bluuebunny/crossref_metadata_2025 huggingface dataset:
CRISPR-Cas guide RNA indel analysis using CRISPResso2 with Nanopore sequencing data
Authors: McFarlane Gus Rowan , Polanco Jenin Victor Cortez , Bogema Daniel
Published: July 2024

Objective

Insertion and deletion (indel) analysis of CRISPR-Cas guide RNAs (gRNAs) is crucial in gene editing to assess gRNA efficiency and indel frequency. This study evaluates the utility of CRISPResso2 with Oxford Nanopore sequencing data (nCRISPResso2) for gRNA indel screening, compared to two common Sanger sequencing-based methods, TIDE and ICE. To achieve this, sheep and horse fibroblasts were transfected with Cas9 and a gRNA targeting the myostatin (MSTN) gene. DNA was subsequently extracted, and PCR products exceeding 600 bp were sequenced using both Sanger and Nanopore sequencing. Indel profiling was then conducted using TIDE, ICE, and nCRISPResso2.

Results

Comparison revealed close correspondence in indel formation among methods. For the sheep MSTN gRNA, indel percentages were 52%, 58%, and 64% for TIDE, ICE, and nCRISPResso2, respectively. Horse MSTN gRNA showed 81%, 87%, and 86% edited amplicons for TIDE, ICE, and nCRISPResso2. The frequency of each type of indel was also comparable among the three methods, with nCRISPResso2 and ICE aligning the closest. nCRISPResso2 offers a viable alternative for CRISPR-Cas gRNA indel screening, especially with large amplicons unsuitable for Illumina sequencing. CRISPResso2’s compatibility with Nanopore data enables cost-effective and efficient indel profiling, yielding results comparable to common Sanger sequencing-based methods.
Identification of profiles associated with conversions between the Alzheimer’s disease stages, using a machine learning approach
Authors: Dauphinot Virginie , Laurent Marie , Prodel Martin , Civet Alexandre , Vainchtock Alexandre , Moutet Claire , Krolak-Salmon Pierre , Garnier-Crussard Antoine
Published: July 2024

Background

The identification of factors involved in the conversion across the different Alzheimer’s disease (AD) stages is crucial to prevent or slow the disease progression. We aimed to assess the factors and their combination associated with the conversion across the AD stages, from mild cognitive impairment to dementia, at a mild, moderate or severe stage and to identify profiles associated with earliest/latest conversion across the AD stages.

Methods

In this study conducted on the real-life MEMORA cohort data collected from January 1, 2013, and December 31, 2019, three cohorts were selected depending on the baseline neurocognitive stage from a consecutive sample of patients attending a memory center, aged between 50 and 90 years old, with a diagnosis of AD during the follow-up, and with at least 2 visits at 6 months to 1 year of interval. A machine learning approach was used to assess the relationship between factors including socio-demographic characteristics, comorbidities and history of diseases, prescription of drugs, and geriatric hospitalizations, and the censored time to conversion from mild cognitive impairment to AD dementia, from the mild stage of dementia to the moderate or severe stages of AD dementia, and from the moderate stage of AD dementia to the severe stage. Profiles of earliest/latest conversion compared to median time to conversion across stages were identified. The median time to conversion was estimated with a Kaplan-Meier estimator.

Results

Overall, 2891 patients were included (mean age 77±9 years old, 65% women). The median time of follow-up was 28 months for mild cognitive impairment (MCI) patients, 33 months for mild AD dementia and 30 months for moderate AD dementia. Among the 1264 patients at MCI stage, 61% converted to AD dementia (median time to conversion: 25 months). Among the 1142 patients with mild AD dementia, 59% converted to moderate/severe stage (median time: 23 months) and among the 1332 patients with moderate AD dementia, 23% converted to severe stage (Q3 time to conversion: 22 months). Among the studied factors, cardiovascular comorbidities, anxiety, social isolation, osteoporosis, and hearing disorders were identified as being associated with earlier conversion across stages. Symptomatic treatment i.e. cholinesterase inhibitors for AD was associated with later conversion from mild stage of dementia to moderate/severe stages.

Conclusion

This study based on a machine learning approach allowed to identify potentially modifiable factors associated with conversion across AD stages for which timely interventions may be implemented to delay disease progression.
The ABCs of Stargardt disease: the latest advances in precision medicine
Authors: Zaydon Yasmine A. , Tsang Stephen H.
Published: July 2024

Stargardt disease (STGD) is the most common form of inherited juvenile macular dystrophy and is caused by sequence variants in the ABCA4 gene. Due to its genetic complexity and phenotypic variability, STGD poses significant therapeutic challenges. In the past decade, a lot of progress has been made regarding our understanding of the molecular and clinical aspects of STGD, along with its mechanisms. This has led to the development of new therapies, and there are human clinical trials currently ongoing. This paper evaluates the emergence of pharmacological approaches targeting the visual cycle to mitigate retinal damage, the role of gene therapy in correcting specific genetic defects, and the use of stem cell therapies aimed at retinal regeneration by showcasing the latest clinical trials and precision medicine approaches.
Shootings across the rural–urban continuum
Authors: Ceccato Vania , Mentel Patryk , Levine Ned , Gerell Manne
Published: July 2024

In this article, we investigate situations involving firearm violence in Sweden. The spatiotemporal distribution of records is assessed in different contexts across the country and linked to land use, demographic, and socio-economic characteristics by area and by street segment. The findings emphasize the prevalence of evening shootings, particularly in economically disadvantaged areas where young people congregate in public places often in residential areas, in parks, in playgrounds, and in transit areas. Although two-thirds of shootings took place in larger urban municipalities, our study sheds light on the non-uniform distribution of gun violence along the rural–urban continuum. We conclude by offering suggestions for future research and practical interventions to address this pressing issue that negatively affects people and communities.
Protocol and preregistration for the CODEC project: measuring, modelling and mechanistically understanding the nature of cognitive variability in early childhood
Authors: Coolen Ilse E. J. I. , van Langen Jordy , Hofman Sophie , van Aagten Fréderique E. , Schaaf Jessica V. , Michel Lea , Aristodemou Michael , Judd Nicholas , van Hout Aran T. B. , Meeussen Emma , Kievit Rogier A.
Published: July 2024

Background

Children’s cognitive performance fluctuates across multiple timescales. However, fluctuations have often been neglected in favour of research into average cognitive performance, limiting the unique insights into cognitive abilities and development that cognitive variability may afford. Preliminary evidence suggests that greater variability is associated with increased symptoms of neurodevelopmental disorders, and differences in behavioural and neural functioning. The relative dearth of empirical work on variability, historically limited due to a lack of suitable data and quantitative methodology, has left crucial questions unanswered, which the CODEC (COgnitive Dynamics in Early Childhood) study aims to address.

Method

The CODEC cohort is an accelerated 3-year longitudinal study which encompasses 600 7-to-10-year-old children. Each year includes a ‘burst’ week (3 times per day, 5 days per week) of cognitive measurements on five cognitive domains (reasoning, working memory, processing speed, vocabulary, exploration), conducted both in classrooms and at home through experience sampling assessments. We also measure academic outcomes and external factors hypothesised to predict cognitive variability, including sleep, mood, motivation and background noise. A subset of 200 children (CODEC-MRI) are invited for two deep phenotyping sessions (in year 1 and year 3 of the study), including structural and functional magnetic resonance imaging, eye-tracking, parental measurements and questionnaire-based demographic and psychosocial measures. We will quantify developmental differences and changes in variability using Dynamic Structural Equation Modelling, allowing us to simultaneously capture variability and the multilevel structure of trials nested in sessions, days, children and classrooms.

Discussion

CODEC’s unique design allows us to measure variability across a range of different cognitive domains, ages, and temporal resolutions. The deep-phenotyping arm allows us to test hypotheses concerning variability, including the role of mind wandering, strategy exploration, mood, sleep, and brain structure. Due to CODEC’s longitudinal nature, we are able to quantify which measures of variability at baseline predict long-term outcomes. In summary, the CODEC study is a unique longitudinal study combining experience sampling, an accelerated longitudinal ‘burst’ design, deep phenotyping, and cutting-edge statistical methodologies to better understand the nature, causes, and consequences of cognitive variability in children.

Trial registration

ClinicalTrials.gov - NCT06330090
Cognitive testing and the hazards of cut-offs
Authors: Series Hugh , Burns Alistair
Published: July 2024

The article reviews some basic statistical concepts used in medicine, including the mean, standard deviation, sensitivity and specificity. Using this background the authors describe how these can be applied to cognitive tests, taking the Montreal Cognitive Assessment (MoCA) as an example. Two different approaches to using the MoCA in diagnosing dementia are considered: one using a fixed cut-off score, the other taking account of normative data about the effects of age and educational level on MoCA scores. It is recommended that clinicians assessing cognitive function should not rely on a fixed cut-off score, but where possible compare the patient's result with those of people of comparable age and educational background, although normative data of this kind are not always available.
Imparting Knowledge to Others: A Qualitative Study Exploring How Ethiopian Women Prefer to Receive Cervical Cancer Education
Authors: Tubassum Rushna , Tisha Tasnim , Boey Emma , Rahman Nimra , Halkiyo Atota B. , Hussein Asiya Jaylan , Dedefo Abdulkerim , Bekele Etsegenet , Pierz Amanda J. , Tefera Biniyam , Madhivanan Purnima , Lott Breanne E.
Published: July 2024

PURPOSE

Cervical cancer is the second deadliest cancer among women in Ethiopia. While preventable through timely screening, there is a low uptake of cancer screening among women due to low awareness and education. Cervical cancer screening practices are essential in decreasing morbidity from disease. We aim to explore Ethiopian women's preferences for cancer education and how that influences their decision to be screened or not.

METHODS

In 2022, four focus group discussions (n=50) were conducted in Adama, Ethiopia after completing the informed consent process. Audio recordings were translated and transcribed verbatim, analyzed by a student research team (RT, NR, TT) using iterative content analysis. Using Dedoose software, a codebook was developed, and excerpts were inductively and deductively coded for major, minor, and emergent themes, and direct participant quotes were used to illustrate participants cancer education and screening decision-making preferences.

RESULTS

Most participants had never been screened for cervical cancer (70%) and almost half had no formal education (44%). They expressed the importance of group and family-based education. Involvement of their spouses, children, and other relatives was highly relevant to the need of ‘family suppor’ at the psychological and financial level during one's decision to get screened. Group education at the hospital-level and ‘home to home’ engagement was also expressed in the need for ‘imparting knowledge to others’ in the community. To enhance patient-provider communication, peer education was described as a facilitator to education to ‘ease the process and encourage exchange of information' between patients and their providers. Finally, common suggestions included educating a patient about screening methods for complete understanding of testing procedures and increasing cancer awareness through ‘community sensitization'

CONCLUSION

These qualitative findings can inform the development of culturally sensitive and health-literate educational interventions that increase cervical cancer knowledge and promote equitable healthcare access and outcomes in Ethiopia. Recommendations include focusing on improved patient-provider communication and family-oriented education. It is important to address cancer stigma and misconceptions to increase uptake of life-saving screening. It is also important to examine how these factors impact patient-provider relationships and necessitate improved education strategies to reduce barriers in health communication for cancer prevention.
Multidisciplinary Cancer Treatment Capacity in Ukraine During the War
Authors: Horiachok Maksym , Kizub Darya , Dzhemiliev Ali , Huivaniuk Inesa , Kopetskyi Vyacheslay , Reutova Mila , Uzlova Anna , Matiushenko Inesa , Kasianchyk Mariia , Beznosenko Andriy , Melnitchouk Nelya
Published: July 2024

PURPOSE

Assessment of cancer diagnostic and treatment capacity is crucial to optimizing cancer care, especially in the setting of limited resources, including as a result of war. We assessed personnel, equipment, and treatment availability during Russia's full-scale invasion of Ukraine to define gaps that could then be addressed with tailored strategies.

METHODS

An online survey designed in collaboration with oncology specialists from the National Cancer Institute in Ukraine was distributed to oncologists in Ukraine through oncology-related social media. Data were analysed using descriptive statistics.

RESULTS

192 physicians from all regions of Ukraine, including 53 (23.6%) medical oncologists, 89 (46.4%) surgical oncologists, and 32 (16.7%) radiation oncologists completed the survey. The average number of medical oncologists per regional cancer centre was 4.7 compared to 2.5 seen as the optimal number. The average number of nurses trained in chemotherapy administration was 6.4 compared to the desired number of 8.6. The average number of chemotherapy infusion machines was 8.2 compared to 17.7 desired. On average, 5.7 ports were put in per month compared to 22.1 desired. Average number of infusion chairs was 6.4 compared to 16.3 desired, while the number of inpatient chemotherapy beds was 26.8 compared to 34.0 perceived as the optimal number. The reported average number of surgical oncologists was 12.1 with an optimal average of 6.0. The average number of surgical beds was 52.8 v 60.7 desired. The average and optimal numbers of the following were fairly close: surgical oncology trainees (2.1 v 2.6), operating room nurses (4.1 v 4.3), anesthesiologists (4.4 v 4.2), operating rooms (3.6 v 3.4), anaesthesia machines (4.4 v 4.0), average surgeries per week (21.5 v 21.8). The average number of radiation oncologists was 7.9 compared to 8.5 optimal numbers. For other metrics, average and optimal numbers were somewhat close: number of radiation therapy laboratory technicians (7.9 v 8.5), medical physicists (3.8 v 4.8), dosimetrists (1.5 v 2.1), Cobalt 60 machines (0.9 v 1.1), brachytherapy machines (1.1 v 1.7).

CONCLUSION

We identified important equipment and personnel gaps in oncology care in Ukraine. Results are limited by the decreased number of respondents from areas directly affected by active hostilities.
Novel, Plastic-Free Vaginal Applicator for Reduction of Environmental and Systemic Plastic Chemical Exposures That Associate With Cancers
Authors: Clifton Dennis , Fichorova Raina , Feldman Sarah , Romaguera Josefina , Godoy-Vitorino Filipa , Fremlin Jenny , Ellington-Lawrence Rayne , Carey Vincent , Pena Nancy , Diaz Janice , Stokes Erisa , Ellington Joanna
Published: July 2024

PURPOSE

A cost-effective, prebiotic gel (PreBioGyn) is being developed to prevent genital cancers by reducing biological risk factors for women including vaginal infections, mucosal inflammation, and plastic contaminant exposure. PreBioGyn is packaged in a reduced-plastic system, using a Kraft-paper vaginal applicator. Vaginal mucosa has high absorption and permeability putting women at risk to contaminants in feminine-care products. Specifically, cell toxic levels of phthalates and bisphenols are found in 90% of these products with increased serum levels (e.g. 5X) occurring in some users. Short-term exposure to plastics used in these products results in over 5,000 leachable chemicals migrating into water samples. Plastic chemical burdens are amplified for women in low-resource settings, women who also have increased genital cancer risks. These studies evaluated the dosing accuracy, user acceptance, and cytotoxicity of the paper PreBioGyn applicator.

METHODS

(1) Dosing accuracy of the paper applicator was compared to that of plastic applicators used with existing vaginal gels (Trimosan and RepHresh; modified ISO11608-1:2014). (2) Table-top acceptability of the paper applicator was scored by 42 HPV-positive women in two locations (BWH and UPRMSC). Women were not educated about any benefits of plastic-free vaginal applicators. (3) Cytotoxicity of the paper applicator was tested (ISO 10993-1:2018, 10993-5:2009, 10993-12:2012) with 48 hr extract exposure to L929 cells. Latex glove extracts served as positive controls.

RESULTS

For the PreBioGyn paper applicator: (1) 90% of gel doses fell within target levels (+10%) which was significantly more accurate as compared to the two plastic applicators. (2) The proportion of women who scored the applicator in Likert responses as neutral or better (vs a negative acceptance score) was >50% for appearance, feel, and dose-preparation; and >64% for use with vaginal medications as part of a cancer prevention program. (3) No cytotoxicity or biological reactivity was seen in applicator extracts. Latex extracts resulted in severe destruction of cells.

CONCLUSION

The novel paper applicator was safe, effective and acceptable in these studies. Acceptability was equal to published ratings for many plastic applicators used in existing vaginal products. The reduced-plastic PreBioGyn delivery system is designed to minimize plastic contaminant exposure in the vagina and the environment, further supporting its adoption as a cancer prevention gel.
Patient Financial Well-Being and Access to Cancer Treatment During Wartime
Authors: Ivanykovych Taras , Kizub Darya , Antoniv Marta , Dzhemiliev Ali , Naumova Marta , Uzlova Anna , Matiushenko Inesa , Reutova Mila , Kopetskyi Viacheslay , Huivaniuk Inesa , Beznosenko Andriy , Melnitchouk Nelya
Published: July 2024

PURPOSE

The high cost of cancer care is a barrier to treatment.,We explored the impact of patient-reported financial well-being on access to cancer care during Russia’s full-scale invasion of Ukraine. Ukraine has universal health insurance (UHC) that covers most cancer care costs.

METHODS

Cancer patients receiving treatment at public cancer centers in Cherkasy, Dnipro, Kyiv, and Kharkiv (the city closest to the front lines) filled out surveys in October 2023. Results were analyzed using descriptive statistics, Chi-Squared test, and Fisher’s exact test.

RESULTS

522 patients filled out surveys, including 329 (63%) women. 214 (41%) were from Kyiv, 141 (27%) from regional centers, 167 (32%) from small towns/villages. 177 (34%) reported having money only for food, 183 (35%) for basic necessities, 131 (25%) for everything needed but not savings, and 26 (5%) were able to make savings. Among 522, 240 (46%) received all diagnostic procedures through UHC, 224 (43%) paid for some and 57 (11%) paid for all aspects of diagnosis. Official payments were most common for CT (73%), MRI (72%), PET-CT (44%), and biopsy (31%). Around half of patients had all treatment covered through UHC in case of chemotherapy (318 (61%)), radiotherapy (256 (49%)) and surgery (245 (47%)). Official payments were made most often for surgery (188 (36%)), radiotherapy (130 (25%)), and chemotherapy (120 (23%)). The most frequent official or unofficial payments for surgery were made in Kharkiv (55% vs. 41-50%, p < 0.05). Among 201 (39%) who paid for treatment, 64 (32%) bought surgical instruments, 58 (29%) bought cancer medicines, and 20 (10%) paid to avoid waiting for treatment. There were no significant differences in wait times for diagnosis and treatment were observed based on financial status (p > 0.05).

CONCLUSION

Reported financial well-being did not impact wait times for cancer care in Ukraine in the setting of UHC, even in times of war. In Kharkiv, the proximity of wartime hostilities resulted in increased out-of-pocket payments for treatment. Future research should describe strategies for overcoming barriers to access in the setting of limited resources and also evaluate the quality of cancer care against existing guidelines.
Sources of Diagnostic Delay for HIV-Associated Lymphoma in a Fine Needle Aspiration Clinic in Soweto, South Africa
Authors: Arora Arshia , Tshabalala Nomathemba , Xian Rena , Ambinder Richard , Omar Tanvier , Martinson Neil , Vogt Samantha
Published: July 2024

PURPOSE

Fine needle aspiration (FNA) is an important diagnostic modality used in the evaluation of lymphadenopathy in people living with HIV (PWH) to differentiate between tuberculosis (TB) and lymphoma. However, an FNA suggestive of lymphoma is generally not sufficient for diagnosis and needs to be confirmed by biopsy. We evaluated time to diagnosis for PWH with FNA findings suggestive of lymphoma in Soweto, South Africa.

METHODS

PWH with lymphadenopathy presenting to an FNA clinic in Soweto, South Africa were enrolled in a prospective observational study between September 2021 to December 2022. Participants were interviewed at initial presentation to the FNA clinic and prospectively followed for 8 months or until death. Patient intervals (PI) and healthcare practitioner intervals (HPI) were obtained and descriptive statistics performed.

RESULTS

Among 146 PWH, 20 participants had FNA cytology suggestive of lymphoma and one participant was ultimately diagnosed with lymphoma although the initial FNA showed reactive adenopathy. The median age for these 21 participants was 46 years (IQR: 38 - 51) with a male predominance (67%). The median CD4 count was 213 (IQR 137 - 304) and 7/20 (35%) had an undetectable viral load. Biopsy confirmation of lymphoma occurred in 11/21 participants, while 8/21 died prior to biopsy confirmation and 2/21 completed 8 months of follow-up alive without biopsy confirmation. Additionally, 2/11 diagnosed with lymphoma died within 2 weeks of diagnosis. The PI was evaluable for 15 participants and was a median of 30 days (IQR 11-71). The HPI was a median of 88 days (IQR 55-134). First presentation with symptoms was to a clinic (10/21; 48%), pharmacy (8/21; 38%), or traditional healer (3/21; 14%). The median clinic visits prior to FNA was 2 (IQR: 2-3). For those that died, there was a trend towards a longer PI, first presentation to either the pharmacy or a traditional healer, and a median total visits prior to FNA.

CONCLUSION

Sources of diagnostic delay for the diagnosis of HIV-associated lymphoma include initial presentation to a non-healthcare practitioner, prolonged median HPI, and non-standardized process of referral for evaluation of lymphadenopathy. Interventions to improve the diagnostic triage are warranted.
A Feasibility Study of a Behavioral Intervention to Increase Uptake of Human Papillomavirus (HPV) Vaccination in Envigado, Colombia
Authors: Sanchez Veronica Cordoba , Lemos Mariantonia , Gorin Sherri Sheinfeld
Published: July 2024

PURPOSE

The estimated HPV vaccination coverage in Colombia is approximately 39%, falling short of the 90% goal set by the Global Strategy for Cervical Cancer Elimination proposed by the WHO for 2030. The aim of this study was to evaluate the feasibility of a behavioral intervention named Super Protegidas, to increase HPV vaccination of girls aged 9 to 14 years. Following the recommendations of the ORBIT model for behavioral interventions development, the problem was conceptualized, an intervention was designed with stakeholders, and the results of the feasibility phase are presented here.

METHODS

The protocol, based on the COM-B model, focuses on dyads of girls and caregivers. For the girls, a playful pedagogical workshop was conducted in two schools, addressing primary prevention of cervical cancer through HPV vaccination. For parents, the protocol includes a letter, a series of multimedia messages with text, a video on cervical cancer prevention, and a reminder message the day before vaccination. After conducting this intervention, a feasibility study was carried out through semi-structured telephone interviews with participating caregivers. This aimed to assess acceptability, retention, comprehension, effort required to participate, and suggestions for improvement.

RESULTS

Fifteen dyads of girls and their caregivers participated, with an 80% sample retention completing both the intervention and the telephonic interview. Of these, 69.2% did not watch the videos, 83.3% read the letter with their daughter, 100% were pleased with the intervention, the clarity of the messages, and the delivery method. Regarding areas for improvement, 41.6% suggested avoiding videos due to the time required to watch them and recommended sending messages in the early hours of the night as this increases the likelihood of reading them.

CONCLUSION

The intervention was well-received by participants and deemed feasible by researchers. Adjustments are needed to enable participants to access information in a more timely manner.
Awkwardness As a Social Anxiety: Perceived Barriers to Gynecologic Screening Among Black Women
Authors: Sesay Nadia A.
Published: July 2024

PURPOSE

Routine gynecologic screening detects cervical cancer symptoms. Black women are 75% more likely to die from cervical cancer than White women, suggesting disparities in screening adherence. Under the Paper Gown, a campaign by the Centers for Disease Control and Prevention, seeks to encourage screening behaviors among Black women. The campaign portrays awkwardness as the Black woman protagonist's impediment to gynecologic screening. There is limited research examining how social anxiety acts as a barrier among Black women to undergo gynecologic screening. Instead, socioeconomic determinants and perceived racism are oft investigated as factors to Black women's gynecologic screening hesitancy. This study conceptualized awkwardness as social anxiety defined by Diagnostic and Statistical Manual of Mental Disorders. Thus, this study aims to challenge the archetypes of barriers to positive health behaviors presented in cancer prevention research. The study has two main goals: (a) to gain insight into Black women's perceived barriers to gynecologic screening and (b) to examine whether a health campaign's portrayal of awkwardness reflects real-life gynecology experiences as reported by the participants.

METHODS

A cross-sectional survey of Black women (N = 20) was conducted to examine gynecology appointment frequency and the role of social anxiety before and during the appointment. Semi-structured interviews (n = 10) guided by the Health Belief Model further explored how social anxiety acts as a hinderance to gynecologic screening.

RESULTS

One-way ANOVA tests revealed that participants' anxiety leading to their appointment did not lead them to skip their appointment. Phronetic iterative analysis of interview transcript analysis produced eight themes: Barriers to scheduling, Gynecology knowledge gaps, Awkwardness valence, Vagina talk, Cues to action, Realism of campaign, Physician dialogue, and Black women physicians' innate understanding (race and gender concordance). Participants reported discordance between the campaign's portrayal and their real-life gynecology experiences.

CONCLUSION

Despite participants' willingness to attend gynecologic screening appointments, there exists knowledge deficits regarding the recommended frequency. This may potentially exacerbate disparities in cervical cancer mortality. Additionally, health campaigns should consider the implications and consequences of ill-representative portrayals of Black women's health experiences. Future studies should explore the multidimensionality of Black women's experiences concerning gynecology and prevention screening.
Genomic and Immunophenotypic Characteristics of Conjunctival Squamous Cell Carcinoma in a Sub-Saharan African Cohort Suggest a Role for Immune Checkpoint Inhibitors in Locally Advanced or Metastatic Patients
Authors: Esmaeli Bita , Gleber-Netto Frederico , Sagiv Oded , Pickering Curtis , Gross Neil , Ning Jing , Yeshi Melisachew , Mitku Yonas , Nagarajan Priyadharsini
Published: July 2024

PURPOSE

Conjunctival squamous cell carcinoma (conjSCC) is more prevalent and aggressive in sub-Saharan African countries compared with North America. The genomic and immunophenotypic characteristics of conjSCC is largely unknown. The long-term goal of this project is to evaluate the possible role of immune checkpoint inhibitor (ICI) therapy for this cancer in Sub-Saharan and developing nations.

METHODS

We compared histologic features and mutational profiles using whole exome sequencing, high-risk human papillomavirus (HPV) status, PD-L1 expression, and tumor-infiltrating lymphocytes in conjSCC tumors of patients from Ethiopia (ETH, n=25) and USA (MDA, n=29). Genomic alterations were compared with SCCs from other anatomic sites using data from The Cancer Genome Atlas. A few patients from the MDA cohort with locally advanced and/or metastatic conjSCC were treated empirically with ICI and treatment outcomes were analyzed.

RESULTS

Solar elastosis was seen in 78% of ETH and 10% of MDA samples. Thicker tumors had higher density of CD8+ and CD3+ cells. HPV status was similar between the cohorts (ETH: 21%, MDA: 28%). The mean tumor mutation burden (TMB) was significantly higher in conjSCC (3.01/Mb, log10) and cutaneous SCC compared other SCC subtypes. ETH samples had higher TMB compared to MDA cohort (3.34 vs 2.73). Mutations in genes associated with ultraviolet light (UV) signature were most frequently encountered (SBS7b: 74% and SBS7a: 72%), with higher prevalence in ETH cohort, while SBS2 and SBS13 signatures were more common among MDA HPV+ conjSCCs. ICI therapy led to significant and dramatic clinical response in several patients with locally advanced conjSCC; these patients will be highlighted in the presentation.

CONCLUSION

Our findings suggest that UV exposure may play a role in conjSCC, with a higher prevalence in sub-Saharan Africa and that this cancer is associated with a high TMB. Of translational significance is the high TMB in conjSCC supports a possible role for ICI in the management of locally advanced or metastatic patients, particularly in sub-Saharan Africa, where this cancer is endemic and leads to significant morbidity and mortality. Future clinical trials should be designed using ICI in locally advanced and /or metastatic conjSCC patients in sub-Saharan Africa.
Health System Strengthening Strategies for Improved Cancer Control in Sub-Saharan Africa: A Case of the International Cancer Institute's Blueprint for Innovative Healthcare Access Program in Western Uganda
Authors: Kitur Gloria , Kwizera Christopher , Olodi Dennis , Chite Fredrick
Published: July 2024

PURPOSE

Globally, cancer is the second leading cause of mortality and morbidity with Sub-Saharan Africa bearing the greatest brunt due to the double burden of communicable and non-communicable diseases (NCDs) thus further constraining the already weakened health system. The goal of the Blueprint program is to improve access to screening, diagnostics, treatment and patient support services for breast, cervical and prostate cancers while integrating with other NCD care through a health systems strengthening approach by collaborating with communities, districts health care services and Uganda's ministry of health and its partners.

METHODS

International Cancer Institute (ICI) partnered with Uganda Non-Communicable Diseases Alliance and Uganda Cancer Society to implement two projects on strengthening community awareness and screening for diabetes and hypertension integrating breast, cervical and prostate cancer; and improving public awareness on cancer by building advocacy capacity for cancer control in Uganda's Bushenyi, Mbarara and Sheema Districts. The program targets were to screen 36,000 clients for the 5 NCDs; train 70 healthcare providers (HCPs) and 160 community health workers (CHWs); reach 150,000 community members with cancer messages and to build the capacity of 10 facilities in NCD care.

RESULTS

Between January and December 2023, at total of 1,675 women were screened for cervical cancer;1,926 for breast cancer; 608 men for prostate cancer; 7,406 people for diabetes and 11,477 for hypertension; 587,172 community members were reached with cancer messages through community dialogue meetings and radio spot messages; 80 HHPs, 30 media personnel and 40 CHWs were trained; and a baseline survey was conducted on 10 facilities and 25 HCPs through which, support for basic NCD screening equipment and supplies was provided and 2 supportive supervision visit conducted. Nine abstracts were also presented in local and international conferences.

CONCLUSION

Implementation of cancer control programs in Sub-Saharan Africa calls for collaborative partnerships between local and international or governmental and non-governmental organizations with the aim of strengthening the existing public health system. Comprehensive interventions that include cancer awareness, research, advocacy, training, screening and linkage to care provide access to resource sharing opportunities and creation of sustainable cancer control programs.
If I Have the Courage…I Prefer to See a Doctor: A Qualitative Exploration of Ethiopian Women’s Hesitancy to Screen for Cervical Cancer Using HPV Self-Sampling
Authors: Rahman Nimra , Boey Emma , Tubassum Rushna , Tisha Tasnim , Halkiyo Atota B. , Hussein Asiya Jaylan , Dedefo Abdulkerim , Bekele Etsegenet , Pierz Amanda J. , Deressa Biniyam Tefera , Madhivanan Purnima , Lott Breanne E.
Published: July 2024

PURPOSE

In Ethiopia, cervical cancer screening uptake remains low (14%), despite efforts to increase access to preventive services. While Ethiopia’s national screening program currently uses a “screen-and-treat” approach with visual inspection with acetic acid (VIA), human papillomavirus (HPV) self-sampling may be a screening option available in the future, which has been found to be a safe and easy approach for sample collection in many global contexts. Some concerns exist among age-eligible women for HPV self-sampling, therefore understanding the nuanced perceptions towards HPV self-sampling from an Ethiopian perspective is important. This qualitative study explores perceived pros and cons to cervical cancer screening with HPV self-sampling so that this approach can be tailored to the cultural and social context of Ethiopia to increase screening uptake.

METHODS

In 2022, four focus groups were conducted with 50 Ethiopian women to discuss their perceptions towards cervical cancer and cervical cancer screening methods. Participants were shown educational videos on VIA and HPV self-sampling. They were prompted to compare the two screening modalities and discuss why they liked or disliked each. Audio recordings were translated and transcribed, transcripts were coded with Dedoose software, and content analysis was conducted to identify major themes contributing to hesitancy to screen using HPV self-sampling.

RESULTS

A lack of awareness, coupled with a lack of confidence in collecting their own specimen, influenced many women to have notable negative views of the HPV self-sampling process. Many women thought the self-sampling would be “difficult,” as it “might hurt sensitive places.” A participant shared: “I might not use the device properly. If I have the courage and the desire, I prefer to see a doctor.” Interestingly, participants often stated that they would be more willing to try HPV self-sampling if they had increased understanding, education, and “awareness” of cervical cancer and the procedure.

CONCLUSION

To promote cancer screening services in underserved communities such as in Ethiopia, it is imperative to understand the major factors that influence screening. Focus groups revealed reasons that women may be hesitant to screen for cervical cancer using HPV self-sampling. Education and screening interventions should address these concerns and self-described knowledge gaps to empower patients to make informed decisions about screening.
Impacting the Cervical Cancer Burden in India: Collective Efforts and Strategies to Train Health Care Providers on HPV Vaccination and Cervical Cancer Screening
Authors: Hayward Ashleigh , Anand Meenu , Biswas Sutapa , Gupta Mridu , Kumar Priya Ganesh , Kurkure Purna , Foley Shaylen
Published: July 2024

PURPOSE

Cervical cancer is the second leading cause of cancer deaths among women in India. More than 77,000 women die each year due to cervical cancer, accounting for 23% of all cervical cancer deaths globally. The Global HPV Cancer Free program of the American Cancer Society (ACS) envisions a world free of HPV cancers, starting with cervical cancer.

METHODS

To increase uptake of cervical cancer prevention services in India, ACS has partnered with civil society organizations (CSOs) with a mission to prevent cancers to catalyze engagement of trusted health care providers through implementation of two programs at the national and district level. A key component is training health care providers at multiple levels to increase knowledge, confidence, beliefs and intent around HPV vaccination and cervical screening. At the national level, the Federation of Obstetric and Gynecological Societies of India (FOGSI) and the Indian Academy of Pediatrics (IAP), with support from Cancer Foundation of India (CFI) and ACS, are convening and training 20,000+ pediatricians and obstetrician-gynecologists via a train-the-trainer model. The training refreshes physicians on HPV vaccination facts and shares evidence-based messaging and communication strategies. At the district level, Cancer Awareness, Prevention, and Early Detection (CAPED), in collaboration with selected districts across three states, is training community health workers (CHWs) and primary health center (PHC) nurses to facilitate and mobilize community uptake of cervical cancer prevention services, starting with screening.

RESULTS

CAPED's 2022 pilot successfully trained 213 CHWs and 61 nurses covering 73 villages, who mobilized 5,653 women for cervical screenings. Implementation of both programs will wrap up in 2024, and data from the program evaluation will be explored to assess the impact on cervical cancer prevention.

CONCLUSION

As one of the leading causes of cancer deaths, cervical cancer is a significant burden in India. Health care providers are the most trusted source of health information for the community. A strong recommendation can increase the demand and uptake of cervical cancer prevention services across communities. This poster and/or presentation will describe the two programs in more detail along with successes, challenges, lessons learned, and impact.
Is the Compassion of Anesthesiologists Associated With Postoperative Pain and Patient Experience? A Prospective Cohort Study
Authors: Mitrev Ludmil V. , Chin Gabrielle R. , Roberts Brian W. , van Helmond Noud , Trivedi Keyur C. , Libraro Nicholas J. , Rana Dhaval D. , Dibato John E. , Trzeciak Stephen , Solina Alann R. , Greeson Jeffrey M.
Published: July 2024

BACKGROUND:

Patient perception of physician compassion may be associated with improved health outcomes, yet it is unclear whether it is associated with postoperative pain reduction or improved patient experience metrics in same-day surgery patients. We hypothesized that higher anesthesiologist compassion during the preanesthesia interview, rated by patients, is associated with lower postoperative pain via the anxiety pathway in same-day surgery patients. We also performed exploratory correlation analysis to assess whether compassion was associated with less opioid consumption and improved patient experience in same-day surgery patients.

METHODS:

We conducted a single-center, prospective, observational cohort study in American Society of Anesthesiologists (ASA) physical status I to III patients scheduled to undergo same-day surgery with anesthesia. Compassion was scored using a validated 5-item tool. State anxiety (SA) and trait anxiety (TA) were measured using the State-Trait Anxiety Inventory. Pain scores were obtained using a 0 to 10 Likert scale. Daily opioid use was recorded. Patient experience was assessed using the Consumer Assessment of Healthcare Providers and Systems Outpatient and Ambulatory Surgery Survey (OAS CAHPS) and the Surgical Care CAHPS. Mediation analysis was used to assess the association between compassion and pain scores via the anxiety pathway. Spearman correlation was performed to test for association between the compassion score and the secondary outcomes.

RESULTS:

A total of 147 subjects completed the study with a median age of 50 years and 81% female. Fifty percent underwent breast surgery, 35% abdominal surgery, and the rest underwent gynecological and urological surgeries. The median (Q1–Q3) postoperative pain scores on postoperative days 0 and 3 days later were 4 (1.5–6) and 3 (1–5), respectively.

Mediation analysis results showed a same-day anxiety-mediated effect (95% confidence interval [CI]) of compassion on pain of −0.08 (−0.13 to −0.02), attributing to 9% of the total effect. On postoperative day 0, an increase in compassion was associated with a significant average drop in pain of between 0.02 and 0.13. In addition, higher compassion was correlated with better patient experience metrics (ρ= −0.53 [95% CI, −0.64 to −0.39]).

CONCLUSIONS:

The study results suggest that an anxiety-mediated pathway exists through which compassionate care may help improve the patient’s perception of postoperative pain on the day of surgery (before discharge from the hospital). Higher compassion was also associated with better patient experience metrics.
Boosting the toolbox for live imaging of translation
Authors: Bellec Maëlle , Chen Ruoyu , Dhayni Jana , Trullo Antonello , Avinens Damien , Karaki Hussein , Mazzarda Flavia , Lenden-Hasse Helene , Favard Cyril , Lehmann Ruth , Bertrand Edouard , Lagha Mounia , Dufourt Jeremy
Published: July 2024

Live imaging of translation based on tag recognition by a single-chain antibody is a powerful technique to assess translation regulation in living cells. However, this approach is challenging and requires optimization in terms of expression level and detection sensitivity of the system, especially in a multicellular organism. Here, we improved existing fluorescent tools and developed new ones to image and quantify nascent translation in the livingDrosophilaembryo and in mammalian cells. We tested and characterized five different green fluorescent protein variants fused to the single-chain fragment variable (scFv) and uncovered photobleaching, aggregation, and intensity disparities. Using different strengths of germline and somatic drivers, we determined that the availability of the scFv is critical in order to detect translation throughout development. We introduced a new translation imaging method based on a nanobody/tag system named ALFA-array, allowing the sensitive and simultaneous detection of the translation of several distinct mRNA species. Finally, we developed a largely improved RNA imaging system based on an MCP-tdStaygold fusion.
Immediate effects of Thai foot massage on renal blood flow, psychological stress, and heart rate variability in community-dwelling older adults: a randomized controlled trial
Authors: Thadanatthaphak Yada , Kanpittaya Jaturat , Takong Wittawat , Chanaboon Sutin , Tudpor Kukiat
Published: July 2024

Background Renal blood flow (RBF) is regulated by an autonomic nervous system and is reduced in older adults. Massage has been previously found to increase blood flow. Objective This two-armed double-blind, randomized controlled trial aimed to investigate the immediate effects of Thai foot massage (TFM) on RBF, psychological stress, and heart rate variability (HRV) in older adult persons. Material and Methods The 26 healthy older adult volunteers were recruited and randomly assigned to the TFM group (13 persons) and the control group (13 persons). The TFM group received a 15-minute Thai foot massage, and the control group received a 15-minute bed rest. Primary outcomes – RBF parameters [peak systolic velocity (PSV), end-diastolic velocity (EDV), resistive index (RI), volumetric arterial blood flow (VF)] and secondary outcomes – HRV parameters [standard deviation of the normal-to-normal intervals (SDNN), root mean square of successive differences (RMSSD), high frequency (HF), low frequency (LF), and low frequency per high frequency (LF/HF)] were measured after each intervention. Results Results showed that the VF significantly increased after TFM (P < 0.05) but not in control. Meanwhile, the stress index significantly reduced after TFM (P < 0.05). SDNN and RMSSD, the proxies of parasympathetic activity, also significantly increased in the TFM group (p < 0.05). Only RMSSD was significantly enhanced in the control group. No side effects were observed. Conclusion The TFM could increase RBF and alleviate psychological stress through parasympathetic activity actuation. Therefore, this intervention might improve RBF and relieve stress in the older population. Further study should be carried out on a larger population.