To see the other types of publications on this topic, follow the link: The program RWCT.
Journal articles on the topic 'The program RWCT'
Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles
Consult the top 50 journal articles for your research on the topic 'The program RWCT.'
Next to every source in the list of references, there is an 'Add to bibliography' button. Press on it, and we will generate automatically the bibliographic reference to the chosen work in the citation style you need: APA, MLA, Harvard, Chicago, Vancouver, etc.
You can also download the full text of the academic publication as pdf and read online its abstract whenever available in the metadata.
Browse journal articles on a wide variety of disciplines and organise your bibliography correctly.
1
Nolan, Robert P., Nicholas P. Spanos, Amber A. Hayward, and Heather A. Scott. "The Efficacy of Hypnotic and Nonhypnotic Response-Based Imagery for Self-Managing Recurrent Headache." Imagination, Cognition and Personality 14, no. 3 (March 1995): 183–201. http://dx.doi.org/10.2190/rwct-78cl-3042-wb34.
Full textAbstract:
Two experiments investigated the use of hypnotic and nonhypnotic response-based imagery training for recurrent headache. In Experiment 1, subjects with symptoms of chronic migraine headache (CMH), or chronic mixed migraine/tension headache (Mixed CMH/CTH) were assigned to a Hypnotic or Nonhypnotic Imagery group, or to a Monitoring Control group. Treatment efficacy was assessed over two-week intervals, at Baseline, Post-treatment, and three successive follow-up periods. In Experiment 2, subjects with symptoms of chronic tension headache (CTH) were assigned to four conditions (Hypnotic Imagery/Nonhypnotic Imagery/Placebo/Monitoring Control), and studied across two-week intervals at Baseline, Post-treatment, and eight-week Follow-up. Hypnotic and Nonhypnotic Imagery conditions did not differ in demonstrating efficacy in reducing headache activity in both experiments. Treatment outcome was not associated with medication consumption, or actual changes in physiologic processes (cardiovascular functioning and frontalis EMG). Headache reduction was not correlated with hypnotizability or the trait propensity to engage in vivid imagery. These results replicate and extend previous findings, and support the use of imagery strategies as a treatment component in pain management programs.
2
Carignato, André, Javier Vázquez-Piqué, Raúl Tapias, Federico Ruiz, and Manuel Fernández. "Variability and Plasticity in Cuticular Transpiration and Leaf Permeability Allow Differentiation of Eucalyptus Clones at an Early Age." Forests 11, no. 1 (December 18, 2019): 9. http://dx.doi.org/10.3390/f11010009.
Full textAbstract:
Background and Objectives. Water stress is a major constraining factor of Eucalyptus plantations’ growth. Within a genetic improvement program, the selection of genotypes that improve drought resistance would help to improve productivity and to expand plantations. Leaf characteristics, among others, are important factors to consider when evaluating drought resistance evaluation, as well as the clone’s ability to modify leaf properties (e.g., stomatal density (d) and size, relative water content at the time of stomatal closure (RWCc), cuticular transpiration (Ec), specific leaf area (SLA)) according to growing conditions. Therefore, this study aimed at analyzing these properties in nursery plants of nine high-productivity Eucalyptus clones. Material and Methods: Five Eucalyptus globulus Labill. clones and four hybrids clones (Eucalyptus urophylla S.T. Blake × Eucalyptus grandis W. Hill ex Maiden, 12€; Eucalyptus urograndis × E. globulus, HE; Eucalyptus dunnii Maiden–E. grandis × E. globulus, HG; Eucalyptus saligna Sm. × Eucalyptus maidenii F. Muell., HI) were studied. Several parameters relating to the aforementioned leaf traits were evaluated for 2.5 years. Results: Significant differences in stomatal d and size, RWCc, Ec, and SLA among clones (p < 0.001) and according to the dates (p < 0.001) were obtained. Each clone varied seasonally the characteristics of its new developing leaves to acclimatize to the growth conditions. The pore opening surface potential (i.e., the stomatal d × size) did not affect transpiration rates with full open stomata, so the water transpired under these conditions might depend on other leaf factors. The clones HE, HG, and 12€ were the ones that differed the most from the drought resistant E. globulus control clone (C14). Those three clones showed lower leaf epidermis impermeability (HE, HG, 12€), higher SLA (12€, HG), and lower stomatal control under moderate water stress (HE, HG) not being, therefore, good candidates to be selected for drought resistance, at least for these measured traits. Conclusions: These parameters can be incorporated into genetic selection and breeding programs, especially Ec, SLA, RWCc, and stomatal control under moderate water stress.
3
Tanaka, Kazuyo, Satoru Hayamizu, Yoichi Yamashita, Kiyohiro Shikano, Shuichi Itahashi, and Ryuichi Oka. "Design and data collection for a spoken dialog database in the Real World Computing (RWC) program." Journal of the Acoustical Society of America 100, no. 4 (October 1996): 2759. http://dx.doi.org/10.1121/1.416338.
Full text
4
Bucciarelli, Valentina, Francesco Bianco, Francesco Mucedola, Andrea Di Blasio, Pascal Izzicupo, Desiree Tuosto, Barbara Ghinassi, et al. "Effect of Adherence to Physical Exercise on Cardiometabolic Profile in Postmenopausal Women." International Journal of Environmental Research and Public Health 18, no. 2 (January 14, 2021): 656. http://dx.doi.org/10.3390/ijerph18020656.
Full textAbstract:
Background: Menopause is associated with negative cardiovascular adaptations related to estrogen depletion, which could be counteracted by physical exercise (PhE). However, the impact of total adherence-rate (TA) to PhE and sedentary time (SedT) on cardiometabolic profile in this population has not been elucidated. Methods: For 13-weeks, 43 women (57.1 ± 4.7 years) participated in a 4-days-a-week moderate-intensity walking training. They underwent laboratory, anthropometric and echocardiographic assessment, before and after training (T0–T1). Spontaneous physical activity (PhA) was assessed with a portable multisensory device. The sample was divided according to TA to PhE program: <70% (n = 17) and ≥70% (n = 26). Results: TA ≥ 70% group experienced a significant T1 improvement of relative wall thickness (RWT), diastolic function, VO2max, cortisol, cortisol/dehydroandrostenedione-sulphate ratio and serum glucose. After adjusting for SedT and 10-min bouts of spontaneous moderate-to-vigorous PhA, TA ≥ 70% showed the most significant absolute change of RWT and diastolic function, body mass index, weight and cortisol. TA ≥ 70% was major predictor of RWT and cortisol improvement. Conclusions: In a group of untrained, postmenopausal women, a high TA to a 13-weeks aerobic PhE program confers a better improvement in cardiometabolic profile, regardless of SedT and PhA levels.
5
James, A. T., R. J. Lawn, and M. Cooper. "Genotypic variation for drought stress response traits in soybean. III. Broad-sense heritability of epidermal conductance, osmotic potential, and relative water content." Australian Journal of Agricultural Research 59, no. 7 (2008): 679. http://dx.doi.org/10.1071/ar07161.
Full textAbstract:
The broad-sense heritability of 3 traits related to leaf survival in severely stressed plants was studied in several hybrid soybean populations. The 3 traits were epidermal conductance (ge), osmotic potential (π), and relative water content (RWC). The populations were generated by hybridising unrelated parental genotypes previously shown to differ in the 3 traits. ge (mm/s) was measured on well watered plants from 10 populations involving all combinations of 5 parental lines, grown in soil-filled beds in the glasshouse. π (MPa) and RWC (%) were measured on severely stressed plants of 3 populations involving all combinations of 3 different parents, growing into a terminal water deficit under a rainout shelter in the field. Broad-sense heritability for ge was significantly different from zero (P < 0.05) in all 10 populations and ranged from 60% to 93%. Heritability estimates for π70 (the tissue osmotic potential at 70% RWC) ranged from 33% to 71%. Only two estimates were statistically significant (P < 0.05) because of large standard errors and the fact that parental differences were smaller than previously observed. Broad-sense heritability for RWC of severely stressed plants ranged from 40% to 74%, and was statistically significant (P < 0.05) for 2 of the 3 populations. For all 3 traits, F2 progeny distributions were consistent with quantitative inheritance with a high degree of additive gene action. It was concluded that capacity exists to breed varieties with low ge, low π70, and high RWC in stressed plants. However, in the case of osmotic potential, genotypes with lower π70 combined with greater precision of measurement would be needed than proved possible in these studies. Further, specific strategies would be needed to select for the critical RWC, the minimal RWC at which leaf tissues die and which provides a measure of tissue dehydration tolerance. More research is also needed to characterise the dynamic relations between ge, π, and RWC in influencing leaf survival in soybean, before they could be confidently used in a breeding program to improve drought tolerance.
6
Virginia, Salvador, Megan Pagan, Melissa Cooper, Stella K. Kantartzi, David A. Lightfoot, Khalid Meksem, and My Abdelmajid Kassem. "Genetic Analysis of Relative Water Content (RWC) in Two Recombinant Inbred Line Populations of Soybean [Glycine max (L.) Merr.]." Plant Genetics, Genomics, and Biotechnology 1, no. 2 (June 15, 2017): 46–53. http://dx.doi.org/10.5147/pggb.v1i2.151.
Full textAbstract:
Drought affects soybean [Glycine max (L.) Merr.] and other crops productivity in the US and other parts of the world. Relative water content (RWC) is an important indicator for plant water deficit tolerance (WDT). The objective of this study is to map quantitative trait loci (QTL) for RWC and several other leaf traits such as leaf dry weight (LDW), leaf fresh weight (LFW), and leaf turgid weight (LTW) in two soybean recombinant inbred line (RIL) populations, one derived from a cross of ‘Essex’ and ‘Forrest’ (ExF, n=94) and the other is derived from a cross of ‘PI 438489B’ and ‘Hamilton’ (PIxH, n=50). In the PIxH RIL population, eight QTL were identified and mapped on 6 different linkage groups (LGs) of the soybean genome. No QTL for LFW were identified in this population. In the ExF RIL population, 10 QTL were identified and mapped on 5 different LGs of soybean. Chromosome 18 (LG G) contains clusters of QTL for LFW, LTW, and RWC in the ExF RIL population. This same chromosome contains a QTL for RWC in the PIxH RIL population. The QTL found here are important to be included in breeding programs for soybean water deficit tolerance (WDT).
7
Nurcahyanto, Herbasuki. "IMPLEMENTASI PROGRAM NASIONAL PEMBERDAYAAN MASYARAKAT (PNPM) DI KOTA SEMARANG." GEMA PUBLICA 2, no. 1 (March 1, 2016): 55. http://dx.doi.org/10.14710/gp.2.1.2016.55-64.
Full textAbstract:
Poverty is a main issue tosolve. National Urban Program for People Empowerment (PNPM MP) has main program to alleviate poverty by involving participation of the villagers. The purpose of the research is to analyze the implementation and identify the inhibiting factors of PNPM MP, in Mangunharjo residence Tembalang District Semarang. The approach used is descriptive qualitative approach. The implementation of PNPM MP in Mangunharjo was started in 2007. Direct People Assistance (Bantuan Langsung Masyarakat/BLM) received are used to alleviate poverty through three areas: economy, social and environment. Self-Assistance Groups (Kelompok Swadaya Masyarakat/KSM) has easy access to obtain additional capital to run a business. Poor villagers are asissted through house rehabilitation program and education package. The negative Impacts also come up that there is social envy especially for those who do not receive the assistance. The inhibitting factors of the implementation of PNPM MP in Mangunharjo Residence include the internal factors: The limited number of the operating unit members, Some BKM members are not active in some activities, The KSM members do not have sufficient skill to arrange the proposal. While the external factors include: the distrust of villagers toward the credibility of KSMmembers to implement physical projects, and the envy shown by those who do not get BKM. To increase the awareness of the BKM and KSM members are through trainings, assistingKSM to prepare the project proposals and eventhe reports regularly and continuously. There should be a socialization to the villagers about the programs managed by BKM through regular meetings of RT / RW or the engagement of the community leaders to take a part routinely in the annual meeting forum of the villagers (Rembug Warga Tahunan/RWT).
8
Alajmi, Reem A., Carl Foster, John P. Porcari, Kimberley Radtke, and Scott Doberstein. "Comparison of non-maximal tests for estimating exercise capacity." Kinesiology 52, no. 1 (2020): 10–18. http://dx.doi.org/10.26582/k.52.1.2.
Full textAbstract:
Although maximal incremental exercise tests (GXT) are the gold standard for outcome assessment and exercise prescription, they are not widely available in either fitness or clinical exercise programs. This study compared the prediction of VO2max in healthy, sedentary volunteers using a non-exercise prediction (Matthews et al., 1999), RPE extrapolation to 19 and 20 and the Rockport Walking Test (RWT), and of ventilatory threshold (VT) using the Talk Test and RPE @ 13,14,15. Subjects performed a treadmill GXT with gas exchange, a submaximal treadmill with RPE and Talk Test, the RWT and Matthews. All methods provided reasonable estimates of both VO2max and VT, with correlations of >0.80 and SEE~1.3 METs. VO2max was best estimated with the extrapolation to RPE=19. VT was intermediate between the TT Last Positive and Equivocal stages and between RPE 13 and 14. Non-maximal evaluation can be used in place of maximal GXT with gas exchange to make reasonable estimates of both VO2max and VT.
9
MIRI-HESAR, Kamal, Ali DADKHODAIE, Saideh DOROSTKAR, and Bahram HEIDARI. "Differential Activity of Antioxidant Enzymes and Physiological Changes in Wheat (Triticum aestivum L.) Under Drought Stress." Notulae Scientia Biologicae 11, no. 2 (June 28, 2019): 266–76. http://dx.doi.org/10.15835/nsb11210390.
Full textAbstract:
Drought stress is one of the most significant environmental factors restricting plant production all over the world. In arid and semi-arid regions where drought often causes serious problems, wheat is usually grown as a major crop and faces water stress. In order to study drought tolerance of wheat, an experiment with 34 genotypes including 11 local and commercial cultivars, 17 landraces, and six genotypes from International Maize and Wheat Improvement Center (CIMMYT) was conducted at the experimental station, School of Agriculture, Shiraz University, Iran in 2010-2011 growing season. Three different irrigation regimes (100%, 75% and 50% Field Capacity) were applied and physiological and biochemical traits were measured for which a significant difference was observed in genotypes. Under severe water stress, proline content and enzymes’ activities increased while the relative water content (RWC) and chlorophyll index decreased significantly in all genotypes. Of these indices, superoxide dismutase (SOD) and RWC were able to distinguish tolerant genotypes from sensitives. Moreover, yield index (YI) was useful in detecting tolerant genotypes. The drought susceptibility index (DSI) varied from 0.40 to 1.71 in genotypes. These results indicated that drought-tolerant genotypes could be selected based on high YI, RWC and SOD and low DSI. On the whole, the genotypes 31 (30ESWYT200), 29 (30ESWYT173) and 25 (Akbari) were identified to be tolerant and could be further used in downstream breeding programs for the improvement of wheat tolerance under water limited conditions.
10
Potts, IW. "Use of the EM-34 instrument in groundwater exploration in the Shepparton region." Soil Research 28, no. 3 (1990): 433. http://dx.doi.org/10.1071/sr9900433.
Full textAbstract:
Since the late 1970's, the Rural Water Commission of Victoria (RWC) has been offering a groundwater exploratory drilling service to landholders in the irrigation areas of the Shepparton Region. The aim of this service has been to encourage exploration for shallow aquifers in the Shepparton Formation and in turn to encourage groundwater pumping for water-table control. The selection of drilling sites in early exploration programs was based on geomorphological expressions of prior stream activity. Later, the dipole-dipole resistivity survey method was used. While giving good resolution of targets in the sedimentary profile, this method was found to be too restrictive in covering large areas of a property. In 1986, the RWC acquired a Geonics EM-34 unit to become the main geophysical tool in groundwater exploration. Since this time, the unit has been used on over 60 individual properties, as well as being used for broader scale exploration surveys on the Riverine Plains. The EM-34 unit has proved to be a useful tool in defining areas where shallow sand aquifers occur in the Upper Shepparton Formation. The RWC uses the horizontal dipole technique with a constant coil separation of 20 m. This technique has allowed good line coverage of up to 7500 m in a day, while allowing fair resolution of the target within the top 15-20 m of the Shepparton Formation. Experience has shown that a number of non-rigorous categories can be applied to the various ranges of conductivity readings. Such categories aid in the interpretation and selection of drilling targets.
11
Al-Dossary, Saleh. "Preconditioning seismic data for channel detection." Interpretation 3, no. 1 (February 1, 2015): T1—T4. http://dx.doi.org/10.1190/int-2014-0031.1.
Full textAbstract:
Random seismic noise, present in all 3D seismic data sets, hampers manual interpretation by geoscientists and automatic analysis by a computer program. As a result, many noise-suppression techniques have been developed to enhance image quality. Accurately suppressing seismic noise without damaging image details is crucial in preserving small-scale geologic features for channel detection. The automatic detection of channel patterns theoretically should be easy because of their unique spatial signatures and scales, which differentiate them from other common 3D geobodies. For example, one notable channel characteristic has high local linearity: Spatial coherency is much greater in one direction than in other directions. A variety of techniques, such as spatial filters, can be used to enhance this “slender” channel feature in areas of high signal-to-noise ratio (S/N). Unfortunately, these spatial filters may also reduce the edge detectability in areas of low S/N. In this paper, I compared the effectiveness of three noise reduction filters: (1) running average, (2) redundant wavelet transform (RWT), and (3) polynomial fitting. I demonstrated the usefulness of these filters prior to edge detection to enhance channel patterns in seismic data collected from Saudi Arabia. The data examples demonstrated that RWT and polynomial fitting can successfully preserve, enhance, and delineate channel edges that were not visible in conventional seismic amplitude displays, whereas the running average filter further smeared the detectability of channel edges.
12
Nazir, Ahmad. "PERAN BADAN KESWADAYAAN MASYARAKAT (BKM) DALAM PEMBANGUNAN DAERAH DI KOTA TANGERANG." Jurnal Mandiri 2, no. 2 (December 4, 2018): 425–40. http://dx.doi.org/10.33753/mandiri.v2i2.52.
Full textAbstract:
Tujuan dalam penelitian ini adalah Untuk mengetahui dan mendeskrifsikan bagaimana mekanisme kerja BKM dalam pembangunan dan Untuk mengetahui dan mendeskrifsikan bagaimana peran BKM dalam pembangunan daerah. Penelitian ini dilakukan pada BKM Mekar Sejati Kelurahan Gondrong Kecamatan Cipondoh alamat : Jl. Ki Hajar Dewantoro, Kel Gondrong, Kec Cipondoh, Kota Tangerang. Dengan menggunakan metode deskriptif melalui pendekatan kualitatif. Metode Deskriptif Menurut Kuncoro adalah “Penelitian deskriptif meliputi kegiatan pengumpulan data untuk menjawab pertanyaan mengenai status terakhir dari subyek penelitianâ€. Penelitian kualitatif tidak hanya mengumpulkan data, tetapi merupakan pendekatan terhadap dunia empiris, serta memberikan penjelasan tentang perencanaan pembangunan dalam pelaksanaan pembangunan. Hasil dari penelitian ini adalah mekasnisme kerja BKM diwali denga rembuk warga tahunan yang disebut RWT atau musyawarah yang dilakukan oleh pengurus badan kesedayaan masyarakat dengan rukun tetannga, rukun warga yang dihadiri oleh perwakilan dari aparatur pemerintahan ditingkat kelurahan dan pendamping BKM itu sendiri yang disebut dengan paskel. Disitu para Rt dan Rw mengajukan program-program yang berhubungan dengan pembangunan di wilayah masing-masing seperti pembanguan jalan paving block, pembangunan saluran air dan pembuatan jamban sampai yang belum diusulkan pada Musrenbang kelurahan dan menjalankan program pembangunan yang sudah disyahkan oleh pemerintah melalui dinas terkait. Peran BKM di masyarakat adalah sebagai roda penggerak masyarakat yang akan mengembangkan modal sosial yaitu kemampuan masyarakat untuk bekerjasama demi mencapai tujuan bersama di dalam berbagai kelompok dan organisasi. Sebagai wadah aspirasi masyarakat dengan cara melibatkan masyarakat agar pro aktif dalam proses pengambilan keputusan dalam program pembangunan dll.
13
Hadley, Megan E., Lisa A. Mullen, Lindsay Dickerson, and Susan C. Harvey. "Assessment and Improvement Strategies for a Breast Cancer Early Detection Program in Rural South Africa." Journal of Global Oncology 4, Supplement 3 (October 2018): 16s. http://dx.doi.org/10.1200/jgo.18.10180.
Full textAbstract:
Purpose More than one half of breast cancer deaths occur in low- and middle-income countries, where survival rates are 60% at best. Appropriate programs that improve detection, diagnosis, and treatment in low- and middle-income countries are essential to improving breast cancer outcomes. The sustainability of such programs requires ongoing efforts, yet there remains a lack of literature on follow-up to assure long-term program success. Our study aimed to understand what needs developed in the year after the implementation of an early detection program and to evaluate potential solutions. Methods A WHO-endorsed RAD-AID Radiology Readiness Assessment evaluated clinic resources. In addition, in 5 weeks of observation we identified resource deficiencies and reviewed existing documentation methods. On the basis of stakeholders’ input and the Breast Imaging Reporting and Data System, we developed new documentation systems. Training was followed by a survey that assessed feasibility and provider acceptance. Results Resource limitations included a lack of computers, unpredictable electrical supply, and inconsistent Internet. Assessment revealed incomplete documentation of breast clinical examinations and history, breast lesions, and follow-up. In addition, limitations negatively impacted communication between providers. Three solutions were developed: a paper patient history form, a paper clinical findings form, and a computerized patient-tracking database that was compliant with the Breast Imaging Reporting and Data System. Three nurses, three nursing assistants, and one counselor completed the survey. Seventy-one percent (five of seven respondents) indicated positive or very positive general attitudes. One hundred percent of respondents agreed or strongly agreed to the following statement: the documentation system is easy, useful, and improves overall quality of care, follow-up, decision making, access to clinical information, and communication between clinicians and patients. Five of seven providers reported that the system increased visit time, but three of these five felt that the process was valuable. Conclusion Implementing a breast cancer early detection program in resource-limited regions is challenging and continued assessment is essential. As a result of identified needs, we developed a documentation system that was broadly accepted. Potential future steps should focus on increasing efficiency, evaluating provider attitudes on a long-term basis, and clinical impact. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Susan C. Harvey Honoraria: Hologic Inc, IBM Watson Imaging Consulting or Advisory Role: IBM Watson, Hologic Inc Research Funding: IBM Watson
14
Pour-Aboughadareh, Alireza, Mansoor Omidi, Mohammad Reza Naghavi, Alireza Etminan, Ali Ashraf Mehrabi, Peter Poczai, and Hamid Bayat. "Effect of Water Deficit Stress on Seedling Biomass and Physio-Chemical Characteristics in Different Species of Wheat Possessing the D Genome." Agronomy 9, no. 9 (September 9, 2019): 522. http://dx.doi.org/10.3390/agronomy9090522.
Full textAbstract:
Wild relatives of wheat serve as an extraordinary source of variability for breeding programs due to their capabilities to respond to various environmental stresses. Here, we investigated some species possessing a D genome (T. aestivum, Ae. tauschii, Ae. crassa and Ae. cylindrica) in terms of relative water content (RWC), stomatal conductance (Gs), relative chlorophyll content, initial fluorescence (Fo), maximum quantum yield of PSII (Fv/Fm), maximum primary yield of PSII photochemistry (Fv/Fo), as well as shoot fresh and dry biomasses under control and water deficit conditions. Our results revealed that water deficit negatively affected all traits; shoot fresh weight, Gs and RWC showed the highest reduction compared to the control condition. Principal component analysis (PCA) identified two PCs that accounted for 53.36% of the total variation in the water deficit conditions. Correlation analysis and PCA-based biplots showed that stress tolerance index (STI) is significantly associated with Fv/Fm and Fv/Fo under water stress conditions, suggesting that these are the best parameters to evaluate when screening for tolerant samples at the seedling stage. We identified 19 accessions from Ae. crassa and one from Ae. tauschii as the most tolerant samples. In conclusion, Ae. crassa might provide an ideal genetic resource for drought-tolerant wheat breeds.
15
Nair, Viji, Viji Dina Nazri, Angela Lau, Rozita Hashim, Clare Ratnasingham, and Murallitharan Munisamy. "Impact of a Targeted Free Mammography Screening Program for Underprivileged Women in Malaysia." Journal of Global Oncology 4, Supplement 3 (October 2018): 28s. http://dx.doi.org/10.1200/jgo.18.10320.
Full textAbstract:
Purpose Breast cancer remains the most prevalent cancer among Malaysians today. Almost two thirds of patients are diagnosed in the late stages of disease, stage III to IV, with poorer outcomes. In addition, evidence has also revealed that most of patients who present in these late stages are those from poorer socioeconomic backgrounds. Women from underprivileged backgrounds have been found to have poorer health-seeking behavior, especially in terms of screening for cancer. This is for a number of reasons, such as affordability, distance to health centers, and other socioeconomic factors, which have a large impact, as Malaysia only offers opportunistic screening for breast cancer and not for free. A specific program to provide free mammography screening targeted toward underprivileged Malaysian women was planned and implemented with the aim of improving access to screening and increasing the rate of screening among this specific group of women. Methods Funding for the program was obtained from successful negotiation with a large Malaysian life insurance carrier. To ensure geographic equity, screening services were strategically purchased from 15 hospitals that were spread out across Malaysia. We also built partnerships with various nongovernmental organizations working in the social arena servicing underprivileged groups to reach these groups specifically. The nongovernmental organizations co-organized awareness programs and screening days, together with the National Cancer Society Malaysia, with additional incentivization that included subsidizing transport to mammography centers. Results A total of 5,000 underprivileged women from different geographic localities and ethnicities were screened across Malaysia. Of these, 62% received a mammogram for the first time in their lives, whereas 21% received their first repeat mammogram in more than 3 years. Conclusion A targeted screening program that incorporated a multipronged approach strategy was successful at increasing access to breast cancer screening for underprivileged Malaysian women. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Murallitharan Munisamy Employment: National Cancer Society of Malaysia Stock or Other Ownership: MMPKV Sdn Bhd–operator of Malaysian Primary Care Clinics
16
Bielsa, Beatriz, María Ángeles Sanz, and María José Rubio-Cabetas. "‘Garnem’ and Myrobalan ‘P.2175’: Two Different Drought Responses and Their Implications in Drought Tolerance." Horticulturae 7, no. 9 (September 9, 2021): 299. http://dx.doi.org/10.3390/horticulturae7090299.
Full textAbstract:
One of the challenges in rootstock breeding programs is the combination of tolerances to different abiotic stresses in new interspecific hybrids adapted to a wide range of environmental conditions. In this work, two Prunus L. rootstocks: Myrobalan ‘P.2175’ (P. cerasifera Ehrh.) and the almond × peach hybrid ‘Garnem’ (P. amygdalus Batsch × P. persica (L.) Batsch) were subjected to drought during 24 h to understand their drought response mechanisms. The study was conducted monitoring leaf water potential (LWP), stomatal conductance (gs), relative water content (RWC), and electrolyte leakage (EL); as well as the abscisic acid (ABA) content in roots. The relative expression of five drought-relative genes was also studied. The obtained results allowed examining the drought tolerance potential of ‘Garnem’ and Myrobalan ‘P.2175’, demonstrating the great potential of ‘Garnem’ as drought tolerance source in future selections in breeding. Furthermore, based on the obtained data, the transcription factor Myb25-like could be a good biomarker of drought sensitivity for use in Prunus rootstock breeding programs.
17
Cabanes, Anna, Mary Rose Giattas, Mavalynne Orozco-Urdaneta, Groesbeck Parham, Leeya Pinder, Armando Sardi, and Safina Yuma. "Different Routes, Similar Destination: Building Breast Care Models in Tanzania, Zambia, and Colombia." Journal of Global Oncology 4, Supplement 3 (October 2018): 7s. http://dx.doi.org/10.1200/jgo.18.10050.
Full textAbstract:
Purpose Cancer is becoming an urgent problem in low- and middle-income countries as the global burden of disease shifts from infectious to noncommunicable diseases. Whereas cervical cancer and breast cancer are preventable and treatable, these diseases are the leading causes of women’s cancer deaths in low-resource settings, mostly because of late-stage presentation and limited diagnostic and treatment capacities. Methods Using the Breast Health Global Initiative resource-stratified guidelines and a phased implementation approach, countries with resource constraints have designed and implemented breast cancer interventions that allow for a balanced, efficient, and equitable use of limited resources. Results Tanzania, Zambia, and a rural area of Colombia serve as examples of evidence-based approaches to the implementation of breast cancer control programs, leveraging the successes and experiences of existing care platforms—mostly cervical cancer and HIV—while creating a solid foundation for country ownership and sustainability. Tanzania used a top-down approach, investing in understanding the needs through a breast health care assessment to inform policy and practice, as well as building a national policy framework. Zambia analyzed the successes and experiences of their public Cervical Cancer Prevention Program to introduce breast cancer education, detection, and surgical treatment, and to improve the time of diagnosis for breast cancer using the single-visit approach recommended by WHO for cervical cancer. A rural community in Colombia has focused on mitigating some of the most common barriers that women face during their cancer journey by improving the cancer education of medical personnel, providing technology for early diagnosis, and implementing an outreach and navigation program that has significantly reduced waiting times from screening through diagnosis and treatment. Conclusion What are key characteristics that guarantee success? Country ownership is crucial, with political, institutional, and community ownership; capabilities; and accountability. Under these four dimensions and a phased implementation framework, we explain the approach that civil society, ministries of health, and stakeholders have taken to implement these programs. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Anna Cabanes Research Funding: Pfizer, Genentech, Merk (Inst) Travel, Accommodations, Expenses: Pfizer, Astra Zeneca Mary Rose Giattas Research Funding: Pfizer, Genentech, Merk (Inst) Travel, Accommodations, Expenses: Pfizer, Astra Zeneca Mavalynne Orozco Urdaneta Stock or Other Ownership: Celgene, Johnson and Johnson Armando Sardi Stock or Other Ownership: Celgene, Johnson and Johnson
18
Tarnowski, C. G., P. A. Worlock, S. Ulanovsky, and S. Gómez Talquenca. "First Report of Rupestris stem pitting associated virus in Argentina." Plant Disease 86, no. 8 (August 2002): 921. http://dx.doi.org/10.1094/pdis.2002.86.8.921b.
Full textAbstract:
Rupestris stem pitting associated virus (RSPaV), a component of the rugose wood complex (RWC), is a worldwide graft transmissible disease of grapevines (Vitis vinifera L.). RSPaV has a single-stranded 8,726-nt RNA genome, belongs to the genus Foveavirus, and is often associated with Rupestris stem pitting (RSP) disease (2). In 1995, a grapevine sanitary selection program was implemented in Mendoza to investigate this and other grapevine viral diseases. RSP can be diagnosed when V. rupestris cv. St. George is used as a woody indicator for biological indexing. Chip-bud inoculated St. George plants developed a row of small pits and grooves on the wood cylinder below the graft or around and below the inoculated point (1,2). After three seasons in the field, 15 accessions with RSP wood markings were observed. Mature leaves and bark shavings were extracted, partially purified, and analyzed by a onestep reverse transcription polymerase chain reaction method. The expected 339-bp band was found in only six of the positively indexed samples using the specific 13/14 primer pair (2). Other viruses associated with RWC have been detected in Argentina, but to our knowledge, this is the first report of RSPaV. References: (1) A. C. Goheen. Page 53 in: Compendium of Grape Diseases, R. C. Pearson and A. C. Goheen, eds. American Phytopatological Society, St. Paul, MN, 1988. (2) B. Meng. Rupestris stem pitting: Insights on etiology and development of reverse transcription-polymerase chain reaction and immunoassays for diagnosis. Ph.D. Diss. Cornell University, Ithaca, NY, 1999.
19
Chidebe, Runcie C. W. "Patient Navigation: Breaking the Barriers of Care While Empowering Patients to Fight Cancer." Journal of Global Oncology 4, Supplement 3 (October 2018): 10s. http://dx.doi.org/10.1200/jgo.18.10090.
Full textAbstract:
Purpose Through the Union for International Cancer Control and Pfizer Oncology SPARC MBC grant, Project PINK BLUE–Health & Psychological Trust Centre implemented the Breast Cancer Navigation and Palliative Program with strategic activities focused on metastatic breast cancer with the goal of “empower[ing] women at risk of, or living with advanced breast cancer and to reduce [the] incidence of stage III or IV breast cancer.” The project established Nigeria's first patient navigation program, which trained 138 health workers and social workers across the six area councils of Abuja and connected 116 breast health facilities, 58 in Abuja and another 58 across Nigeria—diagnostic centers and hospitals—in a Web-based navigation map application. The program was designed to train only 18 patient navigators for Abuja only; however, we trained 44 patient navigators from National Hospital Abuja, Enugu, and Kebbi states who are currently working on establishing Breast Cancer Navigation and Palliative Programs in their respective states. Trained oncology nurse navigators are providing optimum palliative care and navigation to patients across the mapped health facilities in Abuja. Whereas 72 institutions have been engaged through diverse partnerships, 27 resources were produced, including videos, documents, and a palliative/navigation book for health care workers. Ten ECHO palliative care trainings were organized for nurses and pain doctors, with an additional eight in-person workshops on palliative care and patient navigation and five patient support group meetings. Seventy-two news articles were published, including for TV, radio, and in interviews. Methods The program used training of nurses, cancer survivors and nurses to become patient navigators at National Hospital Abuja and across the six area councils of Abuja. Currently, navigators in Niger State and Enugu state have also received training on patient navigation, and more patients with cancer have been tracked and observed during their cancer journeys in Nigeria. Results The program has transited to lead national advocacy at Nigeria’s parliament for the establishment of the National Institute on Cancer Research and Treatment and has also establish such initiatives as Abuja’s first cancer support group and patient-led advocacy and campaign. Several patients with metastatic breast cancer were navigated through their journey with cancer. Conclusion Patients with metastatic breast cancer need more support to live a quality life; more than just pain medication. They need someone to listen to them and caregivers who show their care and love. Patient navigation is an emerging area of oncology and there is a need to support the patient navigators so that they may devote more time to its effects. AUTHOR’S DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Runcie C.W. Chidebe Travel, Accommodations, Expenses: Jansen and Jansen Consulting or Advisory Role: Novartis Pharmaceuticals
20
Singh, Ranjit K. Pritam, Zainab Abdullah, and Salimah Saleh. "A Community-Based Clinical Breast Examination Program: Is it Feasible?" Journal of Global Oncology 4, Supplement 3 (October 2018): 36s. http://dx.doi.org/10.1200/jgo.18.10420.
Full textAbstract:
Purpose Breast cancer presents in advanced stages in low- and middle-income countries where screening mammography is not available. In Malaysia, almost 60% of women, particularly in those the low socioeconomic group, present with stage III and IV breast cancer. We evaluated the feasibility of a community-based early detection program using clinical breast examination (CBE) carried out by the Breast Cancer Welfare Association, a nongovernmental organization. Methods Using a mobile clinic that was equipped to carry out CBE, a team of six health professionals trained in CBE techniques reached out to urban poor communities on the outskirts of the city and the rural population at the invitation of community leaders. At these events, breast self-awareness was taught to the community, with particular regard to the signs and symptoms of breast cancer and to breast self-examination. CBE was carried out in those women who agreed to be examined. Women who were found to have breast lumps were referred to the nearest public hospital and were observed for compliance. Women with anxiety were counseled. Results In 2016 to 2017, CBE was performed for 7,503 women, and 295 (3.9%) were found to have a palpable breast lump. These women were referred to the nearest hospital for additional assessment. Of these women, 156 (52.9%) consulted the doctor and sought additional examination. A total of 153 patients had no malignant findings, whereas three were found to have breast cancer. The mean age for women found to have a palpable breast lump was younger than 40 years—35 years in 2016 and 33 years in 2017—whereas the median age among the 295 women was 33 years in 2016 and 31 years in 2017 (range, 17 to 67 years). Conclusion A community outreach program using CBE as a method of early detection is feasible in Malaysia. Additional study is required to determine why 47% of those who were found to have a breast lump did not seek additional assessment. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.
21
Habus-Jercic, Ivanka, Marijana Baric, Snjezana Keresa, Anita Bosnjak-Mihovilovic, Milan Poljak, and Boris Lazarevic. "Effect of terminal drought on yield and some physiological traits of winter wheat." Genetika 50, no. 2 (2018): 747–53. http://dx.doi.org/10.2298/gensr1802747h.
Full textAbstract:
Terminal drought i.e. drought during grain-filling phase is the most devastating environmental stress to wheat production. In present study the effect of terminal drought on physiological traits and its influence on yield and yield components in two winter wheat varieties (Kuna and Karla) were investigated. Terminal drought stress was applied from the beginning of anthesis by installing mobile plastic roof above the crops. Leaf gas exchange parameters, chlorophyll content index (CCI), relative water content (RWC), and nitrogen (N) content were measured three times during grain-filling phase, at early milk maturity (EMM), late milk maturity (LMM), and at early wax maturity (EWM). Grain yield and 1000 grain weight were measured by harvesting of each plot at crop maturity. Terminal drought enhanced leaf senescence and caused reduction of RWC, CCI, net photosynthetic rate (A), stomatal conductance (gs), and transpiration rate (E) as well as, grain yield and all measured yield components. However, grain yield and grain weight per ear were less affected in Karla indicating enhanced tolerance to terminal drought compared to Kuna variety. Higher tolerance to terminal drought in Karla is based on stay-green strategy. Stay-green strategy in Karla was characterized by retention of CCI at early wax maturity, which contributed to higher E and lower intercellular CO2 concentration compared to Kuna under terminal drought. Stay-green strategy as trait that enhanced terminal drought tolerance in Karla should be used in breeding programs and utilized to ensure maximum economic yields under terminal drought conditions.
22
Munoz-Zuluaga, Carlos, Armando Sardi, Mavalynne Orozco-Urdaneta, Luis Gabriel Parra-Lara, Andres Perez, Farah El-Sharkawy, Carolina Velez-Mejía, and Mary Caitlin King. "Amate: A Mobile Application To Improve Access To Early Breast And Cervical Cancer Detection." Journal of Global Oncology 4, Supplement 3 (October 2018): 26s. http://dx.doi.org/10.1200/jgo.18.10290.
Full textAbstract:
Purpose For Colombian women, breast and cervical cancer are the leading causes of mortality, despite being potentially curable through early detection and timely treatment. Tedious administrative processes and a lack of cancer screening education and awareness hinders early detection. Mobile applications (mApps) have permeated all levels of society and are potential tools by which to deliver personalized information and identify high-risk patients in need of screening tests thereby improving early cancer detection. The aim of this work is to create a free mApp that educates and guides patients to the national screening programs for breast and cervical cancer. Methods An mApp Amate was advertised to women (age ≥ 14 years) in the waiting rooms of a health care facility of a community hospital during a period of 9 months. Amate used educational, evaluative, and risk factor questions to measure the population’s knowledge of breast and cervical cancer. Each question was followed by an explanation. Correct answers yielded points that were redeemable for cellular data. Risk assessment questions identified women who required screening who were subsequently contacted by a health care provider and enrolled in the national cancer care program. Results A total of 4,553 women were contacted from August 2017 to May 2018. Of this group, 830 downloaded Amate and answered all of the questions. On the basis of the risk factor questions, 16% of patients (n = 131) were identified as being at risk for breast and/or cervical cancer and needed to be enrolled in the national screening program. Thus far, 24% of patients (n = 32) have successfully completed their recommended screening tests—mammogram, Papanicolau smear, or both. We also identified specific barriers to enrolling patients in these programs, including an unwillingness to be enrolled, limited available appointments at health care centers, and denied access as a result of health care coverage. Conclusion Amate is a low-cost, accessible tool that identifies women who are at risk for breast and cervical cancer and detects access barriers to early cancer detection. Administrative obstacles still exist and must be addressed to improve early cancer detection and screening. Amate has the potential to reach people from rural areas of Colombia and other underserved countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Armando Sardi Stock or Other Ownership: Celgene, Johnson & Johnson Mavalynne Orozco-Urdaneta Employment: Partners For Cancer Care And Prevention Foundation, Stamina-in-Action Stock or Other Ownership: Celgene, Johnson & Johnson Luis Gabriel Parra-Lara Research Funding: Merk & Co
23
Jang, WonJoon, JaePil Song, MiJung Kim, and EunJi Bang. "Analysis of Key factors in Arms Export and Arms Export Strategy of Middle East Countries." Journal of Advances in Military Studies 1, no. 1 (November 8, 2020): 69–86. http://dx.doi.org/10.37944/jams.v1i1.11.
Full textAbstract:
President Moon has visited to UAE as a National Visit in March, 2018 and express to support co-develop, co-produce and co-export to the third countries of weapon system. Therefore, the paper analyzes the recent arms market in the Middle East, as one of the three major arms export market to Korea, and present an arms export strategy to customize the Middle East countries.Concerning a recent 10 year arms export by region, the ratio of Middle East countries arms export was highly increased by 12%p(17%→29%). And arms acquisition budget in 5 years(2018∼22) will be over 130 billion dollars. UAE has a highly interested in missiles, warship building, surveilance system, RWCS etc after Summit meeting. Iraq has focus on his post war rebuilding to include relevant weapon system and facilities. Also, Saudi Arabia is necessary to fulfill his Saudization policy to enter his arms market.For expanding of Middle East arms market, it is necessary to provide customized defense industry total solution for the whole weapon system lifecycles, dispatch defense cooperation director, find out co-development program between Korea and Middle East countries, and diversify cooperation system in the near future.
24
Huang, Bingru, and Hongwen Gao. "Physiological Responses of Diverse Tall Fescue Cultivars to Drought Stress." HortScience 34, no. 5 (August 1999): 897–901. http://dx.doi.org/10.21273/hortsci.34.5.897.
Full textAbstract:
Drought is among the most limiting factors for turfgrass growth. Understanding genetic variations and physiological mechanisms in turfgrass drought resistance would facilitate breeding and management programs to improve drought resistance. The experiment was designed to investigate shoot physiological responses of six tall fescue (Festuca arundinacea Schreb.) cultivars representing several generations of turfgrass improvement to drought stress. Grasses were grown in well-watered or drying (nonirrigated) soil for 35 days in the greenhouse. Net photosynthetic rate (Pn), stomatal conductance (gs), transpiration rate (Tr), relative water content (RWC), and photochemical efficiency (Fv/Fm) declined during drought progression in all cultivars, but the time and the severity of reductions varied with cultivar and physiological factors. The values of Pn, RWC, gs, and Tr decreased significantly for `Rebel Jr', `Bonsai', and `Phoenix' when soil water content declined to 20% after 9 days of treatment (DOT) and for `Houndog V', `Kentucky-31', and `Falcon II' when soil water content dropped to 10% at 15 DOT. A significant decrease in Fv/Fm was not observed in drought-stressed plants until 21 DOT for `Rebel Jr', `Bonsai', and `Phoenix' and 28 DOT for `Houndog V', `Kentucky-31', and `Falcon II'. The decline in Pn resulted mainly from internal water deficit and stomatal closure under mild drought-stress conditions. After a prolonged period of drought stress (35 DOT), `Falcon II', `Houndog V', and `Kentucky-31' maintained higher Pn than did `Rebel Jr', `Bonsai', and `Phoenix', which could be attributed to their higher Fv/Fm. This study demonstrated variation in drought resistance among tall fescue cultivars, which was related to their differential responses in photosynthetic capacity and water relations.
25
Chowdhury, M. Kaium, M. A. Hasan, M. M. Bahadur, Md Rafiqul Islam, Md Abdul Hakim, Muhammad Aamir Iqbal, Talha Javed, et al. "Evaluation of Drought Tolerance of Some Wheat (Triticum aestivum L.) Genotypes through Phenology, Growth, and Physiological Indices." Agronomy 11, no. 9 (September 7, 2021): 1792. http://dx.doi.org/10.3390/agronomy11091792.
Full textAbstract:
Increasing human population and changing climate, which have given rise to frequent drought spells, pose a serious threat to global food security, while identification of high yielding drought tolerant genotypes remains a proficient approach to cope with these challenges. To offer a methodology for the evaluation of the drought-tolerant wheat genotypes based on the pheno-physiological traits, a field experiment was executed, entailing four wheat genotypes viz. BARI Gom 26, BAW 1158, BAW 1167, and BAW 1169 and two water conditions viz. control treatment (three times irrigation at 20, 50, and 70 DAS, i.e., 100% field capacity) and stressed treatment (no irrigation during the entire growing season). The results revealed that drought stress drastically reduced the days to booting, heading, anthesis and physiological maturity, relative water content (RWC), chlorophyll content, canopy temperature depression (CTD), and photo-assimilates-spike dry matter (SDM), grains spike−1 and grain yield of all wheat genotypes. In addition, the genotypes BAW 1167 and BARI Gom 26 remained more prone to adverse effects of drought as compared to BAW 1169 and BAW 1158. Furthermore, DS induced biosynthesis of compatible solutes such as proline, especially in BAW 1169, which enabled plants to defend against oxidative stress. It was inferred that BAW 1169 remained superior by exhibiting the best adaptation as indicated by the maximum relative values of RWC, total chlorophyll, CTD, proline content, SDM, grains spike−1, and grain yield of wheat. Thus, based on our findings, BAW 1169 may be recommended for general adoption and utilization in future wheat breeding programs aimed at developing potent drought-tolerant wheat genotypes to ensure food security on a sustainable basis.
26
Rivera, Donna, Jennifer J. Lee, Melanie E. Royce, and Paul Gustav Kluetz. "FDA Oncology Center of Excellence landscape analysis of real-world data submissions for oncology drugs." Journal of Clinical Oncology 39, no. 15_suppl (May 20, 2021): e18787-e18787. http://dx.doi.org/10.1200/jco.2021.39.15_suppl.e18787.
Full textAbstract:
e18787 Background: Aligning with 21st Century Cures legislation, the FDA is exploring trial design modernization and methodology to advance appropriate uses of Real World Data (RWD) to generate Real World Evidence (RWE). The Oncology Center of Excellence RWE Program was established in 2020 to advance RWE efforts specific to oncology drug development. Inclusion of RWD to support regulatory decision making has increased in oncology, and a landscape analysis was conducted to characterize the RWD included in submissions. Methods: A systematic search was conducted using internal FDA databases to identify RWD submissions from 2010 to 2020. Search terms included: real world evidence, real world data, electronic health record, cancer registry, administrative claims, external control arm, observational cohort, historical control arm, rwOS, rwRR, rwCR, and rwORR. Relevant regulatory submissions were reviewed, and pre-defined common data elements were extracted. A team of FDA reviewers assessed agreement through subset validation (20%). Descriptive statistics were calculated. Results: A total of 142 regulatory submissions included RWD from 2011 to 2020. A subset of 94 submissions met the criteria for evaluation, consisting of 78 unique studies evaluating 56 molecular entities. RWD submissions increased substantially over time, with 28 submissions in 2020. Nearly half of the RWD submissions were for solid tumor indications (68%), with lung cancer being the most predominant site. More than one third of the RWD submissions (37%) were for rare indications. The most common primary RWD study objective was effectiveness (62%) and the most commonly referenced RWD source was EHR/clinical data (54%). The most frequently used primary RWD endpoints were survival (rwOS, 35%) and response (rwORR/PR/BTR, 31%) outcomes (Table). Conclusions: Our review demonstrates a dramatic increase in RWD submissions to support FDA oncology drug development programs. Submissions included a variety of study objectives, data sources, and endpoints. While this landscape analysis provides a picture of potential regulatory objectives, the adequacy of each proposal to support regulatory decision making was not evaluated. Establishing a set of clear regulatory objectives can help advance the development of metrics for robust data characterization and outcome validation to ensure that RWD can be appropriately evaluated and provide the rigor necessary to be considered adequate RWE.[Table: see text]
27
Buraschi, Florencia B., Federico P. O. Mollard, Agustín A. Grimoldi, and Gustavo G. Striker. "Eco-Physiological Traits Related to Recovery from Complete Submergence in the Model Legume Lotus japonicus." Plants 9, no. 4 (April 21, 2020): 538. http://dx.doi.org/10.3390/plants9040538.
Full textAbstract:
Submergence is a severe form of stress for most plants. Lotus japonicus is a model legume with potential use in assisting breeding programs of closely related forage Lotus species. Twelve L. japonicus genotypes (10 recombinant inbred lines (RILs) and 2 parental accessions) with different constitutive shoot to root dry mass ratios (S:R) were subjected to 7 days of submergence in clear water and allowed to recover for two weeks post-submergence; a set of non-submerged plants served as controls. Relative growth rate (RGR) was used to indicate the recovery ability of the plants. Leaf relative water content (RWC), stomatal conductance (gs), greenness of basal and apical leaves, and chlorophyll fluorescence (Fv/Fm, as a measure of photoinhibition) were monitored during recovery, and relationships among these variables and RGR were explored across genotypes. The main results showed (i) variation in recovery ability (RGR) from short-term complete submergence among genotypes, (ii) a trade-off between growth during vs. after the stress indicated by a negative correlation between RGR during submergence and RGR post-submergence, (iii) an inverse relationship between RGR during recovery and S:R upon de-submergence, (iv) positive relationships between RGR at early recovery and RWC and gs, which were negatively related to S:R, suggesting this parameter as a good estimator of plant water balance post-submergence, (v) chlorophyll retention allowed fast recovery as revealed by the positive relationship between greenness of basal and apical leaves and RGR during the first recovery week, and (vi) full repair of the submergence-damaged photosynthetic apparatus occurred more slowly (second recovery week) than full recovery of plant water relations. The inclusion of these traits contributing to submergence recovery in L. japonicus should be considered to speed up the breeding process of the closely related forage Lotus spp. used in current agriculture.
28
Salma, UK, F. Khatun, MJH Bhuiyan, S. Yasmin, and TH Khan. "In vitro screening for drought tolerance of some chickpea varieties in Bangladesh." Progressive Agriculture 27, no. 2 (August 17, 2016): 110–18. http://dx.doi.org/10.3329/pa.v27i2.29319.
Full textAbstract:
The aim of the present study was to study physiological response of seven chickpea varieties viz. Binachola-2, Binachola-3, Binachola-4, Binachola-5, Binachola-6, Binachola-7 and Binachola-8 at different levels of drought stress induced by polyethylene glycol (PEG). Five different concentrations (0, 20, 35, 50, 60 g/L) of PEG 6000 was added in MS medium to create five different levels of drought stress for in vitro screening of drought tolerant chick pea varieties. Data were recorded on germination percentage, fresh weight, shoot length, root length, dry weight, turgid weight, relative water content (RWC) and proline content. The seven chickpea varieties differed significantly for different parameters in response to the drought stress. Binachola-2 and Binachola-7 showed the best performance for all the parameters studied. At the highest dose of PEG (60 g/l), in the most water deficient condition, fresh weight was recorded 0.59 g and 0.84 g, Shoot lengths of 2.10 cm and 3.75 cm, root lengths of 1.15 cm and 1.00 cm, turgid weight of 0.960 g and 0.970 g, dry weight of 0.13 g and 0.21 g, relative water contents (RWC) of 85.71% and 83.33% were recorded in Binachola-2 and Binachola-7, respectively. Increased proline content was recorded with the increasing level of PEG concentration. Proline content 0.533g/100g FW and 0.598g/100g FW were observed in Binachola-2 and Binachola-7, respectively under the influence of PEG at 60 g/l. Data recorded for Binachola-3, Binachola-4, Binachola-5, Binachola-6 and Binachola-8 for the studied parameters revealed that they showed susceptible response against higher drought stress level generated by PEG. The data of this experiment revealed that, the accumulation of proline was significantly greater under drought stress. Thus, it is evident that Binachola-2 and Binachola-7 performed better against drought stress condition. These results of physiological and biochemical parameters may be utilized as a selection indicator for breeding program and used as a baseline for improvement of chickpea varieties in Bangladesh.Progressive Agriculture 27 (2): 110-118, 2016
29
Taib, Nur Aishah, Tania Islam, Ranjit Kaur, and Suhaida Mushtaffa. "Treatment Information and Navigation Program for New Patients With Breast Cancer in Malaysia." Journal of Global Oncology 4, Supplement 3 (October 2018): 45s. http://dx.doi.org/10.1200/jgo.18.10530.
Full textAbstract:
Purpose Advancements in medical treatment with wider treatment options have made breast cancer (BC) care more complex. Short consultation time with physicians, patient fears, and poor coping skills at the time of diagnosis may affect a patient’s decision, causing treatment delays and nonadherence. The main reasons for advanced BC presentation in Malaysia are a delay in making a treatment decision and poor breast health literacy on the disease and its treatment outcomes. To address this gap, we developed an audio-visual tool on multimodal treatments; adverse effects; navigating admission, discharge, and follow-up; and advice on diet and exercise to maintain a healthy lifestyle during the survivorship period in layperson language in Malay, Mandarin, and English. This study aims to assess its effectiveness in improving patient knowledge and satisfaction. Methods A pilot study of 50 patients found that patients needed face-to-face interaction to watch the video. Hence, a breast care nurse–led orientation was developed. A self-administered pre- and postsurvey in 246 patients with newly diagnosed breast cancer in University Malaya Medical Centre was performed to evaluate expectations, satisfactions, and knowledge. We scored the results with the following Likert scale terms: 0 means no knowledge and 4 means a great degree of knowledge. Scoring was done pre- and postintervention. A Wilcoxon matched paired signed rank test was used in the analysis. Results Among 246 patients who received the intervention, 79.3% (n = 197) found that the video met or exceeded their expectations, and 80.2% found the video effective in broadening their perspective on BC treatments. One hundred seventy-one patients (69.2%) rated the video as highly meeting their expectations. There were significant improvements in knowledge of treatment options for BC (mean scores 0.93 v 2.97 for pre- and postintervention; P < .001). Similar findings were found in different types of operations for BC; admission procedures; and information on chemotherapy, radiotherapy, hormone therapy, and alternative medicine. Knowledge scores for healthy diet, physical activity after treatment, and care of the arm were observed ( P < .001). Conclusion Video-based information on treatments and navigating care through a breast care nurse–led service effectively improved patients’ knowledge and satisfaction. This approach can be used to educate patients with cancer in a middle-resource setting. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.
30
Cabanes, Anna, Fatima Cardoso, Maia Thrift-Perry, Katherine Moose Hunt, and Tauane Araújo Cruz. "Supporting Resource-Stratified Metastatic Breast Cancer Policy Development: A Global Policy Analysis." Journal of Global Oncology 4, Supplement 3 (October 2018): 8s. http://dx.doi.org/10.1200/jgo.18.10060.
Full textAbstract:
Purpose Patients with metastatic breast cancer (mBC) have significant unmet needs that current policies do not fully address. Methods A comprehensive analysis of national cancer control programs and breast cancer (BC) policies and programs was conducted across 16 countries representing diverse geographies, socioeconomic status, and health care systems. Key policy components were identified, aligned with the journey of a patient with BC, and evaluated using standardized criteria that measured the adoption and implementation of national cancer control program goals and mBC-specific programs. The identified gaps for patients with mBC were aligned with promising practices implemented or spearheaded by civil society that demonstrated success at filling the gaps with the objective of creating an information resource that other organizations in the field can use as practice-based evidence. Results Despite considerable BC policy development and implementation, important gaps for patients with mBC persist across all areas of the patient journey and vary between countries studied. Inadequate public awareness, lack of trained specialists, inefficient coordination of care delivery, and limited access to innovative mBC treatments are barriers to effective care in select regions in high-income countries and overall in low- and middle-income countries. In addition, the provision of palliative care remains in its infancy in low- and middle-income countries, although this is an area of increasing policy development in high-income countries. Promising practices that evaluate patient advocacy efforts have revealed that adaptable models can support policy adoption and target specific gaps through an approach that can be tailored to countries’ resource contexts. For example, advocacy efforts identified in sub-Saharan Africa used a range of tools, in collaboration with key hospitals, to address barriers at the diagnosis stage and facilitate access to care. In the United States, a Clinical Trial Helpline launched in partnership with local patient groups aims to connect patients with mBC with innovative treatment options through clinical trials. Conclusion The 70th United Nations World Health Assembly’s cancer resolution discussed the need to leverage efforts and collaborative initiatives among stakeholders. This research exemplifies successful multistakeholder engagement solutions, which are tailored to the country context, and offer targeted ideas to further policy development. Phased BC control implementation strategies must ensure that the policies and programs address the needs of both patients with early BC and of those with advanced BC. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Anna Cabanes Research Funding: Pfizer, Genentech, Merk (Inst) Travel, Accommodations, Expenses: Pfizer, AstraZeneca Fatima Carodso Consulting or Advisory Role: Amgen, Astellas/Medivation, AstraZeneca, Celgene, Daiichi-Sankyo, Eisai, GE Oncology, Genetech, GlaxoSmithKline, Macrogenics, Merk-Sharp, Merus BV, Mylan Mundipharma, Novartis, Pfizer, Pierre-Fabre, Roche, Sanofi, Seattle Genetics, Samsung Bioepis, Teva Expert Testimony: Pfizer, Roche Maia Thrift-Perry Employment: Pfizer Stock or Other Ownership: Pfizer
31
Novakowski, Ann K., and Pat Garcia-Gonzalez. "The Max Access Solution: A 'No Patient Left Behind' Model for Treatment Access." Journal of Global Oncology 4, Supplement 3 (October 2018): 29s. http://dx.doi.org/10.1200/jgo.18.10330.
Full textAbstract:
Purpose The Max Foundation has led the development and implementation of the widely recognized model for patient assistance programs by which manufacturers make available some of their innovative products to patients in low- and middle-income countries. Recognizing that a limitation of a pharmaceutical patient assistance program is the focus on a particular product while a patient’s cancer need is company agnostic, the Max Access Solution borrows from all the lessons learned from developing and managing access programs while shifting the focus from the drug to the patient. This innovative long-term access approach provides a bridge to treatment to individually identified patients in countries where the treatment is not otherwise locally available. Methods The initiative focuses on the patient and his or her needs across the disease spectrum, harnessing the power of multisector collaborations, including drug manufacturers, international distributors, diagnostics companies, ministries of health, ministries of health hospitals, cancer centers and other public institutions in recipient countries, and local nongovernmental organizations and patient organizations, as well as cancer research centers in the United States. We established the following measurable objectives: identify all treatments approved for a particular cancer, identify the supportive care needed to successfully treat the disease, identify local and international stakeholders for the success of the initiative, develop collaborative agreements with each of them, and establish an end-to-end validated supply chain into each country/cancer institution. Results In the first year of implementation, The Max Foundation delivered more than 700,000 required daily doses of oral cancer medication for CML to more than 10,000 patients in 65 countries, made 2,500 molecular tests available to patients, executed more than 220 collaboration agreements, and established a gross domestic product–validated supply chain into 90 cancer-treating institutions. Conclusion The Max Access Solution is a unique and innovative approach to cancer care access. An aim of The Max Foundation in developing the Max Access Solution for CML was as a proof of concept as well as to develop systems and impact measurements, with the long-term vision of expanding the model to other cancers. This model may be replicated in a variety of noncommunicable disease areas, including breast cancer and other cancers, to reduce health disparities globally. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.
32
Wiernik, Andres, Loretta Fernandez, Leonardo Lami, Greivin Vindas, Marissa Durman, and Millie Ramirez. "Oncosmart: A Private Initiative to Improve Breast Cancer Care in Costa Rica." Journal of Global Oncology 4, Supplement 3 (October 2018): 48s. http://dx.doi.org/10.1200/jgo.18.10560.
Full textAbstract:
Purpose Founded in 2010, Hospital Metropolitano is the fastest growing health care system in Costa Rica with a network of two hospitals, 27 clinics, and more than 90,000 patients enrolled in its health plan, Medismart. Given the challenges faced by the national public health care system in providing cancer care, the Oncosmart program was launched in November 2016 with the goal of providing population-based cancer screening, diagnostics, cancer treatment, and survivorship care. The program has no restrictions on preexisting conditions and has a monthly membership cost of $14 USD per patient. Here, we summarize our breast cancer program results during the first 16 months of implementation. Methods We performed a retrospective analysis that evaluated data from our radiology department, cancer center, and survivorship program. We determined the number of patients with breast cancer who were diagnosed and/or received care in our health care system from November 2016 to March 2018. Results During this period analyzed, 5,687 mammograms were performed at our health care system and 215 patients were reported to have a Breast Imaging Reporting and Data System 4 to 5 requiring a breast biopsy. Of these, 24% were diagnosed with breast cancer, 36% had a nonmalignant breast condition, and 41% were false positives. Among patients with newly diagnosed breast cancer, 11% had noninvasive breast cancer and 89% had invasive disease. Twenty-seven percent of all breast cancer diagnosis occurred in women younger than age 50 years and two patients were diagnosed with a BRCA1/2 mutation. All biopsies performed at our program were reported within 30 days from abnormal imaging. During this period, we performed 53 breast cancer surgeries and provided chemotherapy and/or endocrine therapy to 32 patients, and among all patients who followed-up in the survivorship clinic, 22 followed-up for breast cancer survivorship. Conclusion Oncosmart is a low-cost and effective private initiative that improves access to breast cancer screening and breast cancer care in the middle-income country of Costa Rica. On the basis of national statistics, after 16 months of implementation, approximately 4% to 5% of all patients with breast cancer in the country are diagnosed within our program. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Andres Wiernik Consulting or Advisory Role: Grupo Montecristo Leonardo Lami Employment: Roche, Genetech (I) Travel, Accommodations, Expenses: Roche/Genetech (I) Marissa Durman Consulting or Advisory Role: Grupo Montecristo
33
Koppiker, Chaitanyanand B., Santosh Dixit, Aijaz Ul Noor, Laleh Busheri, Gail Lebovic, Gautam Sharan, Upendra Dhar, and Smeeta Nare. "Breast Oncoplasty Surgery in Low- and Middle-Income Countries: Lessons From India." Journal of Global Oncology 4, Supplement 3 (October 2018): 22s. http://dx.doi.org/10.1200/jgo.18.10250.
Full textAbstract:
Purpose Breast cancer is the most common cancer in India, affecting all socio-economic strata. Despite its growing global acceptance, Breast Oncoplasty Surgery (BOS) remains nascent in India, necessitating local context-specific innovative delivery models for clinicians and the general public. Here, we present experiences from Orchids Breast Health Clinic (OBHC; Pune, India) with the implementation of BOS clinical services, training, and research and community outreach. Methods OBHC, a dedicated breast unit, has established the first dedicated BOS clinic in India, conducted hands-on training workshops for trainee surgeons, developed an MCh degree program in breast oncoplasty with the University of East Anglia (Norwich, United Kingdom), undertaken BOS research in Indian patients, and created outreach programs to popularize BOS. Results A cost-effective one surgeon–dual role concept wherein the same surgeon performs onco- and plastic surgery and one-stage implant-based breast reconstruction has been adopted. Since 2013, BOS cases included BCS (n = 440), breast reconstruction (n = 210), and therapeutic mammoplasty (n = 135). The unavailability of acellular dermal matrices has prompted the innovation of a surgical technique, termed Advanced Autologous Dermal Sling, which uses vascularized local tissue as implant cover. Significant improvement in postsurgery outcomes and protection against radiation complications has been observed. BOS hospitalization costs have been reduced by 50% thereby, which has led to high rates of acceptance (80%) of BOS in patients at OBHC. Young breast surgeons from across India and South Asian Association for Regional Cooperation countries have enrolled in the MCh degree program, which involves an embedded curriculum with online didactic modules and hands-on training workshops in Pune, India. Longitudinal follow-up after 1, 3, and 5 years postsurgery in the study cohorts is undertaken for post-BOS outcomes using clinical assessment (Bakers scale) and patient-reported outcomes measures (BREAST-Q questionnaire). Multiple research projects are undergoing peer-review before publication. To increase awareness of BOS among Indian women, community awareness campaigns with the theme of Losing Is Not an Option are underway via public talks, symposia, marathon, and op-eds in electronic and print media. Conclusion The OBHC model of Affordable Excellence in BOS, developed in the Indian context, can be extrapolated to benefit patients with breast cancer from other low- and middle-income countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.
34
Pace, Lydia E., Nancy L. Keating, Jean-Marie Vianney Dusengimana, Vedaste Hategekimana, Vestine Rugema, Gaspard Muvugabigwi, Lauren E. Schleimer, et al. "Impact of an Early Detection Program on Breast Cancer Services, Incidence, and Stage in Rural Rwanda." Journal of Global Oncology 4, Supplement 3 (October 2018): 34s. http://dx.doi.org/10.1200/jgo.18.10380.
Full textAbstract:
Purpose In low-income countries, most women with breast cancer present with advanced-stage disease. To facilitate earlier diagnoses of symptomatic disease, feasible and effective early detection strategies are needed. We assessed health care use and patient outcomes from a randomized pilot study of an early detection program in Burera, a rural Rwandan district, where the Butaro Cancer Center of Excellence (BCCOE) is located. Methods The intervention included training for community health workers in breast health, training for health center (HC) nurses in the evaluation of breast concerns, and weekly breast clinics at HCs and BCCOE. Twelve of 18 eligible HCs were randomly assigned to receive the intervention—seven beginning in April and May 2015, and five in November and December 2015—and six served as controls for the entire study period. We abstracted HC and hospital records of patients seen between April 2015 and April 2017 and used generalized linear models to compare the incidence of biopsies, breast cancer diagnoses, and early-stage diagnoses in the geographic sectors served by intervention versus control HCs. Results Overall, 276,282 person-years were in intervention sectors and 302,856 in control sectors. Of patients, 1,500 patients sought care at intervention HCs for breast concerns versus 600 at control HCs. Three hundred eighteen patients that were referred from intervention HCs were evaluated at BCCOE compared with 62 from control HCs. The biopsy rate was 36.6 per 100,000 person-years from intervention sectors versus 8.9 per 100,000 from control sectors ( P < .001). Breast cancer was diagnosed in 19 of 101 patients from intervention HCs who underwent biopsy (18.8%) compared with 10 (37.0%) of 27 patients from control HCs. Breast cancer incidence was 6.9 per 100,000 in intervention sectors versus 3.3 per 100,000 in control sectors ( P = .35). Nine patients from intervention HCs had early-stage disease (47.4%) versus two from control HCs (20.0%). The incidence rate of early-stage breast cancer was 3.7 per 100,000 in intervention sectors versus 0.7 per 100,000 in control sectors ( P = .08). Conclusion Over 2 years, our early detection program was associated with more patients referred for hospital-level evaluation and requiring biopsies. Most patients referred by intervention HCs had benign conditions; however, there was a trend toward a higher incidence of early-stage breast cancer among patients from intervention regions. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Lydia E. Pace Stock or Other Ownership: Firefly Health
35
Dickerson, Lindsay K., Anne F. Rositch, Susan Lucas, Lisa A. Mullen, and Susan C. Harvey. "An Educational Intervention and Feasibility Assessment of Breast Ultrasound in Rural South Africa." Journal of Global Oncology 4, Supplement 3 (October 2018): 14s. http://dx.doi.org/10.1200/jgo.18.10150.
Full textAbstract:
Purpose Breast cancer is the leading cause of cancer death in women worldwide, with a strikingly high mortality in low- and middle-income countries (LMICs) as a result of the scarcity of detection, diagnosis, and treatment. With mammography unavailable, ultrasound (US) offers a viable alternative. The literature reports successful training in various domains, but a curriculum focused on the breast is novel. We assessed the feasibility—knowledge acquisition, perceived utility, and self-efficacy—of a breast US training program for the detection of breast cancer by nonphysician providers. Methods Training was implemented for 12 providers, including professional nurses, nursing assistants, and lay counselors, at Hlokomela clinic in Hoedspruit, South Africa, over 3 weeks. Didactic presentations and example cases were followed by a presurvey (n = 12) that characterized providers’ initial attitudes toward early detection and a pretest (n = 12) that determined immediate retention of knowledge and areas for focused training. All providers received hands-on training with nurses as models. Five providers trained with patients. A post-test (n = 12) assessed overall knowledge retention and acquisition, and a postsurvey (n = 10) gauged program acceptance and provider self-efficacy with breast US. Results Pretest to post-test averages improved by 68% overall and in four competencies—foundational knowledge, descriptive categories, benign versus malignant, and lesion identification. On the postsurvey, providers expressed the belief that US could significantly affect breast cancer detection (9.1/10), treatment (7.9/10), and survival (8.7/10) in their communities and endorsed moderate confidence in their scanning (6.3/10) and interpreting abilities (5.6/10). Conclusion There is a pressing need for a paradigm shift in breast cancer care in LMICs, with early detection critical to improving outcomes. Our research supports the feasibility of breast US training as part of a breast education program in LMICs. Pretest and post-test results and observed proficiency indicate that training nonphysician providers is achievable. Postsurvey responses indicate program acceptance, provider self-efficacy with US, and community-based ownership of a breast cancer screening and awareness initiative. Follow-up work that is focused on quality improvement and sustainability is ongoing. Future work may show that breast US is viable for early detection when mammography is unavailable. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Susan C. Harvey Consulting or Advisory Role: IBM Watson, Hologic Inc Research Funding: IBM Watson
36
Jaganathan, Maheswari, Stephanie Teh Siu-Hoong, Yeoh Zi-Yi, Nadia Rajaram, Nur Hidayati Zainal, Teo Soo Hwang, and Mohamed Yusof Abdul Wahab. "New Horizons for Breast Cancer Care: Patient Navigation in a Low- and Middle-Income Country." Journal of Global Oncology 4, Supplement 3 (October 2018): 19s. http://dx.doi.org/10.1200/jgo.18.10220.
Full textAbstract:
Purpose We established a patient navigation program in a secondary hospital in Malaysia. Here, we report on its impact on diagnostic and treatment timeliness for patients in the first 2 years of its implementation (n = 135 in 2015 and n = 155 in 2016) and compare these patients’ timeliness outcomes with those of patients who were diagnosed in 2014 (n = 147). Methods A dedicated navigation team provided education, supportive care, and practical help in overcoming individual barriers. Demographic, clinical, and timeliness data were collected and analyzed using Kruskal-Wallis and Fisher’s exact tests. Results Navigated patients were more likely to meet national service targets for mammography (95% in 2015 and 96% in 2016 v 74% in 2014; P < .001), biopsy (92% in 2015 and 94% in 2016 v 77% in 2014; P < .001), and communication of news (80% in 2015 and 82% in 2016 v 58% in 2014; P < .001). There was a modest impact on primary surgery (58% in 2015 and 65% in 2016 v 52% in 2014; P = .077) and neoadjuvant chemotherapy (42% in 2015 and 54% in 2016 v 56% in 2014; P = .284). We observed improvements in surgery timeliness among patients with early-stage disease but not in late-stage patients’ surgery and neoadjuvant timeliness. Barriers typically associated with late-stage disease at presentation, such as health literacy, residential distance from the hospital, and financial barriers, were not associated with delayed treatment initiation. Of interest, patients who delayed treatment initiation were less likely to have dependents younger than age 17 years (29% v 63%; P = .033). Conclusion Our results demonstrate that a navigation program is feasible and sustainable in a state-run hospital in a low-resource community. Whereas the program improved overall diagnostic timeliness, opportunities to improve outcomes in patients with late-stage disease may lie in diversifying navigation solutions. This includes addressing challenges that are specific to late-stage presenters and harnessing efforts at the primary care and community level to downstage breast cancer burden in Malaysia. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Teo Soo Hwang Speakers’ Bureau: AstraZeneca Research Funding: AstraZeneca Patents, Royalties, Other Intellectual Property: Cancer Research Malaysia Travel, Accommodations, Expenses: AstraZeneca
37
Nair, Nita S., Sudeep Gupta, Jaya Ghosh, Sangeeta Desai, Vani Parmar, Tanuja Shet, and Rajendra A. Badwe. "Access to Human Epidermal Growth Factor Receptor 2–Targeted Therapy at a Tertiary Care Center in India: An Evolution." Journal of Global Oncology 4, Supplement 3 (October 2018): 27s. http://dx.doi.org/10.1200/jgo.18.10310.
Full textAbstract:
Purpose In a previous retrospective audit from our institution, access to human epidermal growth factor receptor 2 (HER2) –targeted therapy (H2T) in patients registered and treated in 2008 was reported, wherein only 38 (8.61%) of 441 patients received some form of H2T. Three developments occurred in subsequent years that potentially affected access to H2T at our institution—that is, a patient access program supported by the innovator pharmaceutical company, a generous philanthropic donor, and the use of biosimilars. Methods To evaluate the cumulative impact of these developments on access to trastuzumab, we reviewed access to H2T in a recent cohort of patients with breast cancer registered in at our institution. Results In 2016, 4,717 new patients with breast cancer were registered at our institution. Among these patients, HER2 3+ expression by immunohistochemistry or fluorescent in situ hybridization (FISH) was reported in 828 patients (22.77%). Assuming the same 33.22% amplification rate in the 343 patients who did not undergo FISH testing, there were potentially 114 more patients with HER2-amplified tumors. Thus, the final number of HER2-overexpressing/-amplified tumors is estimated to be 942 in 2016 (729 HER2 immunohistochemistry 3+, 99 known FISH amplified, and 114 estimated FISH amplified). Of these 942 patients, 13 were not deemed suitable for H2T and 94 did not follow-up for additional treatment at our institution. The remaining 835 patients were eligible to receive H2T and were analyzed for access to this treatment. Overall, 444 (53.2%) of these 835 patients received trastuzumab for durations that ranged from 12 weeks to 12 months in the (neo)adjuvant setting or other durations in the metastatic setting. This is in contrast to the previously reported 8.61% use of H2T in the cohort of patients registered in 2008. Conclusion We suggest that other institutions, especially public hospitals that treat underprivileged patients, make concerted efforts to increase access to potentially curative treatments, such as trastuzumab, using targeted programs and philanthropic support, and consider using a shorter duration of 12 weeks of trastuzumab to improve patient outcomes. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.
38
Sarker, Masuma, and Nazmul Hoque Masum. "Two-Phased Strategy for Improvement of Breast Cancer Care in Bangladesh." Journal of Global Oncology 4, Supplement 3 (October 2018): 40s. http://dx.doi.org/10.1200/jgo.18.10470.
Full textAbstract:
Purpose Bangladesh has a low incidence of breast cancer; however, the incidence is rising rapidly and the mortality rate is significantly higher, which is complicated by limited resources. Hence, a screening and treatment strategy will not be the same as those of high-income countries. Methods We did a literature review, resource evaluation, and finally propose a resource-stratified two-phased implementation strategy to improve breast cancer care in Bangladesh. Results There is a lack of qualitative and quantitative epidemiologic data. According to limited available data, breast cancer demography is different, as almost all patients present in advanced stage and most are premenopausal women. We have identified the three most important factors that affect breast cancer management: social, cultural, and religious barriers to early detection; few treatment facilities, which are concentrated mainly in the capital; and a lack of female health care providers while seeking treatment. We propose a two-phased approach. A female-orientated primary health care system has been successful in Bangladesh in achieving many health goals. In the first phase, we propose involving a female health assistant of the primary health care system to increase awareness, early detection (clinical downstaging), and effective referral of patients with breast cancer. This program can be integrated into existing perinatal care, as a majority of patients with breast cancer are of reproductive age. At the same time, we will modify tertiary health care (THC) to establish a model one-stop breast cancer facility and we propose a single day of a week when female health care providers will be available to provide care. THC providers will conduct outreach programs at the district level. In addition, a population-based epidemiologic study and cancer registry should be started immediately. In the second phase, we aim to establish an effective breast cancer care facility at the secondary health care level, as this is accessible by a large portion of the population. We propose establishing a one-stop breast cancer facility in every district that will be inspired by the THC model clinic. Adequate resources should be allocated to achieve this goal. Conclusion This strategy could be a model for other resource-limited developing countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.
39
Sardi, Armando, Mavalynne Orozco-Urdaneta, Carolina Velez-Mejia, Andres Perez, Carlos Munoz-Zuluaga, Farah El-Sharkawy, Luis Gabriel Parra-Lara, John Singer, and Michelle Sittig. "Overcoming Barriers in the Implementation of Programs for Breast and Cervical Cancer: A Pilot Model." Journal of Global Oncology 4, Supplement 3 (October 2018): 39s. http://dx.doi.org/10.1200/jgo.18.10460.
Full textAbstract:
Purpose Breast and cervical cancers are leading causes of mortality in Latin America. Although Colombia has an integrated health system that provides universal coverage, approximately 70% of patients with cancer are diagnosed in a late stage. The government has a 10-year cancer control plan that is focused on prevention, early detection, and treatment; however, many barriers have hindered its implementation. Since 2012, Partners for Cancer Care and Prevention has worked to decrease the burden of breast and cervical cancer by mitigating the obstacles women face during their cancer journeys. Methods Through community outreach and meetings with medical personnel, hospital directors, and government officers, we identified some of the barriers—a deficit of trained personnel and physicians, limited centers and scarcity of equipment for early diagnosis, and a fragmented health system with poor continuity of care. Our proposal included monthly teleconferences, a twice-a-year on-site training and quality control program, improving the equipment for early diagnosis in easily accessible centers for patients, creating a patient navigation program and a mobile application (Amate), and unifying the system by directing patients for diagnosis to level 1 and 2 hospitals with rapid referral for treatment in level 3. Results From 2012 to 2016, we have trained 462 health professionals in the screening, diagnosis, and treatment of breast and cervical cancers and equipped level 1 and 2 hospitals for cancer diagnosis by donating a mammography machine and two video colposcopes, all of which has yielded 3,036 mammograms and 1,500 uterocervical cytologies annually. In addition, Amate is able to provide basic teaching and rapid referral for screening. Thus far, 2,583 women have benefited from the program. This has integrated the health system and shortened wait times. After 4 years, the time from initial consult to biopsy has decreased from 65 days to 20 days (70%), from biopsy to surgery for 154 days to 64 days, and from biopsy to chemotherapy from 148 days to 72 days. Conclusion A system of early diagnosis in level 1 and 2 hospitals—now centers of excellence—with rapid referral to a tertiary care institution has facilitated the implementation of the cancer program in Colombia. Although several barriers are still to be addressed, we are establishing an efficient health care model that could be replicated in other underserved countries. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Armando Sardi Stock or Other Ownership: Celgene, Johnson & Johnson Mavalynne Orozco-Urdaneta Employment: Partners For Cancer Care And Prevention Foundation, Stamina-in-Action Stock or Other Ownership: Celgene, Johnson & Johnson Luis Gabriel Parra-Lara Research Funding: Merk & Co
40
Diaz-Valencia, Paula, Luz Marina Melgarejo, Ivon Arcila, and Teresa Mosquera-Vásquez. "Physiological, Biochemical and Yield-Component Responses of Solanum tuberosum L. Group Phureja Genotypes to a Water Deficit." Plants 10, no. 4 (March 27, 2021): 638. http://dx.doi.org/10.3390/plants10040638.
Full textAbstract:
Water deficits are the major constraint in some potato-growing areas of the world. The effect is most severe at the tuberization stage, resulting in lower yield. Therefore, an assessment of genetic and phenotypic variations resulting from water deficits in Colombia germplasm is required to accelerate breeding efforts. Phenotypic variations in response to a water deficit were studied in a collection of Solanum tuberosum Group Phureja. A progressive water deficit experiment on the tuberization stage was undertaken using 104 genotypes belonging to the Working Collection of the Potato Breeding Program at the Universidad Nacional de Colombia. The response to water deficit conditions was assessed with the relative chlorophyll content (CC), maximum quantum efficiency of PSII (Fv/Fm), relative water content (RWC), leaf sugar content, tuber number per plant (TN) and tuber fresh weight per plant (TW). Principal Component Analysis (PCA) and cluster analysis were used, and the Drought Tolerance Index (DTI) was calculated for the variables and genotypes. The soluble sugar contents increased significantly under the deficit conditions in the leaves, with a weak correlation with yield under both water treatments. The PCA results revealed that the physiological, biochemical and yield-component variables had broad variation, while the yield-component variables more powerfully distinguished between the tolerant and susceptible genotypes than the physiological and biochemical variables. The PCA and cluster analysis based on the DTI revealed different levels of water deficit tolerance for the 104 genotypes. These results provide a foundation for future research directed at understanding the molecular mechanisms underlying potato tolerance to water deficits.
41
Afsar, Sadia, Gulnaz Bibi, Raza Ahmad, Muhammad Bilal, Tatheer Alam Naqvi, Ayesha Baig, Mohammad Maroof Shah, Bangquan Huang, and Jamshaid Hussain. "Evaluation of salt tolerance in Eruca sativa accessions based on morpho-physiological traits." PeerJ 8 (August 13, 2020): e9749. http://dx.doi.org/10.7717/peerj.9749.
Full textAbstract:
Background Salinity is one of the most lethal abiotic stresses which affect multiple aspects of plant physiology. Natural variations in plant germplasm are a great resource that could be exploited for improvement in salt tolerance. Eruca sativa (E. sativa) exhibits tolerance to abiotic stresses. However, thorough evaluation of its salt stress tolerance and screening for traits that could be reliably applied for salt tolerance needs to be studied. The current study was designed to characterize 25 E. sativa accessions, originating from diverse geographical regions of Pakistan, for the salt stress tolerance. Methods Salt stress (150 mM NaCl) was applied for 2 weeks to the plants at four leaf stage in hydroponics. Data of the following morpho-physiological traits were collected from control and treated plants of all the accessions: root length (RL), shoot length (SL), plant height (PH), leaf number (LN), leaf area (LA), fresh weight (FW), dry weight (DW), chlorophyl content (SPAD), electrolyte leakage (EL), relative water content (RWC), gas exchange parameters and mineral ion content. Salt tolerance was determined based on membership function value (MFV) of the tested traits. Results Compared with control, the salt-stressed group had significantly reduced mean SL, RL, PH, LN, LA, FW, DW and SPAD. NaCl treatment triggered a slight increase in EL in few accessions. Mean RWC of control and treated groups were not significantly different although few accessions exhibited variation in this trait. Salt stress caused a significant reduction in photosynthesis rate (PR), transpiration rate (TR) and stomatal conductance (SC) but intercellular CO2 (Ci) was not significantly different between control and treated groups. Compared with control, the salt-stressed plants accumulated significantly higher Na+, K+ and Ca2+ while significantly lower Mg2+. K+/Na+ ratio was significantly decreased in salt-stressed plants compared with control. Importantly, significant inter-accession variations were found for all the tested traits. The principal component analysis identified SL, RL, PH, LN, LA, FW, DW and PR as the most significant traits for resolving inter-accession variability. Based on MFV of the tested traits, accessions were categorized into five standard groups. Among 25 accessions, one accession was ranked as highly tolerant, four as tolerant while 15 accessions were ranked as moderately tolerant. Of the remaining five accessions, four were ranked as sensitive while one accession as highly sensitive. Conclusion E. sativa accessions were found to exhibit significant genetic diversity in all the tested traits. A few most significant traits for dissecting the genetic variability were identified that could be used for future large-scale germplasm screening in E. sativa. Salt tolerant accessions could be a good resource for future breeding programs aiming to improve salt stress tolerance.
42
Tambussi, Eduardo A., Jaume Casadesus, Sergi Munné-Bosch, and José Luis Araus. "Photoprotection in water-stressed plants of durum wheat (Triticum turgidum var. durum): changes in chlorophyll fluorescence, spectral signature and photosynthetic pigments." Functional Plant Biology 29, no. 1 (2002): 35. http://dx.doi.org/10.1071/pp01104.
Full textAbstract:
We analysed the photoprotective response in water-stressed plants of durum wheat (Triticum turgidum L. var. durum cv. Mexa). The plants were grown in a greenhouse for 4 weeks and then exposed to water stress by withholding water for 8 d. Development of water stress was monitored as the decrease in relative water content (RWC) and net CO2 assimilation of the last fully developed leaf. The photoprotective response was evaluated in the same leaves by analysing modulated chlorophyll fluorescence, leaf spectroradiometrical changes, and pigment content. Measurements were performed 3, 6 (moderate stress) and 8 (severe stress) d after water-stress treatment began. The non-photochemical quenching of chlorophyll fluorescence (qN), as well as the contents of zeaxanthin and antheraxanthin increased significantly after 6 d of treatment. However, a further rise in these xanthophylls on day 8 was not associated with any increase in qN. In addition, the β-carotene content rose significantly on day 8, suggesting an increase in antioxidant defences. The photochemical index (PI), derived from spectroradiometrical measurements, showed a strong progressive drop on days 6 and 8, which was paralleled by an increase in the de-epoxidation state of the xanthophyll cycle (DPS), in particular by the zeaxanthin content. At midday, PI was strongly (negatively) correlated with DPS and qN. These results suggest that the PI may be a reliable indicator of photoprotection in the study of plant stress, and in breeding programs.
43
Ali, Esmat F., Fahmy Hassan, Sayed S. A. Abdel-Rahman, and Kadambot H. M. Siddique. "FOLIAR APPLICATION OF POTASSIUM AND ZINC ENHANCES THE PRODUCTIVITY AND VOLATILE OIL CONTENT OF DAMASK ROSE (Rosa damascena Miller var. trigintipetala Dieck)." Acta Scientiarum Polonorum Hortorum Cultus 20, no. 4 (August 31, 2021): 101–14. http://dx.doi.org/10.24326/asphc.2021.4.9.
Full textAbstract:
Potassium (K) levels are decreasing worldwide in agricultural soils, and K deficiency is becoming a major issue. Study on damask rose response to K application is scarce. Furthermore, despite its importance in the cell division, photosynthesis and protein synthesis, there is a lack of published reports on plant responses to zinc (Zn) application. Further research is required to understand the damask rose's response to both elements. This study investigated the effects of K and Zn foliar application on the vegetative growth, flower yield, and volatile oil content and composition of damask rose. K and Zn nutrition was applied either individually or combined as K2SO4 and ZnSO4 at 0.5 or 1.0%. Foliar application of K2SO4 and ZnSO4 was applied with a manual pump four times in each growing season, the first at the beginning of stem elongation and leaf formation, and then at two-weekly intervals. Results showed that K and/or Zn treatments significantly improved the growth characters, flower yield, relative water content (RWC), stomatal conductance, and essential oil content and composition such as linalool, nerol, citronellol, geraniol, and nonadecane. The chlorophyll content, total soluble sugars (TSS), and protein content also increased, but free amino acid content decreased, suggesting that the distribution of nitrogenous compounds (between amino acids and proteins) and their transformation were influenced by K and Zn supply. Individual applications of K or Zn increased the N, P, K, and Zn contents in damask rose leaves, relative to the control, which increased further with combined applications of K and Zn. Results suggest that foliar application of K and/or Zn could be part of the damask rose fertilization program to provide plants with the optimum level of nutrition for improving the quantity and quality of flowers and essential oil yields.
44
Sallam, Ibrahim M., Gamal Amira, and Ahmed Yousri. "National Egyptian Model of Breast Cancer Care." Journal of Global Oncology 4, Supplement 3 (October 2018): 38s. http://dx.doi.org/10.1200/jgo.18.10450.
Full textAbstract:
Purpose Forty percent of Egyptians have access to the public health system, and 60% are served by nongovernmental organizations and private centers. A problem exists, however, with the late presentation and inadequate access to services because of a lack of a structured screening program and awareness. The aim of this work was to present a model of breast cancer (BC) care in a low-resource setting and to assess risk factors for BC in Egypt, which has a high incidence of BC on the basis of registry estimates that indicate that approximately 22,000 new BC cases will be diagnosed by 2020. Methods In the Giza region, there was no mammographic reference service. Women with breast symptoms were referred to the National Cancer Institute, where they were offered services—diagnosis and treatment—with long wait times. Women age 20 years or older visiting one of the five participating centers were evaluated in a cross-sectional study, which included a data entry form questionnaire of risk factors for BC, including a family history of cancer, and the presence of breast symptoms, and breast examination by a trained professional—nurse or medical doctor. All patients with breast complaints or an abnormal physical exam were referred to the National Cancer Institute, MISR Cancer Center, Kasr El Aini, Agouza, and Bahia Hospital for additional evaluation. Women age 40 to 69 years were invited to participate in the screening both actively (digital invitations, Facebook groups, brochures distributed in governmental buildings, and WhatsApp groups) and passively (women who visited other hospitals in the region for any reason were called and delivered brochures and vouchers to join the project). The screening program was based on annual mammographies in women age 40 to 69 years, which are always preceded by physical examination by a breast surgeon or trained nurse. Close control of the frequency of visits was kept using a simple computer program with patient listing and reminder. Close contact and continuous feedback that helped adherence to the screening program. The proposal of the project includes the performance of all clinical, imaging, and pathology exams, as well as clinical visits and surgical treatment, in the same center, in the shortest time, and with the highest standards of care. The health care approach is multidisciplinary and includes nurses, breast surgeons, and a nutritionist. Results A high rate of compliance is the main strength of project. We achieved this with patient education on the importance of screening, intense contact with the primary trained staff with the provision of patient lists of those who should be screened next, and free transportation for women with low income. Every 3 to 4 months, we established jointly a charity workshop and projects of handmade cloths and bags for patients with BC and encouraged social clubs and societies to host parties and educational BC advocacy campaigns. Conclusion A simple project was successful and its cost effectiveness is balanced in Egypt as a developing country where mortality associated with BC is high. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.
45
Antone, Nicoleta, Darya Kizub, Julie Gralow, Jo Anne Zujewski, and Allison Dvaladze. "Identifying Facilitators and Barriers to Patient Advocacy for Women's Cancers: Findings from Eastern Europe/Central Asia WE CAN Summits." Journal of Global Oncology 4, Supplement 3 (October 2018): 3s. http://dx.doi.org/10.1200/jgo.18.10010.
Full textAbstract:
Purpose Patient advocacy plays an important role in alerting policymakers to the public’s concerns about women's cancers and advancing cancer awareness, early diagnosis and care in high-income countries. Patient advocacy for women's cancers is growing in low- and middle-income countries (LMICs) but remains less developed and understudied. This study aimed to describe facilitators and barriers to advocacy from the point of view of advocates for women's cancers participating in Eastern Europe/Central Asia Women's Empowerment Cancer Advocacy Network (WE CAN) Summits. Methods We conducted semistructured, in-depth interviews and focus group discussions with participants representing cancer advocacy organizations from 14 countries attending the 7th Eastern Europe and Central Asia Women’s Empowerment Cancer Advocacy Network (WE CAN) Breast and Cervical Cancer Advocacy Summit held in Romania in 2015. Discussions and interviews were recorded and transcriptions were coded and analyzed. Findings were presented and discussed at the 8th WE CAN EE/CA Summit in Ukraine in 2017. Results Nine in-depth interviews and three focus groups with a total of 36 participants were conducted. Challenges to advocacy included limited collaboration with the medical community, government, and local authorities; a lack of trust between survivors, physicians, and policymakers; difficulty in adapting existing early diagnosis and treatment recommendations to local context and resources; limited organizational professionalism and program monitoring; societal stigma toward cancer; and limited funding. Key facilitators included highly committed staff and volunteers, effective collaboration, and use of social media for networking and to obtain clinical information. Conclusion Our findings highlight the challenges and facilitators of patient advocacy in the Eastern Europe/Central Asia region, involving patient support groups, advocacy organizations, health care systems, policymaking, and societal attitudes and cancer awareness. To advance patient advocacy for women's cancers in the region, the following needs were identified: the dissemination of resourceadapted information for improving patient outcomes, improved program monitoring, and improved dialogue between survivors, medical professionals, and local governments. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Julie Gralow Consulting or Advisory Role: Puma, Novartis, Genentech/Roche, Pfizer, Merck, Sandoz, Astra Zeneca, Immunomedics Darya Kizub Employment: Everett Clinic Jo Anne Zujewski Employment: Leidos (part time as an independent contractor for Leidos in support of NCI Center for Global Health) Consulting or Advisory Role: performed consulting services for PMK biomedical and BeyondSpring Pharmaceutical
46
Cabıoğlu, Neslihan, Sibel Ozkan-Gurdal, Arda Kayhan, Ayse Nilufer Ozaydın, Cennet Şahin, Beyza Ozcinar, Erkin Aribal, and Vahit Ozmen. "Characteristics of Screen-Detected Breast Cancer of Turkish Bahcesehir (Istanbul) Screening Project." Journal of Global Oncology 4, Supplement 3 (October 2018): 9s. http://dx.doi.org/10.1200/jgo.18.10070.
Full textAbstract:
Purpose The Turkish Bahcesehir Breast Cancer Screening Project is a 10-year organized population-based screening program carried out in one of the largest counties of Istanbul, Turkey. The aim of the current study was to examine the biologic features of screen-detected and interval breast cancers for the first 9-year study period. Methods Between January 2009 and January 2018, 26,040 mammographies were performed with 2-year intervals for 8,408 women age 40 to 69 years. Clinicopathologic and biologic tumor characteristics—estrogen receptor, progesterone receptor, human epidermal growth factor receptor 2-neu, and protein encoded by the MKI67 gene (Ki-67) —were analyzed for those patients who were diagnosed with breast cancer. Interval cancer was defined as symptomatic cancer diagnosed within 24 months of a negative screening. Ki-67 level > 20% was considered a high score. Results Median age was 52.5 years, and 37% were younger than age 50 years. Of 8,408 women, 113 breast cancers (1.3%) were detected. There were 14 ductal carcinoma in situ (12.4%) and 99 invasive cancers (87.6%). The majority of patients with invasive cancer had stage 1 (49.1%) or stage 2 (31.8%) disease. The majority of patients underwent breast-conserving therapy (83%) with sentinel lymph node biopsy alone (74.1%). Interval cancers (n = 11) were more likely to have multifocality or multicentricity ( P = .002) and high Ki-67 score ( P = .05). Furthermore, diagnosis with interval cancer was associated with more advanced disease, including stage II to IV disease and axillary positivity, and patients were more likely to have nonluminal cancers or tumors with lymphovascular invasion. However, these associations did not reach statistical significance. Multivariable logistic regression analysis identified multifocality or multicentricity as the only significant factor to be associated with interval cancers (odds ratio, 5.94; 95% CI, 1.4 to 25.4; P = .016). Conclusion Our findings suggest that the majority of screen-detected breast cancers exhibit either luminal A or B subtype with low Ki-67 scores and unifocal tumors. However, interval cancers were more likely to have aggressive biology and multicentricity that was less likely to be detected by mammographic screening programs and that required more aggressive surgical and systemic therapies. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Neslihan Cabioğlu Research Funding: Roche (Inst) Travel, Accommodations, Expenses: Genomic Health Sibel Ozkan-Gurdal Research Funding: Roche (Inst) Arda Kayhan Research Funding: Roche (Inst) Ayse Nilufer Ozaydin Research Funding: Roche (Inst) Cennet Şahin Research Funding: Roche (Inst) Beyza Ozcinar Research Funding: Roche (Inst) Erkin Aribal Employment: Nutricia – Danone and TRPharm (I) Leadership: Nutricia – Danone and TRPharm (I) Stock or Other Ownership: Roche (I) Honoraria: GE Healthcare, Fuji, Roche Travel, Accommodations, Expenses: Bayer Vahit Ozmen Honoraria: Pfizer, Roche Research Funding: Roche (Inst), Genekor, Roche Travel, Accommodations, Expenses: Pfizer
47
Thayumanavan, Ethan, Catherine Duggan, and Barri M. Blauvelt. "An Observational Study Framework to Assess Breast Cancer Control Policy Needs in Low- and Middle-Income Countries." Journal of Global Oncology 4, Supplement 3 (October 2018): 46s. http://dx.doi.org/10.1200/jgo.18.10540.
Full textAbstract:
Purpose Women with breast cancer in low- and middle-income countries (LMICs) have worse health outcomes than their counterparts in high-income countries (HICs). Improved outcomes in HICs are attributable to more rigorous breast cancer control policies, implementation of evidence-based guidelines, and greater national investment in health care. In resource-limited settings, identifying the most effective resource-appropriate policies can be a challenge. The proposed study will provide a framework to identify unmet breast cancer policy and infrastructure needs in LMICs and will aid in the prioritization of key elements of successful breast cancer control programs. Building on previous work, we will develop a framework for policy analysis and conduct a breast cancer policy needs assessment through a comparative analysis of attitudes and preferences for breast cancer control elements in 30 countries. Methods The proposed observational survey-based study will measure and compare attitudes and preferences for breast cancer control across 24 LMICs and six reference HICs from across the six WHO regions, stratifying countries by health care spending and mortality-to-incidence ratios. This study will be a cross-sectional survey of medical, policy, and advocacy experts in breast cancer from each of the selected countries. Research will be conducted in three phases. First, we will conduct key informant interviews of international breast cancer experts. Then we will develop and pilot a survey tool. Finally, we will conduct the full survey in countries. The study will use analysis of variance, conjoint analysis, and best-worst scaling to analyze survey results. Results This study will assess current breast cancer control needs, prioritize elements of a comprehensive breast cancer control plan, and determine attitudes about the potential of emerging technologies to improve breast cancer control. Conclusion This study will facilitate the improvement of health outcomes for women with breast cancer by assessing the specific unmet breast cancer policy and infrastructure needs in LMICs and prioritizing elements to improve breast cancer control programs. The study thus provides a resource-appropriate framework to improve breast cancer control policy, reform, and implementation. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Barri M. Blauvelt Stock or Other Ownership: AstraZeneca, Biogen, Celgene, Ecolab, Elite Pharmaceuticals Consulting or Advisory Role: Boehringer Ingelheim, Novartis
48
Wang, Zhaolong, and Bingru Huang. "Genotypic Variation in Abscisic Acid Accumulation, Water Relations, and Gas Exchange for Kentucky Bluegrass Exposed to Drought Stress." Journal of the American Society for Horticultural Science 128, no. 3 (May 2003): 349–55. http://dx.doi.org/10.21273/jashs.128.3.0349.
Full textAbstract:
Drought is a major limiting factor for turfgrass growth. Understanding genetic variations in physiological responses of turfgrass to drought stress would facilitate breeding and management programs to improve drought resistance. This study was designed to evaluate responses of abscisic acid (ABA) accumulation, water relations, and gas exchange to drought stress in four Kentucky bluegrass (Poa pratensis L.) cultivars differing in drought resistance. Plants of `Midnight' and `A82-204' (drought resistant) and `Brilliant' and `RSP' (drought susceptible) were grown under well-watered (control) or drought stress conditions for 25 days in growth chambers. Turf quality, leaf water potential (Ψleaf), relative water content (RWC), leaf net photosynthesis rate (Pn), and stomatal conductance (gs) declined, while electrolyte leakage (EL) increased during drought progression in all cultivars. The magnitudes of the change in these parameters were greater for `RSP' and `Brilliant' than for `Midnight' and `A82-204'. Leaf ABA content in `RSP' and `Brilliant' increased sharply after 2 days of stress to as much as 34 times the control level at 10 days of drought. Leaf ABA content in `Midnight' and `A82-204' also increased with drought, but to a lesser extent than in the other two cultivars. Leaf ABA level was negatively correlated with Ψleaf and gs. `A82-204' had a significantly lower ABA accumulation rate with changes in Ψleaf during drought compared to `Midnight', `RSP' and `Brilliant'; however, no differences in ABA accumulation rate were detected among the latter three cultivars. In addition, leaf gs was more sensitive to changes in ABA accumulation in `Midnight' and `A82-204' than in `RSP' and `Brilliant'. These results demonstrated that drought tolerant cultivars of Kentucky bluegrass were characterized by lower ABA accumulation and less severe decline in Ψleaf, Pn, gs, and turf quality during drought stress than drought sensitive cultivars. Drought tolerance of Kentucky bluegrass could be related to sensitivity of stomata to endogenous accumulation of ABA under drought stress conditions.
49
Bain, Carolyn, Maria Teresa Núñez Butrón, Vanesa Castillo, Wilfredo Larios, Vivien Tsu, and Ron Balassaninan. "Training to Improve the Quality of Early Detection of Breast Cancer in Low-Resource Settings." Journal of Global Oncology 4, Supplement 3 (October 2018): 5s. http://dx.doi.org/10.1200/jgo.18.10030.
Full textAbstract:
Purpose Breast cancer (BC) is the most common cancer among women in Latin America, yet many countries lack the capacity to provide early detection and diagnostic services. In Peru, mammograms are not readily available in secondary cities, and 57% of women who are diagnosed with BC are diagnosed with stage III and IV disease. To bring services to women in a northern region of Peru, PATH collaborated with Peruvian health institutions at the local, regional, and national levels to design and implement a strategic algorithm with which to increase the early detection of BC in the absence of mammography. Here, we evaluate the impact of training on the quality of clinical breast exam (CBE), ultrasound triage, and fine-needle aspiration (FNA) sampling and the reading of FNA biopsy for triage-positive women. Methods Two hundred twenty-four midwives and 15 doctors were included in two-step training in Trujillo, Peru. CBE trainings were performed using anatomic models and patient exams in 2-day sessions. Team discussion with trainers was used to improve skills. Doctors’ trainings for FNA sampling were led by two international expert pathologists in 2014 and by a Peruvian expert pathologist in 2016. Then in 2017, 43 pretraining and 50 post-training FNA biopsy samples were evaluated for adequacy and quality of diagnosis. Results Since the trainings, 14,223 women have received CBE on an opportunistic basis. Midwives refer abnormal cases (n = 281) for follow-up. All doctors felt well trained for CBE and FNA, whereas five of 15 doctors perceived the need for additional ultrasound training. Quality assessment revealed that the adequacy of FNA samples improved from 26% pretraining to 37% post-training. Of the 43 FNA samples, a low concordance with reviewers was observed in the detection of suspicious/carcinoma (6.9% v 13.9%), whereas full concordance was observed after the training, although the numbers were small. Conclusion In Peru, CBE remains an acceptable and feasible approach if complemented with ultrasound triage and FNA biopsy. Additional efforts are needed to increase coverage through a structured program. Training and continuous monitoring are essential for quality assurance. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . Ronald Balassanian Stock or Other Ownership: Cerus Corp ($400.00)
50
Hopkins, Melissa, and Raphael Mkuzi. "Clinical Breast Examination and Navigation for Early Cancer Detection in Remote Communities Without an Imaging Screening Option." Journal of Global Oncology 4, Supplement 3 (October 2018): 17s. http://dx.doi.org/10.1200/jgo.18.10190.
Full textAbstract:
Purpose According to Gazette Review report 2018, Malawi is reportedly the lowest-income country in southeastern Africa. It has a population of 19 million people, of which 70% are women and children. A powerful women’s organization was established to support the increased care and status of the women in the community. Methods Malawi’s Catholic Women’s Organization (CWO), with the Diocese of Mangochi, submitted approval for comprehensive breast examination (CBE) and basic patient navigation training, which was completed in May 2018, that targeted remote communities without resources for early breast cancer detection. The rural population-based data are incomplete, though it is commonly held that the high mortality rate from breast cancer is a result of a lack of education and transportation, cultural stigmas, a lack of support, and other barriers to care. Breast cancer is the most common cause of cancer death in women in Mangochi. The CWO routinely brings outside medical experts to address health care disparity and invited a breast care and cancer registered nurse to address these barriers and provide training in viable and sustainable solutions to overcome these obstacles. Results Trusted community members of an existing women’s organization were trained in breast physiology, anomalies, simplified medical reporting, and navigation to existing facilities for diagnostics and treatment. The following challenges were addressed: remote locations of communities without available imaging, early detection of anomalies without the benefit of local mammography or ultrasound, a poor to nonexistent belief that breast cancer can be cured with early diagnosis, poor to nonexistent communication and transportation means, and late presentation of breast cancer once diagnosed. With training, the following was achieved: education of CWO women of Mangochi in breast exams, reporting, and navigation pathways for diagnosis; breast molds (eight), PowerPoint presentations, and reporting tools were developed as educational tools; PowerPoints were created for breast education, breast anomaly education, CBE, self-breast examination, reporting, data collection, workshop start-up, and patient education; and ongoing support for breast cancer program development. Conclusion Collaborative and multidisciplinary work to mitigate the effects of breast cancer will greatly increase survivability among the women of Mangochi. Targeting the communities through the trusted women who live in the same villages allows for a unique outreach for ongoing, routine education through workshops, CBE, and supported efforts to overcome barriers through planned patient flow pathways to diagnostics and treatment as needed. AUTHORS' DISCLOSURES OF POTENTIAL CONFLICTS OF INTEREST The following represents disclosure information provided by authors of this manuscript. All relationships are considered compensated. Relationships are self-held unless noted. I = Immediate Family Member, Inst = My Institution. Relationships may not relate to the subject matter of this manuscript. For more information about ASCO's conflict of interest policy, please refer to www.asco.org/rwc or ascopubs.org/jco/site/ifc . No COIs from the authors.