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Mahbub T, Obeid A, Javed S, Dias J, Hassan T, Werghi N. Center-Focused Affinity Loss for Class Imbalance Histology Image Classification. IEEE J Biomed Health Inform 2024; 28:952-963. [PMID: 37999960 DOI: 10.1109/jbhi.2023.3336372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2023]
Abstract
Early-stage cancer diagnosis potentially improves the chances of survival for many cancer patients worldwide. Manual examination of Whole Slide Images (WSIs) is a time-consuming task for analyzing tumor-microenvironment. To overcome this limitation, the conjunction of deep learning with computational pathology has been proposed to assist pathologists in efficiently prognosing the cancerous spread. Nevertheless, the existing deep learning methods are ill-equipped to handle fine-grained histopathology datasets. This is because these models are constrained via conventional softmax loss function, which cannot expose them to learn distinct representational embeddings of the similarly textured WSIs containing an imbalanced data distribution. To address this problem, we propose a novel center-focused affinity loss (CFAL) function that exhibits 1) constructing uniformly distributed class prototypes in the feature space, 2) penalizing difficult samples, 3) minimizing intra-class variations, and 4) placing greater emphasis on learning minority class features. We evaluated the performance of the proposed CFAL loss function on two publicly available breast and colon cancer datasets having varying levels of imbalanced classes. The proposed CFAL function shows better discrimination abilities as compared to the popular loss functions such as ArcFace, CosFace, and Focal loss. Moreover, it outperforms several SOTA methods for histology image classification across both datasets.
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Afandy AN, Tori MB, Bintalib SO, Soh BLP. Threshold in breast compression reduction for full-field digital mammography and digital breast tomosynthesis. Radiography (Lond) 2024; 30:217-225. [PMID: 38035436 DOI: 10.1016/j.radi.2023.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Revised: 11/02/2023] [Accepted: 11/08/2023] [Indexed: 12/02/2023]
Abstract
INTRODUCTION Breast compression is essential in mammography to improve image quality and reduce radiation dose. However, it can cause discomfort or even pain in women which could discourage them from attending future mammography examinations. Therefore, this study aims to explore the maximum reduction in breast compression in full-field digital mammography (FFDM) and digital breast tomosynthesis (DBT) that is achievable without impacting on image quality and dose. METHODS Ten compression force (CF) levels (20N-110N, with 10N intervals) were assessed on Siemens MAMMOMAT Inspiration with Nuclear Associates 18-228 phantom. Imaging was carried out in craniocaudal projection using Automatic Exposure Control at 28 kVp with a Tungsten/Rhodium anode/filter combination, and at 50° sweep angle for DBT. Using ImageJ software, image quality of the acquired mammograms and central tomosynthesis slices were examined based on mass conspicuity (MC) and microcalcification conspicuity (MicroC). Entrance skin dose (ESD) and mean glandular dose (MGD) were recorded from Digital Imaging and Communication in Medicine image header. Linear regression was performed to examine the relationship between CF with ESD, MGD, MC and MicroC. Differences in image quality and radiation dose were assessed with one-way analysis of variance and Kruskal-Wallis H test. RESULTS Significant correlations were noted between CF with ESD and MicroC for FFDM and DBT, with DBT also demonstrating associations with MGD and MC. No significant differences were observed for ESD, MGD, MC and MicroC when CF was reduced to 40N and 80N in FFDM and DBT respectively. CONCLUSION This study demonstrated that CF can be reduced as low as 40N and 80N in FFDM and DBT respectively, without significant impact on image quality and radiation dose. IMPLICATIONS FOR PRACTICE Reduced mammographic compression may reduce discomfort or pain in women, which may improve attendance rate in breast screening programmes. Findings from this study will provide reference for future work examining breast compression in mammography.
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Affiliation(s)
- A N Afandy
- Department of Radiology, Ng Teng Fong General Hospital, Singapore.
| | - M B Tori
- Department of Diagnostic Radiology, Tan Tock Seng Hospital, Singapore
| | - S O Bintalib
- Division of Oncologic Imaging, National Cancer Centre Singapore, Singapore
| | - B L P Soh
- Health and Social Sciences, Singapore Institute of Technology, Singapore
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Yalav O, Sonmezler O, Erdogan KE, Rencuzogullari A, Doran F, Bisgin A, Boga I. Pre-operative Neo-adjuvant Chemotherapy Related miRNAs as Key Regulators and Therapeutic Targets in Colorectal Cancer. Curr Aging Sci 2024; 17:49-57. [PMID: 37723961 DOI: 10.2174/1874609816666230816152744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2022] [Revised: 07/10/2023] [Accepted: 07/24/2023] [Indexed: 09/20/2023]
Abstract
BACKGROUND In colorectal cancer, the investigation of cancer pathogenesis and the determination of the relevant gene and gene pathways is particularly important to provide a basis for treatment-oriented studies. miRNAs which affect gene regulation in the molecular pathogenesis of cancer, have an active role in carcinogenesis. In the literature, miRNA expression levels have been associated with metastasis and prognosis in different cancers. OBJECTIVE In our study, expression profiling of miRNAs involved in oncogenic and apoptotic pathways in patients with locally advanced colorectal cancer receiving neoadjuvant therapy was performed. METHODS miRNAs were isolated from three different FFPE tissue samples taken at different times of the same patient (tumor tissue taken at the time of diagnosis, normal tissue samples, and after neoadjuvant therapy). The expression analysis of 84 miRNAs determined by PCR array (Fluidigm, USA) and mediated meta-analysis was performed comparatively to each study and non-cancerous control group. Evaluations were performed with ΔΔCT calculations. RESULTS As a result of the miRNA PCR array study, in addition to differences were observed in miRNA expression between control and study groups. The potential biomarkers which were hsamiR- 215-5p, hsa-miR-9-59, hsa-miR-193a-5p, hsa-miR-206, hsa-miR-1, hsa-miR-96-5p have been detected for possible treatment resistance, prognosis and predispositions to cancers. CONCLUSION In patients with colorectal cancer, miRNA expression in the tumoral regions before and after neoadjuvant therapy has represented a variable pattern. It has been shown that miRNA studies can be used to predict the clinical course and response to treatment with differences in expression levels. It has been concluded that specific miRNAs may be candidate biomarkers for colorectal cancer..
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Affiliation(s)
- Orcun Yalav
- Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Ozge Sonmezler
- AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Cukurova University, Adana, Turkey
- Biotechnology Department, Cukurova University Institute of Natural and Applied Sciences, Adana, Turkey
| | - Kivilcim Eren Erdogan
- Department of Pathology, Faculty of Medicine, Cukurova University Institute of Natural and Applied Sciences, Adana, Turkey
| | - Ahmet Rencuzogullari
- Department of General Surgery, Faculty of Medicine, Cukurova University, Adana, Turkey
| | - Figen Doran
- Department of Pathology, Faculty of Medicine, Cukurova University Institute of Natural and Applied Sciences, Adana, Turkey
| | - Atil Bisgin
- Department of Medical Genetics, Faculty of Medicine, Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center) & Cukurova University, Adana, Turkey
| | - Ibrahim Boga
- AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center), Cukurova University, Adana, Turkey
- Department of Medical Genetics, Faculty of Medicine, Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center) & Cukurova University, Adana, Turkey
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Prasanth BK, Alkhowaiter S, Sawarkar G, Dharshini BD, R Baskaran A. Unlocking Early Cancer Detection: Exploring Biomarkers, Circulating DNA, and Innovative Technological Approaches. Cureus 2023; 15:e51090. [PMID: 38274938 PMCID: PMC10808885 DOI: 10.7759/cureus.51090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2023] [Indexed: 01/27/2024] Open
Abstract
Research and development improvements in early cancer diagnosis have had a significant positive impact on health. In the treatment and prevention of cancer, early detection is essential. In this context, biomarkers are essential because they offer important information on the state of cells at any particular time. Cells go through unique changes when they shift from a healthy condition to a malignant state, changes that appropriate biomarkers may pick up. Recent advancements have been made to identify and characterize circulating cancer-specific mutations in cell-free circulating DNA derived from tumors and tumor cells. A patient's delay between the time they first detect symptoms and the time they contact a doctor has been noted for many cancer forms. The tumor's location and features significantly impact the presentation of symptoms judged appropriate for early diagnosis. Lack of knowledge of the severity of the symptoms may be one cause for this delay. Our review is largely focused on the ongoing developments of early diagnosis in the study of biomarkers, circulating DNA for diagnosis, the biology of early challenges, early symptoms, liquid biopsies, detectable by imaging, established tumor markers, plasma DNA technologies, gender differences, and artificial intelligence (AI) in diagnosis. This review aims to determine and evaluate Indicators for detecting early cancer, assessing medical conditions, and evaluating potential risks. For Individuals with a heightened likelihood of developing cancer or who have already been diagnosed, early identification is crucial for enhancing prognosis and raising the likelihood of effective treatment.
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Affiliation(s)
- B Krishna Prasanth
- Department of Community Medicine, Sree Balaji Medical College and Hospital, Bharath Institute of Higher Education and Research, Chennai, IND
| | - Saad Alkhowaiter
- Department of Gastroenterology, College of Medicine, King Khalid University Hospital, Riyadh, SAU
| | - Gaurav Sawarkar
- Rachana Sharir, Mahatma Gandhi Ayurveda College, Hospital and Research Centre, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - B Divya Dharshini
- Department of Biochemistry, Government Medical College, Khammam, Telangana, IND
| | - Ajay R Baskaran
- Department of Psychiatry, National Health Service, Shrewsbury, GBR
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Gounella R, Granado TC, Hideo Ando Junior O, Luporini DL, Gazziro M, Carmo JP. Endoscope Capsules: The Present Situation and Future Outlooks. Bioengineering (Basel) 2023; 10:1347. [PMID: 38135938 PMCID: PMC10741108 DOI: 10.3390/bioengineering10121347] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 11/04/2023] [Accepted: 11/20/2023] [Indexed: 12/24/2023] Open
Abstract
This paper presents new perspectives on photonic technologies for capsule endoscopy. It first presents a review of conventional endoscopy (upper endoscopy and colonoscopy), followed by capsule endoscopy (CE), as well as their techniques, advantages, and drawbacks. The technologies for CEs presented in this paper include integration with the existing endoscopic systems that are commercially available. Such technologies include narrow-band imaging (NBI), photodynamic therapy (PDT), confocal laser endomicroscopy (CLE), optical coherence tomography (OCT), and spectroscopy in order to improve the performance of the gastrointestinal (GI) tract examination. In the context of NBI, two optical filters were designed and fabricated for integration into endoscopic capsules, allowing for the visualization of light centered at the 415 nm and 540 nm wavelengths. These optical filters are based on the principle of Fabry-Perot and were made of thin films of titanium dioxide (TiO2) and silicon dioxide (SiO2). Moreover, strategies and solutions for the adaptation of ECs for PDT are also discussed.
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Affiliation(s)
- Rodrigo Gounella
- Group of Metamaterials Microwaves and Optics (GMeta), Department of Electrical Engineering (SEL), University of São Paulo (USP), Avenida Trabalhador São-Carlense, Nr. 400, Parque Industrial Arnold Schimidt, São Carlos 13566-590, Brazil; (T.C.G.); (J.P.C.)
| | - Talita Conte Granado
- Group of Metamaterials Microwaves and Optics (GMeta), Department of Electrical Engineering (SEL), University of São Paulo (USP), Avenida Trabalhador São-Carlense, Nr. 400, Parque Industrial Arnold Schimidt, São Carlos 13566-590, Brazil; (T.C.G.); (J.P.C.)
| | - Oswaldo Hideo Ando Junior
- Academic Unit of Cabo de Santo Agostinho (UACSA), Federal Rural University of Pernambuco (UFRPE), Cabo de Santo Agostinho 54518-430, Brazil;
| | - Daniel Luís Luporini
- Clinica Endoscopia São Carlos, Rua Paulino Botelho de Abreu Sampaio, 958, Centro, São Carlos 13561-060, Brazil;
| | - Mario Gazziro
- Information Engineering Group, Department of Engineering and Social Sciences (CECS), Federal University of ABC (UFABC), Av. dos Estados, 5001, Santo André 09210-580, Brazil;
| | - João Paulo Carmo
- Group of Metamaterials Microwaves and Optics (GMeta), Department of Electrical Engineering (SEL), University of São Paulo (USP), Avenida Trabalhador São-Carlense, Nr. 400, Parque Industrial Arnold Schimidt, São Carlos 13566-590, Brazil; (T.C.G.); (J.P.C.)
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Cheng K, Li L, Du Y, Wang J, Chen Z, Liu J, Zhang X, Dong L, Shen Y, Yang Z. A systematic review of image-guided, surgical robot-assisted percutaneous puncture: Challenges and benefits. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2023; 20:8375-8399. [PMID: 37161203 DOI: 10.3934/mbe.2023367] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Percutaneous puncture is a common medical procedure that involves accessing an internal organ or tissue through the skin. Image guidance and surgical robots have been increasingly used to assist with percutaneous procedures, but the challenges and benefits of these technologies have not been thoroughly explored. The aims of this systematic review are to furnish an overview of the challenges and benefits of image-guided, surgical robot-assisted percutaneous puncture and to provide evidence on this approach. We searched several electronic databases for studies on image-guided, surgical robot-assisted percutaneous punctures published between January 2018 and December 2022. The final analysis refers to 53 studies in total. The results of this review suggest that image guidance and surgical robots can improve the accuracy and precision of percutaneous procedures, decrease radiation exposure to patients and medical personnel and lower the risk of complications. However, there are many challenges related to the use of these technologies, such as the integration of the robot and operating room, immature robotic perception, and deviation of needle insertion. In conclusion, image-guided, surgical robot-assisted percutaneous puncture offers many potential benefits, but further research is needed to fully understand the challenges and optimize the utilization of these technologies in clinical practice.
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Affiliation(s)
- Kai Cheng
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Lixia Li
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Yanmin Du
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Jiangtao Wang
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Zhenghua Chen
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Jian Liu
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Xiangsheng Zhang
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Lin Dong
- Center on Frontiers of Computing Studies, Peking University, Beijing 100089, China
| | - Yuanyuan Shen
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
| | - Zhenlin Yang
- Yantai Affiliated Hospital of Binzhou Medical University, Yantai, Shandong 264100, China
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Ping J, Yang Y, Wen W, Kweon SS, Matsuda K, Jia WH, Shin A, Gao YT, Matsuo K, Kim J, Kim DH, Jee SH, Cai Q, Chen Z, Tao R, Shin MH, Tanikawa C, Pan ZZ, Oh JH, Oze I, Ahn YO, Jung KJ, Ren Z, Shu XO, Long J, Zheng W. Developing and validating polygenic risk scores for colorectal cancer risk prediction in East Asians. Int J Cancer 2022; 151:1726-1736. [PMID: 35765848 PMCID: PMC9509464 DOI: 10.1002/ijc.34194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 06/01/2022] [Accepted: 06/08/2022] [Indexed: 11/12/2022]
Abstract
Several polygenic risk scores (PRSs) have been developed to predict the risk of colorectal cancer (CRC) in European descendants. We used genome-wide association study (GWAS) data from 22 702 cases and 212 486 controls of Asian ancestry to develop PRSs and validated them in two case-control studies (1454 Korean and 1736 Chinese). Eleven PRSs were derived using three approaches: GWAS-identified CRC risk SNPs, CRC risk variants identified through fine-mapping of known risk loci and genome-wide risk prediction algorithms. Logistic regression was used to estimate odds ratios (ORs) and area under the curve (AUC). PRS115-EAS , a PRS with 115 GWAS-reported risk variants derived from East-Asian data, validated significantly better than PRS115-EUR derived from European descendants. In the Korea validation set, OR per SD increase of PRS115-EAS was 1.63 (95% CI = 1.46-1.82; AUC = 0.63), compared with OR of 1.44 (95% CI = 1.29-1.60, AUC = 0.60) for PRS115-EUR . PRS115-EAS/EUR derived using meta-analysis results of both populations slightly improved the AUC to 0.64. Similar but weaker associations were found in the China validation set. Individuals among the highest 5% of PRS115-EAS/EUR have a 2.52-fold elevated CRC risk compared with the medium (41-60th) risk group and have a 12% to 20% risk of developing CRC by age 85. PRSs constructed using results from fine-mapping and genome-wide algorithms did not perform as well as PRS115-EAS and PRS115-EAS/EUR in risk prediction, possibly due to a small sample size. Our results indicate that CRC PRSs are promising in predicting CRC risk in East Asians and highlights the importance of using population-specific data to build CRC risk prediction models.
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Affiliation(s)
- Jie Ping
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Yaohua Yang
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Wanqing Wen
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Sun-Seog Kweon
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Koichi Matsuda
- Laboratory of Clinical Genome Sequencing, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, University of Tokyo, Tokyo, Japan
| | - Wei-Hua Jia
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Aesun Shin
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Yu-Tang Gao
- State Key Laboratory of Oncogenes and Related Genes and Department of Epidemiology, Shanghai Cancer Institute, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Keitaro Matsuo
- Division of Molecular and Clinical Epidemiology, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Epidemiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Jeongseon Kim
- Department of Cancer Biomedical Science, Graduate School of Cancer Science and Policy, National Cancer Center, Gyeonggi-do, South Korea
| | - Dong-Hyun Kim
- Department of Social and Preventive Medicine, Hallym University College of Medicine, Okcheon-dong, Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Zhishan Chen
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Ran Tao
- Department of Biostatistics, Vanderbilt University, 37212 Nashville, TN, USA
| | - Min-Ho Shin
- Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, South Korea
| | - Chizu Tanikawa
- Laboratory of Genome Technology, Human Genome Center, Institute of Medical Science, University of Tokyo, Tokyo, Japan
| | - Zhi-Zhong Pan
- State Key Laboratory of Oncology in South China, Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Jae Hwan Oh
- Center for Colorectal Cancer, National Cancer Center Hospital, National Cancer Center, Gyeonggi-do, South Korea
| | - Isao Oze
- Division of Cancer Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - Yoon-Ok Ahn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, South Korea
| | - Keum Ji Jung
- Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Zefang Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt-Ingram Cancer Center, Vanderbilt Epidemiology Center, Vanderbilt University School of Medicine, Nashville, TN, USA
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Augmentation Mastopexy: A Five-step Standardized Strategy Approach. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2022; 10:e4349. [PMID: 35720197 PMCID: PMC9200382 DOI: 10.1097/gox.0000000000004349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 04/01/2022] [Indexed: 12/05/2022]
Abstract
Planning a combined procedure requires ensuring an optimal fill of the reduced breast skin envelope, which in turn requires a system to quantify skin excess to ensure that the selected implant achieves that optimal fill. This has led us to develop a five-step approach that a surgical team can use to assess patients scheduled to undergo an augmentation mastopexy and arrive at an optimal surgical strategy.
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Saremi B, Yao T, Yuan B. Thermo- and pH-sensitive nanoparticles of poly ( N-isopropylacrylamide-decenoic acid-1-vinylimidazole) for ultrasound switchable fluorescence imaging. Exp Biol Med (Maywood) 2022; 247:1005-1012. [PMID: 35470688 DOI: 10.1177/15353702221087648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
We herein report the synthesis of poly (9-decenoic acid-1-vinylimidazole-N-isopropylacrylamide) nanoparticles containing indocyanine green (ICG) in one pot and in water phase throughout the reaction. We have shown that copolymers of 9-decenoic acid and 1-vinylimidazole, or 9-decenoic acid alone, have an enhanced sensitivity to pH values between 7.4 and 6.8 and are superior to the widely used acrylic acid. We have also shown that incorporation of acidic comonomers leads to the favorable outcome of a higher fluorescence signal intensity in lower pH values, whereas the opposite is true of basic comonomers, where the fluorescence signal intensity is lower at low pH values. It was shown that to keep the pH response favorable the molar ratio of basic comonomers to acidic comonomers should roughly equal 1:4. We controlled the lower critical solution temperature (LCST) of the nanoparticles from around 30 to 38°C for different applications by adding acrylamide comonomers. Finally, the nanoparticles at varying pH values, when imaged by an ultrasound switchable fluorescence (USF) imaging system, showed pH sensitivity and thermosensitivity at physiological and tumor pH.
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Affiliation(s)
- Bahar Saremi
- Ultrasound and Optical Imaging Laboratory, Department of Bioengineering, The University of Texas at Arlington, Arlington, TX 76019, USA.,Joint Biomedical Engineering Program, The University of Texas at Arlington and University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Tingfeng Yao
- Ultrasound and Optical Imaging Laboratory, Department of Bioengineering, The University of Texas at Arlington, Arlington, TX 76019, USA.,Joint Biomedical Engineering Program, The University of Texas at Arlington and University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Baohong Yuan
- Ultrasound and Optical Imaging Laboratory, Department of Bioengineering, The University of Texas at Arlington, Arlington, TX 76019, USA.,Joint Biomedical Engineering Program, The University of Texas at Arlington and University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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Obstetrician-Gynecologists' Experience and Comfort in Treating Children and Adolescents with Gynecologic Needs. J Pediatr Adolesc Gynecol 2022; 35:127-132. [PMID: 34906683 DOI: 10.1016/j.jpag.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 11/17/2021] [Accepted: 12/02/2021] [Indexed: 11/22/2022]
Abstract
STUDY OBJECTIVE To determine which obstetrician-gynecologists care for pediatric and adolescent patients, their practice and referral patterns for common gynecologic symptoms, and desired training opportunities in pediatric and adolescent health care DESIGN: An Internet-based questionnaire designed to elicit information regarding the practice patterns of obstetrician-gynecologists SETTING: United States PARTICIPANTS: Obstetrician-gynecologists practicing clinical medicine and participating in the Pregnancy-Related Research Network (PRCRN) INTERVENTIONS: None MAIN OUTCOME MEASURES: Practice patterns of obstetrician-gynecologists in treating gynecologic issues in pediatric and adolescent patients RESULTS: Of the 103 participants that met the inclusion criteria, most see pediatric patients rarely, if ever. Most participants treat adolescent patients at least monthly in their clinical practice. Just over half (n = 60, 58.3%) have a pediatric-adolescent gynecologist within 50 miles of their practice location, which is associated with referring pediatric patients with vulvar itching but not in the treatment of other gynecologic conditions. The areas in which participants feel they had the least adequate training and had interest in receiving more training were vulvar conditions in pediatric patients and abnormal pubertal development. CONCLUSION Obstetrician-gynecologists feel comfortable managing most adolescent gynecologic conditions themselves and less comfortable managing pediatric gynecologic conditions. Referral patterns vary by distance to pediatric-adolescent gynecologists only in the scenario of pediatric vulvar itching. Participants expressed interest in future training in pediatric gynecologic conditions, especially vulvar conditions and pubertal development. Understanding the patterns and gaps in provision of care for these patients is key to enacting effective interventions to improve the quality of care for young women and children with gynecologic needs.
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Burden of Oral Cancer on the 10 Most Populous Countries from 1990 to 2019: Estimates from the Global Burden of Disease Study 2019. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020875. [PMID: 35055693 PMCID: PMC8775770 DOI: 10.3390/ijerph19020875] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 01/27/2023]
Abstract
Background: Oral cancer (OC) is a common tumour that poses a threat to human health and imposes a heavy burden on countries. This study assessed the burden imposed by OC on the 10 most populous countries from 1990 to 2019 on the basis of gender, age and socio-demographic index. Methods: Data on incidence, mortality, disability-adjusted life years (DALY) and corresponding age-standardised rates (ASR) for OC in the 10 most populous countries from 1990 to 2019 were derived from the Global Burden of Disease Study 2019. Estimated annual percentage changes were calculated to assess the trends of morbidity, mortality and DALY. The indicator that served as a proxy for survival rate was the supplement of mortality-to-incidence ratio (SMIR) (1 − (M/I)). Results: The number of new cases, deaths and DALY have increased in all 10 countries in the past 30 years. Trends in age-standardised incidence rates (ASIR), age-standardised mortality rate (ASMR) and age-standardised DALY for OC in the 10 most populous countries varied. The SMIR increased in all countries, with most countries having an SMIR between 30% and 50%. In 2019, the United States had the highest SMIR at 76%, whereas Russia had the lowest at 21.7%. Incidence and mortality were close between male and female subjects in Japan, Indonesia, Mexico, India, Bangladesh and Pakistan. The incidence and mortality in male subjects in the United States, Russia, China and Brazil were two or more times those of female subjects. Gender difference was highest among patients aged 40–69 years. Conclusion: Trends and gender differences in ASIR, ASMR and age-standardised DALY for OC vary in the 10 most populous countries. Government cancer programs are often expensive to run, especially in countries with large populations. Policy makers need to take these differences into account when formulating policies.
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Kumar I, Kumar A, Kumar VDA, Kannan R, Vimal V, Singh KU, Mahmud M. Dense Tissue Pattern Characterization Using Deep Neural Network. Cognit Comput 2022. [DOI: 10.1007/s12559-021-09970-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
AbstractBreast tumors are from the common infections among women around the world. Classifying the various types of breast tumors contribute to treating breast tumors more efficiently. However, this classification task is often hindered by dense tissue patterns captured in mammograms. The present study has been proposed a dense tissue pattern characterization framework using deep neural network. A total of 322 mammograms belonging to the mini-MIAS dataset and 4880 mammograms from DDSM dataset have been taken, and an ROI of fixed size 224 × 224 pixels from each mammogram has been extracted. In this work, tedious experimentation has been executed using different combinations of training and testing sets using different activation function with AlexNet, ResNet-18 model. Data augmentation has been used to create a similar type of virtual image for proper training of the DL model. After that, the testing set is applied on the trained model to validate the proposed model. During experiments, four different activation functions ‘sigmoid’, ‘tanh’, ‘ReLu’, and ‘leakyReLu’ are used, and the outcome for each function has been reported. It has been found that activation function ‘ReLu’ perform always outstanding with respect to others. For each experiment, classification accuracy and kappa coefficient have been computed. The obtained accuracy and kappa value for MIAS dataset using ResNet-18 model is 91.3% and 0.803, respectively. For DDSM dataset, the accuracy of 92.3% and kappa coefficient value of 0.846 are achieved. After the combination of both dataset images, the achieved accuracy is 91.9%, and kappa coefficient value is 0.839 using ResNet-18 model. Finally, it has been concluded that the ResNet-18 model and ReLu activation function yield outstanding performance for the task.
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13
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Lu Y, Edwards A, Chen Z, Tseng TS, Li M, Gonzalez GV, Zhang K. Insufficient Lycopene Intake Is Associated With High Risk of Prostate Cancer: A Cross-Sectional Study From the National Health and Nutrition Examination Survey (2003-2010). Front Public Health 2021; 9:792572. [PMID: 34966715 PMCID: PMC8710501 DOI: 10.3389/fpubh.2021.792572] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Accepted: 11/18/2021] [Indexed: 11/13/2022] Open
Abstract
Although lycopene intake and risk of prostate cancer have been explored for decades, recent studies show that Non-Hispanic Black Prostate Cancer (PCa) patients benefit less than Non-Hispanic White patients from a lycopene intake intervention program. This study examined whether a lycopene intake-related racial disparity exists in reducing the risk of PCa in healthy adults. Data on healthy, cancer-free Non-Hispanic Black (NHB) men (n = 159) and Non-Hispanic White (NHW) men (n = 478) from the 2003 to 2010 NHANES dataset were analyzed. Total lycopene intake from daily diet, age, living status, race/ethnicity, education level, poverty income ratio, body mass index, and smoking status were studied as independent variables. The combination of total Prostate-Specific Antigen (PSA) level and the ratio of free PSA was set as criteria for evaluating the risk of PCa. Multivariable logistic regression was used in race-stratified analyses to compute odds ratios (OR) and 95% confidence intervals (95% CI) comparing high PCa risk with low PCa risk. We found, in the whole population, race/ethnicity was the only factor that influenced lycopene intake from the daily diet. NHB men consumed less lycopene than NHW men (3,716 vs. 6,487 (mcg), p = 0.01). Sufficient lycopene intake could reduce the risk of PCa (OR: 0.40, 95% CI: 0.18-0.85, p = 0.02). Men aged between 66 and 70 had high PCa risk (OR: 3.32, 95% CI: 1.12-9.85, p = 0.03). Obesity served as a protective factor against the high risk of PCa (OR: 0.25, 95% CI: 0.12-0.54, p = 0.001). NHW men aged between 66 and 70 had a high risk of PCa (OR: 4.01, 95% CI: 1.02-15.73, p = 0.05). Obese NHW men also had lower risk of PCa (OR: 0.18, 95% CI: 0.07-0.47 p = 0.001). NHB men had a high risk of PCa compared to NHW men (OR: 2.27, 95% CI: 1.35-3.81 p = 0.004). NHB men who were living without partners experienced an even higher risk of PCa (OR: 3.35, 95% CI: 1.01-11.19 p = 0.07). Sufficient lycopene intake from daily food could serve as a protector against PCa. Such an association was only observed in NHW men. Further studies are needed to explore the dose-response relationship between lycopene intake and the association of PCa risk in NHB men.
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Affiliation(s)
- You Lu
- Department of Physics and Computer Science, Xavier University of Louisiana, New Orleans, LA, United States
| | - Andrea Edwards
- Department of Physics and Computer Science, Xavier University of Louisiana, New Orleans, LA, United States
| | - Zhong Chen
- Department of Physics and Computer Science, Xavier University of Louisiana, New Orleans, LA, United States
| | - Tung-Sung Tseng
- Behavioral and Community Health Science, School of Public Health, Louisiana State University Health Science Center, New Orleans, LA, United States
| | - Mirandy Li
- Behavioral and Community Health Science, School of Public Health, Louisiana State University Health Science Center, New Orleans, LA, United States
| | - Gabrielle V Gonzalez
- Behavioral and Community Health Science, School of Public Health, Louisiana State University Health Science Center, New Orleans, LA, United States
| | - Kun Zhang
- Department of Physics and Computer Science, Xavier University of Louisiana, New Orleans, LA, United States.,Bioinformatics Core of Xavier NIH RCMI Center of Cancer Research, Xavier University of Louisiana, New Orleans, LA, United States
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14
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Mullen CJR, Barr RD, Franco EL. Timeliness of diagnosis and treatment: the challenge of childhood cancers. Br J Cancer 2021; 125:1612-1620. [PMID: 34471259 PMCID: PMC8651632 DOI: 10.1038/s41416-021-01533-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 08/04/2021] [Accepted: 08/19/2021] [Indexed: 02/07/2023] Open
Abstract
Cancer represents an important cause of disease-related death in children worldwide. Improved treatment and understanding of the ways in which cancer manifests has allowed for a greater prospect of survival in children of all ages. However, variation in childhood cancer experience exists based on factors at the individual, community and systems levels. Throughout the cancer care continuum these factors may influence the access and timeliness of care a child receives, leading to delays in diagnosis and treatment. The pejorative designation 'delay in diagnosis and treatment' is better characterised as lag time, representing an interval that is thought to influence survival and overall outcome. In recent decades, work has been done to expedite early childhood cancer diagnosis through the creation of screening and education-based programmes. Although systematic cancer screening in children poses risks and fails to achieve the goal of early diagnosis, a case has been made for risk-based surveillance that has been shown to improve outcome and reduce occurrence of advanced stage disease in targeted populations. The components of lag time are examined separately and individually. This review highlights the challenges of early diagnosis in childhood cancers and describes important contributors in the cancer care continuum.
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Affiliation(s)
- Callum J R Mullen
- Division of Cancer Epidemiology, McGill University, Montréal, QC, Canada
| | - Ronald D Barr
- Department of Pediatrics, McMaster University, Hamilton, ON, Canada
| | - Eduardo L Franco
- Division of Cancer Epidemiology, McGill University, Montréal, QC, Canada.
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15
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Prusty RK, Begum S, Patil A, Naik DD, Pimple S, Mishra G. Increasing breast cancer awareness and breast examination practices among women through health education and capacity building of primary healthcare providers: a pre-post intervention study in low socioeconomic area of Mumbai, India. BMJ Open 2021; 11:e045424. [PMID: 33906843 PMCID: PMC8088239 DOI: 10.1136/bmjopen-2020-045424] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES The present study aimed to improve breast cancer (BC) awareness and practices using Information, Education and Communication (IEC) modules and health educational sessions for women and primary healthcare providers in low socioeconomic community of Mumbai. DESIGN Pre-post quasi-experimental design. SETTING The study was conducted in a lower socioeconomic area of G-South ward of Mumbai, Maharashtra. The baseline and endline survey was conducted using structured interview schedules. PARTICIPANTS 410 women were selected, aged between 18 and 55 years who were not pregnant, lactating or diagnosed with BC. INTERVENTION A health education-based intervention module was developed to educate women through group and individual sessions. OUTCOMES Summative indices were constructed to understand the net mean difference in knowledge of signs, symptoms and risk factors. Analysis of variance (ANOVA) and paired t-test were used to check the significant improvement of intervention. RESULTS Our results showed statistical significance in difference in mean knowledge scores for both signs and symptoms (mean difference (MD) 4.09, SD 4.05, p<0.00)) and risk factors of BC knowledge (MD 5.64, SD 4.00, p<0.00) among women after intervention. There was a marked improvement in the knowledge of BC among women with low education category. A significant improvement in knowledge of symptoms and risk factors among health workers was also observed. Our interventions resulted in positive change in breast examination practices. The breast self-examination (BSE) practices improved from around 3% to 65% and around 41% additional women went for clinical breast examination after intervention. CONCLUSIONS This study found a significant improvement in knowledge of BC signs and symptoms, risk factors and BSE practices among study participants following our health education interventions among these subpopulations. This evidence calls for inclusion of similar interventions through health education and capacity building of primary healthcare providers in national programmes.
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Affiliation(s)
- Ranjan Kumar Prusty
- Biostatistics, Indian Council of Medical Research-National Institute for Research in Reproductive Health (ICMR-NIRRH), Mumbai, India
| | - Shahina Begum
- Biostatistics, Indian Council of Medical Research-National Institute for Research in Reproductive Health (ICMR-NIRRH), Mumbai, India
| | - Anushree Patil
- Clinical Research, Indian Council of Medical Research-National Institute for Research in Reproductive Health (ICMR-NIRRH), Mumbai, India
| | - D D Naik
- Biostatistics, Indian Council of Medical Research-National Institute for Research in Reproductive Health (ICMR-NIRRH), Mumbai, India
| | - Sharmila Pimple
- Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - Gauravi Mishra
- Preventive Oncology, Centre for Cancer Epidemiology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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16
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Chootipongchaivat S, Wong XY, Ten Haaf K, Hartman M, Tan KB, van Ravesteyn NT, Wee HL. Cost-effectiveness Analysis of Breast Cancer Screening Using Mammography in Singapore: A Modeling Study. Cancer Epidemiol Biomarkers Prev 2021; 30:653-660. [PMID: 33531436 PMCID: PMC8026695 DOI: 10.1158/1055-9965.epi-20-1230] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/15/2020] [Accepted: 01/15/2021] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Limited research is available on the cost-effectiveness of breast cancer screening programs in Asian countries. We evaluated the cost-effectiveness of Singapore's national mammography screening program, implemented in 2002, recommending annual screening between ages 40 and 49 and biennial screening between ages 50 and 69, and alternative screening scenarios taking into account important country-specific factors. METHODS We used national data from Singapore in the MIcrosimulation SCreening ANalysis-Fatal diameter (MISCAN-Fadia) model to simulate 302 screening scenarios for 10 million women born between 1910 and 1969. Screening scenarios varied by starting and ending age, screening interval, and attendance. Outcome measures included life-years gained (LYG), breast cancer deaths averted, false positives, overdiagnosis, quality-adjusted life years (QALY), costs (in 2002 Singapore dollars; S$), and incremental cost-effectiveness ratios (ICER). Costs and effects were calculated and discounted with 3% using a health care provider's perspective. RESULTS Singapore's current screening program at observed attendance levels required 54,158 mammograms per 100,000 women, yielded 1,054 LYG, and averted 57 breast cancer deaths. At attendance rates ≥50%, the current program was near the efficiency frontier. Most scenarios on the efficiency frontier started screening at age 40. The ICERs of the scenarios on the efficiency frontiers ranged between S$10,186 and S$56,306/QALY, which is considered cost-effective at a willingness-to-pay threshold of S$70,000/QALY gained. CONCLUSIONS Singapore's current screening program lies near the efficiency frontier, and starting screening at age 40 or 45 is cost-effective. Furthermore, enhancing screening attendance rates would increase benefits while maintaining cost-effectiveness. IMPACT Screening all women at age 40 or 45 is cost-efficient in Singapore, and a policy change may be considered.
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Affiliation(s)
- Sarocha Chootipongchaivat
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
| | - Xin Yi Wong
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
| | - Kevin Ten Haaf
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Mikael Hartman
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Senior Consultant, Breast and Trauma Surgery, Department of Surgery, National University Hospital, Singapore
| | - Kelvin B Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
- Director of Policy, Research and Economics Office, Ministry of Health, Singapore
| | - Nicolien T van Ravesteyn
- Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Hwee-Lin Wee
- Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
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17
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Molodysky E, Grant R. Person-to-Person Cancer Transmission via Allogenic Blood Transfusion. Asian Pac J Cancer Prev 2021; 22:641-649. [PMID: 33773525 PMCID: PMC8286663 DOI: 10.31557/apjcp.2021.22.3.641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Accepted: 11/03/2021] [Indexed: 11/25/2022] Open
Abstract
Despite the recognized capability of Circulating Tumor Cells (CTCs) to seed tumors, allogenic blood transfusions are not presently screened for the presence of CTCs. Previous research has examined blood transfusions and the associated risk of cancer recurrence, but not cancer of unknown primary (CUP) occurrence. The Hypothesis explored in this paper proposes that there is potential for cancers to be transmitted from donor-to-patient via CTCs in either blood transfusions or organ transplants or both. This proposed haematogenic tumor transmission will be discussed in relation to two scenarios involving the introduction of donor-derived CTC's from allogeneic blood transfusions into either known cancer surgery patients or into non-cancer patients. The source of CTCs arises either from the donor with a 'clinically dormant cancer' or a 'pre-clinical cancer' existing as yet undiagnosed, in the donor. Given the significant number of allogenic blood transfusions that occur worldwide on a yearly basis, allogenic blood transfusions have the potential to expose a substantial number of non-cancer recipients to the transmission of CTCs and associated tumor risk. This risk is greatly amplified in the low-income nations where the blood collection and processing protocols, including exclusion and screening criteria are less stringent than those in high-income countries.
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Affiliation(s)
- Eugen Molodysky
- Sydney Medical School, University of Sydney, Sydney, Australia.
| | - Ross Grant
- Sydney Medical School, University of Sydney, Sydney, Australia.
- School of Medical Sciences, University of NSW, Sydney, Australia.
- Australasian Research Institute, Sydney Adventist Hospital, Wahroonga, Sydney Australia.
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18
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Maksymiuk AW, Tappia PS, Bux RA, Moyer D, Huang G, Joubert P, Miller DW, Ramjiawan B, Sitar DS. Use of amantadine in the evaluation of response to chemotherapy in lung cancer: a pilot study. Future Sci OA 2021; 7:FSO679. [PMID: 33815824 PMCID: PMC8015664 DOI: 10.2144/fsoa-2020-0176] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Aim: The assessment of tumor response to therapy is of critical importance as it permits for a prospective end point evaluation and provides a guide to clinicians for making future treatment decisions. However, current practices in early evaluation of chemotherapy are insufficient. Amantadine is a substrate for SSAT-1. The present pilot study tests the hypothesis that SSAT-1 activity within the tumor, as measured by plasma acetylamantadine concentrations, can be used to monitor patient response to therapy. Results: In cases with evidence of disease response, there was a reduction in the plasma acetylamantadine concentration at 4 h by approximately 32%. There was a mean increase of approximately 34% at the 4 h collection in the nonresponders. Conclusion: Although large-scale studies are required these findings suggest that the amantadine test could allow for determination of the efficacy of therapeutic interventions earlier, providing an effective test to assess response to treatment and for better management of patients. Aim: It is very important to get early information on the effectiveness of tumor treatment such that clinicians have a better understanding and decide on the next treatment regimen. Current methods are not sufficient to assess whether chemotherapy is effective early during a treatment cycle. We have previously used the presence of the acetylated metabolite of the drug amantadine in urine of patients diagnosed with lung cancer as a biomarker for disease. In the present study, our goal was to test the hypothesis that tumor responsiveness to therapy could be assessed by monitoring changes in the levels of the acetylated form of amantadine in the blood during the course of treatment. Results: In 70% of the patients we were able to relate disease progression or remission/stability to the levels of the acetylated form of amantadine in the blood. Conclusion: Although a larger study with a greater number of patients is required, our test could be used as a simple and effective tool to assess response to treatment and to better tailor treatment of the patient as well as reduce side effects and costs.
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Affiliation(s)
- Andrew W Maksymiuk
- Cancer Care Manitoba, Winnipeg, MB R3E 0V9, Canada.,Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3A 1R9, Canada
| | - Paramjit S Tappia
- Asper Clinical Research Institute & Office of Clinical Research, St. Boniface Hospital, Winnipeg, MB, R2H 2A6, Canada
| | | | - Dante Moyer
- BioMark Diagnostics Inc., Richmond, BC, V6X 2W2, Canada
| | - Guoyu Huang
- BioMark Diagnostics Inc., Richmond, BC, V6X 2W2, Canada
| | - Philippe Joubert
- Department of Pathology, Institut Universitaire de Cardiologie et de Pneumologie de Québec, Laval University, Quebec, PQ, G1V 4G5, Canada
| | - Donald W Miller
- Department of Pharmacology & Therapeutics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Bram Ramjiawan
- Asper Clinical Research Institute & Office of Clinical Research, St. Boniface Hospital, Winnipeg, MB, R2H 2A6, Canada.,Department of Pharmacology & Therapeutics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
| | - Daniel S Sitar
- Department of Internal Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3A 1R9, Canada.,Department of Pharmacology & Therapeutics, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB, R3E 0T6, Canada
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19
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Bartzatt R. Prostate Cancer: Biology, Incidence, Detection Methods, Treatment Methods, and Vaccines. Curr Top Med Chem 2021; 20:847-854. [PMID: 32091336 DOI: 10.2174/1568026620666200224100730] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/18/2019] [Accepted: 12/24/2019] [Indexed: 12/14/2022]
Abstract
Cancer of the prostate are cancers in which most incidences are slow-growing, and in the U.S., a record of 1.2 million new cases of prostate cancer occurred in 2018. The rates of this type of cancer have been increasing in developing nations. The risk factors for prostate cancer include age, family history, and obesity. It is believed that the rate of prostate cancer is correlated with the Western diet. Various advances in methods of radiotherapy have contributed to lowering morbidity. Therapy for hormone- refractory prostate cancer is making progress, for almost all men with metastases will proceed to hormone-refractory prostate cancer. Smoking cigarettes along with the presence of prostate cancer has been shown to cause a higher risk of mortality in prostate cancer. The serious outcome of incontinence and erectile dysfunction result from the cancer treatment of surgery and radiation, particularly for prostate- specific antigen detected cancers that will not cause morbidity or mortality. Families of patients, as well as patients, are profoundly affected following the diagnosis of prostate cancer. Poor communication between spouses during prostate cancer increases the risk for poor adjustment to prostate cancer. The use of serum prostate-specific antigen to screen for prostate cancer has led to a greater detection, in its early stage, of this cancer. Prostate cancer is the most common malignancy in American men, accounting for more than 29% of all diagnosed cancers and about 13% of all cancer deaths. A shortened course of hormonal therapy with docetaxel following radical prostatectomy (or radiation therapy) for high-risk prostate cancer has been shown to be both safe and feasible. Patients treated with docetaxel-estramustine had a prostate-specific antigen response decline of at least 50%. Cancer vaccines are an immune-based cancer treatment that may provide the promise of a non-toxic but efficacious therapeutic alternative for cancer patients. Further studies will elucidate improved methods of detection and treatment.
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Affiliation(s)
- Ronald Bartzatt
- Durham Science Center, College of Arts and Sciences, University of Nebraska at Omaha, 6001 Dodge Street, Omaha, Nebraska 68182, United States
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20
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Tron A, Caulliez S, Malmartel A. Comparison of mammography results from individual and organized screening for breast cancer. J Gynecol Obstet Hum Reprod 2020; 50:101926. [PMID: 33007526 DOI: 10.1016/j.jogoh.2020.101926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 09/24/2020] [Accepted: 09/25/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND In France, the coexistence of individual screening (IS) and organized screening (OS) for breast cancer induces difficulties for primary care practitioners to position themselves. This study assessed whether the risk of having a mammography with a high risk of malignancy (BI-RADS 4 or 5) was different between patients aged from 50 to 74year performing it as part of an IS or of the OS. METHOD This cross-sectional multicenter study included women aged 50-74, with no personal history of breast cancer, performing mammography in radiology centers in Paris (France). The nature of the screening (OS or IS), breast cancer risk (high risk: BI-RADS 4 or 5), risk factors and clinical breast examination (CBE) abnormalities were collected. Patients in the IS and OS group were matched on age, breast density, history of benign lesions and family history of breast cancer using a propensity score. The association between the nature of screening and the risk of malignancy was evaluated by conditional logistic regression. RESULTS Among 2190 included patients, 77 % performed a mammography with the IS and had more CBE abnormalities (23 % vs 11 %, p<0,001), a history of benign lesion (15 % vs 11 %, p=0.01) and a family history of breast cancer (42 % vs 29 %, p<0,001). After matching 503 OS patients with 941 IS patients, the risk of malignancy and the nature of the screening were not associated (OR=0.72 [0.35-1.47], p=0.50). CONCLUSION The risk of malignancy was not different whether the mammography was performed as part of the OS or IS.
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Affiliation(s)
- Arthur Tron
- Université de Paris, Faculté de Santé, UFR de Médecine, Département de médecine générale, F-75014, Paris, France.
| | - Ségolène Caulliez
- Université de Paris, Faculté de Santé, UFR de Médecine, Département de médecine générale, F-75014, Paris, France
| | - Alexandre Malmartel
- Université de Paris, Faculté de Santé, UFR de Médecine, Département de médecine générale, F-75014, Paris, France
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21
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Li Y, Chen W, Qi Y, Wang S, Li L, Li W, Xie T, Zhu H, Tang Z, Zhou M. H 2 S-Scavenged and Activated Iron Oxide-Hydroxide Nanospindles for MRI-Guided Photothermal Therapy and Ferroptosis in Colon Cancer. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2020; 16:e2001356. [PMID: 32789963 DOI: 10.1002/smll.202001356] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 06/06/2020] [Indexed: 05/27/2023]
Abstract
Overproduced hydrogen sulfide (H2 S) is of vital importance for the progress of colon cancer and promotes cancer cellular proliferation. Devising pharmacological nanomaterials for tumor-specific H2 S activation will be significant for precise colon cancer treatment. Herein, a biocompatible fusiform iron oxide-hydroxide nanospindles (FeOOH NSs) nanosystem for magnetic resonance imaging (MRI), ferroptosis, and H2 S based cascade reaction-enhanced combinational colon cancer treatment is developed. The FeOOH NSs can effectively scavenge endogenous H2 S via the reduction reaction to prohibit the growth of CT26 colon cancer. The cascade produced FeS driven by overexpressed H2 S exhibits near-infrared-triggered photothermal therapy capability and Fe2+ -mediated ferroptosis functionality. Meanwhile, the as-prepared FeOOH NSs can light up tumor tissues as a potent MRI contrast agent. Additionally, FeOOH NSs present desirable biosafety in a murine model for up to three months and avoid any long-term toxicity. Furthermore, it is found that these H2 S-responsible nanotheranostics do not cause any cure effects on other cancer types, such as 4T1 breast cancer. Overall, the findings illustrate that the biocompatible FeOOH NSs can be successfully employed as a theranostic for specifically treating colon cancer, which may promote the clinical translation and development of H2 S-responsive nanoplatforms.
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Affiliation(s)
- Yangyang Li
- Department of Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Weiyu Chen
- Molecular Imaging Program at Stanford, Department of Radiology, Stanford University, Stanford, CA, 94305-5427, USA
| | - Yuchen Qi
- Department of Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Shuai Wang
- Department of Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Lei Li
- Shanghai Key Laboratory of Regulatory Biology, Institute of Biomedical Sciences, School of Life Sciences, East China Normal University, Shanghai, 200241, China
| | - Wanlin Li
- Institute of Translational Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Tingting Xie
- Institute of Translational Medicine, Zhejiang University, Hangzhou, 310009, China
| | - Huanle Zhu
- Department of Radiology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, 310016, China
| | - Zhe Tang
- Department of Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
| | - Min Zhou
- Department of Surgery, The Fourth Affiliated Hospital, Zhejiang University School of Medicine, Yiwu, 322000, China
- Institute of Translational Medicine, Zhejiang University, Hangzhou, 310009, China
- State Key Laboratory of Modern Optical Instrumentations, Zhejiang University, Hangzhou, 310058, China
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22
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Feng Y, Zhang L, Mo J. Deep Manifold Preserving Autoencoder for Classifying Breast Cancer Histopathological Images. IEEE/ACM TRANSACTIONS ON COMPUTATIONAL BIOLOGY AND BIOINFORMATICS 2020; 17:91-101. [PMID: 30040652 DOI: 10.1109/tcbb.2018.2858763] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Classifying breast cancer histopathological images automatically is an important task in computer assisted pathology analysis. However, extracting informative and non-redundant features for histopathological image classification is challenging due to the appearance variability caused by the heterogeneity of the disease, the tissue preparation, and staining processes. In this paper, we propose a new feature extractor, called deep manifold preserving autoencoder, to learn discriminative features from unlabeled data. Then, we integrate the proposed feature extractor with a softmax classifier to classify breast cancer histopathology images. Specifically, it learns hierarchal features from unlabeled image patches by minimizing the distance between its input and output, and simultaneously preserving the geometric structure of the whole input data set. After the unsupervised training, we connect the encoder layers of the trained deep manifold preserving autoencoder with a softmax classifier to construct a cascade model and fine-tune this deep neural network with labeled training data. The proposed method learns discriminative features by preserving the structure of the input datasets from the manifold learning view and minimizing reconstruction error from the deep learning view from a large amount of unlabeled data. Extensive experiments on the public breast cancer dataset (BreaKHis) demonstrate the effectiveness of the proposed method.
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23
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Zhu C, Song F, Wang Y, Dong H, Guo Y, Liu J. Breast cancer histopathology image classification through assembling multiple compact CNNs. BMC Med Inform Decis Mak 2019; 19:198. [PMID: 31640686 PMCID: PMC6805574 DOI: 10.1186/s12911-019-0913-x] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Accepted: 09/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Breast cancer causes hundreds of thousands of deaths each year worldwide. The early stage diagnosis and treatment can significantly reduce the mortality rate. However, the traditional manual diagnosis needs intense workload, and diagnostic errors are prone to happen with the prolonged work of pathologists. Automatic histopathology image recognition plays a key role in speeding up diagnosis and improving the quality of diagnosis. METHODS In this work, we propose a breast cancer histopathology image classification by assembling multiple compact Convolutional Neural Networks (CNNs). First, a hybrid CNN architecture is designed, which contains a global model branch and a local model branch. By local voting and two-branch information merging, our hybrid model obtains stronger representation ability. Second, by embedding the proposed Squeeze-Excitation-Pruning (SEP) block into our hybrid model, the channel importance can be learned and the redundant channels are thus removed. The proposed channel pruning scheme can decrease the risk of overfitting and produce higher accuracy with the same model size. At last, with different data partition and composition, we build multiple models and assemble them together to further enhance the model generalization ability. RESULTS Experimental results show that in public BreaKHis dataset, our proposed hybrid model achieves comparable performance with the state-of-the-art. By adopting the multi-model assembling scheme, our method outperforms the state-of-the-art in both patient level and image level accuracy for BACH dataset. CONCLUSIONS We propose a novel compact breast cancer histopathology image classification scheme by assembling multiple compact hybrid CNNs. The proposed scheme achieves promising results for the breast cancer image classification task. Our method can be used in breast cancer auxiliary diagnostic scenario, and it can reduce the workload of pathologists as well as improve the quality of diagnosis.
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Affiliation(s)
- Chuang Zhu
- The Center for Data Science, the Beijing Key Laboratory of Network System Architecture and Convergence, the School of Information and Communication Engineering, Beijing University of Posts and Telecommunications, Xitucheng Road, Beijing, China.
| | - Fangzhou Song
- The Center for Data Science, the Beijing Key Laboratory of Network System Architecture and Convergence, the School of Information and Communication Engineering, Beijing University of Posts and Telecommunications, Xitucheng Road, Beijing, China
| | - Ying Wang
- The Department of Pathology, Beijing Chaoyang Hospital, the Third Clinical Medical College of Capital Medical University, Gongren Tiyuchang Nanlu, Beijing, China
| | - Huihui Dong
- The Center for Data Science, the Beijing Key Laboratory of Network System Architecture and Convergence, the School of Information and Communication Engineering, Beijing University of Posts and Telecommunications, Xitucheng Road, Beijing, China
| | - Yao Guo
- The Center for Data Science, the Beijing Key Laboratory of Network System Architecture and Convergence, the School of Information and Communication Engineering, Beijing University of Posts and Telecommunications, Xitucheng Road, Beijing, China
| | - Jun Liu
- The Center for Data Science, the Beijing Key Laboratory of Network System Architecture and Convergence, the School of Information and Communication Engineering, Beijing University of Posts and Telecommunications, Xitucheng Road, Beijing, China
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24
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Mansour-Ghanaei F, Varshi G, Joukar F, Ashoobi MT, Esmaeilpour J, Gharibpoor A, Daryakar A, Mansour-Ghanaei R, Balou HA, Saedi HS, Mavaddati S, Sepehrimanesh M. Prevalence of pre-cancerous colon lesions in referred patients under patronage of a local relief foundation in Guilan province. J Med Life 2019; 12:133-139. [PMID: 31406514 PMCID: PMC6685299 DOI: 10.25122/jml-2018-0074] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Colon cancer is the most commonly diagnosed gastrointestinal cancers in developed countries with varied incidence and the onset age of disease worldwide. Overall, 161 participants who were under patronage of a local relief foundation and referred to the endoscopy ward of Razi Hospital affiliated to the Guilan University of Medical Sciences. These patients have been aged more than 50 or more than 40 years with history of colorectal cancer in their first-degree family were enrolled from March 2016–March 2017. Demographic information were collected. Colonoscopy was performed and histopathological evaluation of observed lesions and polyps was done. Most of participants were female (113 individuals, 70.2%) and aged 50–60 years (83 individuals, 51.6%). Seventy-four (46%) had certain lesions. Most of colonoscopy findings were observed in the ascending colon in which depressed polyps and diverticulum were most frequent. However, rectum showed the most histological findings. All polyps of descending and ascending colons were neoplastic, while most of rectal polyps were non-neoplastic. Male patients, who were aged more than 60 years and smokers had significant higher percentage of both lesions and polyps in their colon (p<0.05). Moreover, significant positive association was detected between exposure to harmful industries and having polyps (p=0.01). We found male gender, higher age, smoking, and exposure to harmful industries as important risk factors for having colorectal lesions, which must be confirmed in further studies.
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Affiliation(s)
- Fariborz Mansour-Ghanaei
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Gharmohammad Varshi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Farahnaz Joukar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Mohammad Taghi Ashoobi
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Javad Esmaeilpour
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Alireza Gharibpoor
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Arash Daryakar
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Roya Mansour-Ghanaei
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Heydar Ali Balou
- Caspian Digestive Disease Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | - Hamid Saeidi Saedi
- GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
| | | | - Masood Sepehrimanesh
- Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.,GI Cancer Screening and Prevention Research Center, Guilan University of Medical Sciences, Rasht, Iran
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25
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Owens OL, Wooten NR, Tavakoli AS. Development and initial psychometric evaluation of the computer-based prostate Cancer screening decision aid acceptance scale for African-American men. BMC Med Res Methodol 2019; 19:146. [PMID: 31291906 PMCID: PMC6617606 DOI: 10.1186/s12874-019-0776-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 06/11/2019] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND To reliably evaluate the acceptance and use of computer-based prostate cancer decision aids (CBDAs) for African-American men, culturally relevant measures are needed. This study describes the development and initial psychometric evaluation of the 24-item Computer-Based Prostate Cancer Screening Decision Aid Acceptance Scale among 357 African-American men. METHODS Exploratory factor analysis (EFA) with maximum likelihood estimation and polychoric correlations followed by Promax and Varimax rotations. RESULTS EFA yielded three factors: Technology Use Expectancy and Intention (16 items), Technology Use Anxiety (5 items), and Technology Use Self-Efficacy (3 items) with good to excellent internal consistency reliability at .95, .90, and .85, respectively. The standardized root mean square residual (0.035) indicated the factor structure explained most of the correlations. CONCLUSIONS Findings suggest the three-factor, 24-item Computer-Based Prostate Cancer Screening Decision Aid Acceptance Scale has utility in determining the acceptance and use of CBDAs among African-American men at risk for prostate cancer. Future research is needed to confirm this factor structure among socio-demographically diverse African-Americans.
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Affiliation(s)
- Otis L. Owens
- University of South Carolina, College of Social Work, 1514 Pendleton Street, Columbia, SC 29208 USA
| | - Nikki R. Wooten
- University of South Carolina, College of Social Work, 1514 Pendleton Street, Columbia, SC 29208 USA
| | - Abbas S. Tavakoli
- University of South Carolina, College of Nursing, 1601 Greene Street, Columbia, SC 29208 USA
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26
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He T, Puppala M, Ezeana CF, Huang YS, Chou PH, Yu X, Chen S, Wang L, Yin Z, Danforth RL, Ensor J, Chang J, Patel T, Wong ST. A Deep Learning-Based Decision Support Tool for Precision Risk Assessment of Breast Cancer. JCO Clin Cancer Inform 2019; 3:1-12. [PMID: 31141423 PMCID: PMC10445790 DOI: 10.1200/cci.18.00121] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/27/2019] [Indexed: 08/25/2023] Open
Abstract
PURPOSE The Breast Imaging Reporting and Data System (BI-RADS) lexicon was developed to standardize mammographic reporting to assess cancer risk and facilitate the decision to biopsy. Because of substantial interobserver variability in the application of the BI-RADS lexicon, the decision to biopsy varies greatly and results in overdiagnosis and excessive biopsies. The false-positive rate from mammograms is estimated to be 7% to approximately 10% overall, but within the BI-RADS 4 category, it is greater than 70%. Therefore, we developed the Breast Cancer Risk Calculator (BRISK) to target a well-characterized and specific patient subgroup (BI-RADS 4) rather than a broad heterogeneous group in assessing breast cancer risk. METHODS BRISK provides a novel precise risk assessment model to reduce overdiagnosis and unnecessary biopsies. It was developed by applying natural language processing and deep learning methods on 5,147 patient records archived in the Houston Methodist systemwide data warehouse from 2006 to May 2015, including imaging and pathology reports, mammographic images, and patient demographics. Key characteristics for BI-RADS 4 patients were collected and computed to output an index measure for biopsy recommendation that is clinically relevant and informative and improves upon the traditional BI-RADS 4 scores. RESULTS For the validation set, we assessed data from 1,247 BI-RADS 4 patients, including mammographic images and medical reports. The BRISK model sensitivity to predict malignancy was 100%, whereas the specificity was 74%. The total accuracy of our implemented model in BRISK was 81%. Overall area under the curve was 0.93. CONCLUSION BRISK for abnormal mammogram uses integrative artificial intelligence technology and has demonstrated high sensitivity in the prediction of malignancy. Prospective evaluation is under way and can lead to improvement in patient-physician engagement in making informed decisions with regard to biopsy.
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Affiliation(s)
| | | | | | - Yan-siang Huang
- Houston Methodist, Houston, TX
- Far-Eastern Memorial Hospital, Taiwan,
Republic of China
| | - Ping-hsuan Chou
- Houston Methodist, Houston, TX
- Far-Eastern Memorial Hospital, Taiwan,
Republic of China
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27
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Yu H, Liu M, Qiu H, Yang K. Urinary and Plasma Cell-Free DNA Comparison for Lung Cancer Patients Treated With Epidermal Growth Factor Receptor-Thyroxine Kinase Inhibitors. Am J Med Sci 2019; 357:29-36. [PMID: 30611317 DOI: 10.1016/j.amjms.2018.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 10/12/2018] [Accepted: 10/13/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Mutations in the EGFR gene are known to affect treatment efficacy. Comparison of urinary and plasma cell-free DNA allows possible noninvasive probing of disease mutations. MATERIALS AND METHODS A total of 130 patients with known epidermal growth factor receptor (EGFR) mutations derived from tissue biopsies were enrolled. Patients received thyroxine kinase inhibitor therapy. Peripheral blood and urine specimens were collected at different time intervals and processed using digital droplet polymerase chain reaction. Concordance between specimens and the prognostic utility were evaluated with an observational study. RESULTS Prior to treatment, we observed an overall agreement of 86.2% between tumor tissue and cell-free DNA. Spearman rank correlation coefficient showed a strong correlation between plasma and urinary DNA results. In serial measurements following thyroxine kinase inhibitor therapy, secondary EGFR T790M mutation was observed. This occurred in 45% and 30% of non-small cell lung cancer patients with urine and plasma samples, respectively. Progression-free survival of patients with T790M mutation had a worse outcome and hazard ratios for the study cohort using urinary and plasma DNA were 5.3 and 3.5, respectively. CONCLUSIONS Both urinary and plasma DNA presents new opportunities to detect mutations in non-small cell lung cancer patients and provide real-time updates to genetic profiles needed for treatment. In the current study, plasma DNA demonstrated better positive predictive value at baseline. For serial monitoring, we observed that changes in the T790M profiles were detected earlier in urine samples. The prognostic value of the assay can possibly aid in early clinical interventions.
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Affiliation(s)
- Haiying Yu
- Department of Oncology, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang Central Hospital, Xiangyang, Hubei, People's Republic of China
| | - Mei Liu
- Department of Oncology, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang Central Hospital, Xiangyang, Hubei, People's Republic of China
| | - Huibing Qiu
- Department of Oncology, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang Central Hospital, Xiangyang, Hubei, People's Republic of China.
| | - Kai Yang
- Department of Oncology, The Affiliated Hospital of Hubei University of Arts and Science, Xiangyang Central Hospital, Xiangyang, Hubei, People's Republic of China.
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28
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The effect of Medicare's Annual Wellness Visit on preventive care for the elderly. Prev Med 2018; 116:126-133. [PMID: 30176266 DOI: 10.1016/j.ypmed.2018.08.035] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2017] [Revised: 08/21/2018] [Accepted: 08/28/2018] [Indexed: 01/02/2023]
Abstract
The study aim was to assess the effect of receiving an Annual Wellness Visit (AWV) between 2011 and 2013 on the annual rate of eight preventive services recommended for the Medicare population following the AWV. We used retrospective Medicare claims from 2009 to 2014 for a 5% national sample of fee-for-service beneficiaries in the United States. Propensity score-adjusted logistic regressions were performed to estimate the log odds of the probability of receiving the preventive services between beneficiaries who received AWVs during 2011-13 and those who did not during the same period. The average marginal effect was also reported. Among 845,318 patients who met the inclusion and exclusion criteria, 23% had an AWV in 2011-2013. In a propensity-matched sample of 381,934 patients, AWV participants are more likely to undergo subsequent preventive services within a year (adjusted odds ratio ranges from 1.46 (95% CI, 1.44, 1.49) to 2.43 (95% CI, 2.38, 2.49). The findings are consistent using secondary outcomes or with subgroups defined by baseline primary care provider visits or baseline preventive services. These analyses showed that AWV is associated with a significant increase in all the preventive services examined. As Healthy People 2020 has established a target goal to increase the proportion of older adults who receive a core set of clinical preventive services by 10%, AWV represents a promising opportunity to facilitate the delivery of preventive care for the elderly and to advance our knowledge about effective strategies for healthy aging.
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29
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A computer-aided diagnosis system using Tchebichef features and improved grey wolf optimized extreme learning machine. APPL INTELL 2018. [DOI: 10.1007/s10489-018-1294-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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30
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Label-free distinction between p53+/+ and p53 -/- colon cancer cells using a graphene based SERS platform. Biosens Bioelectron 2018; 118:108-114. [DOI: 10.1016/j.bios.2018.07.038] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Revised: 07/16/2018] [Accepted: 07/17/2018] [Indexed: 01/10/2023]
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31
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Massetti GM, Townsend JS, Thomas CC, Basile KC, Richardson LC. Healthcare Access and Cancer Screening Among Victims of Intimate Partner Violence. J Womens Health (Larchmt) 2017; 27:607-614. [PMID: 28880705 DOI: 10.1089/jwh.2017.6402] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Intimate partner violence (IPV) victims often experience substantial and persistent mental and physical health problems, including increased risk for chronic disease and barriers to healthcare access. This study investigated the association between IPV and cancer screening. MATERIALS AND METHODS Behavioral Risk Factor Surveillance System data from the eight states and one U.S. territory that administered the optional IPV module in 2006 were analyzed to examine demographic characteristics, health behaviors, health status, healthcare coverage, use of health services, and cancer screening among men and women who reported IPV victimization compared with those among men and women who did not. IPV victimization included physical violence, threats, and sexual violence. RESULTS In the nine jurisdictions that administered the IPV module, 23.6% of women and 11.3% of men experienced IPV. Fewer women and men reporting IPV victimization had health insurance, a personal doctor or healthcare provider, or regular checkups within the past 2 years than nonvictims. More male and female IPV victims were current tobacco users and engaged in binge drinking in the past month. IPV victims of both sexes also had poorer health status, lower life satisfaction, less social and emotional support, and more days with poor physical and mental health in the past month than nonvictims. IPV victimization was associated with lower rates of mammography and colorectal cancer screening but not cervical cancer screening in women and was not associated with colorectal cancer screening in men. In multivariable logistic regression results presented as adjusted proportions controlling for demographics, health status, and healthcare access, only the association with mammography screening remained significant, and the magnitude of this association was modest. CONCLUSIONS There were consistent differences between IPV victims and nonvictims in nearly every measure of healthcare access, health status, and preventive service use. Much of this association seems explained by population characteristics associated with both IPV and lower use of preventive service use, including differences in demographic characteristics, health status, and healthcare access. Healthcare providers could take steps to identify populations at high risk for lack of access or use of preventive services and IPV victimization.
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Affiliation(s)
- Greta M Massetti
- 1 Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Julie S Townsend
- 1 Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Cheryll C Thomas
- 1 Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Kathleen C Basile
- 2 Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention , Atlanta, Georgia
| | - Lisa C Richardson
- 1 Division of Cancer Prevention and Control, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention , Atlanta, Georgia
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Mokhtari TE, Rosas US, Downey JR, Miyake KK, Ikeda DM, Morton JM. Mammography before and after bariatric surgery. Surg Obes Relat Dis 2017; 13:451-456. [DOI: 10.1016/j.soard.2016.10.021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 10/03/2016] [Accepted: 10/26/2016] [Indexed: 01/26/2023]
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33
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Alamudun F, Yoon HJ, Hudson KB, Morin-Ducote G, Hammond T, Tourassi GD. Fractal analysis of visual search activity for mass detection during mammographic screening. Med Phys 2017; 44:832-846. [PMID: 28079249 DOI: 10.1002/mp.12100] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2016] [Revised: 10/18/2016] [Accepted: 12/20/2016] [Indexed: 11/10/2022] Open
Abstract
PURPOSE The objective of this study was to assess the complexity of human visual search activity during mammographic screening using fractal analysis and to investigate its relationship with case and reader characteristics. METHODS The study was performed for the task of mammographic screening with simultaneous viewing of four coordinated breast views as typically done in clinical practice. Eye-tracking data and diagnostic decisions collected for 100 mammographic cases (25 normal, 25 benign, 50 malignant) from 10 readers (three board certified radiologists and seven Radiology residents), formed the corpus for this study. The fractal dimension of the readers' visual scanning pattern was computed with the Minkowski-Bouligand box-counting method and used as a measure of gaze complexity. Individual factor and group-based interaction ANOVA analysis was performed to study the association between fractal dimension, case pathology, breast density, and reader experience level. The consistency of the observed trends depending on gaze data representation was also examined. RESULTS Case pathology, breast density, reader experience level, and individual reader differences are all independent predictors of the complexity of visual scanning pattern when screening for breast cancer. No higher order effects were found to be significant. CONCLUSIONS Fractal characterization of visual search behavior during mammographic screening is dependent on case properties and image reader characteristics.
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Affiliation(s)
- Folami Alamudun
- Biomedical Sciences, Engineering, and Computing Group, Health Data Sciences Institute, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - Hong-Jun Yoon
- Biomedical Sciences, Engineering, and Computing Group, Health Data Sciences Institute, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
| | - Kathleen B Hudson
- Department of Radiology, University of Tennessee Medical Center at Knoxville, Knoxville, TN, 37920, USA
| | - Garnetta Morin-Ducote
- Department of Radiology, University of Tennessee Medical Center at Knoxville, Knoxville, TN, 37920, USA
| | - Tracy Hammond
- Department of Computer Science and Engineering, Texas A&M University, College Station, TX, USA, 77843
| | - Georgia D Tourassi
- Biomedical Sciences, Engineering, and Computing Group, Health Data Sciences Institute, Oak Ridge National Laboratory, Oak Ridge, TN, 37831, USA
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Ye Y, Neil AL, Wills KE, Venn AJ. Temporal trends in the risk of developing multiple primary cancers: a systematic review. BMC Cancer 2016; 16:849. [PMID: 27814758 PMCID: PMC5097442 DOI: 10.1186/s12885-016-2876-y] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2016] [Accepted: 10/24/2016] [Indexed: 01/21/2023] Open
Abstract
Background Cancer survivors are at risk of developing second and subsequent primary cancers, referred to as multiple primary cancers (MPCs). It is not clear whether the risk of MPCs has increased over recent decades, but increasing use of radiological imaging and potentially harmful effects of certain cancer treatments raise this possibility. A systematic review was undertaken to assess whether there has been a temporal change in the risk of developing MPCs. Methods A systematic search to identify population-based studies of MPCs was performed in Medline/PubMed and Embase databases from inception to August 2016. Included studies were those reporting risk of MPCs for all sites combined following a first cancer at any site or a specific site, using standard incidence ratios (SIRs) or equivalent, and with analysis stratified by calendar years. Results We identified 28 articles eligible for inclusion, comprising 26 population-based studies and two monographs. MPC incidence was reported in nearly 6.5 million cancer survivors. For all first cancer sites combined, a higher rate of MPCs was reported in more recent than earlier calendar periods in four of the six relevant studies. The SIRs ranged from 1.14 for a first cancer diagnosis in the early 1980s to 1.21–1.46 in the late 1990s in the USA and Australia. Two studies from Italy and France showed no significant difference in SIRs across time periods 1978–2010 and 1989–2004. The remaining 22 studies reported various temporal trends in the risk of developing MPCs after a first cancer at a specific site, but most showed little change. Conclusion Overall, the risk of developing MPCs appears to have increased since the 1980s when considering studies of all primary cancer sites combined from the USA and Australia but not from Europe. With the introduction of more routine nuclear medical imaging over the last 15 years, more studies are needed to confirm recent trends of MPC risk in adult cancer survivors. Electronic supplementary material The online version of this article (doi:10.1186/s12885-016-2876-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yuanzi Ye
- Menzies Institute for Medical Research, Univeristy of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Amanda L Neil
- Menzies Institute for Medical Research, Univeristy of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Karen E Wills
- Menzies Institute for Medical Research, Univeristy of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia
| | - Alison J Venn
- Menzies Institute for Medical Research, Univeristy of Tasmania, Private Bag 23, Hobart, Tasmania, 7000, Australia.
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Hagar YC, Harvey DJ, Beckett LA. A multivariate cure model for left-censored and right-censored data with application to colorectal cancer screening patterns. Stat Med 2016; 35:3347-67. [PMID: 26990553 PMCID: PMC4938788 DOI: 10.1002/sim.6934] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 12/23/2015] [Accepted: 02/17/2016] [Indexed: 12/26/2022]
Abstract
We develop a multivariate cure survival model to estimate lifetime patterns of colorectal cancer screening. Screening data cover long periods of time, with sparse observations for each person. Some events may occur before the study begins or after the study ends, so the data are both left-censored and right-censored, and some individuals are never screened (the 'cured' population). We propose a multivariate parametric cure model that can be used with left-censored and right-censored data. Our model allows for the estimation of the time to screening as well as the average number of times individuals will be screened. We calculate likelihood functions based on the observations for each subject using a distribution that accounts for within-subject correlation and estimate parameters using Markov chain Monte Carlo methods. We apply our methods to the estimation of lifetime colorectal cancer screening behavior in the SEER-Medicare data set. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Yolanda C Hagar
- Department of Applied Mathematics, University of Colorado Boulder, Boulder, CO, U.S.A
| | - Danielle J Harvey
- Department of Public Health Sciences, University of California, Davis, Davis, CA, U.S.A
| | - Laurel A Beckett
- Department of Public Health Sciences, University of California, Davis, Davis, CA, U.S.A
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Parker PA, Cohen L, Bhadkamkar VA, Babaian RJ, Smith MA, Gritz ER, Basen-Engquist KM. Demographic and Past Screening Behaviors of Men Attending a Free Community Screening Program for Prostate Cancer. Health Promot Pract 2016; 7:213-20. [PMID: 16585144 DOI: 10.1177/1524839905278881] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study characterizes demographic and past prostate screening behaviors of men who participated in a free screening for prostate cancer. Demographics, past prostate screening behavior, perceived risk, and cancer worry were assessed in 1,680 men. Mean age was 58.2 years, 56% were White, and 76% had health insurance. Men with insurance were more likely to have had a previous prostate-specific antigen (PSA) test and digital rectal exam (DRE). White men were more likely to have had a previous PSA and DRE and to have discussed PSA testing with a physician than African American men. African American men reported greater perceived risk and more worry than White men. Screening differences between African American and White men were explained by insurance status. These results may help guide the development of and promotion for future screening programs. Future efforts should be directed at increasing awareness about screening procedures for prostate cancer.
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Affiliation(s)
- Patricia A Parker
- The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77230-1439, USA.
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Danish SJ, Forneris T, Schaaf KW. Counseling Psychology and Culturally Competent Health Care. COUNSELING PSYCHOLOGIST 2016. [DOI: 10.1177/0011000007303633] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Addressing health care disparity and working toward a culturally sensitive and competent health care delivery system is a monumental task that calls for social and cultural change. As Herman and colleagues note in this issue, counseling psychologists have contributed greatly to the area of cultural competence and may be capable of taking on a number of roles that can lead to these changes. However, if counseling psychologists are to be part of the solution, they face a number of challenges. In this reaction article, the authors identify a number of issues related to the creation of a culturally sensitive health care system, including the definition of cultural competence, access to health care, the context of health care delivery, and reactions to the model of patient-centered cultural sensitive health care proposed by Tucker and colleagues in this issue.
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Janbaziroudsari H, Mirzaei A, Maleki N. Association of serum prostate-specific antigen levels with the results of the prostate needle biopsy. Bull Cancer 2016; 103:730-4. [PMID: 27345449 DOI: 10.1016/j.bulcan.2016.05.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2015] [Accepted: 05/16/2016] [Indexed: 11/30/2022]
Abstract
AIM To investigate the relationship of serum prostate-specific antigen (PSA) levels with outcomes of prostate needle biopsy in men 50 or more years old. METHODS We measured serum PSA levels in 1472 healthy men 50 or more years old. Men who had serum PSA values 4.0ng/mL or higher underwent digital rectal examination. If there were either an elevated PSA level (≥4ng/mL) or abnormal digital rectal examination, a transrectal ultrasound-guided prostate biopsy was performed. RESULTS The mean serum total PSA level was 13.73±11.44ng/mL, and the mean serum free PSA level was 4.99±0.97ng/mL. Of the 260 men who had serum total PSA levels of≥4ng/mL, 139 underwent biopsy. Of these 139 men, 45 (32.4%) had prostate cancer. Benign prostatic hyperplasia with or without prostatitis was diagnosed in 94 patients (67.6%). There was no significant correlation between age and histologic results of prostate needle biopsy (P-value=0.469). The serum free PSA showed no significant correlation with histologic results of prostate needle biopsy, whereas the serum total PSA level had a significant correlation in patients with adenocarcinoma compared with other diagnosis. CONCLUSIONS The overall frequency of detection of prostate adenocarcinoma was 32.4%. This study revealed that no level of PSA was associated with a 100% positive predictive value and negative biopsy can occur virtually at any PSA level. There is a need to create awareness among the general population and health professionals for an early diagnosis of this common form of cancer.
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Affiliation(s)
- Hamid Janbaziroudsari
- Imam Khomeini Hospital, Ardabil University of Medical Sciences, Department of Internal Medicine, Ardabil, Iran
| | - Arezoo Mirzaei
- Imam Khomeini Hospital, Ardabil University of Medical Sciences, Department of Internal Medicine, Ardabil, Iran
| | - Nasrollah Maleki
- Bushehr University of Medical Sciences, The Persian Gulf Marine Medicine Biotechnology Research Center, Department of Endocrinology, Bushehr, Iran.
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Hariri S, Markowitz LE, Bennett NM, Niccolai LM, Schafer S, Bloch K, Park IU, Scahill MW, Julian P, Abdullah N, Levine D, Whitney E, Unger ER, Steinau M, Bauer HM, Meek J, Hadler J, Sosa L, Powell SE, Johnson ML. Monitoring Effect of Human Papillomavirus Vaccines in US Population, Emerging Infections Program, 2008-2012. Emerg Infect Dis 2016; 21:1557-61. [PMID: 26291379 PMCID: PMC4550135 DOI: 10.3201/eid2109.141841] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Methods for surveillance of cervical precancers and associated types were developed to monitor effect of HPV vaccination. In 2007, five Emerging Infections Program (EIP) sites were funded to determine the feasibility of establishing a population-based surveillance system for monitoring the effect of human papillomavirus (HPV) vaccine on pre-invasive cervical lesions. The project involved active population-based surveillance of cervical intraepithelial neoplasia grades 2 and 3 and adenocarcinoma in situ as well as associated HPV types in women >18 years of age residing in defined catchment areas; collecting relevant clinical information and detailed HPV vaccination histories for women 18–39 years of age; and estimating the annual rate of cervical cancer screening among the catchment area population. The first few years of the project provided key information, including data on HPV type distribution, before expected effect of vaccine introduction. The project’s success exemplifies the flexibility of EIP’s network to expand core activities to include emerging surveillance needs beyond acute infectious diseases. Project results contribute key information regarding the impact of HPV vaccination in the United States.
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Wiegering A, Ackermann S, Riegel J, Dietz UA, Götze O, Germer CT, Klein I. Improved survival of patients with colon cancer detected by screening colonoscopy. Int J Colorectal Dis 2016; 31:1039-1045. [PMID: 26763006 DOI: 10.1007/s00384-015-2501-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/31/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Screening for colon cancer (CC) may not only reduce its occurrence but has also the potential to reduce the overall mortality. So far, there has been little evidence that detection of colon cancer by screening colonoscopy results in different survival rates compared to symptomatic patients. PATIENTS AND METHODS Clinical, histological, diagnostic, and survival data of 1016 consecutive patients with CC from a prospectively expanded single-institutional database were analyzed for diagnostic, treatment, and prognostic factors. Findings were then stratified according to detection by screening colonoscopy vs. patients who became symptomatic prior to further diagnostic work-up. RESULTS 7.1 % of all patients were identified by screening colonoscopy for colon cancer. Screened patients were younger (68.2 vs. 64.8 years), had smaller T stage (p = 0.032), lower tumor stage (p = 0.009), and a tendency to less lymph node metastasis. Overall survival was superior in screened patients, and stage-specific survival showed a tendency to improved survival, which was not statistically significant. Furthermore, a higher percentage of screened patients underwent adjuvant chemotherapy (84.6 vs. 55.0 %, p = 0.032). CONCLUSION Survival outcome and enrollment in a multimodal treatment was higher in screening-detected patients compared to patients diagnosed after the onset of clinical symptoms. Besides a potential occurrence of lead time bias, these findings strongly support the need for continued improvement of screening programs and the recruitment of more patients for colorectal cancer screening.
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Affiliation(s)
- Armin Wiegering
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr. 2, 97080, Wuerzburg, Germany. .,Department of Biochemistry and Molecular Biology, University of Wuerzburg, Oberduerrbacherstr. 2, 97074, Wuerzburg, Germany. .,Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, Julius-Maximilian's University, Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany.
| | - Sabine Ackermann
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr. 2, 97080, Wuerzburg, Germany
| | - Johannes Riegel
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr. 2, 97080, Wuerzburg, Germany
| | - Ulrich A Dietz
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr. 2, 97080, Wuerzburg, Germany
| | - Oliver Götze
- Department of Medicine II, Division of Gastroenterology and Hepatology, University Hospital Würzburg, Oberduerrbacherstr. 2, 97074, Wuerzburg, Germany
| | - Christoph-Thomas Germer
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr. 2, 97080, Wuerzburg, Germany.,Comprehensive Cancer Centre Mainfranken, University Hospital, University of Wuerzburg, Josef-Schneiderstr. 6, 97080, Wuerzburg, Germany
| | - Ingo Klein
- Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, University of Wuerzburg, Oberduerrbacherstr. 2, 97080, Wuerzburg, Germany. .,Comprehensive Cancer Centre Mainfranken, University Hospital, University of Wuerzburg, Josef-Schneiderstr. 6, 97080, Wuerzburg, Germany. .,Department of General, Visceral, Vascular and Pediatric Surgery, University Hospital, Julius-Maximilian's University, Wuerzburg, Oberduerrbacherstr. 6, 97080, Wuerzburg, Germany.
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Zhou CK, Check DP, Lortet-Tieulent J, Laversanne M, Jemal A, Ferlay J, Bray F, Cook MB, Devesa SS. Prostate cancer incidence in 43 populations worldwide: An analysis of time trends overall and by age group. Int J Cancer 2016; 138:1388-400. [PMID: 26488767 PMCID: PMC4712103 DOI: 10.1002/ijc.29894] [Citation(s) in RCA: 191] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 10/08/2015] [Accepted: 10/15/2015] [Indexed: 01/09/2023]
Abstract
Prostate cancer is a significant public health burden and a major cause of morbidity and mortality among men worldwide. Analyzing geographic patterns and temporal trends may help identify high-risk populations, suggest the degree of PSA testing, and provide clues to etiology. We used incidence data available from the International Agency for Research on Cancer (IARC) and certain cancer registries for 43 populations across five continents during a median period of 24 years. Trends in overall prostate cancer rates showed five distinct patterns ranging from generally monotonic increases to peaking of rates followed by declines, which coincide somewhat with changes in the prevalence of PSA testing. Trends in age-specific rates generally mirrored those in the overall rates, with several notable exceptions. For populations where overall rates increased rapidly and then peaked, exemplified in North America and Oceania, the highest incidence tended to be most pronounced and occurred during earlier calendar years among older men compared with younger ones. For populations with almost continual increases in overall rates, exemplified in Eastern Europe and Asia, peaks were evident among men aged ≥ 75 years in many instances. Rates for ages 45-54 years did not clearly stabilize or decline in the majority of studied populations. Global geographic variation remained substantial for both overall and age-specific incidence rates regardless of levels of PSA testing, with the lowest rates consistently in Asia. Explanations for the persistent geographic differences and the continuing increases of especially early-onset prostate cancer remain unclear.
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Affiliation(s)
- Cindy Ke Zhou
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - David P. Check
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Mathieu Laversanne
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Ahmedin Jemal
- Surveillance and Health Services Research, American Cancer Society, Atlanta, GA, USA
| | - Jacques Ferlay
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Freddie Bray
- Section of Cancer Surveillance, International Agency for Research on Cancer, Lyon, France
| | - Michael B. Cook
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | - Susan S. Devesa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
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Atakere DK, Baker TA. Immuned by Race: Ethnic Identity, Masculinity, and Attachment as Predictors of Cancer Screening among Black Men. ACTA ACUST UNITED AC 2016. [DOI: 10.4236/psych.2016.77103] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Cervical cancer screening among women ≥70 years of age in the United States-A referral problem or patient choice. Prev Med 2015; 81:427-32. [PMID: 26500084 PMCID: PMC4679483 DOI: 10.1016/j.ypmed.2015.10.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/12/2015] [Accepted: 10/13/2015] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Clinical guidelines recommend that women with a history of adequate screening and not otherwise at high risk may discontinue cervical cancer screening after 65 years of age. However, screening remains common among US women over 65 years old. This study was conducted to examine whether overutilization was attributable to provider's recommendation or patient choice. METHOD This cross-sectional study used data from 1752 female participants (70+ years) from the 2013 National Health Interview Survey (NHIS). We quantitatively assessed the proportions of provider-recommended and patient self-initiated Pap smears. RESULTS Among female respondents, 40.8% had a Pap smear within the past 3 years, 19.4% had a Pap smear in the last year, and 39.7% reported receiving a recommendation for a Pap smear from their provider in the past year. Among women who received a recommendation to obtain a Pap smear, 39.8% did so within the past 12 months compared to 5.9% of women who did not receive a recommendation (adjusted odds ratio 10.5, 95% confidence interval 7.39-15.0). About 70% of women who visited an obstetrician/gynecologist and reported receiving a recommendation to have a Pap smear did so in the past year, while 32.3% of women who visited an obstetrician/gynecologist but did not receive a recommendation obtained one. CONCLUSION Pap smears were common among women ≥70 years of age. Health care providers may need additional education on current guidelines regarding indications for Pap smears in this age group to help reduce screening of patients who may not benefit.
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Robertson-Tessi M, El-Kareh A, Goriely A. A model for effects of adaptive immunity on tumor response to chemotherapy and chemoimmunotherapy. J Theor Biol 2015; 380:569-84. [PMID: 26087282 DOI: 10.1016/j.jtbi.2015.06.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2013] [Revised: 05/08/2015] [Accepted: 06/02/2015] [Indexed: 10/23/2022]
Abstract
Complete clinical regressions of solid tumors in response to chemotherapy are difficult to explain by direct cytotoxicity alone, because of low growth fractions and obstacles to drug delivery. A plausible indirect mechanism that might reconcile this is the action of the immune system. A model for interaction between tumors and the adaptive immune system is presented here, and used to examine controllability of tumors through the interplay of cytotoxic, cytostatic and immunogenic effects of chemotherapy and the adaptive immune response. The model includes cytotoxic and helper T cells, T regulatory cells (Tregs), dendritic cells, memory cells, and several key cytokines. Nearly all parameter estimates are derived from experimental and clinical data. Individual tumors are characterized by two parameters: growth rate and antigenicity, and regions of tumor control are identified in this parameter space. The model predicts that inclusion of the immune response significantly expands the region of tumor control for both cytostatic and cytotoxic chemotherapies. Moreover, outside the control zone, tumor growth is delayed significantly. An optimal fractionation schedule is predicted, for a fixed cumulative dose. The model further predicts expanded regions of tumor control when several forms of immunotherapy (adoptive T cell transfer, Treg depletion, and dendritic cell vaccination) are combined with chemotherapy. Outcomes depend greatly on tumor characteristics, the schedule of administration, and the type of immunotherapy chosen, suggesting promising opportunities for personalized medicine. Overall, the model provides insight into the role of the adaptive immune system in chemotherapy, and how scheduling and immunotherapeutic interventions might improve efficacy.
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Affiliation(s)
- Mark Robertson-Tessi
- Program in Applied Mathematics, University of Arizona, Tucson, AZ 85721, United States; Integrated Mathematical Oncology, Moffitt Cancer Center, Tampa, FL 33612, United States.
| | - Ardith El-Kareh
- ARL-Microcirculation Division, University of Arizona, Tucson, AZ 85724, United States
| | - Alain Goriely
- Mathematical Institute, University of Oxford, Woodstock Road, OX2 6GG, UK
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Islam M, Sajid A, Mahmood MAI, Bellah MM, Allen PB, Kim YT, Iqbal SM. Nanotextured polymer substrates show enhanced cancer cell isolation and cell culture. NANOTECHNOLOGY 2015; 26:225101. [PMID: 25961762 DOI: 10.1088/0957-4484/26/22/225101] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Detection of circulating tumor cells (CTCs) in the early stages of cancer is a great challenge because of their exceedingly small concentration. There are only a few approaches sensitive enough to differentiate tumor cells from the plethora of other cells in a sample like blood. In order to detect CTCs, several antibodies and aptamers have already shown high affinity. Nanotexture can be used to mimic basement membrane to further enhance this affinity. This article reports an approach to fabricate nanotextured polydimethylsiloxane (PDMS) substrates using micro reactive ion etching (micro-RIE). Three recipes were used to prepare nanotextured PDMS using oxygen and carbon tetrafluoride. Micro-RIE provided better control on surface properties. Nanotexturing improved the affinity of PDMS surfaces to capture cancer cells using surface immobilized aptamers against cell membrane overexpressed with epidermal growth factor receptors. In all cases, nanotexture of PDMS increased the effective surface area by creating nanoscale roughness on the surface. Nanotexture also enhanced the growth rate of cultured cells compared to plain surfaces. A comparison among the three nanotextured surfaces demonstrated an almost linear relationship between the surface roughness and density of captured tumor cells. The nanotextured PDMS mimicked biophysical environments for cells to grow faster. This can have many implications in microfluidic platforms used for cell handling.
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Affiliation(s)
- Muhymin Islam
- Nano-Bio Lab, University of Texas at Arlington, Arlington, TX 76019, USA. Department of Electrical Engineering, University of Texas at Arlington, Arlington, TX 76011, USA. Nanotechnology Research Center, University of Texas at Arlington, Arlington, TX 76019, USA
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Meric K, Bakal N, Aydin S, Yesil A, Tekesin K, Simsek M. Fecal tag CT colonography with a limited 2-day bowel preparation following incomplete colonoscopy. Jpn J Radiol 2015; 33:329-35. [PMID: 25895857 DOI: 10.1007/s11604-015-0421-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2015] [Accepted: 04/08/2015] [Indexed: 12/15/2022]
Abstract
PURPOSE This study aimed to assess the feasibility and patient tolerance of a 2-day limited fecal tag bowel preparation in computed tomographic colonography (CTC) performed for incomplete conventional colonoscopy (CC) patients. MATERIALS AND METHODS Seventy-five patients who underwent a CTC examination fbecause of incomplete CC were included. A low-residue diet was given for 2 days before CTC. Fecal tagging (FT) was done using a barium sulfate suspension. The quality of the preparation, success of tagging and patient experience with the bowel preparation were investigated. RESULTS Four hundred fifty bowel segments were evaluated. The number of solid stool balls of 6-9 mm size was 284; the corresponding figure was 93 for solid stool balls ≥ 10 mm. Residual fluid was present in about one-third of the segments. The fecal tagging efficacy for ≥ 6 mm residual stool balls was 92 %. Overall, 16 (21.3 %) patients presented with colonic lesions at CTC. Three out of four colonic mass lesions had not been diagnosed with CC. Most patients reported mild discomfort. CONCLUSION FT-CTC performed after a limited 2-day bowel preparation seems to be a technically feasible, safe and acceptable procedure that allows a complete a colonic study in incomplete CC patients.
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Affiliation(s)
- Kaan Meric
- Department of Radiology, Haydarpaşa Numune Training and Research Hospital, Tibbiye Caddesi No: 40, 34668, Uskudar, Istanbul, Turkey,
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Comparison of a 4-Day versus 2-Day Low Fiber Diet Regimen in Barium Tagging CT Colonography in Incomplete Colonoscopy Patients. Gastroenterol Res Pract 2015; 2015:609150. [PMID: 25873945 PMCID: PMC4385636 DOI: 10.1155/2015/609150] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2015] [Accepted: 03/04/2015] [Indexed: 11/18/2022] Open
Abstract
Our aim was to compare the amount of residual feces, residual fluid, the tagging quality, and patient compliance using 4-day versus 2-day low fiber diet regimen in barium tagging CT colonography in incomplete colonoscopy patients. Methods. A total of 101 patients who underwent CT colonography were assigned to 2-day diet group (n = 56) and 4-day diet group (n = 45). Fecal tagging was achieved with barium sulphate while bisacodyl and sennoside B were used for bowel preparation. Residual solid stool was divided into two groups measuring <6 mm and ≥6 mm. We graded the residual fluid, tagging quality for solid stool, and fluid per bowel segment. We performed a questionnaire to assess patient compliance. Results. 604 bowel segments were evaluated. There was no significant difference between 2-day and 4-day diet groups with respect to residual solid stool, residual fluid, tagging quality for stool, and fluid observed in fecal tag CT colonography (P > 0.05). The prevalence of moderate discomfort was significantly higher in 4-day group (P < 0.001). Conclusion. Our study shows that 2-day limited bowel preparation regimen for fecal tag CT colonography is a safe and reasonable technique to evaluate the entire colon, particularly in incomplete conventional colonoscopy patients.
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Wee A. Need for Primary Care Providers to Carry out Annual Oral Cancer Examinations. ACTA ACUST UNITED AC 2015; 2:46-51. [DOI: 10.15406/jdhodt.2015.02.00041] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Jiang M, Hughes DR, Appleton CM, McGinty G, Duszak R. Recent trends in adherence to continuous screening for breast cancer among Medicare beneficiaries. Prev Med 2015; 73:47-52. [PMID: 25584984 DOI: 10.1016/j.ypmed.2014.12.031] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Revised: 12/22/2014] [Accepted: 12/26/2014] [Indexed: 11/28/2022]
Abstract
OBJECTIVE The aim of this study is to examine recent trends in adherence to continuous screening, especially the rate of subsequent screening mammography following an initial screening before and after the U.S. Preventive Services Task Force (USPSTF) revised its guidelines on breast cancer in November 2009. METHODS We retrospectively analyzed Medicare fee-for-service claims data to: 1) compare rate of subsequent screening mammography over 27 month periods for 317,150 women screened in either 2004 or 2009; and 2) examine patterns of subsequent screening by age and race. RESULTS When adjusted for age, race, state of residence, county-level covariates, and clustered on ordering provider, the rate of subsequent screening decreased in 2009 relative to 2004 (OR=0.75; 95% CI: 0.74-0.76). Adjusted odds ratios are similar for alternative follow-up windows (15 months, 0.71; 24 months, 0.70; 30 months 0.75). The decline was mostly attributable to women 75 and older who are now less likely to return for a subsequent screening. Although USPSTF guidelines call for 24 months, approximately half of women continue screening at 12-month intervals in both cohorts. CONCLUSIONS The rate of subsequent screening mammography has declined after 2009. Older women seem to follow the revised USPSTF guideline, but confusion by physicians and patients about competing guidelines may be contributing to these findings.
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Affiliation(s)
- Miao Jiang
- Harvey L. Neiman Health Policy Institute, 1891 Preston White Drive, Reston, VA 20191, United States; Department of Health Administration and Policy, George Mason University, Fairfax, VA 22030, United States.
| | - Danny R Hughes
- Harvey L. Neiman Health Policy Institute, 1891 Preston White Drive, Reston, VA 20191, United States; Department of Health Administration and Policy, George Mason University, Fairfax, VA 22030, United States
| | - Catherine M Appleton
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, 510 South Kingshighway Blvd., St. Louis, MO 63110, United States
| | - Geraldine McGinty
- Department of Radiology, Weill Cornell Medical College, 1300 York Avenue, New York, NY 10065, United States
| | - Richard Duszak
- Harvey L. Neiman Health Policy Institute, 1891 Preston White Drive, Reston, VA 20191, United States; Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA 30322, United States
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Niv Y, Dickman R, Levi Z, Neumann G, Ehrlich D, Bitterman H, Dreiher J, Cohen A, Comaneshter D, Halpern E. Establishing an integrated gastroenterology service between a medical center and the community. World J Gastroenterol 2015; 21:2152-8. [PMID: 25717251 PMCID: PMC4326153 DOI: 10.3748/wjg.v21.i7.2152] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2014] [Revised: 07/18/2014] [Accepted: 09/05/2014] [Indexed: 02/06/2023] Open
Abstract
AIM To combine community and hospital services in order to enable improvements in patient management, an integrated gastroenterology service (IGS) was established. METHODS Referral patterns to specialist clinics were optimized; open access route for endoscopic procedures (including esophago-gastro-duodenoscopy, sigmoidoscopy and colonoscopy) was established; family physicians' knowledge and confidence were enhanced; direct communication lines between experts and primary care physicians were opened. Continuing education, guidelines and agreed instructions for referral were promoted by the IGS. Six quality indicators were developed by the Delphi method, rigorously designed and regularly monitored. Improvement was assessed by comparing 2010, 2011 and 2012 indicators. RESULTS An integrated delivery system in a specific medical field may provide a solution to a fragmented healthcare system impaired by a lack of coordination. In this paper we describe a new integrated gastroenterology service established in April 2010. Waiting time for procedures decreased: 3 mo in April 30th 2010 to 3 wk in April 30th 2011 and stayed between 1-3 wk till December 30th 2012. Average cost for patient's visit decreased from 691 to 638 NIS (a decrease of 7.6%). Six health indicators were improved significantly comparing 2010 to 2012, 2.5% to 67.5%: Bone densitometry for patients with inflammatory bowel disease, preventive medications for high risk patients on aspirin/NSAIDs, colonoscopy following positive fecal occult blood test, gastroscopy in Barrett's esophagus, documentation of family history of colorectal cancer, and colonoscopy in patients with a family history of colorectal cancer. CONCLUSION Establishment of an IGS was found to effectively improve quality of care, while being cost-effective.
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