The effects on public health of climate change adaptation responses: a systematic review of evidence from low- and middle-income countries

Climate change adaptation responses are being developed and delivered in many parts of the world in the absence of detailed knowledge of their effects on public health. Here we present the results of a systematic review of peer-reviewed literature reporting the effects on health of climate change adaptation responses in low- and middle-income countries (LMICs). The review used the 'Global Adaptation Mapping Initiative' database (comprising 1682 publications related to climate change adaptation responses) that was constructed through systematic literature searches in Scopus, Web of Science and Google Scholar (2013–2020). For this study, further screening was performed to identify studies from LMICs reporting the effects on human health of climate change adaptation responses. Studies were categorised by study design and data were extracted on geographic region, population under investigation, type of adaptation response and reported health effects. The review identified 99 studies (1117 reported outcomes), reporting evidence from 66 LMICs. Only two studies were ex ante formal evaluations of climate change adaptation responses. Papers reported adaptation responses related to flooding, rainfall, drought and extreme heat, predominantly through behaviour change, and infrastructural and technological improvements. Reported (direct and intermediate) health outcomes included reduction in infectious disease incidence, improved access to water/sanitation and improved food security. All-cause mortality was rarely reported, and no papers were identified reporting on maternal and child health. Reported maladaptations were predominantly related to widening of inequalities and unforeseen co-harms. Reporting and publication-bias seems likely with only 3.5% of all 1117 health outcomes reported to be negative. Our review identified some evidence that climate change adaptation responses may have benefits for human health but the overall paucity of evidence is concerning and represents a major missed opportunity for learning. There is an urgent need for greater focus on the funding, design, evaluation and standardised reporting of the effects on health of climate change adaptation responses to enable evidence-based policy action

Pan-cancer analysis of whole genomes

Cancer is driven by genetic change, and the advent of massively parallel sequencing has enabled systematic documentation of this variation at the whole-genome scale(1-3). Here we report the integrative analysis of 2,658 whole-cancer genomes and their matching normal tissues across 38 tumour types from the Pan-Cancer Analysis of Whole Genomes (PCAWG) Consortium of the International Cancer Genome Consortium (ICGC) and The Cancer Genome Atlas (TCGA). We describe the generation of the PCAWG resource, facilitated by international data sharing using compute clouds. On average, cancer genomes contained 4-5 driver mutations when combining coding and non-coding genomic elements; however, in around 5% of cases no drivers were identified, suggesting that cancer driver discovery is not yet complete. Chromothripsis, in which many clustered structural variants arise in a single catastrophic event, is frequently an early event in tumour evolution; in acral melanoma, for example, these events precede most somatic point mutations and affect several cancer-associated genes simultaneously. Cancers with abnormal telomere maintenance often originate from tissues with low replicative activity and show several mechanisms of preventing telomere attrition to critical levels. Common and rare germline variants affect patterns of somatic mutation, including point mutations, structural variants and somatic retrotransposition. A collection of papers from the PCAWG Consortium describes non-coding mutations that drive cancer beyond those in the TERT promoter(4); identifies new signatures of mutational processes that cause base substitutions, small insertions and deletions and structural variation(5,6); analyses timings and patterns of tumour evolution(7); describes the diverse transcriptional consequences of somatic mutation on splicing, expression levels, fusion genes and promoter activity(8,9); and evaluates a range of more-specialized features of cancer genomes(8,10-18).Peer reviewe

Progetto integrato per la ricerca traslazionale nel carcinoma duttale del pancreas [Integrated project for the translational research on pancreatic ductal carcinoma]

The narrow chances of therapy and the poor prognosis of pancreatic cancer make basic research a crucial way for both a better knowledge and a possible improvement in the treatment of this disease. The very limited availability of pancreatic specimen for genetic and biological studies forced the researchers to plan "in vitro" and "in vivo" models in order to overcome this handicap. Among the animal models, the one according to Fu et al. seemed to be the most helpful and effective approach. Nevertheless, being this model complex and failing in main perspective applications, an enlarged project perpetuating B-lymphocytes of the patients, successfully xenografting from vitally criopreserved specimen and developing cell lines from xenografts was planned. According to the aim of our project, a really perpetual and renewable bank of tumoral and normal tissue from patients suffering from pancreatic carcinoma was obtained. This model is also expected to be an effective approach for the evaluation of experimental chemotherapeutic schedules and new gene therapy assessment

Establishment and characterization of a vitally cryopreserved tissue bank for pancreatic cancer. Vol. 41

The Authors established a cryopreserved tissue bank and xenografting facility for the study of human pancreatic cance

Establishment and characterization of a vitally cryopreserved tissue bank for pancreatic cancer. Vol. 41

The Authors established a cryopreserved tissue bank and xenografting facility for the study of human pancreatic cance