Category: 3. Business

  • Prospective Study on Clinical Performance of Host DNA Methylation Assay for Triage in Women Who Are HPV-Positive — 4 Provinces, China, 2018–2021



    Introduction: Effective detection methods to distinguish between transient human papillomavirus (HPV) infection and clinically relevant high-risk HPV (hrHPV)-induced diseases are lacking, leading to excessive referrals and overtreatment. This study evaluated the clinical performance of a host DNA six-methylation marker panel (ASTN1, DLX1, ITGA4, RXFP3, SOX17, and ZNF671) to triage Chinese women who were hrHPV-positive.







    Methods: This prospective multicenter study enrolled women aged 21–65 years with positive hrHPV testing. hrHPV genotyping, cytology, colposcopy, and the six-methylation marker assay were performed. High-grade cervical lesions were defined as histologically confirmed CIN2+. Forest plots analyses were performed to assess the triage performance of the methylation assay.







    Results: Of the 1,806 patients recruited from 4 hospitals in China, 1,659 were included. The methylation assay positivity rates were 7.5%, 73.9%, 88.9%, and 100% for CIN1, CIN2, CIN3, and cervical cancer, respectively. The six-methylation marker assay demonstrated sensitivities of 82.2% and 90.3% and specificities of 92.4% and 84.1% for CIN2+ and CIN3+, respectively, which were higher than those of HPV genotype testing and cytology (≥ASCUS) screening; the areas under the curve for CIN3+ detection were 0.87 (0.84–0.90), 0.68 (0.64–0.72), and 0.64 (0.60–0.69), respectively. The six-methylation marker assay showed the lowest colposcopy referral rate (24.2%) and required the fewest referrals for detection, with 1.32 and 2.39 referrals per CIN2+ and CIN3+ cases, respectively. In women aged <30 years, the six-methylation marker assay had the highest specificity for CIN2+ (95.7%) and a sensitivity and specificity for CIN3+ of 80.8% and 88.9%, respectively. It had the lowest referral rate (17.17%) and colposcopy referrals, with 1.24 and 2.43 per CIN2+ and CIN3+ cases, respectively.







    Conclusions: The host DNA six-methylation marker assay is a reliable triage tool for women who are hrHPV-positive, providing evidence supporting the application of methylation markers in China.







    Cervical cancer is the second most common gynecological malignancy that causes death among female patients, with approximately 529,800 new cases and 275,100 deaths annually worldwide. Notably, China accounts for 28% of global cases and 50% of new cases in Asia each year, representing 25%–33% of the annual deaths in Asia (1). Persistent infection with hrHPV is considered the primary cause of cervical cancer and its precancerous lesions. However, HPV genotype testing demonstrates a low specificity of only 31.8% for CIN3 and worse (2). This is because most HPV infections are transient and clear naturally, especially in women younger than 30 years, who have regression rates of 60% (3). Therefore, given China’s large population and the substantial number of women who test HPV-positive annually, a reliable triage tool for high-grade intraepithelial lesions (HSIL) is urgently needed.







    Ideal triage strategies require a balance between safety, sensitivity, specificity, and screening-related burden; however, a consensus on the optimal triage test is lacking. Various triage methods have been proposed, including p16/Ki-67 cytological dual staining and methylation assays. While p16/Ki-67 staining demonstrates 90% sensitivity for CIN3+, its limited specificity (42%) fails to reduce colposcopy referral rates (4). A meta-analysis showed that the sensitivity and specificity of all methylation assays for CIN3+ were 0.708 and 0.780, respectively (5). Among these, a methylation panel comprising six markers (ASTN1, DLX1, ITGA4, RXFP3, SOX17, and ZNF671) is suitable for application in developing countries due to its superior specificity (88.7%–94.6%) for CIN3+ (3,6). However, data for this methylation panel come only from clinical trials conducted in Western countries, and the prevalence and distribution of HPV genotypes in China differ from those in Western countries, with significantly higher infection rates of HPV52 and HPV58. Furthermore, the applicability of the positive threshold of this methylation panel to Chinese women and differences in the expression of methylation markers are unclear.







    Therefore, this study hypothesized that the methylation pattern in China might be distinct and conducted a prospective multicenter study to evaluate the clinical performance of a host DNA six-methylation marker panel in Chinese women who were hrHPV-positive. This was the first prospective multicenter study in China with a large sample size to evaluate the feasibility of the six-methylation marker assay as a triage tool for hrHPV-positive women.







    Overall, 1,806 women from the colposcopy clinics of 4 hospitals across China underwent HPV genotype testing, cytological screening, methylation assays, and colposcopy between August 2018 and April 2021. The participating institutions included Peking University First Hospital, Nanjing Drum Tower Hospital, Hunan Provincial Maternal and Child Health Care Hospital, and The First Affiliated Hospital of Anhui Medical University, representing 4 different provinces. The inclusion criteria were as follows: 1) women aged 21–65 years with an intact cervix, 2) hrHPV-positive status with available cervical cytology results, and 3) cervical lesions confirmed through colposcopy biopsy. The exclusion criteria were as follows: 1) pregnant, maternal, or lactating women; 2) unwillingness to participate or inability to provide informed consent; and 3) a history of cervical cancer. This study received ethical approval from all 4 participating hospitals (ethics approval numbers: JNFL2020001, 2020-180-04, JNFL2018001, and PJ 2021-02-06).







    Samples were obtained by experienced gynecologists using a cervical brush. Cytology screening employed the liquid-based cytology (LBC) method, and the diagnosis was classified into 5 levels according to the 2014 Bethesda System (TBS) criteria. HPV genotype testing was performed using fluorescence quantification PCR, and results were categorized into 2 groups: HPV16/18-positive and positive for the other 12 hrHPV genotypes, i.e., “other-hrHPV positive.” Host DNA from LBC samples was heavy sulfite-transformed for methylation analyses. The methylation panel comprised 6 gene markers: DLX1, ASTN1, ITGA4, RXFP3, SOX17, and ZNF671. All procedures were performed according to standardized instructions. ZNF671 was assigned a score of 3 points, while the other 5 methylation markers were assigned 1 point each. The six-methylation marker assay was considered positive if the cumulative score across all 6 markers was ≥3. All HPV genotyping and methylation assays were conducted in a central laboratory. All women underwent colposcopy, and cervical biopsies were performed based on colposcopic impressions. Cervical lesions were histologically classified as CIN1/2/3 or cervical cancer (CC), while those with normal biopsy results or colposcopic impressions were categorized as “normal.”







    This study evaluated 5 triage strategies for detecting CIN2+ and CIN3+ in hrHPV-positive women using histopathology as the gold standard. The evaluated strategies were as follows: 1) HPV16/18 genotyping; 2) cytology (≥ASCUS); 3) six-methylation marker assay; 4) six-methylation marker assay and HPV16/18 co-screening; and 5) six-methylation marker assay and cytology (≥ASCUS) co-screening. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), area under the receiver operating characteristic curve (AUC), and forest plots were calculated for each method. Statistical analyses were performed using SPSS (version 26.0, IBM Corp., NY, USA) and R (version 4.1.2, R Core Team, Vienna, Austria). Independent-sample t-tests were used to compare normally distributed continuous data, whereas nonparametric continuous variables were analyzed using the Mann-Whitney test. Categorical variables were assessed using the chi-squared or Fisher’s exact test. To compare methylation marker scores among different CIN groups that followed a non-normal distribution, this study employed the Kruskal-Wallis test, followed by Dunn’s test for pairwise comparisons. Two-sided P<0.05 were considered significant.







    Finally, 144 cases did not meet the inclusion criteria, and 3 cases were excluded due to unsuccessful methylation detection, resulting in 1,659 cases available for final analysis, as shown in Figure 1. Assessment using a mixed-effects model showed no significant center effect (P>0.05) on baseline characteristics or CIN2+/CIN3+ detection rates. Data from all centers were therefore pooled for final analysis. The study flowchart is presented in Figure 1.









    Figure 1. 

    Study flowchart of women who were hrHPV-positive.


    Abbreviation: HPV=human papillomavirus; TCT=ThinPrep Cytologic Test; CIN=cervical intraepithelial neoplasia.





    The mean patient age was 41.3 years (range: 21–65). Histopathological findings included 320 (19.3%), 184 (11.1%), 162 (9.8%), and 24 (1.4%) cases of CIN1, CIN2, CIN3, and CC, respectively. Among all cases, 37.1% (259/690) were HPV16/18-positive. The methylation assay demonstrated positivity rates of 7.5% (24/320), 73.9% (136/184), 88.9% (144/162), and 100% (24/24) for CIN1, CIN2, CIN3, and CC, respectively. The methylation scores increased significantly with the severity of cervical lesions (P<0.05). Characteristics of the CC screening and methylation assays are presented in Table 1.










    Table 1. 
    Cervical screening and six-methylation marker assay for cervical precancerous lesions and cervical cancer.




    The 3 most frequently positive methylation markers in the CIN2+ and CIN3+ groups were ZNF671 (65.8% vs. 88.2%), DLX1 (43.5% vs. 68.3%), and ASTN1 (37% vs. 61.3%). In the CIN1 group, DLX1 showed the highest positivity rate (21.6%). However, as the cervical lesions progressed in severity from CIN1 to CIN2, the positive methylation rate of ZNF671 increased dramatically by 59.2%, which was substantially higher than that of the other markers (Supplementary Table S1). The proportion of samples testing positive for all 6 markers increased from 2.3% in CIN1 to 11.4% in CIN2 and 24.1% in CIN3+. The mean numbers of positive markers in the CIN2, CIN3, and CC groups were 2.5, 3.5, and 4.6, respectively.







    The six-methylation marker assay as a single triage tool demonstrated a sensitivity of 82.2% for CIN2+ and a specificity of 92.4%. This sensitivity was significantly higher than that of HPV16/18 genotyping but comparable to that of cytology (≥ASCUS), while its specificity was the highest among all 3 methods. For CIN3+, the six-methylation marker assay achieved a sensitivity of 90.3% and a specificity of 84.1% (Table 2).










    Table 2. 
    Performance of different triage tools for the detection of CIN2+/CIN3+ among women who were hrHPV-positive.




    The AUCs of HPV16/18 genotyping, cytology (≥ASCUS), and the six-methylation marker assay for CIN2+ and CIN3+ were 0.61 and 0.64, 0.69 and 0.68, and 0.87 and 0.87, respectively. Combining the six-methylation marker assay with HPV16/18 genotyping (≥ one positive) as a triage tool for CIN2+/3+ resulted in a higher sensitivity but a lower specificity compared to HPV16/18 genotyping alone. The relative sensitivity and specificity with HPV16/18 genotyping and cytology (≥ASCUS) as the reference strategy for CIN2+ and CIN3+ are shown in Figures 2 and 3.









    Figure 2. 

    Forest plots showing the relative sensitivity and specificity for CIN2+ detection of different triage tools compared with HPV16/18 genotyping and cytology (≥ASCUS). The relative (A) sensitivity and (B) specificity of different triage tools compared with HPV16/18 genotyping; The relative (C) sensitivity and (D) specificity of different triage tools compared with cytology (≥ASCUS).


    Abbreviation: CIN2+=cervical intraepithelial neoplasia grade 2 or worse; HPV=human papillomavirus; ASCUS=atypical squamous cells of undetermined significance.







    Figure 3. 

    Forest plots showing the relative sensitivity and specificity for CIN3+ detection of different triage tools compared with HPV 16/18 genotyping and cytology (≥ASCUS). (A) The relative sensitivity of different triage tools compared with HPV 16/18 genotyping; (B) The relative specificity of different triage tools compared with HPV 16/18 genotyping; (C) The relative sensitivity of different triage tools compared with cytology (≥ASCUS); (D) The relative specificity of different triage tools compared with cytology (≥ASCUS).


    Abbreviation: CIN2+=cervical intraepithelial neoplasia grade 2 or worse; HPV=human papillomavirus; ASCUS=atypical squamous cells of undetermined significance.





    This study further analyzed the efficacy of different triage tools in women aged <30 years. The DNA methylation positivity rate among women who were <30 years of age and hrHPV-positive was 17.2% (51/297), which was lower than that among women >30 years of age (25.8%). The combination of the six-methylation marker assay and cytology had the highest sensitivity for CIN2+ (89.2%). However, the six-methylation marker assay showed the highest specificity (95.7%), with relative specificities of 1.34 and 1.8 compared to HPV genotyping and cytology (≥ASCUS), respectively. For CIN3+ detection, the six-methylation marker assay demonstrated relatively good sensitivity and specificity, with values of 80.8% and 88.9%, respectively (Supplementary Table S2). Notably, it also demonstrated the highest specificity among the 5 triage strategies in the overall cohort for the detection of CIN2+ or CIN3+, particularly in the subgroup analysis of women <30 years of age for CIN2+ (Table 2 and Supplementary Table S2).







    In addition, the six-methylation marker assay demonstrated the lowest colposcopy referral rate (24.23%) and the fewest referrals required for detection, with 1.32 and 2.39 referrals per CIN2+ and CIN3+ cases, respectively. In contrast, HPV16/18 genotyping and cytology (≥ASCUS) required approximately 3 referrals each per CIN2+ case, and 5.02 and 5.61 referrals per CIN3+ case, respectively. In the subgroup analysis of women <30 years of age, the six-methylation marker assay also demonstrated the lowest colposcopy referral rates (17.17%) and colposcopy referrals (Supplementary Table S3).





    Continue Reading

  • Bedford hybrid airship firm secures first military reservations

    Bedford hybrid airship firm secures first military reservations

    The company behind the Airlander 10 giant hybrid aircraft has secured its first reservations for use in the military.

    Bedford-based Hybrid Air Vehicles (HAV) said three had been reserved by an “innovative defence contractor” looking to make use of Airlander’s unique capabilities.

    Airlander 10, which has not yet gone into production, was expected to initially be certified for civil use, but HAV said its versatile nature meant it could be modified to meet the needs of the military market.

    George Land, executive director of sales at HAV, said they were “pleased to be working with an undisclosed customer to provide three aircraft for further customisation”.

    The Airlander is a combination of an airship and a plane and currently uses four combustion engines and gases to take-off and in flight.

    HAV said the Airlander could:

    • be used to transport personnel and equipment to austere environments as well as holding, releasing and recovering drones
    • was capable of remaining in the air unrefuelled for up to five days, and operating from any relatively flat surface, including water
    • could lift a payload of over three tonnes enabling high powered radars to remain aloft for days on end, as opposed to hours at present
    • could cost-effectively survey large areas, monitoring anti-submarine warfare sensors

    The company said new threats across the globe required new solutions, and Airlander would directly respond to current and emerging threats.

    Work on a production facility started last December in Doncaster where it was expected airships would be built and tested in 2026.

    The company had previously said the European-based Air Nostrum Group had reserved 10 Airlanders, but that number had increased to 20, for delivery by 2027.

    The Airlander has been designed to be about 320ft (98m) long, with a cabin underneath, making it the world’s longest aircraft.

    Mr Land said: “Its versatility, high payload, and endurance have always given Airlander 10 obvious advantages over other aircraft in Command, Control, Communications, Computers, Intelligence, Surveillance, and Reconnaissance (C4ISR).

    “As warfare evolves to meet current threats this capability is ever more valuable, and we have worked hard to showcase the aircraft’s capabilities.”

    He added that they expected other military reservations to follow.

    Continue Reading

  • Japan’s growth momentum slows while price pressures intensify in October – S&P Global

    1. Japan’s growth momentum slows while price pressures intensify in October  S&P Global
    2. Japan Services Growth at 4-Month Low  TradingView
    3. Japanese business activity increases at slowest rate in five months amid renewed drop in sales  Forex Factory
    4. Japan’s factory activity hits 19-month-low in October, PMI shows  MSN
    5. Japan Composite PMI Slips to 5-Month Low  TradingView

    Continue Reading

  • Japan’s growth momentum slows while price pressures intensify in October – S&P Global

    1. Japan’s growth momentum slows while price pressures intensify in October  S&P Global
    2. Japan Services Growth at 4-Month Low  TradingView
    3. Japanese business activity increases at slowest rate in five months amid renewed drop in sales  Forex Factory
    4. Japan’s factory activity hits 19-month-low in October, PMI shows  MSN
    5. Japan Composite PMI Slips to 5-Month Low  TradingView

    Continue Reading

  • Amazon reveals cause of AWS outage that took everything from banks to smart beds offline | Amazon

    Amazon reveals cause of AWS outage that took everything from banks to smart beds offline | Amazon

    Amazon has revealed the cause of this week’s hours-long AWS outage, which took everything from Signal to smart beds offline, was a bug in automation software that had widespread consequences.

    In a lengthy outline of the cause of the outage published on Thursday, AWS revealed a cascading set of events brought down thousands of sites and applications that host their services with the company.

    AWS said customers were unable to connect to DynamoDB, its database system where AWS customers store, due to “a latent defect within the service’s automated DNS [domain name system] management system”.

    DynamoDB maintains hundreds of thousands of DNS records. It uses automation to monitor the system to ensure records are updated frequently to ensure additional capacity is added as required, hardware failures are handled and traffic is distributed efficiently.

    The root cause of the issue, AWS said, was an empty DNS record for the Virginia-based US-East-1 datacentre region. The bug failed to automatically repair, and required manual operator intervention to correct.

    AWS said it had disabled the DynamoDB DNS planner and DNS enactor automation worldwide while it fixes the conditions that led to the outage and adds extra protections.

    The issue also caused outages for other AWS tools as a result.

    Platforms including Signal, Snapchat, Roblox, Duolingo, as well as services such as banking sites and the Ring doorbell company were some of the 2,000 companies affected by the outage, according to Downdetector – a site that monitors internet outages – with more than 8.1m reports of problems from users across the world.

    While services were restored in a matter of hours, the impact of the outage was felt widely.

    Customers of Eight Sleep – a smart bed company that connects to the internet to control the temperature and incline of a person’s bed – found they were unable to adjust the bed or the temperature of the bed during the outage because they were unable to connect to the bed in their phone app.

    The company’s chief executive, Matteo Franceschetti, apologised to customers on X and this week rolled out an update to its services that would allow users to control the bed’s critical functions via Bluetooth in the event of an outage.

    Dr Suelette Dreyfus, a computing and information systems lecturer at the University of Melbourne, said the outages showed how dependent the world was on single points of failure on the internet.

    “That single point isn’t just AWS – they’re the biggest cloud provider with 30% or so of the market – but rather the cloud as a whole, which is basically just three companies,” she said.

    “The internet was designed to be resilient; many other channels existed for routing around problems or attacks, but we’ve lost some of that resilience by becoming so dependent on a handful of giant tech companies to provide not just data storage but also house data services.”

    Continue Reading

  • Nokia extends long-term partnership with VNPT in Vietnam

    Nokia extends long-term partnership with VNPT in Vietnam

    At Nokia, we create technology that helps the world act together.

    As a B2B technology innovation leader, we are pioneering networks that sense, think and act by leveraging our work across mobile, fixed and cloud networks. In addition, we create value with intellectual property and long-term research, led by the award-winning Nokia Bell Labs, which is celebrating 100 years of innovation.

    With truly open architectures that seamlessly integrate into any ecosystem, our high-performance networks create new opportunities for monetization and scale. Service providers, enterprises and partners worldwide trust Nokia to deliver secure, reliable and sustainable networks today – and work with us to create the digital services and applications of the future

    ';

    Continue Reading

  • Should drug companies be allowed to run ‘awareness’ ads for conditions their drugs treat? We asked 5 experts

    Should drug companies be allowed to run ‘awareness’ ads for conditions their drugs treat? We asked 5 experts

    Unlike in the United States and New Zealand, it’s illegal in Australia to advertise prescription medicines directly to the public.

    The main idea is to avoid demand for a drug that may not be appropriate, but which doctors may feel under pressure to prescribe.

    But drug companies can get around this restriction by running “awareness” ads that indirectly promote their products.

    For instance, we’re currently seeing ads raising awareness about weight loss that don’t mention the names of specific Ozempic-style drugs. Instead, these ads recommend you speak to your doctor about your weight.

    The main argument for such awareness ads is they encourage people to seek help from their doctor, rather than suffer from symptoms they might have been embarrassed about, or have not been able to address themselves.

    For instance, Novo Nordisk and Eli Lilly – which make weight-loss drugs – told the ABC recently their campaigns were trying to raise awareness of obesity as a chronic disease.

    The main counterargument is that awareness ads act as drug promotion in disguise.

    So, should pharmaceutical companies be allowed to run awareness ads for diseases or conditions their drugs treat?

    We asked five experts. Four out of five said no. Here are their detailed answers.

    Continue Reading

  • Busway through Cambridge orchard will destroy trees, says owner

    Busway through Cambridge orchard will destroy trees, says owner

    The owner of a historical orchard said its apple trees will not survive being dug up and moved to make way for a proposed busway.

    Coton Orchard lies in the path of the proposed £200m Cambourne to Cambridge (C2C) guided busway.

    Planners hoped that linking the town and city will ease congestion on local roads and 10,000 trips will be made each day on the new route.

    However, Anna Gazeley, whose family owns the Coton Orchard, told an ongoing public inquiry into the proposals that 12 of the oldest Bramley apple trees on the site were “fragile”, vital to the area’s ecosystem and would not survive the move.

    The C2C Busway project has been put together by the Greater Cambridge Partnership (GCP) on behalf of Cambridgeshire County Council.

    If it goes ahead it will see a new busway built from Cambourne to Cambridge, via the Bourn Airfield development, Hardwick, Coton, and the West Cambridge Site.

    A pathway alongside the busway is also proposed for pedestrians and cyclists. A travel hub is also planned at Scotland Farm.

    The proposed route would run through Coton Orchard, which is a century-old 60-acre site.

    Ms Gazeley told the inquiry on Wednesday that her father bought the orchard in 1996 after he had seen other orchards he knew from his childhood disappear.

    She told inspectors about the ecological importance of the orchard, and shared fears about the impact the development would have on its “fragile” trees.

    It was “one of the largest remaining traditional orchards in Cambridgeshire” and had been designated a priority habitat under the UK Biodiversity Action Plan and a county wildlife site, she said.

    “This is a habitat with ecological memory – more than 100 botanical species have been recorded in its understory, such as mosses, liverworts, fungi… confirming as ecological evidence has shown that this site has matured far beyond commercial cultivation,” she added.

    She said the trees were “fragile” and argued they would not survive the move.

    “The applicant now accepts the veteran status of those founding Bramleys, yet still asserts that no loss or deterioration would result from the scheme,” she said.

    One of the legal representatives of the Cambridgeshire County Council challenged Ms Gazeley on her evidence and questioned its credibility.

    They highlighted an example in her written submission of a reference she made to an article about the impact of moving trees, which they said did not actually exist.

    They said: “You referred to a reference that does not exist. It has been made up and hallucinated by AI.”

    Ms Gazeley said she had used AI to help create her submission and accepted it may not be a perfect document.

    However, she said there were other references made and advice taken from experts about the impact of moving the trees.

    She said: “Those trees, they are hollow, they are fragile, the features that make them veteran trees is what makes them structurally very poor.

    “The thought that you can sever the roots, pull them up, drag them the length of the orchard to put them in a hole and expect them to survive with no deterioration defies credibility.”

    At the conclusion of the inquiry, which is taking place in Cambourne and expected to last until November, inspectors will make recommendations to the government about the scheme.

    Continue Reading

  • Secret report shows likely source of ‘poo balls’ that closed Sydney’s beaches last summer | Pollution

    Secret report shows likely source of ‘poo balls’ that closed Sydney’s beaches last summer | Pollution

    A secret report reveals the likely source of the fatberg balls that closed a raft of Sydney beaches last summer – with most coming from the deepwater ocean outfalls at Malabar, Bondi and North Head.

    The partly-redacted scientific report, obtained by Guardian Australia under freedom of information laws, points to a combination of heavy rains and a buildup of fats, oils and greases as the likely cause of the “poo balls”.

    Authorities are unable to say when balls could wash up again – but are urgently working on solutions.

    “We do believe that fat is accumulating somewhere in the system. We know [it’s] in the pipes, definitely, [but] we’re unsure of its whereabouts specifically,” Sydney Water’s environment manager, Ben Armstrong, told Guardian Australia.

    The report notes that the debris balls “are assumed to be of a sewage origin” and their “discharge is most likely to be from an outfall, but the stormwater system may also be implicated”.

    “Fats, oils and greases (FOGs) in the sewerage system provide the ‘stickiness’ for the debris balls. They possibly adhere to the sides of pipes. Particulate material may then stick to these FOGs,” the oceanographic modelling report by WQ Data states.

    “High rainfall in the year or so leading up to the discharge of the debris balls effectively ‘primes’ the sewerage (or stormwater) system. Within a few days prior to their discharge, further rainfall is sufficient to move the combined FOGs and particles out of the pipes.”

    Wave action then rolls the combined FOGs and particulate matter into balls. Between October 2024 and February 2025, “the oceanographic / meteorological conditions were suitable for the debris balls to be released and for them to be moved to the Sydney and NSW south coast beaches”.

    Oceanographic modelling data prepared by WQ Data. Photograph: WQ Data Pty Ltd

    Work by Sydney Water and the NSW Environment Protection Authority (EPA) suggests the so-called fatbergs are due to an increased use of vegetable oils, which break down slowly, an increase in food outlets and the overall growth of the city’s population.

    The EPA has previously said testing revealed the balls were consistent with human-generated waste such as grease and faecal matter.

    There are particular concerns about the Malabar sewage treatment plant.

    “There are global issues about fatbergs and sewers, and it’s effectively the same thing,” the chair of the EPA’s advisory panel, and an independent expert, Prof Stuart Khan says.

    “This particular sewer [at Malabar] has had a long time for fats, oils and grease to build up.

    “There’s nearly 2 million customers in that system and over the past 10 years, not only has there been growth in population using that system, but also increasing numbers of food outlets that may or may not have appropriate trade waste licenses in place or the right infrastructure in terms of grease traps and things to be preventing run off of fats, oils and grease.”

    The release of the oceanographic report, commissioned by Sydney Water, suggests the state-owned corporation could have known as early as 3 February 2025 that the debris balls were likely from its ocean outfalls. That is the date of the “preliminary draft”.

    Guardian Australia first reported in October 2024 that a team of scientists was investigating whether the balls could be linked to sewage and whether they could have come from water treatment plants.

    The EPA chose to reveal the content – but not the source – of the beach balls on the day of the US election in November.

    The EPA publicly confirmed their likely origin in April 2025 when it issued a preliminary investigation notice to Sydney Water.

    Since then, the two agencies have been conducting urgent studies to ascertain the extent of the problem.

    Sydney’s sewage system relies on three “deepwater ocean outfall” pipes that run up to 4km out to sea at Malabar, Bondi and North Head. The sewage receives primary treatment to remove some solids and is then pumped through pipes, exiting through diffusers 60 metres below the surface, where the plume mixes with seawater.

    Treatment plants map

    Prior to 1990, Sydney’s sewage was discharged from the bottom of the cliffs near the plants, just a few hundred metres out to sea. Pollution was a regular phenomenon, particularly after rain, with faecal contamination and other rubbish regularly washing onto beaches.

    The ocean outfalls were highly successful in improving water quality, with faecal contamination becoming almost negligible, except immediately after rain, when stormwater runoff sometimes caused an issue.

    But the growth in population, food outlets and industry, particularly in Sydney’s west, is causing a buildup of fats, oils and grease in the system, which threatens to overwhelm it.

    The oceanographic study

    The study commissioned by Sydney Water, which mapped oceanographic currents and winds, traced the balls back to more than one of the three major sewage outfalls.

    It hypothesises that heavy rain about six months prior to the discharge of the balls, which occurred between October 2024 and January 2025, primed the system and further heavy rain then dislodged the fatbergs.

    “No single discharge from a single origin could be responsible for the appearance of the debris ball on all beaches between October 2024 and February 2025.

    “Ten (or perhaps more) discharge events may be responsible for the observed debris balls on the beaches during this period.”

    skip past newsletter promotion

    The report studied 10 incidents. The first balls were found on Coogee beach in October 2024. Subsequent incidents occurred at other eastern suburbs beaches and Botany Bay, Manly, the northern beaches and on the south coast.

    The report and subsequent studies raise the question of whether Sydney Water’s sewage system has reached its limits and whether debris balls will return to the beaches this summer if rainfall conditions are repeated.

    “We’ve had rainfall events and pulses going through the system without having debris balls previously, to our knowledge,” Khan says.

    “So we’re trying to find out: why now? And why only sometimes now? Why not after every wet weather event? There are questions around whether the catchment to the sewer is changing, and therefore whether or not it’s something that we’re going to see more often. If that’s the case, then better controls over what goes into the sewer will be important.”

    Wastewater systems in greater Sydney. Illustration: Sydney Water

    There are concerns about what is lurking in the deepwater outfall pipes.

    Sydney Water can inspect other parts of the system, but is unable to inspect these pipes, which are 35 years old. To undertake maintenance would require decommissioning the outfalls and reverting to releasing barely treated sewage at Sydney’s cliffs.

    The solution

    Armstrong says Sydney Water’s “Save our sinks” campaign encourages businesses and households to avoid putting oils and fats, milk, coffee grounds and other solids down the sink.

    Changing consumer behaviour is an important part of the solution, he says. Maintenance is also crucial.

    Julian Thompson, operations manager at the Environmental Protection Authority, says Sydney Water has “a fairly stringent” maintenance program, particularly around the Malabar catchment.

    “They spend quite a lot of money on desilting their sewers. They have crews that can get into those pipes. It sounds like a pretty unpleasant job, but they’re basically within those large pipes … taking out fats, oils and greases, taking out wet wipes and other things that block up sewers.”

    The longer-term solutions require greater investment and some hard decisions for the NSW government.

    What we’re currently doing now is not sustainable – discharging 80% of the sewage produced by 5 million people into the ocean after only primary treatment,” Khan says. “Every drop of water we send out into the Pacific Ocean is wasted water.”

    Sydney Water is looking to expand or build water resource recovery facilities which take sewage, highly treat it and render it suitable for reuse. It has a demonstration plant at Quakers Hill.

    This could reduce pressure on the existing wastewater system while potentially providing Sydney with a non-rainfall-dependent form of additional drinking water.

    A map showing proposed new water treatment sites and Sydney Water’s existing plants, which have deepwater outfall pipes that reach up to 4km off the coast.

    “The NSW government made a very clear statement that we would only proceed with that if it could be demonstrated that there’s a social license for it,” Khan says.

    Sydney Water’s long-term plan has these projects listed with a 10-year horizon. They may need to be brought forward.

    The state’s water minister, Rose Jackson, says: Sydney Water is now working to prevent future events through new programs to help reduce the amount of fats, oils and grease entering the wastewater system.”

    She noted the long-term plan to upgrade the system and reduce the volume of water flowing through the outfalls.

    “This approach delivers environmental benefits while avoiding the significant cost to customers of upgrading coastal plants and pipelines to manage increasing flows, she said.

    Mysterious debris balls that washed up in Sydney were examined by Prof Jon Beves and his team at UNSW. Photograph: Prof Jon Beves

    Continue Reading

  • FIG, Fujitsu, Acer Medical collaborate to develop health-promoting insurance concept to support preventative care in aging societies

    FIG, Fujitsu, Acer Medical collaborate to develop health-promoting insurance concept to support preventative care in aging societies

    The three parties will carry out a field trial from October 23 to October 24, 2025 at the 53rd Artistic Gymnastics World Championships in Jakarta where local seniors will be able to experience the app.

    Furthermore, the three parties will develop a points-based health-promotion insurance concept. This proposed service will convert users’ exercise assessments from the app and participation in health check-ups into points, which can then be used for insurance premium discounts or other benefits. Participating insurance companies will be selected by the parties at a later date.

    Through this initiative, FIG aims to promote the widespread adoption of gymnastics programs for seniors and accelerate its contribution to extending healthy life expectancies through sports, as envisioned by the ASWG. The initial target for this insurance service will be the estimated 30 million worldwide participants in FIG’s Gymnastics for All sports program. FIG will also contribute to the World Health Organization (WHO)’s Global Action Plan on the Public Health Response to Dementia [1].

    Fujitsu will contribute to promoting the health of seniors through its advanced skeleton recognition AI technology. Furthermore, under its Uvance business model, which addresses societal challenges, Fujitsu will continue to co-create with Uvance Partners to realize advanced health management services through Decision Intelligence powered by data and AI, thereby advancing people’s well-being.

    Acer Medical will enhance the abnormal gait pattern detection function in aiGait to meet the growing demand for preventive medicine and smart healthcare in aging societies. Acer Medical is transforming routine movements—like standing, sitting, and walking—into valuable clinical insights. The goal is to help caregivers and clinicians detect subtle changes early, enabling timely intervention and improving patient outcomes.

    Continue Reading