Robotic nerve ‘cuffs’ could help treat a range of neurological conditions
The researchers, from the University of Cambridge, combined flexible electronics and soft robotics techniques to develop the devices, which could be used for the diagnosis and treatment of a range of disorders, including epilepsy and chronic pain, or the control of prosthetic limbs.
Current tools for interfacing with the peripheral nerves – the 43 pairs of motor and sensory nerves that connect the brain and the spinal cord – are outdated, bulky and carry a high risk of nerve injury. However, the robotic nerve ‘cuffs’ developed by the Cambridge team are sensitive enough to grasp or wrap around delicate nerve fibres without causing any damage.
Tests of the nerve cuffs in rats showed that the devices only require tiny voltages to change shape in a controlled way, forming a self-closing loop around nerves without the need for surgical sutures or glues.
The researchers say the combination of soft electrical actuators with neurotechnology could be an answer to minimally invasive monitoring and treatment for a range of neurological conditions. The results are reported in the journal Nature Materials.
Electric nerve implants can be used to either stimulate or block signals in target nerves. For example, they might help relieve pain by blocking pain signals, or they could be used to restore movement in paralysed limbs by sending electrical signals to the nerves. Nerve monitoring is also standard surgical procedure when operating in areas of the body containing a high concentration of nerve fibres, such as anywhere near the spinal cord.
These implants allow direct access to nerve fibres, but they come with certain risks. “Nerve implants come with a high risk of nerve injury,” said Professor George Malliaras from Cambridge’s Department of Engineering, who led the research. “Nerves are small and highly delicate, so anytime you put something large, like an electrode, in contact with them, it represents a danger to the nerves.”
“Nerve cuffs that wrap around nerves are the least invasive implants currently available, but despite this they are still too bulky, stiff and difficult to implant, requiring significant handling and potential trauma to the nerve,” said co-author Dr Damiano Barone from Cambridge’s Department of Clinical Neurosciences.
The researchers designed a new type of nerve cuff made from conducting polymers, normally used in soft robotics. The ultra-thin cuffs are engineered in two separate layers. Applying tiny amounts of electricity – just a few hundred millivolts – causes the devices to swell or shrink.
The cuffs are small enough that they could be rolled up into a needle and injected near the target nerve. When activated electrically, the cuffs will change their shape to wrap around the nerve, allowing nerve activity to be monitored or altered.
“To ensure the safe use of these devices inside the body, we have managed to reduce the voltage required for actuation to very low values,” said Dr Chaoqun Dong, the paper’s first author. “What's even more significant is that these cuffs can change shape in both directions and be reprogrammed. This means surgeons can adjust how tightly the device fits around a nerve until they get the best results for recording and stimulating the nerve.”
Tests in rats showed that the cuffs could be successfully placed without surgery, and formed a self-closing loop around the target nerve. The researchers are planning further testing of the devices in animal models, and are hoping to begin testing in humans within the next few years.
“Using this approach, we can reach nerves that are difficult to reach through open surgery, such as the nerves that control, pain, vision or hearing, but without the need to implant anything inside the brain,” said Barone. “The ability to place these cuffs so they wrap around the nerves makes this a much easier procedure for surgeons, and it’s less risky for patients.”
“The ability to make an implant that can change shape through electrical activation opens up a range of future possibilities for highly targeted treatments,” said Malliaras. “In future, we might be able to have implants that can move through the body, or even into the brain – it makes you dream how we could use technology to benefit patients in future.”
The research was supported in part by the Swiss National Science Foundation, the Cambridge Trust, and the Engineering and Physical Sciences Research Council (EPSRC), part of UK Research and Innovation (UKRI).
Reference:
Chaoqun Dong et al. ‘Electrochemically actuated microelectrodes for minimally invasive peripheral nerve interfaces.’ Nature Materials (2024). DOI: 10.1038/s41563-024-01886-0
Researchers have developed tiny, flexible devices that can wrap around individual nerve fibres without damaging them.
Neurosciencenervous systemnerveroboticsanimal researchpainsurgeryEngineeringGeorge MalliarasDamiano BaroneChaoqun DongCambridge TrustsEngineering and Physical Sciences Research Council (EPSRC)UK Research and Innovation (UKRI)Department of EngineeringDepartment of Clinical NeurosciencesSchool of TechnologySchool of Clinical MedicineThe ability to make an implant that can change shape through electrical activation opens up a range of future possibilities for highly targeted treatmentsGeorge MalliarasXH4D via iStock / Getty Images PlusIllustration of the human nervous system
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Robotic nerve ‘cuffs’ could help treat a range of neurological conditions
The researchers, from the University of Cambridge, combined flexible electronics and soft robotics techniques to develop the devices, which could be used for the diagnosis and treatment of a range of disorders, including epilepsy and chronic pain, or the control of prosthetic limbs.
Current tools for interfacing with the peripheral nerves – the 43 pairs of motor and sensory nerves that connect the brain and the spinal cord – are outdated, bulky and carry a high risk of nerve injury. However, the robotic nerve ‘cuffs’ developed by the Cambridge team are sensitive enough to grasp or wrap around delicate nerve fibres without causing any damage.
Tests of the nerve cuffs in rats showed that the devices only require tiny voltages to change shape in a controlled way, forming a self-closing loop around nerves without the need for surgical sutures or glues.
The researchers say the combination of soft electrical actuators with neurotechnology could be an answer to minimally invasive monitoring and treatment for a range of neurological conditions. The results are reported in the journal Nature Materials.
Electric nerve implants can be used to either stimulate or block signals in target nerves. For example, they might help relieve pain by blocking pain signals, or they could be used to restore movement in paralysed limbs by sending electrical signals to the nerves. Nerve monitoring is also standard surgical procedure when operating in areas of the body containing a high concentration of nerve fibres, such as anywhere near the spinal cord.
These implants allow direct access to nerve fibres, but they come with certain risks. “Nerve implants come with a high risk of nerve injury,” said Professor George Malliaras from Cambridge’s Department of Engineering, who led the research. “Nerves are small and highly delicate, so anytime you put something large, like an electrode, in contact with them, it represents a danger to the nerves.”
“Nerve cuffs that wrap around nerves are the least invasive implants currently available, but despite this they are still too bulky, stiff and difficult to implant, requiring significant handling and potential trauma to the nerve,” said co-author Dr Damiano Barone from Cambridge’s Department of Clinical Neurosciences.
The researchers designed a new type of nerve cuff made from conducting polymers, normally used in soft robotics. The ultra-thin cuffs are engineered in two separate layers. Applying tiny amounts of electricity – just a few hundred millivolts – causes the devices to swell or shrink.
The cuffs are small enough that they could be rolled up into a needle and injected near the target nerve. When activated electrically, the cuffs will change their shape to wrap around the nerve, allowing nerve activity to be monitored or altered.
“To ensure the safe use of these devices inside the body, we have managed to reduce the voltage required for actuation to very low values,” said Dr Chaoqun Dong, the paper’s first author. “What's even more significant is that these cuffs can change shape in both directions and be reprogrammed. This means surgeons can adjust how tightly the device fits around a nerve until they get the best results for recording and stimulating the nerve.”
Tests in rats showed that the cuffs could be successfully placed without surgery, and formed a self-closing loop around the target nerve. The researchers are planning further testing of the devices in animal models, and are hoping to begin testing in humans within the next few years.
“Using this approach, we can reach nerves that are difficult to reach through open surgery, such as the nerves that control, pain, vision or hearing, but without the need to implant anything inside the brain,” said Barone. “The ability to place these cuffs so they wrap around the nerves makes this a much easier procedure for surgeons, and it’s less risky for patients.”
“The ability to make an implant that can change shape through electrical activation opens up a range of future possibilities for highly targeted treatments,” said Malliaras. “In future, we might be able to have implants that can move through the body, or even into the brain – it makes you dream how we could use technology to benefit patients in future.”
The research was supported in part by the Swiss National Science Foundation, the Cambridge Trust, and the Engineering and Physical Sciences Research Council (EPSRC), part of UK Research and Innovation (UKRI).
Reference:
Chaoqun Dong et al. ‘Electrochemically actuated microelectrodes for minimally invasive peripheral nerve interfaces.’ Nature Materials (2024). DOI: 10.1038/s41563-024-01886-0
Researchers have developed tiny, flexible devices that can wrap around individual nerve fibres without damaging them.
Neurosciencenervous systemnerveroboticsanimal researchpainsurgeryEngineeringGeorge MalliarasDamiano BaroneChaoqun DongCambridge TrustsEngineering and Physical Sciences Research Council (EPSRC)UK Research and Innovation (UKRI)Department of EngineeringDepartment of Clinical NeurosciencesSchool of TechnologySchool of Clinical MedicineThe ability to make an implant that can change shape through electrical activation opens up a range of future possibilities for highly targeted treatmentsGeorge MalliarasXH4D via iStock / Getty Images PlusIllustration of the human nervous system
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Study highlights increased risk of second cancers among breast cancer survivors
For the first time, the research has shown that this risk is higher in people living in areas of greater socioeconomic deprivation.
Breast cancer is the most commonly diagnosed cancer in the UK. Around 56,000 people in the UK are diagnosed each year, the vast majority (over 99%) of whom are women. Improvements in earlier diagnosis and in treatments mean that five year survival rates have been increasing over time, reaching 87% by 2017 in England.
People who survive breast cancer are at risk of second primary cancer, but until now the exact risk has been unclear. Previously published research suggested that women and men who survive breast cancer are at a 24% and 27% greater risk of a non-breast second primary cancer than the wider population respectively. There have been also suggestions that second primary cancer risks differ by the age at breast cancer diagnosis.
To provide more accurate estimates, a team led by researchers at the University of Cambridge analysed data from over 580,000 female and over 3,500 male breast cancer survivors diagnosed between 1995 and 2019 using the National Cancer Registration Dataset. The results of their analysis are published today in Lancet Regional Health – Europe.
First author Isaac Allen from the Department of Public Health and Primary Care at the University of Cambridge said: “It’s important for us to understand to what extent having one type of cancer puts you at risk of a second cancer at a different site. The female and male breast cancer survivors whose data we studied were at increased risk of a number of second cancers. Knowing this can help inform conversations with their care teams to look out for signs of potential new cancers.”
The researchers found significantly increased risks of cancer in the contralateral (that is, unaffected) breast and for endometrium and prostate cancer in females and males, respectively. Females who survived breast cancer were at double the risk of contralateral breast cancer compared to the general population and at 87% greater risk of endometrial cancer, 58% greater risk of myeloid leukaemia and 25% greater risk of ovarian cancer.
Age of diagnosis was important, too – females diagnosed with breast cancer under the age of 50 were 86% more likely to develop a second primary cancer compared to the general population of the same age, whereas women diagnosed after age 50 were at a 17% increased risk. One potential explanation is that a larger number of younger breast cancer survivors may have inherited genetic alterations that increase risk for multiple cancers. For example, women with inherited changes to the BRCA1 and BRCA2 genes are at increased risk of contralateral breast cancer, ovarian and pancreatic cancer.
Females from the most socioeconomically deprived backgrounds were at 35% greater risk of a second primary cancer compared to females from the least deprived backgrounds. These differences were primarily driven by non-breast cancer risks, particularly for lung, kidney, head and neck, bladder, oesophageal and stomach cancers. This may be because smoking, obesity, and alcohol consumption – established risk factors for these cancers – are more common among more deprived groups.
Allen, a PhD student at Clare Hall, added: “This is further evidence of the health inequalities that people from more deprived backgrounds experience. We need to fully understand why they are at greater risk of second cancers so that we can intervene and reduce this risk.”
Male breast cancer survivors were 55 times more likely than the general male population to develop contralateral breast cancer – though the researchers stress that an individual’s risk was still very low. For example, for every 100 men diagnosed with breast cancer at age 50 or over, about three developed contralateral breast cancer during a 25 year period. Male breast cancer survivors were also 58% more likely than the general male population to develop prostate cancer.
Professor Antonis Antoniou from the Department of Public Health and Primary Care at the University of Cambridge, the study’s senior author, said: “This is the largest study to date to look at the risk in breast cancer survivors of developing a second cancer. We were able to carry this out and calculate more accurate estimates because of the outstanding data sets available to researchers through the NHS.”
The research was funded by Cancer Research UK with support from the National Institute for Health and Care Research Cambridge Biomedical Research Centre.
Cancer Research UK’s senior cancer intelligence manager, Katrina Brown, said: “This study shows us that the risk of second primary cancers is higher in people who have had breast cancer, and this can differ depending on someone’s socioeconomic background. But more research is needed to understand what is driving this difference and how to tackle these health inequalities.”
People who are concerned about their cancer risk should contact their GP for advice. If you or someone close to you have been affected by cancer and you’ve got questions, you can call Cancer Research UK nurses on freephone 0808 800 4040, Monday to Friday.
Reference
Allen, I, et al. Risks of second primary cancers among 584,965 female and male breast cancer survivors in England: a 25-year retrospective cohort study. Lancet Regional Health – Europe; 24 April 2024: DOI: 10.1016/j.lanepe.2024.100903
Survivors of breast cancer are at significantly higher risk of developing second cancers, including endometrial and ovarian cancer for women and prostate cancer for men, according to new research studying data from almost 600,000 patients in England.
Cancerbreast cancerAntonis AntoniouIsaac AllenCancer Research UK (CRUK)School of Clinical MedicineDepartment of Public Health and Primary CareCambridge Cancer CentreIt’s important for us to understand to what extent having one type of cancer puts you at risk of a second cancer at a different site. Knowing this can help inform conversations with their care teams to look out for signs of potential new cancersIsaac AllenNational Cancer InstituteDoctor standing near woman patient doing breast cancer
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Study highlights increased risk of second cancers among breast cancer survivors
For the first time, the research has shown that this risk is higher in people living in areas of greater socioeconomic deprivation.
Breast cancer is the most commonly diagnosed cancer in the UK. Around 56,000 people in the UK are diagnosed each year, the vast majority (over 99%) of whom are women. Improvements in earlier diagnosis and in treatments mean that five year survival rates have been increasing over time, reaching 87% by 2017 in England.
People who survive breast cancer are at risk of second primary cancer, but until now the exact risk has been unclear. Previously published research suggested that women and men who survive breast cancer are at a 24% and 27% greater risk of a non-breast second primary cancer than the wider population respectively. There have been also suggestions that second primary cancer risks differ by the age at breast cancer diagnosis.
To provide more accurate estimates, a team led by researchers at the University of Cambridge analysed data from over 580,000 female and over 3,500 male breast cancer survivors diagnosed between 1995 and 2019 using the National Cancer Registration Dataset. The results of their analysis are published today in Lancet Regional Health – Europe.
First author Isaac Allen from the Department of Public Health and Primary Care at the University of Cambridge said: “It’s important for us to understand to what extent having one type of cancer puts you at risk of a second cancer at a different site. The female and male breast cancer survivors whose data we studied were at increased risk of a number of second cancers. Knowing this can help inform conversations with their care teams to look out for signs of potential new cancers.”
The researchers found significantly increased risks of cancer in the contralateral (that is, unaffected) breast and for endometrium and prostate cancer in females and males, respectively. Females who survived breast cancer were at double the risk of contralateral breast cancer compared to the general population and at 87% greater risk of endometrial cancer, 58% greater risk of myeloid leukaemia and 25% greater risk of ovarian cancer.
Age of diagnosis was important, too – females diagnosed with breast cancer under the age of 50 were 86% more likely to develop a second primary cancer compared to the general population of the same age, whereas women diagnosed after age 50 were at a 17% increased risk. One potential explanation is that a larger number of younger breast cancer survivors may have inherited genetic alterations that increase risk for multiple cancers. For example, women with inherited changes to the BRCA1 and BRCA2 genes are at increased risk of contralateral breast cancer, ovarian and pancreatic cancer.
Females from the most socioeconomically deprived backgrounds were at 35% greater risk of a second primary cancer compared to females from the least deprived backgrounds. These differences were primarily driven by non-breast cancer risks, particularly for lung, kidney, head and neck, bladder, oesophageal and stomach cancers. This may be because smoking, obesity, and alcohol consumption – established risk factors for these cancers – are more common among more deprived groups.
Allen, a PhD student at Clare Hall, added: “This is further evidence of the health inequalities that people from more deprived backgrounds experience. We need to fully understand why they are at greater risk of second cancers so that we can intervene and reduce this risk.”
Male breast cancer survivors were 55 times more likely than the general male population to develop contralateral breast cancer – though the researchers stress that an individual’s risk was still very low. For example, for every 100 men diagnosed with breast cancer at age 50 or over, about three developed contralateral breast cancer during a 25 year period. Male breast cancer survivors were also 58% more likely than the general male population to develop prostate cancer.
Professor Antonis Antoniou from the Department of Public Health and Primary Care at the University of Cambridge, the study’s senior author, said: “This is the largest study to date to look at the risk in breast cancer survivors of developing a second cancer. We were able to carry this out and calculate more accurate estimates because of the outstanding data sets available to researchers through the NHS.”
The research was funded by Cancer Research UK with support from the National Institute for Health and Care Research Cambridge Biomedical Research Centre.
Cancer Research UK’s senior cancer intelligence manager, Katrina Brown, said: “This study shows us that the risk of second primary cancers is higher in people who have had breast cancer, and this can differ depending on someone’s socioeconomic background. But more research is needed to understand what is driving this difference and how to tackle these health inequalities.”
People who are concerned about their cancer risk should contact their GP for advice. If you or someone close to you have been affected by cancer and you’ve got questions, you can call Cancer Research UK nurses on freephone 0808 800 4040, Monday to Friday.
Reference
Allen, I, et al. Risks of second primary cancers among 584,965 female and male breast cancer survivors in England: a 25-year retrospective cohort study. Lancet Regional Health – Europe; 24 April 2024: DOI: 10.1016/j.lanepe.2024.100903
Survivors of breast cancer are at significantly higher risk of developing second cancers, including endometrial and ovarian cancer for women and prostate cancer for men, according to new research studying data from almost 600,000 patients in England.
Cancerbreast cancerAntonis AntoniouIsaac AllenCancer Research UK (CRUK)School of Clinical MedicineDepartment of Public Health and Primary CareCambridge Cancer CentreIt’s important for us to understand to what extent having one type of cancer puts you at risk of a second cancer at a different site. Knowing this can help inform conversations with their care teams to look out for signs of potential new cancersIsaac AllenNational Cancer InstituteDoctor standing near woman patient doing breast cancer
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Rare disease research at Cambridge receives major boost with launch of two new centres
The virtual centres, supported by the charity LifeArc, will focus on areas where there are significant unmet needs. They will tackle barriers that ordinarily prevent new tests and treatments reaching patients with rare diseases and speed up the delivery of rare disease treatment trials.
The centres will bring together leading scientists and rare disease clinical specialists from across the UK for the first time, encouraging new collaborations across different research disciplines and providing improved access to facilities and training.
LifeArc Centre for Rare Mitochondrial DiseasesProfessor Patrick Chinnery will lead the LifeArc Centre for Rare Mitochondrial Diseases, a national partnership with the Lily Foundation and Muscular Dystrophy UK, together with key partners at UCL, Newcastle University and three other centres (Oxford, Birmingham and Manchester).
Mitochondrial diseases are genetic disorders affecting 1 in 5,000 people. They often cause progressive damage to the brain, eyes, muscles, heart and liver, leading to severe disability and a shorter life. There is currently have no cure for most conditions, however, new opportunities to treat mitochondrial diseases have been identified in the last five years, meaning that it’s a critical time for research development. The £7.5M centre will establish a national platform that will connect patient groups, knowledge and infrastructure in order to accelerate new treatments getting to clinical trial.
Professor Chinnery said: “The new LifeArc centre unites scientific and clinical strengths from across the UK. For the first time we will form a single team, focussed on developing new treatments for mitochondrial diseases which currently have no cure.”
Adam Harraway has Mitochondrial Disease and says he lives in constant fear of what might go wrong next with his condition. “With rare diseases such as these, it can feel like the questions always outweigh the answers. The news of this investment from LifeArc fills me with hope for the future. To know that there are so many wonderful people and organisations working towards treatments and cures makes me feel seen and heard. It gives a voice to people who often have to suffer in silence, and I'm excited to see how this project can help Mito patients in the future."
LifeArc Centre for Rare Respiratory DiseasesProfessor Stefan Marciniak will co-lead the LifeArc Centre for Rare Respiratory Diseases, a UK wide collaborative centre co-created in partnership with patients and charities. This Centre is a partnership between Universities and NHS Trusts across the UK, co-led by Edinburgh with Nottingham, Dundee, Cambridge, Southampton, University College London and supported by six other centres (Belfast, Cardiff, Leeds, Leicester, Manchester and Royal Brompton).
For the first time ever, it will provide a single ‘go to’ centre that will connect children and adults with rare respiratory disease with clinical experts, researchers, investors and industry leaders across the UK. The £9.4M centre will create a UK-wide biobank of patient samples and models of disease that will allow researchers to advance pioneering therapies and engage with industry and regulatory partners to develop innovative human clinical studies.
Professor Marciniak said: “There are many rare lung diseases, and together those affected constitute a larger underserved group of patients. The National Translational Centre for Rare Respiratory Diseases brings together expertise from across the UK to find effective treatments and train the next generation of rare disease researchers.”
Former BBC News journalist and presenter, Philippa Thomas, has the rare incurable lung disease, Lymphangioleiomyomatosis (LAM). Her condition has stabilised but for many people, the disease can be severely life-limiting. Philippa said: “There is so little research funding for rare respiratory diseases, that getting treatment - let alone an accurate diagnosis - really does feel like a lottery. It is also terrifying being diagnosed with something your GP will never have heard of.”
Globally, there are more than 300 million people living with rare diseases. However, rare disease research can be fragmented. Researchers can lack access to specialist facilities, as well as advice on regulation, trial designs, preclinical regulatory requirements, and translational project management, which are vital in getting new innovations to patients.
Dr Catriona Crombie, Head of Rare Disease at LifeArc, says: “We’re extremely proud to be launching four new LifeArc Translational Centres for Rare Diseases. Each centre has been awarded funding because it holds real promise for delivering change for people living with rare diseases. These centres also have the potential to create a blueprint for accelerating improvements across other disease areas, including common diseases.”
Adapted from a press release from LifeArc
Cambridge researchers will play key roles in two new centres dedicated to developing improved tests, treatments and potentially cures for thousands of people living with rare medical conditions.
Rare diseasesPatrick ChinneryStefan MarciniakLifeArcSchool of Clinical MedicineDepartment Clinical NeurosciencesCambridge Institute for Medical Research (CIMR)Department of MedicineSt Catharine's CollegeGonville and Caius CollegeThe new LifeArc centre unites scientific and clinical strengths from across the UKPatrick ChinneryAlexander_Safonov (Getty)Woman inhaling from a mask nebulizer
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Rare disease research at Cambridge receives major boost with launch of two new centres
The virtual centres, supported by the charity LifeArc, will focus on areas where there are significant unmet needs. They will tackle barriers that ordinarily prevent new tests and treatments reaching patients with rare diseases and speed up the delivery of rare disease treatment trials.
The centres will bring together leading scientists and rare disease clinical specialists from across the UK for the first time, encouraging new collaborations across different research disciplines and providing improved access to facilities and training.
LifeArc Centre for Rare Mitochondrial DiseasesProfessor Patrick Chinnery will lead the LifeArc Centre for Rare Mitochondrial Diseases, a national partnership with the Lily Foundation and Muscular Dystrophy UK, together with key partners at UCL, Newcastle University and three other centres (Oxford, Birmingham and Manchester).
Mitochondrial diseases are genetic disorders affecting 1 in 5,000 people. They often cause progressive damage to the brain, eyes, muscles, heart and liver, leading to severe disability and a shorter life. There is currently have no cure for most conditions, however, new opportunities to treat mitochondrial diseases have been identified in the last five years, meaning that it’s a critical time for research development. The £7.5M centre will establish a national platform that will connect patient groups, knowledge and infrastructure in order to accelerate new treatments getting to clinical trial.
Professor Chinnery said: “The new LifeArc centre unites scientific and clinical strengths from across the UK. For the first time we will form a single team, focussed on developing new treatments for mitochondrial diseases which currently have no cure.”
Adam Harraway has Mitochondrial Disease and says he lives in constant fear of what might go wrong next with his condition. “With rare diseases such as these, it can feel like the questions always outweigh the answers. The news of this investment from LifeArc fills me with hope for the future. To know that there are so many wonderful people and organisations working towards treatments and cures makes me feel seen and heard. It gives a voice to people who often have to suffer in silence, and I'm excited to see how this project can help Mito patients in the future."
LifeArc Centre for Rare Respiratory DiseasesProfessor Stefan Marciniak will co-lead the LifeArc Centre for Rare Respiratory Diseases, a UK wide collaborative centre co-created in partnership with patients and charities. This Centre is a partnership between Universities and NHS Trusts across the UK, co-led by Edinburgh with Nottingham, Dundee, Cambridge, Southampton, University College London and supported by six other centres (Belfast, Cardiff, Leeds, Leicester, Manchester and Royal Brompton).
For the first time ever, it will provide a single ‘go to’ centre that will connect children and adults with rare respiratory disease with clinical experts, researchers, investors and industry leaders across the UK. The £9.4M centre will create a UK-wide biobank of patient samples and models of disease that will allow researchers to advance pioneering therapies and engage with industry and regulatory partners to develop innovative human clinical studies.
Professor Marciniak said: “There are many rare lung diseases, and together those affected constitute a larger underserved group of patients. The National Translational Centre for Rare Respiratory Diseases brings together expertise from across the UK to find effective treatments and train the next generation of rare disease researchers.”
Former BBC News journalist and presenter, Philippa Thomas, has the rare incurable lung disease, Lymphangioleiomyomatosis (LAM). Her condition has stabilised but for many people, the disease can be severely life-limiting. Philippa said: “There is so little research funding for rare respiratory diseases, that getting treatment - let alone an accurate diagnosis - really does feel like a lottery. It is also terrifying being diagnosed with something your GP will never have heard of.”
Globally, there are more than 300 million people living with rare diseases. However, rare disease research can be fragmented. Researchers can lack access to specialist facilities, as well as advice on regulation, trial designs, preclinical regulatory requirements, and translational project management, which are vital in getting new innovations to patients.
Dr Catriona Crombie, Head of Rare Disease at LifeArc, says: “We’re extremely proud to be launching four new LifeArc Translational Centres for Rare Diseases. Each centre has been awarded funding because it holds real promise for delivering change for people living with rare diseases. These centres also have the potential to create a blueprint for accelerating improvements across other disease areas, including common diseases.”
Adapted from a press release from LifeArc
Cambridge researchers will play key roles in two new centres dedicated to developing improved tests, treatments and potentially cures for thousands of people living with rare medical conditions.
Rare diseasesPatrick ChinneryStefan MarciniakLifeArcSchool of Clinical MedicineDepartment Clinical NeurosciencesCambridge Institute for Medical Research (CIMR)Department of MedicineSt Catharine's CollegeGonville and Caius CollegeThe new LifeArc centre unites scientific and clinical strengths from across the UKPatrick ChinneryAlexander_Safonov (Getty)Woman inhaling from a mask nebulizer
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Training AI models to answer ‘what if?’ questions could improve medical treatments
Artificial intelligence techniques can be helpful for multiple medical applications, such as radiology or oncology, where the ability to recognise patterns in large volumes of data is vital. For these types of applications, the AI compares information against learned examples, draws conclusions, and makes extrapolations.
Now, an international team led by researchers from Ludwig-Maximilians-Universität München (LMU) and including researchers from the University of Cambridge, is exploring the potential of a comparatively new branch of AI for diagnostics and therapy.
The researchers found that causal machine learning (ML) can estimate treatment outcomes – and do so better than the machine learning methods generally used to date. Causal machine learning makes it easier for clinicians to personalise treatment strategies, which individually improves the health of patients.
The results, reported in the journal Nature Medicine, suggest how causal machine learning could improve the effectiveness and safety of a variety of medical treatments.
Classical machine learning recognises patterns and discovers correlations. However, the principle of cause and effect remains closed to machines as a rule; they cannot address the question of why. When making therapy decisions for a patient, the ‘why’ is vital to achieve the best outcomes.
“Developing machine learning tools to address why and what if questions is empowering for clinicians, because it can strengthen their decision-making processes,” said senior author Professor Michaela van der Schaar, Director of the Cambridge Centre for AI in Medicine. “But this sort of machine learning is far more complex than assessing personalised risk.”
For example, when attempting to determine therapy decisions for someone at risk of developing diabetes, classical ML would aim to predict how probable it is for a given patient with a range of risk factors to develop the disease. With causal ML, it would be possible to answer how the risk changes if the patient receives an anti-diabetes drug; that is, gauge the effect of a cause. It would also be possible to estimate whether metformin, the commonly-prescribed medication, would be the best treatment, or whether another treatment plan would be better.
To be able to estimate the effect of a hypothetical treatment, the AI models must learn to answer ‘what if?’ questions. “We give the machine rules for recognising the causal structure and correctly formalising the problem,” said Professor Stefan Feuerriegel from LMU, who led the research. “Then the machine has to learn to recognise the effects of interventions and understand, so to speak, how real-life consequences are mirrored in the data that has been fed into the computers.”
Even in situations for which reliable treatment standards do not yet exist or where randomised studies are not possible for ethical reasons because they always contain a placebo group, machines could still gauge potential treatment outcomes from the available patient data and form hypotheses for possible treatment plans, so the researchers hope.
With such real-world data, it should generally be possible to describe the patient cohorts with ever greater precision in the estimates, bringing individualised therapy decisions that much closer. Naturally, there would still be the challenge of ensuring the reliability and robustness of the methods.
“The software we need for causal ML methods in medicine doesn’t exist out of the box,” says Feuerriegel. “Rather, complex modelling of the respective problem is required, involving close collaboration between AI experts and doctors.”
In other fields, such as marketing, explains Feuerriegel, the work with causal ML has already been in the testing phase for some years now. “Our goal is to bring the methods a step closer to practice,” he said. The paper describes the direction in which things could move over the coming years.”
“I have worked in this area for almost 10 years, working relentlessly in our lab with generations of students to crack this problem,” said van der Schaar, who is affiliated with the Departments of Applied Mathematics and Theoretical Physics, Engineering and Medicine. “It’s an extremely challenging area of machine learning, and seeing it come closer to clinical use, where it will empower clinicians and patients alike, is very satisfying.”
Van der Schaar is continuing to work closely with clinicians to validate these tools in diverse clinical settings, including transplantation, cancer and cardiovascular disease.
Reference:
Stefan Feuerriegel et al. ‘Causal machine learning for predicting treatments.’ Nature Medicine (2024). DOI: 10.1038/s41591-024-02902-1
Adapted from an LMU media release.
Machines can learn not only to make predictions, but to handle causal relationships. An international research team shows how this could make medical treatments safer, more efficient, and more personalised.
Artificial intelligencemedicinemachine learninghealthEngineeringMihaela van der SchaarLudwig-Maximilians-UniversitätCambridge Centre for AI in MedicineDepartment of Applied Mathematics and Theoretical PhysicsDepartment of EngineeringDepartment of MedicineSchool of the Physical SciencesSchool of TechnologySchool of Clinical MedicineYuichiro Chino via Getty ImagesComputer-generated image of human brain
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Training AI models to answer ‘what if?’ questions could improve medical treatments
Artificial intelligence techniques can be helpful for multiple medical applications, such as radiology or oncology, where the ability to recognise patterns in large volumes of data is vital. For these types of applications, the AI compares information against learned examples, draws conclusions, and makes extrapolations.
Now, an international team led by researchers from Ludwig-Maximilians-Universität München (LMU) and including researchers from the University of Cambridge, is exploring the potential of a comparatively new branch of AI for diagnostics and therapy.
The researchers found that causal machine learning (ML) can estimate treatment outcomes – and do so better than the machine learning methods generally used to date. Causal machine learning makes it easier for clinicians to personalise treatment strategies, which individually improves the health of patients.
The results, reported in the journal Nature Medicine, suggest how causal machine learning could improve the effectiveness and safety of a variety of medical treatments.
Classical machine learning recognises patterns and discovers correlations. However, the principle of cause and effect remains closed to machines as a rule; they cannot address the question of why. When making therapy decisions for a patient, the ‘why’ is vital to achieve the best outcomes.
“Developing machine learning tools to address why and what if questions is empowering for clinicians, because it can strengthen their decision-making processes,” said senior author Professor Michaela van der Schaar, Director of the Cambridge Centre for AI in Medicine. “But this sort of machine learning is far more complex than assessing personalised risk.”
For example, when attempting to determine therapy decisions for someone at risk of developing diabetes, classical ML would aim to predict how probable it is for a given patient with a range of risk factors to develop the disease. With causal ML, it would be possible to answer how the risk changes if the patient receives an anti-diabetes drug; that is, gauge the effect of a cause. It would also be possible to estimate whether metformin, the commonly-prescribed medication, would be the best treatment, or whether another treatment plan would be better.
To be able to estimate the effect of a hypothetical treatment, the AI models must learn to answer ‘what if?’ questions. “We give the machine rules for recognising the causal structure and correctly formalising the problem,” said Professor Stefan Feuerriegel from LMU, who led the research. “Then the machine has to learn to recognise the effects of interventions and understand, so to speak, how real-life consequences are mirrored in the data that has been fed into the computers.”
Even in situations for which reliable treatment standards do not yet exist or where randomised studies are not possible for ethical reasons because they always contain a placebo group, machines could still gauge potential treatment outcomes from the available patient data and form hypotheses for possible treatment plans, so the researchers hope.
With such real-world data, it should generally be possible to describe the patient cohorts with ever greater precision in the estimates, bringing individualised therapy decisions that much closer. Naturally, there would still be the challenge of ensuring the reliability and robustness of the methods.
“The software we need for causal ML methods in medicine doesn’t exist out of the box,” says Feuerriegel. “Rather, complex modelling of the respective problem is required, involving close collaboration between AI experts and doctors.”
In other fields, such as marketing, explains Feuerriegel, the work with causal ML has already been in the testing phase for some years now. “Our goal is to bring the methods a step closer to practice,” he said. The paper describes the direction in which things could move over the coming years.”
“I have worked in this area for almost 10 years, working relentlessly in our lab with generations of students to crack this problem,” said van der Schaar, who is affiliated with the Departments of Applied Mathematics and Theoretical Physics, Engineering and Medicine. “It’s an extremely challenging area of machine learning, and seeing it come closer to clinical use, where it will empower clinicians and patients alike, is very satisfying.”
Van der Schaar is continuing to work closely with clinicians to validate these tools in diverse clinical settings, including transplantation, cancer and cardiovascular disease.
Reference:
Stefan Feuerriegel et al. ‘Causal machine learning for predicting treatments.’ Nature Medicine (2024). DOI: 10.1038/s41591-024-02902-1
Adapted from an LMU media release.
Machines can learn not only to make predictions, but to handle causal relationships. An international research team shows how this could make medical treatments safer, more efficient, and more personalised.
Artificial intelligencemedicinemachine learninghealthEngineeringMihaela van der SchaarLudwig-Maximilians-UniversitätCambridge Centre for AI in MedicineDepartment of Applied Mathematics and Theoretical PhysicsDepartment of EngineeringDepartment of MedicineSchool of the Physical SciencesSchool of TechnologySchool of Clinical MedicineYuichiro Chino via Getty ImagesComputer-generated image of human brain
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Artificial Intelligence beats doctors in accurately assessing eye problems
The clinical knowledge and reasoning skills of GPT-4 are approaching the level of specialist eye doctors, a study led by the University of Cambridge has found.
GPT-4 - a ‘large language model’ - was tested against doctors at different stages in their careers, including unspecialised junior doctors, and trainee and expert eye doctors. Each was presented with a series of 87 patient scenarios involving a specific eye problem, and asked to give a diagnosis or advise on treatment by selecting from four options.
GPT-4 scored significantly better in the test than unspecialised junior doctors, who are comparable to general practitioners in their level of specialist eye knowledge.
GPT-4 gained similar scores to trainee and expert eye doctors - although the top performing doctors scored higher.
The researchers say that large language models aren’t likely to replace healthcare professionals, but have the potential to improve healthcare as part of the clinical workflow.
They say state-of-the-art large language models like GPT-4 could be useful for providing eye-related advice, diagnosis, and management suggestions in well-controlled contexts, like triaging patients, or where access to specialist healthcare professionals is limited.
“We could realistically deploy AI in triaging patients with eye issues to decide which cases are emergencies that need to be seen by a specialist immediately, which can be seen by a GP, and which don’t need treatment,” said Dr Arun Thirunavukarasu, lead author of the study, which he carried out while a student at the University of Cambridge’s School of Clinical Medicine.
He added: “The models could follow clear algorithms already in use, and we’ve found that GPT-4 is as good as expert clinicians at processing eye symptoms and signs to answer more complicated questions.
“With further development, large language models could also advise GPs who are struggling to get prompt advice from eye doctors. People in the UK are waiting longer than ever for eye care.
Large volumes of clinical text are needed to help fine-tune and develop these models, and work is ongoing around the world to facilitate this.
The researchers say that their study is superior to similar, previous studies because they compared the abilities of AI to practicing doctors, rather than to sets of examination results.
“Doctors aren't revising for exams for their whole career. We wanted to see how AI fared when pitted against to the on-the-spot knowledge and abilities of practicing doctors, to provide a fair comparison,” said Thirunavukarasu, who is now an Academic Foundation Doctor at Oxford University Hospitals NHS Foundation Trust.
He added: “We also need to characterise the capabilities and limitations of commercially available models, as patients may already be using them - rather than the internet - for advice.”
The test included questions about a huge range of eye problems, including extreme light sensitivity, decreased vision, lesions, itchy and painful eyes, taken from a textbook used to test trainee eye doctors. This textbook is not freely available on the internet, making it unlikely that its content was included in GPT-4’s training datasets.
The results are published today in the journal PLOS Digital Health.
“Even taking the future use of AI into account, I think doctors will continue to be in charge of patient care. The most important thing is to empower patients to decide whether they want computer systems to be involved or not. That will be an individual decision for each patient to make,” said Thirunavukarasu.
GPT-4 and GPT-3.5 – or ‘Generative Pre-trained Transformers’ - are trained on datasets containing hundreds of billions of words from articles, books, and other internet sources. These are two examples of large language models; others in wide use include Pathways Language Model 2 (PaLM 2) and Large Language Model Meta AI 2 (LLaMA 2).
The study also tested GPT-3.5, PaLM2, and LLaMA with the same set of questions. GPT-4 gave more accurate responses than all of them.
GPT-4 powers the online chatbot ChatGPT to provide bespoke responses to human queries. In recent months, ChatGPT has attracted significant attention in medicine for attaining passing level performance in medical school examinations, and providing more accurate and empathetic messages than human doctors in response to patient queries.
The field of artificially intelligent large language models is moving very rapidly. Since the study was conducted, more advanced models have been released - which may be even closer to the level of expert eye doctors.
Reference: Thirunavukarasu, A.J. et al: ‘Large language models approach expert-level clinical knowledge and reasoning in ophthalmology: A head-to-head cross-sectional study.’ PLOS Digital Health, April 2024. DOI: 10.1371/journal.pdig.0000341
A study has found that the AI model GPT-4 significantly exceeds the ability of non-specialist doctors to assess eye problems and provide advice.
Artificial intelligenceArun ThirunavukarasuOxford University Hospitals NHS Foundation TrustUniversity of OxfordSchool of Clinical MedicineCorpus Christi CollegeWe could realistically deploy AI in triaging patients with eye issues to decide which cases are emergencies.Arun ThirunavukarasuMavocado on Getty
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Artificial Intelligence beats doctors in accurately assessing eye problems
The clinical knowledge and reasoning skills of GPT-4 are approaching the level of specialist eye doctors, a study led by the University of Cambridge has found.
GPT-4 - a ‘large language model’ - was tested against doctors at different stages in their careers, including unspecialised junior doctors, and trainee and expert eye doctors. Each was presented with a series of 87 patient scenarios involving a specific eye problem, and asked to give a diagnosis or advise on treatment by selecting from four options.
GPT-4 scored significantly better in the test than unspecialised junior doctors, who are comparable to general practitioners in their level of specialist eye knowledge.
GPT-4 gained similar scores to trainee and expert eye doctors - although the top performing doctors scored higher.
The researchers say that large language models aren’t likely to replace healthcare professionals, but have the potential to improve healthcare as part of the clinical workflow.
They say state-of-the-art large language models like GPT-4 could be useful for providing eye-related advice, diagnosis, and management suggestions in well-controlled contexts, like triaging patients, or where access to specialist healthcare professionals is limited.
“We could realistically deploy AI in triaging patients with eye issues to decide which cases are emergencies that need to be seen by a specialist immediately, which can be seen by a GP, and which don’t need treatment,” said Dr Arun Thirunavukarasu, lead author of the study, which he carried out while a student at the University of Cambridge’s School of Clinical Medicine.
He added: “The models could follow clear algorithms already in use, and we’ve found that GPT-4 is as good as expert clinicians at processing eye symptoms and signs to answer more complicated questions.
“With further development, large language models could also advise GPs who are struggling to get prompt advice from eye doctors. People in the UK are waiting longer than ever for eye care.
Large volumes of clinical text are needed to help fine-tune and develop these models, and work is ongoing around the world to facilitate this.
The researchers say that their study is superior to similar, previous studies because they compared the abilities of AI to practicing doctors, rather than to sets of examination results.
“Doctors aren't revising for exams for their whole career. We wanted to see how AI fared when pitted against to the on-the-spot knowledge and abilities of practicing doctors, to provide a fair comparison,” said Thirunavukarasu, who is now an Academic Foundation Doctor at Oxford University Hospitals NHS Foundation Trust.
He added: “We also need to characterise the capabilities and limitations of commercially available models, as patients may already be using them - rather than the internet - for advice.”
The test included questions about a huge range of eye problems, including extreme light sensitivity, decreased vision, lesions, itchy and painful eyes, taken from a textbook used to test trainee eye doctors. This textbook is not freely available on the internet, making it unlikely that its content was included in GPT-4’s training datasets.
The results are published today in the journal PLOS Digital Health.
“Even taking the future use of AI into account, I think doctors will continue to be in charge of patient care. The most important thing is to empower patients to decide whether they want computer systems to be involved or not. That will be an individual decision for each patient to make,” said Thirunavukarasu.
GPT-4 and GPT-3.5 – or ‘Generative Pre-trained Transformers’ - are trained on datasets containing hundreds of billions of words from articles, books, and other internet sources. These are two examples of large language models; others in wide use include Pathways Language Model 2 (PaLM 2) and Large Language Model Meta AI 2 (LLaMA 2).
The study also tested GPT-3.5, PaLM2, and LLaMA with the same set of questions. GPT-4 gave more accurate responses than all of them.
GPT-4 powers the online chatbot ChatGPT to provide bespoke responses to human queries. In recent months, ChatGPT has attracted significant attention in medicine for attaining passing level performance in medical school examinations, and providing more accurate and empathetic messages than human doctors in response to patient queries.
The field of artificially intelligent large language models is moving very rapidly. Since the study was conducted, more advanced models have been released - which may be even closer to the level of expert eye doctors.
Reference: Thirunavukarasu, A.J. et al: ‘Large language models approach expert-level clinical knowledge and reasoning in ophthalmology: A head-to-head cross-sectional study.’ PLOS Digital Health, April 2024. DOI: 10.1371/journal.pdig.0000341
A study has found that the AI model GPT-4 significantly exceeds the ability of non-specialist doctors to assess eye problems and provide advice.
Artificial intelligenceArun ThirunavukarasuOxford University Hospitals NHS Foundation TrustUniversity of OxfordSchool of Clinical MedicineCorpus Christi CollegeWe could realistically deploy AI in triaging patients with eye issues to decide which cases are emergencies.Arun ThirunavukarasuMavocado on Getty
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Report highlights inequalities and hidden suffering among people living with breast cancer
Shorthand Story: Fc5mFrzPLZShorthand Story Head:
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Report highlights inequalities and hidden suffering among people living with breast cancer
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Report highlights inequalities and hidden suffering among people living with breast cancer
Many people with breast cancer ‘systematically left behind’, say researchers
Experts predict 3 million new cases a year of breast cancer worldwide by 2040 and a million deaths, with people living in low- and middle-income countries disproportionately affected. Despite major advances in the diagnosis and treatment, inequalities mean that many women worldwide still experience significant suffering related to physical symptoms, emotional despair, and financial burden.
These are among the conclusions of the new Lancet Commission, led by Professor Charlotte Coles from the University of Cambridge, which sets out recommendations to tackle these urgent challenges in breast cancer. The Commission builds on previous evidence, presents new data, and integrates patient voices to shed light on a large unseen burden.
"Recent improvements in breast cancer survival represent a great success of modern medicine. However, we can’t ignore how many patients are being systematically left behind."Professor Charlotte Coles, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust
Professor Coles added: "We hope that, by highlighting these inequities and hidden costs and suffering in breast cancer, they can be better recognised and addressed by health care professionals and policymakers in partnership with patients and the public around the world."
At the end of 2020, 7.8 million women were alive having been diagnosed with breast cancer in the previous five years. Progress in research and cancer management has led to a decrease of over 40% in breast cancer mortality in most high-income countries. Estimates suggest that global breast cancer incidence will rise from 2.3 million new cases in 2020 to over 3 million by 2040.
Although breast cancer is the most common cancer, gaps in knowledge continue to prevent effective action.
Professor Charlotte Coles
Professor Charlotte Coles
Lack of information on number of people with metastatic breast cancerEven though 20-30% of patients with early breast cancer experience relapse, relapse is not typically recorded by most national cancer registries. Therefore, the number of patients living with metastatic breast cancer is not known. Meeting the needs of an under-measured patient population is difficult, and as a result, feelings of abandonment and isolation are common among those living with the condition.
"Metastatic breast cancer remains poorly understood by the public, policymakers, and even health care professionals. Some patients have told me that they feel ‘written off’. This sense of being ignored and left behind can mean they are less likely to seek help or engage with research that could help them."Lesley Stephen, collaborator and patient advocate
Lesley added: "Patients with metastatic disease need more support and information in order to feel valued."
In the last decade, metastatic breast cancer outcomes have improved considerably. The median overall survival for the two major subtypes, which include approximately 85% of metastatic breast cancer patients, has reached five years where recommended therapies are made available. In a Commission survey of 382 healthcare professionals, more than half (55%) agreed that specific subtypes of metastatic breast cancer may become curable, and three-quarters agreed that it will become a chronic disease.
The authors make a case for a minimum of 70% of registries worldwide to record cancer stage and relapse. These data could drive significant improvements in metastatic breast cancer care, outcomes, and emotional wellbeing among patients. Initiatives that promote societal inclusion of people living with metastatic breast cancer are also paramount; for example, changes to labour market laws that empower more flexible working arrangements. With a shift in perception, it may be possible to treat most, alleviate suffering for all, and forget no-one living with the disease, the Commission argues.
The hidden costs of breast cancerThe associated costs of breast cancer – including physical, psychological, social, and financial costs – are immense but under-recognised. Many of these costs are not captured by current global health metrics.
In response, the Commission established a UK-based pilot study that provides a snapshot of the economic burden and supportive care needs for people affected by breast cancer. Nearly all of the 606 people living with breast cancer and carers surveyed by the Commission stated physical or well-being issues related to breast cancer. One participant described losing their job as as result of being unable to cope during chemotherapy, while another experienced sexual dysfunction but found it difficult to ask for help.
Additionally, a fifth of participants with early breast cancer and a quarter of those with metastatic breast cancer reported difficulty in covering the costs of travel for treatment. 27% with early breast cancer and 35% with metastatic breast cancer said they had financial problems.
This pilot research suggests that, even in countries with a health care system free at the point of care, people with breast cancer can incur hidden costs.
Building on previous work, the Commission report also discusses serious health-related suffering, an indicator of the need for palliative care, with estimates provided by a small expert group. In 2020, an estimated 120 million days were spent with serious health-related suffering per year for people who died of their cancer. A further 520 million days were estimated for patients living with the disease. Behind these numbers are individuals experiencing pain, shortness of breath, fatigue, and other, often resolvable, distressing symptoms.
"Even in countries with well-developed health care systems, patients with breast cancer experience inadequate support and care. In countries lacking affordable health care facilities, patients experience these costs more commonly and intensely, too often leading to catastrophic spending and impoverishment."Dr Carlos Barrios, Oncology Research Center, Hospital São Lucas, Brazil
The Commission advocates the development of new tools and metrics that capture the many costs associated with the disease. This measurement should guide policymakers to invest in breast cancer prevention, early detection, cost-effective therapy, optimal management, financial protection, and other interventions that relieve suffering.
Better communication for better patient outcomesMany patients describe breast cancer as robbing them of power. Therefore, healthcare professional-patient communication that empowers is highlighted by the authors as an important intervention. A review of research by the Commission suggests better communication with patients can improve quality of life, decision-making, body image, and even adherence to therapy – with positive impacts on survival.
"Improving the quality of communication between patients and health professionals, though seemingly simple, could have profound positive impacts that extend far beyond the specific setting of breast cancer management."Professor Reshma Jagsi, Emory University School of Medicine, USA
Professor Jagsi added: "Patients should be encouraged to exercise their voices, choosing their level of involvement in care decisions."
The Commission calls for every healthcare professional in every country to receive communication skills training and for patient involvement in all stages of clinical research on breast cancer – from concept to translation into clinical practice. To support these transitions, the report outlines a framework based on strategies to build rapport and empathy, share information, check understanding, and jointly agree next steps with patients.
Collaborate to improve prevention and early detectionUp to a quarter of breast cancer in high income countries could be prevented by modifying risk factors for breast cancer. While education and awareness-raising efforts are important in this respect, bold policy changes that minimise population exposure to modifiable risk factors (including alcohol consumption, being overweight, and physical inactivity) are vital to reduce cancer incidence, suggests the Commission.
In addition, systematic approaches that identify those at increased risk of the disease are essential to enable equitable access to personalised prevention strategies, including cheap and effective medications that can avert breast cancer for many women.
The authors also argue for improved early detection programmes, beginning with efforts to promote stage shifting in diagnosis so that at least 60% of confirmed invasive cancers are early disease (stages one or two).
"Access to evidence-based prevention and care that isn’t dependent on where an individual lives or their ability to pay would reap wide-ranging benefits for patients, families, and health care systems striving to achieve universal health coverage."Professor Benjamin Anderson, Departments of Surgery and Global Health, University of Washington, USA
Published 16 April 2024
Adapted from a press release by The Lancet.
Reference
Coles, CE et al. The Lancet Breast Cancer Commission. Lancet; 15 Apr 2024; DOI: 10.1016/S0140-6736(24)00747-5
Images
- Woman in white bath towel holding her hair (National Cancer Institute/Unsplash)
- Professor Charlotte Coles (Patrick Harrison/Cancer Research UK)
- Young breast cancer patient (Rebekah Voz/Unsplash)
- Oncology Portrait - stock photo (FatCamera/Getty Images)
- Asian woman with cancer meeting with female physician - stock photo (FatCamera/Getty Images)
- Nurse with young women having a mammography - stock photo (choja/Getty Images)
Many people with breast cancer ‘systematically left behind’, say researchers in Lancet Commission led by Professor Charlotte Coles.
Image: Affiliation (schools and institutions): School of Clinical MedicineDepartment of OncologyCambridge Cancer CentreExternal Affiliations: National Institute for Health Research (NIHR)LancetPeople (our academics and staff): Charlotte ColesSubject (including Spotlight on ... where applicable): Cancerbreast cancerinequalitySection: ResearchSuper Tags: Health and medicineShorthand Story Description/Subtitle: New report highlights inaction on inequities and hidden sufferingShorthand Story Thumbnail: https://www.cam.ac.uk/sites/www.cam.ac.uk/files/shorthand/245641/Fc5mFrzPLZ/assets/W4fAsv8Woo/national-cancer-institute-icm-ceifk4i-unsplash-land-bw-0.6-thumbnail.jpgReport highlights inequalities and hidden suffering among people living with breast cancer
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Report highlights inequalities and hidden suffering among people living with breast cancer
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Report highlights inequalities and hidden suffering among people living with breast cancer
Many people with breast cancer ‘systematically left behind’, say researchers
Experts predict 3 million new cases a year of breast cancer worldwide by 2040 and a million deaths, with people living in low- and middle-income countries disproportionately affected. Despite major advances in the diagnosis and treatment, inequalities mean that many women worldwide still experience significant suffering related to physical symptoms, emotional despair, and financial burden.
These are among the conclusions of the new Lancet Commission, led by Professor Charlotte Coles from the University of Cambridge, which sets out recommendations to tackle these urgent challenges in breast cancer. The Commission builds on previous evidence, presents new data, and integrates patient voices to shed light on a large unseen burden.
"Recent improvements in breast cancer survival represent a great success of modern medicine. However, we can’t ignore how many patients are being systematically left behind."Professor Charlotte Coles, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust
Professor Coles added: "We hope that, by highlighting these inequities and hidden costs and suffering in breast cancer, they can be better recognised and addressed by health care professionals and policymakers in partnership with patients and the public around the world."
At the end of 2020, 7.8 million women were alive having been diagnosed with breast cancer in the previous five years. Progress in research and cancer management has led to a decrease of over 40% in breast cancer mortality in most high-income countries. Estimates suggest that global breast cancer incidence will rise from 2.3 million new cases in 2020 to over 3 million by 2040.
Although breast cancer is the most common cancer, gaps in knowledge continue to prevent effective action.
Professor Charlotte Coles
Professor Charlotte Coles
Lack of information on number of people with metastatic breast cancerEven though 20-30% of patients with early breast cancer experience relapse, relapse is not typically recorded by most national cancer registries. Therefore, the number of patients living with metastatic breast cancer is not known. Meeting the needs of an under-measured patient population is difficult, and as a result, feelings of abandonment and isolation are common among those living with the condition.
"Metastatic breast cancer remains poorly understood by the public, policymakers, and even health care professionals. Some patients have told me that they feel ‘written off’. This sense of being ignored and left behind can mean they are less likely to seek help or engage with research that could help them."Lesley Stephen, collaborator and patient advocate
Lesley added: "Patients with metastatic disease need more support and information in order to feel valued."
In the last decade, metastatic breast cancer outcomes have improved considerably. The median overall survival for the two major subtypes, which include approximately 85% of metastatic breast cancer patients, has reached five years where recommended therapies are made available. In a Commission survey of 382 healthcare professionals, more than half (55%) agreed that specific subtypes of metastatic breast cancer may become curable, and three-quarters agreed that it will become a chronic disease.
The authors make a case for a minimum of 70% of registries worldwide to record cancer stage and relapse. These data could drive significant improvements in metastatic breast cancer care, outcomes, and emotional wellbeing among patients. Initiatives that promote societal inclusion of people living with metastatic breast cancer are also paramount; for example, changes to labour market laws that empower more flexible working arrangements. With a shift in perception, it may be possible to treat most, alleviate suffering for all, and forget no-one living with the disease, the Commission argues.
The hidden costs of breast cancerThe associated costs of breast cancer – including physical, psychological, social, and financial costs – are immense but under-recognised. Many of these costs are not captured by current global health metrics.
In response, the Commission established a UK-based pilot study that provides a snapshot of the economic burden and supportive care needs for people affected by breast cancer. Nearly all of the 606 people living with breast cancer and carers surveyed by the Commission stated physical or well-being issues related to breast cancer. One participant described losing their job as as result of being unable to cope during chemotherapy, while another experienced sexual dysfunction but found it difficult to ask for help.
Additionally, a fifth of participants with early breast cancer and a quarter of those with metastatic breast cancer reported difficulty in covering the costs of travel for treatment. 27% with early breast cancer and 35% with metastatic breast cancer said they had financial problems.
This pilot research suggests that, even in countries with a health care system free at the point of care, people with breast cancer can incur hidden costs.
Building on previous work, the Commission report also discusses serious health-related suffering, an indicator of the need for palliative care, with estimates provided by a small expert group. In 2020, an estimated 120 million days were spent with serious health-related suffering per year for people who died of their cancer. A further 520 million days were estimated for patients living with the disease. Behind these numbers are individuals experiencing pain, shortness of breath, fatigue, and other, often resolvable, distressing symptoms.
"Even in countries with well-developed health care systems, patients with breast cancer experience inadequate support and care. In countries lacking affordable health care facilities, patients experience these costs more commonly and intensely, too often leading to catastrophic spending and impoverishment."Dr Carlos Barrios, Oncology Research Center, Hospital São Lucas, Brazil
The Commission advocates the development of new tools and metrics that capture the many costs associated with the disease. This measurement should guide policymakers to invest in breast cancer prevention, early detection, cost-effective therapy, optimal management, financial protection, and other interventions that relieve suffering.
Better communication for better patient outcomesMany patients describe breast cancer as robbing them of power. Therefore, healthcare professional-patient communication that empowers is highlighted by the authors as an important intervention. A review of research by the Commission suggests better communication with patients can improve quality of life, decision-making, body image, and even adherence to therapy – with positive impacts on survival.
"Improving the quality of communication between patients and health professionals, though seemingly simple, could have profound positive impacts that extend far beyond the specific setting of breast cancer management."Professor Reshma Jagsi, Emory University School of Medicine, USA
Professor Jagsi added: "Patients should be encouraged to exercise their voices, choosing their level of involvement in care decisions."
The Commission calls for every healthcare professional in every country to receive communication skills training and for patient involvement in all stages of clinical research on breast cancer – from concept to translation into clinical practice. To support these transitions, the report outlines a framework based on strategies to build rapport and empathy, share information, check understanding, and jointly agree next steps with patients.
Collaborate to improve prevention and early detectionUp to a quarter of breast cancer in high income countries could be prevented by modifying risk factors for breast cancer. While education and awareness-raising efforts are important in this respect, bold policy changes that minimise population exposure to modifiable risk factors (including alcohol consumption, being overweight, and physical inactivity) are vital to reduce cancer incidence, suggests the Commission.
In addition, systematic approaches that identify those at increased risk of the disease are essential to enable equitable access to personalised prevention strategies, including cheap and effective medications that can avert breast cancer for many women.
The authors also argue for improved early detection programmes, beginning with efforts to promote stage shifting in diagnosis so that at least 60% of confirmed invasive cancers are early disease (stages one or two).
"Access to evidence-based prevention and care that isn’t dependent on where an individual lives or their ability to pay would reap wide-ranging benefits for patients, families, and health care systems striving to achieve universal health coverage."Professor Benjamin Anderson, Departments of Surgery and Global Health, University of Washington, USA
Published 16 April 2024
Adapted from a press release by The Lancet.
Reference
Coles, CE et al. The Lancet Breast Cancer Commission. Lancet; 15 Apr 2024; DOI: 10.1016/S0140-6736(24)00747-5
Images
- Woman in white bath towel holding her hair (National Cancer Institute/Unsplash)
- Professor Charlotte Coles (Patrick Harrison/Cancer Research UK)
- Young breast cancer patient (Rebekah Voz/Unsplash)
- Oncology Portrait - stock photo (FatCamera/Getty Images)
- Asian woman with cancer meeting with female physician - stock photo (FatCamera/Getty Images)
- Nurse with young women having a mammography - stock photo (choja/Getty Images)
Many people with breast cancer ‘systematically left behind’, say researchers in Lancet Commission led by Professor Charlotte Coles.
Image: Affiliation (schools and institutions): School of Clinical MedicineDepartment of OncologyCambridge Cancer CentreExternal Affiliations: National Institute for Health Research (NIHR)LancetPeople (our academics and staff): Charlotte ColesSubject (including Spotlight on ... where applicable): Cancerbreast cancerinequalitySection: ResearchSuper Tags: Health and medicineShorthand Story Description/Subtitle: New report highlights inaction on inequities and hidden sufferingShorthand Story Thumbnail: https://www.cam.ac.uk/sites/www.cam.ac.uk/files/shorthand/245641/Fc5mFrzPLZ/assets/W4fAsv8Woo/national-cancer-institute-icm-ceifk4i-unsplash-land-bw-0.6-thumbnail.jpgStudy unpicks why childhood maltreatment continues to impact on mental and physical health into adulthood
Individuals who experienced maltreatment in childhood – such as emotional, physical and sexual abuse, or emotional and physical neglect – are more likely to develop mental illness throughout their entire life, but it is not yet well understood why this risk persists many decades after maltreatment first took place.
In a study published in Proceedings of the National Academy of Sciences, scientists from the University of Cambridge and Leiden University found that adult brains continue to be affected by childhood maltreatment in adulthood because these experiences make individuals more likely to experience obesity, inflammation and traumatic events, all of which are risk factors for poor health and wellbeing, which in turn also affect brain structure and therefore brain health.
The researchers examined MRI brain scans from approximately 21,000 adult participants aged 40 to 70 years in UK Biobank, as well as information on body mass index (an indicator of metabolic health), CRP (a blood marker of inflammation) and experiences of childhood maltreatment and adult trauma.
Sofia Orellana, a PhD student at the Department of Psychiatry and Darwin College, University of Cambridge, said: “We’ve known for some time that people who experience abuse or neglect as a child can continue to experience mental health problems long into adulthood and that their experiences can also cause long term problems for the brain, the immune system and the metabolic system, which ultimately controls the health of your heart or your propensity to diabetes for instance. What hasn’t been clear is how all these effects interact or reinforce each other.”
Using a type of statistical modelling that allowed them to determine how these interactions work, the researchers confirmed that experiencing childhood maltreatment made individuals more likely to have an increased body mass index (or obesity) and experience greater rates of trauma in adulthood. Individuals with a history of maltreatment tended to show signs of dysfunction in their immune systems, and the researchers showed that this dysfunction is the product of obesity and repeated exposure to traumatic events.
Next, the researchers expanded their models to include MRI measures of the adult’s brains and were able to show that widespread increases and decreases in brain thickness and volume associated with greater body mass index, inflammation and trauma were attributable to childhood maltreatment having made these factors more likely in the first place. These changes in brain structure likely mean that some form of physical damage is occurring to brain cells, affecting how they work and function.
Although there is more to do to understand how these effects operate at a cellular level in the brain, the researchers believe that their findings advance our understanding of how adverse events in childhood can contribute to life-long increased risk of brain and mind health disorders.
Professor Ed Bullmore from the Department of Psychiatry and an Honorary Fellow at Downing College, Cambridge, said: “Now that we have a better understanding of why childhood maltreatment has long term effects, we can potentially look for biomarkers – biological red flags – that indicate whether an individual is at increased risk of continuing problems. This could help us target early on those who most need help, and hopefully aid them in breaking this chain of ill health.”
The research was supported by MQ: Transforming Mental Health, the Royal Society, Medical Research Council, National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre, the NIHR Applied Research Collaboration East of England, Girton College and Darwin College.
Reference
Orellana, SC et al. Childhood maltreatment influences adult brain structure through its effects on immune, metabolic and psychosocial factors. PNAS; 9 Apr 2024 ; DOI: 10.1073/pnas.230470412
Childhood maltreatment can continue to have an impact long into adulthood because of how it effects an individual’s risk of poor physical health and traumatic experiences many years later, a new study has found.
Spotlight on neuroscienceMental healthChildrenSofia OrellanaEd BullmoreMQRoyal SocietyMedical Research CouncilNIHR Cambridge Biomedical Research CentreNIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation TrustSchool of Clinical MedicineDepartment of PsychiatryGirton CollegeDowning CollegeWe’ve known for some time that people who experience abuse or neglect as a child can continue to experience mental health problems long into adulthoodSofia Orellanamali desha (Unsplash)Black and white image of boy curled up on the floor
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Study unpicks why childhood maltreatment continues to impact on mental and physical health into adulthood
Individuals who experienced maltreatment in childhood – such as emotional, physical and sexual abuse, or emotional and physical neglect – are more likely to develop mental illness throughout their entire life, but it is not yet well understood why this risk persists many decades after maltreatment first took place.
In a study published in Proceedings of the National Academy of Sciences, scientists from the University of Cambridge and Leiden University found that adult brains continue to be affected by childhood maltreatment in adulthood because these experiences make individuals more likely to experience obesity, inflammation and traumatic events, all of which are risk factors for poor health and wellbeing, which in turn also affect brain structure and therefore brain health.
The researchers examined MRI brain scans from approximately 21,000 adult participants aged 40 to 70 years in UK Biobank, as well as information on body mass index (an indicator of metabolic health), CRP (a blood marker of inflammation) and experiences of childhood maltreatment and adult trauma.
Sofia Orellana, a PhD student at the Department of Psychiatry and Darwin College, University of Cambridge, said: “We’ve known for some time that people who experience abuse or neglect as a child can continue to experience mental health problems long into adulthood and that their experiences can also cause long term problems for the brain, the immune system and the metabolic system, which ultimately controls the health of your heart or your propensity to diabetes for instance. What hasn’t been clear is how all these effects interact or reinforce each other.”
Using a type of statistical modelling that allowed them to determine how these interactions work, the researchers confirmed that experiencing childhood maltreatment made individuals more likely to have an increased body mass index (or obesity) and experience greater rates of trauma in adulthood. Individuals with a history of maltreatment tended to show signs of dysfunction in their immune systems, and the researchers showed that this dysfunction is the product of obesity and repeated exposure to traumatic events.
Next, the researchers expanded their models to include MRI measures of the adult’s brains and were able to show that widespread increases and decreases in brain thickness and volume associated with greater body mass index, inflammation and trauma were attributable to childhood maltreatment having made these factors more likely in the first place. These changes in brain structure likely mean that some form of physical damage is occurring to brain cells, affecting how they work and function.
Although there is more to do to understand how these effects operate at a cellular level in the brain, the researchers believe that their findings advance our understanding of how adverse events in childhood can contribute to life-long increased risk of brain and mind health disorders.
Professor Ed Bullmore from the Department of Psychiatry and an Honorary Fellow at Downing College, Cambridge, said: “Now that we have a better understanding of why childhood maltreatment has long term effects, we can potentially look for biomarkers – biological red flags – that indicate whether an individual is at increased risk of continuing problems. This could help us target early on those who most need help, and hopefully aid them in breaking this chain of ill health.”
The research was supported by MQ: Transforming Mental Health, the Royal Society, Medical Research Council, National Institute for Health and Care Research (NIHR) Cambridge Biomedical Research Centre, the NIHR Applied Research Collaboration East of England, Girton College and Darwin College.
Reference
Orellana, SC et al. Childhood maltreatment influences adult brain structure through its effects on immune, metabolic and psychosocial factors. PNAS; 9 Apr 2024 ; DOI: 10.1073/pnas.230470412
Childhood maltreatment can continue to have an impact long into adulthood because of how it effects an individual’s risk of poor physical health and traumatic experiences many years later, a new study has found.
Spotlight on neuroscienceMental healthChildrenSofia OrellanaEd BullmoreMQRoyal SocietyMedical Research CouncilNIHR Cambridge Biomedical Research CentreNIHR CLAHRC for Cambridgeshire and Peterborough NHS Foundation TrustSchool of Clinical MedicineDepartment of PsychiatryGirton CollegeDowning CollegeWe’ve known for some time that people who experience abuse or neglect as a child can continue to experience mental health problems long into adulthoodSofia Orellanamali desha (Unsplash)Black and white image of boy curled up on the floor
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Four Cambridge researchers awarded prestigious European Research Council Advanced Grants
The European Research Council (ERC) has announced today the award of 255 Advanced Grants to outstanding research leaders across Europe, as part of the EU’s Horizon Europe programme. Four University of Cambridge researchers are amongst those to receive this prestigious and competitive funding.
The University of Cambridge’s grant awardees are:
Dr Albert Guillén i Fàbregas in the Department of Engineering for his project Scaling and Concentration Laws in Information Theory.
Fàbregas, who has previously received ERC Starting, Consolidator and Proof of Concept Grants, said: “I am truly delighted with the news that the ERC will continue to fund my research in information theory, which studies the mathematical aspects of data transmission and data compression.
“This project will broaden the theory to study arbitrary scaling laws of the number of messages to transmit or compress."
Professor Beverley Glover in the Department of Plant Sciences and Director of Cambridge University Botanic Garden, for her project Convergent evolution of floral patterning through alternative optimisation of mechanical parameter space.
Glover said: “This funding will enable us to explore how iridescent colour evolved repeatedly in different flowers. We think it will shed new light on evolution itself, as we think about the development of iridescence structure from a mechanical perspective, focusing on the forces acting as a petal grows and the mechanical properties of the petal tissue.
“It's only possible for me to do this work because of the amazing living collection at Cambridge University Botanic Garden, and I'm thrilled that the ERC is keen to support it."
Professor Ian Henderson in the Department of Plant Sciences for his project Evolution of the Arabidopsis Pancentromere.
Henderson said: “This project seeks to investigate enigmatic regions of the genome called the centromeres, using the model plant Arabidopsis. These regions play a deeply conserved role in cell division yet paradoxically are fast evolving.
“I am highly honoured and excited to be awarded an ERC Advanced grant. The advent of long-read sequencing technology makes addressing these questions timely. The ERC’s long-term support will allow us to capitalise on these advances, build new collaborations, and train postdoctoral researchers.”
Professor Paul Lane in the Department of Archaeology, for his project Landscape Historical Ecology and Archaeology of Ancient Pastoral Societies in Kenya.
Lane said: “Pastoralism has been an extraordinarily resilient livelihood strategy across Africa. This project provides an excellent opportunity to reconstruct how East Africa’s pastoralists responded to significant climate change in the past, and to draw lessons from these adaptations for responding to contemporary climate crises in a region that is witnessing heightened water scarcity and loss of access to critically important grazing lands.”
“This project will allow us to utilise the department’s world-leading archaeological science laboratories and expertise to answer crucial questions about past patterns of mobility, dietary diversity, climatic regimes and food security among East African pastoralists over the last fifteen hundred years. This has never been attempted before for this time period.”
Professor Anne Ferguson-Smith, Pro-Vice Chancellor for Research at the University of Cambridge said: “Many congratulations to Albert, Beverley, Ian and Paul on receiving these prestigious and highly competitive awards. It is fantastic that their ambitious, cutting-edge research will be supported by the European Research Council, marking them as outstanding European research leaders.
“Now that the UK is an associated country to Horizon Europe I encourage other Cambridge researchers to also consider applying to the ERC and other Horizon Europe programmes.”
President of the European Research Council Professor Maria Leptin said: “Congratulations to the 255 researchers who will receive grants to follow their scientific instinct in this new funding round. I am particularly happy to see more mid-career scientists amongst the Advanced Grant winners this time. I hope that it will encourage more researchers at this career stage to apply for these grants.”
The ERC is the premier European funding organisation for excellent frontier research. The 255 ERC Advanced Grants, totalling €652 million, support cutting-edge research in a wide range of fields from medicine and physics to social sciences and humanities.
The European Commission and the UK Government have reached an agreement on the association of the UK to Horizon Europe, which applies for calls for proposals implementing the 2024 budget and onwards.
The ERC Advanced Grants target established, leading researchers with a proven track-record of significant achievements. In recent years, there has been a steady rise in mid-career researchers (12-17 years post-PhD), who have been successful in the Advanced Grants competitions, with 18% securing grants in this latest round.
The funding provides leading senior researchers with the opportunity to pursue ambitious, curiosity-driven projects that could lead to major scientific breakthroughs.
Engineeringplant sciencesArchaeologyAlbert Guillén i FàbregasBeverley GloverIan HendersonPaul LaneEuropean Research CouncilDepartment of EngineeringSchool of TechnologyDepartment of Plant SciencesCambridge University Botanic GardenSchool of the Biological SciencesDepartment of ArchaeologySchool of the Humanities and Social SciencesMagdalene CollegeQueens' CollegeGonville and Caius CollegeMany congratulations to Albert, Beverley, Ian and Paul... It is fantastic that their ambitious, cutting-edge research will be supported by the European Research Council, marking them as outstanding European research leaders.Anne Ferguson-Smith
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Four Cambridge researchers awarded prestigious European Research Council Advanced Grants
The European Research Council (ERC) has announced today the award of 255 Advanced Grants to outstanding research leaders across Europe, as part of the EU’s Horizon Europe programme. Four University of Cambridge researchers are amongst those to receive this prestigious and competitive funding.
The University of Cambridge’s grant awardees are:
Dr Albert Guillén i Fàbregas in the Department of Engineering for his project Scaling and Concentration Laws in Information Theory.
Fàbregas, who has previously received ERC Starting, Consolidator and Proof of Concept Grants, said: “I am truly delighted with the news that the ERC will continue to fund my research in information theory, which studies the mathematical aspects of data transmission and data compression.
“This project will broaden the theory to study arbitrary scaling laws of the number of messages to transmit or compress."
Professor Beverley Glover in the Department of Plant Sciences and Director of Cambridge University Botanic Garden, for her project Convergent evolution of floral patterning through alternative optimisation of mechanical parameter space.
Glover said: “This funding will enable us to explore how iridescent colour evolved repeatedly in different flowers. We think it will shed new light on evolution itself, as we think about the development of iridescence structure from a mechanical perspective, focusing on the forces acting as a petal grows and the mechanical properties of the petal tissue.
“It's only possible for me to do this work because of the amazing living collection at Cambridge University Botanic Garden, and I'm thrilled that the ERC is keen to support it."
Professor Ian Henderson in the Department of Plant Sciences for his project Evolution of the Arabidopsis Pancentromere.
Henderson said: “This project seeks to investigate enigmatic regions of the genome called the centromeres, using the model plant Arabidopsis. These regions play a deeply conserved role in cell division yet paradoxically are fast evolving.
“I am highly honoured and excited to be awarded an ERC Advanced grant. The advent of long-read sequencing technology makes addressing these questions timely. The ERC’s long-term support will allow us to capitalise on these advances, build new collaborations, and train postdoctoral researchers.”
Professor Paul Lane in the Department of Archaeology, for his project Landscape Historical Ecology and Archaeology of Ancient Pastoral Societies in Kenya.
Lane said: “Pastoralism has been an extraordinarily resilient livelihood strategy across Africa. This project provides an excellent opportunity to reconstruct how East Africa’s pastoralists responded to significant climate change in the past, and to draw lessons from these adaptations for responding to contemporary climate crises in a region that is witnessing heightened water scarcity and loss of access to critically important grazing lands.”
“This project will allow us to utilise the department’s world-leading archaeological science laboratories and expertise to answer crucial questions about past patterns of mobility, dietary diversity, climatic regimes and food security among East African pastoralists over the last fifteen hundred years. This has never been attempted before for this time period.”
Professor Anne Ferguson-Smith, Pro-Vice Chancellor for Research at the University of Cambridge said: “Many congratulations to Albert, Beverley, Ian and Paul on receiving these prestigious and highly competitive awards. It is fantastic that their ambitious, cutting-edge research will be supported by the European Research Council, marking them as outstanding European research leaders.
“Now that the UK is an associated country to Horizon Europe I encourage other Cambridge researchers to also consider applying to the ERC and other Horizon Europe programmes.”
President of the European Research Council Professor Maria Leptin said: “Congratulations to the 255 researchers who will receive grants to follow their scientific instinct in this new funding round. I am particularly happy to see more mid-career scientists amongst the Advanced Grant winners this time. I hope that it will encourage more researchers at this career stage to apply for these grants.”
The ERC is the premier European funding organisation for excellent frontier research. The 255 ERC Advanced Grants, totalling €652 million, support cutting-edge research in a wide range of fields from medicine and physics to social sciences and humanities.
The European Commission and the UK Government have reached an agreement on the association of the UK to Horizon Europe, which applies for calls for proposals implementing the 2024 budget and onwards.
The ERC Advanced Grants target established, leading researchers with a proven track-record of significant achievements. In recent years, there has been a steady rise in mid-career researchers (12-17 years post-PhD), who have been successful in the Advanced Grants competitions, with 18% securing grants in this latest round.
The funding provides leading senior researchers with the opportunity to pursue ambitious, curiosity-driven projects that could lead to major scientific breakthroughs.
Engineeringplant sciencesArchaeologyAlbert Guillén i FàbregasBeverley GloverIan HendersonPaul LaneEuropean Research CouncilDepartment of EngineeringSchool of TechnologyDepartment of Plant SciencesCambridge University Botanic GardenSchool of the Biological SciencesDepartment of ArchaeologySchool of the Humanities and Social SciencesMagdalene CollegeQueens' CollegeGonville and Caius CollegeMany congratulations to Albert, Beverley, Ian and Paul... It is fantastic that their ambitious, cutting-edge research will be supported by the European Research Council, marking them as outstanding European research leaders.Anne Ferguson-Smith
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Pork labelling schemes ‘not helpful’ in making informed buying choices, say researchers
Researchers have evaluated different types of pig farming – including woodland, organic, free range, RSPCA assured, and Red Tractor certified, to assess each systems’ impact across four areas: land use (representing biodiversity loss), greenhouse gas emissions, antibiotics use and animal welfare. Their study concludes that none of the farm types performed consistently well across all four areas – a finding that has important implications for increasingly climate conscious consumers, as well as farmers themselves.
However, there were individual farms that did perform well in all domains, including an indoor Red Tractor farm, an outdoor bred, indoor finished RSPCA assured farm and fully outdoor woodland farm. “Outliers like these show that trade-offs are not inevitable,” said lead author Dr Harriet Bartlett, Research Associate at the University of Oxford's Smith School of Enterprise and the Environment, who was formerly at the University of Cambridge.
“Somewhat unexpectedly we found that a handful of farms perform far better than average across all four of our environmental and welfare measures,” added senior author Andrew Balmford, Professor of Conservation Science at the University of Cambridge. However, none of the current label or assurance schemes predicted which farms these would be.
“The way we classify farm types and label pork isn’t helpful for making informed decisions when it comes to buying more sustainable meat. Even more importantly, we aren’t rewarding and incentivising the best-performing farmers. Instead of focusing on farm types or practices, we need to focus on meaningful outcomes for people, the planet and the pigs – and assess, and reward farms based on these,” said Bartlett.
The findings also show that common assumptions around food labelling can be misplaced. For instance, Organic farming systems, which consumers might see as climate and environmentally friendly, have on average three times the CO2 output per kg of meat of more intensive Red Tractor or RSPCA assured systems and four times the land use. However, these same systems use on average almost 90% fewer antibiotic medicines, and result in improved animal welfare compared with production from Red tractor or RSPCA assured systems.
The way we classify livestock farms must be improved, Bartlett says, because livestock production is growing rapidly, especially pork production, which has quadrupled in the past 50 years and already accounts for 9% of greenhouse gas emissions from livestock. Pig farming also uses more antibiotics than any other livestock sector, and 8.5% of all arable land.
“Our findings show that mitigating the environmental impacts of livestock farming isn’t a case of saying which farm type is the best,” said Bartlett. “There is substantial scope for improvement within types, and our current means of classification is not identifying the best farms for the planet and animals overall. Instead, we need to identify farms that successfully limit their impacts across all areas of societal concern, and understand, promote and incentivise their practises.”
The study reached its conclusions using data from 74 UK and 17 Brazilian breed-to-finish systems, each made up of 1-3 farms and representing the annual production of over 1.2 million pigs. It is published today in the journal Nature Food.
“To the best of our knowledge, our dataset covers by far the largest and most diverse sample of pig production systems examined in any single study,” said Bartlett.
James Wood, Professor of Equine and Farm Animal Science at the University of Cambridge, commented: “This important study identifies a key need to clarify what different farm labels should indicate to consumers; there is a pressing need to extend this work into other farming sectors. It also clearly demonstrates the critical importance that individual farmers play in promoting best practice across all farming systems.”
Trade-offs in the externalities of pig production are not inevitable was authored by academics at the University of Oxford, University of Cambridge and the University of São Paulo.
The research was funded by the Biotechnology and Biological Sciences Research Council (BBSRC).
Reference: Bartlett, H.,‘Trade-offs in the externalities of pig production are not inevitable.’ Nature Food, April 2024. DOI: 10.1038/s43016-024-00921-2
Adapted from a press release by the University of Oxford.
Farmers don’t have to choose between lowering environmental impact and improving welfare for their pigs, a new study has found: it is possible to do both. But this is not reflected in the current food labelling schemes relied on by consumers.
food systemGlobal food securityEnvironmentHarriet BartlettJames WoodMark HolmesAndrew BalmfordUniversity of OxfordUniversidade de Sao PauloDepartment of Veterinary MedicineDepartment of ZoologySchool of the Biological SciencesCambridge Global Food Security Interdisciplinary Research CentreChurchill CollegeThe way we classify farm types and label pork isn’t helpful for making informed decisions when it comes to buying more sustainable meat.Harriet BartlettCharity Burggraaf/ GettyTwo pigs on a farm
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Pork labelling schemes ‘not helpful’ in making informed buying choices, say researchers
Researchers have evaluated different types of pig farming – including woodland, organic, free range, RSPCA assured, and Red Tractor certified, to assess each systems’ impact across four areas: land use (representing biodiversity loss), greenhouse gas emissions, antibiotics use and animal welfare. Their study concludes that none of the farm types performed consistently well across all four areas – a finding that has important implications for increasingly climate conscious consumers, as well as farmers themselves.
However, there were individual farms that did perform well in all domains, including an indoor Red Tractor farm, an outdoor bred, indoor finished RSPCA assured farm and fully outdoor woodland farm. “Outliers like these show that trade-offs are not inevitable,” said lead author Dr Harriet Bartlett, Research Associate at the University of Oxford's Smith School of Enterprise and the Environment, who was formerly at the University of Cambridge.
“Somewhat unexpectedly we found that a handful of farms perform far better than average across all four of our environmental and welfare measures,” added senior author Andrew Balmford, Professor of Conservation Science at the University of Cambridge. However, none of the current label or assurance schemes predicted which farms these would be.
“The way we classify farm types and label pork isn’t helpful for making informed decisions when it comes to buying more sustainable meat. Even more importantly, we aren’t rewarding and incentivising the best-performing farmers. Instead of focusing on farm types or practices, we need to focus on meaningful outcomes for people, the planet and the pigs – and assess, and reward farms based on these,” said Bartlett.
The findings also show that common assumptions around food labelling can be misplaced. For instance, Organic farming systems, which consumers might see as climate and environmentally friendly, have on average three times the CO2 output per kg of meat of more intensive Red Tractor or RSPCA assured systems and four times the land use. However, these same systems use on average almost 90% fewer antibiotic medicines, and result in improved animal welfare compared with production from Red tractor or RSPCA assured systems.
The way we classify livestock farms must be improved, Bartlett says, because livestock production is growing rapidly, especially pork production, which has quadrupled in the past 50 years and already accounts for 9% of greenhouse gas emissions from livestock. Pig farming also uses more antibiotics than any other livestock sector, and 8.5% of all arable land.
“Our findings show that mitigating the environmental impacts of livestock farming isn’t a case of saying which farm type is the best,” said Bartlett. “There is substantial scope for improvement within types, and our current means of classification is not identifying the best farms for the planet and animals overall. Instead, we need to identify farms that successfully limit their impacts across all areas of societal concern, and understand, promote and incentivise their practises.”
The study reached its conclusions using data from 74 UK and 17 Brazilian breed-to-finish systems, each made up of 1-3 farms and representing the annual production of over 1.2 million pigs. It is published today in the journal Nature Food.
“To the best of our knowledge, our dataset covers by far the largest and most diverse sample of pig production systems examined in any single study,” said Bartlett.
James Wood, Professor of Equine and Farm Animal Science at the University of Cambridge, commented: “This important study identifies a key need to clarify what different farm labels should indicate to consumers; there is a pressing need to extend this work into other farming sectors. It also clearly demonstrates the critical importance that individual farmers play in promoting best practice across all farming systems.”
Trade-offs in the externalities of pig production are not inevitable was authored by academics at the University of Oxford, University of Cambridge and the University of São Paulo.
The research was funded by the Biotechnology and Biological Sciences Research Council (BBSRC).
Reference: Bartlett, H.,‘Trade-offs in the externalities of pig production are not inevitable.’ Nature Food, April 2024. DOI: 10.1038/s43016-024-00921-2
Adapted from a press release by the University of Oxford.
Farmers don’t have to choose between lowering environmental impact and improving welfare for their pigs, a new study has found: it is possible to do both. But this is not reflected in the current food labelling schemes relied on by consumers.
food systemGlobal food securityEnvironmentHarriet BartlettJames WoodMark HolmesAndrew BalmfordUniversity of OxfordUniversidade de Sao PauloDepartment of Veterinary MedicineDepartment of ZoologySchool of the Biological SciencesCambridge Global Food Security Interdisciplinary Research CentreChurchill CollegeThe way we classify farm types and label pork isn’t helpful for making informed decisions when it comes to buying more sustainable meat.Harriet BartlettCharity Burggraaf/ GettyTwo pigs on a farm
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Pork labelling schemes ‘not helpful’ in making informed buying choices, say researchers
Researchers have evaluated different types of pig farming – including woodland, organic, free range, RSPCA assured, and Red Tractor certified, to assess each systems’ impact across four areas: land use (representing biodiversity loss), greenhouse gas emissions, antibiotics use and animal welfare. Their study concludes that none of the farm types performed consistently well across all four areas – a finding that has important implications for increasingly climate conscious consumers, as well as farmers themselves.
However, there were individual farms that did perform well in all domains, including an indoor Red Tractor farm, an outdoor bred, indoor finished RSPCA assured farm and fully outdoor woodland farm. “Outliers like these show that trade-offs are not inevitable,” said lead author Dr Harriet Bartlett, Research Associate at the University of Oxford's Smith School of Enterprise and the Environment, who was formerly at the University of Cambridge.
“Somewhat unexpectedly we found that a handful of farms perform far better than average across all four of our environmental and welfare measures,” added senior author Andrew Balmford, Professor of Conservation Science at the University of Cambridge. However, none of the current label or assurance schemes predicted which farms these would be.
“The way we classify farm types and label pork isn’t helpful for making informed decisions when it comes to buying more sustainable meat. Even more importantly, we aren’t rewarding and incentivising the best-performing farmers. Instead of focusing on farm types or practices, we need to focus on meaningful outcomes for people, the planet and the pigs – and assess, and reward farms based on these,” said Bartlett.
The findings also show that common assumptions around food labelling can be misplaced. For instance, Organic farming systems, which consumers might see as climate and environmentally friendly, have on average three times the CO2 output per kg of meat of more intensive Red Tractor or RSPCA assured systems and four times the land use. However, these same systems use on average almost 90% fewer antibiotic medicines, and result in improved animal welfare compared with production from Red tractor or RSPCA assured systems.
The way we classify livestock farms must be improved, Bartlett says, because livestock production is growing rapidly, especially pork production, which has quadrupled in the past 50 years and already accounts for 9% of greenhouse gas emissions from livestock. Pig farming also uses more antibiotics than any other livestock sector, and 8.5% of all arable land.
“Our findings show that mitigating the environmental impacts of livestock farming isn’t a case of saying which farm type is the best,” said Bartlett. “There is substantial scope for improvement within types, and our current means of classification is not identifying the best farms for the planet and animals overall. Instead, we need to identify farms that successfully limit their impacts across all areas of societal concern, and understand, promote and incentivise their practises.”
The study reached its conclusions using data from 74 UK and 17 Brazilian breed-to-finish systems, each made up of 1-3 farms and representing the annual production of over 1.2 million pigs. It is published today in the journal Nature Food.
“To the best of our knowledge, our dataset covers by far the largest and most diverse sample of pig production systems examined in any single study,” said Bartlett.
James Wood, Professor of Equine and Farm Animal Science at the University of Cambridge, commented: “This important study identifies a key need to clarify what different farm labels should indicate to consumers; there is a pressing need to extend this work into other farming sectors. It also clearly demonstrates the critical importance that individual farmers play in promoting best practice across all farming systems.”
Trade-offs in the externalities of pig production are not inevitable was authored by academics at the University of Oxford, University of Cambridge and the University of São Paulo.
The research was funded by the Biotechnology and Biological Sciences Research Council (BBSRC).
Reference: Bartlett, H.,‘Trade-offs in the externalities of pig production are not inevitable.’ Nature Food, April 2024. DOI: 10.1038/s43016-024-00921-2
Adapted from a press release by the University of Oxford.
Farmers don’t have to choose between lowering environmental impact and improving welfare for their pigs, a new study has found: it is possible to do both. But this is not reflected in the current food labelling schemes relied on by consumers.
food systemGlobal food securityEnvironmentHarriet BartlettJames WoodMark HolmesAndrew BalmfordUniversity of OxfordUniversidade de Sao PauloDepartment of Veterinary MedicineDepartment of ZoologySchool of the Biological SciencesCambridge Global Food Security Interdisciplinary Research CentreChurchill CollegeThe way we classify farm types and label pork isn’t helpful for making informed decisions when it comes to buying more sustainable meat.Harriet BartlettCharity Burggraaf/ GettyTwo pigs on a farm
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.
Pork labelling schemes ‘not helpful’ in making informed buying choices, say researchers
Researchers have evaluated different types of pig farming – including woodland, organic, free range, RSPCA assured, and Red Tractor certified, to assess each systems’ impact across four areas: land use (representing biodiversity loss), greenhouse gas emissions, antibiotics use and animal welfare. Their study concludes that none of the farm types performed consistently well across all four areas – a finding that has important implications for increasingly climate conscious consumers, as well as farmers themselves.
However, there were individual farms that did perform well in all domains, including an indoor Red Tractor farm, an outdoor bred, indoor finished RSPCA assured farm and fully outdoor woodland farm. “Outliers like these show that trade-offs are not inevitable,” said lead author Dr Harriet Bartlett, Research Associate at the University of Oxford's Smith School of Enterprise and the Environment, who was formerly at the University of Cambridge.
“Somewhat unexpectedly we found that a handful of farms perform far better than average across all four of our environmental and welfare measures,” added senior author Andrew Balmford, Professor of Conservation Science at the University of Cambridge. However, none of the current label or assurance schemes predicted which farms these would be.
“The way we classify farm types and label pork isn’t helpful for making informed decisions when it comes to buying more sustainable meat. Even more importantly, we aren’t rewarding and incentivising the best-performing farmers. Instead of focusing on farm types or practices, we need to focus on meaningful outcomes for people, the planet and the pigs – and assess, and reward farms based on these,” said Bartlett.
The findings also show that common assumptions around food labelling can be misplaced. For instance, Organic farming systems, which consumers might see as climate and environmentally friendly, have on average three times the CO2 output per kg of meat of more intensive Red Tractor or RSPCA assured systems and four times the land use. However, these same systems use on average almost 90% fewer antibiotic medicines, and result in improved animal welfare compared with production from Red tractor or RSPCA assured systems.
The way we classify livestock farms must be improved, Bartlett says, because livestock production is growing rapidly, especially pork production, which has quadrupled in the past 50 years and already accounts for 9% of greenhouse gas emissions from livestock. Pig farming also uses more antibiotics than any other livestock sector, and 8.5% of all arable land.
“Our findings show that mitigating the environmental impacts of livestock farming isn’t a case of saying which farm type is the best,” said Bartlett. “There is substantial scope for improvement within types, and our current means of classification is not identifying the best farms for the planet and animals overall. Instead, we need to identify farms that successfully limit their impacts across all areas of societal concern, and understand, promote and incentivise their practises.”
The study reached its conclusions using data from 74 UK and 17 Brazilian breed-to-finish systems, each made up of 1-3 farms and representing the annual production of over 1.2 million pigs. It is published today in the journal Nature Food.
“To the best of our knowledge, our dataset covers by far the largest and most diverse sample of pig production systems examined in any single study,” said Bartlett.
James Wood, Professor of Equine and Farm Animal Science at the University of Cambridge, commented: “This important study identifies a key need to clarify what different farm labels should indicate to consumers; there is a pressing need to extend this work into other farming sectors. It also clearly demonstrates the critical importance that individual farmers play in promoting best practice across all farming systems.”
Trade-offs in the externalities of pig production are not inevitable was authored by academics at the University of Oxford, University of Cambridge and the University of São Paulo.
The research was funded by the Biotechnology and Biological Sciences Research Council (BBSRC).
Reference: Bartlett, H.,‘Trade-offs in the externalities of pig production are not inevitable.’ Nature Food, April 2024. DOI: 10.1038/s43016-024-00921-2
Adapted from a press release by the University of Oxford.
Farmers don’t have to choose between lowering environmental impact and improving welfare for their pigs, a new study has found: it is possible to do both. But this is not reflected in the current food labelling schemes relied on by consumers.
food systemGlobal food securityEnvironmentHarriet BartlettJames WoodMark HolmesAndrew BalmfordUniversity of OxfordUniversidade de Sao PauloDepartment of Veterinary MedicineDepartment of ZoologySchool of the Biological SciencesCambridge Global Food Security Interdisciplinary Research CentreChurchill CollegeThe way we classify farm types and label pork isn’t helpful for making informed decisions when it comes to buying more sustainable meat.Harriet BartlettCharity Burggraaf/ GettyTwo pigs on a farm
The text in this work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License. Images, including our videos, are Copyright ©University of Cambridge and licensors/contributors as identified. All rights reserved. We make our image and video content available in a number of ways – on our main website under its Terms and conditions, and on a range of channels including social media that permit your use and sharing of our content under their respective Terms.