Category: 8. Health

  • EU researchers call for wider use of alternatives to animal testing

    EU researchers call for wider use of alternatives to animal testing

    Researchers examine how the use of animal testing to identify endocrine-disrupting substances in the EU can be reduced. Although it is, in principle, possible to identify such substances without using animals, non-animal methods are still rarely applied.

    A team from the MERLON research project, led by the DTU National Food Institute, has mapped the use of alternatives to animal testing – so-called New Approach Methodologies (NAMs) – in the identification of endocrine disruptors. This required a thorough review of the complex legal framework underlying the EU’s regulation of chemicals in everyday products, ranging from hair shampoo to food.

    The conclusion is that alternative methods are almost never used to demonstrate the harmful effects of endocrine-disrupting substances, even though EU legislation allows for their use in this context. The research has been published in the scientific journal Regulatory Toxicology and Pharmacology.

    According to the EU law, alternative methods may be used to demonstrate harmful effects of endocrine disruptors if they provide a ‘similar predictive capacity’ as animal tests. The problem is that we currently have only one alternative method that can actually be used for this purpose – namely ‘read-across’, where data from one substance is used to assess another, similar substance.”


    Marie Louise Holmer, Special Consultant at the DTU National Food Institute, and one of the authors of the scientific article

    “Read-across is ready to be used now, and we should apply it as broadly as possible. However, when it comes to other alternative methods, such as computer-based models and cell-based tests, substantial further development is still required.”

    Better for both animals and humans

    Alternative testing methods are, from an animal welfare perspective, clearly preferable. However, these methods are also much faster to carry out, which means that NAMs could significantly increase the efficiency of identifying endocrine disruptors in the EU.

    “This is an area in which we are in urgent need of the support offered by digitalisation and new laboratory techniques. The WHO estimates that over 60,000 chemical substances are in global commerce. With today’s methods, we would not be able to test them all for the many harmful effects associated with endocrine disruptors – not even in 100 years,” says Marie Louise Holmer.

    Endocrine disrupting substances pose risks to humans, animals and the environment, and can affect health in multiple ways. They may, for example, be carcinogenic, impair fertility, or interfere with the development of the brain and immune system. In the EU, substances can be regulated if testing confirms they are endocrinedisrupting – and such testing has so far primarily relied on animal experiments.

    Animal testing has been widely debated for many years. Following a large public petition, the European Commission is developing a roadmap to outline how all animal testing for chemical safety assessments can eventually be phased out.

    A balanced transition

    The researchers advocate a balanced approach. They argue that there is a need both to develop and validate alternative methods and to explore how these, potentially in combination, can predict harmful effects to the same degree as animal tests. At the same time, animal testing should be refined and optimised to provide as much valuable information as possible.

    “We must ensure that the alternatives are just as effective as animal testing before animal methods can be phased out completely. That is why we also emphasise the continued need for animal testing until alternatives are fully accepted and routinely implemented in chemical regulation,” says Marie Louise Holmer.

    Dialogue to build common ground

    One of the recommendations from the researchers is to bring together all stakeholders affected by the legislation in order to build consensus.

    “We need, among other things, to determine when results from New Approach Methodologies – or combinations of New Approach Methodologies – are sufficiently robust and reliable to predict harmful effects and thus replace animal testing,” says Marie Louise Holmer.

    Stakeholders could include national authorities (such as the Danish Environmental Protection Agency), relevant EU agencies, researchers, industry representatives, and NGOs.

    Facts: Identifying endocrine-disrupting substances in the EU

    Three criteria must be fulfilled to classify a substance as endocrine-disrupting:

    1. It must cause harm (as assessed via animal tests or NAMs – the latter are currently seldom used for this purpose).
    2. It must interfere with hormone systems (NAMs are already used here).
    3. A link must be demonstrated between the hormonal disruption and the adverse effect.

    Facts: What are NAMs?

    NAMs include:

    • In vitro tests – laboratory experiments carried out on cells or tissues outside a living organism.
    • In silico models – computer-based models that predict the properties and effects of chemicals.
    • Read-across – using data from one chemically similar substance to assess another.

    Source:

    DTU (Technical University of Denmark)

    Journal reference:

    Holmer, M. L., et al. (2025). Assessment of endocrine disruptors in the European Union: Current regulatory framework, use of new approach methodologies (NAMs) and recommendations for improvements. Regulatory Toxicology and Pharmacology. doi.org/10.1016/j.yrtph.2025.105883.

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  • Canada faces growing threat from communicable diseases and misinformation

    Canada faces growing threat from communicable diseases and misinformation

    Canada must address the growing crisis of communicable diseases that has occurred in tandem with a rise in misinformation that threatens our health systems, argue authors in an editorial in CMAJ (Canadian Medical Association Journal) https://www.cmaj.ca/lookup/doi/10.1503/cmaj.250916.

    A crisis of communicable diseases is unfolding in North America, just as Canada’s health systems’ responses are being hampered by the dismantling of public health and research infrastructure in the United States,” writes family physician Dr. Shannon Charlebois, medical editor, CMAJ, with coauthor Dr. Jasmine Pawa, Dalla Lana School of Public Health, University of Toronto, Ontario. “Coordinated attacks on US health institutions by the country’s executive office have drastically reduced their capacity to collect, interpret, and share data in the service of public health delivery. This coincides with a concerning spread of novel and existing communicable diseases across the continent, including in Canada.”

    The spillover effect of changes in the US will likely affect Canada and other countries around the globe, as programs to track infectious diseases and address potential pandemic threats like avian flu have been cut or cancelled, and specialized staff with the capacity to rapidly develop reliable tests have been fired. Canada and other countries have relied on this work for disease surveillance and public health preparedness.

    Now is the time for Canada to act on long-standing calls to strengthen health surveillance systems, improve interoperability and data exchange between electronic medical records and health systems, and better document and report rates of vaccine coverage.

    The editorial outlines the threats from several infectious diseases to Canadians – information the public should be made aware of. However, “[p]eople living in Canada are vulnerable to a cross-border bleed of not only microorganisms, but also of attitudes, health misinformation, and exposure to biased US media.” write Charlebois and Pawa.

    “Canada does not have control over the situation south of the border, but strengthening national capacity to manage communicable diseases by optimizing data collection and interprovincial sharing of the information required to do this is possible.”

    Source:

    Canadian Medical Association Journal

    Journal reference:

    Charlebois, S., & Pawa, J. (2025). Tackling communicable disease surveillance and misinformation in Canada. Canadian Medical Association Journal. doi.org/10.1503/cmaj.250916.

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  • Cambodia confirms 12th H5N1 avian flu infection of the year

    Cambodia confirms 12th H5N1 avian flu infection of the year

    Governor Tom Wolf / Flickr cc

    The National Association of County and City Health Officials (NACCHO) yesterday released its 2024 Forces of Change Survey report that found that more and more local health departments are losing staff through layoffs or attrition, raising concerns about a shrinking public health safety net.

    The study spotlights experiences of health departments at the county, city, and district level, including staffing and budget changes, health department governance, use of public health fellowship and training programs, the roles of public health nurses, program evaluation capacity, and activities that address the infectious disease consequences of substance use. Of 1,200 local health departments invited to complete the survey from March to June 2024, a total of 667 (56%) responded.

    “The latest findings highlight critical trends and challenges faced by local health departments during a time of uncertainty in the local public health landscape,” NACCHO said in a news release.

    1 in 5 local health departments note job losses

    The survey found that, in 2023, 19% of local health departments reported job losses—an increase from 14% in 2021 and 17% in 2022. The rate rose to nearly 40% among large local health departments. Also, 17% of local health departments reported budget cuts during fiscal year (FY) 2024, with 23% anticipating cuts in FY2025.

    The latest findings highlight critical trends and challenges faced by local health departments during a time of uncertainty in the local public health landscape.

    In addition, 90% of local health departments reported that nurses are involved in health promotion and protection; 72% said they are involved in emergency preparedness, disaster recovery, and cross-sector collaboration; and 41% reported that nurses contribute to policy and advocacy work.

    NACCHO also reported, “In 2024, 84% of local health departments reported having programs with an evaluation component. While most incorporated evaluation into their work, nearly 60% reported challenges due to insufficient staff time or capacity.”

    NACCHO added, “Overall, few local health departments had individuals from training and fellowship programs assigned to their agency, which puts future workforce development at risk.” NACCHO represents more than 3,300 local health departments.

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  • RFK’s proposal to let bird flu spread through poultry could set us up for a pandemic, experts warn

    RFK’s proposal to let bird flu spread through poultry could set us up for a pandemic, experts warn

    High-ranking federal officials have suggested that bird flu virus should be left to “rip” through poultry farms across the U.S. — but experts warn that this hands-off approach could hasten the beginning of a new pandemic

    Robert F. Kennedy Jr., the secretary of Health and Human Services, and Brooke Rollins, secretary of Agriculture, have floated the notion that instead of culling birds infected with the highly pathogenic H5N1 virus, farmers should let it spread through flocks. The idea is that by doing this, farmers can “identify the birds, and preserve the birds, that are immune to it,” Kennedy told Fox News on March 11.

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  • Mpox cases decline in Sierra Leone as Africa faces shortage in vaccine funding – CIDRAP

    Mpox cases decline in Sierra Leone as Africa faces shortage in vaccine funding – CIDRAP

    1. Mpox cases decline in Sierra Leone as Africa faces shortage in vaccine funding  CIDRAP
    2. World Health Organization (WHO) donates medical supplies and equipment to boost mpox response  ZAWYA
    3. Sierra Leone bolters mpox response: WHO leads groundbreaking genomic surveillance and bioinformatics training  WHO | Regional Office for Africa
    4. Mpox epidemic strains African health systems after US aid cuts  Financial Times
    5. Mpox Surge in Sierra Leone: A Stress Test for National Readiness  Think Global Health

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  • Measles cases rise in the Americas in 2025 – PAHO/WHO

    Measles cases rise in the Americas in 2025 – PAHO/WHO

    Washington, D.C., 3 July 2025 (PAHO) – A total of 7,132 confirmed cases of measles and 13 deaths have been reported in the Region of the Americas as of mid-June 2025, according to the latest epidemiological update from the Pan American Health Organization (PAHO). This represents a 29-fold increase compared to the 244 cases reported during the same period in 2024.

    Nine countries have reported cases in 2025, with Canada (3,170 cases, 1 death), Mexico (2,597 cases, 9 deaths) and the United States (1,227 cases, 3 deaths), accounting for the majority. Other countries reporting cases include Bolivia (60), Argentina (34), Belize (34), Brazil (5), Peru (4) and Costa Rica (1). The outbreaks originated from importations from countries both within and outside the Region. The most affected age groups are children under 5 and adolescents aged 10 to 19 years.

    The rise in cases underscores the urgent need to address gaps in routine immunization. PAHO is calling on countries to reach and sustain 95% coverage with two doses of measles-containing vaccine, especially in communities with low coverage or active outbreaks.

    PAHO is providing technical cooperation to most countries to strengthen epidemiological surveillance, train healthcare workers, and engage with communities to ensure timely detection and an effective response. To contain the outbreaks and prevent the spread of this vaccine-preventable disease, the Organization recommends the urgent implementation of intensified vaccination campaigns in affected areas and in those areas at risk of spread. PAHO does not recommend implementing restrictions on international travel.

    The upward trend mirrors the global situation, where surveillance data from the World Health Organization (WHO) has recorded 188,355 suspected cases and 88,853 confirmed in 168 countries as of 6 June 2025. The Eastern Mediterranean Region accounts for the highest share (35%), followed by the African Region (21%) and the European Region (16%).

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  • Gut microbiota and metabolic imbalance linked to pregnancy risks in PCOS

    Gut microbiota and metabolic imbalance linked to pregnancy risks in PCOS

    Gut microbiota and metabolic imbalance linked to pregnancy risks in PCOS | Image Credit: © Ekaterina – © Ekaterina – stock.adobe.com.

    There are distinct gut microbiota and metabolic signatures associated with premature endometrial aging and adverse pregnancy outcomes in patients with polycystic ovary syndrome (PCOS), according to a study presented at the 41st Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE).1

    Key microbial and metabolic differences identified

    In PCOS patients, Parabacteroides merdae (P. merdae), a benefitial gut bacterium, was reduced, while branched-chain amino acids (BCAAs) were more prevalent. This may lead to worse endometrial function and adverse reproductive outcomes in this population.

    “In clinical practice, we noticed that even younger women with PCOS who achieved pregnancy still faced unexpectedly high rates of miscarriage and other complications”, said Aixia Liu, MD, lead study author.

    Systemic risks of PCOS

    PCOS presents in up to 20% of reproductive-aged women worldwide and is a major driver of infertility. Fertility treatment reduces these risks, but the odds of complications such as gestational diabetes, miscarriage, and preterm birth are still higher in these patients. According to investigators, the factors behind this risk have remained unknown.

    Symptoms of PCOS include hyperandrogenism, ovulatory dysfunction, and polycystic ovarian morphology.2 Increased rates of type 2 diabetes mellitus, gestational diabetes, cerebrovascular and cardiovascular events, endometrial cancer, and other adverse health outcomes have been reported in PCOS patients, highlighting the need for tailored treatment.

    Comparing PCOS and non-PCOS cohorts

    Across 44 cities in China, 220 women aged under 35 years were recruited for the trial.1 Of these, 110 had PCOS and another 110 were matched controls. Investigators profiled differences between these cohorts through both gut microbiome sequencing and metabolomics.

    Ageing and decidualization were evaluated through laboratory studies on endometrial stromal cells (ESCs). Overall, PCOS patients presented with significantly reduced microbial diversity. Investigators noted this population had less P. merdae, which has been linked to metabolic health.

    BCAAs were also reported in serum metabolomics of patients with PCOS vs those without PCOS, with this trend especially pronounced for isoleucine. PCOS patients also presented with reduced levels of short-chain fatty acids.

    Increased pregnancy risk and endometrial dysfunction

    The odds of an adverse pregnancy outcome were increased 1.95-fold in the PCOS group vs the non-PCOS group. These included miscarriage, preterm birth, low birth weight, macrosomia, hypertensive disorders, gestational diabetes, and perinatal death.

    Endometrial tissue also had increased isoleucine levels in PCOS patients. Additionally, investigators exposed ESCs to isoleucine in the lab and found increased markers of cellular senescence, alongside a weakened ability for decidualization.

    Implications for early uterine aging and personalized interventions

    According to Liu, this indicated ageing-like changes in the uterus far sooner than expected. Therefore, even women aged under 35 years may experience adverse impacts on endometrial health.

    This data indicated possible efficacy of P. merdae and BCAAs as biomarkers for identifying patients with high-risk PCOS and providing personalized care. Liu recommended future research to assess the impact of dietary interventions, probiotics, and BAAA-restricted diets on these effects and pregnancy outcomes.

    “The study provides compelling evidence that metabolic and microbial imbalances in PCOS are not only systemic but may directly impair endometrial receptivity, even in younger women,” said Anis Feki, MD, PhD, Chair-Elect of ESHRE.

    References

    1. Gut bacteria and amino acid imbalance linked to higher miscarriage risk in women with PCOS. European Society of Human Reproduction and Embryology. June 29, 2025. Accessed July 2, 2025. https://www.eurekalert.org/news-releases/1088637.
    2. Azziz R, Carmina E, Chen Z, et al. Polycystic ovary syndrome. Nature Reviews Disease Primers. 2016. doi:10.1038/nrdp.2016.57

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  • Youth facing isolation and low resilience at higher risk for adult anxiety and depression

    Youth facing isolation and low resilience at higher risk for adult anxiety and depression

    Adolescents who experience both loneliness and low resilience are much more susceptible to developing anxiety and depression as adults.

    It has long been known that loneliness is a risk factor in the development of anxiety and depression. However, the association itself has been less well studied. This is especially true during the transition from adolescence to adulthood.

    Our research team investigated how loneliness in adolescence, both in isolation and in interaction with low resilience, affects anxiety and depression in young adulthood.”


    Nayan Deepak Parlikar, PhD candidate, Norwegian University of Science and Technology (NTNU’s) Department of Public Health and Nursing

    Adolescents who experience both loneliness and low resilience are at significantly greater risk of developing anxiety and depression compared with other groups.

    Individuals with low resilience are less able to cope with stress, adversity and other emotional challenges compared with others.

    These new findings have now been published in Social Psychiatry and Psychiatric Epidemiology.

    Worst combination

    This is the second article that Parlikar has written on the risk of developing anxiety and depression as an adult. It concentrates on the long-term consequences for young people, and on the link between loneliness and low resilience.

    “Adolescents who experience both loneliness and low resilience are at significantly greater risk of developing anxiety and depression compared with other groups,” said Parllikar.

    The study compared groups of adolescents who reported high resilience and low levels of loneliness with groups of adolescents who reported high resilience and high levels of loneliness, and adolescents with low resilience and low loneliness.

    “We found that the combination of loneliness and low resilience considerably increases the risk of developing symptoms of anxiety and depression together compared with exposure to only one of the factors,” continued Parlikar.

    The results have a number of consequences.

    Preventive measures become important

    “Health professionals working with young people should concentrate on identifying individuals with both loneliness and low resilience at an early stage. Once they have been identified, it is important to intervene quickly,” said Parlikar.

    The work may include screening in schools and health services to identify young people who are at risk.

    “It may also help to introduce programmes that promote social skills and build resilience. This can help to reduce the risk of developing anxiety and depression,” she added.

    Professionals treating the young people can adapt cognitive behavioural therapy (CBT) and other therapeutic approaches to address both loneliness and low resilience in adolescents.

    “Therapists should be aware that, when combined, these factors have a particularly high risk. Health professionals can receive special training in identifying people with low resilience.”

    More groups needed

    Group therapy can help cement networks and thus reduce loneliness. Involving the family can both strengthen resilience and reduce loneliness.

    With a school service that is under pressure, screening at the individual level is an expensive approach. So perhaps the best solution is to target all pupils, while still working to identify and help individuals who are particularly vulnerable or at risk.

    Collaboration across sectors is important for children and young people’s mental health.

    “It is important that schools, clubs and communities work together to prevent loneliness and exclusion, and to create a safe and inclusive environment. A sense of belonging has a huge impact on children and adolescents’ health and quality of life,” explained supervisor Unni Karin Moksnes.

    She is a professor at the Department of Public Health and Nursing at NTNU.

    “School plays a particularly important role, because it is an arena where all children and young people meet. Here, we can build communities that promote well-being, learning and good mental health.”

    Initiatives to promote good mental health among children and young people offer many benefits in both the short and long term. They can help improve many people’s wellbeing and better enable them to overcome challenges. Eventually, this could lead to cuts in school dropout rates, increase participation in working life, and result in fewer cases of mental illness. In other words, it is a good investment – for individuals and society alike.

    Source:

    Norwegian University of Science and Technology

    Journal reference:

    Parlikar, N., et al. (2025) The prospective association of adolescent loneliness and low resilience with anxiety and depression in young adulthood: The HUNT study. Social Psychiatry and Psychiatric Epidemiology. doi.org/10.1007/s00127-025-02888-2

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  • Quality of life, insomnia, attitudes and beliefs in women undergoing chemotherapy for breast cancer: a cross-sectional study in Amol city Northern Iran | BMC Women’s Health

    Quality of life, insomnia, attitudes and beliefs in women undergoing chemotherapy for breast cancer: a cross-sectional study in Amol city Northern Iran | BMC Women’s Health

    Study design

    The researchers conducted a cross-sectional, descriptive correlational study to investigate factors affecting women undergoing chemotherapy for breast cancer. This type of study design was chosen to capture information of the variables of interest and to determine relationships among them without manipulating any variables.

    Study setting and population

    The study was carried out among women undergoing chemotherapy for breast cancer referred to selected hospitals and outpatient oncology clinics located at the Arian Clinic, in Amol city, Mazandaran Province, northern Iran. These healthcare centers were selected based on their patient volume and accessibility to ensure a representative sample of the regional population. Data collection was conducted over a six-month period, from July to December 2024.

    Inclusion criteria

    Participants were selected based on the following inclusion criteria: (i) female patients aged 18 years and older, (ii) histologically confirmed non-metastatic breast cancer (Stages I–III), (iii) patients who were either currently receiving or scheduled to receive chemotherapy treatment, (iv) provided informed consent for participation in the study.

    Exclusion criteria

    Patients were excluded from the study if they met any of the following conditions: i: presence of significant psychiatric disorders (such as major depression, bipolar disorder, or schizophrenia), ii) diagnosis of non-cancer-related chronic conditions that could independently affect the study outcomes (e.g., severe anemia, chronic pain syndromes), iii) concurrent use of medications known to impact sleep or psychological well-being, such as sedatives, antipsychotics, or stimulants, iv) employment involving night-shift work, as such work schedules can independently disrupt circadian rhythms and sleep patterns, thus confounding the study findings.

    Sampling technique and sample size

    This study included 468 women with breast cancer undergoing chemotherapy, recruited through convenience sampling due to feasibility constraints in a single-center setting and to maximize participation during treatment visits. The required sample size was calculated using G*Power software version 3.1.9.7, based on a two-tailed test, an alpha of 0.05, a power of 0.90, and a correlation coefficient of 0.16 from a previous study [16]. The minimum sample size was determined to be 406. To account for potential dropouts or incomplete data, a 15% increase was applied, resulting in a final target of 467 participants.

    Research instruments

    The data collected included demographic information (age, marital status, occupation, place of residence, education level, economic status, family history of illness, and duration of cancer), quality of life according to the EORTC QLQ-C30 (European Organization for Research and Treatment of Cancer), insomnia according to the Insomnia Severity Index Questionnaire (ISI), and patients’ attitudes and beliefs according to the Cancer Attitude and Belief Questionnaire.

    EORTC QLQ-C30

    The quality of life (QoL) of women undergoing chemotherapy for breast cancer was evaluated via the EORTC QLQ-C30 (version 3), which consists of 30 items across three subscales: global health status/QoL; functional scales (covering physical, role, cognitive, emotional, and social aspects); and symptom scales (covering fatigue, pain, nausea/vomiting, insomnia, etc.) [17]. The global health/QoL assessment used a 7-point Likert scale, whereas the symptom and functional items used a 4-point scale. According to the EORTC standards [18], scores were also converted from 0 to 100 and interpreted so that higher functional/global scores denoted better outcomes and higher symptom ratings denoted greater burdens. Excellent reliability was demonstrated by the validated Persian adaptation [19, 20]. In this study, the reliability of this questionnaire was assessed via the calculation of Cronbach’s alpha coefficient and was reported as 0.88 for overall quality of life.

    Insomnia severity index questionnaire (ISI)

    The Insomnia Severity Index (ISI) was used to assess the level of insomnia. The ISI questionnaire contains seven items, which include difficulty in starting sleep and problems with staying asleep (waking up at night and waking up early in the morning), satisfaction with the current sleep pattern, and interference with daily functioning. The questionnaire helps to evaluate the severity of the damage attributed to the sleep problem and the degree of confusion or worry caused by the sleep problem and is estimated on a 5-point Likert scale (0 = never and 4 = very much). The total score (0–28) of this questionnaire was categorized as follows: 0–7 = clinically significant insomnia, 14–8 = below the clinical threshold, 21–15 = moderate clinical insomnia, and 28–22 = severe clinical insomnia [21]. The validated Persian-translated version of the ISI is highly valid and reliable [22, 23]. The present study’s internal consistency with this research tool was similarly good (α = 0.80).

    Cancer attitude and belief questionnaire

    The researchers assessed attitudes and beliefs toward cancer via the questionnaire developed by Cho et al., which consists of 12 items in three domains: (a) impossibility of recovery; (b) stereotypes; and (c) discrimination, each with four questions related to the impossibility of recovery, stereotypes, and discrimination. The data were collected via a Likert scale (1 = completely disagree, 2 = disagree, 3 = agree, and 4 = completely agree). After the scores of the questions were summed, a total score between 12 and 48 was obtained. The higher the participants’ scores for each dimension are than the mean values are, the more negative the attitude toward cancer and the greater the degree of stigma [24]. In a study by Shervin Badihian, the internal consistency of the questionnaire items in the study sample was satisfactory, with Cronbach’s alpha coefficients for the impossibility of recovery, stereotypes, and discrimination of 0.67, 0.38, and 0.66, respectively [25]. In the present study, the internal consistency of this research tool was similarly good: 0.70, 0.85, and 0.72.

    Data collection procedure

    After receiving a permission letter from the research committee and head of institution, the researcher collected samples from women undergoing chemotherapy for breast cancer as the research population. The researchers used a convenient sampling method to choose participants after informed consent was obtained from the research participants. Each participant was thoroughly informed about the study’s objectives and procedures, with clear assurances regarding the protection of their anonymity and the confidentiality of their data. Additionally, they were explicitly made aware that their participation was entirely voluntary and that they could withdraw from the study at any time without any negative consequences. Following this, self-administered questionnaires were distributed to a total of 468 participants. To facilitate data collection, three trained researchers were assigned to the task. These researchers underwent comprehensive training covering the study’s objectives, methodology, inclusion and exclusion criteria, and ethical considerations. Moreover, the training sessions included instructions on how to collect data from illiterate participants data collection and these researchers assisted illiterate participants in completing questionnaires.

    Statistical analysis

    The data were analyzed with IBM SPSS (Statistical Package for the Social Sciences) version 24 statistical software. Data normality was evaluated via kurtosis, skewness and Q-Q plots. Nonparametric tests (Gamma/Cramer’s) were used for skewed data. Descriptive statistics (frequency, percentage and mean) were used for demographic variables. Gamma and Cramer’s correlation coefficients were employed to determine the relationships between variables (insomnia, QoL, and attitudes/beliefs toward cancer). The rank logistic test was used to investigate the predictors of the variables. P values less than 0.05 were regarded as statistically significant.

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  • Lung cells generated from mouse embryonic fibroblasts in just 7 to 10 days

    Lung cells generated from mouse embryonic fibroblasts in just 7 to 10 days

    Researchers in Japan have successfully generated lung cells similar to alveolar epithelial type 2 (AT2) cells from mouse embryonic fibroblasts without using stem cell technology. The AT2-like cells were generated in just 7 to 10 days-a significant reduction compared to the approximately one month typically required by conventional stem cell-based differentiation methods.

    This approach may pave the way for treating serious respiratory diseases, such as interstitial pneumonia and chronic obstructive pulmonary disease, which currently lack effective treatments. The study was published in npj Regenerative Medicine.

    AT2 cells are essential for maintaining lung homeostasis. They produce surfactant and serve as progenitor cells for alveolar repair. In patients with severe lung diseases, such as interstitial pneumonia, these cells are often reduced in number or functionally impaired, which highlights the therapeutic potential of regenerating AT2 cells.

    The advent of the induced pluripotent stem cell (iPSC) technology in 2006 has enabled the generation of AT2 cells in approximately one month, but this method is costly and carries risks of tumor formation and immune rejection. To overcome these disadvantages, we focused on direct reprogramming instead. The direct reprogramming approach produces AT2-like cells in just 7 to 10 days, with lower tumor risk and potential for autologous use.”


    Professor Makoto Ishii of Nagoya University Graduate School of Medicine

    Professor Ishii and colleagues, including Professor Koichi Fukunaga, Assistant Professor Takanori Asakura, and Joint Researcher Atsuho Morita from Keio University School of Medicine, conducted a study to generate AT2-like cells from fibroblasts in mice through direct reprogramming, which had never been accomplished before.

    First, the researchers selected 14 candidate genes associated with lung development. Then, they investigated the expression levels of the AT2 cell marker, surfactant protein-C (Sftpc), to determine the gene combination with the highest reprogramming efficiency. They found that a combination of four genes-Nkx2-1, Foxa1, Foxa2, and Gata6-was the most effective for reprogramming AT2 cells.

    The four genes were introduced into a three-dimensional culture made from mouse embryonic fibroblasts that express green fluorescent protein (GFP) in response to Sftpc. As a result, approximately 4% of the cells became Sftpc/GFP-positive in 7 to 10 days, showing their success in inducing AT2-like cells, called induced pulmonary epithelial-like cells (iPULs).

    The researchers analyzed iPULs after isolating GFP-positive cells by flow cytometry. These purified iPULs exhibited lamellar body-like structures, which are organelles characteristic of normal AT2 cells. In addition, transcriptomic analysis revealed that their gene expression profiles were highly similar to those of native AT2 cells.

    Next, they transplanted purified iPULs into mouse lungs with interstitial pneumonia. Forty-two days later, the transplanted cells had successfully engrafted in the alveolar region. Notably, some of the cells had differentiated into alveolar epithelial type 1 (AT1)-like cells, which are essential for lung tissue regeneration.

    Ishii concluded: “In this study, we succeeded in direct reprogramming of fibroblasts into AT2-like cells in mice. We now aim to explore the application of this technology to human cells, with the ultimate goal of developing a safe regenerative therapy using a patient’s own fibroblasts.”

    This study was funded by JSPS KAKENHI Grant Numbers JP24K02113, JP24K23468, JP22KJ2672, JP21J21344, JP21H02926, JP19K17682, JP18K19566, JP18H02821, JP15K19945, and AMED Grant Numbers JP21bm0404053, JP23wm0325031, and JP24ym0126807.

    Source:

    Journal reference:

    Morita, A., et al. (2025). Direct reprogramming of mouse fibroblasts into self-renewable alveolar epithelial-like cells. npj Regenerative Medicine. doi.org/10.1038/s41536-025-00411-4.

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