bluuebunny/crossref_metadata_2025_split huggingface dataset:
E-009 What is the real risk of dislodging thrombi during endovascular revascularization of a proximal internal carotid artery occlusion?
Authors: Baik S , Jeon U , Choo K , Kim Y , Jeong H 
Published: December 2010

PurposeThere is a theoretical concern that a thrombus may be dislodged distally when crossing the occluded segment during recanalization of a complete occlusion. In the present study, we assessed the immediate postprocedural brain diffusion weighted image (DWI) findings following endovascular recanalization using an embolic protection device for proximal internal carotid artery (ICA) occlusion.Materials and methodsWe retrospectively identified 12 patients who underwent stent implantation for sudden symptomatic occlusion of the proximal ICA. In eight patients, no additional intracranial occlusions were identified. In four patients, an additional intracerebral thrombus was detected in the middle cerebral artery. Distal protection devices were used in all cases. We evaluated the presence and amount of retrieved embolic fragments in the distal protection devices. The incidence and location of postprocedural emboli were determined using DWI.ResultsRecanalization of the proximal ICA was achieved in all patients. After complete occlusion of the proximal ICA was demonstrated, primary passage of the embolic protection device through the occluded ICA was gently navigated in seven patients. However, this was not possible in five patients. Three patients developed new lesions on postprocedural DWI. Of the 12 patients in which distal protection devices were used, debris was detected in seven patients.ConclusionIn endovascular revascularization of proximal ICA occlusion, postprocedural emboli occur less frequently than reported in a systemic review of the DWI literature. The real risk of dislodging thrombi appears to derive from plaque fragment mobilization by angioplasty, rather than crossing an occluded segment.Abstract E-009 Figure 1
Abstract A104: Involvement of FOXO1 in E2/ER pathway and tamoxifen resistance in MCF-7 cells
Authors: Washington Eleby R. , Sarkissyan Marianna , Sarkissyan Suren , Wu Yanyuan , Vadgama Jay V. 
Published: December 2010

Abstract
Introduction: Estrogen receptor positive breast tumors frequently become resistant to Tamoxifen therapy. Elucidating mechanisms that contribute to resistance are critical for developing therapeutic targets. Previously, we have shown in our lab that FOXO1, a pro-apoptotic transcription factor, plays a role in Trastuzumab resistance, and is inactivated in Her2-overexpressing tumors associated with increased AKT activation. Restoration of FOXO1, both by inhibiting the AKT pathway and by FOXO1 transfection, restored cell-sensitivity to Trastuzumab. Currently, we are exploring whether FOXO1 may play a similar role in resistance to Tamoxifen in ER positive breast cancer cells. We hypothesize that loss of function of FOXO1 may contribute to Tamoxifen resistance and reactivation may restore sensitivity to tamoxifen.
Methods: We have generated two tamoxifen resistant clones and in addition have studied a Tamoxifen resistant clone called MCF-7 TAMR/HER2 (HER2-transfected). tamoxifen resistant clones were generated by passaging wildtype MCF-7 (WT) cells through sphere cultures in the presence of tamoxifen. These clones are termed MCF-7 TAMR7 and MCF-7 TAMR26, representing 7 and 26 passages in sphere culture respectively. Cell line characteristics were assayed by immunohistochemistry (IHC) and RT-Q-PCR. Furthermore, MTT assays were used to test for E2 response in WT and TAMR cells.
Results: Tamoxifen resistance was acquired by utilizing the sphere assay in the presence of Tamoxifen. IHC results revealed a significant loss of ER receptor in TAMR7 and TAMR26 clones. RT-Q-PCR demonstrated 85% loss of ER receptor mRNA in the TAMR7 and TAMR26 compared to WT cells. There was no difference in ER expression in WT and TAMR/HER2 cells. KI67 and CyclinD1 expression were lower in TAMR (TAMR7 and TAMR26) cells compared to WT and TAMR/HER2 cells. TAMR26 cells had lower proliferative response to E2 compared to WT cells. There was increased expression of CK5 in TAMR26 cells. FOXO1 was phosphorylated and located in the cytoplasm of the TAMR cells (TAMR7 and TAMR26) compared to WT and TAMR/HER2 cells.
Conclusions: This study demonstrates that one mechanism of Tamoxifen resistance may be through the loss of the Tamoxifen target, the estrogen receptor (ER). TAMR clones isolated from mammosphere cultures with long term Tamoxifen treatment acquire an ER negative phenotype. These cells demonstrate loss of function of FOXO1. In addition, TAMR cells with high HER2 and normal ER, also acquire Tamoxifen resistance, by mechanisms not clearly understood. Further studies are currently underway in our lab to explore these mechanisms.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A104.
Abstract A13: How do breast imaging centers communicate results: A national survey
Authors: Marcus Erin N. , Koru-Sengul Tulay 
Published: December 2010

Abstract
Background: Effective communication of mammogram results is important as a step toward reducing patient anxiety and diagnostic delay. Research suggests, however, that many women do not correctly understand their results. The purpose of this study is to describe current communication practices among a nationally representative sample of mammography centers.
Methods: A 35-question anonymous online survey was sent to members of the National Consortium of Breast Centers (NCBC), an association of more than 2000 physicians, nurses, administrators, radiology technicians, and others involved in breast care. Those involved in mammography were invited to participate. The survey was also distributed at the NCBC's annual meeting. It asked about centers’ verbal, written, and telephone communication with patients, whether they employ patient navigators and staff with fluency in languages other than English, and whether and how they contact patients who do not follow up. Descriptive statistics were calculated for all responses. Additional analysis to assess the association of demographic variables with responses is ongoing.
Results: 221 centers completed the questionnaire. 34% were affiliated with a private radiology practice, 26% were academically affiliated, and 16% were free-standing centers. Nearly half of the centers indicated that more than a quarter of their patients lacked insurance and/or relied on government programs such as Medicaid. Ten percent of the centers indicated that more than a quarter of their patients lacked English proficiency.
Ten percent of the respondents indicated that they rarely inform patients of their results at the time of their mammogram; 17% indicated that they inform patients all or most of the time; 35% indicated that the result letters they send are English only; and 12% indicated that they do not have multilingual staff or translators available to answer questions. 22% of the centers indicated that they use patient navigators. 16% of respondents indicated that they do not routinely telephone any patients about results. Chi-square analysis to detect associations between variables is ongoing.
Conclusions and Implications: Our sample included a diverse cross-section of mammogram centers, many of which serve low-income patients. More than one in three centers indicated that they do not send result letters in languages other than English, which is concerning given the increasing number of patients with limited English proficiency in the U.S. and past research indicating many women do not understand their result. One in five centers use patient navigators, however, which may help ensure appropriate follow up among patients who lack easy access to healthcare. Informing patients of their results at the time of their test may also be a step more centers could take to enhance patient understanding and reduce anxiety.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A13.
Abstract A14: Qualitative study of African American smokers regarding lung cancer
Authors: Lathan Christopher , Browning Emily , Gagne Joshua 
Published: December 2010

Abstract
Background: The differences in mortality and incidence for lung cancer in African Americans are well-documented; however, the underlying reasons for these disparities are not well-delineated. The role that patient preferences and knowledge play in exploring these patterns among African American patients is unclear. This qualitative study was designed to explore potential themes involving treatment, and assess the level of general knowledge about lung cancer in African Americans.
Methods: 32 African American smokers with ages ranging from 26 to 70 years of age, (mean, 47.5 years), who did not have a cancer diagnosis were recruited to a series of focus groups held in a Boston housing complex. Four focus groups were held over an 8-week period. The groups were evenly divided between men and women. Focus groups were facilitated by a trained qualitative researcher and the sessions were audio taped. The data was transcribed and analyzed using standard anthropology coding and thematic formulation processes.
Results: Participants understood the link between smoking and lung cancer, as well as the common signs and symptoms of the disease. Regarding prevention, participants wanted the information to be in-depth, and tailored to their situation. They were familiar with the lethality of lung cancer, and had a good working knowledge of the treatment modalities. The impact of patient preferences and mistrust on treatment choice was minimal. When asked specifically about the role of race in getting appropriate treatment for lung cancer; most participants felt that insurance and socioeconomic factors were more important than race.
Conclusions: This study suggests that African American smokers are informed about the link between smoking and lung cancer, and have a good working knowledge of the disease. Participants did not feel that their race prevented them from accessing high-quality cancer care, but were concerned about the effect of socioeconomic status and insurance on this process. Our study suggests that African Americans are interested in access to quality cancer treatment and information, and that patient preferences and mistrust of clinicians may not be major factors in lung cancer treatment disparities.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A14.
Abstract A22: New instrument to measure functional breast cancer literacy
Authors: Williams Karen Patricia , Templin Thomas N. 
Published: December 2010

Abstract
A critical undertaking in designing research interventions that study effective ways to reduce health disparities among racial/ethnic and underserved women is to have instruments that are linguistically and culturally appropriate. Traditionally, when instruments are developed, even those that are used in health disparities, they have been normed using Caucasians and then used with other populations.
We were funded by the National Institutes of Health, National Institute of Nursing Research to use traditional rigors of psychometric methods in the context of a community-based participatory research intervention to validate cancer literacy assessment tools (CLAT) that measure a woman's functional understanding of breast and cervical cancer in English, Spanish, and Arabic.
With a sample size of 543 women, the reliability, factor structure, validity of the Breast Cancer Literacy Assessment Tool (BCLAT) was determined by exploratory and confirmatory factor analysis. We examined differential item functioning (DIF) with nonparametric IRT Multiple regression was used to identify variables predictive of performance on the BCLAT.
Results: A confirmatory factor analysis (CFA), using a 2-parameter IRT model, had a good fit (CFI = .81, RMSEA = .05) to the proposed three factor structure. Maximum likelihood exploratory factor analysis of tetrachoric correlations and examination of scree plots also indicated a 3-factor solution. No items were eliminated as a result of the DIF analysis. The three scales, Awareness, Screening, and Prevention/Control, were moderately difficult with 63%, 62%, and 68% correct, respectively, with internal consistency reliability of .53, .62, and .63, respectively. The scales were only weakly inter-correlated (r's &lt; .40). The total scale reliability was .70. Income, education and self-rated health were positively associated with Awareness but not related to Screening or Prevention/Control. Age was positively associated with Prevention/Control. Seventy seven participants were in a family with a history of breast cancer. This was associated with higher scores on Screening and Prevention/Control. Having friends with a history of breast cancer was unrelated to any of the BCLAT scales. The BCLAT scales have demonstrated internal consistency reliability and validity in this multiethnic community based sample.
Even when implementing the Kin KeeperSM Cancer Prevention Intervention to deliver cancer education to Black, Latina and Arab women as the context in which we validated our cancer literacy assessment tools, we were still able to adhere to the rigorous of psychometric testing.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A22.
Abstract A25: Reaching diverse populations about cancer clinical trials: Lessons learned from ENACCT's pilot education program
Authors: Michaels Margo , Blakeney Natasha , Britton Abbey , Swords Liz , Bitow Naomi , Gibbs Brian , Yeun Samantha , Rytkonen Bruce , Goodman Robert , Greene Amanda , Jarama Lisbeth 
Published: December 2010

Abstract
Adult participation in cancer clinical trials (CCTs) nationally remains less than 5%, with even fewer participants among communities of color. Barriers to participation are experienced by patients, providers, as well as research staff. Efforts to improve diverse populations’ interest and participation in cancer clinical trials requires a multipronged approach targeting key stakeholders.
The Education Network to Advance Cancer Clinical Trials (ENACCT) is the only national organization solely devoted to evidence-based, community-centered approaches to CCTs education. In 2006, ENACCT launched the Pilot Education Program (PEP), a 3-year initiative which sought to improve CCT awareness, access, and accrual, particularly among medically underserved populations. Three diverse PEP community sites (Boston MA, Tacoma WA, and Decatur, IL) participated in training of community leaders (CLs) and health care providers (HCPs), using an action-oriented train the trainer curriculum that addressed cancer health disparities, past research abuses, and current patient protections, as well as the significance of diverse CCTs participation as a social justice issue. Multiple training modules, as well as educational “palm cards” were translated to Spanish and Korean. Workshops for CCT staff focused on strategies to improve recruitment and retention practices to reach medically underserved populations, highlighting the role of Culturally and Linguistically Appropriate Services (CLAS) standards in the clinical research setting.
PEP reached 461 HCPs (62% nurses), 926 CLs (66% minority) and 61 CCT staff (13% minority) in educational workshops. Four thousand individuals were reached through community presentations and over 49,000 educational palm cards were distributed. Post training, over 60% of CLs trained said they shared messages about CCTs with at least one other person. HCP trainees had more favorable attitudes and beliefs regarding CCTs and HCPs’ role in CCT referral from pre-to post-workshop assessment. Additionally, at first assessment post-training, 81 % of CLs, 95% of HCPs and 94% of CCT staff agreed that equal access to CCTs is a matter of social justice. Nearly 100 unique patient profiles were created via a national CCTs matching service. ENACCT's training overall positively improved recognition of CCTs access and participation as a social justice issue among stakeholders. Successful community based interventions on CCTs must meet the needs of diverse populations by (1) tailoring key education messages to be culturally relevant and (2) building synergistic relationships among stakeholders to reduce barriers to trial access.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A25.
Abstract A28: Reaching vulnerable populations: A process-oriented approach to breast screening
Authors: Baker-Calloway Jena , Albrecht Terrance L. , Berry-Bobovski Lisa , Stengle William , Brittain Kelly , Francis Carie 
Published: December 2010

Abstract
This community-based project evolved out of relationships established through the Detroit CNP for Older, Underserved African-Americans (NIH# U01-CA114583-04) to address the unmet needs of the clientele of three partnering community agencies. The need for breast cancer screening among older women from lower socioeconomic groups, the mentally ill, and the disabled has been well-documented. However, mammography among these special populations is low. This project brought together five organizations (three community service agencies, the NCI's Cancer Information Service Partnership Program, and the Karmanos Cancer Institute's Community Network Program) to provide breast health awareness, mammography screening, and navigation to underserved African American women. The five agencies collaborated to address the needs of the homebound, developmentally disabled, homeless, nursing home residents, grandparents raising grandchildren, and others. All groups were identified through a community assessment to identify significant barriers to accessing preventive health care services.
Through community-based participatory research (CBPR), the members of the partner organizations worked with community health education professionals to define: 1) community-level needs; 2) assess how best to integrate screening messages and health service navigation into existing service provision; and 3) identify ways to obtain external funding for program implementation. The CBPR process yielded an intervention that consisted of staff training, improved screening needs assessment and procedures for case management referral and follow-up that increased agency capacity to address breast health disparities.
A total of 490 women participated in this “high-touch” breast health education and screening intervention. Of those, 170 women received screening mammography and six women were diagnosed and received subsequent treatment and follow-up. The project was recently recognized by the Michigan Cancer Consortium, receiving their highest recognition, the Spirit of Collaboration Award.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A28.
Abstract A4: Do social class gradients predict breast cancer burden differently for black and white women?
Authors: Klassen Ann C. , Curriero Frank , Ward Abigail 
Published: December 2010

Abstract
This research utilizes 50,000 cases of breast cancer diagnosed during 1992-2003 reported to the Maryland Cancer Registry, and linked by residential address to U.S. Census block group data. The goal of the research is to model social class patterns in breast cancer burden for white and black women, and examine the ways in which social class influences differ across racial groups.
After geocoding cases to their Census blockgroup, we used factor analysis to create two indices capturing distinct aspects of area-level social resources. A composite index for social class captured area-level educational attainment, overall employment rates, portion of white collar employment, and income. The material resources index combined the portion of households with cars, telephones, living above poverty, and owning their own home. These indices were used to predict four aspects of case disease characteristics related to adverse outcome: tumor size, histologic grade, histologic type, and stage of disease at diagnosis. Multilevel random and fixed effects models estimated social resource effects across the State of Maryland's 3600 blockgroups. Race-specific models were used to examine whether social gradients in disease burden differed between black and white women.
Results indicate that the two indices effectively capture social gradients in breast cancer burden for both ethnic groups, but that there are important differences. For white women, social class is a stronger predictor for tumor grade, size and type but both social class and material resources are predictive of stage at diagnosis. For black women, material resources are a stronger predictor for grade and tumor size, and social class is a stronger predictor for stage at diagnosis and tumor type. We found significant or borderline significant effects of race on the effect of both indices on all tumor characteristic outcomes. In almost all models, the direction of the interaction suggests that the protective effect of social resources on the outcome of interest is stronger for white women, than for black women. Additional analyses further examine the impact of neighborhood racial composition on social class influences.
We conclude that investigating race-specific patterns of social class influences is one important strategy for understanding how social class patterns influence breast cancer disparities, as well as identifying possible avenues for intervention.
Citation Information: Cancer Epidemiol Biomarkers Prev 2010;19(10 Suppl):A4.