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Fleisher, Linda, Carrie Norbeck, Miria Kano, Amy Herrera, Emily Kay, Erin Oakley, Z'kera Sims, Cassidy Kenny, and Zoe Landau. "Abstract B008: Evaluation of the NCI’s Geographic Management of Cancer Health Disparities (GMaP) program." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): B008. http://dx.doi.org/10.1158/1538-7755.disp22-b008.
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Abstract (A) Purpose: The Geographic Management of Cancer Health Disparities Programs (GMaP) is a national program funded by the National Cancer Institute’s Center to Reduce Cancer Health Disparities (CRCHD). GMaP supports the academic and professional development of underrepresented minority (URM) scholars conducting cancer and cancer health disparities (CHDs) research and is comprised of seven regions with an academic institution or cancer center serving as the region-based “hub”. Collectively, each region enhances capacity of scholars through dispersal of pilot funding and research stimulus awards for preliminary research, technical assistance workshops and webinars, expert grant reviews, conference travel and registration support, mentor matching, and training navigation among others. Understanding the value and impact of these services for URM scholars is essential to future programmatic planning. (B) Description: The regional offices collaborated on the development and deployment of a GMaP Awardee Evaluation Survey to GMaP scholars that have received support (e.g., pilot funding, travel scholarships, expert grant reviews) over the past 10 years. The survey included demographic questions, research interests, extent of engagement, awards applied for and/or received, as well as general feedback of the value of the program. The goal of the survey was to evaluate how and through which mechanisms GMaP funding has facilitated professional development activities, in addition to understanding the value of this support to scholars. (C) Results: 190 awardees from across the country responded to the survey. The majority (61%) of respondents were new to GMaP having joined in the last three years. 71.3% were female, and represented diverse racial and ethnic backgrounds (33% were white, 28% Black or African American, 16% Asian) and 31% were of Hispanic or Latino decent. Almost half (42%) were first generation college students. Over one-third (37.2%) stated that they were early stage investigators followed by postdoctoral (22.3%). 60% stated they had received conference and travel support, 19% research stimulus awards, and 25% a pilot project award. A number of respondents indicated they had received a CURE Diversity Supplement or KOI. Comments such as, “I was able to get my dissertation research completed. Funding from GMaP was instrumental to my success”, “I hired an undergrad research assistant from an URM community and we have published 2 papers together”, and “I was able to attend the AACR conference to present my work” highlight the scholars’ perspectives when asked about the impact/value of GMaP. Here, we will present both quantitative and qualitative data from this survey. (D) Conclusions: There is a national priority to increase diversity in the biomedical research workforce, and GMaP supports these efforts through enhancing the capacity of URM cancer and CHDs researchers. The funding opportunities provided by GMaP are highly valued by URM scholars and provide support to building a strong pipeline of diverse scholars. Citation Format: Linda Fleisher, Carrie Norbeck, Miria Kano, Amy Herrera, Emily Kay, Erin Oakley, Z'kera Sims, Cassidy Kenny, Zoe Landau. Evaluation of the NCI’s Geographic Management of Cancer Health Disparities (GMaP) program [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B008.
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DRITSAS, LAWRENCE. "From Lake Nyassa to Philadelphia: a geography of the Zambesi Expedition, 1858–64." British Journal for the History of Science 38, no. 1 (March 2005): 35–52. http://dx.doi.org/10.1017/s0007087404006454.
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This paper is about collecting, travel and the geographies of science. At one level it examines the circumstances that led to Isaac Lea's description in Philadelphia of six freshwater mussel shells of the family Unionidae, originally collected by John Kirk during David Livingstone's Zambesi Expedition, 1858–64. At another level it is about how travel is necessary in the making of scientific knowledge. Following these shells from south-eastern Africa to Philadelphia via London elucidates the journeys necessary for Kirk and Lea's scientific work to progress and illustrates that the production of what was held to be malacological knowledge occurred through collaborative endeavours that required the travel of the specimens themselves. Intermediaries in London acted to link the expedition, Kirk's efforts and Lea's classification across three continents and to facilitate the novel description of six species of freshwater mussel. The paper demonstrates the role of travel in the making of mid-nineteenth-century natural history and in developing the relationships and credibility necessary to perform the research on which classifications undertaken elsewhere were based.
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Bae, Sejong, Vishruti Pandya, Hao Wang, Chenguang Wang, and Warner K. Huh. "Abstract C084: Distance traveled for cervical cancer treatment and its impact on five-year survival." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): C084. http://dx.doi.org/10.1158/1538-7755.disp22-c084.
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Abstract Objective: To evaluate the impact of distance from patient residence to treatment facility and five-year cervical cancer survival. Materials and Methods: To assess five-year cervical cancer survival, cervical cancer data were obtained from the National Cancer Database (NCDB) years 2004-2017, only from patients with a minimum follow-up time of 5 years. It covers more than 70% of newly diagnosed cancer cases in the United States. Women younger than 20 years old were excluded from this study, as well as women with race other than white or black (Hispanic origin was not distinguished). Five-year survival was calculated. SAS version 9.4 was used for statistical analysis. Results: 50,582 patients met study criteria, with 79% white and 13.5% who had stage III/IV disease. Insurance type was 56% private, 18% Medicaid, 13% Medicare, and 11% uninsured or unknown. Distance between residence zip code and hospital was less than 50 miles (80%), more than 50 miles (14%), and 7% unknown. Rural-Urban status was 96% Urban, 1.5% Rural, and 2.9% unknown. Whites were more likely to travel more than 50 miles to a treatment facility (P <0.0001). Travel of more than 50 miles was associated with race (P <0.0001), insurance (P <0.0001), facility type (P <0.0001), stage (P <0.0001), age (P <0.0001), geographic location (P <0.0001), income (P <0.0001), education (P <0.0001), and Rural-Urban status (P <0.0001). White, Medicaid/Medicare insured, academic/research program facility, stage I, younger age, those who lived in the South, income <$50,353, and less education were more likely to travel more than 50 miles to treatment facility. In the adjusted model for five-year survival, insurance (P <0.0001), facility type (P <0.0001), comorbidity (P <0.0001), distance (P=0.0485), stage (P <0.0001), age (P <0.0001), geographic location (P=0.0074), income (P=0.0014), and education (P=0.0184) were associated with survival. Conclusion: Fourteen percent (14%) of patients resided more than 50 miles from treatment facility. Medicaid/Medicare, non-academic/research program facility, higher comorbidity, higher cancer stage, greater than 50 miles travel distance, older age, living in the South, income < $50,353, and less education were associated with five-year cervical cancer survival. Citation Format: Sejong Bae, Vishruti Pandya, Hao Wang, Chenguang Wang, Warner K. Huh. Distance traveled for cervical cancer treatment and its impact on five-year survival [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C084.
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Batterson, Ella, Marilyn Tseng, Emily C. Walton, Brian Egleston, Julia Zhong, Minzi Li, and Carolyn Fang. "Abstract A013: Patterns of heterolocalism among Chinese immigrants in Philadelphia." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): A013. http://dx.doi.org/10.1158/1538-7755.disp22-a013.
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Abstract Residence in an immigrant enclave has been linked to lower risk for some cancers but higher risk of late-stage diagnosis. In part, these patterns may be explained by the cultural, institutional, and social resources in immigrant enclaves that protect against ill health. Modern communication and transportation can facilitate “exposure” to immigrant enclaves as resource hubs, while individuals may reside in more racially integrated neighborhoods. This process of heterolocalism is underexplored in its relationship to cancer risk. The current study compares residents and non-residents of Chinese immigrant enclaves in Philadelphia with respect to distances traveled for various activities. Participants were 520 Chinese immigrant men and women aged 35-65 y. Interviews conducted 9/18-01/20 included questions on residence and usual locations of five types of activities: employment, grocery shopping, religious services, healthcare, and leisure. Participants were categorized as residing in a traditional (n=167), emerging (n=202), or non-enclave (n=151) neighborhood depending on the co-ethnic density of their census tract and adjacent tracts. We used ArcGIS to geocode participants’ residences and activity locations and conducted spatial analyses to examine distances traveled to these activities. Results indicated that residents of traditional enclaves stayed within or near their residential neighborhoods for grocery shopping, religious services, and leisure activities (median distances all <1 mi), although they traveled further for employment (median 2.5 mi) and healthcare (median 1.9 mi). Based on non-parametric Kruskal-Wallis tests, traditional enclave residents traveled the shortest median distances to all activities (all p<0.001). In contrast, non-enclave residents traveled the furthest for groceries (median 2.9 mi), religious services (median 8.2 mi), and leisure (median 3.2 mi) (all p<0.001). Mapped travel patterns indicate that many non-enclave residents travelled to enclave areas for these activities. Our findings suggest that heterolocalism is a means by which immigrants maintain co-ethnic connections. They also suggest the importance of understanding enclave ‘exposure’ beyond place of residence to clarify the relationships between immigrant enclaves and cancer outcomes. Citation Format: Ella Batterson, Marilyn Tseng, Emily C. Walton, Brian Egleston, Julia Zhong, Minzi Li, Carolyn Fang. Patterns of heterolocalism among Chinese immigrants in Philadelphia [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A013.
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Carozzi, Albert, and Marguerite Carozzi. "Franz Joseph Märter, Travel Companion of Johann David Schöpf in a Journey From Philadelphia to Florida and the Bahamas in 1783-1784." Earth Sciences History 13, no. 1 (January 1, 1994): 5–20. http://dx.doi.org/10.17704/eshi.13.1.60757v173568t071.
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Two years before Johann David Schöpf (1752-1800) published his Beyträge … (1787), Franz Joseph Märter (1753-1827) sent letters from Pennsylvania, Virginia, South Carolina, and East-Florida to Ignaz von Born, describing plants, animals, and geological features of the newly independent states. These letters were speedily printed in Physikalische Arbeiten … in Vienna (1785). A last letter sent from the Bahamas appeared in the same periodical in 1786. Märter's geological observations are translated and analyzed here for the first time. His descriptions of various rocks along the Schuylkill River, upstream from Philadelphia (granites, limestones, marble quarries, widespread weathered iron ores), and his interpretation of the fossiliferous sandstones in the Appalachian mountains are very similar to those by Schöpf. So are Märter's observations of shell banks, either exposed in ditches many miles from the sea, or in cliffs at Yorktown, Virginia, and Wilmington, North Carolina, as well as his description of granite and of a large coal mine near Richmond, Virginia. Finally, both travelers noticed that the rocky cliffs in the Bahamas consisted of limestone formed by Muschelsand [beachrock]. We established that Märter and Schöpf traveled together from Philadelphia to the Bahamas (November 1783 to March 1784). But neither acknowledged the influence, or at least the presence of the other, probably for political reasons.
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Eberhart, M. G., C. D. Voytek, A. Hillier, D. S. Metzger, M. B. Blank, and K. A. Brady. "Travel Distance to HIV Medical Care: A Geographic Analysis of Weighted Survey Data from the Medical Monitoring Project in Philadelphia, PA." AIDS and Behavior 18, no. 4 (October 19, 2013): 776–82. http://dx.doi.org/10.1007/s10461-013-0597-7.
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Bahr, Allison, Edna Gordián, Jaileene Pérez-Morales, José Oliveras, Teresita Muñoz-Antonia, Idhaliz Flores, and W. Douglas Cress. "Abstract C100: Initial description and analysis of study participants of the Puerto Rico Biobank from 2009 to 2019." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): C100. http://dx.doi.org/10.1158/1538-7755.disp22-c100.
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Abstract Objectives: The Puerto Rico Biobank (PRBB) is a tissue biorepository that collects biospecimens and associated data for cancer research investigations. One of its purposes is to acquire and provide data regarding cancers within the the Hispanic/Latino and Puerto Rican population not otherwise available. Herein we report on data from a self-administered questionnaire providing insight into factors associated with cancer in this unique patient population. Procedures: A questionnaire is administered to all PRBB subjects in Spanish at the time of consent. It is divided into sections including but not limited to demographics, clinical history, family history, nutrition, physical activity, cancer risk factors, and psychological wellness. Data was obtained from the PRBB questionnaire administered from 2009 to 2019. We analyzed the PRBB questionnaire by comparing questionnaire responses from: overall population that completed a questionnaire, those represented by biobank tissue, and by stratifying population into cancer participants and non-cancer participants. Results: Among the 1,710 patients that completed the PRBB questionnaires 60% were female, 61% white, 92% Hispanic/Latino, and 41% reported having an education level of 12th grade or lower. In the domain of cancer personal history, 70% of the PRBB consented cancer participants were diagnosed with either breast, prostate, colon, lung, or uterine cancers. The average age of PRBB non-cancer participants was less than the average age of the cancer participants (45.8 vs 61.2, respectively). Of the cancer participants, 76% were more likely to have a family member have cancer than the non-cancer participants (65%). Conclusion: Analysis of self-reported data collected through a self-administered questionnaire provides insights into the unique demographic, lifestyle, and family history of this Hispanic/Latino population. The most diagnosed cancer types of the respondents are consistent with the top 3 and 4 newly diagnosed cancers in Puerto Rico for men and women, respectively. The information from this analysis will support future investigations on cancer health disparities related to this minority cancer population. Citation Format: Allison Bahr, Edna Gordián, Jaileene Pérez-Morales, José Oliveras, Teresita Muñoz-Antonia, Idhaliz Flores, W. Douglas Cress. Initial description and analysis of study participants of the Puerto Rico Biobank from 2009 to 2019 [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C100.
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Mesa-Mazo, M. J., Johnny Valencia-Calvo, and Gerard Olivar-Tost. "Analytical Approximation of Fuel Consumption and Periodic Behaviors for a Vehicle that Travels Through a Traffic Light Series." Ingeniería y Ciencia 15, no. 29 (June 2019): 127–56. http://dx.doi.org/10.17230/ingciencia.15.29.5.
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In this paper, we present a piecewise smooth system, that describes thedynamics of a single vehicle moving through a street that has a sequence oflights that turn on and off with a specific frequency. The model presentsthree dynamic ways: accelerated, decelerated and zero state. Besides,we show the description of the mathematical model used to simulate thesystem. The simulation was developed under an event-based scheme andimplemented in Matlab. To make the numerical analysis, we take as a pa-rameter study the cycle traffic light, which provides benefits to vehiculartraffic system due to its configuration is achieved implementing optimiza-tion strategies for the phenomenon of green wave and reduces the travel time as the vehicle minimizes the number of stops along the road. Also, thestability was studied for the periodic orbits one and two. Finally, we madean approximation of fuel consumption. We assume that this is proportionalto the mechanical energy produced by the motor. From this point of view,it can be concluded that it is possible to apply modeling and simulationstrategies based on dynamic systems to understand the complex behaviorsassociated with the travel of vehicles in a traffic controlled by traffic lights.
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Sandberg, Joanne C., and Otis L. Owens. "Abstract B129: Workplace accommodations during and after prostate cancer treatment." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): B129. http://dx.doi.org/10.1158/1538-7755.disp22-b129.
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Abstract This study was designed to examine the modifications and accommodations African-American and White prostate cancer survivors experience at their workplaces during and following radiation therapy or a prostatectomy. Approximately 1 in 8 men will be diagnosed with prostate cancer. Although the average age at time of prostate cancer diagnosis is 66, the substantial number of younger men diagnosed results in large number of men facing treatment during their working years. African-American men are disproportionately affected by prostate cancer; understanding their experiences is therefore particularly vital. Forty-five prostate cancer survivors who had undergone radiation therapy or a prostatectomy within the past 6-36 months, had worked within one month prior to treatment initiation, and had expected to be working six months in six months participated in semi-structured, in-depth interviews about their experiences at work prior to, during, and after treatment. The audio-recorded interviews were transcribed and systematically analyzed. Twenty of the participants were African-American men and 25 were White men, and their mean age was 61. Most men were able to receive accommodations to address their needs in addition to time off for treatment and recovery if needed. These accommodations included temporarily changing their jobs duties so that they could focus on tasks that eliminated or reduced the most physically demanding aspects of their jobs such lifting heavy objects, performing tasks that could be conducted while seated, and reducing work-related travel. Working from home, reducing their work hours, and taking breaks during the work day also benefited some survivors. Although rare, a man who experienced difficulty meeting the physical demands of his job lacked accommodations and was afraid to request any due to his concern that he would lose his job. Men who lacked access to conveniently placed bathrooms used creative strategies. The move to have employees working at home and eliminating or reducing work-related travel due to the COVID-19 enabled some workers to forgo some accommodations they would have otherwise required. Variation in experience by race will be addressed. The needs of and workplace accommodations provided to prostate cancer survivors undergoing and recovering from prostate cancer treatment vary widely. Increased attention to their needs and strategies to address them could enable prostate cancer survivors to be better prepared for work-related challenges. Citation Format: Joanne C. Sandberg, Otis L. Owens. Workplace accommodations during and after prostate cancer treatment [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B129.
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Barry, Michele, and Brian Blackburn. "Travel Medicine, 2nd Edition Travel Medicine, 2nd Edition Edited by Jay S. Keystone , Phyllis E. Kozarsky , David O. Freedman , Hans O. Nothdurft , Bradley A. Connor Philadelphia, PA: Mosby Elsevier, 2008. 640 pp $169.00 (hardcover)." Clinical Infectious Diseases 49, no. 9 (November 2009): 1461. http://dx.doi.org/10.1086/630202.
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Joseph, Adedayo, Adeseye Akinsete, Ugonna Fakile, Chidiebere Agbakwuru, Lensa Keno, Omolola O. Adisa, Aishat Oladipo, Oluwafunmilayo Fagbemide, Muhammad Habeebu, and Wilfred Ngwa. "Abstract 4814: Pediatric radiation treatment adherence in LMIC." Cancer Research 84, no. 6_Supplement (March 22, 2024): 4814. http://dx.doi.org/10.1158/1538-7445.am2024-4814.
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Abstract Background: Radiation therapy plays a significant role in the treatment of pediatric cancer. However, there have been documented challenges and difficulties encountered by patients while accessing care for cancer and it has been postulated that travel distance contributes to treatment breaks and abandonment. Objectives: The objective of this study was to determine the prevalence of treatment breaks, assess the travel burden of patients receiving radiotherapy for pediatric cancers at a high-volume center in Nigeria and to determine the impact of travel burden on treatment breaks and treatment completion. Materials and Methods: A retrospective cross-sectional study design was utilized. Data was extracted from the electronic medical records of all pediatric patients referred to the center for radiation therapy between June 2019 and June 2023. Data was analyzed using Microsoft Excel and the results were presented in descriptive statistics. Association between data were analyzed using chi-square test with the level of significance (p) set at <0.05. Results: A total of 210 pediatric cancer patients were enrolled with an average age of 10.9 years. Children aged 0-14 years accounted for 69.05% while 30.95% were between the age of 15 and 19 years. Brain tumors were the most predominant diagnosis, representing 28.10% of cases. Treatment intent was predominantly radical or curative (81.69%). 61.43% (129) of the patient population came from the within the state with an average travel distance of 19.3 km. Of all the 210 patients, 44.29% of patients did not commence RT. The reasons for this were mostly financial constraints but were not explored in this study. Of those who did commence RT, 54.70% had breaks, and 45.30% did not have breaks. Also, 75.21% of patients completed their treatment; however, 24.79% were unable to complete their treatment. Travel distances varied, with the average distance to the treatment center being 165.3 km and the median at 28.5 km. The study categorized travel distance into quartiles: short (0-16 km), medium (>16 km to 28.5 km), long (>28.5 km to 302 km), and very long (>302 km to 1387 km). Chi-square test did not reveal a significant association between travel distance and treatment completion (p=0.57), nor between travel distance and treatment breaks (p=0.20). Conclusion: These findings highlight the complex interplay of demographic factors, disease profiles, and socioeconomic barriers affecting treatment continuity and completion among pediatric oncology patients in a resource-limited setting. These findings suggest that in this low - resource context, other variables such as socioeconomic status and financial barriers may play a more pivotal role than travel distance in treatment commencement, adherence and completion. As such, more detailed investigation of the obstacles through a comprehensive and targeted strategy could lead to more favorable outcomes in pediatric cancer radiation therapy adherence. Citation Format: Adedayo Joseph, Adeseye Akinsete, Ugonna Fakile, Chidiebere Agbakwuru, Lensa Keno, Omolola O. Adisa, Aishat Oladipo, Oluwafunmilayo Fagbemide, Muhammad Habeebu, Wilfred Ngwa. Pediatric radiation treatment adherence in LMIC [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4814.
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Altukhova, Anna. "A Review of Mirjam Galley, Building Communism and Policing Deviance in the Soviet Union: Residential Childcare, 1958–1991. Philadelphia, PA: Routledge, 2020, 240 pp." Antropologicheskij forum 20, no. 60 (2024): 215–25. http://dx.doi.org/10.31250/1815-8870-2024-20-60-215-225.
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Mirjam Galley’s monograph on the history of boarding schools in the USSR from 1958 to 1991 fills a significant gap in the historiography of Soviet boarding institutions. Prior to the publication of this book, there was no in-depth analysis and description of this phenomenon throughout the post-Stalin era. The monograph analyses the historical context which conditioned the project of boarding schools, reconstructs their routine, which the author describes as unchanged during thirty years, and uncovers the personal experiences of boarding school staff and charges. However, the author’s primary interests lie within the domain of management principles. While high officials postulated ideals of care and concern, the key features of these institutions were austere conditions, on the one hand, and the almost total indifference that officials and representatives of state institutions demonstrated towards the project of boarding schools and schoolchildren in particular, on the other hand. Galley outlines how the upbringing of future workers, which was advertised as a duty of the utmost importance, actually depended on the personal goodwill of bureaucrats as well as on the ability of boarding schools’ staff to present the paper results of their work in the best possible manner.
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Gautom, Priyanka, Jamie H. Thompson, Cheryl A. Johnson, Jennifer S. Rivelli, and Gloria D. Coronado. "Abstract A102: Developing faith-based messaging and materials for colorectal cancer screening: Application of boot camp translation within the African Methodist Episcopal Church." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): A102. http://dx.doi.org/10.1158/1538-7755.disp22-a102.
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Abstract Introductory sentences: We use boot camp translation (BCT), a validated community based participatory strategy, to elicit input from African Methodist Episcopal (AME) congregants, leadership, and healthcare systems in Atlanta, Georgia to create culturally appropriate and locally relevant colorectal cancer (CRC) faith-based screening messages and materials for AME church communities. Brief description of pertinent experimental procedures: In the United States, CRC is the third-leading cause of cancer death and disproportionately impacts African Americans, highlighting the need for timely screening within this community. African American adults have higher annual rates of new CRC cases and are diagnosed with CRC at younger ages when compared to White adults. Regular CRC screening is pertinent to increasing the chance of early diagnosis and survival, however, African Americans are less likely to get screened for CRC than Whites. Church-based educational programs have been successful in promoting cancer screening, including CRC screening, in various racial and ethnic groups. Churches can serve as key partners in delivering health information as they are among the most trusted institutions within the African American community. As part of a collaboration among the American Cancer Society, the Centers for Disease Control and Prevention, AME churches and Atlanta-based healthcare systems, we will apply BCT to develop and disseminate messaging to promote CRC screening within the AME community. The BCT session aims are twofold: 1) to identify the role of the church in bringing CRC information to the AME community and 2) to define the content and format of effective faith-based CRC messages tailored for the AME community. Summary of new, unpublished data: The BCT workshops will occur in July 2022.Statement of conclusions: We anticipate preliminary findings and materials to be ready by September 2022. Citation Format: Priyanka Gautom, Jamie H. Thompson, Cheryl A. Johnson, Jennifer S. Rivelli, Gloria D. Coronado. Developing faith-based messaging and materials for colorectal cancer screening: Application of boot camp translation within the African Methodist Episcopal Church [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A102.
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Fur, Gunlög. "Different ways of seeing ‘savagery’: Two Nordic travellers in 18th-century North America." History of the Human Sciences 32, no. 4 (July 22, 2019): 43–62. http://dx.doi.org/10.1177/0952695119846003.
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Andreas Hesselius and Pehr Kalm both spent time in eastern North America during the first half of the 18th century. Both came with an ardent desire to observe and learn about the natural environment and inhabitants of the region. Both produced writings, in the form of journals that have proved immensely useful to subsequent scholars. Yet their writings also display differences that illuminate the epistemological and sociological underpinnings of their observations, and which had consequences for their encounters with foreign environments. Hesselius, who served as pastor to the Swedish congregation in Philadelphia from 1712 to 1724, described his experiences and observations with what we might call a historical awareness, while Kalm, known as the first of Linnaeus’s students to travel to the New World, primarily offered dehistoricized and denarrativized taxonomic ethnographic descriptions. At first glance, Hesselius and Kalm appear to illustrate perfectly Michel Foucault’s description of the difference between Renaissance and classical epistemologies. Kalm’s disembodied and decontextualized representations fit well with Foucault’s description of natural history in the classical age as consisting ‘of undertaking a meticulous examination of things themselves…and then of transcribing what it has gathered in smooth, neutralized, and faithful words’. This article, however, points out that while Hesselius and Kalm arrive at similar descriptions of plants and other-than-human beings by employing different methodologies, when it comes to describing indigenous peoples their respective methodologies lead to radically different approaches, with Hesselius writing them into history, while Kalm relegates them to ethnology in the sense of savage ‘peoples without histories’.
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Merner, Nancy, Elizabeth Stallworth, Erica Reasor, Katia Khoury, Lily Gutnik, Meagan Farmer, and Brandon Johnson. "Abstract B088: The Alabama Hereditary Cancer Cohort – New strategies for African American recruitment." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): B088. http://dx.doi.org/10.1158/1538-7755.disp22-b088.
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Abstract Our group has established the Alabama Hereditary Cancer Cohort and primarily investigates breast cancer genetics in African American, an underrepresented group in biomedical research. Alabama has double the national percentage of African Americans and is the location of the infamous and unethical Tuskegee Syphilis Study. Therefore, strategic protocols were developed to break research participation barriers, effectively recruiting African American hereditary breast cancer cases and families. Our initial recruitment strategies involved both hospital-based and community-based recruitment; the latter involved our recruitment bus, the Gene Machine, and focused on African American engagement. Since our initial publication, our community-based recruitment protocol has been modified. Many of the modifications were due to the pandemic, limiting in-person community engagement. In-person education seminars and enrollment sessions transitioned to virtual meetings, using various video-conferencing platforms. Regarding virtual enrollments, upon agreement to proceed with the virtual consent process, study participants are mailed an enrollment kit containing study consent forms, saliva collection kits, return mailing materials, and instructions. Once received, an enrollment appointment is made, and the consent process follows the procedure for in-person study enrollment, concluding with the saliva sample collection. Once collected, the sample is packaged with the consent forms and returned to our laboratory in the postage-paid mailer. Community-based recruitment has also been enhanced by partnering with the Alabama Department of Public Health to identify study participants through the Alabama Statewide Cancer Registry, similar to the very successful Carolina Breast Cancer Study. Furthermore, Research Champions have been added to the protocol, defined as primary healthcare providers and specialists who aid in recruitment by identifying individuals who fit the study criteria. The concept of Research Champions was developed after recognizing that the requirements to execute hospital-based recruitment are arduous on partnering hospitals. Thus, the sole function of a Research Champion is identifying prospective study participants, relieving the burden on physicians and hospital staff. Lastly, our Gene Machine Facebook page and newly designed website, tailored towards laypeople/study participants, facilitate additional engagement through ads, videos, and photos. Ultimately, these processes reduce the travel burden, aid in social distancing, and expand our reach, enhancing recruitment and enrollment efforts and breaking barriers to African American research. Citation Format: Nancy Merner, Elizabeth Stallworth, Erica Reasor, Katia Khoury, Lily Gutnik, Meagan Farmer, Brandon Johnson. The Alabama Hereditary Cancer Cohort – New strategies for African American recruitment [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B088.
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Poceros-Coba, Alma A., Ana Estrada-Florez, Ted Toal, Paul Lott, Macarena Garrido, Craig Steinmaus, Catterina Ferrecio R., and Luis Carvajal-Carmona. "Abstract 229: Elucidating arsenic dependent carcinogenesis in humans." Cancer Research 82, no. 12_Supplement (June 15, 2022): 229. http://dx.doi.org/10.1158/1538-7445.am2022-229.
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Abstract Arsenic contamination in drinking water is one of the major health issues worldwide. Over 140 million people from 50+ countries are exposed to drinking water containing arsenic at levels above “safe” levels of 10 μg/L. Several studies indicate that chronic arsenic exposure is associated with the development of carcinogenic changes in the lungs, bladder, liver, and skin and other potential health problems. In this project, we aim to characterize bladder cancer mutational signatures and somatic mutations in a cohort of bladder cancer patients known to have been highly exposed to arsenic in northern Chile by using whole-exome sequencing (WES). We analyzed WES data and identified somatic mutations and mutational signatures using Mutec2 and SigProfiler. Preliminary analyses from a small number of exposed patients identified two mutational signatures, previously described as having “unknown” etiology, that showed an association with arsenic exposure. We are currently validating these findings in additional samples and with functional studies. Alma Poceros-Coba Ph.D. Candidate is the recipient of the Conacyt-UC-MEXUS Doctoral Fellowship and is the recipient of the UCDCCC Travel Award. Citation Format: Alma A. Poceros-Coba, Ana Estrada-Florez, Ted Toal, Paul Lott, Macarena Garrido, Craig Steinmaus, Catterina Ferrecio R., Luis Carvajal-Carmona. Elucidating arsenic dependent carcinogenesis in humans [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2022; 2022 Apr 8-13. Philadelphia (PA): AACR; Cancer Res 2022;82(12_Suppl):Abstract nr 229.
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Bae, Sejong, Vishruti Pandya, Chenguang Wang, Hao Wang, Rebecca C. Arend, Charles A. Leath, and Warner K. Huh. "Abstract 2144: Disparities in gynecologic cancer survival outcome by treatment facility and region." Cancer Research 84, no. 6_Supplement (March 22, 2024): 2144. http://dx.doi.org/10.1158/1538-7445.am2024-2144.
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Abstract Objective: To explore five-year survival of patients with gynecologic cancers by region and treatment facility in the United States. Background: Research studies have examined the risk factors associated with gynecologic cancers, specifically cervical, ovarian, and endometrial, incidence and mortality. In addition to older age, Black/African American race, living in south, less income, less education, having comorbidity, stages of cancer, and lack of insurance have reported as risk factors for the incidence and mortality of gynecologic cancers. In addition, prior studies reported the possible effects from the distance to cancer care facilities on gynecologic cancer outcomes indicated varying results. In this study, we explore the impact of distance travelled by region and treatment facility on gynecologic cancer outcomes. Methods: This study aims to assess five-year cervical, ovarian, and endometrial cancer survival. Data were obtained from the National Cancer Database (NCDB) years 2004-2017, only from patients with a minimum 5-year follow-up. Women with races other than White or Black were excluded from the study. Demographics, region, treatment center type, distance to the treatment center, and cancer stage at diagnosis were analyzed by cancer type and 5-year survival status. Multivariate logistic regression model was used to assess the relationship between distance travelled to treatment facility by region and five-year survival. SAS version 9.4 was used for statistical analysis. Results: The distribution of the demographics across the three cancers were similar. Multivariate logistic models showed significant interactions between facility type and region on five-year survival among cervical, ovarian and endometrial cancer patients. Risk factors varied by region and treatment facility type. Age and cancer stage were significantly associated with survival among all cancers. Distance was significantly associated with survival in cervical and endometrial cancers. Conclusion: Cervical cancer patients in the South Atlantic who travel longer distances to Academic/Research Programs have poorer survival. Likewise, patients with endometrial cancer who live in New England region, and travel longer distances to Integrated Network Cancer Programs, as well as those who live in the West North Central region and travel longer distances to Community Cancer Programs have poorer survival. Further research is warranted to explore the specifics of region and treatment center types among different cancers to get a better understanding of the risk factors. Moreover, to improve the clinical outcomes, further study is needed to aim to identify which of these factors are actionable. Citation Format: Sejong Bae, Vishruti Pandya, Chenguang Wang, Hao Wang, Rebecca C. Arend, Charles A. Leath, Warner K. Huh. Disparities in gynecologic cancer survival outcome by treatment facility and region [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 2144.
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Nguyen, Annelise, and My Doan. "Abstract 338: Regulation of gap junction intercellular communication in pancreatic cancer cells." Cancer Research 83, no. 7_Supplement (April 4, 2023): 338. http://dx.doi.org/10.1158/1538-7445.am2023-338.
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Abstract According to the American Cancer Society, approximately 62,210 people (32,970 men and 29,240 women) in the United States are estimated to be diagnosed with pancreatic cancer by the end of 2022. An estimated 80% of these patients will die as a result of pancreatic cancer. This type of cancer has been challenging to treat due to the complexity of tumor cells, tumor aggressiveness, current drug availability, and drug delivery. A new class of substituted quinolines, known as PQ compounds, acts as gap junction enhancer, having the ability to increase the gap junctional intercellular communication cancerous cells. The goal of this project is to provide a new approach to treat pancreatic cancer via restoration of gap junctional intercellular communication and combining treatment with antineoplastic drugs. One approach was to increase cell communication of pancreatic cancer cells using small molecules, PQs, and hence allowing antineoplastic drugs to effectively travel from cell to cell. Pancreatic cancer cells were treated with gap junction enhancers, PQs, in the presence and absence of antineoplastic drugs. Interestingly, 5-FU significantly decreased the expression of gap junction protein, connexin 43, compared to control and PQ1 treatments. PQ1 has demonstrated to increase Cx43 expression and increase 4.5-fold of gap junction activity. Furthermore, cells treated with nilotinib have a significant effect on PANC-1 cells. Current studies focus on functional assays to determine if PQ1 can increase cell-cell communication, allowing a reduced concentration of antineoplastic drugs to be used. Overall, the findings provide an initial insight to a new approach in treating pancreatic cancer. Citation Format: Annelise Nguyen, My Doan. Regulation of gap junction intercellular communication in pancreatic cancer cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 338.
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Napit, Krishtee, Kendra L. Ratnapradipa, Lady Beverly Luma, Danae Dinkel, and Shinobu Watanabe-Galloway. "Abstract PR003: Colorectal cancer screening among Native Americans of Nebraska: A qualitative analysis of the barriers and facilitators." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): PR003. http://dx.doi.org/10.1158/1538-7755.disp22-pr003.
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Abstract As a component of statewide cancer needs assessment, this study explored factors impacting colorectal cancer (CRC) screening and approaches to increase screening among Native Americans of Nebraska. Three 75-minute focus groups were conducted October-December 2021: Omaha Urban Indian clinic (n=11), Lincoln Urban Indian clinic (n=6), and Ponca Tribe (n=9). Participants were Native American cancer survivors and caregivers aged 30+ residing in Nebraska. Verbatim transcripts were inductively coded and analyzed using a directed content analysis approach. Most participants were female (88%) and caregivers (85%). Most had heard of colonoscopies (83%), but awareness of fecal tests was low with two participants unaware of any screening. Only 38% had heard of the Fecal Occult Blood Test despite tribal outreach during March incentivizing stool tests. Reasons for low uptake of screening tests included lack of awareness (“What is colorectal cancer?” and “I don't think a lot of Natives get that type of cancer, do they?”), elderly avoidance of medical care (“even when I’m real sick I have to be…near…death” before seeking care), fear (“fearing what they’re gonna find out”), and embarrassment (“perception of manhood”). The invasive and uncomfortable procedural aspect of colonoscopy and use of excreta for stool-based tests "Because I don't wanna be digging in my poop" were other deterrents. Some providers did not strongly recommend the screening. Other barriers include insurance and transportation/travel distance for colonoscopy. Suggested approaches to improve CRC screening were increasing awareness of CRC and screening options using billboards, flyers, posters, brochures, health fairs, public meetings, and social media (e.g., Facebook). Posters and educational materials in clinics were already in use. Suggested message content should portray that CRC is treatable “if they catch it in time,” emphasizing being there for family (“you’ve got kids, you want to see them graduate”), funny (“goofy…they can kinda laugh at the ad and hopefully not be so nervous”) and having community members share CRC survival stories. Engaging the community was also discussed either through 1) having nursing students provide health education outreach, 2) forming elder committees to encourage the elderly to complete screenings, and/or 3) ensuring physicians recommend and explain the importance of screenings during appointments. Community support in terms of transportation, social workers to attend appointments with the elderly, and financial counselors were discussed as important to complete screenings. Certain types of health facilities should enhance their partnership with Native Americans to share information with the community. Low awareness and wrong perception of CRC and screening tests are reasons for low utilization of screening. Participants expressed a desire for the researchers to continue building relationships with the tribal groups to address CRC. The state can use study results to prioritize interventions to reduce cancer care disparities. Citation Format: Krishtee Napit, Kendra L. Ratnapradipa, Lady Beverly Luma, Danae Dinkel, Shinobu Watanabe-Galloway. Colorectal cancer screening among Native Americans of Nebraska: A qualitative analysis of the barriers and facilitators [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr PR003.
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Dwyer, Kathleen, Dorothy A. Rhoades, Mark Doescher, Brook McCann, Michele Gibson, and Zsolt Nagykaldi. "Abstract A101: Exploring facilitators and barriers to low-dose CT screening for lung cancer among Native American patients: The TEALS study." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): A101. http://dx.doi.org/10.1158/1538-7755.disp22-a101.
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Abstract Purpose: Lung cancer screening (LCS) with low dose CT scanning reduces mortality but uptake of LCS is poor. Lung cancer mortality in Oklahoma’s Native American population is 45% higher than for the non-Hispanic White population. The Tribally Engaged Approaches to Lung Screening (TEALS) study is a collaboration between the University of Oklahoma Health Sciences Center and the Choctaw Nation of Oklahoma Health Services Authority (CNHSA). The goals of TEALS are to implement a systematic LCS program within Choctaw Nation and to understand LCS decision-making processes, barriers and facilitators. Procedures: Using purposive sampling from 2 of 8 CNHSA clinics in Oklahoma in 2021, we conducted a pilot study using phone interviews with patients who had completed LCS and those who had not. Using a semi-structured interview guide, we asked patients about their experience with the LCS program, factors that influenced their decision, and suggestions for improving the program. Conventional inductive content analysis was used to identify major themes. Multiple coders and peer debriefing enhanced scientific rigor. Results: Completers (4 men and 5 women) and non-completers (3 men and 3 women) were included. Major themes included: (1) Contextual factors influencing the decision-making process; (2) Individual characteristics influencing the decision-making process; and (3) Barriers to screening. Contextual factors included the provider raising the discussion of LCS, which was most frequently cited by completers but not the non-completers. Other contextual factors included the use of handouts and pamphlets during clinic visits. Patient suggestions included brochures/posters in waiting rooms and creating an information video to run on TVs in waiting areas. Individual characteristics included motivation to ‘be there’ for family/children, previous cancer in family/friends, and ease of arranging appointments. Non-completers preferred not to know or were scared to know the results of screening. Barriers included long distance travel to LCS sites, missing work, access to transportation or assistance, confusion about the appointment leading to missed appointments. Interviews highlighted the need to clarify eligibility criteria. Notably, some patients who were classified as ‘non-completers’ had already had a diagnostic CT for respiratory symptoms or as follow-up for prior cancer, indicating a gap in correctly identifying LCS eligibility. Conclusions: Findings from this pilot have guided implementation of the TEALS clinical trial. Large banners are now available in participating clinics. Academic detailing ensures the decision aid pamphlet is available and used in waiting rooms. Providers are reminded of the critical role they play in informing patients about LCS. Appointment reminders and assistance with transportation (e.g., tribal transportation) are in place. Eligibility criteria for the clinical trial have been clarified. Gathering this information from pilot study participants has enabled the team to refine the LCS intervention as it expands to other sites. Citation Format: Kathleen Dwyer, Dorothy A. Rhoades, Mark Doescher, Brook McCann, Michele Gibson, Zsolt Nagykaldi. Exploring facilitators and barriers to low-dose CT screening for lung cancer among Native American patients: The TEALS study [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A101.
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Henderson, Nicole L., Andrews Courtney, Lawhon Valerie, Stacey A. Ingram, Lisa Zubkoff, Nadine Tung, Lynne Wagner, Lauren P. Wallner, Antonio C. Wolff, and Gabrielle B. Rocque. "Abstract P6-05-54: "Clinical Trials are Space Travel": Moderators of Recurrence Stress among Breast Cancer Oncologists." Cancer Research 83, no. 5_Supplement (March 1, 2023): P6–05–54—P6–05–54. http://dx.doi.org/10.1158/1538-7445.sabcs22-p6-05-54.
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Abstract Background: Being an oncologist means accepting that some patients will have disease recurrence despite the most expert treatments. The universality of that experience, however, does not negate the potential for decisional regret and emotional distress on the part of the physician. The broad scale movement towards treatment optimization in medicine likely complicates this experience, as enrollment in de-escalation clinical trials inevitably means that the patient will receive less than the current standard of care. The objective of this study was to assess physician perceptions of potential emotional distress and decisional regret following patient recurrence through exploring the broad range of factors that either moderate or exacerbate those experiences. Methods: Physicians who treat breast cancer in academic and community settings across the United States participated in a qualitative interview designed to assess physician perspectives regarding patient enrollment in de-escalation clinical trials. Purposive sampling techniques were utilized to construct a balanced sample (sex, time in practice) of 39 participants. A subsection of the interview schedule centered on the experiences of decisional regret and distress surrounding patient recurrence. Interviews were recorded, transcribed, and analyzed in order to identify shared themes. Two independent coders performed a content analysis, identifying and recording factors that impact the level of distress that the physician may feel. Results: Thirty-six physicians provided in depth responses regarding their experience when a patient recurs. A total of 21 factors that affected recurrence stress were identified and spanned broad categories including patient features, disease biology, the design of the clinical trial, and characteristics of the physician. All participants expressed willingness to enroll patients in de-escalation-focused clinical trials. However, approximately half of the sample indicated that the experience would be worse after enrollment in a de-escalation trial than after a traditional intensification trial, and a quarter admitted that patient recurrence after a de-escalation trial would impact their decision making regarding future patient enrollment. Individuals not likely to experience distress emphasized having a strong trial rationale, informed patient consent, and engaging in shared decision-making, while greater distress centered on the fear of “not doing enough” and the patient missing out on necessary treatment. Conclusions: Many factors contribute to the experience of physician decisional regret and emotional distress after patient recurrence. Although most physicians recognize the importance of de-escalation focused clinical trials, a significant proportion indicated a greater potential for distress following patient recurrence in such trials and offered insight into how trial design and the process of patient enrollment can be improved to minimize potential distress. Citation Format: Nicole L. Henderson, Andrews Courtney, Lawhon Valerie, Stacey A. Ingram, Lisa Zubkoff, Nadine Tung, Lynne Wagner, Lauren P. Wallner, Antonio C. Wolff, Gabrielle B. Rocque. "Clinical Trials are Space Travel": Moderators of Recurrence Stress among Breast Cancer Oncologists [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-05-54.
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Beyer, Kirsten M. M. "Abstract C086: A summary of findings from the Breast Cancer, Race and Place (BCRP) study on structural racism and breast cancer survival disparities in the United States, based in Milwaukee, WI." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): C086. http://dx.doi.org/10.1158/1538-7755.disp22-c086.
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Abstract Racial disparities in breast cancer survival are significant, with only 68% of US Black women diagnosed with breast cancer remaining alive 10 years post-diagnosis, compared to 84% of White women. However, the size of racial disparities in breast cancer mortality varies geographically across the US. Such geographical variation suggests that disparities are not inevitable, and this variation has not been explained. Structural racism and racial residential segregation are widely considered to contribute to health disparities and may partially explain geographical variation in the size of the disparities. While some studies have shown that segregation is related to poor survival, others have found that this is not always the case, and some studies highlight the case of ethnic enclaves, which may be protective. The NCI funded Breast Cancer, Race and Place (BCRP) study is a national study of structural racism and breast cancer survival with three aims: (1) Construct new metrics of structural racism at the local level for the largest US metropolitan areas, (2) Determine whether these measures are related to breast cancer survival disparities among Black, Hispanic and Non-Hispanic White women, and whether relationships are mediated by local stressors, social resources, or opportunities, and (3) Explore the ways in which Black and Hispanic breast cancer survivors in a highly segregated metropolitan area (Milwaukee, WI) navigate cancer survivorship in the context of segregation. The project is supported by an interdisciplinary research team and a community advisory board. We have published several studies based on this work with others in review or in preparation and share an overview of this body of work here. This summary of findings includes: (1) a description of new measures of contemporary racial bias and property location based bias (redlining) in mortgage lending, (2) a direct association between redlining and breast cancer survival in older women diagnosed with breast cancer in the US, (3) collaborative work using these metrics in other cohorts and locations, (4) a clear gradient association between historic redlining and contemporary redlining, (5) new evidence of potential mediating factors, (6) qualitative evidence of lived experience of Black and Hispanic survivors in Milwaukee, WI, and (7) a new web-based tool to explore and download mortgage lending bias metrics. We hope that this work will support the development of multi-sectoral interventions to reduce cancer disparities by targeting local systems and policies, including in the housing sector. Citation Format: Kirsten M. M. Beyer, BCRP Team. A summary of findings from the Breast Cancer, Race and Place (BCRP) study on structural racism and breast cancer survival disparities in the United States, based in Milwaukee, WI [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr C086.
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Patel, Manish R., Michael Tees, Farrukh T. Awan, Nadia Khan, Nancy Mota, Hui Zhang, Su Young Kim, and Jennifer Woyach. "Abstract PO-009: AC676 a BTK Chimeric Degrader: Phase 1 study in patients with B-cell Malignancies." Blood Cancer Discovery 5, no. 3_Supplement (June 19, 2024): PO—009—PO—009. http://dx.doi.org/10.1158/2643-3249.lymphoma24-po-009.
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Abstract Study Background: Bruton tyrosine kinase (BTK) is a key signaling molecule that plays a central role in B-cell receptor transduction. The development of agents that inhibit BTK has transformed the management of patients with B-cell malignancies. However, therapy using covalent BTK inhibitors such as ibrutinib, as well as non-covalent inhibitors such as pirtobrutinib, can still result in resistance, primarily due to the development of mutations in BTK including residues C481 and L528. AC676 is designed as a chimeric degrader to target and degrade BTK using Accutar's proprietary Protein-Protein Interaction Targeting Chimeras (PPI-TAC) platform. By effectively linking a BTK ligand to the cereblon E3-ligase recruiting ligand, AC676 brings BTK in proximity to cereblon, thereby inducing subsequent ubiquitination and degradation of BTK. AC676 degrades BTK proteins irrespective of mutations; including C481, kinase dead L528 and others, and thus may be effective for the treatment of patients who have progressed on both covalent and non-covalent BTK inhibitors. Notably, it is also effective in cell lines expressing gain of function PLCG2 mutants, suggesting that it removes BTK’s scaffolding function. AC676 does not degrade cereblon neo-substrates, so neutropenia is not expected to be an on-target effect. This abstract describes an ongoing first in human Phase 1 trial of AC676. Study Description: AC676-001 is a Phase 1 dose-escalation study of AC676 administered orally once daily as monotherapy in patients with relapsed and refractory B-cell malignancies. Approximately 60 patients may be enrolled. Eligible patients must be ≥ 18 years, and have one of the following histologically confirmed relapsed or refractory disease types: chronic lymphocytic leukemia and small lymphocytic lymphoma, diffuse large B cell lymphoma – non-GCB subtype, follicular lymphoma, mantle cell lymphoma, marginal zone lymphoma, lymphoplasmacytic lymphoma including Waldenstrom macroglobulinemia. Patients must have received at least two prior systemic therapies or have no other standard of care therapies to provide significant clinical benefit. Patients must have measurable disease per disease-specific response criteria and Eastern Cooperative Oncology Group performance status ≤ 1. Dose-escalation will begin with an accelerated titration phase, followed by a standard 3+3 phase. AC676 is administered orally once daily on a 28 day per cycle schedule at doses ranging from 50mg to 600mg. The primary objective of the study is to evaluate the safety and tolerability of AC676. Secondary objectives include the evaluation of anti-tumor activity and the pharmacokinetic profile following single and multiple doses. Study enrollment began April in 2023 with five sites currently open in the United States (NCT05780034). Citation Format: Manish R Patel, Michael Tees, Farrukh T Awan, Nadia Khan, Nancy Mota, Hui Zhang, Su Young Kim, Jennifer Woyach. AC676 a BTK Chimeric Degrader: Phase 1 study in patients with B-cell Malignancies [abstract]. In: Proceedings of the Fourth AACR International Meeting on Advances in Malignant Lymphoma: Maximizing the Basic-Translational Interface for Clinical Application; 2024 Jun 19-22; Philadelphia, PA. Philadelphia (PA): AACR; Blood Cancer Discov 2024;5(3_Suppl):Abstract nr PO-009.
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Abate-Shen, Cory, Arianna Giacobbe, Aleksandar Obradovic, Alessandro Vasciaveo, Florencia Picech, Kacey Ronaldson-Bouchard, Gordana Vunjak-Novakovic, Michael M. Shen, Andrea Califano, and Peter Sims. "Abstract IA012: Modeling prostate cancer metastasis in genetically engineered mouse models." Cancer Research 83, no. 11_Supplement (June 2, 2023): IA012. http://dx.doi.org/10.1158/1538-7445.prca2023-ia012.
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Abstract My laboratory has a longstanding interest in developing mouse models of prostate cancer that recapitulate the broad spectrum of prostate cancer phenotypes. We have been employing state-of-the-art systems biology approaches to integrate molecular data from our mouse models with comparable data from human prostate cancer, with the ultimate goal of informing patient care. This is exemplified by our recent description of OncoLoop, a transcriptomic framework that can support rapid-turnaround co-clinical studies to identify and validate drugs for individual patients. Our current studies have largely focused on modeling metastatic prostate cancer, particularly metastasis to bone. We have generated genetically engineered mouse models, as well as syngeneic allograft models, that model bone metastasis with high penetrance. In addition, we are employing an “organ-on-a-chip” platform that simulates bone tropism. We are using these models to decipher the molecular mechanisms that drive metastatic dissemination and bone metastasis. My presentation at this AACR conference will focus on how we have been using these various models to study circulating tumor cells (CTCs). In particular, I will describe our recent studies in which we have been using single-cell sequencing of CTCs and have generated CTC-derived organoids to interrogate mechanisms that drive dissemination and metastasis. Citation Format: Cory Abate-Shen, Arianna Giacobbe, Aleksandar Obradovic, Alessandro Vasciaveo, Florencia Picech, Kacey Ronaldson-Bouchard, Gordana Vunjak-Novakovic, Michael M. Shen, Andrea Califano, Peter Sims. Modeling prostate cancer metastasis in genetically engineered mouse models [abstract]. In: Proceedings of the AACR Special Conference: Advances in Prostate Cancer Research; 2023 Mar 15-18; Denver, Colorado. Philadelphia (PA): AACR; Cancer Res 2023;83(11 Suppl):Abstract nr IA012.
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Kasliwal, Prasad Jaychand. "Fluoroscopy-Guided Sacroiliac Joint Injection: Description of a Modified Technique." Pain Physician 19, no. 2;2 (February 14, 2016): E329—E337. http://dx.doi.org/10.36076/ppj/2016.19.e329.
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Sacroiliac joint (SIJ) pathology is a common etiologic cause for 10 – 27% of cases of mechanical low back pain (LBP) below the L5 level. In the absence of definite clinical or radiologic diagnostic criteria, controlled blocks of the SIJ have become the choice assessment method for making the diagnosis of SIJ pain. The SI joint is most often characterized as a large, auricular-shaped, diarthrodial synovial joint. In reality, its synovial characteristic is limited only to the distal third and anterior third. In SIJ interventions, the lateral view has been underutilized. In our technique, we used the lateral view to create a three-dimensional view of the SIJ to aid in gauging the accurateness of the contrast spread and to obtain a precise block. After obtaining appropriate fluoroscopic images, a curved tip spinal needle was directed into the inferior aspect of the SIJ using a posterior approach. As the needle contacts firm tissues on the posterior aspect of the joint, position of the needle tip is checked using lateral fluoroscopy. In the lateral view, the needle tip position is manipulated to keep it in the anterior third of the SIJ and contrast is injected. Our criteria for accurate SIJ block, in posteroanterior (PA) view, is the injection of the contrast medium should outline the joint space and the contrast medium should be seen to travel cephalad along the joint line. In the lateral view, the contrast medium most densely outlines the parameter of the joint. We have utilized this method with good effect in approximately 30 cases over one year. Out of 30 cases, needle position and contrast spread was satisfactory in 28 and 27 cases, respectively. So satisfactory needle placement and contrast spread was in 93% and 87% cases. Pain relief of 80% or more after intra-articular injection of local anaesthetic was seen in 50% (15 of 30) patients; pain relief of 50 – 79% was witnessed in 30% (9 of 30) patients. Thus, pain decreased 50% or more in 80% (24 of 30) of the joints. Out of 24 joints where we got satisfactory needle position and contrast spread, 23 joints got more than 50% relief. Thus, if needle position and contrast spread is satisfactory as per the criteria, pain relief of 50% or more was in 96% (23 of 24) of joints. There are few possible limitations with this study like difficulty to go up to the anterior third of the SIJ, it may be more painful as a narrow joint line has to be travelled in depth, sciatic numbness due to drug leak, or injuring the pelvic structure. Advantages of this method are that depth and level of the needle tip for a SIJ block is described for the more precise block. This will reduce false positive and false negative results, i.e., sensitivity and specificity of SIJ blocks and results for diagnostic blocks become more reliable. It will also reduce the chances of a case getting abandoned due to inappropriate contrast spread obscuring the fluoroscopic landmarks. As we know the depth of the needle, the chances of injuring pelvic structures become less and safety improves. Key words: Sacroiliac joint, low back pain, contrast dye, fluoroscopy, lateral view, pain management, SI joint block, modified technique
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Stephen, Lesley, Janet A. Dunn, Claire Balmer, Sophie J. Gasson, Nada I. Elbeltagi, Ellen R. Copson, and Carlo Palmieri. "Abstract P4-07-37: A UK study exploring the attitudes and experience of patients living with metastatic breast cancer with regard to clinical research: A patient advocate-academic collaborative study." Cancer Research 83, no. 5_Supplement (March 1, 2023): P4–07–37—P4–07–37. http://dx.doi.org/10.1158/1538-7445.sabcs22-p4-07-37.
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Abstract Background: Clinical trials are key to improving outcomes in metastatic breast cancer (MBC). However, participation is low. Little data exists regarding the attitudes and experiences of patients in relation to clinical research. This study co-developed by a patient living with MBC and researchers aims to explore the experiences and issues related to accessing and participating in clinical research. Material and Method: A mixed methods study consisting of an online survey and qualitative interviews. Participants responded to an online questionnaire which contained closed and open questions, this was live between 17th May 2021 and 30th November 2021. Qualitative interviews from a sample of patients who gave their consent were carried out between 15th August 2021 and 22nd November 2021. Descriptive statistical analysis of the quantitative results from the closed questions and thematic analysis of the qualitative data generated by the open-ended questions and interviews were utilised. Data were extracted on 1st December 2021. Results: 768 eligible responses were received (765 female, 2 male, 1 unknown gender). The greatest proportion of responders were aged 51-60 years (37%), 92% were white (n=708) and 45% employed (n=345). 31% (n=235) were diagnosed with MBC within the last year with 14% (n=107) >5 years ago. 86% (n=660) knew what a clinical trial was. With 23% (n=173) reported an oncologist raising trial participation while 32% (n=243) of patients raising participation with their oncologist. Responses to such inquiries varied from positive and supportive to ‘vague and dismissive’. Accessing new treatments (96%, n=737) and playing a more active role in own health (81%, n=619) would encourage trial participation while being unsure of potential benefits (43%, n=333) was the commonest reason for possible non-participation. Preferred sources of information on trials were a consultant (80%, n=612), nurse (61%, n=467) or trial database (29%, n=220). 36% (n=276) were willing to travel for a study increasing to 56% (n=430) if travel costs were covered, and 43% (n=306) would travel worldwide for a study. £0 to over £100 per month for travel was reported to be affordable. Of the 14% (107 of 768) who had taken part in clinical trials; 72% (n=77) found it a positive experience. Free text responses indicated this was related to additional/longer monitoring. The lack of information relating to trials was a recurring theme. 21 participants were interviewed for the qualitative sub study, with three complementary themes emerging from these namely (1) information about clinical trials/research, (2) barriers to participation and (3) research priorities. Conclusion: This large UK study provides insights into the experiences and attitudes of patients with MBC in relation to clinical research. It demonstrates that patients are keen to be involved in research but face barriers to inclusions. Key messages include the need to develop patient facing trial databases, the importance of clinical staff in the provision of study information and a willingness to travel for a trial but the need for financial support. Addressing the issues identified in this survey are key to ensuring MBC patients not only have opportunities to participate in clinical research but also the ability to take these opportunities up. Citation Format: Lesley Stephen, Janet A. Dunn, Claire Balmer, Sophie J. Gasson, Nada I. Elbeltagi, Ellen R. Copson, Carlo Palmieri. A UK study exploring the attitudes and experience of patients living with metastatic breast cancer with regard to clinical research: A patient advocate-academic collaborative study [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P4-07-37.
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Pruitt, Sandi L., Lynn N. Ibekwe, Kaitlin Todd, Erica S. Breslau, Andrea N. Burnett-Hartman, Cheryl R. Clark, Natalie J. Del Vecchio, et al. "Abstract A114: Association of racial residential segregation and screening uptake for cervical and colorectal cancer among Black and White patients in five diverse U.S. healthcare systems." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): A114. http://dx.doi.org/10.1158/1538-7755.disp22-a114.
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Abstract Background Black people experience excess cervical and colorectal (CRC) cancer burden. Racial residential segregation, one measure of exposure to racism, is a potential driver of these inequities. To achieve cancer equity, it is crucial to better understand the role of racism and cancer prevention and early detection behaviors, including cancer screening. We assessed the association of exposure to Black residential segregation and cancer screening among Black and White adults. Methods This was a retrospective cohort study using electronic medical record data from patients who were members of the Population-based Research to Optimize the Screening Process (PROSPR) cohort. The sample included non-Hispanic (NH) Black or NH White average-risk urban adults at five U.S. healthcare settings who were eligible and due for cervical cancer screening (women aged 21-65 years) or CRC screening (50-75 years) when they had a primary care appointment (cohort entry) from 2010-2012. Black residential segregation was measured using sample-based quartiles of the local exposure and isolation (LEx/Is) metric comprising census-tract level data from 2008-2012 American Community Survey. The outcome was receipt of cervical cancer screening (completion of Pap or Pap/human papillomavirus [HPV] co-test) or CRC screening (completion of FIT/gFOBT, sigmoidoscopy, or colonoscopy) within 3 years of cohort entry. Multilevel logistic regression was used to calculate association of segregation and screening while adjusting for patient- and census-travel level covariates (age, race, sex, year of cohort entry, comorbidities, healthcare system, and census tract level poverty rate.) Results Of 164,238 and 652,719 patients eligible and due for cervical cancer or CRC screening respectively, 106,753 (65.0%) and 465,042 (71.2%) received timely screening. Black patients (6.4% of cervical screening and 15.7% of CRC screening sample), compared to White patients, were more likely to live in neighborhoods in the highest quartile of Black segregation (cervical sample: 44.1% vs. 17.6%; CRC sample: 51.8% vs. 19.4%). Greater exposure to segregation was associated with lower odds of cervical cancer screening (Quartile [Q]4 vs. Q1 odds ratio [OR]=0.92; 95% CI 0.89-0.94) and CRC screening (Q4 vs. Q1 OR=0.91; 95% CI 0.89-0.92) in unadjusted models; these associations were attenuated in adjusted models for cervical (Q4 vs. Q1 adjusted OR[aOR]=0.99; 95%CI=0.95-1.03) and CRC screening (Q4 vs. Q1 aOR=1.0; 95% CI 0.97-1.02). Notably, in adjusted models for both screening types, higher census tract level neighborhood poverty rate was associated with lower odds of screening, and Black (vs. White) race was associated with higher odds of cervical cancer screening but lower odds of CRC screening. Discussion In this study within five healthcare systems, Black residential segregation was not associated with screening after adjustment for other variables. Additional analyses will assess potential for effect measure modification by patient race, healthcare system, and other factors. Citation Format: Sandi L. Pruitt, Lynn N. Ibekwe, Kaitlin Todd, Erica S. Breslau, Andrea N. Burnett-Hartman, Cheryl R. Clark, Natalie J. Del Vecchio, Jennifer S. Haas, Stacey Honda, Christopher I. Li, Rachel L. Winer, Christine Neslund-Dudas, Rachel Issaka. Association of racial residential segregation and screening uptake for cervical and colorectal cancer among Black and White patients in five diverse U.S. healthcare systems [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A114.
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Phung, Minh Tung, Pham Le An, Lilah Khoja, Pham Duong Uyen Binh, Hong H. T. C. Le, Karen McLean, Bhramar Mukherjee, Rafael Meza, Alice W. Lee, and Celeste Leigh Pearce. "Abstract A113: Insight into cervical cancer prevention awareness, experiences, and attitudes among Southern Vietnamese women." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): A113. http://dx.doi.org/10.1158/1538-7755.disp22-a113.
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Abstract Background At least 80% of new cervical cancer cases and deaths occur in low- and middle-income countries. Vietnam is a middle-income country where cervical cancer is the second most common and the deadliest gynecologic cancer. Cervical cancer incidence in Southern Vietnam has been shown to be 1.5-4 times higher than that in Northern Vietnam. However, less than 10% of Southern Vietnamese women have received the Human papillomavirus (HPV) vaccine and only 50% have ever been screened for cervical cancer. No study has examined the perceptions toward cervical cancer prevention and screening in Southern Vietnamese women. Hence, this study aimed to explore cervical cancer awareness, barriers to screening, and acceptability of HPV self-sampling for cervical cancer screening among rural and urban women in Southern Vietnam. Methods In October-November 2021, three focus groups were conducted in the rural district of Can Gio (n=21 participants) and three were conducted in the urban District Four (n=23 participants) in Ho Chi Minh City, Southern Vietnam. All participants were cervical cancer-free women aged 30-65 years. Awareness of, attitudes toward, and experience with cervical cancer prevention and screening were explored using audio-recorded, semi-structured discussions in Vietnamese. During the focus groups, participants also watched four short videos with Vietnamese subtitles and voiceover about cervical cancer screening methods and discussed their views on each. The recordings were transcribed, translated into English, and coded and analyzed using Dedoose 9.0.46. Results Four main themes emerged. First, women showed low awareness, but high acceptance of cervical cancer screening and HPV vaccination. Second, screening barriers were related to logistics (e.g., cost, time, travel distance), psychology (e.g., fear of pain, embarrassment, fear of the test revealing they had cancer), and healthcare providers (e.g., doctors’ impolite manners, male doctors). Third, women were concerned about self-sampling incorrectly and pain, but believed HPV self-sampling to be a feasible screening tool in some circumstances (e.g., during the COVID-19 pandemic, those living in remote areas). Fourth, women related cervical cancer prevention to COVID-19 prevention; they believed strategies that have been successful for COVID-19 control in Vietnam could be applied to cervical cancer. No differences in themes emerged by rural/urban areas. Conclusions Southern Vietnamese women showed low awareness but high acceptance of cervical cancer screening despite barriers. Strategies for successful COVID-19 control in Vietnam, including campaigns to increase public awareness, advocacy from the government and doctors, and efforts to increase access to screening and vaccination, should be applied to cervical cancer control. Health education programs to address HPV self-sampling concerns and promote it as a cervical cancer screening tool are warranted given its potential to improve screening uptake in this low-resource setting. Citation Format: Minh Tung Phung, Pham Le An, Lilah Khoja, Pham Duong Uyen Binh, Hong H.T.C. Le, Karen McLean, Bhramar Mukherjee, Rafael Meza, Alice W. Lee, Celeste Leigh Pearce. Insight into cervical cancer prevention awareness, experiences, and attitudes among Southern Vietnamese women [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A113.
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Schott, Dorothea, Monika PIZON, and Katharina Pachmann. "Abstract P2-26-12: Interaction between CTCs and platelets complicate their detection by masking surface epitopes." Cancer Research 83, no. 5_Supplement (March 1, 2023): P2–26–12—P2–26–12. http://dx.doi.org/10.1158/1538-7445.sabcs22-p2-26-12.
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Abstract 1) Background: It is well known that solid tumors have the ability to form metastases. The development of distant metastases is due to the primary tumor shedding cells that travel to distant sites via the blood vessels. Platelets specifically promote tumor cells survival in the bloodstream. To investigate the interplay between platelets and circulating tumor cells, we implemented our approach to label simultaneously circulating epithelial tumor cells and platelets. 2) Methods: 40 breast cancer patients were enrolled into the study. Blood samples were collected in EDTA tubes without fixatives and processed at 3 timepoints (0h, 24h and 48h) using the maintrac® approach. In order to visualize platelets we used anti-CD36 antibody staining. 3) Results: We observed at 0h post-blood draw platelet aggregates strictly attached to single cells that did not stain with anti-EpCAM antibody. After keeping blood samples at room temperature for 24h platelet aggregates could still be detected, but the anti-EpCAM antibody became accessible to the underlying cells. CTCs were detected in 94% of patients on day 1 post-blood draw. At 48h following initial blood drawing, platelets had almost completely disappeared from the cell surface and the number of detected CTCs remains stable between 24h and 48h. Furthermore, the number of CTCs correlates with clinical stage of disease. Patients with stage I/II have significantly less CTCs as compared to patients with stage III/IV (median 5 vs. 19 CTCs/100µl cell suspension, p< 0.05). 4) Conclusion: Our results suggest that platelets play a key role in masking circulating tumor cells. Masking may explain the difficulties in detection of these cells and prevention of their elimination by the immune system. Citation Format: Dorothea Schott, Monika PIZON, Katharina Pachmann. Interaction between CTCs and platelets complicate their detection by masking surface epitopes [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-26-12.
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Halas, Paige, Hannah Savage, Dennis Ma, Jacob Insua-Rodriguez, Sharmila Mallya, Connie Chan, Radhika Domadia, Tatyana Lev, and Devon Lawson. "Abstract B003: Investigating PHLDA2 as a Genetic Driver of Breast Cancer Metastasis." Cancer Research 84, no. 3_Supplement_1 (February 1, 2024): B003. http://dx.doi.org/10.1158/1538-7445.advbc23-b003.
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Abstract Metastasis is cancer’s lethal driver. Metastatic cancer cells leave the primary tumor and travel through the blood stream to distal sites. These cancer cells are aggressive, highly recurring and pose challenges for clinical treatment. There is a critical need to define drivers of metastasis in order to identify novel drug targets and improve patient prognosis. Our previous work identified a potential breast cancer metastasis promoting gene known as PHLDA2. By single cell RNA sequencing, PHLDA2 gene expression was elevated in metastatic lesions compared to primary breast tumor tissue. This gene has not previously been linked to cancer metastasis; therefore, the objective of the current study is to confirm PHLDA2 as a driver of breast cancer metastasis and define the mechanisms by which it exerts its pro-metastatic function. We manipulated multiple breast cancer models to have elevated or reduced PHLDA2 levels to investigate its role in metastasis. We have additionally explored the mechanism of PHLDA2 in metastasis at the RNA level by qPCR, the protein level by western blot analysis, and the organ level using immunofluorescence staining and bulk sequencing. We confirmed using our breast cancer models of elevated or reduced PHLDA2 expression that PHLDA2 has a pro-metastatic function. Bulk RNA sequencing data revealed that PHLDA2 promotes extracellular matrix (ECM) remodeling. This finding is significant as ECM remodeling plays a critical role in cancer progression and metastasis. Investigation of PHLDA2’s pro-metastatic function is necessary to gain deeper insights into the mechanisms of cancer cell spread and reveal novel drug targets to improve patient survival. Citation Format: Paige Halas, Hannah Savage, Dennis Ma, Jacob Insua-Rodriguez, Sharmila Mallya, Connie Chan, Radhika Domadia, Tatyana Lev, Devon Lawson. Investigating PHLDA2 as a Genetic Driver of Breast Cancer Metastasis [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Breast Cancer Research; 2023 Oct 19-22; San Diego, California. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_1):Abstract nr B003.
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Omisore, Adeleye, Elizabeth J. Sutton, Gavin Tansley, Rachael Adeyanju AKINOLA, and Gregory Knapp. "Abstract P3-04-02: Population level access to diagnostic mammography and ultrasound guided breast biopsy in Nigeria: a geospatial analysis." Cancer Research 83, no. 5_Supplement (March 1, 2023): P3–04–02—P3–04–02. http://dx.doi.org/10.1158/1538-7445.sabcs22-p3-04-02.
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Abstract Introduction: Breast cancer is the most common cause of cancer-related mortality among women in Nigeria. Physical proximity to a diagnostic center is an important component of access, which has direct implication on the cost and timeliness of diagnosis and treatment. Beyond diagnostic mammography, ultrasound (US)-guided biopsy is an essential tool in the diagnostic pathway for suspicious lesions of the breast and is recommended by the Whole Health Organization Breast Health Global Initiative for LMICs. Unfortunately, there is a dearth of data on the population level access to mammography and US-guided breast biopsy in Nigeria and little is known about the geospatial inequities in access that targeted programming or investment could potentially address. This study undertook a comprehensive evaluation of breast imaging and diagnostic services in Nigeria and using a previously validated geographic information system (GIS) model, evaluated geospatial access to diagnostic mammography and US-guided breast biopsy in Nigeria. Methods: A comprehensive list of public and private facilities offering diagnostic mammography and/or US-guided breast biopsy was compiled using publicly available facility data from the Nigerian Ministry of Health, a survey administered to members of the Breast Imaging Society of Nigeria (BISON) as well as key stakeholder interviews from each of the countries six geopolitical zones. A novel survey was delivered to BISON members to identify additional/new facilities not captured by the latest Nigerian Ministry of Health data. Facility location, administration (public vs. private) and duration of service delivery were elicited from respondents and paired with the Ministry of Health facility dataset. Data on provider training and volume were also captured in the survey. All facilities were geolocated using Google Earth™ (Google, Mountain View, CA). A previously described cost-distance model, that uses open-source population density data to 100m2 (GeoData Institute) and road network data (OpenStreetMap) was used to estimate population level travel time to the nearest diagnostic center. Any portion of a route that included travel over terrain without roads was assigned a walking speed of 5 kmh-1. Geospatial access was calculated for mammography and US-guided biopsy separately and as well as by geopolitical zone. This study was approved by the research ethics board at Obafemi Awolowo University. Results: In addition to publicly available data from the Ministry of Health, facility and practice data was obtained from 63 Nigerian Radiologists from across the country. In total, 124 centers were identified that offer diagnostic mammography, of which 78 (63%) are privately administered. Nine of the countries 36 states did not have a center offering this service. Across the country, 33 centers offer US-guided breast biopsy, of which the majority (72.7%) are public. At a population level, 83.1% of the population has access within 120 minutes of continuous one-way travel to a center with diagnostic mammogram or US. At 240 minutes of continuous one-way travel, which corresponds to a full day of travel round-trip, 80.8% of the population has access to US-guided breast biopsy. However, there are differences in access between geopolitical zones. Just 68.7% of the population in the North East geopolitical zone has access to US-guided biopsy within a day’s travel (i.e. 240 minutes one-way). The remaining five geopolitical zones have population level access to this service of ≥80%. Conclusions: This is the first comprehensive evaluation of breast cancer imaging and diagnostic services in Nigeria. Our results, demonstrate that the majority of the population in Nigeria has reasonable geospatial access to basic breast cancer imaging services. However, there are inequalities in access between states and geopolitical zones in the north and south of the country, which may have an impact on timely diagnosis and care. Citation Format: Adeleye Omisore, Elizabeth J. Sutton, Gavin Tansley, Rachael Adeyanju AKINOLA, Gregory Knapp. Population level access to diagnostic mammography and ultrasound guided breast biopsy in Nigeria: a geospatial analysis [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P3-04-02.
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Clements, Karen, David Dodwell, Elinor Sawyer, Ramsey Cutress, Nisha Sharma, Abeer Shaaban, and Alastair Thompson. "Abstract PO4-17-05: Patterns of care: radiotherapy after breast conserving surgery and the use of endocrine therapy for screen-detected ductal carcinoma in situ (DCIS) in the UK." Cancer Research 84, no. 9_Supplement (May 2, 2024): PO4–17–05—PO4–17–05. http://dx.doi.org/10.1158/1538-7445.sabcs23-po4-17-05.
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Abstract Background The use of adjuvant radiotherapy (RT) and endocrine therapy (ET) in the management of pure ductal carcinoma in situ (DCIS) remains controversial. We investigate how the use of adjuvant RT after breast conserving surgery (BCS) and use of adjuvant ET (in BCS and mastectomy patients) has changed over time. Methods A prospective cohort SQL database of 11,284 patients (the Sloane Project) diagnosed 2003-2012 with screen-detected DCIS in the UK was interrogated for use of adjuvant RT and ET over time and association with factors reported to be predictive of recurrence (patient age, DCIS nuclear grade, size, comedo necrosis, resection margins), as well as institution of surgery, travel time to radiotherapy facility, Index of Multiple Deprivation and outcome (provided by the National Disease Registration Service, NDRS). RT data by site were confirmed with more recent data from the National Audit of Breast Cancer in Older Patients (NABCOP), which looked at patterns of care and outcomes for women aged 70 years and over, compared with those aged 50-64 in England and Wales. Results Among the 7,949 women (70.6%) treated by BCS, post-operative adjuvant RT was given to 4,939 (62.1%); RT use after BCS increased over time (R2 =0.92; p< 0.01). RT use was associated with year of diagnosis (p < 0.01), younger age at diagnosis (p < 0.01), larger DCIS size (p < 0.01), presence of comedo necrosis (p < 0.01), higher nuclear grade (p < 0.01) and presence of microinvasion (p < 0.01). Adjusted analyses showed the most significant factor for RT after BCS was the surgery institution. Travel time to RT facility, Index of Multiple Deprivation and final radial margin were not associated with RT use. When compared with the more recent data from the NABCOP, a marked variation in radiotherapy use across hospitals remains. Ipsilateral recurrence rate varied significantly by hospital, with some of the difference associated with RT utilisation. ET was prescribed in 1313 women (12%), more often following BCS than mastectomy (p < 0.001), with significant variation by institution and a decline in the use of ET over time. Conclusion Marked geographic variation in the use of RT and ET after surgery for DCIS persists in the UK and is likely due to physician choice rather than other factors such as travel times to RT facilities. This is contributing to geographic variation in ipsilateral recurrence rates, suggesting the need for adoption of more authoritative guidelines to support clinical decision-making. Consistent national practice could provide auditable performance standards for adjuvant therapy of screen detected DCIS and contribute to more uniform patient care. Citation Format: Karen Clements, David Dodwell, Elinor Sawyer, Ramsey Cutress, Nisha Sharma, Abeer Shaaban, Alastair Thompson. Patterns of care: radiotherapy after breast conserving surgery and the use of endocrine therapy for screen-detected ductal carcinoma in situ (DCIS) in the UK [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO4-17-05.
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Jubran, Ritta, Yelena Lapidot, Tzvia Bader, and Avital Gaziel. "Abstract A119: Unveiling disparities in clinical trial participation: Exploring socioeconomic barriers and access to insurance among diverse ethnic groups." Cancer Epidemiology, Biomarkers & Prevention 32, no. 12_Supplement (December 1, 2023): A119. http://dx.doi.org/10.1158/1538-7755.disp23-a119.
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Abstract Introduction: Diversity in clinical trials (CTs) is crucial for enhancing the ability to generalize research findings and promote equal health services for underserved populations. Researchers and companies seeking approval for late-stage CTs are now asked by the US Food and Drug Administration (FDA) to provide a diversity plan to ensure inclusivity among CT participants. To design such a plan, it is important to study the barriers leading to underrepresentation in CTs. While CTs interventions are mostly covered by trial sponsors, insurance coverage is still required for participation. We studied the impact of insurance coverage, as a potential factor impacting participation in CTs among underserved communities, while considering other key parameters such as age, sex, cancer type and disease status. Methods: Leal is an AI-based platform that matches cancer patients (pts) to CTs based on a self reported medical profile. The profile includes parameters essential for CT matching including disease status, stage, biomarker/mutational status, treatment history, comorbidities and demographics. This study included a multi-ethnic cohort of 4,525 pts who signed up to the platform in 2023. We analyzed potential barriers for CT enrollment among various ethnic groups. We implemented the non-parametric Pearson's Χ², the Welch's t-test and the Games-Howell pairwise comparisons tests, at significance level of 0.05. Results: Insurance coverage was significantly linked to ethnicity. Non-white pts comprised 37% of uninsured pts, which was markedly higher compared to their representation in the insured group (24%, p<0.0001). Medicaid had the most diverse subscriber base (33%) compared to other insurance providers (p<0.0001), independently from disease status and cancer type. In addition, when considering participation in CTs, 78% of non-white pts were willing to travel up to 50 miles, while a larger percentage of white pts (64%) were open to traveling between 100 and 200 miles (p<0.0001). Conclusions: We found a strong association between socioeconomic status and potential barriers for CTs participation including insurance coverage and willingness to travel. The higher proportion of uninsured non-whites highlights the disparity in access to insurance of underserved populations. This may stem from both financial constraints or limited education and community resources. Medicaid had the most diverse subscriber base, which is aligned with its aim to provide coverage to pts with low income. To increase diversity in CTs, financial support programs for uninsured patients should be considered. In addition, CT sites should consider incorporating insurance programs for pts with disadvantaged backgrounds. Our study also revealed reduced willingness among non-whites to travel long distances to trial sites. To ensuring representative outcomes across diverse populations, regardless of location or socioeconomic status, requires addressing accessibility limitations through financial support, localized trial sites, and community-targeted recruitment strategies. Citation Format: Ritta Jubran, Yelena Lapidot, Tzvia Bader, Avital Gaziel. Unveiling disparities in clinical trial participation: Exploring socioeconomic barriers and access to insurance among diverse ethnic groups [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A119.
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Spees, Lisa P., Blen M. Biru, Wendy R. Brewster, Jennifer Leeman, Brianna Taffe, and Stephanie B. Wheeler. "Abstract A130: Stakeholder perspectives of the multi-level barriers to treatment among rural endometrial cancer patients: A qualitative study." Cancer Epidemiology, Biomarkers & Prevention 32, no. 12_Supplement (December 1, 2023): A130. http://dx.doi.org/10.1158/1538-7755.disp23-a130.
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Abstract Purpose. Rural individuals with endometrial cancer (EC) have an 8-17% higher mortality risk than their urban counterparts. EC patients have distinct needs, such as requiring treatment to be directed by gynecologic oncologists who are often located in urban areas or at academic medical centers. Our objective was to identify barriers to treatment of rural EC patients. Methods. We conducted semi-structured interviews with 25 providers (e.g. gynecologic oncologists, nurses, pharmacists), and healthcare administrators who provided services to EC patients. Participants represented three large and geographically-diverse, integrated healthcare systems located across North Carolina. A semi-structured interview guide was developed to examine the treatment process and then probe on multi-level barriers to treatment. Initial codes were derived from an adapted multi-level conceptual framework of rural cancer control. We used template analysis to analyze transcribed interviews. Results. The majority of interview participants were gynecologic oncologists (n=7) and nurses (n=7). Participants highlighted barriers at multiple levels, including the patient-, provider/clinic-, and community-levels. At the patient-level, common barriers included patients’ anxiety and fears about undergoing treatment as well as patients’ low medical literacy. Patients without a support network or caregiver often encountered logistical problems when it came to traveling and planning their treatment; in some cases, interviewees said patients would have to hire someone to take them to their treatment appointments. At the provider/clinic-levels, interviewees reported that providers were not always made aware of supportive resources, such as gas cards, that were available to patients; this was particularly a problem since, to access these resources, patients often had to be referred by a provider. At the same time, however, providers who were aware of these supportive resources said that only a limited amount was available and insufficient in meeting patients’ needs. Finally, at the community-level, treatment services for patients with gynecologic malignancies were often only available at large urban or academic medical centers; consequently, EC patients frequently faced geographic barriers and had to travel long distances for treatment. This travel burden for treatment created financial hardship for patients, due to the increased temporary housing and travel costs. Furthermore, even if there were oncology-related providers within a patient’s community, most did not have appropriate experience or feel comfortable in treating patients with EC. Among the few community-based oncology-related providers that would treat EC patients, interviewees expressed concerns about the quality of care received by these patients as they could not oversee or direct the patient’s treatment plan. Conclusions. To achieve equitable outcomes among EC patients, those living in rural areas may require more intensive outreach, support, and resources that can effectively target multi-level barriers. Citation Format: Lisa P. Spees, Blen M. Biru, Wendy R. Brewster, Jennifer Leeman, Brianna Taffe, Stephanie B. Wheeler. Stakeholder perspectives of the multi-level barriers to treatment among rural endometrial cancer patients: A qualitative study [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr A130.
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Redwood, Diana. "Abstract 4787: Preference for multi-target stool DNA for colorectal cancer screening among Alaska Native people in rural/remote communities." Cancer Research 84, no. 6_Supplement (March 22, 2024): 4787. http://dx.doi.org/10.1158/1538-7445.am2024-4787.
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Abstract Background: The Alaska Tribal Health System is working on increasing colorectal cancer (CRC) screening rates among Alaska Native people, who have the highest CRC rates in the world. Most remote Alaska Native communities are not connected to the road system, which severely limits access to screening colonoscopy. As part of a clinical trial, Alaska Native patients were offered either colonoscopy or the at-home multi-target stool DNA test (mt-sDNA; Cologuard®). Patients had never been offered mt-sDNA before and it was unknown what they would think about the new test option. Both tests were provided at no cost to patients. Methods: From April 2022 to July 2023, 194 patients who chose mt-sDNA for screening received a follow-up phone survey asking whether they were aware that they could have had colonoscopy instead, their reasons for choosing mt-sDNA, and the factors influencing their choice of mt-sDNA over colonoscopy. Patients answered the survey before receiving results of their mt-sDNA test in order to capture initial screening test preferences. Results: A total of 115 (59%) Alaska Native patients participated in the survey; 56% men and 44% women. About 70% were ages 45 to 60 years while the remaining 30% were 61 to 75 years old. The majority (80%) were aware that they had the option to undergo colonoscopy for CRC screening instead of mt-sDNA. Key themes for mt-sDNA preference included not having to travel, less time commitment, and greater convenience. Many patients expressed financial concerns arising from the costs of air travel and accommodation required to access screening colonoscopy even though the procedure itself was covered. Additionally, patients highlighted existing obligations such as childcare and work responsibilities which made the use of mt-sDNA at home more appealing. Many respondents also shared negative perceptions of colonoscopy procedure including fear, embarrassment, and discomfort as reasons why they preferred mt-sDNA instead. Conclusions: These findings demonstrate the multifaceted factors influencing the preference for at-home mt-sDNA CRC screening among Alaska Native individuals. Challenges such as limited access to medical facilities, financial burdens, and personal commitments have significant bearing on the screening decision-making process. Moreover, the emotional aspect of fear and discomfort associated with colonoscopy plays a role in shaping these preferences. CRC screening programs need to be aware of patient needs and preferences when deciding which screening methods to offer to increase screening rates and result in improved colorectal health outcomes. Citation Format: Diana Redwood. Preference for multi-target stool DNA for colorectal cancer screening among Alaska Native people in rural/remote communities [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4787.
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Riegel, Devon C., Jamila L. Kwarteng, Laura Pinsoneault, AnaKaren Manriquez Prado, Sandra Contreras, Sophia Aboagye, Erica Wasserman, et al. "Abstract B029: Partnering with an urban public recreation system to implement Total Wellness, a cancer prevention intervention." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): B029. http://dx.doi.org/10.1158/1538-7755.disp22-b029.
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Abstract Introduction Cancer is a leading cause of death in Wisconsin, with higher mortality rates in African American (AA) and Hispanic (Hisp) populations. Focus groups with community members highlighted interest in programming to increase cancer awareness and support healthy behaviors. With this goal in mind and in partnership with the Milwaukee Recreation System (MKE Rec), Total Wellness (TW) was created to provide programming to Milwaukee communities. We present a program description and preliminary results for implementation of TW. Methods TW program content was informed by the American Cancer Society Guidelines and community feedback through surveys and discussion sessions. TW is a 16-week program implemented over two 8-week sessions (TW 1.0, 2.0) led by instructors trained in cancer prevention and lifestyle change. The program meets 2x weekly: Class 1 is a 30-min cancer and lifestyle education session targeting a weekly topic (wks 6, 10 include cooking demo), followed by a 60-min exercise class; Class 2 is a 60-min exercise class. TW is listed as a wellness class in the MKE Rec program guide. To promote enrollment, TW was advertised on MKE Rec’s website and social media, and program ads were distributed to zip codes of predominantly AA and Hisp neighborhoods. Once registered, participants were invited to complete an evaluation to assess program impact. Evaluation completion was not required to enroll in the class. TW is being evaluated at a systems level (i.e., # of registrants and # of instructors trained) and at an individual level (i.e., cancer awareness, health behaviors, fitness). Results At the systems level, 3 instructors were trained (2 are bilingual English/Spanish, 1 English only). The first TW 1.0 class began in January 2022 at a MKE Rec facility within a predominantly AA neighborhood and enrolled to capacity. In March 2022, a new TW 1.0 session at the same site enrolled to capacity, and 66% from the premiere TW 1.0 class re-enrolled for TW 2.0. Going forward, MKE Rec will offer TW 1.0 and 2.0 each season at the first site. In June 2022, MKE Rec began a TW 1.0 Spanish language class, the first of its kind, at a new site in a predominantly Hispanic neighborhood. At the individual level, 22 of 30 enrollees consented to participate in the evaluation. Participants are a mean age of 45.81 yrs; 72.7% are Black/African American, 22.7% White, 10.5% Hispanic/Latino, and 4.5% American Indian/Alaska Native (>100% ethnicity includes mixed-race participants). Most participants are employed full-time with varied education, marital status, and incomes. 57.1% of participants report HTN, 28.6% hyperlipidemia, and 54.5% obesity (mean BMI 35.25). 28.5% were current/former tobacco users, and 57.2% were insufficiently physically active. Given ongoing data collection, pre- and post-intervention changes have not yet been analyzed. Conclusion Though still in its early stages, TW has shown success in being integrated into MKE Rec and reaching AA and Hisp communities. Future reports will demonstrate program efficacy and sustainability. Citation Format: Devon C. Riegel, Jamila L. Kwarteng, Laura Pinsoneault, AnaKaren Manriquez Prado, Sandra Contreras, Sophia Aboagye, Erica Wasserman, Derek Donlevy, Alexis Visotcky, Patricia Sheean, Margaret Tovar, Kathleen Jensik, Regina Vidaver, Melinda R. Stolley. Partnering with an urban public recreation system to implement Total Wellness, a cancer prevention intervention [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B029.
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Brecher, Alison C., Cassidy Kenny, Donna Edmondson, Allison Zambon, Linda Fleisher, and Hossein Borghaei. "Abstract B002: Addressing disparities and barriers to care between Black and White cancer patients who use tobacco." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): B002. http://dx.doi.org/10.1158/1538-7755.disp22-b002.
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Abstract Purpose of the study: Smoking is detrimental to treatment outcomes for both smoking and non-smoking-related cancers, and tobacco cessation is an integral part of comprehensive cancer care. Through the support of a competitive grant funded by the NCI’s Cancer Center Cessation Initiative, Fox Chase Cancer Center (FCCC) optimized their Tobacco Treatment Program (TTP). Within the first year of optimization, TTP’s reach increased tenfold by implementing an automated tobacco registry through a nightly EMR feed that proactively reaches all new cancer patients who have used tobacco in the last 30 days. This registry serves as a repository and referral source for the optimized program and includes demographic information and smoking status of all new patients who use tobacco. Within the first year of the program at FCCC, the registry was comprised of 70% white (W) and 20% black (B). FCCC TTP has since expanded to the broader Temple University Health System (TUHS) to increase smoking cessation and cancer prevention efforts within a predominantly underrepresented population that often face higher rates of tobacco use and barriers to quitting. Description: Patients are referred to TTP in 3 ways (survey from the tobacco registry, a provider referral from the newly implemented BPA, or self-referral from AVS and marketing materials in three languages). The TTP provides access to evidence-based smoking cessation resources, motivational interviewing with a health educator, treatment with Advanced Practice Tobacco Specialists, and access to NRTs. A REDCap Case Management System was utilized to collect programmatic data that includes scheduled TTP appointments, no-show rates, prescribing data, and readiness to quit. These data have allowed us to evaluate access disparities between B and W patients that will further be explored with the broader expansion to TUHS. Results: Within the first year of optimization, there were no significant differences in number of appointments, no-show rates, and NRT prescriptions between B and W patients. The maximum number of appointments for B patients was 9 compared to 11 W, and TTP had an overall no-show rate of 22% (W patients had a no-show rate of 23%, and B patients had a lower no-show rate of 15%). Additionally, 60% of W patients scheduled TTP visits compared to 50% of B patients. Over 85% of B/W patients were prescribed NRTs, and the breakdown of what was prescribed (patch, gum, lozenge, Chantix, Zyban) did not differ by race. Conclusions: While access to services is comparable in B/W populations, there may be approaches to increase B patients scheduling and explore access all patient populations, particularly as we expand our services throughout TUHS. We will examine barriers to scheduling appointments for B patients as they were less likely than W patients to schedule a TTP appointment. The expansion to TUHS will allow us to provide tobacco cessation and explore differences across sociodemographic factors and further explain utilization/access to TTP. Citation Format: Alison C. Brecher, Cassidy Kenny, Donna Edmondson, Allison Zambon, Linda Fleisher, Hossein Borghaei. Addressing disparities and barriers to care between Black and White cancer patients who use tobacco [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr B002.
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Telisnor, Guettchina, Alexander S. Lim, Zhongyue Zhang, XiangYang Lou, Ibrahim Nassour, and Sherise C. Rogers. "Abstract A076: Pancreatic cancer survival disparities in Florida using a statewide database." Cancer Epidemiology, Biomarkers & Prevention 32, no. 1_Supplement (January 1, 2023): A076. http://dx.doi.org/10.1158/1538-7755.disp22-a076.
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Abstract Introduction Pancreatic cancer (PC) portends a poor prognosis, is the current third-leading cause of cancer deaths in the United States, and is still rising. The state of Florida has the second-highest rate of new cases of PC within the United States with an incidence of 460/100,000. It is also a disease with significant disparities. African Americans with PC have a 50–90% increased incidence, lower rates of surgery, and worse overall mortality in comparison to other racial groups. With increased knowledge of these disparities in recent years, we sought out to identify whether these differences were present in the state of Florida by examining differences in pancreatic cancer survival outcomes between race, age, and income. Materials and Methods Patients with pancreatic adenocarcinoma diagnosed from January 1st, 2017 to October 31st, 2020 were identified through the statewide clinical research and network database called OneFlorida Clinical Consortium (OneFlorida) by using the ICD10 diagnosis code for pancreatic cancer. Patients with a diagnosis of neuroendocrine carcinoma were excluded. Patients were followed for at least one year unless a death occurred. Summary statistics were reported for demographic variables. The demographic variable for income was stratified by low being < $53,000 and high being ≥ $53,000. Kaplan-Meier analysis with log-rank test was performed to compare the difference in overall survival time among groups. Cox proportional hazards models were also fitted to test the between-group differences and compute the 95% confidence intervals of hazard ratio, while adjusting for informative covariate(s) when necessary. Results A total of 2,739 unique patients were available for analysis. The distribution of the sample was 68.7% White, 23.4% Black, and 7.9% Other. The median age was 67 years (27–89). There were 49.8% women and 50.2% men. The median income was $52,915 ($23,704–$124,821). Significant differences in overall survival were detected (p-values < 0.001) between age, income, and racial groups, but not between sex. Patients that were Black, >67 years old, and had low-income had a significantly less survival time than their corresponding contrasts independently. The mean survival (in days) for low income vs. high income was 779.5 vs. 945.9 (p<.0001). The differences remained significant in stratified analyses by cancer stage. In stage II PC, the mean survival (in days) for White vs. Black populations was 1134.9 days vs 472.2 days, and in stage IV PC the survival comparison was 770.2 days vs. 787.5 days between the same groups. Discussion Significant race, age and income disparities in survival exist in the state of Florida. These disparities are present even when stage is accounted for. Knowledge of health disparities statistics are not sufficient, and a targeted multi-stakeholder approach needs to be developed to improve survival outcomes of our patients. Limitations to this study include the racial demographic of “other” not having further description due to limited data availability through the clinical research network. Citation Format: Guettchina Telisnor, Alexander S. Lim, Zhongyue Zhang, XiangYang Lou, Ibrahim Nassour, Sherise C. Rogers. Pancreatic cancer survival disparities in Florida using a statewide database [abstract]. In: Proceedings of the 15th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2022 Sep 16-19; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2022;31(1 Suppl):Abstract nr A076.
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Morelli, Whitney A., Kelly Clohesey, and Jessica Liu. "Abstract PR005: Preferences of older cancer survivors for integration of remote activity monitoring using wearable devices." Cancer Epidemiology, Biomarkers & Prevention 32, no. 12_Supplement (December 1, 2023): PR005. http://dx.doi.org/10.1158/1538-7755.disp23-pr005.
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Abstract Purpose: To describe the preferences for integration of wearable devices into their healthcare to remotely monitor physical activity among older adult cancer survivors. Methods: 89 cancer survivors, aged 65 and older, completed our preferences for wearable devices in healthcare questionnaire. Participants were asked to self-report demographic information, current physical activity participation, and preferences for inclusion of wearable devices as part of their care plan through a current provider (i.e. physician, physical therapist, etc.). Data are summarized and reported as mean ± standard deviation or percent. Results: Participants were on average 71±5 years old, 59% female, and mostly White, non-Hispanic (93%). 76.2% of participants reporting engaging in 0 days of vigorous intensity physical activity, with 31% reporting no moderate intensity physical activity. 59% of older cancer survivors report they already own a wearable device, with the most common device being a wrist-worn device (93%). For those that do not currently own a device, 94% report they would be interested in owning a wearable device. 94% of older cancer survivors state they would be interested in using a wearable device as part of their usual care plan for their provider to remotely monitor their health. 88% report having no privacy concerns with sharing their wearable data with their healthcare provider. Participants report they would be willing to purchase their own monitor if it meant future out of pocket healthcare costs (81%) or reduced time investment to travel to the clinic (63%). Conclusions: Results indicate older cancer survivors are interested in their care team remotely monitoring their activity levels. Further, the majority of older cancer survivors report they are willing to purchase their own device. Future research is warranted to determine an implementation plan to integrate these devices into current clinic workflows and determine optimal interaction among patients and providers. Citation Format: Whitney A. Morelli, Kelly Clohesey, Jessica Liu. Preferences of older cancer survivors for integration of remote activity monitoring using wearable devices [abstract]. In: Proceedings of the 16th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2023 Sep 29-Oct 2;Orlando, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2023;32(12 Suppl):Abstract nr PR005.
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Neinavaie, Fargam, and Andrew Kramer. "Abstract A038: Does mutation rate of cancer cells change as the stage of the disease advances?" Cancer Research 82, no. 10_Supplement (May 15, 2022): A038. http://dx.doi.org/10.1158/1538-7445.evodyn22-a038.
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Abstract Tumorigenesis begins with cells that have normal mutation rates. As the cells become immortal and accumulate different numbers of mutations along the way, current literature splits in two describing if and how mutation rates increase as the cancer progresses. Some argue that as the mutation rates are small (mutation rate in healthy cells is per nucleotide site per cell division) and malignant cells are loaded with thousands of different types of mutations, they must have acquired a mutator phenotype early in their development. Others argue that immortality of malignant cells, and their rate of proliferation is responsible for their genetic instability and number of mutations observed in their genome. We conduct a review of the literature with the key words “mutation rate” and “cancer” in their title. We review 123 papers and found that description of mutation rates varied in the published work. This leads to estimates of mutation rates in cancer from per nucleotide site per cell division. Some of this variation in mutational rates arises across different organs of the body, for instance liver cells have a higher mutation rate than heart and brain. Cancer treatments such as chemotherapy influence mutation rate, and mutation rate of drug and multidrug resistance cancer cell is higher than newly diagnosed cancer cells. Further, mutation rate is defined differently in different literature, some papers measure the mutation rate in a population or a gene, some calculate it per base pair, genome, or mitosis. Here we provide a comprehensive picture of published mutation rates across different cancer types in order to inform cancer models and treatment plans for individual patients. We propose a unified framework for discussing and reporting mutation rate of cancer cells and formulations on how to switch between definitions. Citation Format: Fargam Neinavaie, Andrew Kramer. Does mutation rate of cancer cells change as the stage of the disease advances? [abstract]. In: Proceedings of the AACR Special Conference on the Evolutionary Dynamics in Carcinogenesis and Response to Therapy; 2022 Mar 14-17. Philadelphia (PA): AACR; Cancer Res 2022;82(10 Suppl):Abstract nr A038.
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Cheng, Hao, Arun Kharghoria, Zhong He, and Akhil Datta-Gupta. "Fast History Matching of Finite-Difference Models Using Streamline-Based Sensitivities." SPE Reservoir Evaluation & Engineering 8, no. 05 (October 1, 2005): 426–36. http://dx.doi.org/10.2118/89447-pa.
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Summary We propose a novel approach to history matching finite-difference models that combines the advantages of streamline models with the versatility of finite-difference simulation. Current streamline models are limited in their ability to incorporate complex physical processes and cross-streamline mechanisms in a computationally efficient manner. A unique feature of streamline models is their ability to analytically compute the sensitivity of the production data with respect to reservoir parameters using a single flow simulation. These sensitivities define the relationship between changes in production response because of small changes in reservoir parameters and, thus, form the basis for many history-matching algorithms. In our approach, we use the streamline-derived sensitivities to facilitate history matching during finite-difference simulation. First, the velocity field from the finite-difference model is used to compute streamline trajectories, time of flight, and parameter sensitivities. The sensitivities are then used in an inversion algorithm to update the reservoir model during finite-difference simulation. The use of a finite-difference model allows us to account for detailed process physics and compressibility effects. Although the streamline-derived sensitivities are only approximate, they do not seem to noticeably impact the quality of the match or the efficiency of the approach. For history matching, we use a generalized travel-time inversion (GTTI) that is shown to be robust because of its quasilinear properties and that converges in only a few iterations. The approach is very fast and avoids many of the subjective judgments and time-consuming trial-and-error steps associated with manual history matching. We demonstrate the power and utility of our approach with a synthetic example and two field examples. The first one is from a CO2 pilot area in the Goldsmith San Andreas Unit (GSAU), a dolomite formation in west Texas with more than 20 years of waterflood production history. The second example is from a Middle Eastern reservoir and involves history matching a multimillion-cell geologic model with 16 injectors and 70 producers. The final model preserved all of the prior geologic constraints while matching 30 years of production history. Introduction Geological models derived from static data alone often fail to reproduce the field production history. Reconciling geologic models to the dynamic response of the reservoir is critical to building reliable reservoir models. Classical history-matching procedures whereby reservoir parameters are adjusted manually by trial and error can be tedious and often yield a reservoir description that may not be realistic or consistent with the geologic interpretation. In recent years, several techniques have been developed for integrating production data into reservoir models. Integration of dynamic data typically requires a least-squares-based minimization to match the observed and calculated production response. There are several approaches to such minimization, and these can be classified broadly into three categories: gradient-based methods, sensitivity-based methods, and derivative-free methods. The derivative-free approaches, such as simulated annealing or genetic algorithms, require numerous flow simulations and can be computationally prohibitive for field-scale applications. Gradient-based methods have been used widely for automatic history matching, although the convergence rates of these methods are typically slower than the sensitivity-based methods such as the Gauss-Newton or the LSQR method. An integral part of the sensitivity-based methods is the computation of sensitivity coefficients. These sensitivities are simply partial derivatives that define the change in production response because of small changes in reservoir parameters. There are several approaches to calculating sensitivity coefficients, and these generally fall into one of three categories: perturbation method, direct method, and adjoint-state methods. Conceptually, the perturbation approach is the simplest and requires the fewest changes in an existing code. Sensitivities are estimated simply by perturbing the model parameters one at a time by a small amount and then computing the corresponding production response. This approach requires (N+1) forward simulations, where N is the number of parameters. Obviously, it can be computationally prohibitive for reservoir models with many parameters. In the direct or sensitivity equation method, the flow and transport equations are differentiated to obtain expressions for the sensitivity coefficients. Because there is one equation for each parameter, this approach requires the same amount of work. A variation of this method, called the gradient simulator method, uses the discretized version of the flow equations and takes advantage of the fact that the coefficient matrix remains unchanged for all the parameters and needs to be decomposed only once. Thus, sensitivity computation for each parameter now requires a matrix/vector multiplication. This method can also be computationally expensive for a large number of parameters. Finally, the adjoint-state method requires derivation and solution of adjoint equations that can be quite cumbersome for multiphase-flow applications. Furthermore, the number of adjoint solutions will generally depend on the amount of production data and, thus, the length of the production history.
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Ramos, Elizabeth, Vivian Nguyen, Ashley Santaniello, Dana Dornsife, Robert G. Johnson, Paul E. Wileyto, Robert H. Vonderheide, and Carmen E. Guerra. "Abstract 4825: Addressing financial toxicity in cancer clinical trial participation: Barriers and facilitators of enrolling in a reimbursement program for out-of-pocket travel costs." Cancer Research 84, no. 6_Supplement (March 22, 2024): 4825. http://dx.doi.org/10.1158/1538-7445.am2024-4825.
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Abstract Financial toxicity has been associated with adverse outcomes for patients with cancer. Out-of-pocket (OOP) costs contribute to the high financial toxicity (FT) experienced by patients with cancer. Cancer clinical trial (CCT) participants face significant extra OOP expenses presenting a barrier to participation and retention. To address FT in CCTs, the Lazarex Foundation created the Improving Patient Access to Cancer Clinical Trials (IMPACT) Program, a financial reimbursement program (FRP) for OOP travel and lodging costs associated with therapeutic CCT participation. Our study aimed to quantify the FT experienced by patients in CCTs and understand their experience to determine the barriers and facilitators of enrolling in the Lazarex IMPACT Program. Patients enrolled in a CCT were referred to the IMPACT team to determine eligibility. Patients were eligible for IMPACT if they were active on a therapeutic CCT and their household income was less than 700% of the most recent HHS federal poverty guidelines. Patients who enrolled in the program were invited to participate in a brief semi-structured interview via telephone call. We used grounded theory techniques of analysis to identify themes of barriers and facilitators to enrollment in the Lazarex IMPACT program at our cancer center. Table 1 shows the emerging themes from the interviews as barriers and facilitators of enrolling in IMPACT. As a part of the interview process, patients also completed the COST-FACIT questionnaire, a patent reported outcomes measure to evaluate the degree of FT associated with cancer. COST scores in our cohort (n=39) ranged from 14-39.6, mean=27.12, median=27.5; SD=7.96. Following enrollment in the program, patients on average had COST scores indicating low degrees of financial distress. Taken altogether, our results have the potential to inform the development of FRPs for patients with cancer to facilitate their participation in CCTs. Table 1. Emerging themes from grounded analysis of semi-structured interviews and their frequency Barrier to enrolling in FRP program. No. of Participants Facilitator of enrolling in FRP program No. of Participants Patients wanted to be made aware of program earlier in their CCT timeline 4 Enrollment process was easy and straightforward 17 Patients made aware of program after their CCT started 3 IMPACT team contacted patients to offer program 13 CCT Team unaware of program availability 3 Patients learned about the program through their CCT team 8 Patients reported difficulty with technology access and literacy 3 Patients reported sufficient technology access and literacy 4 Patients reported hesitancy sharing financial information 2 Cancer foundation was timely and helpful in enrollment process 2 Patients reported difficulty navigating vast resources at cancer center 1 Cancer Center social workers provided connection to program 1 Citation Format: Elizabeth Ramos, Vivian Nguyen, Ashley Santaniello, Dana Dornsife, Robert G. Johnson, Paul E. Wileyto, Robert H. Vonderheide, Carmen E. Guerra. Addressing financial toxicity in cancer clinical trial participation: Barriers and facilitators of enrolling in a reimbursement program for out-of-pocket travel costs [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 4825.
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Mishra, S., M. K. Choudhary, and A. Datta-Gupta. "A Novel Approach for Reservoir Forecasting Under Uncertainty." SPE Reservoir Evaluation & Engineering 5, no. 01 (February 1, 2002): 42–48. http://dx.doi.org/10.2118/75353-pa.
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Summary This paper presents a novel approach for developing statistical estimates of uncertainty in reservoir performance from a limited number of simulations. The methodology involves ranking and weighting the full suite of geostatistical models on the basis of a surrogate performance measure, then estimating the mean/variance of the desired performance measure by using a weighted average of simulation results from a few selected realizations. The streamline time-of-flight-based volumetric sweep efficiency is used as the surrogate performance measure to rank geostatistical models, and their weights are determined from a moment-matching algorithm. Introduction The use of geostatistical techniques for generating multiple realizations of 3D porosity and permeability fields is becoming increasingly commonplace in reservoir engineering. Geostatistical methods can generate fine-scale images of reservoir properties honoring data from a variety of sources, with the realization-to realization variations characterizing the uncertainty caused by incomplete information and paucity of data. Quantifying the impacts of such uncertainty on forecasts of reservoir performance would necessitate flow simulations for a large number of these plausible reservoir descriptions. However, computational constraints often preclude the use of a full suite of geostatistical models for reservoir forecasting. Typically, only a few selected realizations are used in detailed simulations to provide an indication of the range of uncertainty in reservoir performance. These realizations are selected by ranking stochastic reservoir models on the basis of some surrogate measure of reservoir performance. The ranking technique has generally become accepted as an economical way of quantifying the impact of uncertainty in reservoir description on reservoir performance. Refs. 1 through 6 (and the references therein) describe several approaches to the problem of ranking geostatistical realizations. Ballin et al.1 suggested the use of a fast simulator for modeling single-phase tracer transport as the surrogate for a comprehensive flow simulator. Their approach then relied on identifying an appropriate quantile-preserving response parameter for ranking realizations. Deutsch and Srinivasan2 investigated different ranking techniques to choose low-side, expected, and high-side realizations for oil recovery and reservoir management. Saad et al.3 proposed a ranking scheme based on the tracer production history, which worked well for a quarter five-spot pattern but did not appear to be as effective for multiple well configurations. Gomez-Hernandez and Carrera4 used a first-order analysis relating the probability of extreme pressure (head) values to element-averaged log transmissivities as the basis for ranking geostatistical models in predictions of groundwater model uncertainty. Kupfersberger and Deutsch5 suggested using coarse-scale groundwater flow and transport simulation with all realizations, followed by fine-scale simulation on a few realizations based on their ranks. Idrobo et al.6 proposed a new ranking criterion for geostatistical models that uses connectivity in streamline time of flight, which provides a direct estimate of areal or volumetric sweep efficiency. The ranking methods described previously typically provide estimates of reservoir performance corresponding to the "best" case, the "median" case, and the "worst" case. These qualifiers are obtained from the surrogate performance measure (e.g., volumetric sweep) and are also assumed to apply to the actual performance measure of interest (e.g., fractional water cut). However, nothing else can be ascertained about the likelihood of various values that fall within this range between the best case and the worst case. In addition, summary statistics of reservoir performance (e.g., mean and standard deviation), which are useful quantities for performing economic risk analysis, cannot be generated based on a knowledge of the uncertainty range alone. To this end, Mishra and Kelley7 have recently presented a method for ranking and weighting geostatistical models for environmental health-risk applications. Their approach involves (a) ranking the realizations based on the readily computed advective travel time, (b) determining the model weights with a momentmatching algorithm, and (c) estimating mean and standard deviation of aquifer performance by weighting the results of the realizations selected for detailed simulation. The objective of this study is to combine the Mishra and Kelley7 method for weighting geostatistical models with the Idrobo et al.6 approach of using streamline time-of-flight-based volumetric sweep as a surrogate measure of reservoir performance. Together, these two techniques provide a new and computationally expedient methodology for putting error bars on reservoir engineering forecasts. In what follows, the theoretical bases for the weighting and ranking methods are described, along with a field example from the North Robertson Unit in west Texas that demonstrates the application of the methodology. Approach The key issue, as noted earlier, is that computational limitations prevent the running of forward simulations for each of the geostatistical realizations collectively representing reservoir characterization uncertainty. Therefore, for practical applications, we need to be able to select only a few realizations for detailed simulations and then extract information regarding the mean and variance of reservoir performance by appropriately weighting the results of those simulations. Our proposed methodology uses volumetric sweep efficiency as a surrogate performance measure to rank (and select from) the geostatistical realizations and a momentmatching algorithm to compute the weights corresponding to these realizations for combining their results. In the following sections, the proposed weighting method is presented first in a generic format so that it can be applied to any surrogate performance measure. Next, we describe the technique for computing streamline time-of-flight-based volumetric sweep as the ranking criterion for the purposes of this paper.
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Carey, Alexis Erasta, Yash Chhabra, Ethan Black, Murilo Ramos Rocha, Mitchell Fane, Vania Wang, Daniel Zabransky, Gloria Bravante, Laura Hueser, and Ashani Weeraratna. "Abstract 71: Melanoma alters the bone marrow immune composition in an age-related manner." Cancer Research 83, no. 7_Supplement (April 4, 2023): 71. http://dx.doi.org/10.1158/1538-7445.am2023-71.
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Abstract Melanoma accounts for the most skin cancer-related deaths in the United States. As patients age, anti-tumor responses decline, making age a negative independent prognostic factor of overall survival in melanoma. Despite advances in immunotherapeutic modalities, there remains a subset of patients who do not benefit from these treatments. Understanding cancer and age-related changes to immune cell development in the bone marrow can improve patient outcomes. We hypothesize that during aging, the bone marrow niche is reshaped, driving precursor cells to become immunosuppressive. This ultimately decreases the anti-tumor response to melanoma due to the skewing of hematopoiesis to yield decreased immune function. In order to tackle this hypothesis, flow cytometry was used to analyze immune compositional changes in the bone marrow of mice challenged with melanoma. Our preliminary data suggests that when melanoma is present in the skin, there are changes to the bone marrow niche, such as an increase in total myeloid cells. Specifically, in the bone marrow of aged tumor-bearing mice, we see a decrease in Ly6C+Ly6G+ granulocytic progenitor cells and an increase in Ly6C+Ly6G- monocytic progenitor cells compared to the bone marrow of young tumor-bearing mice. We predict that the secretome of the aged bone marrow niche will impact immune cell development by producing more immature myeloid cells that can travel to the tumor site. We also saw an increase in the proportion of CD4+ T-cells in the aged bone marrow when melanoma is present. Thus, there appears to be a shift in cell populations in the aged bone marrow niche when the mice are burdened with melanoma. As a future direction, we plan to investigate the role of the aged bone marrow niche and its secretome on the effectiveness of immunotherapies, such as anti-PD-1. These insights could lead to improved outcomes for elderly patients with melanoma. Citation Format: Alexis Erasta Carey, Yash Chhabra, Ethan Black, Murilo Ramos Rocha, Mitchell Fane, Vania Wang, Daniel Zabransky, Gloria Bravante, Laura Hueser, Ashani Weeraratna. Melanoma alters the bone marrow immune composition in an age-related manner [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2023; Part 1 (Regular and Invited Abstracts); 2023 Apr 14-19; Orlando, FL. Philadelphia (PA): AACR; Cancer Res 2023;83(7_Suppl):Abstract nr 71.
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Kang, Yi, Shinghei Mok, Xiaoyu Zong, and Yin Cao. "Abstract 3436: Circadian rhythm dysregulation with risk of gastrointestinal cancers: A large-scale prospective analysis." Cancer Research 84, no. 6_Supplement (March 22, 2024): 3436. http://dx.doi.org/10.1158/1538-7445.am2024-3436.
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Abstract Introduction: The incidence of multiple gastrointestinal (GI) cancers has been rising among younger adults with unknown etiology. Circadian rhythm dysregulation due to increasing exposures to artificial lighting, irregular work hours, and frequent travel, has been recently linked with multiple diseases. Disruption of the circadian clock drives Apc LOH to hyperactivate Wnt signaling and enhances MYC-dependent glycolytic metabolism to accelerate colorectal cancer progression. However, the association between circadian rhythm dysregulation, quantified by relative amplitude (RA)–a parameter derived from rest-activity patterns, and risk of colorectal and other GI cancers has not been evaluated in epidemiologic studies. Methods: We prospectively examined the associations between RA and risk of incident GI cancers among 87,653 UK Biobank participants who wore an Axivity AX3 triaxial accelerometer over 7 days (2013-15) with follow-up to 2021. RA was derived and averaged across all valid days, using the difference between the mean activity levels during the most active 10-hour period and the least active 5-hour period. Cox models were used to estimate relative risks (RRs) and 95% confidence intervals (CIs). Results: During 512,074 person-years, 1,079 incident GI cancer cases occurred. After multivariable adjustment, lower RA was associated with an increased risk of overall GI cancer (RR per SD [standard deviation] = 1.12, 95% CI 1.04-1.21, P for trend = 0.01). Compared to individuals in the highest tertile (T1), those with RA in the lowest tertile (T3) had a 25% increased risk of overall GI cancer (RR = 1.25, 95% CI 1.05-1.50). The positive associations with GI cancers were mainly driven by gastric cancer (RR per SD = 1.33, 95% CI 1.02-1.74, P for trend= 0.04) and colon cancer (RR per SD = 1.13, 95% CI 1.00-1.28, P for trend = 0.03). Conclusion: In this large-scale, prospective analysis of accelerometer data, circadian rhythm dysregulation was associated with subsequent risk of GI cancers, primarily gastric and colon cancer. To our knowledge, this is among the first population-based studies reporting the positive link between circadian rhythm dysregulation with cancer risk. Citation Format: Yi Kang, Shinghei Mok, Xiaoyu Zong, Yin Cao. Circadian rhythm dysregulation with risk of gastrointestinal cancers: A large-scale prospective analysis [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3436.
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Schubert, Antonia, Nadine Winkler, Ajaree Mongkolsittisilp, Matthias Schulz, Oksana Voloshanenko, Meike Schaffrinski, Dominique Kranz, et al. "Abstract 6968: Extracellular vesicles as carriers of signaling factors in cancer." Cancer Research 84, no. 6_Supplement (March 22, 2024): 6968. http://dx.doi.org/10.1158/1538-7445.am2024-6968.
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Abstract Extracellular vesicles (EVs) are small, membrane-bound structures released by cells. They contain various biomolecules and have emerged as mediators of cellular signaling. EVs of various origins can be isolated from body fluids and hold potential as novel biomarkers. However, their clinical implementation as biomarkers is hampered by complex isolation procedures, limited expertise in routine labs, and a lack of mechanistic understanding of signal transfer, particularly in vivo. To better understand how EVs carry oncogenic signaling factors, we performed mechanistic investigations into the role of EVs in WNT signaling as a representative cancer-associated signaling pathway, as well as ex vivo validation experiments analyzing patient-derived EVs. Hydrophobic WNT ligands can use EVs to travel the extracellular space. However, little is known about the quantities of WNT secretion onto different EV fractions and potentially other vehicles. To explore WNT secretory routes and potential functional differences, we generated fluorescently tagged marker constructs of the non-canonical ligand WNT5a, which has context-dependent tumor-suppressing or -promoting functions in cancer. In additional in vitro experiments, we tested how the WNT signaling activation state and cancer-specific WNT mutations, such as CRISPR/Cas9-induced APC truncations, quantitatively and qualitatively affect EV shedding in colorectal cancer cell lines. Further functional testing of EV-bound vs. non-EV WNT ligands is ongoing. For proof-of-concept analyses and to test EVs as biomarkers, we set up the liquid biopsy study EValuate. The project aims for cross-entity analysis of EV profiles and correlation of results to cancer presence, stage, and survival. For quality control and before pipeline implementation, we tested various EV isolation methods and compared different sample pre-processing steps. By combining multidisciplinary expertise in biophysics, molecular biology, and basic and clinical cancer research, we aim to gain a better mechanistic understanding of EV-mediated signal transfer and facilitate the integration of EVs as diagnostic and prognostic biomarkers into clinical studies. Citation Format: Antonia Schubert, Nadine Winkler, Ajaree Mongkolsittisilp, Matthias Schulz, Oksana Voloshanenko, Meike Schaffrinski, Dominique Kranz, Karin Nienhaus, Dirk Jäger, Lorenz Trümper, Judith Büntzel, Claudia Binder, Gerd Ulrich Nienhaus, Michael Boutros. Extracellular vesicles as carriers of signaling factors in cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 6968.
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Safran, Michal, Yelena Lapidot, Tzvia Bader, and Avital Gaziel. "Abstract P2-13-05: Triple Negative Breast Cancer (TNBC) patients are more likely to digitally explore clinical trial options and prior to receiving treatment for advanced disease compared to non-TNBC patients." Cancer Research 83, no. 5_Supplement (March 1, 2023): P2–13–05—P2–13–05. http://dx.doi.org/10.1158/1538-7445.sabcs22-p2-13-05.
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Abstract Introduction: Triple-negative breast cancer (TNBC), an aggressive form of breast cancer (BC) that is associated with poor prognosis, accounts for 10-15% of all BCs. Chemotherapy remains the standard of care (SOC) for advanced disease, with limited clinical benefit. Oncology clinical trials (CTs) are globally recommended and encouraged as the preferred treatment (tx) option for any cancer patient (pt). ‘TrialJectory’ (TJ) is an artificial intelligence (AI)-based technology that matches pts to oncology CTs. Here, we identified distinct characteristics of TNBC pts who signed up to the TJ platform compared to non-TNBC pts. Methods: Using AI and an unsupervised natural language processing approach, the TJ platform clinically matches pts to CTs. Matching is achieved by pt response to an online dynamic questionnaire (www.trialjectory.com) that collects detailed clinical data including clinico-pathologic characteristics, tx history, general health, and comorbidities. Those are compared to the eligibility criteria of available CTs to yield a high-quality actionable matched-trial list. Results: Between 1/2020 and 12/2021, out of 9796 BC pts that signed up, 2688 were TNBC pts (27%). There was no significant difference in age at sign-up between TNBC and non-TNBC patients (median age of 57 years vs 58 years, respectively). Consistently with Non-hispanic black (NHB) race prevalence in the different molecular subtypes in the general US population, NHB race had higher signup rate in TNBC compared to non-TNBC (9.95% vs 5.76%, respectively). TNBC pts signed up at a later disease stage compared to non-TNBC pts (19% of TNBC reported having a stage 1 disease compared to 27% of non-TNBC pts, p< 0.001).A significantly higher percentage of pts with advanced/metastatic TNBC signed up to the TJ platform before starting tx compared to non-TNBC patients (34% vs 22%, respectively, p< 0.001). Furthermore, there was a significant difference in the willingness to travel any distance within the US for a matched clinical trial between TNBC and non-TNBC pts (39% vs 34%, respectively, p< 0.001). Conclusions: In this study, we found significant differences in the characteristics of TNBC vs non-TNBC pts that have signed up to the TJ platform. There was an up to 2-fold enrichment of TNBC on the TJ platform pts compared to their frequency in the general population. While previous studies do not show a difference in stage distribution between different subtypes, TNBC patients initiated their search for CTs at a higher stage. In addition, advanced TNBC patients started their search earlier in their journey, before starting chemotherapy. This may reflect the lack of effective SOC and possibly, the motivation to avoid the use of chemotherapy. This is also supported by the willingness of TNBC patients to travel farther in order to identify and enroll in a CT compared to non-TNBC pts. Importantly, the motivation of TNBC pts to travel any distance has not been reduced despite the COVID-19 pandemic, reflecting a strong drive of this pt population to enroll in CTs. It also demonstrates that with the right access, diverse patient populations are willing to participate in clinical trials. In sum, TNBC pts are more likely to explore CT options, in the advanced stage setting, earlier in their journey. This study demonstrates the power of TJ platform for clinico-pathologic characterization and diverse pt groups, including their drivers and behavioral choices during their battle with cancer. Citation Format: Michal Safran, Yelena Lapidot, Tzvia Bader, Avital Gaziel. Triple Negative Breast Cancer (TNBC) patients are more likely to digitally explore clinical trial options and prior to receiving treatment for advanced disease compared to non-TNBC patients [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P2-13-05.
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Safran, Michal, Yelena Lapidot, Tzvia Bader, and Avital Gaziel. "Abstract PO3-10-07: Leveraging AI to identify factors influencing access to care and their association with overall survival- a multiracial Breast Cancer cohort." Cancer Research 84, no. 9_Supplement (May 2, 2024): PO3–10–07—PO3–10–07. http://dx.doi.org/10.1158/1538-7445.sabcs23-po3-10-07.
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Abstract Introduction: Data from the Centers for Disease Control and Prevention (CDC) labels each US state based on its 5-Year Relative Survival of Breast Cancer (BC) patients (pts). Data is categorized into four “survival groups'', each representing a range of 5-year survival percentages. Using real-world data, this study characterized the populations in each survival group, examining pt knowledge and education about their disease as well as preferences and factors influencing their decision to explore clinical trial (CT) opportunities. Methods: Leal is an AI-based platform that employs self-reported medical profiles to match cancer pts with CTs. This study involved a diverse cohort of 14,509 BC pts who completed the questionnaire. The geographic distribution of pts across US states was analyzed, taking into account the state’s 5-year BC survival %. Four groups were defined as follows: Group A (86.4 - 89.4%), Group B (89.4 - 90.4%), Group C (90.4 - 91.5%), and Group D (92.0 - 95.0%). Parameters such as race, willingness to travel, insurance coverage, performance of genetic testing, and biomarker knowledge were considered in the analysis. Results: We found significant variations in registration rates on the Leal platform across groups. The Highest registration rate was recorded for Group D which has the highest 5-year survival rate (p< 0.0001). Group A which has the lowest 5-year relative survival had a significantly higher proportion of African Americans compared to group D (14% vs 4%, p < 0.0001). Moreover, while there was no difference in the percentage of pts undergoing Next-Generation Sequencing (NGS) in both groups, a larger proportion of pts in Group D demonstrated proficiency in interpreting the test reports (p = 0.05). Although no significant differences were found in the proportion of pts who were aware of their treatment (tx) history between the two groups, whites in both groups exhibited greater knowledge of their tx (p = 0.001). Additionally, pts in Group D showed a significantly higher willingness to travel longer distances to participate in CTs (p=0.001), and a larger percentage of them had insurance coverage. Conclusions: This study used data from CDC that categorized US states into four groups based on BC pts’ 5-Year Survival. CT participation is associated with better clinical outcomes, especially for pts with poorer prognosis. In agreement, we show a higher signup rate to the Leal platform in States with higher 5-year relative survival, possibly pointing to higher CT education and knowledge among pts in those states. This is further supported by higher proficiency in interpreting NGS reports, resulting in better-optimized CT options on the Leal platform. Group A was also characterized by a reduced willingness to travel for a CT and a larger proportion of pts without health insurance. Those are significant barriers for CT enrollment, and ultimately limit access to optimal care and may impact outcomes. Gaps in knowledge of key disease parameters such as tx history were observed for African Americans, regardless of geographic location, highlighting the need to focus on minority populations even in states where the survival rate is relatively high. In agreement, the proportion of African Americans in group A was markedly higher, correlating with current disparities in access to tx and poorer outcomes. AI-based platforms are optimized for the exact identification of barriers to access to care and for enabling relevant healthcare and support organizations to effectively address individual patient issues, consequently increasing access to CTs, particularly among different racial and ethnic populations. Citation Format: Michal Safran, Yelena Lapidot, Tzvia Bader, Avital Gaziel. Leveraging AI to identify factors influencing access to care and their association with overall survival- a multiracial Breast Cancer cohort [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-10-07.
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KITLV, Redactie. "Book Reviews." New West Indian Guide / Nieuwe West-Indische Gids 71, no. 3-4 (January 1, 1997): 317–91. http://dx.doi.org/10.1163/13822373-90002612.
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-Leslie G. Desmangles, Joan Dayan, Haiti, history, and the Gods. Berkeley: University of California Press, 1995. xxiii + 339 pp.-Barry Chevannes, James T. Houk, Spirits, blood, and drums: The Orisha religion in Trinidad. Philadelphia: Temple University Press, 1995. xvi + 238 pp.-Barry Chevannes, Walter F. Pitts, Jr., Old ship of Zion: The Afro-Baptist ritual in the African Diaspora. New York: Oxford University Press, 1993. xvi + 199 pp.-Robert J. Stewart, Lewin L. Williams, Caribbean theology. New York: Peter Lang, 1994. xiii + 231 pp.-Robert J. Stewart, Barry Chevannes, Rastafari and other African-Caribbean worldviews. London: Macmillan, 1995. xxv + 282 pp.-Michael Aceto, Maureen Warner-Lewis, Yoruba songs of Trinidad. London: Karnak House, 1994. 158 pp.''Trinidad Yoruba: From mother tongue to memory. Tuscaloosa: University of Alabama Press, 1996. xviii + 279 pp.-Erika Bourguignon, Nicola H. Götz, Obeah - Hexerei in der Karibik - zwischen Macht und Ohnmacht. Frankfurt am Main: Peter Lang, 1995. 256 pp.-John Murphy, Hernando Calvo Ospina, Salsa! Havana heat: Bronx Beat. London: Latin America Bureau, 1995. viii + 151 pp.-Donald R. Hill, Stephen Stuempfle, The steelband movement: The forging of a national art in Trinidad and Tobago. Philadelphia: University of Pennsylvania Press, 1995. xx + 289 pp.-Hilary McD. Beckles, Jay R. Mandle ,Caribbean Hoops: The development of West Indian basketball. Langhorne PA: Gordon and Breach, 1994. ix + 121 pp., Joan D. Mandle (eds)-Edmund Burke, III, Lewis R. Gordon ,Fanon: A critical reader. Oxford: Blackwell, 1996. xxi + 344 pp., T. Denean Sharpley-Whiting, Renée T. White (eds)-Keith Alan Sprouse, Ikenna Dieke, The primordial image: African, Afro-American, and Caribbean Mythopoetic text. New York: Peter Lang, 1993. xiv + 434 pp.-Keith Alan Sprouse, Wimal Dissanayake ,Self and colonial desire: Travel writings of V.S. Naipaul. New York : Peter Lang, 1993. vii + 160 pp., Carmen Wickramagamage (eds)-Yannick Tarrieu, Moira Ferguson, Jamaica Kincaid: Where the land meets the body: Charlottesville: University Press of Virginia, 1994. xiii + 205 pp.-Neil L. Whitehead, Vera Lawrence Hyatt ,Race, discourse, and the origin of the Americas: A new world view. Washington DC: Smithsonian Institution Press, 1995. xiii + 302 pp., Rex Nettleford (eds)-Neil L. Whitehead, Patricia Seed, Ceremonies of possession in Europe's conquest of the new world, 1492-1640. Cambridge: Cambridge University Press, 1995. viii + 199 pp.-Livio Sansone, Michiel Baud ,Etnicidad como estrategia en America Latina y en el Caribe. Arij Ouweneel & Patricio Silva. Quito: Ediciones Abya-Yala, 1996. 214 pp., Kees Koonings, Gert Oostindie (eds)-D.C. Griffith, Linda Basch ,Nations unbound: Transnational projects, postcolonial predicaments, and deterritorialized nation-states. Langhorne PA: Gordon and Breach, 1994. vii + 344 pp., Nina Glick Schiller, Cristina Szanton Blanc (eds)-John Stiles, Richard D.E. Burton ,French and West Indian: Martinique, Guadeloupe and French Guiana today. Charlottesville: University Press of Virginia; London: Macmillan Caribbean, 1995. xii + 202 pp., Fred Réno (eds)-Frank F. Taylor, Dennis J. Gayle ,Tourism marketing and management in the Caribbean. New York: Routledge, 1993. xxvi + 270 pp., Jonathan N. Goodrich (eds)-Ivelaw L. Griffith, John La Guerre, Structural adjustment: Public policy and administration in the Caribbean. St. Augustine: School of continuing studies, University of the West Indies, 1994. vii + 258 pp.-Luis Martínez-Fernández, Kelvin A. Santiago-Valles, 'Subject People' and colonial discourses: Economic transformation and social disorder in Puerto Rico, 1898-1947. Albany: State University of New York Press, 1994. xiii + 304 pp.-Alicia Pousada, Bonnie Urciuoli, Exposing prejudice: Puerto Rican experiences of language, race, and class. Boulder: Westview Press, 1996. xiv + 222 pp.-David A.B. Murray, Ian Lumsden, Machos, Maricones, and Gays: Cuba and homosexuality. Philadelphia: Temple University Press, 1996. xxvii + 263 pp.-Robert Fatton, Jr., Georges A. Fauriol, Haitian frustrations: Dilemmas for U.S. policy. Washington DC: Center for strategic & international studies, 1995. xii + 236 pp.-Leni Ashmore Sorensen, David Barry Gaspar ,More than Chattel: Black women and slavery in the Americas. Bloomington: Indiana University Press, 1996. xi + 341 pp., Darlene Clark Hine (eds)-A. Lynn Bolles, Verene Shepherd ,Engendering history: Caribbean women in historical perspective. Kingston: Ian Randle; London: James Currey, 1995. xxii + 406 pp., Bridget Brereton, Barbara Bailey (eds)-Bridget Brereton, Mary Turner, From chattel slaves to wage slaves: The dynamics of labour bargaining in the Americas. Kingston: Ian Randle; Bloomington: Indiana University Press; London: James Currey, 1995. x + 310 pp.-Carl E. Swanson, Duncan Crewe, Yellow Jack and the worm: British Naval administration in the West Indies, 1739-1748. Liverpool: Liverpool University Press, 1993. x + 321 pp.-Jerome Egger, Wim Hoogbergen, Het Kamp van Broos en Kaliko: De geschiedenis van een Afro-Surinaamse familie. Amsterdam: Prometheus, 1996. 213 pp.-Ellen Klinkers, Lila Gobardhan-Rambocus ,De erfenis van de slavernij. Paramaribo: Anton de Kom Universiteit, 1995. 297 pp., Maurits S. Hassankhan, Jerry L. Egger (eds)-Kevin K. Birth, Sylvia Moodie-Kublalsingh, The Cocoa Panyols of Trinidad: An oral record. London & New York: British Academic Press, 1994. xiii + 242 pp.-David R. Watters, C.N. Dubelaar, The Petroglyphs of the Lesser Antilles, the Virgin Islands and Trinidad. Amsterdam: Foundation for scientific research in the Caribbean region, 1995. vii + 492 pp.-Suzannah England, Mitchell W. Marken, Pottery from Spanish shipwrecks, 1500-1800. Gainesville: University Press of Florida, 1994. xvi + 264 pp.
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Papautsky, Elizabeth, Devika Salunke, Hannah Montague, Martha Carlson, Sheila Johnson, Deanna Attai, and Maryam Lustberg. "Abstract P6-09-05: Using Mixed Methods to Examine Clinician and Patient Use of Terminology to Describe Trastuzumab Biosimilars." Cancer Research 83, no. 5_Supplement (March 1, 2023): P6–09–05—P6–09–05. http://dx.doi.org/10.1158/1538-7445.sabcs22-p6-09-05.
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Abstract Although the uptake of trastuzumab biosimilars to treat HER2-positive breast cancer is growing, knowledge gaps remain for both, patients and clinicians. In a mixed-methods study, inconsistencies in terminology used to describe trastuzumab biosimilars. We analyzed open-ended questions from surveys (n = 143 breast cancer patients, n = 33 medical oncologists) and interviews (n = 8 patients, n = 4 oncologist, nurse, pharmacists) indentifying terminology as an a priori (top-down) category for qualitative thematic analysis. We specifically looked for examples of inconsistent or incorrect use of terminology in the interviews. Findings suggest that 1) terminology used to refer to trastuzumab biosimilars is variable across patients and some is not representative of the formal definition (e.g. generic, generic-like, interchangeable, Herceptin, generic Herceptin (as per how their oncologist refers to biosimilars) and 2) clinicians discussed the challenges of talking about biosimilars in a manner that is both understandable to patients and accurate. Specifically, one pharmacist highlighted concerns around this complexity and suggested that it should be part of clinician education to use the correct terminology, rather than using the term generic. A medical oncologist said that “Explaining biosimilars to a patient can be challenging” as part of their survey response. Lack of consistent terminology for trastuzumab biosimilars is a potential barrier to effective patient-clinician communication on this topic and may perpetuate lack of comprehension on the part of patients. Further, the intentional use (to make information more digestible to patients) of incorrect terminology by clinicians has the potential to negatively impact the patient-clinician relationship in cases where patients identify conflicting information on their own. The adoption of terminology that is consistent across clinicians and patient-facing resources on the introduction and description of trastuzumab biosimilars, may serve to facilitate common grounding among all roles. Citation Format: Elizabeth Papautsky, Devika Salunke, Hannah Montague, Martha Carlson, Sheila Johnson, Deanna Attai, Maryam Lustberg. Using Mixed Methods to Examine Clinician and Patient Use of Terminology to Describe Trastuzumab Biosimilars [abstract]. In: Proceedings of the 2022 San Antonio Breast Cancer Symposium; 2022 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2023;83(5 Suppl):Abstract nr P6-09-05.