bluuebunny/crossref_metadata_2025 huggingface dataset:
Deaths Due to Cancer Among Women of Reproductive Age in Bangladesh on the Rise: Findings From Two National Level Mortality and Health Care Survey
Authors: Khan S. , Arifeen S. , Chakrobarty N. , Rahman A.E.
Published: September 2018

Background: Bangladesh, a developing country from southeast Asia has the population of 160 million and currently ranks as being the 7th most populated country in the world. Like many other developing countries, Bangladesh is going through an epidemiologic transition, with significant reductions in mortality due to acute, infectious, and parasitic diseases and increases in noncommunicable, degenerative, and chronic diseases over the last 20 years. In this course, of transition, the deaths due to cancer is also on the rise. Among all adult deaths, cancer the third leading cause of death and accounts for one fifth of all mortality in Bangladesh. However, for women the proportions are even higher. Aim: This abstract looks into the datasets of 2 national surveys - Bangladesh maternal mortality and health care survey 2010 and 2016 - and assess the cause of death among women from reproductive age in Bangladesh. The 2010 survey covered over 150,000 households around Bangladesh, while the 2016 survey covered over 310,000 households from the whole of Bangladesh. Methods: Both the survey followed the same clustering process and sampling procedure, to ensure the compatibility among the surveys. Though the main objective of the survey was to look into the status of maternal mortality and corresponding health service seeking behavior, the surveys also shed lights on overall cause of death for women of reproductive age in Bangladesh. The death cases were assessed by verbal autopsy - using WHO process - and the cause of deaths were classified following ICD 10. The particular deaths due to cancer or neoplasm were separated from the main datasets and then it was looked by demographic information of the respondents. Results: The comparison between the national datasets reveals that, in 2010, 21% Bangladeshi women of reproductive age (15-49 years) were dying due to cancer, meaning 1 in 5 Bangladeshi women from reproductive age is dying due to cancer. However, in 2016 the proportion of death due to cancer raised up to 24% women of reproductive age (15-49 years), meaning 1 in 4 Bangladeshi women from reproductive age is dying due to cancer. Age segregated data shows that, only within this 6 years of timespan, more women from younger age (40-45 vs 50-55 years) are dying out of cancer. Conclusion: The findings of this comparison between the 2 national survey shows that, deaths due to cancer among women of reproductive age in Bangladesh is on the rise. Though Bangladesh has developed a National Cancer Control Strategy and Action Plan with the aim of delivering a universal, quality-based and timely service, the initiative are still boutique. A comprehensive preventive approach through tobacco control, health promotion and vaccination program, in addition to, early detection needs to be established with effective referral chain.
New Developments in Photodynamic and Sonodynamic Cancer Therapy
Authors: Weber M.
Published: September 2018

Background: Photodynamic therapy (PDT) is already widely used for the treatment of superficial tumors. Due to technological developments in the field of low-level laser therapy it can now also be used to treat various kinds of internal cancers, including breast, lung, prostate, bladder, rectal and other cancers. The principle is the photoactivation of a light sensitive substance (photosensitizer) which is injected into the bloodstream or directly into the tumor. After a certain amount of time the photosensitizer will be taken up by cancer cells by endocytosis. The cancerous area is then irradiated by laser light of appropriate wavelength, according to the absorption spectra of the photosensitizer. The emitted photons are absorbed by the photosensitizer which is thereby shifted to a highly reactive state. As a consequent, it interacts with tissue oxygen, leading to the development of reactive singlet oxygen radicals which are cytotoxic for cancer cells. Additional sonodynamic cancer therapy (SDT) improves the clinical outcomes. Aim: We describe a broad number of case studies to demonstrate the outstanding potential of the treatment protocols. Methods: We used indocyanine green, curcumin and hypericin as photosensitizing agents. Upon light activation, the agents react with oxygen, leading to the development of oxygen radicals which induce irreparable damage on cancer cells. Results: In the vast majority of all cases, significant reductions of tumor mass up to complete remissions could be achieved. Conclusion: Protocols consisting of photodynamic and sonodynamic cancer therapies have the potential to become mainstream cancer therapies in the next couple of years.
Dendritic Cell Production From Allogeneic Donor CD34+ Stem Cells and Mononuclear Cells for Patients With AML: Cancer Vaccine
Authors: Unal A. , Birekul A. , Unal C. , Karakus E. , Köker Y.
Published: September 2018

Background: Active immunotherapy provides better recognition of tumor-related antigens by immune system of patient, enhanced immune system and elimination of malignant cells. This modality employs therapeutic potential of donor specific and tumor specific immune responses. Active immunotherapy targets immunosuppressive and tolerogenic mechanisms suppressed by tumor cells. Aim: T lymphocytes and antigen-presenting cells (dendritic cells) are 2 cell lineages that play crucial role in the battle of organism against cancer. Close similarity between cancer cells and normal cell structure is the most important reason of escape from defense cells, namely T lymphocytes. Stimulation and enhancement of T lymphocytes against cancer cells comprise principal part of therapy. Methods: To generate allogeneic dendritic cells, leukemic stem cells were isolated from bone marrow samples from patients with acute leukemia. Lysate was prepared from leukemic stem cells identified by flow cytometer. Stem cells and mononuclear cells (1 × 10 > 6/kg) obtained from sibling donors by apheresis were separated to produce dendritic cells. For dendritic cell transformation, GM-CSF and IL-4 were added to media where leukemic stem cell lysate from patient and mononuclear cells from sibling donor were treated. From samples taken from the culture medium, after 48, 72 and 96 hours, dendritic cell surface markers (CD80, CD83 and CD86) was assessed by flow cytometry. CD3, CD14, CD19, CD56, CD66b-negative, and HLA-DR, CD86 positive are indicative of immature DC. HLA-DR, CD80 and CD83 positive are indicative of mature DC. Results: Mononuclear cells were detected by 27% among allogeneic hematopoietic cell groups harvested by apheresis. After culture under GMP conditions, mononuclear cell rate was found to be 24% on hours 96 and 120. It was seen that 88% of mononuclear cells transformed to mature dendritic cells after 96 hours culture. Conclusion: In cancer patients, minimal residual disease can be eliminated by active tumor vaccine after reducing tumor burden by standard methods. Tumor vaccine obtained from allogeneic sibling donor can be used in lieu of autologous tumor vaccine and it is thought to be more effective. Allogeneic dendritic cells produced at 37°C in CO2 media under GMP conditions can be used in tumor immunotherapy. More effective method would have been used by employing dendritic cells against cancer stem cells rather than cancer cells itself.
Patient Delay in Breast Cancer Diagnosis, Its Associated Factors and Stage of Breast Cancer at First Presentation
Authors: Shamsi U.
Published: September 2018

Background: Patients with breast cancer in Pakistan commonly present with advanced disease. An understanding of the factors influencing delays is important to formulate strategies and shorten delays. Aim: The objective of the current study was to evaluate the frequency and magnitude of patient delay in women of Karachi with a diagnosis of breast, and in addition to provide a detailed assessment of the reasons for this delay of breast cancer patients in seeking medical treatment and if there was a relationship between delays and disease stage. Methods: 533 newly diagnosed cases of breast cancer were enrolled and interviewed during the period from Feb 2015 to Aug 2016. Patient delay in breast cancer diagnosis was defined as time from first symptoms until first medical consultation. Results: The mean age of women was 48.2 ± 12.3 years. The mean consultation time was 7 months. The factors associated with delay were welfare hospital (OR= 2.73, 95% CI: 1.85- 4.01), education level of less than grade 8 (OR= 2.97; 95% CI: 1.86- 4.75), poor SES (OR= 4.32, 95% CI: 2.45-7.60), and breast cancer at stage 4 (OR= 6.53, 95% CI: 2.22-19.18). Patient delay was due to lack of awareness about breast cancer (58.1%) thinking that the lump was harmless. There were misconceptions, embarrassment, shame and fears related to treatment and diagnosis of breast cancer among 86 (16.1%) patients. 49 (9.2%) women wasted time in complementary alternative medicine (CAM)/traditional treatment and had other factors like husband reaction to BC, family commitments, financial constraints. Conclusion: Diagnosis delay is very serious problem in Pakistan. Patient delay was significantly associated with the consequent diagnosis of breast cancer at an advanced stage and consequently with a very poor prognosis. This is a preventable problem which if addressed would have a significant impact on reducing the morbidity and mortality of breast cancer in Pakistan. There is an urgent need for intensive and comprehensive breast cancer education, addressing myths and misconceptions, related to breast cancer. there is no conflict of interest
Associated Factors for Health Quality of Life in Moroccan Women With Breast Cancers
Authors: Kava A.C. Filankembo , Conde P. , El Rhazi K. , Bennani M. , Benider A. , Errihani H. , Bekkali R. , Nejjari C. , El Fakir S.
Published: September 2018

Background: Breast cancer is the most common cancer among women. Breast cancer is ranked the first female cancer (33.4%) in Morocco; and more than 60% cases are diagnosed at stage III or IV. During the last decade, health-related quality of life (HRQOL) has become an important part of breast cancer treatment. Aim: The objective of this study is to describe self- reported HRQOL in patients with breast cancer and to investigate its associations with socio-demographic and clinical variables. Methods: A prospective study was carried out in the main oncology centers in Morocco. Quality of life was measured using the Moroccan Arabic version of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C 30 (EORTC QLQ C30) and Breast Cancer-Specific Quality of Life Questionnaire (EORTC QLQ-BR23). Statistical data analyses were performed using descriptive statistics and multivariate analyses. Results: A total of 1463 subjects were included in the study. The subjects' mean age was 55.6 (SD. 11.2) years, 70% were married. The majority of the subjects had stage II (45.9%) and the few cases had stage IV (12.9%). Participants had a mean score for global health of 68.5. Among functional scales, social functioning scored the highest (mean 86.2, SD = 22.7). The most distressing symptom on the symptom scales was financial difficulties (mean 63.2, SD = 38.2). Using the disease-specific tool, it was found that future perspective scored the lowest (mean 40.5, SD = 37.3). On the symptom scale, arm symptoms scored the highest (mean 23.6, SD = 21.6). Significant mean differences were noted for many functional and symptom scales. Conclusion: Our results emphasize that the general HRQOL of the studied women is fairer than that of the corresponding population in other countries. This study provided baseline information on the quality of life of a large sample of Moroccan women diagnosed with breast cancer.
Social Innovation and Scaling Applied to Cancer Control: MAKNA The Social Entrepreneurship Case Study
Authors: Cupitre C.
Published: September 2018

Background: Cancer is one of the most pressing social issues within the contemporary world, affecting all segments of the global population, however despite its importance, the research literature in regard to social entrepreneurship and social innovation within the field of cancer control is scarce. Aim: Because of this reason, the researcher decided to develop his Master Thesis in Social Entrepreneurship and Management at Roskilde University through a case study research focused on the characteristics and dynamics of social innovation and scaling when applied within the context of cancer control activities, with a particular focus on resource generation and fund raising. The Majlis Kanser Nasional (National Cancer Council; MAKNA) is an organization that since 1995 is dedicated to the task of preventing, treating and reducing the burden of cancer among the most vulnerable populations, first in Malaysia and since 2011 also in Vietnam. Currently MAKNA benefits more than 10,000 cancer patients every year based on a structure of near 200 employees and 400 active volunteers. The organization has constantly figured out ways to keep innovating by expanding its pool of programs and benefits, additionally its distinctive approach combining both charity fund raising and social enterprise operations to ensure a diversified and sustainable resource generation model, makes MAKNA a worthy subject of study. Methods: For this study, the researcher have chosen to follow a phenomenological - hermeneutic approach applying a mixed method research based on interviews, participant observations and document analysis. All this based on a theoretical framework building on the model proposed by Johanna Mair and Christian Seelos from Stanford University in “Innovation and Scaling for Impact” (2017) regarding social entrepreneurship, social innovation and scaling as well complementary notions from diverse authors regarding the concepts of hybridity and cross-sector partnerships. The study took place between June 2017 and March 2018 in Malaysia and Vietnam, including 20 interviews with employees, volunteers, patients, partners and other stakeholders. Additionally it comprises 6 participant observation of the organizations activities and the analysis of over 50 different documents and reports. Results: Based on the already mentioned concepts and the gathered data, the researcher conducts a discussive analysis on the evolution of the organizations different resource generation strategies over time, developing a set of conclusions and future perspectives within the framework of social entrepreneurship and social innovation. Conclusion: The organization has constantly figured out ways to keep innovating by expanding its pool of programs and benefits, additionally its distinctive approach combining both charity fund raising and social enterprise operations to ensure a diversified and sustainable resource generation model, makes MAKNA a worthy subject of study.
Development of Operational Framework for Management of Common Cancers in India
Authors: Chandra A. , Kaushik R. , Hariprasad R. , Ved R.R. , Mehrotra R.
Published: September 2018

Background and context: Cancers of the breast, uterine cervix, and oral cavity are the 3 most common malignancies in India. Overall, they comprise around one third of >1 million cases diagnosed with cancer in India each year. An effective operational framework (OF) for early detection and screening programs should play a key role in reducing and managing the cancer burden in India. Aim: i. To provide guidelines to the clinicians, and public health practitioners for screening and early detection of breast, uterine cervix, and lip or oral cavity cancers in India. ii. To build guide/roadmap for policymakers involved in developing and implementing strategies for cancer control in India. Strategy/Tactics: In collaboration with the Center for Global Health at the U.S. National Cancer Institute, 25 scientific experts comprising researchers, public health leaders, medical and dental professionals from France, India, United States, and Zambia met at Indian Council of Medical Research (ICMR)-National Institute of Cancer Prevention and Research, to summarize the feasible options and relevant evidence for screening and early detection of common cancers in India. They came out with the operational framework Program/Policy process: Recognizing the key role that effective early detection and screening programs could have in reducing the cancer burden, the ICMR-National Institute of Cancer Prevention and Research, in collaboration with the U.S. National Cancer Institute Center for Global Health, held a workshop to summarize feasible options and relevant evidence for screening and early detection of common cancers in India. Outcomes: a. A publication in Lancet: Rajaraman P, Anderson BO, Basu P, et al: Recommendations for screening and early detection of common cancers in India. Lancet Oncol 16(7):e352-e361, 2015. b. State and PHC level trainings on operational framework started in each state for the primary health care providers. What was learned: The OF acts as a guide for policymakers, clinicians, and public health practitioners who are developing and implementing strategies in cancer control. Common and consistent OF will go a long way to chart out the intensity of the problem and to rectify it.
Cancer Care in Poverty
Authors: Malaker K.
Published: September 2018

Background and context: Cancer incidence is increasing more so in developing countries, simultaneously cancer treatment is skyrocketing, beyond the means of resource-limited country, where 80% world´s population lives. So how to bridge the gap. Or is there a hope? Aim: Bridge the gap of the level of cancer care between the resource-poor countries and resource-abound nations. In the term of therapy, our aim is to bring the therapeutic gain of treatments available for resource-poor countries, close to the rich countries. Strategy/Tactics: In the name innovation many useful cancer treatment are rejected, and thrown in the wayside. The strategy is to combine all rejected agents and combine them in an astute tactical manner, sequencing intelligently, to achieve a higher therapeutic gain. As we use multiple modality, the tiny gains can add up to a big gain. Program/Policy process: Bring back the telecobalt unit for radiotherapy, universal use of hyperthermia to enhance therapeutic gain. Plan to use combination of cheaper multiple combinations chemotherapy instead single expensive single combinations, use of neoadjuvant chemotherapy, concurrent chemoradiation, lesser and limited surgery, easy to manage. Thus, total plan is neoadjuvant chemo + hyperthermia + concurrent chemo-radiation + hyperthermia + if needed minimal surgical resection. With planned use of this program, the gain in therapeutic ratio may be close to expensive radiotherapy with or without innovative drugs costing hundreds of thousands per patient. Outcomes: Affordable effective, less technology dependent, less machine breakdown, higher cure rate for poor countries. What was learned: It is possible to offer effective cancer treatment in poor countries using biologically optimized higher therapeutic gain and cure as well, without modet drugs and radiotherapy equipment without any increase in side effects.
Surveillance for Jordan Cancer Burden: Jordan Cancer Registry Data 2010-2014
Authors: Nimri O.
Published: September 2018

Background: Cancer registry is an important tool for any successful cancer control program. The cancer-related data from Jordan was vague scarcity. This, urged scholars to set up the first and only population-based cancer registry in Jordan. Which did the Ministry of Health and the Middle East Cancer Consortium (MECC) established it jointly. The registry started to collect data from cases of cancer referred to the treatment and diagnostic facilities throughout the country to improve cancer reporting in the country and define the size of the cancer problem and the pattern of cancer in Jordan; distribution of cancer by geographical locations; age; gender; type and cancer sites for both Jordanians and non-Jordanians. Strategy/Tactics: The Jordan Cancer Registry (JCR) collects cancer data in passive and active methods of case finding, the collected data coded by means of ICD_O3. Quality control measures applied, and the data stored and computerized using CanReg_4 and CanReg_5; then analyzed statistically. World standard population for age adjustment and standardization to facilitate national and international comparison and contrast. Outcomes: Incidence of the most common cancers among Jordanians, distributed by site, age, gender, and geographically for the period 2010-2014. The leading cancer among adults, males was colorectal (11.9%) followed by lung (11.7%), leukemia (9.1%), urinary bladder (8.9%) and prostate (8.1%). While among female cancers are breast (34.4%), colorectal (9.4%); leukemia (6.7%); lymphomas (5.8%) and thyroid (5.3%). Childhood cancers were about (4.9%) of all cancers; leukemia was 1st (34.8%) followed by brain and CNS (20.9%) and lymphomas (17.5%). Whereas the most recent mortality data showed lung is responsible for (21.03%) deaths among males followed by colorectal (11.0%) and leukemia (8.02%). Among females breast deaths (26.8%); colorectal (9.3%) and leukemia (7.2%). What was learned: Knowledge to action, based on the JCR data, Jordan started the Jordan Breast Cancer Program for early detection and screening of breast cancer. We are looking forward starting early detection for colorectal cancer soon.
Longitudinal Trial of a Smart Phone Application for Tele–Follow-Up of Thyroid Cancer Patients in Context of a Developing Country: Compliance, Satisfaction and Cost-Benefit Analysis
Authors: Yadav S. , Mishra S.
Published: September 2018

Background and context: Over the next decades, cancer burden is expected to reach 20 million new cases annually in low- and middle-income countries (LMICs) by 2025. The rate of incidence of thyroid cancer has increased more than any other cancer worldwide. In the United States has seen >300% increase within the past 30 years and few estimates suggest that thyroid cancer could become the third most common cancer diagnosed in women by 2019. Health care services therefore need to gear up to provide close clinical follow-up care for people both in primary and specialist care. Information and communication technologies may enable more integrated treatment and care pathways across geographical boundaries. Though, hospital-based telemedicine system has been proved to be effective in carrying out continuity of care after primary treatment is over, current usage of social media in such situations are not studied well. The social media–based remote monitoring can be done at leisure, convenient to both patients and treating surgeons and does not require costly hospital infrastructure. Aim: We conducted this study to assess the effect of remote monitoring using tele–follow-up on compliance, satisfaction and economic benefit. Strategy/Tactics: Use of social media tools to empower patients on regular follow-up. Program/Policy process: Remote monitoring using social media. Outcomes: A total of 67 postoperative patients were followed up using social media tools. A total of 248 tele-sessions were held. The average number of tele-consultation per patient was 3.7 (range 2-6). The reasons for tele–follow-up were: confirmation of histology report (n = 62), medication dosage adjustments (n = 58), wound evaluation (n = 42), reporting of S. TSH and S. calcium levels (n = 128) and medical fitness certificate (n = 3). Wound evaluation through tele–follow-up was on par with OPD follow-up as no patient had to report to OPD for wound infection. Satisfaction level was excellent in 55% of patients and very good in 25%. 20% of the patients said that satisfaction level was average. If all of these 67 patients would have come to our OPD follow-up, they would have traveled 830 km per patient on an average, apart from losing work hours. Average cost and work days saving per visit was $78 and 5.4 days respectively. Compliance was good as all patients reported on the date and time of appointment. The technique ensures satisfactory follow-up. What was learned: Low- and middle-income countries need an eHealth revolution using this type of technology to achieve the goal of health for all as availability of health care facilities is a problem in such geographical locations in addition to lack of human resources as compared with patients needing healthcare.
The International Cancer Prevention Consortium
Authors: AlKharusi W.
Published: September 2018

Background and context: The burden of cancers in LMIC and countries with civil strife is enormous and disturbing and the availability of cancer prevention, control and management in these countries is very minimal with no priority due to lack of holistic approach and care of cancers. The lack of diagnostic and therapeutic facilities, lack of trained human resources, shortage of chemotherapeutic and narcotic drugs is evident. Education and training for human resource development and research is very minimal. Appreciating WHO and IARC reports the Oman Cancer Association committed to develop with other partners, a pragmatic solution that will bridge the gap between the developed and rich countries and the LMIC to work together and support the unfortunate communities and improve their socioeconomic status and reduce the cancer burden in these countries. Aim: To find a mechanism to bridge the gap between the developed and rich countries with the low- and middle-income country and countries with civil strife where cancers control is not a priority. Strategy/Tactics: Identify countries, academic institutions and private corporate sectors who are prepared to work together to support the communities in the LMIC and control cancer prevention. To develop in education and training program for human resource development. Support these countries in awareness programs and treatment of cancer patients. Program/Policy process: To develop an administrative structure to develop: 1. Research programs to identify and priorities the needs in these countries. 2. Work with students who have been awarded grants from the developed countries to their research in LMIC. 3. Develop education and training workshops in awareness, palliative care, pain relief, data registry, research and leadership training in spirituality for terminally ill patients. Outcomes: 1. 24 countries have joined the partnership. 2. At least 100 health care providers have benefited from trainings. 3. Donation of diagnostic and therapeutic equipment 4. Support the availability of medication What was learned: This program has created awareness in the developed and rich countries in the need of supporting cancer patients in LMIC and countries with civil strife.
Online Sentinel: A Sentiment Analysis Tool for Identifying Pseudoscience in the Cancer Care Continuum
Authors: Munisamy M. , Saravanan G.
Published: September 2018

Background/Context: The online narrative of the cancer care continuum shows an alarming rise in pseudoscience-driven material; often acting to confuse patients who are in the cancer journey, especially those with inadequate information, for making various decisions on cancer treatment and care. This worrying phenomenon is co-opting more patients away from scientifically tested care strategies. Sentiment analysis refers to the use of natural language processing, text analysis, computational linguistics, and biometrics to systematically identify, extract, quantify, and study affective states and subjective information in populations. Working together, MIMOS Berhad, Malaysia's largest Applied Research and Development Centre in Information and Communications Technology, Industrial Electronics Technology and Nano-Semiconductor Technology; and the National Cancer Society of Malaysia aimed to tackle this serious health systems gap in provision of health information to cancer patients, families and the larger public. Aim: The aim of this project was to construct a sentiment analysis tool on cancer and develop an expert-driven support network for utilizing this tool for identifying pseudoscience-related cancer discussions and material in the Malaysian online space; and act to counterbalance these discussions with scientific facts. Strategy/Tactics: First, the tool was evaluated to determine its accuracy in identifying cancer-related pseudoscience news in the Malaysian context. This was done by having content experts objectively ascertain the analysis carried out by the tool. Once consensus had been reached with the experts, the tool was deployed. The support system mechanism consisted of a voluntarily recruited expert panel consisting of healthcare professionals briefed on the mechanism of the tool. Once the tool was deployed, the resultant analysis was shared out to the expert panel who then responded; counterbalancing the pseudoscience material identified in the respective online medium with accurate information. Program/Policy process: The sentiment analysis tool deployed machine learning, statistics, and natural language processing techniques to automate sentiment analysis on large collections of online cancer-related texts, including Web pages, online news, Internet discussion groups, online reviews, Web blogs, and social media. The tool was combined with a support-systems network of healthcare professionals who acted on the analysis results. A weekly run analysis and feedback mechanism was determined to be viable in terms of turn-around-time (TOT) while still remaining 'current' in the fast-paced online scene. Outcomes/What was learned: A marriage of an artificial intelligence system backed by human content experts can be a viable, sustainable mechanism in reducing the impact of pseudoscience in the online cancer ecosphere and help in provisioning accurate health information to cancer patients, families and the general public as a whole.
Implementation of a Comprehensive Hospital-Based Smoking-Cessation Program in Cancer
Authors: Abdelmutti N. , Brual J. , Jones J. , Goldstein D. , Liu G. , Eng L. , Papadakos J. , Papadakos T. , Giuliani M.
Published: September 2018

Background and context: Quitting smoking after a cancer diagnosis minimizes treatment-related effects, improves prognosis and enhances quality of life. However, smoking cessation has yet to be integrated as a standard component of cancer care and cessation programs are underused. Aim: To address this gap between evidence and practice, the Princess Margaret Cancer Centre in Toronto, Canada sought to implement a comprehensive, evidence-based program that would introduce smoking cessation–related screening, referrals and education as standard practice in cancer care. Strategy/Tactics: We adapted the Framework for Managing eHealth Change to guide successful implementation of a Smoking Cessation Program (SCP) utilizing 6 components: 1) Leadership and governance 2) Stakeholder engagement and partnerships 3) Communication 4) Patient and provider education 5) Analysis and clinical integration 6) Monitoring and evaluation of program performance metrics. Program/Policy process: The SCP designed, tested and implemented a multilingual e-referral system (CEASE) to screen patients for smoking status, provide education and advice on quitting, and generate an electronic referral to cessation programs. Partnerships were established with 3 smoking-cessation programs to offer patients a breadth of services tailored to individual needs, preferences and medical history. Patient and provider education was developed to address the unique knowledge gaps, beliefs and stigma associated with smoking and a cancer diagnosis. Outcomes: Program metrics indicate that of 11,366 new patients eligible for screening between April 2017 to March 2018, 62% (n = 6629) were screened with 10% (n = 655) identifying as current smokers and 4% (n = 261) as recent quitters (6 months or less). Of smokers and recent quitters, 21% (n = 170) accepted a referral to a smoking-cessation program. What was learned: The implementation of the SCP presents a comprehensive blueprint to establish a smoking-cessation program as a standard of quality care. Elements of the SCP can be adapted to local, regional and national contexts. Future directions include assessing strategies to increase screening and referral rates, collection of long-term outcomes, and integration into the patient portal.
Private Public Partnership Vital Role
Authors: Al Khrusi W.
Published: September 2018

Amount raised: 3,640,000 USD Background and context: Nongovernmental Organizations especially in middle-income countries have to breed the culture of CSR and PPP within itself and the community to address the financial challenges that limit their activities and performance especially in cancer prevention and control otherwise they would not positively impact the socioeconomic aspect of cancers. We at our association appreciated the importance of integrity, professionalism, innovativeness and transparency so as to convince and achieve this partnership to serve the community. Aim: Is to fundraise to support awareness, human resource development and breast cancer screening. Strategy/Tactics: Private public partnership after needs assessment for each of our projects with full transparency and innovation. Program process: After needs assessment, we put together a full budget for each project. The negotiations with the private companies start and present through audio visuals. We receive support by the government. Repeated annual auditing of the program. We then report to the entity that assisted with the fund raising for the project and the government. Appreciating those who are working for the projects through the media and awards. Develop a cohesive partnership team.Costs and returns: 1- Mobile mammography unit: 17,800 women screenings around the country, the data are used for research. 6% found positive. Paradigm change in breast cancer presentation in the breast clinics with now higher percentage of stage 1 and 2 compared with before. Acceptance of the word “cancer: within the community. Savings of the government expenditure of treating with stage 1 is 13,000 USD, stage 4 is 300,000 USD. Reduction in the number that needs palliative care. The project won his Majesty´s award and the United Nations award in Gender section. 2- Dar Al Hanan: home away from home for children with cancer residing far from the oncology center, who need outpatient treatment. This caters to 16 families free of charge supporting accommodation, meals and a shuttle bus to the hospital. Won local and international awards. So far since 2011, it catered for 489 families with all nationalities. 3- Palliative care: training of hospital and community nurses and primary health care physicians from Oman and 51 from low- and middle-income countries. 60 of them qualified as certified trainers to continue training in their countries. What was learned: The importance of private public partnership but the nonprofit organizations have to learn a different culture on how to convince the private sector to fund the programs.
Modelling brain dopamine-serotonin vesicular transport disease in Caenorhabditis elegans
Authors: Young Alexander T. , Ly Kien N. , Wilson Callum , Lehnert Klaus , Snell Russell G. , Reid Suzanne J. , Jacobsen Jessie C.
Published: September 2018

Brain dopamine-serotonin vesicular transport disease is a rare disease caused by autosomal recessive mutations in the SLC18A2 gene, which encodes the VMAT2 protein. VMAT2 is a membrane protein responsible for vesicular transport of monoamines, and its disruption negatively affects neurotransmission. This results in a severe neurodevelopmental disorder affecting motor skills and development, and causes muscular hypotonia. The condition was initially described in a consanguineous Saudi Arabian family with affected siblings homozygous for a P387L mutation. We subsequently found a second mutation in a New Zealand family (homozygous P237H), which was later also identified in an Iraqi family. Pramipexole has been shown to have some therapeutic benefit. Transgenic Caenorhabditis elegans were developed to model the P237H and P387L mutations. Investigations into dopamine- and serotonin-related C. elegans phenotypes, including pharyngeal pumping and grazing, showed that both mutations cause significant impairment of these processes when compared with a non-transgenic N2 strain and a transgenic containing the wild-type human SLC18A2 gene. Preliminary experiments investigating the therapeutic effects of serotonin and pramipexole demonstrated that serotonin could successfully restore the pharyngeal pumping phenotype. These analyses provide further support for the role of these mutations in this disease.
Carpenter ants use diverse antennae sampling strategies to track odor trails
Authors: Draft Ryan W. , McGill Matthew R. , Kapoor Vikrant , Murthy Venkatesh N.
Published: September 2018

Directed and meaningful animal behavior depends on the ability to sense key features in the environment. Among the different environmental signals, olfactory cues are critically important for foraging, navigation, and social communication in many species, including ants. Ants use their two antennae to explore the olfactory world, but how they do so remains largely unknown. In this study, we use high resolution videography to characterize the antennae dynamics of carpenter ants (Camponotus pennsylvanicus). Antennae are highly active during both odor tracking and exploratory behavior. When tracking, ants used several distinct behavioral strategies with stereotyped antennae sampling patterns (which we call Sinusoidal, Probing, and Trail Following). In all behaviors, left and right antennae movements were anti-correlated, and tracking ants exhibited biases in the use of left vs right antenna to sample the odor trail. These results suggest non-redundant roles for the two antennae. In one of the behavioral modules (Trail Following), ants used both antennae to detect trail edges and direct subsequent turns, suggesting a specialized form of tropotaxis. Lastly, removal of an antenna resulted not only in less accurate tracking but also in changes in the sampling pattern of the remaining antenna. Our quantitative characterization of odor trail tracking lays a foundation to build better models of olfactory sensory processing and sensorimotor behavior in terrestrial insects.
Evaluating Strategic Forecasters
Authors: Deb Rahul , Pai Mallesh M. , Said Maher
Published: September 2018

Motivated by the question of how one should evaluate professional election forecasters, we study a novel dynamic mechanism design problem without transfers. A principal who wishes to hire only high-quality forecasters is faced with an agent of unknown quality. The agent privately observes signals about a publicly observable future event, and may strategically misrepresent information to inflate the principal’s perception of his quality. We show that the optimal deterministic mechanism is simple and easy to implement in practice: it evaluates a single, optimally timed prediction. We study the generality of this result and its robustness to randomization and noncommitment. (JEL C53, D72, D82)
Differentiated thyroid cancer theranostics: radioiodine and beyond
Authors: Choudhury Partha S , Gupta Manoj
Published: September 2018

The term theranostics is the combination of a diagnostic tool that helps to define the right therapeutic tool for specific disease. It signifies the “we know which sites require treatment (diagnostic scan) and confirm that those sites have been treated (post-therapy scan)” demonstrating the achievable tumor dose concept. This term was first used by John Funkhouser at the beginning of the 90s, at the same time the concept of personalized medicine appeared. In nuclear medicine, theranostics is easy to apply and understand because of an easy switch from diagnosis to therapy with the same vector. It helps in maximizing tumor dose and sparing normal tissue with high specific and rapid uptake in metastasis. The oldest application of this concept is radioactive iodine I-131 (RAI). The first treatment based on the theranostic concept was performed on thyroid cancer patients with RAI in 1946. From then on management of differentiated thyroid cancer (DTC) has evolved on the multimodality concept. We now use the term “our” patient instead of “my” patient to signify this. However, the initial surgical management followed by RAI as per the theranostics has remained the mainstay in achieving a cure in most of DTC patients. The normal thyroid cells metabolise iodine, the principle of which is utilized in imaging of the thyroid gland with isotopes of iodine. RAI treatment of DTC is based on the principle of sodium iodide symporter (NIS) expressing thyroid cells with DTC cells having the ability of trapping circulating RAI successfully helping in treatment of residual and metastatic disease. NIS is usually negative in poorly differentiated cells and is inversely proportional to Glucose transporter receptor Type 1 expression. Both positive and negative NIS are the key components of the theranostic approach in treatment of DTC. Presence or absence of NIS is documented by either whole body iodine scintigraphy (WBS) or 2-deoxy-2(18F) fludeoxyglucose (FDG) positron emission tomography computed tomography (PET-CT). Currently, single photon emission CT and CT (SPECT-CT) has significantly improved the precision and sensitivity of whole body iodine scintigraphy with its capability of accurate localization of disease foci whether iodine avid or non-avid. This has helped in a more personalized approach in treatment. This review will give an overview of the role of NIS in the theranostic approach to management with RAI, its current status and also the molecular approach to treatment in RAI refractory disease.
Role of alarmin cytokines and microRNAs in the host-schistosome interaction
Authors: He Xing , Pan Weiqing
Published: September 2018

Schistosomiasis is a serious but neglected tropical infectious disease, afflicting more than 240 million people in 78 countries. Lack of an effective vaccine and obscuring disease mechanism could be the main hurdles to effectively control and eradicate this disease. A better understanding of the host–schistosome interaction is the key to clearing these hurdles. Recently, accumulating evidence shows that alarmin cytokines and microRNAs (miRNAs) are crucial regulators in the host–schistosome interaction. Alarmin cytokines are proven to be potent mechanisms driving type 2 immunity, which is the central disease mechanism of schistosomiasis. MiRNA deregulation is a hallmark of a variety of human diseases, including schistosomiasis. In this review, we summarize the research advances on the role of alarmin cytokines and miRNAs in the host–schistosome interaction.
Recent advances in understanding and managing sepsis
Authors: Berg Daniela , Gerlach Herwig
Published: September 2018

The last two to three years provided several “big steps” regarding our understanding and management of sepsis. The increasing insight into pathomechanisms of post-infectious defense led to some new models of host response. Besides hyper-, hypo-, and anti-inflammation as the traditional approaches to sepsis pathophysiology, tolerance and resilience were described as natural ways that organisms react to microbes. In parallel, huge data analyses confirmed these research insights with a new way to define sepsis and septic shock (called “Sepsis-3”), which led to discussions within the scientific community. In addition to these advances in understanding and defining the disease, follow-up protocols of the initial “sepsis bundles” from the Surviving Sepsis Campaign were created; some of them were part of quality management studies by clinicians, and some were in the form of mandatory procedures. As a result, new “bundles” were initiated with the goal of enabling standardized management of sepsis and septic shock, especially in the very early phase. This short commentary provides a brief overview of these two major fields as recent hallmarks of sepsis research.
Healing capacity of bone marrow mesenchymal stem cells versus platelet-rich fibrin in tibial bone defects of albino rats: an in vivo study
Authors: Rady Dina , Mubarak Rabab , Abdel Moneim Rehab A.
Published: September 2018

Background: Various techniques for tissue engineering have been introduced to aid the regeneration of defective or lost bone tissue. The aim of this study was to compare the in vivo bone-forming potential of bone marrow mesenchymal stem cells (BM-MSCs) and platelet-rich fibrin (PRF) on induced bone defects in rats’ tibiae.

Methods: In total, one defect of 3-mm diameter was created in each tibia of 36 Wistar male rats. There were two groups: group A, left tibia bone defects that received PRF; and group B, right tibia bone defects of the same animal that received BM-MSCs loaded on a chitosan scaffold. Subsequently, Scanning electron microscope/energy-dispersive X-ray (SEM/EDX) analyses was performed at 3 and 10 days, and 3 weeks post‑implantation and following euthanasia; (n=12).

Results: The EDX analysis performed for each group and time point revealed a significant increase in the mean calcium and phosphorous weight percentage in the BM-MSC-treated group relative to the PRF-treated group at all-time intervals (P < 0.05). Moreover, the mean calcium and phosphorus weight percentage increased as time progressed since the surgical intervention in the PRF-treated and BM-MSCs groups (P < 0.05).

Conclusions: In the present study, both BM-MSCs and PRF were capable of healing osseous defects induced in a rat tibial model. Yet, BM-MSCs promoted more adequate healing, with higher mean calcium and phosphorous weight percentages than PRF at all-time points, and showed greater integration into the surrounding tissues than PRF.
Case Report: Sporadic Burkitt lymphoma misdiagnosed as dental abscess in a 15-year-old girl
Authors: Cabras Marco , Arduino Paolo G. , Chiusa Luigi , Broccoletti Roberto , Carbone Mario
Published: September 2018

Background: Burkitt lymphoma (BL) is a non-Hodgkin’s B-cell tumor that can be classified into three variants, based on clinical characteristics and epidemiology: endemic, human immunodeficiency-related and sporadic. Oral sporadic BL is quite an unusual entity, with the gastrointestinal trait being often the first site of appearance.

Clinical finding: A 15-year-old patient that presented a symptomatic swelling of the right maxilla, unsuccessfully treated as a primary endodontic disease, displaying solid tissue on CT scan, “starry sky” pattern on oral biopsy, multifocal bone and lymph node uptake on PET.

Diagnoses, interventions, and outcomes: A diagnosis of stage IV BL was formulated; Rituximab was then administered for three months according to Inter-B-NHL ritux 2010 protocol and CYM (cytarabine and methotrexate) chemotherapy. The patient was followed-up for three years, with no recurrence.

Conclusion: It is important for general dental practitioners to suspect a malignancy in the differential diagnosis of unresponsive odontogenic infections in young healthy patients.
Editorial
Authors: Moraes Joysi
Published: September 2018

Editorial