bluuebunny/crossref_metadata_2025_split huggingface dataset:
Abstract 62: An Assessment of Cervical Cancer Prevention and Treatment Infrastructure in Belize
Authors: Neibart Shane , Smith Tiffany , Fang Jennifer , Anderson Taylor , Kulkarni Abha , Tsui Jennifer , Hudson Shawna , Peck Gregory , Hanna Joseph , Beer Natalia Largaespada , Einstein Mark 
Published: July 2021

Abstract
Purpose: Belize has among the highest cervical cancer incidence and mortality rates of Latin American and Caribbean countries despite efforts to increase access to prevention and treatment services. This study evaluates the policies, infrastructure, and workforce of the cervical cancer management system in Belize to inform the strengthening of sustainable screening and treatment programs.
Methods: In 2018, health facility assessments were conducted across the 6 districts of Belize at the national pathology facility and 12 public facilities identified by Ministry of Health as critical to cervical cancer control. We used a standardized instrument to assess human resources, physical infrastructure, and existing policies related to cervical cancer management.
Results: The public cervical cancer screening workforce in Belize consists of 75 nurses and physicians (1 per 1,075 screening-eligible women), and 44% (n=33) are members of the outreach workforce who serve rural areas (1 per 2,537 screening-eligible women). All districts have at least 1 screening facility, 50% (n=6) of which perform screening services including visual inspection with acetic acid and cervical cytology 1 day per week. Cervical cancer diagnosis and treatment service availability differ across districts. At the national pathology facility, 38% (n=5) of essential equipment (e.g. microtomes) were available and functional, 23% (n=3) of equipment were available but non-functional, and 38% (n=5) of equipment were unavailable. Regarding essential pathology supplies (e.g. hematoxylin and eosin), 30% (n=6) of supplies were out of stock at the time of assessment and 75% (n=15) were out of stock at one point in the past 12 months.
Conclusion: Public sector cervical cancer management services differ between districts of Belize, with tertiary service availability concentrated in the largest district. Screening, outreach, and pathology are limited by resource availability, and although no standard benchmarks exist for contextualization, this insight into current capacity pinpoints health system components for future investment.
Citation Format: Shane Neibart, Tiffany Smith, Jennifer Fang, Taylor Anderson, Abha Kulkarni, Jennifer Tsui, Shawna Hudson, Gregory Peck, Joseph Hanna, Natalia Largaespada Beer, Mark Einstein. An Assessment of Cervical Cancer Prevention and Treatment Infrastructure in Belize [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 62.
Abstract 66: Screening and Risk Factor Analysis for Oral, Breast and Cervical Cancer amongst Garbage Cleaners of Bangalore, India; An Underserved Community.
Authors: T Chethana , Shetty Punith , Kulkarni Radhika 
Published: July 2021

Abstract
Purpose: According to GLOBOCON 2018, in India oral cancer is the most common cancer among men while breast and cervical cancers are the most common cancers in women. Tobacco is a common and significant risk factor. This study was conducted amongst garbage cleaners of Bangalore, India. This population represents one of the lowest socio-economic classes in India due to poor health literacy and financial poverty. The objectives of this study were to identify the risk factors for oral, breast, and cervical cancer in this population and to identify premalignant and malignant lesions.
Methods: A cross-sectional descriptive study was conducted in Bangalore, India. Validated questionnaires were used to assess risk factors. Over a period of one year, screening programs were conducted once a week in the municipality clinics. The screening included a visual exam of the oral cavity and exfoliative cytology of lesions, clinical breast exam (CBE), and pap smears. Follow up of suspected lesions were referred to higher centers for further management.
Results: Of the 1123 attendees, 81.5% were women, 85% were illiterate. 68 oral premalignant lesions were identified on clinical exam and all of them underwent tobacco cessation counselling. 913/915 women underwent CBE, of which 23 were abnormal and were referred for mammogram. 28 abnormal pap smears were detected; 16 underwent biopsy:1 SCC (treated), 3 HSIL (1 treated/1 refused/1 under follow up), 2 LSIL (under follow up), 10 normal. Multiple logistic regression was done to assess the impact of risk factors on the oral pre-malignant cases. The intercept/constant was statistically significant with tobacco having a positive relationship while gender and age had a marginally positive relationship.
Conclusion: Garbage cleaners represent a high-risk population due to poor health literacy, limited access to health care and hazardous working conditions. This program not only helped to create awareness about these cancers and the implications of tobacco use but also provided opportunity for screening. Imparting knowledge about oral and self-breast exams will help to create a sustainable model. Implementation of tobacco cessation programs would be beneficial.
Citation Format: Chethana T, Punith Shetty, Radhika Kulkarni. Screening and Risk Factor Analysis for Oral, Breast and Cervical Cancer amongst Garbage Cleaners of Bangalore, India; An Underserved Community. [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 66.
Abstract 70: Integrated Cancer Management in Indonesia: Synergism to Achieve a Good Quality Cancer Management 2020-2024
Authors: Gondhowiardjo Soehartati , Permata Tiara Bunga Mayang , Nurhanita  , Khumaessa Novi Elis , Maharani Putri , Nicholas  , Rahmartani Lusi Tania , Octavianus Steven 
Published: July 2021

Abstract
Purpose: Numerous long-term efforts have been established for cancer control by Indonesian government. Still, these efforts seem incapable of keeping up with the increasing number of cancer cases and have not yielded satisfactory outcomes. To further enhance Indonesia's cancer control program, we proposed strategies that mainly focus on prevention and early diagnosis, which consider a promising investment in cancer control. Rather than solely concentrating on treatment plans, which may result in cost-inefficiencies and augmenting its state financial burden.
Methods: A thorough situational analysis for Indonesia's cancer control was performed, including cancer risk factors, screening and early detection, access to cancer care and palliative care, human resource, and cancer registry. The analysis was performed by data collection from literature reviews, site surveys at primary health care, tertiary health care, Indonesia Health Care Insurance, and in-depth interviews with national experts in various professional organizations and NGOs. Based on these findings and analysis, a proposed cancer control program was then formulated by the National Cancer Control Committee (NCCC) and Ministry of Health with WHO-SEAR.
Results: The NCCC has formulated National Cancer Control Program for 2020-2024 with three main visions, increased healthy lifestyle, plenary cancer control and prevention, and effective data-based cancer control, which is well pictured in the 'hour-glass' approach. The strategy mainly focuses on health promotion and primary prevention synergized by other healthcare systems such as cancer care, cancer registry, and palliative care.
Conclusion: Efforts should focus on the three primary cancers in Indonesia, which significantly impact cancer burden, namely breast cancer, cervical cancer, and childhood cancer. Therefore, Indonesia will achieve reasonable cancer control and reduce cancer burden. However, formulating NCCP is crucial to help the country pan out its priorities and action plan in cancer control. Each country should decide its strategy and approach, which is most relevant to their situation.
Citation Format: Soehartati Gondhowiardjo, Tiara Bunga Mayang Permata, Nurhanita, Novi Elis Khumaessa, Putri Maharani, Nicholas, Lusi Tania Rahmartani, Steven Octavianus. Integrated Cancer Management in Indonesia: Synergism to Achieve a Good Quality Cancer Management 2020-2024 [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 70.
Abstract 84: Development and Implementation of a Case-based Virtual Training Program for Oncologic Emergencies in Botswana
Authors: Li Sharon , Qureshi Sadaf , Antony Reena , Wilson Kara , Moumakwa Robert , Lebelonyane Refeletswe , Gaolathe Tendani , Shah Mansi , Popli Pallvi , Chandar Ashwin , Kaur Sukhdeep , Marlink Richard , Mayer Tina , Vuylsteke Peter , Ralefala Tlotlo 
Published: July 2021

Abstract
Purpose: Oncologic emergencies contribute to a large proportion of morbidity and mortality for oncology patients, who present unique medical challenges due to disease and treatment complexities. Emergencies training of medical staff is important, particularly if there is high turnover. We describe the development and implementation of a program to enhance timely recognition and treatment of oncologic emergencies. Due to the COVID19 pandemic, sessions were conducted virtually.
Methods: Healthcare workers who normally care for oncology patients at Princess Marina Hospital (PMH) were invited to participate in a series of weekly virtual case-based lectures. Didactic content was developed between Botswana and Rutgers faculty and fellows to reflect specific management and resources available at PMH. Participation was through live chat case reviews and pre- and post- session questions. Feedback was elicited through Likert-scale surveys.
Results: An average of 19 participants (range 13-29) attended the training sessions. Average make-up per session were as follows: 16% physicians, 26% Medical Officers, 4% Internal Medicine Residents, 32% nurses, 21% other. Healthcare workers from Botswana were invited to participate in content preparation and presentation to their peers; 3 of 8 presentations were by Botswana personnel. Average pre-session test score was 70% (range 40-89%); post-session score was 82% (range 55-97%). In post sessions surveys, average confidence in diagnosis and recognition across emergencies was 84% (range 71-100%); average confidence in management was 81% (range 57-100%).
Conclusions: We describe the successful piloting of a case-based virtual training program in oncologic emergencies, which to our knowledge is the first of its kind. The program was adapted to the Botswana health care setting. Overall, confidence in diagnosis, recognition and management of oncologic emergencies appeared to increase after sessions. Plans are in place to expand the series to more sites within the country, most of which do not have dedicated oncology trained staff.
Citation Format: Sharon Li, Sadaf Qureshi, Reena Antony, Kara Wilson, Robert Moumakwa, Refeletswe Lebelonyane, Tendani Gaolathe, Mansi Shah, Pallvi Popli, Ashwin Chandar, Sukhdeep Kaur, Richard Marlink, Tina Mayer, Peter Vuylsteke, Tlotlo Ralefala. Development and Implementation of a Case-based Virtual Training Program for Oncologic Emergencies in Botswana [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 84.
Abstract 87: Virtual Mentoring of Dentists in Oral Cancer Screening and Tobacco Cessation: An Advanced Level Program
Authors: Nethan Suzanne , John Amrita , Ravi Priyanka , Kumar Vipin , Dhanasekaran Kavitha , Babu Roshni , Hariprasad Roopa 
Published: July 2021

Abstract
Purpose: Oral cancer is the third common cancer in India, the mortality of which can be reduced by early detection. Dentists are ideal for this task and tobacco cessation owing to their forte of work. This paper discusses findings of a Project ECHO (Extension for Community Health Outcome)-based advanced telementoring program in these areas for dentists across India.
Methods: The 14-week long training program in 2018, with weekly, hour-long sessions conducted by our Organization (hub) on Zoom app, had 52 participants (spokes) from across India. Each session comprised of an expert-led didactic, and case discussions by spokes. Participants were evaluated through online, pre- and post-training, and weekly post-session quizzes, along with weekly and post-one-year feedback. Successful spokes attended a hands-on workshop at our organization subsequently.
Results: A notable increase in the overall and per-session mean knowledge score, and confidence in oral cancer screening was seen among the spokes. Many started such services at their respective clinics (and continued till even a year later) and reduced referrals to other healthcare facilities for confirmation of their diagnosis. They also felt motivated to spread community awareness about oral cancer prevention.
Conclusion: The ECHO telementoring model comprising of expert didactics, case discussions by spokes, along with significant interaction between the spokes and experts, is a promising best-practice tool to reduce knowledge and skills disparity regarding oral cancer prevention among dentists situated across different locations. This in turn would enable these most appropriate healthcare providers to contribute towards the overall goal of oral cancer prevention.
Citation Format: Suzanne Nethan, Amrita John, Priyanka Ravi, Vipin Kumar, Kavitha Dhanasekaran, Roshni Babu, Roopa Hariprasad. Virtual Mentoring of Dentists in Oral Cancer Screening and Tobacco Cessation: An Advanced Level Program [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 87.
Abstract 92: Clinical Care and Short-Term Survival Outcomes for Women with Breast Cancer in Gaza, Occupied Palestinian Territory
Authors: Alwaheidi Shaymaa , Sullivan Professor Richard , Davies Dr Elizabeth 
Published: July 2021

Abstract
Purpose: We aimed to provide robust breast cancer survival estimates for Palestinian women in Gaza, and to identify interventions necessary to improve care in this setting.
Methods: We collected detailed clinical and treatment data from the medical records of all women diagnosed with breast cancer from Jan 1, 2017 to Dec 31, 2018 in Gaza. Semi-structured interviews with 11 healthcare providers and 20 patients diagnosed during this period were conducted to examine experiences of giving and receiving cancer care. Women were followed using clinical and death records until 31 December 2019. The one-year crude survival rate was estimated using the Kaplan-Meier method.
Results: 524 new diagnoses of breast cancer (mean age:53, range:23-100) were recorded during the study period, giving a crude annual incidence rate of 27 per 100,000 population. Key prognostic factors were available in most cases -stage (93%), ER, PR, HER2 (82%) and slightly less often for tumour grade (77%) and tumour size (70%). 51% of women underwent mastectomy. By December 31, 2019 24 (5%) of these women had died. The total estimated mean time until death was 11·7 months, and the one-year crude survival rate was 95·4%. Many women reported lack of treatment as the main barrier to effective cancer care, especially those receiving Gosorelin or radiotherapy. This issue was also cited by oncologists who described the difficulty of adhering to treatment protocols for early-stage breast cancer because of radiotherapy not being available in Gaza. Regarding diagnosis, delays were observed in the macroscopic examination of biopsies due to lack of staff, and a severe shortage of immunohistopathology staining kits hindered treatment planning.
Conclusion: Lack of hospital facilities for diagnosis and treatment are barriers to effective cancer care in Gaza. Despite major challenges, Palestinian women with breast cancer have a high short-term survival.
Citation Format: Shaymaa Alwaheidi, Professor Richard Sullivan, Dr Elizabeth Davies. Clinical Care and Short-Term Survival Outcomes for Women with Breast Cancer in Gaza, Occupied Palestinian Territory [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 92.
Abstract 93: Serum miRNA-210 Level in Clear Cell Renal Cell Carcinoma
Authors: Htun Yin Min , Htun Moh Moh , Aung Khin Thida 
Published: July 2021

Abstract
Purpose: Renal cell carcinoma (RCC) is the 12th most common cancer and its incidence is in increasing trend worldwide.
Methods: This study was carried out at Urosurgical ward of Yangon Specialty Hospital including (87) cases of clinically suspected renal cell carcinoma patients. Preoperative serum samples were collected and histologically proven clear cell renal cell carcinoma cases were selected and miRNA level were determined by quantitative reverse-transcriptase polymerase chain reaction.
Results: Clear cell renal cell carcinoma occurred in all age groups ranging from 24 to 82 years. The most commonly affected age group were 41-60 years including 52 patients (56.5%) and male to female ratio was 1.6:1. Serum miRNA-210 level was found to be significantly high in relation to normal and the receiver-operator characteristic (ROC) curve demonstrated the most promising sensitivity and specificity when the miRNA-210 level was set at 8.13 × 103copies/ul. Most of the patients were grade 2 histology followed by grade 3 and grade 4. Grade 1 histology cases were not found in this study. When analyzing with chi squared test, the mean serum miRNA-210 level of the total study population, (8.3057 × 104 copies/µl) was used to categorize the data into two groups in which those having serum miRNA-210 level below mean and those with the mean and above in relation to the low and high grades as well as low and high stages of RCC. There was statistically significant association between miRNA-210 expression of lower grades (grade 1 & 2) and higher grades (grade 3 &4) of clear cell RCC (p = 0.0001). There was also statistically significant association between miRNA-210 expression of lower stages (Stage I & II) and higher stages (Stage III &IV) of RCC (p = 0.005).
Conclusion: The upregulated miRNA-210 expression could estimate prognosis for active surveillance from patients having undergone surgical resection.
Citation Format: Yin Min Htun, Moh Moh Htun, Khin Thida Aung. Serum miRNA-210 Level in Clear Cell Renal Cell Carcinoma [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 93.
Abstract 98: Custom Gene Fusion Assays for the Rapid Diagnosis of Pediatric Cancers in Low-Resourced Settings
Authors: Gastier-Foster Julie , Lutwama Fredrick , Lubega Joseph , Fisher Kevin , Lopez-Terrada Dolores , Roy Angshumoy , Ozuah Nmazuo , Slone Jeremy , Wasswa Peter , Allen Carl , Poplack David 
Published: July 2021

Abstract
Purpose: Risk stratification and molecular targeting have been key to increasing cure rates for pediatric cancers in high-income countries. Precise diagnosis and successful treatment of pediatric cancer in low-resourced settings is often hindered by insufficient pathology infrastructure, including lack of laboratory platforms for molecular analysis. Given the high frequency of gene fusions in pediatric cancers, identifying such fusions would greatly aid cost-effective pediatric cancer diagnosis, risk stratification, and precision medicine in low-resourced settings.
Methods: To allow for implementation of gene fusion detection at Global HOPE sites in Sub-Saharan Africa (SSA), methodologies were reviewed to consider minimal technical expertise required, the ability to utilize samples with sub-optimal RNA quality, and rapid turn-around-time. Literature review, clinical laboratory results, public databases, and large-scale genomic studies were used to obtain exact breakpoint sequence information for gene fusions associated with pediatric and adolescent cancers.
Results: Two custom pediatric gene fusions panels were designed using the NanoString Elements technology. The hematologic malignancy panel was designed to detect 439 breakpoints for 223 non-IGH/TCR fusions reported in ALL, AML, lymphomas, and histiocytosis. The solid tumor panel was designed to detect 204 breakpoints for 436 fusions associated with pediatric sarcomas, brain tumors, and renal malignancies. Each panel was tested using 96 samples with known fusion status at Texas Children's Hospital to determine specificity, sensitivity, precision, and ease of workflow.
Conclusions: The design, testing, and implementation of a rapid assay to detect gene fusions with diagnostic, prognostic, and therapeutic impact would be transformational in the care of pediatric cancer patients in low-resourced settings. The custom designed panels will allow for large-scale fusion detection in 2-3 days with only 15 minutes of technician time after RNA isolation. Additional steps are needed to identify and address any challenges upon initiation in SSA to fully realize the potential of such technology.
Citation Format: Julie Gastier-Foster, Fredrick Lutwama, Joseph Lubega, Kevin Fisher, Dolores Lopez-Terrada, Angshumoy Roy, Nmazuo Ozuah, Jeremy Slone, Peter Wasswa, Carl Allen, David Poplack. Custom Gene Fusion Assays for the Rapid Diagnosis of Pediatric Cancers in Low-Resourced Settings [abstract]. In: Proceedings of the 9th Annual Symposium on Global Cancer Research; Global Cancer Research and Control: Looking Back and Charting a Path Forward; 2021 Mar 10-11. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2021;30(7 Suppl):Abstract nr 98.
Intersexual behaviour and effect of male and female intruders in the Tenerife skink (Chalcides viridanus). Is there any mate guarding?
Authors: Sánchez-Hernández Paula , Suárez-Rancel M. Mercedes , Molina-Borja Miguel 
Published: July 2021

Abstract
Individuals avoid potential competitors accessing mates during reproductive periods staying close to the mate and chasing same-sex intruders. We studied intersexual relationships and the effect of intruders of each sex in male-female pairs of Chalcides viridanus. We analysed: (1) behaviour patterns of each pair member and the time they spent together during three successive days in March, April and May; and (2) interactions of intruder-resident of the same sex, during each of the three months. Sexual and monthly differences appeared in intersexual behaviour as the breeding season progressed. In each month, time together was significantly larger on the third trial day than in the two previous days but did not significantly change between months. Sexes did not significantly differ in intruder-resident behaviours, but male aggressive interactions were significantly larger in May. Intruder females performed higher frequencies of non-agonistic behaviours than residents. We discuss all these results considering the predictions of mate guarding hypothesis.