Halal cultivated meat: an untapped opportunity.

The global Halal food market is forecast to reach US$1.67 trillion by 2025, growing to meet the dietary demands of a rapidly increasing Muslim population, set to comprise 30% of the global population by mid-century. Meat consumption levels are increasing in many Muslim countries, with important implications for health and environmental sustainability. Alt protein products are currently being manufactured and positioned as one possible solution to reduce the environmental impact of meat consumption, yet, little is currently known about the Halal status of these products, nor the extent to which they appeal to Muslim consumers in emerging markets in Asia and Africa. Here, we explore key considerations regarding the acceptability of alt protein products for Muslim consumers, explore Halal certification requirements in the context of cultivated meat, and examine some unique beliefs within the Islamic faith that may support, as well as impede, widespread adoption of alt protein among the 2.8 billion Muslims of the future.

How does Linkage to the National Death Index Affect Population-Based Net Survival Estimates for Women with Cervical Cancer in Saudi Arabia?

BACKGROUND: Population-based cancer survival is a key metric for the assessment of cancer control strategies. Accurate estimation of cancer survival requires complete follow-up data for all patients. AIM: To explore the impact of linking national cancer registry data to the national death index on net survival estimates for women diagnosed with cervical cancer in Saudi Arabia during 2005-2016. METHODS: We acquired data on 1,250 Saudi women diagnosed with invasive cervical cancer during the 12- year period 2005-2016 from the Saudi Cancer Registry. These included the woman's last known vital status and the date of last known vital status, but this was restricted to information from clinical records and death certificates that mention cancer as a cause of death ("registry follow-up"). We submitted available national ID numbers to the National Information Center (NIC) of the Ministry of Interior, to ascertain the date of death, from any cause of death, for women who had died up until 31 December 2018 ("NIC follow-up"). We estimated age-standardised 5-year net survival using the Pohar-Perme estimator under five different scenarios using the two sources of follow-up, and censoring at the date of last contact with the registry versus extending survival until the closing date if no information on death was obtained. RESULTS: 1,219 women were eligible for survival analysis. Five-year net survival was lowest when using NIC followup only (56.8%; 95%CI 53.5 - 60.1%), and highest when registry follow-up only was used and survival time was extended until closure date for those with no information on death (81.8%; 95%CI 79.6 - 84%). CONCLUSION: Reliance solely on information from deaths certified as due to cancer and clinical records leads to a high proportion of missing deaths in the national cancer registry. This is probably due to low quality of certification of the cause of death in Saudi Arabia. Linkage of the national cancer registry to the national death index at the NIC identifies virtually all deaths, providing more reliable survival estimates, and it eliminates the ambiguity in determining the underlying cause of death. Therefore, this should become the standard approach to estimating cancer survival in Saudi Arabia.

National cancer control plans across the Eastern Mediterranean region: challenges and opportunities to scale-up.

National cancer control planning is crucial for countries in the WHO Eastern Mediterranean region. This region is challenged with an increase in cancer incidence leading to substantial disease burden, premature deaths, and increasing health-care costs in most countries. Huge inequity in cancer control planning and implementation exists between and within the countries. Over half of the countries (12 [55%] of 22) have standalone comprehensive National Cancer Control Plans and six (27%) have non-communicable disease plans that include cancer. The implementation of cancer plans has common challenges related to weak governance structure, few coordination mechanisms within countries, and inadequate human and financial resources. In most countries, the plan is not costed. Yet, the majority of countries (20 [91%]) reported having fully or partially funded plans. Additionally, political instability and conflicts affecting over half of the countries in the Eastern Mediterranean region have enormously affected cancer planning and implementation, both among the affected countries and those that host large numbers of refugees. In this Policy Review, we used the WHO regional framework for action on cancer to systematically analyse the status of cancer control planning and implementation across the six domains of cancer control, from prevention to palliation. We highlight the gaps, and the opportunities for bridging these gaps, to achieve scale-up on implementation of cancer control programmes in the Eastern Mediterranean region.

Disparities in cervical cancer survival in the United States by race and stage at diagnosis: An analysis of 138,883 women diagnosed between 2001 and 2014 (CONCORD-3).

OBJECTIVE: During 2000-2014, age-standardized five-year net survival for cervical cancer was 63-64% in the United States. Using data from CONCORD-3, we analyzed cervical cancer survival trends by race, stage and period of diagnosis. METHODS: Data from 41 state-wide population-based cancer registries on 138,883 women diagnosed with cervical cancer during 2001-2014 were available. Vital status was followed up until December 31, 2014. We estimated age-standardized five-year net survival, by race (Black or White), stage and calendar period of diagnosis (2001-2003, 2004-2008, 2009-2014) in each state, and for all participating states combined. RESULTS: White women were most commonly diagnosed with localized tumors (45-50%). However, for Black women, localized tumors were the most common stage (43.0%) only during 2001-2003. A smaller proportion of Black women received cancer-directed surgery than White women. For all stages combined, five-year survival decreased between 2001-2003 and 2009-2014 for both White (64.7% to 63.0%) and Black (56.7% to 55.8%) women. For localized and regional tumors, survival increased over the same period for both White (by 2-3%) and Black women (by 5%). Survival did not change for Black women diagnosed with distant tumors but increased by around 2% for White women. CONCLUSIONS: Despite similar screening coverage for both Black and White women and improvements in stage-specific survival, Black women still have poorer survival than White women. This may be partially explained by inequities in access to optimal treatment. The results from this study highlight the continuing need to address the disparity in cervical cancer survival between White and Black women in the United States.

Residential traffic noise exposure and headaches: Results from the population-based heinz nixdorf recall study.

CONTEXT AND AIM: The link between headaches and exposure to loud noise in occupational settings has been established. However, the effect of less intense but chronic residential traffic noise exposure on headache occurrence is less clear. SETTINGS AND DESIGN: We included 3,025 participants from the Heinz Nixdorf Recall study in Germany for this cross-sectional analysis. METHODS AND MATERIAL: Residential road traffic noise exposure at the 2006-2008 address was modelled in A-weighted decibels (dB(A)) according to the European Noise Directive (2002/49/EC) for 24-hour (Lden) and night-time noise (22-6 h, Lnight). Indoor traffic noise exposure was obtained by modifying Lden and Lnight based on residence orientation, window type, and personal window opening habits. Traffic noise exposure below 55, 45 dB(A), 35 and 25 dB(A) were set as the reference for Lden, Lnight, Lden,indoor and Lnight,indoor, respectively. Average number of days with headache per month over the past three months was ascertained during the follow-up (2011-2015) medical interview. STATISTICAL ANALYSIS USED: Prevalence Odds Ratios (POR) of having eight or more headaches per month per 5 dB(A) increase in traffic noise exposure were calculated using logistic regression, adjusting for age, sex, sport, number of chronic conditions, years of education and smoking status. RESULTS: The mean age of participants was 58.3. Mean Lden was 54 dB(A). Median monthly headache days was one. No association was seen between traffic noise exposure and having ≥8 headaches/month for all the examined traffic noise indicators. However, traffic noise was positively associated with traffic noise-annoyance and insomnia; and night-time traffic noise-annoyance and insomnia were positively associated with headache. CONCLUSION: In conclusion, our data did not provide any evidence for an association between chronic traffic noise exposure and prevalence of headaches at this population's exposure levels. This should be explored in different populations given that this is the first study of its type and that noise exposure was generally low in our population.

Cervical Cancer Incidence and Trends among Nationals of the Gulf Cooperation Council States, 1998-2012.

BACKGROUND: Cervical cancer is the ninth most common female malignancy in the Gulf Cooperation Council (GCC) States. We describe trends in cervical cancer incidence among GCC nationals. GCC states include Bahrain, Kuwait, Oman, Saudi Arabia, Qatar and the United Arab Emirates; which share similar demographic, socioeconomic and cultural backgrounds. METHODS: The Gulf Centre for Cancer Control and Prevention (GCCCP) has maintained a database of cancer in the GCC states since 1998. Women diagnosed with invasive cervical cancer during the 15 years 1998-2012 were included (N=2,332). Age-specific incidence over three periods (1998-2002, 2003-2007 and 2008-2012) are presented for all states combined. Trends in the frequency of registered cases, age-standardized incidence rates (ASRs) and in the distribution of stage at diagnosis for the six member states are compared between the three periods. RESULTS: Over the 15-year period, the peak age of cervical cancer diagnosis has slightly shifted towards older age. While the number of cases in the GCC has increased, the ASR has decreased. 39% of women were diagnosed in localized stage. The proportion of unknown stage ranged between 10% in the UAE and 58% in Oman, and has increased over time in Kuwait, Oman and the UAE. CONCLUSION: The present study indicates some success in cervical cancer preventive measures but the GCC may still see an increase in the number of cases in the coming years. More efforts should be directed towards documentation of stage and towards early diagnosis.

Perfluoroalkyl acids (PFAAs) and anthropometric measures in the first year of life: Results from the Duisburg Birth Cohort.

In the context of the Duisburg Birth Cohort, this retrospective cohort study provides results of internal exposure to perfluorooctanoic acid (PFOA), perfluorooctanesulfonic acid (PFOS), and perfluorohexanesulfonic acid (PFHxS) in 156 mother-child pairs, and investigates whether and to what extent in utero exposure of these chemicals at German background levels exerts an effect on newborn and infant weight and length, and weight in relation to length expressed by ponderal index, in order to examine whether any reduction in weight is disproportionate to length. The levels of PFOA, PFOS, and PFHxS were determined in 81 maternal and 83 umbilical cord stored frozen plasma samples and 105 umbilical cord blood samples. Calculated factors were used to convert umbilical cord values to maternal levels. Weights and lengths were retrieved at birth and at 1, 4, 6, and 12 mo from examination booklets and ponderal index (kg/m3) was calculated. Subsequently, correlations were assessed using multiple linear regressions and generalized estimation equations with each of the measures as a continuous outcome variable and with PFOA, PFOS, and PFHxS concentration quartiles as categorized predictor variables, while adjusting for relevant covariates. PFOA, PFOS, and PFHxS were generally within German background exposure levels. There was a significant association between PFOA, PFOS, and PFHxS concentration quartiles and decrease in ponderal index at birth but not weight or height. A nonsignificant negative association between exposure to all three compounds and birth weight was noted. Follow-up showed no sustained effect of the PFAA on anthropometric measures during the first year.