Predictive Modeling of Long-Term Survivors with Stage IV Breast Cancer Using the SEER-Medicare Dataset.

Importance: Treatment of women with stage IV breast cancer (BC) extends population-averaged survival by only a few months. Here, we develop a model for identifying individual circumstances where appropriate therapy will extend survival while minimizing adverse events.

Objective: Our goal is to develop high-confidence deep learning (DL) models to predict survival in individual stage IV breast cancer patients based on their unique circumstances generated by patient, cancer, treatment, and adverse event variables.

AI Survival Prediction Modeling: The Importance of Considering Treatments and Changes in Health Status over Time.

Background And Objectives: Deep learning (DL)-based models for predicting the survival of patients with local stages of breast cancer only use time-fixed covariates, i.e., patient and cancer data at the time of diagnosis.

Bone Marrow Stroma Co-cultivation Model of Breast Cancer Dormancy.

Breast cancer cells metastasize to the bone marrow before a primary tumor is detected. Most micrometastases die in this hostile microenvironment, but some survive and enter a state of dormancy and chemoresistance due to their close interaction with cells in the bone marrow hematopoietic niche. Over many years, some of the cells reawaken and result in metastatic disease that cannot be cured.

Correction: Wieder, R.; Adam, N. Racial Disparities in Breast Cancer Treatments and Adverse Events in the SEER-Medicare Data. 2023, , 4333.

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Temporal Association Rule Mining: Race-Based Patterns of Treatment-Adverse Events in Breast Cancer Patients Using SEER-Medicare Dataset.

Purpose: Disparities in the screening, treatment, and survival of African American (AA) patients with breast cancer extend to adverse events experienced with systemic therapy. However, data are limited and difficult to obtain. We addressed this challenge by applying temporal association rule (TAR) mining using the SEER-Medicare dataset for differences in the association of specific adverse events (AEs) and treatments (TRs) for breast cancer between AA and White women.

Racial Disparities in Breast Cancer Treatments and Adverse Events in the SEER-Medicare Data.

Despite lower incidence rates, African American (AA) patients have shorter survival from breast cancer (BC) than white (W) patients. Multiple factors contribute to decreased survival, including screening disparities, later presentation, and access to care. Disparities in adverse events (AEs) may contribute to delayed or incomplete treatment, earlier recurrence, and shortened survival.

Awakening of Dormant Breast Cancer Cells in the Bone Marrow.

Up to 40% of patients with breast cancer (BC) have metastatic cells in the bone marrow (BM) at the initial diagnosis of localized disease. Despite definitive systemic adjuvant therapy, these cells survive in the BM microenvironment, enter a dormant state and recur stochastically for more than 20 years. Once they begin to proliferate, recurrent macrometastases are not curable, and patients generally succumb to their disease.

Fibroblasts as Turned Agents in Cancer Progression.

Differentiated epithelial cells reside in the homeostatic microenvironment of the native organ stroma. The stroma supports their normal function, their G differentiated state, and their expansion/contraction through the various stages of the life cycle and physiologic functions of the host. When malignant transformation begins, the microenvironment tries to suppress and eliminate the transformed cells, while cancer cells, in turn, try to resist these suppressive efforts.

Are bog plant/lichen tissue concentrations of Ca, Mg, K, and P affected by fugitive dust released from oil sands development in the Fort McMurray region of Alberta?

Bogs are ombrotrophic, relying solely on atmospheric deposition for new inputs of elements. Increased element deposition through anthropogenic activities has the potential to alter nutrient availability, and hence ecosystem function, in bogs. Further, because of efficient element retention, bogs may function as effective monitors of element deposition.

Stromal Co-Cultivation for Modeling Breast Cancer Dormancy in the Bone Marrow.

Cancers metastasize to the bone marrow before primary tumors can be detected. Bone marrow micrometastases are resistant to therapy, and while they are able to remain dormant for decades, they recur steadily and result in incurable metastatic disease. The bone marrow microenvironment maintains the dormancy and chemoresistance of micrometastases through interactions with multiple cell types and through structural and soluble factors.

Drug repositioning for cancer in the era of AI, big omics, and real-world data.

Drug repositioning in cancer has been pursued for years because of slowing drug development, increasing costs, and the availability of drugs licensed for other indications with anticancer effects in the laboratory. Repositioning has encountered obstacles due to generally insufficient single-agent clinical anticancer effects of licensed drugs and a subsequent reluctance by pharmaceutical companies to invest in phase III combination studies with them. Here we review potential machine learning/artificial intelligence (ML/AI) approaches for using real-world data (RWD) that could overcome the limitations of clinical trials and retrospective analyses.

Is bog water chemistry affected by increasing N and S deposition from oil sands development in Northern Alberta, Canada?

Nitrogen and sulfur emissions from oil sands operations in northern Alberta, Canada have resulted in increasing deposition of N and S to the region's ecosystems. To assess whether a changing N and S deposition regime affects bog porewater chemistry, we sampled bog porewater at sites at different distances from the oil sands industrial center from 2009 to 2012 (10-cm intervals to a depth of 1 m) and from 2009 to 2019 (top of the bog water table only). We hypothesized that: (1) as atmospheric N and S deposition increases with increasing proximity to the oil sands industrial center, surface porewater concentrations of NH, NO, DON, and SO would increase and (2) with increasing N and S deposition, elevated porewater concentrations of NH, NO, DON, and SO would be manifested increasingly deeper into the peat profile.

Bog plant/lichen tissue nitrogen and sulfur concentrations as indicators of emissions from oil sands development in Alberta, Canada.

Increasing gaseous emissions of nitrogen (N) and sulfur (S) associated with oil sands development in northern Alberta (Canada) has led to changing regional wet and dry N and S deposition regimes. We assessed the potential for using bog plant/lichen tissue chemistry (N and S concentrations, C:N and C:S ratios, in 10 plant/lichen species) to monitor changing atmospheric N and S deposition through sampling at five bog sites, 3-6 times per growing season from 2009 to 2016. During this 8-year period, oil sands N emissions steadily increased, while S emissions steadily decreased.

A protocol for monitoring plant responses to changing nitrogen deposition regimes in Alberta bogs.

Bogs are nutrient poor, acidic ecosystems that receive their water and nutrients entirely from precipitation (= ombrogenous) and as a result are sensitive to nutrient loading from atmospheric sources. Bogs occur frequently on the northern Alberta landscape, estimated to cover 6% of the Athabasca Oil Sands Area. As a result of oil sand extraction and processing, emissions of nitrogen (N) and sulfur (S) to the atmosphere have led to increasing N and S deposition that have the potential to alter the structure and function of these traditionally nutrient-poor ecosystems.

Restructuring of Academic Tracks to Create Successful Career Paths for the Faculty of Rutgers Biomedical and Health Sciences.

Background: We report faculty affairs lessons from the formation and academic restructuring of Rutgers Biomedical and Health Sciences. Our approach may be a blueprint for development of a new track system that can be adapted by other institutions, after consideration of their own special circumstances.

Methods: We created new Appointments and Promotions guidelines consisting of one Tenure Track and four Non-Tenure Tracks, each with different missions.

Experimental nitrogen addition alters structure and function of a boreal poor fen: Implications for critical loads.

Bogs and fens cover 6 and 21%, respectively, of the 140,329 km Oil Sands Administrative Area in northern Alberta. Regional background atmospheric N deposition is low (<2 kg N ha yr), but oil sands development has led to increasing N deposition (as high as 17 kg N ha yr). To examine responses to N deposition, over five years, we experimentally applied N (as NHNO) to a poor fen near Mariana Lake, Alberta, unaffected by oil sands activities, at rates of 0, 5, 10, 15, 20, and 25 kg N ha yr, plus controls (no water or N addition).

Greater Survival Improvement in African American vs. Caucasian Women with Hormone Negative Breast Cancer.

African American women have not benefited equally from recently improved breast cancer survival. We investigated if this was true for all subsets. We identified 395,170 patients with breast adenocarcinoma from the SEER database from 1990 to 2011 with designated race, age, stage, grade, ER and PR status, marital status and laterality, as control.

Reawakening of dormant estrogen-dependent human breast cancer cells by bone marrow stroma secretory senescence.

Background: Dormant estrogen receptor positive (ER+) breast cancer micrometastases in the bone marrow survive adjuvant chemotherapy and recur stochastically for more than 20 years. We hypothesized that inflammatory cytokines produced by stromal injury can re-awaken dormant breast cancer cells.

Methods: We used an established in vitro dormancy model of Michigan Cancer Foundation-7 (MCF-7) breast cancer cells incubated at clonogenic density on fibronectin-coated plates to determine the effects of inflammatory cytokines on reactivation of dormant ER+ breast cancer cells.

Improving cancer patient emergency room utilization: A New Jersey state assessment.

Introduction: Due to its increasing incidence and its major contribution to healthcare costs, cancer is a major public health problem in the United States. The impact across different services is not well documented and utilization of emergency departments (ED) by cancer patients is not well characterized. The aim of our study was to identify factors that can be addressed to improve the appropriate delivery of quality cancer care thereby reducing ED utilization, decreasing hospitalizations and reducing the related healthcare costs.

Data science, learning, and applications to biomedical and health sciences.

The last decade has seen an unprecedented increase in the volume and variety of electronic data related to research and development, health records, and patient self-tracking, collectively referred to as Big Data. Properly harnessed, Big Data can provide insights and drive discovery that will accelerate biomedical advances, improve patient outcomes, and reduce costs. However, the considerable potential of Big Data remains unrealized owing to obstacles including a limited ability to standardize and consolidate data and challenges in sharing data, among a variety of sources, providers, and facilities.

Differential Effects of High Atmospheric N and S Deposition on Bog Plant/Lichen Tissue and Porewater Chemistry across the Athabasca Oil Sands Region.

Oil extraction and development activities in the Athabasca Oil Sands Region of northern Alberta, Canada, release NO, SO, and NH to the atmosphere, ultimately resulting in increasing N and S inputs to surrounding ecosystems through atmospheric deposition. Peatlands are a major feature of the northern Alberta landscape, with bogs covering 6-10% of the land area, and fens covering 21-53%. Bulk deposition of NH-N, NO-N, dissolved inorganic N (DIN), and SO-S, was quantified using ion-exchange resin collectors deployed at 23 locations, over 1-6 years.

African American Race is an Independent Risk Factor in Survival from Initially Diagnosed Localized Breast Cancer.

: African American race negatively impacts survival from localized breast cancer but co-variable factors confound the impact. Data sets were analyzed from the Surveillance, Epidemiology and End Results (SEER) directories from 1973 to 2011 consisting of patients with designated diagnosis of breast adenocarcinoma, race as White or Caucasian, Black or African American, Asian, American Indian or Alaskan Native, Native Hawaiian or Pacific Islander, age, stage I, II or III, grade 1, 2 or 3, estrogen receptor or progesterone receptor positive or negative, marital status as single, married, separated, divorced or widowed and laterality as right or left. The Cox Proportional Hazards Regression model was used to determine hazard ratios for survival.

An In Vitro Dormancy Model of Estrogen-sensitive Breast Cancer in the Bone Marrow: A Tool for Molecular Mechanism Studies and Hypothesis Generation.

The study of breast cancer dormancy in the bone marrow is an exceptionally difficult undertaking due to the complexity of the interactions of dormant cells with their microenvironment, their rarity and the overwhelming excess of hematopoietic cells. Towards this end, we developed an in vitro 2D clonogenic model of dormancy of estrogen-sensitive breast cancer cells in the bone marrow. The model consists of a few key elements necessary for dormancy.

Prescription coverage in indigent patients affects the use of long-acting opioids in the management of cancer pain.

Purpose: We tested the hypothesis that prescription coverage affects the prescribing of long-acting opiates to indigent inner city minority patients with cancer pain.

Materials And Methods: We conducted a chart review of 360 patients treated in the Oncology Practice at University of Medicine and Dentistry of New Jersey University Hospital, who were prescribed opiate pain medications. Half the patients were charity care or self-pay (CC/SP), without the benefit of prescription coverage, and half had Medicaid, with unlimited prescription coverage.

Establishing a minority-based community clinical oncology program: the University of Medicine and Dentistry of New Jersey, New Jersey Medical School-university Hospital Cancer Center experience.

The Minority-Based Community Clinical Oncology Program (MB-CCOP) at University of Medicine and Dentistry of New Jersey, New Jersey Medical School-University Hospital Cancer Center was established to serve an unmet need in a medically, educationally, and socioeconomically underserved community of primarily African American and Latino patients in Newark and Essex County, New Jersey. The MB-CCOP was built on an existing infrastructure of multidisciplinary teams of cancer specialists who collaborated in patient care and an existing clinical research program, which included multilingual staff and a breast cancer navigator. This article highlights some of the unique opportunities and challenges involved in the startup of an MB-CCOP specifically relevant to an academic setting.