.; San Segundo Acosta, P.; Montoya, J.J.; Pingarrón, J.M. Fast electrochemical miRNAs determination in cancer cells and tumor tissues with antibody-functionalized magnetic microcarriers. ACS Sensors 2016, 1, 896–903. [Google Scholar] [CrossRef]Torrente-Rodríguez; Campuzano, S.; Ruiz-Valdepeñas Montiel, V.; Montoya, J.J.; Pingarrón, J.M. Sensitive electrochemical determination of miRNAs based on a sándwich assay onto magnetic microcarriers and hybridization chain reaction amplification. Biosens. Bioelectron. 2016, 86, 516–521. [Google Scholar] [CrossRef] [PubMed]Torrente-Rodríguez; Campuzano, S.; Ruiz-Valdepeñas Montiel, V.; Sagrera, A.; Domínguez-Cañete, J.J.; Vargas, E.; Montoya, J.J.; Granados, R.; Sánchez-Puelles, J.M.; Pingarrón, J.M. Electrochemical miRNAs determination in formalin-fixed, paraffin-embedded breast tumor tissues association with HER2 expression. J. Biotecnol. Biomed. Eng. 2016, 3, 1064. [Google Scholar]Garranzo-Asensio, M.; Guzmán-Aranguez, A.; Povés, C.; Fernández-Aceñero, M.J.; Torrente-Rodríguez, R.M.; Ruiz-Valdepeñas Montiel, V.; Domínguez, G.; San Frutos, L.; Rodríguez, N.; Villalba, M.; et al. Anal. Chem. 2016, 88, 12339–12345. [CrossRef] [PubMed]Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations. © 2017 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). Share and Cite MDPI and ACS Style Pingarrón, J.M.; Campuzano, S.; Torrente-Rodríguez, R.M.; Montiel, V.R.-V.; Vargas, E.; Barderas, R. Improving Cancer Outcomes through Electrochemical Biosensing of Early Diagnosis/Prognosis Biomarkers in Human Biopsies. Proceedings 2017, 1, 759. https://doi.org/10.3390/proceedings1080759 AMA Style Pingarrón JM, Campuzano S, Torrente-Rodríguez RM, Montiel VR-V, Vargas E, Barderas R. Improving Cancer Outcomes through Electrochemical Biosensing of Early Diagnosis/Prognosis Biomarkers in Human Biopsies. Proceedings. 2017; 1(8):759. https://doi.org/10.3390/proceedings1080759 Chicago/Turabian Style Pingarrón, José Manuel, Susana Campuzano, Rebeca Magnolia Torrente-Rodríguez, Víctor Ruiz-Valdepeñas Montiel, Eva Vargas, and Rodrigo Barderas. 2017. "Improving Cancer Outcomes through Electrochemical Biosensing of Early Diagnosis/Prognosis Biomarkers in Human Biopsies" Proceedings 1, no. 8: 759. https://doi.org/10.3390/proceedings1080759 Find Other Styles Article Metrics No No Article Access Statistics Multiple requests from the same IP address are counted as one view.

The global cancer divide: Relationships between national healthcare resources and cancer outcomes in high-income vs. middle- and low-income countries

Exploring and optimising maternal and infant nutrition in North West Pakistan

To explore the nutritional status of chronic heart failure (CHF) patients and evaluate the effect of a transtheoretical model-based stepwise nutritional management program on nutritional improvement. This study conducted a retrospective analysis of 100 chronic heart failure (CHF) patients admitted to our hospital from March 2023 to May 2024. After applying inclusion and exclusion criteria, the patients were divided into an observation group and a control group. The observation group received a stepwise nutritional management program based on the transtheoretical model (TTM), while the control group received routine care. Nutritional improvement and clinical effects were compared between the two groups. Among the 100 CHF patients, 27% had good nutritional status, 42% were at nutritional risk, and 31% had malnutrition. No significant differences in baseline data were found between the two groups (P > 0.05). After the intervention, the observation group showed significantly lower B-type natriuretic peptide (BNP) levels and higher left ventricular ejection fraction (LVEF) levels compared to the control group (P < 0.05). Psychological scores (Self-Rating Depression Scale (SDS) and Self-Rating Anxiety Scale (SAS)) in the observation group were also significantly lower than those in the control group (P < 0.05). Additionally, serum total cholesterol (TC) and triglycerides (TG) levels were lower in the observation group (P < 0.05), and levels of prealbumin, transferrin, hemoglobin, and albumin were higher (P < 0.05). The Minnesota Living with Heart Failure Questionnaire (MLHFQ) scores in the observation group were significantly lower than in the control group (P < 0.05). The nutritional status of CHF patients is generally poor, and the transtheoretical model-based stepwise nutritional management program can effectively improve their nutritional status, enhance cardiac function, improve quality of life, and alleviate psychological burden. This intervention is promising for clinical practice.

PCN148 Community Oncologists' Experience and Perceptions of Cancer Survivorship

Cancer research in India: national priorities, global results

ABSTRACTIntroductionProstate cancer is the second most common cancer worldwide, and there is no national prostate cancer screening programme in the United Kingdom. Men of African ancestry are twice as likely to be diagnosed as men of European ancestry and are diagnosed at a younger age. Despite this, Black men are under‐represented in seeking advice about prostate cancer symptoms, screening and genetic research. There is increasing research focused on targeted prostate cancer screening, using genetic testing to guide screening by identifying those at highest risk, but this could only be considered if people of all ethnicities would accept this approach. It is vital to diagnose prostate cancer early, when it is curable. We wanted to identify the barriers to engagement with prostate cancer genetic research to increase participation from those at highest risk.MethodsWe conducted two community discussion groups, each attended by 30–35 Black men and their families. We conducted interviews with three Black community champions who have a lived experience of prostate cancer. Thematic analysis was performed on the transcripts. We used a participatory approach to develop our themes with members of the community, two of whom are co‐authors on this paper.ResultsThemes were grouped as barriers or facilitators to engagement with prostate cancer genetic risk services. Barriers included GP reluctance to perform prostate‐specific antigen (PSA) testing, cultural inhibition around discussing prostate cancer and family history, fear of rectal examination, fear of cancer diagnosis and lack of trust in the healthcare system, no awareness about the role of genetics in prostate cancer risk assessment, negative connotations of genetic testing (e.g., genetic modification) and genetic data being used inappropriately. Facilitators were family and community support, the sharing of experiences, good communication with doctors, raised prostate cancer awareness, genetic risk assessment to guide the need for screening and facilitate early diagnosis, improving future outcomes for prostate cancer in the Black community through engaging with genetic research and assurance that there are regulations in place to protect genetic and personal data with guidance around when genetic results must be disclosed.ConclusionsUnderstanding barriers and facilitators can guide recommendations for health services to improve access and uptake within the Black community and improve representation in genetic research. Better representation will support improvements in cancer outcomes and understanding of the genetic risk of prostate cancer in the Black community.Patient or Public ContributionWe initially attended community prostate cancer awareness events to speak to members of the community. We established trusted and two‐way relationships with Black ‘community champions’ who lead support groups in the Black community and often have a lived experience of prostate cancer. We were invited to attend their support groups to deliver awareness talks and address concerns about prostate cancer risk and screening. We then conducted discussion groups and collected data. Our analysis was conducted in partnership with our community champions. Our findings are described in this paper, with their co‐authorship. We have also disseminated our findings in a co‐produced newsletter to feed back our findings to the community members, who gave us their time. We have also shared information at a stakeholder day, attended by 65 individuals from the community, where we also planned future work. We have reimbursed participants for their time, which is in line with NIHR guidance. As described above, patient and public involvement has been the guiding principle throughout this project.

The aim of this study was to evaluate the clinical implications of pathologic complete response (pCR) (i.e., T0N0M0) after neoadjuvant chemoradiation and radical surgery in patients with locally advanced rectal cancer. A single-center, prospectively maintained colorectal cancer database was queried for patients with primary cII and cIII rectal cancer staged by CT and ERUS/MRI undergoing long-course neoadjuvant chemoradiation followed by proctectomy with curative intent between 1997 and 2007. Patients were stratified into pCR and no-pCR groups and compared with respect to demographics, tumor and treatment characteristics, and oncologic outcomes. Outcomes evaluated were 5-year overall survival, disease-free survival, disease-specific mortality, local recurrence, and distant recurrence. The query returned 238 patients (73% male), with a median age of 57years and median follow-up of 54months. Of these, 58 patients achieved pCR. Patients with pCR vs no-pCR were statistically comparable with respect to demographics, chemoradiation regimens, tumor distance from anal verge, clinical stage, surgical procedures performed, and follow-up time. No patient with pCR had local recurrence. Overall survival and distant recurrence were also significantly improved for patients achieving pCR. Achievement of pCR after neoadjuvant chemoradiation is associated with greatly improved cancer outcomes in locally advanced rectal cancer. Future studies should evaluate the relationship between increases in pCR rates and improvements in cancer outcomes in this population.

Observational studies suggest that physical activity after a breast cancer diagnosis is associated with improved cancer outcomes; however, no randomized data are available. Here, we report an exploratory follow-up of cancer outcomes from the Supervised Trial of Aerobic versus Resistance Training (START). The START was a Canadian multicenter trial that randomized 242 breast cancer patients between 2003 and 2005 to usual care (n = 82), supervised aerobic (n = 78), or resistance (n = 82) exercise during chemotherapy. The primary end point for this exploratory analysis was disease-free survival (DFS). Secondary end points were overall survival, distant DFS, and recurrence-free interval. The two exercise arms were combined for analysis (n = 160), and selected subgroups were explored. After a median follow-up of 89 months, there were 25/160 (15.6%) DFS events in the exercise groups and 18/82 (22.0%) in the control group. Eight-year DFS was 82.7% for the exercise groups compared with 75.6% for the control group (HR, 0.68; 95% confidence interval (CI), 0.37-1.24; log-rank, P = 0.21). Slightly stronger effects were observed for overall survival (HR, 0.60; 95% CI, 0.27-1.33; log-rank, P = 0.21), distant DFS (HR, 0.62; 95% CI, 0.32-1.19; log-rank, P = 0.15), and recurrence-free interval (HR, 0.58; 95% CI, 0.30-1.11; Gray test, P = 0.095). Subgroup analyses suggested potentially stronger exercise effects on DFS for women who were overweight/obese (HR, 0.59; 95% CI, 0.27-1.27), had stage II/III cancer (HR, 0.61; 95% CI, 0.31-1.20), estrogen receptor-positive tumors (HR, 0.58; 95% CI, 0.26-1.29), human epidermal growth factor receptor 2-positive tumors (HR, 0.21; 95% CI, 0.04-1.02), received taxane-based chemotherapies (HR, 0.46; 95% CI, 0.19-1.15), and ≥85% of their planned chemotherapy (HR, 0.50; 95% CI, 0.25-1.01). This exploratory follow-up of the START provides the first randomized data to suggest that adding exercise to standard chemotherapy may improve breast cancer outcomes. A definitive phase III trial is warranted.

Plant-based diets are increasingly popular and have many well-established benefits for health and environmental sustainability. Our objective was to perform a systematic review of plant-based diets and prostate cancer. We performed a systematic database and citation search in February 2022. Studies were included if they reported primary data on plant-based dietary patterns (i.e., vegan, vegetarian, plant-based) and incidence among at-risk men for prostate cancer, or oncologic, general health/nutrition, or quality of life outcomes among patients with prostate cancer or caregivers. A total of 32 publications were eligible for the qualitative synthesis, representing 5 interventional and 11 observational studies. Interventional studies primarily focused on lifestyle modification including plant-based diets for men on active surveillance for localized prostate cancer or with biochemical recurrence after treatment, showing improvements in short-term oncologic outcomes alongside improvements in general health and nutrition. Observationalstudies primarily focused on prostate cancer risk, showing either protective or null associations for plant-based dietary patterns. Studies of the vegan diet consistently showed favorable associations with risk and/or outcomes. Gaps in the current literature include impact for long-term disease-specific outcomes. Interventional studies showed generally favorable results of lifestyle modifications incorporating a plant-based diet with prostate cancer outcomes as well as improvements in nutrition and general health. Observational studies demonstrated either a lower risk of prostate cancer or no significant difference. These results are encouraging in light of the many benefits of plant-based diets for overall health, as well as environmental sustainability and animal welfare.

Objective: To analyze the situation and influencing factors of school meals leftover among primary and secondary school students in the area of the Nutrition Improvement Program for Rural Compulsory Education Students, improve the quality of school meals, develop healthy dietary behavior, and reduce food waste. Methods: In 2019, among the 50 monitoring counties that implemented the Compulsory Education Student Nutrition Improvement Program, two primary schools and two junior schools were randomly selected according to different food supply patterns.This study randomly selected one or two classes from grade 3 to grade 9. Basic information and school meals of 26 778 students were collected by using a student questionnaire. Multivariate logistic regression was used to analyze the influencing factors of leftovers rate. Results: 54.93% (14 709) of students wasted school meals, in which the highest rate was the staple food, with the main reason as "not in favor". 11.87% (1 743) of the students wasted school meals 6-7 days a week, with 54.20% (7 957) of students wasted but in less amount. The leftover rate of staple food was the highest (29.78%), followed by vegetables and meat. The main reason of leftovers was that they didn't like this kind of food (33.52%). The rate of school meal waste was higher for girls (OR=1.19,95%CI:1.13-1.25), junior high school students (OR=1.17, 95%CI: 1.11-1.25), resident students (OR=1.06, 95%CI: 1.00-1.12), lower economic level (OR=1.06, 95%CI: 1.00-1.12), parents working outside their houses (OR=1.22, 95%CI: 1.13-1.30), health education classes (OR=1.70, 95%CI: 1.40-2.06), company-based meals (OR=1.89, 95%CI: 1.71-2.07) and school meals were not as good as home food(OR=1.89, 95%CI: 1.78-2.00)(P<0.05). Conclusions: It is common for poor rural primary and middle school students in central and western China to waste school meals, and the reasons were affected by many factors. Reducing food waste requires the joint efforts of individuals, families, schools and society.

The assessment of physical activity in children undergoing cancer treatment

Pathogenic germline variants in Breast Cancer 1/2 (BRCA) genes confer increased cancer risk. Understanding BRCA status/risk can enable family cascade screening and improve cancer outcomes. However, more than half of the families do not communicate family cancer history/BRCA status, and cancer outcomes differ according to parent of origin (i.e., maternally vs. paternally inherited pathogenic variant). We aimed to explore communication patterns around family cancer history/BRCA risk according to parent of origin. We analyzed qualitative interviews (n = 97) using template analysis and employed the Theory of Planned Behavior (TPB) to identify interventions to improve communication. Interviews revealed sub-codes of ‘male stoicism and ‘paternal guilt’ that impede family communication (template code: gender scripting). Conversely, ‘fatherly protection’ and ‘female camaraderie’ promote communication of risk. The template code ‘dysfunctional family communication’ was contextualized by several sub-codes (‘harmful negligence’, ‘intra-family ignorance’ and ‘active withdrawal of support’) emerging from interview data. Sub-codes ‘medical misconceptions’ and ‘medical minimizing’ deepened our understanding of the template code ‘medical biases’. Importantly, sub-codes of ‘informed physicians’ and ‘trust in healthcare’ mitigated bias. Mapping findings to the TPB identified variables to tailor interventions aimed at enhancing family communication of risk and promoting cascade screening. In conclusion, these data provide empirical evidence of the human factors impeding communication of family BRCA risk. Tailored, theory-informed interventions merit consideration for overcoming blocked communication and improving cascade screening uptake.

PurposeBeta-blockers, originally developed for cardiovascular conditions, have been explored for their potential role in cancer treatment. Propranolol, a non-selective beta-blocker, has shown promise in inhibiting stress-induced signalling pathways associated with cancer progression. This systematic review aims to assess the evidence for the repurposing of propranolol as a treatment for various cancers, particularly breast cancer to answer the research question: Does propranolol improve cancer outcomes, including survival and recurrence?MethodsWe conducted a systematic search of MEDLINE, EMBASE, Global Health, Web of Science, and the Cochrane Library, including studies up to July 2024. Randomised Controlled Trials (RCTs), systematic reviews, and meta-analyses were included if they assessed the effects of propranolol on cancer outcomes such as mortality, survival, recurrence, or biomarkers of tumour regression. A narrative synthesis was performed to summarise the findings.ResultsThirty-one studies were included, consisting of 7 RCTs, 4 systematic reviews and 20 meta-analyses. The evidence suggests that propranolol may improve cancer outcomes, especially when administered perioperatively, by reducing recurrence risk. However, the results remain inconclusive regarding its use in combination with chemotherapy or radiotherapy, as studies showed mixed results. The timing of propranolol administration, alongside its combination with other cancer therapies, appears to be a key factor in its effectiveness.ConclusionPropranolol has potential as an adjunctive therapy in cancer treatment, particularly in reducing recurrence risk during the perioperative period. However, further clinical trials are needed to better define its role in cancer therapy, particularly regarding optimal treatment regimens and patient populations.