bluuebunny/crossref_metadata_2025 huggingface dataset:
Evolution of Sexual Dimorphism in the Lepidoptera
Authors: Allen Cerisse E. , Zwaan Bas J. , Brakefield Paul M.
Published: December 2010

Among the animals, the Lepidoptera (moths and butterflies) are second only to beetles in number of described species and are known for their striking intra- and interspecific diversity. Within species, sexual dimorphism is a source of variation in life history (e.g., sexual size dimorphism and protandry), morphology (e.g., wing shape and color pattern), and behavior (e.g., chemical and visual signaling). Sexual selection and mating systems have been considered the primary forces driving the evolution of sexual dimorphism in the Lepidoptera, and alternative hypotheses have been neglected. Here, we examine opportunities for sexual selection, natural selection, and the interplay between the two forces in the evolution of sexual differences in the moths and butterflies. Our primary goal is to identify mechanisms that either facilitate or constrain the evolution of sexual dimorphism, rather than to resolve any perceived controversy between hypotheses that may not be mutually exclusive.
Vision and Visual Navigation in Nocturnal Insects
Authors: Warrant Eric , Dacke Marie
Published: December 2010

With their highly sensitive visual systems, nocturnal insects have evolved a remarkable capacity to discriminate colors, orient themselves using faint celestial cues, fly unimpeded through a complicated habitat, and navigate to and from a nest using learned visual landmarks. Even though the compound eyes of nocturnal insects are significantly more sensitive to light than those of their closely related diurnal relatives, their photoreceptors absorb photons at very low rates in dim light, even during demanding nocturnal visual tasks. To explain this apparent paradox, it is hypothesized that the necessary bridge between retinal signaling and visual behavior is a neural strategy of spatial and temporal summation at a higher level in the visual system. Exactly where in the visual system this summation takes place, and the nature of the neural circuitry that is involved, is currently unknown but provides a promising avenue for future research.
Delay‐Dependent Stability Criterion of Arbitrary Switched Linear Systems with Time‐Varying Delay
Authors: Li Jun , Wu Weigen , Yuan Jimin , Tan Qianrong , Yin Xing
Published: December 2010

This paper deals with the problem of delay‐dependent stability criterion of arbitrary switched linear systems with time‐varying delay. Based on switched quadratic Lyapunov functional approach and free‐weighting matrix approach, some linear matrix inequality criterions are found to guarantee delay‐dependent asymptotically stability of these systems. Simultaneously, arbitrary switched linear system can be expressed as a problem of uncertain liner system, so some delay‐dependent stability criterions are obtained with the result of uncertain liner system. Two examples illustrate the exactness of the proposed criterions.
A Strong Convergence Theorem for a Common Fixed Point of Two Sequences of Strictly Pseudocontractive Mappings in Hilbert Spaces and Applications
Authors: Ungchittrakool Kasamsuk
Published: December 2010

We prove a strong convergence theorem for a common fixed point of two sequences of strictly
pseudocontractive mappings in Hilbert spaces. We also provide some applications of the main theorem to find a common
element of the set of fixed points of a strict pseudocontraction and the set of solutions of an equilibrium problem in
Hilbert spaces. The results extend and improve the recent ones announced by Marino and Xu (2007) and others.
Placental Leucine Aminopeptidase‐ and Aminopeptidase A‐Deficient Mice Offer Insight concerning the Mechanisms Underlying Preterm Labor and Preeclampsia
Authors: Mizutani Shigehiko , Wright John W. , Kobayashi Hiroshi
Published: December 2010

Preeclampsia and preterm delivery are important potential complications in pregnancy and represent the leading causes for maternal and perinatal morbidity and mortality. The mechanisms underlying both diseases remain unknown, thus available treatments (beta2‐stimulants and magnesium sulfate) are essentially symptomatic. Both molecules have molecular weights less than 5–8 kDa, cross the placental barrier, and thus exert their effects on the fetus. The fetus produces peptides that are highly vasoactive and uterotonic and increase in response to maternal stress and with continued development. Fetal peptides are also small molecules that inevitably leak across into the maternal circulation. Aminopeptidases such as placental leucine aminopeptidase (P‐LAP) and aminopeptidase A (APA) are large molecules that do not cross the placental barrier. We have shown that APA acts as an antihypertensive agent in the pregnant spontaneously hypertensive rat by degrading vasoactive peptides and as a result returns the animal to a normotensive state. P‐LAP also acts as an antiuterotonic agent by degrading uterotonic peptides and thus prolongs gestation in the pregnant mouse. Given the ever increasing worldwide incidences of preeclampsia and preterm labor, it is imperative that new agents be developed to safely prolong gestation. We believe that the use of aminopeptidases hold promise in this regard.
Minimally Invasive Ablative Therapies for Definitive Treatment of Localized Prostate Cancer in the Primary Setting
Authors: Lee Eugene W. , Huang William C.
Published: December 2010

Traditionally, the patient with a new diagnosis of localized prostate cancer faces either radical therapy, in the form of surgery or radiation, or active surveillance. A growing subset of these men may not be willing to accept the psychological burden of active surveillance nor the side effects of extirpative or radiation therapy. Local ablative therapies including cryotherapy, high-intensity focused ultrasound, and vascular-targeted photodynamic therapy have emerged as a means for minimally invasive definitive treatment. These treatments are well tolerated with decreased morbidity in association with improvements in technology; however, long-term oncologic efficacy remains to be determined.
Weight Gain, Schizophrenia and Antipsychotics: New Findings from Animal Model and Pharmacogenomic Studies
Authors: Panariello Fabio , De Luca Vincenzo , de Bartolomeis Andrea
Published: December 2010

Excess body weight is one of the most common physical health problems among patients with schizophrenia that increases the risk for many medical problems, including type 2 diabetes mellitus, coronary heart disease, osteoarthritis, and hypertension, and accounts in part for 20% shorter life expectancy than in general population. Among patients with severe mental illness, obesity can be attributed to an unhealthy lifestyle, personal genetic profile, as well as the effects of psychotropic medications, above all antipsychotic drugs. Novel “atypical” antipsychotic drugs represent a substantial improvement on older “typical” drugs. However, clinical experience has shown that some, but not all, of these drugs can induce substantial weight gain. Animal models of antipsychotic-related weight gain and animal transgenic models of knockout or overexpressed genes of antipsychotic receptors have been largely evaluated by scientific community for changes in obesity-related gene expression or phenotypes. Moreover, pharmacogenomic approaches have allowed to detect more than 300 possible candidate genes for antipsychotics-induced body weight gain. In this paper, we summarize current thinking on: (1) the role of polymorphisms in several candidate genes, (2) the possible roles of various neurotransmitters and neuropeptides in this adverse drug reaction, and (3) the state of development of animal models in this matter. We also outline major areas for future research.
p53: The Attractive Tumor Suppressor in the Cancer Research Field
Authors: Ozaki Toshinori , Nakagawara Akira
Published: December 2010

p53 is one of the most studied tumor suppressors in the cancer research field. Of note, over 50% of human tumors carry loss of function mutations, and thus p53 has been considered to be a classical Knudson‐type tumor suppressor. From the functional point of view, p53 is a nuclear transcription factor to transactivate a variety of its target genes implicated in the induction of cell cycle arrest, DNA repair, and apoptotic cell death. In response to cellular stresses such as DNA damage, p53 is activated and promotes cell cycle arrest followed by the replacement of DNA lesions and/or apoptotic cell death. Therefore, p53 is able to maintain the genomic integrity to prevent the accumulation of genetic alterations, and thus stands at a crossroad between cell survival and cell death. In this paper, we describe a variety of molecular mechanisms behind the regulation of p53.
Tuberculosis Immunity: Opportunities from Studies with Cattle
Authors: Waters W. Ray , Palmer Mitchell V. , Thacker Tyler C. , Davis William C. , Sreevatsan Srinand , Coussens Paul , Meade Kieran G. , Hope Jayne C. , Estes D. Mark
Published: December 2010

Mycobacterium tuberculosisandM. bovisshare >99% genetic identity and induce similar host responses and disease profiles upon infection. There is a rich history of codiscovery in the development of control measures applicable to both human and bovine tuberculosis (TB) including skin-testing procedures,M. bovisBCG vaccination, and interferon-γ release assays. The calf TB infection model offers several opportunities to further our understanding of TB immunopathogenesis. Recent observations include correlation of central memory immune responses with TB vaccine efficacy, association of SIRPα+cells in ESAT-6:CFP10-elicited multinucleate giant cell formation, early γδ T cell responses to TB, antimycobacterial activity of memory CD4+T cells via granulysin production, association of specific antibody with antigen burden, and suppression of innate immune gene expression in infected animals. Partnerships teaming researchers with veterinary and medical perspectives will continue to provide mutual benefit to TB research in man and animals.
Identification of Urinary Biomarkers of Colon Inflammation in IL10-/- Mice Using Short‐Column LCMS Metabolomics
Authors: Otter Don , Cao Mingshu , Lin Hui-Ming , Fraser Karl , Edmunds Shelley , Lane Geoff , Rowan Daryl
Published: December 2010

The interleukin‐10‐deficient (IL10-/-) mouse develops colon inflammation in response to normal intestinal microflora and has been used as a model of Crohn′s disease. Short‐Column LCMS metabolite profiling of urine from IL10-/- and wild‐type (WT) mice was used, in two independent experiments, to identify mass spectral ions differing in intensity between these two genotypes. Three differential metabolites were identified as xanthurenic acid and as the glucuronides of xanthurenic acid and of α‐CEHC (2,5,7,8‐tetramethyl‐2‐(2′‐carboxyethyl)‐6‐hydroxychroman). The significance of several differential metabolites as potential biomarkers of colon inflammation was evaluated in an experiment which compared metabolite concentrations in IL10-/- and WT mice housed, either under conventional conditions and dosed with intestinal microflora, or maintained under specific pathogen‐free (SPF) conditions. Concentrations of xanthurenic acid, α‐CEHC glucuronide, and an unidentified metabolite m/z 495-/497+ were associated with the degree of inflammation in IL10-/- mice and may prove useful as biomarkers of colon inflammation.
Abstract A106: Neighborhood socioeconomic deprivation is associated with higher risk of diagnosis with nonlocalized colorectal cancers
Authors: Chyke Doubeni A. , Laiyemo Adeyinka O. , Stone Rosalie Torres , Major Jacqueline , Li Wenjun , Graubard Barry , Schatzkin Arthur
Published: December 2010

Background: Previous studies have found that, in the US, the incidence rate for colorectal cancer (CRC) is disproportionally high among persons residing in socioeconomic deprived neighborhoods. However, no previous studies have determined if there are disparities in incidence or tumor stage at diagnosis for CRC according to socioeconomic conditions in the neighborhood of residence after adjusting for individual-level CRC risk factors.

Methods: Data were obtained from the ongoing NIH-AARP Diet and Health Study, a prospective cohort of 566,402 persons residing in 6 US states and 2 metropolitan areas who were 50-71 years of age at baseline (1995-1996). Detailed individual-level data were obtained on diet, lifestyle and other cancer risk factors using questionnaires. For this analysis, we excluded participants who reported a history of CRC at the time of the baseline questionnaire. CRC incidence was then ascertained from tumor registries through December 31,2003. We used an empirically derived neighborhood socioeconomic deprivation index from linked 2000 US census data based on participants’ home addresses at the time of the baseline questionnaire. The index was categorized into quintiles at the census-tract level. We used proportional hazards models that accounted for clustering of persons within census tracts to separately estimate the hazard ratios for CRC incidence and tumor stage at the time of diagnosis (based on SEER summary staging system). We defined regional, distant or unstaged tumors as non-localized.

Results: There were 6,934 incident cases of CRC among the 560,288 eligible participants included in the analyses, of which 59% were non-localized. The age and sex adjusted incidence of CRC among the cohort was 17.5 per 10,000 person-years. The incidence rate was 16.2% among persons residing in census-tracts in the first (least deprived) socioeconomic quintile and 19.8% for the 5th (most deprived) quintile. In proportional hazard models that adjusted for individual-level education and demographic, diet and lifestyle factors, those in the most deprived census-tracts had a higher incidence of CRC, overall (adjusted hazard ratios (HR)=1.16:95% confidence intervals (CI) 1.04-1.29); and non-localized CRC, compared to persons residing in the least socioeconomically deprived (first quintile) census-tracts.

Conclusion: Persons residing in socioeconomically deprived neighborhoods were more likely to be diagnosis with non-localized CRC. This may contribute to neighborhood socioeconomic disparities in mortality for CRC.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A106.
Abstract A112: Temporal trends in treatment and survival among white and black women with uterine cancer
Authors: Berzins Ilze , Albuquerque Kevin
Published: December 2010

Background: Despite the lower overall incidence rates for Uterine cancer in black compared to white women mortality rates are known to be very high in blacks. Our focus was to elucidate trends over time and describe differences in clinical characteristics by particular treatment, and survival outcomes between black and white women.

Methods: Black and white women diagnosed with uterine cancer during 1991-2000 were identified from SEER 9 database and stratified in two groups by year of diagnosis: 1991-1995 and 1996-2000. Kaplan-Meier and Cox proportional hazard models were developed to compare women by race and accounting for other prognostic variables.

Results: A total of 30,673 patients were diagnosed with Uterine cancer (adenocarcinoma Type I, Type II and Sarcoma) between 1991-2000; blacks forming 6.5% of total (1978 patients). Black women were 2 times more likely not to receive therapy (OR 2.29; p<0.0001; 95% CI 1.98-2.66). Most untreated group was black women when diagnosed with Type I Uterine cancer.

Difference in treatment distribution between white and black women was significant with Type-I (p<0.0001) and Type-II (p<0.001) carcinomas. During years 1996-2000 percentage of surgical extirpation of cancer increased in black patients with Type-I carcinoma (56.63%), though still not reaching the level administered for whites (67.98%). The combined surgery and radiation treatment increased in black women diagnosed with Type-II and sarcoma which is an improving trend. Radiation decreased for both races in all histological types.

Black women had 32% higher risk to die from uterus cancer during 1991-2000 (HR1.32; 95% CI 1.15-1.51). Histological type, age at diagnosis, radiation therapy, advanced stage and grade were significant predictors. However a refreshing trend is that black women had 19% less risk of dying from uterus cancer in 2nd period (HR 0.81; p=0.127; 95%CI 0.63-1.05). While Type II cancers fared better black women had 47% higher risk to die from Type-I carcinoma compare to white women when diagnosed during years 1991-2000 (even after adjusting for time period, histological type, age at diagnosis, therapy, stage, and grade (HR 1.47; 95%CI 1.24-1.75).

Conclusions: Treatments for Uterine cancer improved during 2nd period in black women with consequent tendency for improved 5 year survival. Overall percentage of treated versus not-treated cases remained the same between periods, changes in treatment patterns were noted only when stratified by histological types. Black women diagnosed with Type-I Uterine cancer need special targeting with public educational policy: twice as many were not treated compare to white patient and had the greatest disparity in surgery. Overall there is a trend for the better for most recent time period for black women diagnosed with Uterine cancer but challenges remain.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A112.
Abstract A27: Developing sisters informing sisters: A peer-based intervention in treatment decision making for newly diagnosed black breast cancer patients
Authors: Sheppard Vanessa B.
Published: December 2010

Background: Improved treatment decision making has been suggested as a strategy to increase use of adjuvant systemic breast cancer therapies. However, few interventions address this issue particularly in black patients. The study objective was to assess the feasibility of delivering a patient education intervention to improve treatment decision making.

Methods: Seventy-six women with histologically confirmed breast cancer were recruited from the Washington, DC, metropolitan area. After a baseline telephone interview, women received an in-person educational session with a trained breast cancer survivor (survivor coach). The coach used a culturally appropriate guidebook and decision-making model TALK Back!SM, which instructs breast cancer patients to Tell your story, Ask questions, Listen actively, and Know your treatment options. After the session, patients were recontacted to assess their acceptability of the intervention and self-reported outcomes.

Results: Most (87%) found the intervention acceptable. After the intervention, participants reported: increased treatment knowledge (79%), better self-efficacy in communicating with providers (70%), and increased self-efficacy in making treatment decisions (57%). Compared to baseline scores, post-intervention communication with providers significantly increased (p<.05).

Conclusions: These findings support the feasibility and acceptability of intervening with this population. Testing the impact of this intervention on decision outcomes and treatment adherence using RCTs or similar designs will be important next steps.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A27.
Abstract A30: A cancer education program for community health workers in NYC
Authors: Sanchez Martha M. , Grann Victor R. , Magai Carol , Ashby-Thomspon Maxine , Chacon Ana , Hepburn Patricia , Adjai Brenda , Neugut Alfred
Published: December 2010

Background: Our minority institution/comprehensive cancer center partnership is based in Brooklyn and northern Manhattan, NY. Our institutions are surrounded by the largest community of individuals from the Caribbean in the United States, representing Haiti, Jamaica, Trinidad-Tobago, Barbados, the Dominican Republic, and other parts of the West Indies. Although research on racial/ethnic health disparities in the United States has undergone tremendous growth in the past decade, few research teams have access to ethnic enclaves as large as ours.

Objective: To train community health workers (CHWs) about cancer prevention and control for breast, cervical, colorectal, and prostate cancer; and the importance of community participation in cancer clinical research, including prevention and treatment trials.

Methods: We worked with community-based organizations (CBOs) to conduct community needs assessment, review cancer educational materials and resources for appropriateness, identify gaps, develop new materials to fill the gaps, and coordinate educational activities across partner institutions. Outreach and education efforts focused on breast, cervical, colorectal, and prostate cancer and research participation. Cancer education materials from NCI, the American Cancer Society (ACS), and other national organizations were reviewed and adapted for the CBOs. Evaluation addressed development of materials; educational curricula; scheduling of, number of, and attendance at CHW trainings; number of individuals recruited by CHWs to our database; and changes in clients’ self-reported screening and cancer risk behaviors and intentions.

Results: In each of six participating CBOs serving diverse constituencies, we recruited at least six CHWs to participate in our Cancer Education Training Program and then to educate their constituencies (n≥10 each CHW) about cancer, cancer prevention, and clinical research. The trainees also obtained certification in Good Clinical Practices (GCP) and the requirements of the Health Insurance Portability and Accountability Act (HIPAA). The CHWs’ education of their clients is now in progress.

Conclusions: Community health workers are eager to receive training to provide cancer education to their clients, and to obtain certification in GCP and HIPAA. By providing this training, we are obtaining access to previously unreached constituencies in need of cancer screening.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A30.
Abstract A40: An institutional strategy to increase minority recruitment to therapeutic trials
Authors: Anwuri Victoria V , Hall Lannis E. , Mathews Katherine , Springer Brian C. , Tappenden Jennifer R. , Farria Dione M. , Jackson Sherrill , Eberlein Timothy J. , Coldtiz Graham A.
Published: December 2010

Purpose: Participation in therapeutic clinical trials rarely reflects the race and ethnic composition of the patient population. To meet NIH-mandated goals, strategies to increase participation are required. Here, we present a framework for institutional enhancement of minority clinical trial accrual that provides linkages to other interventions. We report implementation of this framework at the Siteman Cancer Center, an NCI-designated Comprehensive Cancer Center.

Methods: We implemented structural changes on four levels to induce and sustain minority accrual to clinical trials: 1) leadership support, 2) center-wide policy change, 3) infrastructural process control, data analysis and reporting and 4) follow up with clinical investigators. The Protocol Review and Monitoring Committee (PRMC) reviews studies and monitors accrual, and the Program for the Elimination Cancer Disparities (PECaD) leads efforts for proportional accrual, supporting the system through data tracking and web tools.

Results: Following implementation in 2005, minority accrual to trials (therapeutic and nontherapeutic) increased from 13.7% in 2005, to 14.4% in 2006,15.9% in 2007 and 16.8% in 2008. The “rolling average” minority cancer incidence at the Cancer Center during this four-year timeframe was 17.3%. There has been an increase in the number of minorities participating in clinical trials in the years 2005 to 2008 (from 346 to 630,82%) compared to a 43% increase in the number of Caucasians during the same time period. Minority accrual in therapeutic clinical trials increased from 11.4% to 14.6%.

Conclusion: Implementing a system to aid investigators in planning and establishing targets for accrual, while requiring this component as a part of annual protocol review and monitoring accrual, offers a successful strategy that can be replicated in other cancer centers. This approach may also be extendable to other clinical and translational centers.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A40.
Abstract A49: Colorectal cancer screening practices by race and physician specialty
Authors: Phillips Karon L. , Doubeni Chyke
Published: December 2010

Primary care physicians play a critical role in the provision of colorectal cancer screening. Differences in CRC screening practices among PCP may contribute to underutilization of CRC screening. Low colorectal cancer screening rates may be attributed to the differences in screening practices among primary care physicians (PCPs). These screening practices may also account for racial disparities in colorectal cancer. The purpose of this study was to compare the colorectal cancer screening practices of black and white Medicare beneficiaries based on the type primary care provider that they had. Study data were obtained from Medicare Current Beneficiary Survey (MCBS) with matched Medicare claims. There were a total of 3666 Medicare beneficiaries included in the study, aged 50 to 75, identified as white or black, and “usually” received care from an internist, family physician, or general practitioner. Two-year longitudinal survey weights were used in all the analyses. Colorectal cancer screening was defined as having had a sigmoidoscopy or colonoscopy within five years and/or a home fecal occult blood test within one year. Unadjusted and adjusted logistic regression analyses were performed with stratification by the race of the beneficiary and the physician specialty. Compared to internist, a significantly lower proportion of beneficiaries that received care from a family physician or a general practitioner had undergone colorectal cancer screening or knew that Medicare provided reimbursement for screenings. Both black and white beneficiaries that had a family physician or general practitioner as their PCP were less likely to undergo screening and less likely receive a recommendation for screening and they were also less likely to know that Medicare helps pay for testing. However, when the analyses were stratified by physician specialty using a specialty-race interaction term, compared to whites, blacks receiving care from a family physician or a general practitioner were less likely to receive a recommendation for a colonoscopy. These results indicate that family physicians and general practitioners may be providing lower quality care regarding colorectal cancer screening services, compared to internists.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A49.
Abstract A5: Structural equation modeling analysis associated with prostate cancer screening among Chinese American Men
Authors: Ma Grace X , Wang Min Q. , Gao Wanzhen , Shive Steven E. , Toubbeh Jamil I.
Published: December 2010

Introduction: In Asian countries, the reported incidence rate and its subsequent mortality have been on the rise. Asian Americans have increased prostate cancer rates over those of Asians in their native lands. Chinese represent the largest ethnic group among Asian Americans, but there is lack of studies regarding their behavior in prostate cancer (PCa) screening. The purpose of this community based study was to develop a structural equation model for factors contributing to prostate cancer screening among Chinese American men.

Methods: A cross-sectional design included a sample of 163 Chinese men age 50 and older. The initial step involved use of confirmatory factor analysis. Structural equation model analyses were conducted on factors for prostate cancer screening.

Results: Education, annual income, and health insurance status were significantly related to PCa screening. Those with less than a high school education, low annual incomes, and without health insurance were more likely to be “never screened” for PCa than those having more education, higher annual income, and health insurance. The path analysis findings also lent support for components of the Sociocultural Model and indicated that there was a positive and significant relationship between PCa screening and the enabling factors, between cultural factors and predisposing, enabling, and access/satisfaction with health care factors and between enabling factors and access/satisfaction with health care.

Conclusions: The model highlights the significance that sociocultural factors play in relation to PCa screening and reinforces the need to assist Chinese men with poor English fluency in translation and awareness of PCa screening.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A5.
Abstract A70: Crafting a collaborative agenda to create health equality: Outcomes from a cancer survivorship research roundtable
Authors: Chapman Mandi , Gilyard Amina L. , Patierno Steven
Published: December 2010

The George Washington University Cancer Institute's (GWCI) Center for the Advancement of Cancer Survivorship, Navigation and Policy (caSNP) hosted a research roundtable in which oncology and policy leaders gathered to identify significant barriers to equitable survivorship care and create recommendations to reduce health disparities among cancer survivors, particularly for underserved populations.

Procedure: Twenty-four leaders in the fields of oncology and health policy were invited to attend the 2009 Cancer Survivorship Research and Health Disparities Symposium. The following day, the experts convened to discuss three core topics: 1) Primary barriers to optimal survivorship for underserved groups; 2) Research strategies that have been most effective in reaching and helping underserved communities in promoting wellness and addressing other chronic diseases that require long-term follow-up; 3) Research, resources, and measures needed to establish efficient, effective, sustainable models to provide survivorship care to underserved populations. These topics were predetermined based on feedback from the symposium that occurred the previous day.

Summary of Data: Three areas of research focus needed to reduce health inequalities in cancer survivorship emerged from the roundtable discussion: improved physician-patient communication, transition from active care, and late effects of cancer treatment. Experts were divided into three groups and each group was assigned the task of addressing one of the primary areas of focus. Groups presented their findings in the form of a request for proposals (RFP). Mock-RFPs included culturally-tailored communication interventions to improve patient understanding of his/her diagnosis and treatment options; comparative effectiveness studies to study the impact of longitudinal patient navigation on patient-reported health outcomes; and the need for evidence-based guidelines for screening and management of long-term effects of cancer.

Conclusions: In order to help researchers conduct studies that work to reduce health and quality of life inequities among survivor populations, the panel recommends the following guidelines: Community-based research designs should incorporate insights from the population(s) under study; The development and use of culturally-specific communication methods and evaluation tools; Research to improve physician-patient communication and patient-centered care; Research and training to improve cultural competence among health care professionals; Research on the outcomes and comparative effectiveness of navigation models, survivorship care planning and survivorship program models; Research to develop evidence-based management of cancer survivors and guidelines for survivorship care planning.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A70.
Abstract A76: Cancer control outcomes in Asian Americans: Using secondary data from large surveys to investigate populations with limited sample
Authors: Chou Wen-ying Sylvia , Oh April , Shariff-Marco Salma , Moser Richard M. , Srinivasan Shobha
Published: December 2010

Background: Cancer control researchers studying Asian Americans face many challenges in utilizing/analyzing health survey data due to limited sample sizes and population heterogeneity resulting in underrepresented in many health surveys. National-level initiatives have begun to address this problem, including a recent White House initiative to increase representation of Asian Americans and Pacific Islanders in research, data-collection, and analysis on AAPI populations and subpopulations. Within public health and specifically behavioral epidemiology, identifying and triangulating sources of data on Asian Americans can illuminate facilitate better understanding of health outcomes as well as behavioral mediators and moderators impacting this population.

Purpose of Study: This project examines federal and state health surveys relevant to cancer control to: 1) identify sources and types of Asian American data, 2) identify the gaps in behavioral research in Asian Americans and 3) facilitate research in Asian American cancer health disparities. Special attention is paid to measurement of cancer control and prevention, including relevant health behaviors and social determinants.

Method: Publically available health surveys including Asian-Americans will be presented and discussed, including but not limited to: the National Health Interview Survey, National Health and Nutrition Examination Survey, Health Information National Trends Survey, the Tobacco Use Supplement to the Current Population Survey, and the California Health Interview Survey. The analysis identifies how Asian Americans are reported and classified and highlights behavioral constructs relevant to cancer incidence and mortality. Differences between surveys will be presented along with an applied example of how data from different surveys may be merged together to create larger sample sizes to increase analytic power.

Discussion: The results of this project will demonstrate the utility of using multiple data sets to better understand cancer-related outcomes in Asian American populations. The applied example of a combined analysis will address analytic challenges and opportunities in studying populations with small sample sizes and with heterogeneous sub-groups using available nationally representative data. Finally, we will discuss ways in which the available data can illuminate gaps in behavioral research in cancer control among Asian Americans.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A76.
Abstract A94: Multidisciplinary team approach improves breast cancer survival in minority women
Authors: Beech Derrick J. , Atanda Abiola , Weatherspoon Beverly
Published: December 2010

Background: Approximately 192,370 women were diagnosed with breast cancer in the United States in 2009. This represents approximately 1 in 8 American women facing the challenge of Breast Cancer therapy in their lifetime. Further, more than 40,000 women will die of breast cancer annually. These statistics represent a significant improvement in the U.S. mortality rate for breast cancer. There continues to be a disparity in outcome from breast cancer with a significantly lower survival in African American women and the uninsured. Our multidisciplinary treatment team includes physicians, nurse navigator and clinical trials specialist are all focused on optimizing multimodal treatment, clinical trial participation, improved quality of life and survival.

Methods: All patients with invasive breast cancer diagnosed between 2004 and 2008 at our inner city, public safety-net hospital were included in this evaluation. Each patient had a confirmed histological diagnosis of breast adenocarcinoma. Patient demographic data, tumor staging, treatment and outcomes/survival were evaluated. Tumor Registry Data from our institution was compared to data from the National Cancer Database for the above mentioned time period. All patients at our hospital were treated by the same clinicians and staff utilizing a multidisciplinary team approach.

Results: There were 120 patients included in this study during the 5 year period. Of these, 4 patients were men. The majority of patients were between age 40 and 60. Our patients were significantly younger at initial diagnosis compared to the national findings. The ethnic distribution of our patient population: 54% African American, 41 % Caucasian, 3% Asian, 1 % American Indian, and 2% other. Evaluation of our payer status demonstrated that approximately 30% of our patients were self-pay and 32% indigent. Only 5% of our patients were insured with managed care organizations and less than 1% had private insurance.

Conclusion: Carefully coordinated multidisciplinary team management of patients with breast cancer resulted in improved clinical outcomes regardless of the patient's ethnicity or insurance status. Implementation of best practice protocols (coordinate multidisciplinary team management; nurse navigator and a vibrant clinical trials program) should become standard at all Community hospitals and academic medical centers, particularly medical facilities serving minority and uninsured patients.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A94.
Abstract B10: Nueva Vida: A support network for Latinas with cancer model and system of care delivery with an eye to community participatory research
Authors: Caicedo Larisa , BrintzenhofeSzoc Karlynn , Zabora James R.
Published: December 2010

Nueva Vida's (NV) goal is to help translate research into practice in the Latino community to shape evidence based practices and influence health policy while communicating the real needs of Latina breast cancer survivors to the scientific community.

NV was founded in 1996 by Latina breast cancer survivors and health professionals to address the lack of culturally sensitive cancer support services for Latinas in the Washington, DC area. The mission of NV is to inform, support, and empower Latinas whose lives are affected by cancer, and to advocate for and facilitate the timely access to state of the art cancer care, including screening, diagnosis, and treatment for all Latinas. Since NV's inception, research participation, development, and implementation are integral to the system of care developed and provided in the community to Latina's with breast cancer. Specifically, NV's involvement in community participatory research enables the organization to influence the research agenda about breast cancer in the Latina community, particularly in the fields of psycho-oncology and access to care. NV's prioritization of research in its service delivery model provides an increased opportunity for the enrollment of Latinas in meaningful research on breast cancer with the goal of increasing not only access but awareness of the unique needs of this population. NV's pioneering programs and expertise serving uninsured/underserved Latinas with breast cancer places the agency in the role as a reliable source and key partner to work with the scientific community in the planning, designing, and development of relevant research.

Nueva Vida's collaboration with respected research institutions has led to the publication of research portraying critical demographic, clinical, and psychosocial information about minority survivor's behavior. NV has acquired an important presence in the consumer cancer advocacy movement at the national level, bringing the voice of Latinas with cancer to influential tables where research and health policy are shaped.

NV's research model not only sets a precedent for community research, but also establishes a better understanding of a historically misrepresented and misunderstood minority population in cancer research in the United States. NV's model of community participatory research documents best practice of service delivery which can be disseminated to other Latino communities and minorities across the United States.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B10.
Abstract B100: Regional predictors of smoking status in three cities in Tennessee
Authors: Patel Kushal A. , Liu Jianguo , Kenerson Donna , Sanderson Maureen , Hargreaves Margaret
Published: December 2010

Background: Smoking is one of the leading causes of premature mortality worldwide and remains the leading cause of preventable death in the United States. Smoking is a major risk factor for lung cancer and a risk factor for other types of cancers including cancers of the throat, mouth, bladder, pancreas, and cervix. Despite overall lower smoking rates, African Americans have a higher incidence and mortality from lung cancer.

Objectives: The purpose of this study was to examine regional predictors of smoking status among African American residents of Nashville, Chattanooga, and Memphis. The goal was to use this information to culturally and geographically tailor smoking cessation programs and to improve understanding of regional differences in smoking rates.

Methods: As part of the Meharry Community Networks Program (CNP) needs assessment, a 123-item community survey was administered to assess demographic characteristics, smoking status, health care access and utilization, and lifestyle behaviors in low-income African Americans. Participants were recruited from African American communities in Nashville, Chattanooga, and Memphis. The final sample size was 1,118. The primary outcome of interest was smoking status.

Results: The smoking rates in Nashville, Memphis, and Chattanooga were 45%, 36%, and 22% respectively. Several demographic and lifestyle variables were associated with smoking. For example, smokers were more likely to be males, have a high school or less education, have annual household incomes <$15,000, have no health insurance, consume at least one alcoholic drink in the past month, and be exposed to smoke at home. Being exposed to smoke at home and alcohol use were the only common predictors of smoking status across the three cities. A logistic regression was used to ascertain potential explanations for differences in smoking rates between Nashville and Memphis, and Chattanooga and Memphis. The comparison city was Memphis because its smoking rates were lower than the other two cities. These analyses revealed that alcohol use, overeating more than once a week, annual household income, and making at least one medical visit in the past 12-months were potential contributors of differences in smoking rates between the cities.

Discussion: Information about regional similarities and differences in predictors to smoking status can be used to develop culturally and geographically tailored smoking cessation programs.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B100.
Abstract B101: Cervical cancer screening along the U.S./Mexico border
Authors: Thompson Beti , Vilchis Hugo , Moran Crystal , Coronado Gloria D.
Published: December 2010

Latinas are at nearly double the risk for cervical cancer than non-Hispanic whites (NHW). The problem is especially severe in the border communities between Mexico and the United States. The border region includes some of the poorest areas in the United States and health services in the region remain scarce. Cervical cancer rates among the border population are high.

In this project, we worked with three local health care systems that provide services to the poor and underserved along the New Mexican/Mexican border. One system was the intervention health care system, while the other two were controls. We obtained names from the intervention clinic system of women who were out of compliance with pap testing; that is, they had not had a pap for three or more years. Promotoras (lay health workers) in the clinic system were trained to contact the non-compliant women. We prepared a PowerPoint presentation that described cervical cancer, explained how cervical cancer spread, and showed a brief video of a cartoon woman receiving a pap test. The PowerPoint was developed as a result of focus group discussions and was approved by the promotoras. The promotoras (lay health workers) went to the homes of the non-compliant women and used the PowerPoint presentation to educate the women about the importance of pap testing; they also helped arrange clinic appointments for women to receive pap testing.

A total of 198 non-compliant women in the intervention clinic system were contacted. Of these, 78% received pap testing within six months of being contacted. A baseline survey asked the women about knowledge of and attitudes toward cervical cancer screening. Data suggest that knowledge was not linked to compliance with pap testing. A final survey suggested that women who did not receive pap testing intended to be tested in the next six months. Comparisons with the control clinic is currently being made.

The project supports the idea that border women can be motivated to receive cervical cancer screening. Given that Latinas are at high risk for cervical cancer and given that a promotora approach is common in the border communities of New Mexico, this study shows that screening for cervical cancer can be increased among women at high risk. This approach may be useful in other border communities.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B101.
Abstract B103: Time for a change in breast cancer screening? A survey of female physicians’ perception of 2009 USPSTF guidelines on breast cancer screening
Authors: Liu Hui , Sloan Susan , Nasreen Fahima , Krishnamurthy Mahesh
Published: December 2010

Objective: To explore the attitudes and compliance of female physicians to the 2009 USPSTF guidelines and its influencing factors.

Methods: An anonymous cross-sectional survey was conducted on the SurveyMonkey website with a self-designed questionnaire. Email invitations were sent to the presidents of various organizations including American Medical Association (AMA) to explain the purpose of this survey and to recruit participates. Of the 111 female physicians participated in the survey, 109 completed the questionnaire, resulting in an effective response rate of 98.2%.

Results: Mammography (71.7%) and clinical breast examination (67.3%) are the most preferred screening tests of female physicians for women aged 40 to 49 years. Consistent with the results, mammography was considered as “very effective” in reducing breast cancer mortality in women aged 40 to 49 years by 66.7% of respondents, compared with breast self examination (23.4%) and clinical breast examination (24.8%) (P < 0.0001). Logistic regression analysis results showed that the following items “Recommend not to begin routine screening mammography in women aged 40 to 49 years”, “Recommend biennial screening mammography in women aged 50 to 74 years”, and the female physicians’ age would significantly influence the female physicians’ decision on whether or not to follow the 2009 USPSTF guidelines.

Conclusion: Our survey reveals that most female physician's unwillingness to follow the 2009 USPSTF guidelines is primarily associated with their opposition to the 2009 USPSTF guidelines not to begin routine screening mammography in women aged 40 to 49 years and to start biennial screening mammography in women aged 50 to 74 years. The concerns about the false positive rate and the cost-effectiveness of breast cancer screening, particularly the routine screening mammography for women aged 40 to 49 years, did not significantly influence the female physicians to follow the 2009 USPSTF guidelines. Based on these findings, we propose the following: 1. Inform women about the harms and benefits of mammography as a component of informed decision making and continue annual screening mammography starting at age 40; 2. Educate the public about breast cancer and the importance of early screening remains a high priority. Personalized risk assessment and screening tailored to risks are our future goals. Although there remains some debate about the optimal age at which to begin screening and the optimal frequency of screening, as more robust evidence and improved technical advances are more readily available, the USPSTF guidelines will be updated. The art and science of medicine continue to be intertwined as physicians attempt to balance their current knowledge with the needs and concerns of their individual patients.

Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):B103.