bluuebunny/crossref_metadata_2025_split huggingface dataset:
Addressing the Barrier of Physical Access to Oncology Care in Sub-Saharan Africa (SSA) Through Establishment of Short-Stay Homes for Cancer Patients: A Case of International Cancer Institute, Child and Family Wellness Center in Eldoret, Kenya
Authors: Kitur Gloria , Mbandar Florence , Muyodi David , Asirwa Chite 
Published: May 2022

PURPOSE Geographical distance to access services and lack of decentralized diagnostic and treatment facilities have been identified as barriers to positive treatment outcomes among cancer patients in Sub-Saharan Africa who have to undergo financial and logistical challenges. Potential approaches to reducing this barrier include providing transport/travel allowance to patients from far flung regions, decentralizing cancer care services or providing patient housing close to cancer treatment facilities. METHODS The International Cancer Institute Child and Family Wellness Center was established in June 2020 as a half-way home for patients undergoing treatment at the ICI Cancer Care and Research Clinic (ICI_CRC). The center aims to provide safe accommodation for patients having challenges to travel to and from their homes for diagnostic work-up and treatment. RESULTS Between June 2020 and October 2021, a total of 101 admissions were made to the ICI Child and Family Wellness Center, of these 76% were female while 24% were male patients. A majority of the patients were first time admissions while 22% of them were admitted more than once; 69% of them were accompanied by a caregiver. The longest duration of stay was 18 days while the shortest was 1 day depending on the reason for admission; the most common being treatment sessions ending late in the day or treatment sessions taking more than one day. The patients admitted were drawn from 15 different counties in Kenya. CONCLUSION Physical inaccessibility to cancer care services in SSA greatly affects patient compliance with treatment and follow-up. Patients who live far from specialist care hospitals are more likely to have an advanced disease at diagnosis, inappropriate treatment, a worse prognosis and poorer quality of life compared to those living closer to hospitals. In addition to decentralization of cancer care, provision of accommodation for cancer patients close to hospitals can greatly improve compliance to treatment resulting in positive treatment outcomes.
Effective Innovative Models of Health Care Delivery in the Era of the COVID-19 Pandemic to Reduce Disparities in Cancer Care and for Cancer Control in Low-Middle Income Countries—South African Experience of the Cancer ECHO Model
Authors: Osei-Fofie Daniel 
Published: May 2022

PURPOSE The Northern Cape province is the largest province in South Africa. However, it has the least resources for cancer care. Patients have to travel very long distances to access cancer care. Cancers are diagnosed in late stages due to lack of resources including trained health care personnel. There was the need for an innovative model for training health care personnel, mentorship and empowerment to enable provision of cancer care in the rural areas of the province. METHODS In 2017, the Northern Cape Health Department had a collaboration with the Project ECHO Institute, University of New Mexico. An Immersion training in ECHO was provided in Albuquerque under the sponsorship of Bristol Myers Squibb Foundation and the Project ECHO Institute. An ECHO Hub was established at the tertiary cancer center with spoke sites in two district hospitals. The first cancer ECHO in Africa was launched at Kimberley Hospital in July 2018 to provide training and mentorship in Lung cancer and Mesothelioma care. In 2020, during the COVID-19 pandemic, the ECHO clinics were used on a more regular basis for patients' management. RESULTS Doctors, nurses and community healthcare workers have been trained using the ECHO model to provide cancer care in all the district hospitals. The ECHO clinics have now been expanded to cover other cancers. Palliative care ECHO has also been launched to improve provision of palliative care services. There has been retention of staff in the rural areas to provide cancer care due to mentorship and empowerment using the ECHO model. CONCLUSION ECHO is an effective innovative model to democratize knowledge and help reduce disparities and inequities in cancer care and for cancer control in low-middle income countries. In the era of the COVID-19 pandemic, ECHO clinics can assist with effective patient care.
How Did the Covid-19 Pandemic Impact Cancer Prevention and Treatment? Examining Nationally Representative Survey Data
Authors: Semprini Jason 
Published: May 2022

PURPOSE In March 2020, policymakers, healthcare providers, and public health professionals shifted their resources toward covid-19 prevention and mitigation. This reallocation came at the expense of other essential healthcare services, including cancer prevention and treatment. Delaying cancer services will increase the burden and cost of cancer treatment in the coming years, but the extent of these delays is unknown. As the country continues to move forward, a better understanding of how cancer services were impacted will help policymakers prioritize strategies to mitigate the adverse effects of delayed cancer prevention and treatment. METHODS This study is among the first to use the newly released 2020 Behavioral Risk Factor Surveillance System (BRFSS) questionnaire. BRFSS is a phone-based survey and is representative of the U.S population. The BRFSS questionnaire asks about cancer screening, vaccination, and treatment services within the past year. I compared the total weighted responses in Q1, 2020 with the total weighted responses in Q4, 2020. With the latter group being exposed to six months of the covid-19 pandemic, these results serve as a baseline or “floor” estimate of how much cancer prevention and detection service patterns changed in the United States. RESULTS Mammographies declined 4.7% (Q1 = 21,407,433 v Q4 = 20,403,265), pap smears declined 1.3% (Q1 = 19,464,724 v Q4 = 19,211,238), colorectal cancer screenings declined 9.9% (Q1 = 8,534,587 v Q4 = 7,693,484). While there was no estimated change in adults diagnosed with cancer, the number of adults currently receiving cancer treatment declined by 5.3% (Q1 = 485,425 v Q4 = 459,620). CONCLUSION The covid-19 pandemic forced Americans to delay critical cancer prevention and treatment services. Fewer breast cancer, cervical, colorectal cancer screenings in 2020 will undoubtedly lead to more cancer diagnoses in the coming years, likely at more advanced and aggressive stages. Meanwhile cancer patients seemed to have delayed cancer treatment, but such delays cannot be sustained. Policymakers can mitigate the potential strain on cancer control systems by advancing cancer screening initiatives.
Immortalized B Cells Transfected With mRNA of Antigen Fused to MITD (IBMAM): An Effective Immunological Tool for In-Vitro Immune-Monitoring of Antigen-specific T Cells
Authors: Zhang Tiantian , Wang Zhe , Cha Soung-Chul , Liu Jingwei , Dong Zhenyuan , Szymura Szymon , Anderson Aaron , Kuang Benjamin , Neelapu Sattva , Kwak Larry 
Published: May 2022

PURPOSE To overcome technical limitations of detecting low frequencies of antigen-specific-T cells in human patients, we sought to establish a highly sensitive platform for antigen-specific-T cell detection and activation using IBMAM (immortalized B cells transfected with mRNA of antigen fused to MHC-class-I-trafficking-domain [MITD]). METHODS We first established immortalized B cells in-vitro as antigen-presenting cells. B cells were isolated from CMV-seropositive normal healthy donors (NHDs), stimulated, and transduced with retrovirus containing BCL-6 and BCL-XL. Purified CD4+ T lymphocytes obtained from the NHDs PBMC were co-cultured in-vitro with autologous immortalized B cells transfected with CMVpp65 mRNA fused to MITD (IBMAM) as a model antigen and then measured for activation using IFN-g ELISA. We developed two pathways for IBMAM mediated antigen-specific T cell activation and detection. For the first pathway, if IFN-g is detected, T cells are isolated again from NHDs PBMC and expanded using rapid expansion procedures (REP). After the first REP, antigen-specific T cells are detected using IBMAM, sorted, and a second REP is performed. However, for the second pathway, if IFN-g is not detected, NHDs PBMC is stimulated twice using IBMAM and subsequently antigen-specific T cells are detected using IBMAM again. RESULTS B cells were successfully immortalized by transfecting at least 5*105 cells with retrovirus (1MOI) and co-cultured with CD40L-IL21 expressing human fibroblasts. We observed a significantly increased activation of antigen-specific CD4+ T cells when using IBMAM in comparison to controls transfected with CMVpp65 mRNA lacking the MITD fusion or a known CMVpp65 peptide pool. For pathway 1 and 2 of our platform, successful detection, activation, and expansion of CMVpp65-specific T cells were observed from low frequency NHDs samples using IBMAM. CONCLUSION We have thus established a highly sensitive method of immuno-monitoring that can be used for the detection of antigen-specific T cells in patient samples with low frequencies of antigen-specific-T cells, such as human cancer antigens.
Formative Research to Design SMS Messages to Increase Breast Cancer Screening Uptake in Argentina
Authors: Antelo Victoria Sanchez , Paolino Melisa , Frejdkes Paula , Correa Silvina , Furia Anabel , Lopez de Degani Graciela , Arrossi Silvina 
Published: May 2022

PURPOSE There is a need for interventions to promote breast cancer screening among high-risk population. This formative research is part of a pragmatic randomized trial being conducted in Santa Fe, Argentina, in which we are evaluating whether SMS messages sent to women aged 50-69 increases breast cancer screening uptake. Here, we describe the formative results used to design the content of the SMS messages to be tested in the trial. METHODS We conducted four on-line focus groups with women aged 50+ (n = 14). Participatory techniques were used to debate the advantages and disadvantages of different options for the five structural elements -i.e., greeting, recipient, sender, message's topic, and closing line-of the SMS message. We openly coded the discussions for agreements and preferences regarding the SMS message content. RESULTS SMS messages as reminders to increase breast cancer screening were highly accepted. Women argued that the greeting line should provide clear information about the topic of the SMS message (eg, Health information). SMS messages should also include the woman's name, because this inclusion would be an indicator that it was a personal SMS message. Most women considered that the sender of the SMS messages should be a health institution as this would legitimize the content. Regarding the topic of the message, women preferred an imperative tone and they mentioned that the SMS message should include information about how to get a mammogram (eg, “Women aged 50-69 should have a mammogram done every two years. Do you have an appointment? WhatsApp to xxxxx”). The closing line should encourage women to get a mammogram (eg, “Ask for your appointment now! It is important!”). CONCLUSION Our findings have some implications for the design of mHealth interventions targeted at improving breast cancer screening. A personalized SMS could be a good way of inviting women, although its content must be carefully designed to provide clear information about how to get a mammogram.
Modulation of Metastasis and Stemness-Associated Genes by Heme Oxygenase 1 (HO-1) in Prostate Cancer
Authors: Sabater Agustina , Toro Ayelen , Sanchis Pablo , Pascual Gaston , Seniuk Rocio , Vazquez Elba , Cotignola Javier , Gueron Geraldine , Bizzotto Juan , Lage-Vickers Sofia 
Published: May 2022

PURPOSE Prostate cancer stem cells enhance the tumor's capacity to proliferate, metastasize, and to resist therapies. Thus, stemness represents a therapeutic challenge in prostate cancer (PCa). We have previously reported a strong anti-tumoral effect of heme oxygenase 1 (HO-1) in prostate carcinogenesis in vivo and in vitro. However, its association with metastasis-stemness is still poorly elucidated. Thus, we aimed at describing the effects of HO-1 overexpression on metastasis/stemness processes in PCa, by also identifying key HO-1-modulated genes. METHODS We performed clonogenic assays to evaluate the effect of HO-1 pharmacological induction on the stem properties of PC3-cells. We carried out an RNA-seq analysis to assess the transcriptional differences of 144 metastasis/stemness/STAT3-signature genes after HO-1 induction. The clinical significance of HO-1-modulated genes was assessed by comprehensive bioinformatics analyses using public data repositories with gene expression and survival data of PCa patients (Oncomine, n = 1,128; TCGA-PRAD, n = 565). RNA-seq results were validated by RT-qPCR. RESULTS Clonogenic assays results showed a significant reduction in colony formation efficiency after HO-1 pharmacological induction with hemin ( P ≤ .01). Transcriptomics profiling by RNA-seq evidenced a significant modulation of 32 key markers related to metastasis/stemness/STAT3-signature under HO-1 induction. Further, 15 HO-1-modulated genes were differentially expressed in PCa vs. normal prostate gland (Oncomine) and HO-1 induction reverted the expression profile observed for these genes. We next used the TCGA-PRAD dataset which revealed that ADAM15, BCL2L1, LTBR, MBNL2 and SPINT1 had the same expression profile as in Oncomine. Additionally, PCa patients with high MBNL2 expression showed a longer disease progression-free survival, which is interesting as it is upregulated in PC3-cells overexpressing HO-1, as validated by RT-qPCR. CONCLUSION Here, we propose a potential mechanism by which HO-1 could inhibit metastasis/stemness by modulating relevant genes in PCa progression. This study may cast a new light on PCa treatment, highlighting HO-1 modulation of cell plasticity, supporting it as a potential therapeutic target for the disease.
Breast Cancer Among Indigenous and Non-Indigenous Women at the Mexican Teachers' Cohort
Authors: Gómez-Flores-Ramos Liliana , Cortés-Valencia Adrian , Stern Dalia , Brochier Marion , Sánchez-Blas Hugo Rodrigo , Erazo-Valle-Solís Aura , Chávez-Cárdenas Mildred Yazmin , Miranda Pabel , Lajous Martín 
Published: May 2022

PURPOSE Hispanics and Indigenous women are underrepresented in cancer research. We aimed to estimate the incidence of breast cancer (BC) among indigenous and non-indigenous women and describe reproductive and lifestyle risk factors. METHODS The baseline questionnaire was completed by 115,307 women (2006-2008). Indigenous ancestry was defined by self-adscription and/or speaking an indigenous language. Incident BC-cases were confirmed using self-reports, administrative and clinical databases, cancer registries, and death certificates. We calculated person-years from the baseline questionnaire to the date of diagnosis, death, or the end of follow-up (December 31, 2019). We age-standardized reproductive and lifestyle information. RESULTS After a median follow-up of 10.8 years, we confirmed 1,212 BC-cases. The crude incidence rate per 100,000 person-years was 55 for indigenous and 95 for non-indigenous women; the mean age at diagnosis was 48.2 and 50.8, respectively. In indigenous BC-cases, early menarche (11.9 v 26.7%), first pregnancy > 25 years (36.8% v 51.7%), and nulliparity (11.7% v 14.1%) were less frequent compared to non-indigenous. The number of children (3.0 v 2.6) and breastfeeding > 12 months (71.6% v 45.2%) were higher among indigenous. Indigenous had earlier menopause (44.8 v 47.5 years) and more premenopausal-BC (27.8% v 25.1%). Oral contraceptives use (42.6% v 48.0%), hormone-replacement therapy (12.4% v 24.6%), family history of BC (11.9% v 15.1%) and benign breast-disease (17.8% v 23.0%) were less frequent in indigenous cases. Physical activity (> 150 min/week) was higher in indigenous women (34.3% v 27.8%). Smoking (6.6% v 11.2%) and alcohol consumption (47.9% v 61.3%) were lower in indigenous women; however, they had more diabetes (14.6% v 6.0%) and were at the highest tertile of the dietary glycemic index (40.2% v 35.0%). CONCLUSION In the MTC, BC-incidence in indigenous women is lower than in non-indigenous; this might be explained by a lower prevalence of hormonal and reproductive risk factors and higher physical activity among indigenous women.
Dental Health Utilization in the Republic of Palau: A Survey to Determine Feasibility of an Oral Cancer Screening Program
Authors: Rieth Katherine , Dye Timothy , Ikerdu Edolem , McIntosh Scott , Sy Angela 
Published: May 2022

PURPOSE Oral cancer is the 5th most common cancer in Palau. Betel nut use is a highly prevalent cultural tradition in Palau and also a carcinogen, whose effect may be synergistic with the addition of smokeless tobacco in betel quid in the development of oral cancer. Prognosis can be improved with early detection. The purpose of this study is to assess the feasibility of an oral cancer screening program using existing dental health infrastructure with mixed methods assessment of utilization of dental health resources by adults in Palau. METHODS An Internet-based survey was used. Both quantitative and qualitative assessments of dental health care utilization were explored. Quantitative analyses of survey responses were done using descriptive and analytical statistical functions. Open-ended survey questions were coded and analyzed for emergent themes to develop recommendations for the proposed intervention. RESULTS The survey was available (Facebook Ads) for 9 days. There were 223 completed surveys, age range was 18-75 (mean = 42.7 years), 177 (80.1%) identified as female, 60.4% reside on Koror, and 60.4% have some university/college level education. Dental care was seen to be important (mean score 82.27). Most felt there were no major barriers to seeing a dentist (n = 164, 72.5%). Themes pertaining to barriers to access focused on lack of availability of appointments and cost. Themes pertaining to facilitators included multilevel resources and services provided by dental clinics. CONCLUSION Dental care is important to Palauans, and most would prefer to have this occur in a clinic setting. The themes generated suggest that while there are important facilitators that are in place to promote seeking and obtaining dental care, the existing infrastructure and access to dental care currently do not support an oral cancer screening program. However, these data do provide important areas to address the delays associated with dental care that can improve access and support the implementation of oral cancer screening in the future.
A Prebiotic Hydrogel to Prevent Cervical Cancer by Optimizing the Vaginal Ecology and Reducing Oncogenic Biological Risk Factors in Women Across Global Health Care Access
Authors: Ellington Joanna , Clifton G. Dennis , Ellington-Lawrence Rayne D. , De la Fuente Vega Zamora , Fichorova Raina 
Published: May 2022

PURPOSE Persistent oncogenic, high-risk human papillomavirus (hrHPV) is a leading cause of cervical cancer and driven by vaginal dysbiosis and mucosal irritation. There is a high need for a product to optimize vaginal ecology and decrease biological risk factors of hrHPV persistence and cervical cancer. METHODS A prebiotic hydrogel (PreBioGyn) was designed for cervical cancer prevention to support the cervicovaginal ecology and anti-viral function. PreBioGyn was compared to over-the-counter (OTC) acidifying vaginal gels RepHresh and Trimosan for impact on: (1) in-vitro growth of L. crispatus—a Lactobacillus essential for the healthy vaginal biome; (2) inhibition of P. bivia—a pathobiont characteristic of vaginal dysbiosis and directly linked to hrHPV reactivation and cervical cancer spread; (3) mucosal irritation potential measured as daily mucus production by slugs (Arion lusitanicus) after 5-day intermittent product exposure; and (4) osmolality and mucoadhesion essential for compatibility with the cervicovaginal mucosal barrier (ability of gel to interdigitate with mucins in vivo). RESULTS Exposure to PreBioGyn for 24 hours completely suppressed P. bivia while sustaining L. crispatus growth which was recovered at 100 ± 1%. Trimosan was bactericidal to L. crispatus within 4 hours incubation and RepHresh within 24 hours of incubation. The mucosal irritation potential of PreBioGyn equaled negative controls, whereas the OTC acidifying-gels resulted in greater irritation potential with > 2-fold mucus production versus the control ( P < .05). The PreBioGyn formula was iso-osmotic to the human vagina (280 mOsmo/kg), while RepHresh was hyper- (1,400 mOsmo/kg) and Trimosan - hypoosmotic (81 mOsmo/kg). The mucoadhesion index of PreBioGyn (10 ± 2.0) was higher ( P < .05) than that of RepHresh (1 ± 0.2) and Trimosan (1 ± 0.3). CONCLUSION Our results provide preclinical evidence for the biocompatibility and safety of the Pre-BioGyn gel. The prebiotic PreBioGyn vaginal gel improved microbiota parameters essential for cervical cancer prevention, compared to leading OTC acidifying-gels. PreBioGyn may offer a simple, affordable user-directed cervical cancer prevention intervention.
Findings of a Nationwide Mixed-Methods Assessment of Cancer Care and Prevention Needs in Botswana
Authors: Sharma Kirthana , Lebelonyane Refeletswe , Ralefela Tlotlo , Vuylsteke Peter , Antony Reena , Legwaila Morongwa , Leselwa Tapologo , Masupe Tiny , Gaolathe Tendani , Marlink Richard 
Published: May 2022

PURPOSE High-level investment in cancer prevention and control in low- and middle-income countries is urgently needed to address the predicted surge in cancer incidence, yet few assessments of health systems have systematically identified gaps in infrastructure, training, and patient care in sub-Saharan Africa. In Botswana, we evaluated the current state of cancer care and prevention, to understand the strengths, weaknesses, and needs regarding the provision of comprehensive cancer services. METHODS The study evaluated four regional hospitals designated as cancer sites by the Botswana Ministry of Health and Wellness to decentralize cancer services. A multi-site, cross-sectional evaluation using qualitative and quantitative methods was conducted. Focus Group Discussions with cancer patients, cancer survivors, caregivers, the general population, and healthcare workers were analyzed for emergent themes. Quantitative surveys assessed knowledge, attitudes and practices of health workers and hospital management staff, and cancer service gaps at health facilities. RESULTS Knowledge gaps included low awareness of cancer signs and symptoms among the general population, poor knowledge of early detection and treatment among health workers, and caregivers lacked skills to support cancer patients. Cancer screening services, other than cervical screening, were limited in all sites. Diagnosis and treatment barriers included lack of specialized personnel, equipment, timely pathology services, and drug stockouts. There were low levels of confidence in cancer management, including chemotherapy, without support from oncologists. Providers reported low patient screening uptake due lack of access and patients reported fear of diagnosis. Health facilities did not routinely notify cancers to the national registry. Radiotherapy was limited to one private hospital in the capital. CONCLUSION Decentralization of cancer services to regions will require substantial capacity building at district hospitals to strengthen fragmented screening, early diagnosis and treatment services. Health provider training needs and infrastructure gaps were substantial, with low public awareness of cancer signs, symptoms and causes.