bluuebunny/crossref_metadata_2025_split huggingface dataset:
Smoking Rates, Attitudes Towards Second Hand Smoking and Lung Cancer Awareness Among Medical and Dental Students in India
Authors: Francis Delfin 
Published: July 2024

PURPOSE There is no safe level of second hand smoke and conclusive evidence exists about the association between life threatening disease and passive smoking. Breathing even a little second hand smoke can be dangerous. Second hand smoke contains over 4,000 chemicals, 200 of which are toxins and 43 are carcinogens. Those who have heart disease and/or asthma are particularly susceptible to exposure to second hand smoke exposure Passive smoking, according to the recent global assessment of the burden of environmental tobacco smoke (ETS), is still one of the most important threats to public health. The aim of the study was to determine the smoking rates and perceptions of students towards second hand smoke in a University setting. MATERIALS AND METHODS A questionnaire was prepared based on the guidelines of WHO global adult tobacco surveillance data. The study proposal was approved by ethics committee. A comparative study was done to determine the smoking rates and attitudes towards second hand smoke between the Medical and Dental students at Tagore dental and medical college, India. The responses were tabled and data was analysed statistically using SPSS and other data analysis software. RESULTS A total of 118 dental students and 63 medical students completed the survey. Fewer dental students (2.5%) have smoked more than 100 cigarettes in their life when compared to the medical students (19.05 %) who were also current smokers. Current smokers averaged 6.4 cigarettes per day and smoked 2.6 per day on campus. A majority of dental students (37.2%) and medical students (11.1%) believed air quality to be poor. All medical had an experience of second hand smoke while (3.4%) dental students have never experienced second hand smoke. On the other hand (81.3%) of the Dental students and (30.2%) of medical students believed that a smoking ban would greatly improve the public image of college. Though (95%) of Dental students and (71.4%) of medical students agreed that tobacco smoke is dangerous for smokers and non-smokers health; only the dental students (85%) wanted the campus to be smoke free in the future, while the medical students (38%) only wanted campus to be smoke free. The difference is because of the higher smoking rates among the medical students. CONCLUSION It is clear that there is considerable support for a smoke free policy in the college campus but there must be adequate education and consultation. In the meantime, students should be provided health education to discourage tobacco use. Information on tobacco control policies needs to be more widely disseminated.
Social Support As a Predictor of Opioid Misuse Risk in Cancer Patients
Authors: Zhu Jonathan , Quinn Ryan , Chittams Jesse , Meghani Salimah 
Published: July 2024

PURPOSE In cancer patients, prescription opioid analgesics are a staple medication for cancer-related-pain management. Amidst the onslaught of legislative efforts to decrease opioid prescribing, cancer patients have been inadequately protected from increased restrictions. This fear of opioid misuse has made it more difficult for these patients to access opioids for necessary pain management purposes. In order to safely prescribe and administer opioids in these populations, predictors of opioid misuse and the development of OUD need to be studied. METHODS This study concerns the analysis of preliminary data from an ongoing parent study (1R01NR017853) looking at longitudinal outcomes of opioid therapy in patients with cancer and how patterns of opioid use over time relate to patient-reported outcomes and healthcare utilization. Adult patients with cancer receiving outpatient oncology care were recruited from three different sites affiliated with the University of Pennsylvania Health System. A multivariable linear regression model was used to analyze the predictive value of different factors on opioid misuse risk. RESULTS The regression model was significant overall (F(25, 389) = 7.64, p < .001) and captured 28.62% of the variance in opioid misuse risk scores. In this model, moderate depression (b = 4.16, p < .001), moderately severe depression (b = 7.07, p < .001), and severe depression (b = 8.27, p < .001) were correlated with higher opioid misuse risk scores than participants with 'none-minimal' depression levels. Social support (b = -1.42, p < .001) had a significant inverse correlation with opioid misuse risk scores. CONCLUSION The results of this study suggest that depression and social support are correlated with opioid misuse risk in cancer patients with opioid prescriptions. Increases in depression severity were more strongly correlated with opioid misuse risk, suggesting that cancer patients with more severe depression are especially susceptible to opioid misuse. Social support was inversely correlated with opioid misuse risk. To minimize the risk of opioid misuse and provide proper support for cancer patients who are prescribed opioids for pain management, patients should be screened for depression and social support levels prior to starting opioid analgesics. Patients who have depression or low levels of social support should receive additional interdisciplinary support services to address those modalities concurrently with their opioid regimen.
Stakeholders' Experiences, Knowledge and Perspectives Regarding Care Quality for Breast Cancer in South-West Nigeria
Authors: Alabi Adewumi , Ainsworth Victoria , Lawal Abdulrazzaq , Kizub Darya , Chin Jennifer , Omidiji Olubukola , Adegboyega Bolane , Sowunmi Anthonia , Ogunyemi Doyin , Swanson William , Joseph Adedoyin , Ngwa William 
Published: July 2024

PURPOSE The majority of breast cancer cases seen in LMIC present in advanced stages where the disease has spread. Breast cancer patients in Nigeria face numerous barriers to and delays in care ranging from individual to structural issues. The ability to seek treatment starts with the personal recognition of the signs and symptoms of breast cancer. This is often hindered by lack of knowledge about breast cancer in the community, and among local healthcare practitioners resulting in many instances of misdiagnosis, which contributes to delays in patient care. To evaluate patient lived experiences and healthcare provider perspectives about breast cancer care in South-West Nigeria. METHODS A mixed method study was conducted in 2 phases: Phase I: 3 Focus group discussions were conducted at the NSIA-LUTH Cancer Centre in Lagos, Nigeria. The three focus groups had up to six participants each a total of 23 participants. Phase II: A pre and post-survey of a continuing medical education course focused on breast cancer was delivered to 70 healthcare providers in South-west Nigeria. Provider responses and causes for delays and barriers were extracted and analyzed. Ethical approval was obtained from Institutional HREC. RESULTS Data from our study reports that 70% of patients receive help from family to fund treatment highlighting why cancer can be a poverty trap for families and the need for universal health insurance. Our study also reports 42% of healthcare providers feeling only “somewhat” qualified to deal with breast cancer, highlighting the significant need for more education, with a further 14% feeling neutral or negative about their qualification, a potential contributing factor in negative interactions recalled by patients. Half of the focus group participants had a positive interaction with their doctors, with the rest reporting neutral (19%) or even negative (31%) interactions. Fear of mastectomy was a perceived barrier to care for 90% of healthcare providers while 87% and 86% of providers perceived seeking spiritual and herbal treatments as the largest delays of care. CONCLUSION With the success of the course and the inspiration of breast cancer survivors, a proposed expansion into community awareness is planned along with enlisting local practitioners in the fight against breast cancer in hopes of lowering the barriers to and delays of care in Nigeria.
The Economic Burden of Cervical Cancer on Women and Families in Uganda
Authors: Dau Hallie , Nankya Esther , Naguti Prisculla , Basemera Miriam , Payne Beth A. , Vidler Marianne , Singer Joel , McNair Avery , AboMoslim Maryam , Smith Laurie , Orem Jackson , Nakisige Carolyn , Ogilvie Gina 
Published: July 2024

PURPOSE There is little research on how a cervical cancer diagnosis financially impacts women and their families in low-and middle-income countries, including the burden of out-of-pocket costs. The objective of this analysis is to describe the economic burden of cervical cancer treatment, including how this differs by socio-economic status (SES) in Uganda. METHODS We conducted a cross-sectional study from September 19, 2022 to January 17, 2023. Women were recruited from the Uganda Cancer Institute and Jinja Regional Referral Hospital and were eligible for this study if they were ≥ 18 years, being treated for cervical cancer, and provided consent. Participants completed a 45-minute survey which included questions about their out-of-pocket costs, unpaid labor, and changes in their family’s economic situation. A wealth index was constructed from the participant’s ownership of household items to determine their SES. Descriptive statistics were reported. RESULTS Of the 338 participants who completed the survey, 183 were from the lower SES. Women from the lower SES were significantly more likely to be older, have primary school education, and have a more advanced stage of cervical cancer. Both groups of women reported paying out-of-pocket for cervical cancer care (higher SES 95.5%, lower SES 92.3%). Only 15/338 participants stopped treatment because they could not afford it. Women of a lower SES were significantly more likely to report borrowing money (p-value=0.004) and selling possessions to pay for cancer care (p-value=0.006). With regards to unpaid labor, women from both groups reported decreasing the amount of time that they spent caring for their children since their cervical cancer diagnosis. CONCLUSION Regardless of their SES, women in Uganda incur out-of-pocket costs related to their cervical cancer treatment. However, there are inequities as women from the lower SES groups were more likely to borrow funds to afford treatment. Alternative payment models and further financial support could help alleviate the financial burden of cervical cancer care on women and families in Uganda. The results of this analysis can be used to demonstrate the indirect economic impact that a cervical cancer diagnosis has on not only women but their families as well. This in turn can be as evidence to expand global cervical cancer screening programs and eliminate cervical cancer worldwide.
The Impact of YAP-Mediated Hippo Signaling in Obesity and Triple Negative Breast Cancer
Authors: Dave Krisha , Cui Xin , Zhu Yueming , Wan Yong 
Published: July 2024

PURPOSE Obesity is one of the most prevalent and modifiable risk factors for chronic diseases such as cancer. Recent meta-analyses suggests that breast cancer-specific death among obese women is elevated 1.3-fold in comparison to normal weight woman. There is also an increased risk of developing triple negative breast cancer (TNBC) in women with a higher waist/hip ratio. However, the underlying pathophysiology linking obesity, adiposity, and TNBC needs further investigation. METHODS Colony formation assays were performed where cells were infected with control or shYAP lentivirus for 48 hours before 400 4T1 cells per well were seeded into a six-well plate. Seeded colonies were treated with stromal conditional medium (SCM) or adipocyte conditional medium (ACM) for 10 days. Cells were fixed with 4% paraformaldehyde for 15 min at room temperature, followed by staining with 0.025% crystal violet for 30 minutes. For Western blotting, cells were harvested and lysed in 1x SDS loading buffer. The protein concentration was determined using Bio-Rad protein reagent. Antibodies against YAP and HRP-conjugated goat anti-rabbit secondary antibody (Promega) were used. Signals were detected with ECL reagents (Bio-Rad). Semi-quantification of data was performed using NIH ImageJ. RESULTS This study establishes a mechanistic link between obesity-altered metabolism and dysregulated proteasomal pathways, specifically the YAP-mediated Hippo cascade. Results show that the Hippo signaling pathway is highly regulated in obese mice in comparison to normal controls, as supported by RNA-sequencing. KEGG data also depicts other genes in oncogenic metabolic pathways as present in obese mice. Furthermore, data from clonogenic assays on three TNBC cell lines treated with ACM show increased cancer cell colony formation efficiency, suggesting that adipocyte secretome can increase tumor growth. In addition, YAP expression levels are elevated in the breast cancer cells under ACM treatment, and the knockdown of YAP diminishes the tumor inductive effect driven by ACM. Thus, this study uncovers the clinical relevance of the Hippo-YAP axis in regulating obesity-related breast cancer. CONCLUSION In conclusion, the study suggests that adipocyte secretome affects tumor proliferation and progression, as observed by experimentation on TNBC cell lines using ACM/SCM and testing for YAP expression levels. Future directions would studying the effect of the YAP inhibitor on ACM treated tumor cell growth.
The Increase in Deaths From Breast Cancer in Brazil: An Analysis of a Decade
Authors: Pires Rafaela , Afonso Mariana , Loureiro Yasmin 
Published: July 2024

PURPOSE Analyze the increase in the number of deaths from breast cancer in Brazil between 2012 and 2022. METHODS Descriptive cross-sectional epidemiological study based on secondary data from the Mortality section of the DATASUS platform from 2012 to 2022. The variable analyzed was the number of deaths from breast cancer in the Brazilian population. In addition, data from the National Cancer Institute (INCA) regarding the estimated number of breast cancer cases for 2012 and 2022 was used as a secondary data source. RESULTS In 2012, a total of 13,755 deaths from breast cancer were recorded in Brazil by the SUS (Brazil's public health system). In the subsequent ten years, this number gets more significant. There were 14,394 deaths from this cause in 2013, 14,789 in 2014, 15,600 in 2015, 16,259 in 2016, 16,932 in 2017, 17,770 in 2018, 18,300 in 2019, 18,036 in 2020, 18,365 in 2021 and 19,371 in 2022. Therefore, when comparing directly 2012 and 2022, it reveals a total increase of 134.57% in the number of deaths from breast cancer. Furthermore, according to the National Cancer Institute, the estimated number of cases of breast cancer in 2012 was 52,680, and in 2022 was 66,280, representing a growth of 125,81%. CONCLUSION Notably, there was a considerable increase in breast cancer deaths over the analyzed decade. This increase is related to the change in the women's way of life since they are more concerned about their health today. In the last ten years in Brazil, public health campaigns for breast cancer awareness have grown significantly, encouraging women to be attentive to symptoms by self-touching and to do medical exams regularly. As a result, the number of diagnoses increased, as well as the number of deaths, not necessarily meaning that more women have breast cancer compared to previous years, but more women are having the diagnosis and being aware that they have the disease.
The Role of Racial Disparities in Gene Expression Profiling for the Prediction of Therapeutic Response in Patients With Breast Cancer
Authors: Ani Angela , Achi Franklyn , Okafor Michael , Ohayi Samuel Robsam , Agu Kenneth , Ghasi Samual , Okoli Uzoamaka 
Published: July 2024

PURPOSE Genetic variations affecting gene expression play a crucial role in breast cancer chemotherapy response. This study investigates how gene expression profiles impact treatment outcomes and explores racial disparities in chemotherapy response among breast cancer patients. METHODS Utilizing data from The Cancer Genome Atlas (TCGA) via Cbioportal, gene expression profiles of 8,132 breast cancer patients from 23 studies were analysed. 2030 patients were categorized into 1,743 white and 287 black. Among them, 407 received cyclophosphamide, 291 received doxorubicin, and 215 received tamoxifen or combination therapy. Mutual exclusivity was assessed, and P-values were calculated using Fisher's exact test, assuming the null hypothesis that the frequency of alteration occurrence in a pair of genes is proportional to independent occurrences in each gene. The enrichment of genes between patients of European ancestry and African descent was analysed. Kaplan-Meier plots were generated, and P-values from the log-rank test were determined to assess survival differences. RESULTS Significant differences in gene expression profiles were observed between white and black/African American patients. Notably, the GCA (p < 0.001) gene, encoding a calcium-binding protein abundant in immune cells, showed complete alteration in less than 1% of white patients and was absent in black/African American patients. Commonly expressed genes with variations in both racial groups included TP53, PIK3CA, IGLV3-25, CSMD1, ERBB2, MYC, TTN, CDK12, and CASC8. Ethnicity influenced chemotherapy response, with patients of European ancestry exhibiting superior overall survival. Both racial groups showed heightened response to cyclophosphamide but reduced response to tamoxifen. CONCLUSION Patients of European ancestry had better survival rates compared to black or African American patients, possibly due to differences in gene expression profiles amongst other factors. However, the specific role of the GCA gene in breast cancer pathogenesis remains unclear. Understanding gene expression patterns, particularly in tumour-infiltrating lymphocytes, may shed light on immune responses in breast cancer. Racial disparities in gene expression profiles significantly impact chemotherapy response and patient outcomes, highlighting the need for further research into genetic determinants and immune responses to refine therapeutic interventions. This study highlights the importance of personalized treatment strategies informed by genetic and racial considerations in breast cancer management.
Transcriptomic Features Associated to Neoadjuvant Chemotherapy Response in Four Molecular Breast Cancer Subtypes
Authors: Guevara-Nieto Hedda Michelle , Parra-Medina Rafael , Orozco Carlos Alberto , Mejia-Garcia Alejandro , Zabaleta Jovanny , Lopez-Kleine Liliana , Combita-Rojas Alba Lucia 
Published: July 2024

PURPOSE Breast cancer (BC) represents a major public health issue. The effectiveness of neoadjuvant chemotherapy (NAC) varies among breast cancer patients, with some experiencing incomplete pathological responses. This variability in treatment response may be attributed to differences in tumor heterogeneity and its microenvironment (TME). This study investigates gene expression patterns associated to non-response to NAC in invasive BC patients, emphasizing the role of genes, pathways and the variability among BC subtypes. METHODS A transcriptomic study analyzed 58 baseline samples from women with advanced breast cancer at the Colombian National Cancer Institute, categorizing them into 29 NAC responders and 29 non-responders. The study comprised gene expression comparison, enrichment analysis, tumor microenvironment estimation via xCell, and therapeutic efficacy of targeted drugs using PrRophetic package. RESULTS Different gene expression profiles distinguished responders from non-responders among various breast cancer subtypes, highlighting immune-related pathways like IL-17 and TNF signaling, B and T cell receptor signaling, complement and coagulation cascades, natural killer cell-mediated cytotoxicity, and NF-kB signaling. Non-responders in Luminal B HER2- subtype exhibited increased endothelial cells and immune and microenvironment scores, while Luminal B HER2+ non-responders showed higher levels of CD4 Tcm, CD4 Tem, and megakaryocytes. Sensitivity to multiple potential therapeutic drugs (Lestaurtinib, Avagacestat, GSK3 inhibitor, Veliparib, Tretinoin, Afatinib, Vinorelbine, RSK1 inhibitor, Motesanib) varied distinctly among non-responders. CONCLUSION Immune-related genes and diverse immune cell subtypes within the TME correlate with response to NAC, with significant changes observed between response groups and subtypes. Comprehensive detection and evaluation of TME components are crucial for predicting NAC efficacy and preventing disease relapse. These findings underscore the importance of studying mixed populations to uncover novel insights and address disparities.
Vaccine Attitudes Among Parents: Comparing HPV and COVID-19 Vaccines Perceptions in Healthcare Workers' and the General Population in Japan
Authors: Jamil Hasan , Abubakar Aminu , Gilmour Stuart , Ozaki Akihiko , Tabuchi Takahiro 
Published: July 2024

PURPOSE This study explores attitudes towards HPV and COVID-19 vaccinations among parents of healthcare workers and the broader Japanese population, emphasizing parental decisions about vaccinating daughters. It contrasts these attitudes with those of healthcare workers, providing insights into vaccine acceptance and hesitancy. METHODS Data from the 2022 Japan COVID-19 and Society Internet Survey (JACSIS) were used for a cross-sectional analysis. Subjects included parents of healthcare workers and the general population with daughters born between 1997 and 2010. The survey assessed willingness to vaccinate against HPV and COVID-19 under various conditions, like doctor advice and media reports. Responses were captured on a Likert scale and aggregated into a composite vaccination propensity score. This score was compared between parents of healthcare workers and other respondents using an independent samples t-test. RESULTS The analysis included 965 participants, with 70 medical workers and 895 non-medical workers. No significant difference was observed in attitudes towards the COVID-19 vaccine between medical and non-medical workers (p-value = 0.0655). In contrast, a significant difference was observed in attitudes towards the HPV vaccine (t = 2.7017, df = 80.296, p-value = 0.008413). Medical workers were more willing to vaccinate their daughters against HPV (mean score = 2.7) compared to their counterparts in other occupations (mean score = 1.3). CONCLUSION The study reveals a distinct divergence in vaccine acceptance in Japan: while COVID-19 vaccination attitudes are uniform across different groups, parents of healthcare workers demonstrate a higher acceptance of HPV vaccination than the general public. This indicates that vaccine perceptions are significantly influenced by specific disease characteristics and accessible information, rather than a uniform vaccination viewpoint. The findings emphasize the need for targeted, disease-specific public health campaigns, particularly for HPV vaccines. Adapting successful strategies from COVID-19 vaccination drives, such as clear communication of benefits, countering hesitancy with trusted medical advice, and widespread public campaigns, could improve HPV vaccine acceptance. In this context, the influential role of healthcare workers and their families in advocating for vaccines becomes vital for enhancing public perception and increasing uptake of the HPV vaccine.