bluuebunny/crossref_metadata_2025_split huggingface dataset:
Strategies to Improve Pediatric Cancer Pathology and Tissue Handling for Clinical Care and Research in Low-Resource Settings
Authors: Lubega Joseph , Nabadda Susan , Wasswa Peter , Mbabazi Olive , Cubbage Mike , Munube Deogratias , Gaikwad Amos , Elghetany Tarek , Adesina Adekunle , Allen Carl , Lutwama Fredrick , Scheurer Michael , Gastier-Foster Julie 
Published: July 2020

PURPOSE Evidence-based pediatric cancer control is dependent on accurate, timely cancer diagnosis, as well as maintenance of tissue integrity and annotation for clinical diagnosis and clinical/translational research. Scarcity of cancer pathology infrastructure and the delinkage of clinical pathology and research workflows in low- and middle-income countries thwarts real-time, high-resolution diagnosis, risk stratification, and maintenance of tissue integrity for future research. This renders the application of evidence-based treatments and conduct of translational research and clinical trials, particularly across multiple centers in low- and middle-income countries, impractical. We present the innovative approach and impact of a Texas Children’s Global HOPE model designed to overcome these systemic obstacles in a sub-Saharan Africa setting. METHODS We designed a pathology algorithm at Mulago Hospital Complex in Uganda with the following goals: integrate clinical and research workflows, ensure safe and optimal tissue biopsies, and maintain tissue integrity for clinical and research assays. We introduced new assays built on locally available technology platforms for anatomic pathology and immunophenotyping. RESULTS The novel workflow and assays enabled consistent real-time hematoxylin and eosin microscopy, immunohistochemistry, and multiparametric flow cytometry. The proportion of cancer diagnoses based on tissue pathology increased from 67.5% to 100%. Streamlined pathology processes improved the timeliness of commencement of treatment from 4 to 6 weeks to 24 hours in the case of acute leukemias. The refined diagnosis process has enabled implementation of risk-adapted treatment regimens. Overall, these strategies contributed to improved overall survival from 30% to 85% at 1 month, and have revealed hitherto unrecognized clinical patterns of pediatric cancers in sub-Saharan Africa. CONCLUSION Accurate real-time pathology for pediatric cancers improves survival. Improvements should aim at enhancing the capabilities of existing in-country platforms and skilled personnel. Future efforts will focus on scaling up these practices to other sites and integrating molecular diagnostics that reduce overall cost and improve diagnostic accuracy or risk stratification.
Cancer Knowledge and Practices Among Indigenous Women in Guatemala
Authors: Hurtado-de-Mendoza Alejandra , Gómez-Trillos Sara , Arana-Chicas Evelyn , Cartujano-Barrera Francisco , Xinico Ajú Silvia Angélica , Braithwaite Dejana , Monsalve Natalia , Morales Daniela , Palacardo Federico , Cupertino Ana Paula 
Published: July 2020

PURPOSE Guatemala, a low- and middle-income country, has some of the poorest worldwide health indicators, including a high cancer incidence. We explored general cancer knowledge and breast and cervical cancer screening practices among Indigenous women in Lake Atitlán, Guatemala. METHODS We conducted 14 in-person, semistructured interviews and one focus group with 5 traditional midwives (comadronas). All participants were Mayan women from a rural community in Lake Atitlán (median age, 43.5 years; range, 18-72 years). The interviews and focus group were conducted in the participant’s preferred language, Spanish or Kaqchikel. Three coders analyzed the data using a process of inductive thematic analysis. RESULTS Participants had little knowledge and awareness about cancer in general, including screening and prevention. They associated the term cancer with death. Most had more knowledge about cervical cancer risk factors and screening compared with breast cancer. Participants voiced misinformation that breast cancer is caused by bad breast milk and that screenings for cervical cancer involve a hysterectomy. The terms uterine, ovarian, and cervical cancer were used interchangeably. None of the participants had ever been screened for breast cancer and all participants reported not knowing anyone who had been screened in the community. Some participants reported having received pap smears in the past. Major barriers reported include the cost and travel to health institutions and fear that the procedures may hurt. There was a strong preference for female doctors to conduct screenings given stigma. Participants reported experiencing discrimination and language barriers when attending hospitals. Participants mostly relied on family members and natural traditional medicine when they felt sick. Community and family support seemed to be key for health-seeking behaviors. CONCLUSION Findings highlight the lack of knowledge, limited screening practices, and numerous barriers among Mayan women in Guatemala. Efforts should focus on health promotion through educational workshops and increased accessibility to health services.
Reducing Oncologic Disparities by Standardizing Cancer Care
Authors: Popli Pallvi , Shah Mansi R. , Ralefala Tlotlo B. , Toppmeyer Deborah , Strair Roger , Lebelonyane Refeletswe , Mompe Atlang , Gaolathe Tendani , Antony Reena , Marlink Richard , Mayer Tina M. 
Published: July 2020

PURPOSE Shortages in oncology-trained health care providers pose a major challenge in low- and middle-income countries (LMICs) and contribute to delays in the diagnosis and treatment of cancer. Presently, the sole oncologist in the public sector at Princess Marina Hospital, Botswana’s largest oncology referral center, is overextended, causing medical officers to be the primary providers for patients with cancer. Medical officers do not possess formal oncology training, which can potentially lead to imprecise management and suboptimal treatment. In addition, there is no standardized patient interview process in the hematology clinic, leading to inadequately captured patient records. These realities highlight the need for the dissemination and implementation of evidence-based guidelines and intake forms to standardize the delivery of cancer care for practitioners with varying degrees of training. METHODS To serve as a reference for medical officers and oncologists, we reviewed clinical guidelines for the most prevalent cancers in Botswana, namely breast, cervical, prostate, colorectal, and head and neck cancer. We incorporated American Joint Committee on Cancer 8th edition staging criteria into the preexisting guidelines approved by Ministry of Health and Wellness Botswana. We further customized them on the basis of radiology, pathology, and pharmaceutical resource availability in Botswana. Finally, to streamline patient visits, we created intake forms to capture comprehensive hematology-pertinent information. As a quality improvement project, we will record the use and impact of these forms as a tool to standardize the medical records. RESULTS Standardized cancer care guidelines were updated and are under review by the Ministry of Health and Wellness Botswana before circulation. In addition, feedback regarding the new intake forms and their use is currently being recorded. CONCLUSION In low- and middle-income countries, the development of cancer-specific treatment guidelines optimizes disease management through incorporation of evidence-based, resource-adjusted recommendations for clinicians and may aid in reducing global oncologic disparities. As the next phase in the implementation of guidelines, we plan to develop quick-reference cancer pathways for use in public institutions without existing oncologic expertise.
Can We Leverage HIV Prevention Programs for Breast Cancer Interventions? Preliminary Findings From a Study in Nigerian Women Working in the Informal Work Sector
Authors: Oluwasanu Mojisola M. , Wang Yue , Oladepo Oladimeji , Huo Dezheng , Olopade Olufunmilayo 
Published: July 2020

PURPOSE Breast cancer (BC) is the leading cause of cancer-related deaths in Nigerian women. A large proportion of Nigerian women work as artisans in the informal work sector. As a population, they are unreached and underserved with poor access to BC information and screening services. Studies have demonstrated the feasibility of implementing HIV prevention programs through artisan groups. Integrating BC programs to existing HIV prevention programs may offer potentials to tap synergies and could lead to sustainable integrated interventions. This study assessed BC screening practices and the feasibility of implementing integrated HIV and BC programs among artisans. METHODS A cross-sectional study was carried out in 3 local government areas in Ibadan, Nigeria. Data were collected using an electronic data capture tool from 400 consenting respondents selected through a multistage sampling technique. Knowledge of BC and HIV were measured on 14- and 8-item scales. Data were analyzed using descriptive statistics and inferential tests at P < .05. RESULTS A quarter of the 400 respondents were age ≥ 40 years, a third were Muslims, and 64.8% had secondary level education or less. One third (32.8%) of the respondents had adequate knowledge of BC signs and symptoms. Of the respondents, 11.3% of the women received clinical breast examination, while the mammography rate for women age ≥ 40 years was 9.0%. In contrast, the proportion of artisans with adequate knowledge of HIV’s modes of transmission was 92.7% and HIV screening was 74%. Educational level, religion, and knowledge of BC signs and symptoms were significantly associated with BC screening ( P < .05). Rate of willingness to participate in an integrated HIV and BC intervention was 95.5%. CONCLUSION BC knowledge and screening practices are low. Findings will inform the development of an integrated intervention that can serve as a model with the potential to expand coverage, and reduce missed opportunities for early detection and treatment of BC and other noncommunicable diseases.
Breast Cancer Survival Disparities in Mexican Women Under a Comprehensive Health Reform
Authors: Huerta-Gutierrez Rodrigo , Lajous Martin , Zamora-Muñoz Salvador , Hernández-Ávila Juan Eugenio , Mohar Alejandro , Muñoz-Aguirre Paloma 
Published: July 2020

PURPOSE One of the goals of Seguro Popular, Mexico’s landmark healthcare reform, was bridging the existing disparities in access to health care and health status. In 2007, this program began reimbursement of breast cancer treatment of previously uninsured Mexican women. We evaluated geographic disparities in breast cancer survival in women treated under this program and explored potential sources of heterogeneity. METHODS We classified women who were treated between 2007 and 2016 as having early (stages 0-IIA), locally advanced (stages IIB-IIIC), or metastatic (stage IV) disease. We categorized women based on a widely used marginalization index that considers education, household characteristics, rural population, and poverty levels in Mexican municipalities (low, moderate, high, and very high marginalization). We cross-linked reimbursement data with a national death registry and estimated 5-year overall survival according to clinical stage, marginalization levels, and state where women received treated. RESULTS Among 53,990 women treated for breast cancer the mean age was 52.9 years (± SD 12.4). Most patients had locally advanced disease (57.4%, n = 30,996). Early disease was more common in women with very low marginalization levels compared with women with very high levels (34% v 19%). Survival was 89.4% (95% CI: 88.8 to 89.9) for early disease, 69.8% (95% CI: 69.2 to 70.4) for locally advanced disease, and 36.1% (95% CI: 34.6 to 37.6) for metastatic disease. The least marginalized state experienced the highest survival for locally-advanced disease [76.0% (95% CI: 71.4 to 80.0)] whereas the most marginalized state experienced the lowest survival [50.2% (95% CI: 45.5 to 54.7)]. Survival in women from very highly marginalized communities was 68.7% (95% CI: 64.7 to 72.4), whereas survival in women from low marginalized communities was 74.8% (95% CI: 74.1 to 75.5). CONCLUSION In the face of a new wave of healthcare reform, Mexico will need to monitor and evaluate health disparities to achieve universal care for women with breast cancer.
Objective Measurement of Carcinogens Among Dominican Republic Firefighters Using Silicone-Based Wristbands
Authors: Caban-Martinez Alberto J. , Feliciano Paola Louzado , Baum Jeramy , Bakali Umer F. , Santiago Katerina M. , Solle Natasha Schaefer , Rivera Geovanny , Ramirez Cesar E. , Deo Sapna , Miric Marija , Perez-Then Eddy , Kobetz Erin N. , Daunert Sylvia 
Published: July 2020

PURPOSE Firefighters around the world are exposed to physical hazards and toxic chemical agents during fire incident response. Occupational epidemiologic studies of the firefighter workforce have documented an excess cancer risk for brain, digestive, genitourinary, and lymphohematopoietic organs compared with the general population. Despite the elevated cancer risk, little is known about what specific types of carcinogenic chemicals first responders encounter during a typical work shift, particularly in low-resources settings, like the Dominican Republic. This pilot study characterizes objective measurements of carcinogenic exposure using passive sampling silicone-based wristbands among Dominican firefighters. METHODS Firefighters from a metropolitan fire service in the Dominican Republic were asked to wear a silicone-based wristband during one typical 24-hour shift. A pre- and postshift survey was administered to the firefighter to assess their self-reported sociodemographic, employment, and work shift characteristics. Wristbands were collected after their 24-hour shift and processed for the type and quantity of polycyclic aromatic hydrocarbons (PAHs), a family of known carcinogenic compounds, to which firefighters were exposed. RESULTS Among 15 firefighters who wore a wristband during their 24-hour shift, 73.3% responded to a fire with an average of 3.7 calls during the shift. Fire incident responses included structural fires (54.5%), outside and other fires (36.4%), and vehicle fires (9.1%). Total PAH exposure was significantly higher among Dominican firefighters who responded to a fire compared with firefighters with no fire during their shift (261 parts per billion [ppb] v 117 ppb, respectively; P = .003). Among the 19 PAHs quantified, low-molecular-weight phenanthrene was present in the highest concentration (32 ppb) among firefighters not responding to fires. CONCLUSION Passive objective sampling of PAHs using silicone-based wristbands among Dominican firefighters showed direct exposure to carcinogenic compounds during a typical 24-hour firefighter shift. Firefighters not attending a fire had lower levels of PAHs, suggesting carcinogenic contaminants are present at the fire station.
Avelumab in Patients With Gestational Trophoblastic Tumors With Resistance to Single-Agent Chemotherapy: Cohort A of the TROPHIMMUN Phase II Trial
Authors: You Benoit , Bolze Pierre-Adrien , Lotz Jean-Pierre , Massardier Jérome , Gladieff Laurence , Joly Florence , Hajri Touria , Maucort-Boulch Delphine , Bin Sylvie , Rousset Pascal , Devouassoux-Shisheboran Mojgan , Roux Adeline , Alves-Ferreira Marine , Grazziotin-Soares Daniele , Langlois-Jacques Carole , Mercier Catherine , Villeneuve Laurent , Freyer Gilles , Golfier Francois 
Published: July 2020

PURPOSE Women with gestational trophoblastic tumors (GTT) resistant to single-agent chemotherapy receive alternative chemotherapy regimens, which, although effective, cause considerable toxicity. All GTT subtypes express programmed death-ligand 1 (PD-L1), and natural killer (NK) cells are involved in trophoblast immunosurveillance. Avelumab (anti–PD-L1) induces NK cell–mediated cytotoxicity. The TROPHIMMUN trial assessed avelumab in women with chemotherapy-resistant GTT. METHODS In this phase II multicenter trial (ClinicalTrials.gov identifier: NCT03135769 ), women with GTT who experienced disease progression after single-agent chemotherapy received avelumab 10 mg/kg intravenously every 2 weeks until human chorionic gonadotropin (hCG) normalization, followed by 3 consolidation cycles. Rate of hCG normalization was the primary endpoint (2-step Simon design). RESULTS Between December 2016 and September 2018, 15 patients were treated. Median age was 34 years; disease stage was I or III in 53.3% and 46.7% of women, respectively; and International Federation of Gynecology and Obstetrics (FIGO) score was 0-4 in 33.3%, 5-6 in 46.7%, and ≥ 7 in 20% of patients. Prior treatment included methotrexate (100%) and actinomycin D (7%). Median follow-up was 25 months, and median number of avelumab cycles was 8 (range, 2-11). Grade 1-2 treatment-related adverse events occurred in 93% of patients, most commonly (≥ 25%) fatigue (33.3%), nausea/vomiting (33.3%), and infusion-related reaction (26.7%). One patient had grade 3 uterine bleeding (treatment unrelated). Eight patients (53.3%) had hCG normalization after a median of 9 avelumab cycles; none subsequently relapsed. Probability of normalization was not associated with disease stage, FIGO score, or baseline hCG. One patient subsequently had a healthy pregnancy. In avelumab-resistant patients (46.7%), hCG was normalized with actinomycin D (42.3%) or combination chemotherapy/surgery (57.1%). CONCLUSION In patients with single-agent chemotherapy-resistant GTT, avelumab had a favorable safety profile and cured approximately 50% of patients. Avelumab could be a new therapeutic option, particularly in patients who would otherwise receive combination chemotherapy.
First draft genome assembly of the desert locust, Schistocerca gregaria
Authors: Verlinden Heleen , Sterck Lieven , Li Jia , Li Zhen , Yssel Anna , Gansemans Yannick , Verdonck Rik , Holtof Michiel , Song Hojun , Behmer Spencer T. , Sword Gregory A. , Matheson Tom , Ott Swidbert R. , Deforce Dieter , Van Nieuwerburgh Filip , Van de Peer Yves , Vanden Broeck Jozef 
Published: July 2020

Background: At the time of publication, the most devastating desert locust crisis in decades is affecting East Africa, the Arabian Peninsula and South-West Asia. The situation is extremely alarming in East Africa, where Kenya, Ethiopia and Somalia face an unprecedented threat to food security and livelihoods. Most of the time, however, locusts do not occur in swarms, but live as relatively harmless solitary insects. The phenotypically distinct solitarious and gregarious locust phases differ markedly in many aspects of behaviour, physiology and morphology, making them an excellent model to study how environmental factors shape behaviour and development. A better understanding of the extreme phenotypic plasticity in desert locusts will offer new, more environmentally sustainable ways of fighting devastating swarms. Methods: High molecular weight DNA derived from two adult males was used for Mate Pair and Paired End Illumina sequencing and PacBio sequencing. A reliable reference genome of Schistocerca gregaria was assembled using the ABySS pipeline, scaffolding was improved using LINKS. Results: In total, 1,316 Gb Illumina reads and 112 Gb PacBio reads were produced and assembled. The resulting draft genome consists of 8,817,834,205 bp organised in 955,015 scaffolds with an N50 of 157,705 bp, making the desert locust genome the largest insect genome sequenced and assembled to date. In total, 18,815 protein-encoding genes are predicted in the desert locust genome, of which 13,646 (72.53%) obtained at least one functional assignment based on similarity to known proteins. Conclusions: The desert locust genome data will contribute greatly to studies of phenotypic plasticity, physiology, neurobiology, molecular ecology, evolutionary genetics and comparative genomics, and will promote the desert locust’s use as a model system. The data will also facilitate the development of novel, more sustainable strategies for preventing or combating swarms of these infamous insects.
Assortment Rotation and the Value of Concealment
Authors: Ferreira Kris Johnson , Goh Joel 
Published: July 2020

Assortment rotation—the retailing practice of changing the assortment of products offered to customers—has recently been used as a competitive advantage for both brick-and-mortar and online retailers. We focus on product categories where consumers may purchase multiple products during a season and investigate a new reason why frequent assortment rotations can be valuable to a retailer. Namely, by distributing its seasonal catalog of products over multiple assortments rotated throughout the season, as opposed to selling all products in a single, fixed assortment, the retailer effectively conceals a portion of its full product catalog from consumers, injecting uncertainty into the consumer’s relative product valuations. Rationally acting consumers may respond to this structural difference by purchasing more products, thereby generating additional sales for the retailer. We refer to this phenomenon as the value of concealment and show that the retailer enjoys a positive and significant value of concealment under quite general conditions. However, we show that when consumers are forward looking, the value of concealment is context dependent. We present insights and discuss intuition regarding which product categories likely lead to a positive versus negative value of concealment. This paper was accepted by Vishal Gaur, operations management.
Boost your confidence: learning new skills in orthodontics
Authors: Modha Bhaven 
Published: July 2020

Dr Bhaven Modha's guide for prospective students to achieving success in the Certificate in Orthodontic Dental Nursing This article provides advice from a tutor's perspective. It aims to help potential students achieve success in the Certificate in Orthodontic Dental Nursing qualification. It considers: Realistic expectations Choosing a suitable course provider The need for a supportive workplace Professionalism The Record of Competence Feedback Reflection The final examination.