Explore the vast range of titles available.

Documents the story of how scientists took cells from an unsuspecting descendant of freed slaves and created a human cell line that has been kept alive indefinitely, enabling discoveries in such areas as cancer research, in vitro fertilization, and gene mapping.

Perfluorooctanoic acid (PFOA) has been linked to cancer in occupational mortality studies and animal toxicologic research. We investigated the relationship between PFOA exposure and cancer among residents living near the DuPont Teflon-manufacturing plant in Parkersburg, West Virginia (WV). Our analyses included incident cases of 18 cancers diagnosed from 1996 through 2005 in five Ohio (OH) counties and eight WV counties. For analyses of each cancer outcome, controls comprised all other cancers in the study data set except kidney, pancreatic, testicular, and liver cancers, which have been associated with PFOA in animal or human studies. We applied logistic regression models to individual-level data to calculate adjusted odds ratios (AORs) and confidence intervals (CIs). For the combined analysis of OH and WV data, the exposure of interest was resident water district. Within OH, geocoded addresses were integrated with a PFOA exposure model to examine the relationship between cancer odds and categories of estimated PFOA serum. Our final data set included 7,869 OH cases and 17,238 WV cases. There was a positive association between kidney cancer and the very high and high serum exposure categories [AOR = 2.0 (95% CI: 1.0, 3.9) n = 9 and 2.0 (95% CI: 1.3, 3.2) n = 22, respectively] and a null association with the other exposure categories compared with the unexposed. The largest AOR was for testicular cancer with the very high exposure category [2.8 (95% CI: 0.8, 9.2) n = 6], but there was an inverse association with the lower exposure groups, and all estimates were imprecise because of small case numbers. Our results suggest that higher PFOA serum levels may be associated with testicular, kidney, prostate, and ovarian cancers and non-Hodgkin lymphoma. Strengths of this study include near-complete case ascertainment for state residents and well-characterized contrasts in predicted PFOA serum levels from six contaminated water supplies.

To determine the time to treatment for patients with non-small cell lung cancer (NSCLC) in West Virginia (WV) by baseline characteristics and the association of timely treatment with survival. A retrospective study was conducted using 1993–2021 WV Cancer Registry data to identify persons diagnosed with NSCLC who received treatment. Time to treatment from diagnosis was determined and dichotomized as early treatment (<35 days) vs delayed treatment (≥35 days). Descriptive statistics, comparative and survival analyses (with univariate and multivariate Cox regression were used to address study objectives. Of 10,463 participants, the majority were male (58.1 %), married or partnered (59.9 %), non-Hispanic white (97.5 %). 61 % received early treatment. 45 %, 38 %, and 16 % received systemic therapy, surgery, and radiation, respectively. Baseline characteristics significantly associated with treatment receipt included being male (HR=1.08, 95 % CI=1.04–1.13), cancer stage (HR range=1.19–2.38, being Black and receiving surgery (0.43, 0.30–0.62), radiation (0.48, 0.33–0.68), or systemic therapy (0.33,0.23–0.47) (compared to other treatment). Baseline characteristics significantly associated with death include rurality (HR=1.09, 95 % CI=1.00–1.18), age (HR=1.01, 1.01–1.02), male gender (HR=1.21 (1.16–1.26), being married (0.92, 0.88–0.96), comorbidity (1.07, 1.05–1.09), cancer stage (HR range=1.58–4.79), and receiving surgery (0.16, 0.11–0.22), radiation (0.34, 0.24–0.49), or systemic therapy (0.17, 0.12–0.24) (compared to other treatment). In WV, most patients with NSCLC who receive treatment are treated early. Sociodemographic and clinical factors such as being male, cancer stage and type of treatment predicted time to treatment receipt and were likewise associated with overall survival. Cancer stage represents a modifiable factor that may be responsive to interventions aimed at improving lung cancer outcomes through early diagnosis. •Most patients in WV with NSCLC who receive treatment are treated early•Being male, cancer stage and type of treatment predicted time to treatment receipt and were likewise associated with overall survival.•Delayed treatment was associated with 18 % lower risk of death.

Background Colorectal cancer (CRC) disparities vary by country and population group, but often have spatial features. This study of the United States state of Virginia assessed CRC outcomes, and identified demographic, socioeconomic and healthcare access contributors to CRC disparities. Methods County- and city-level cross-sectional data for 2011–2015 CRC incidence, mortality, and mortality-incidence ratio (MIR) were analyzed for geographically determined clusters (hotspots and cold spots) and their correlates. Spatial regression examined predictors including proportion of African American (AA) residents, rural-urban status, socioeconomic (SES) index, CRC screening rate, and densities of primary care providers (PCP) and gastroenterologists. Stationarity, which assesses spatial equality, was examined with geographically weighted regression. Results For incidence, one CRC hotspot and two cold spots were identified, including one large hotspot for MIR in southwest Virginia. In the spatial distribution of mortality, no clusters were found. Rurality and AA population were most associated with incidence. SES index, rurality, and PCP density were associated with spatial distribution of mortality. SES index and rurality were associated with MIR. Local coefficients indicated stronger associations of predictor variables in the southwestern region. Conclusions Rurality, low SES, and racial distribution were important predictors of CRC incidence, mortality, and MIR. Regions with concentrations of one or more factors of disparities face additional hurdles to improving CRC outcomes. A large cluster of high MIR in southwest Virginia region requires further investigation to improve early cancer detection and support survivorship. Spatial analysis can identify high-disparity populations and be used to inform targeted cancer control programming.

Breast cancer chemotherapy/immunotherapy can be associated with treatment-limiting cardiotoxicity. Radiomics techniques applied to ultrasound, known as ultrasomics, can be used in cardio-oncology to leverage echocardiography for added prognostic value. To utilize ultrasomics features collected prior to antineoplastic therapy to enhance prediction of mortality and heart failure (HF) in patients with breast cancer. Patients were retrospectively recruited in a study at the West Virginia University Cancer Institute. The final inclusion criteria were met by a total of 134 patients identified for the study. Patients were imaged using echocardiography in the parasternal long axis prior to receiving chemotherapy. All-cause mortality and HF, developed during treatment, were the primary outcomes. 269 features were assessed, grouped into four major classes: demographics (n = 21), heart function (n = 7), antineoplastic medication (n = 17), and ultrasomics (n = 224). Data was split into an internal training (60%, n = 81) and testing (40%, n = 53) set. Ultrasomics features augmented classification of mortality (area under the curve (AUC) 0.89 vs. 0.65, P = 0.003), when compared to demographic variables. When developing a risk prediction score for each feature category, ultrasomics features were significantly associated with both mortality (P = 0.031, log-rank test) and HF (P = 0.002, log-rank test). Further, only ultrasomics features provided significant improvement over demographic variables when predicting mortality (C-Index: 0.78 vs. 0.65, P = 0.044) and HF (C-Index: 0.77 vs. 0.60, P = 0.017), respectively. With further investigation, a clinical decision support tool could be developed utilizing routinely obtained patient data alongside ultrasomics variables to augment treatment regimens.

The purpose of this study is to evaluate the effectiveness of the West Virginia Program to Increase Colorectal Cancer Screening in implementing patient reminders to increase fecal immunochemical test (FIT) kit return rates in nine federally qualified health centers (FQHCs). Using process measures and cost data collected, the authors examined the differences in the intensity of the phone calls across FQHCs and compared them with the return rates achieved. They also reported the cost per kit successfully returned as a result of the intervention. Across all FQHCs, 5,041 FIT kits were ordered, and the initial return rate (without a reminder) was 41.1%. A total of 2,201 patients received reminder phone calls; on average, patients received 1.61 reminder calls each. The reminder interventions increased the average FIT kit return rate to 60.7%. The average total cost per FIT kit returned across all FQHCs was $60.18, and the average cost of only the reminders was $11.20 per FIT kit returned. FQHCs achieved an average increase of 19.6 percentage points in FIT kit return rates, and costs across clinics varied. Clinics with high-quality health information systems that enabled tracking of patients with minimal effort were able to implement lower cost reminder interventions.

Medical ideas are addressed among medical students, health care professionals, physicians, and other health practitioners using the concepts from the humanities. In 1972, Joanne Trautmann Banks, an English professor, was appointed in the Pennsylvania State University College of Medicine, Hershey, marking the first-time literature was incorporated into a medical school curriculum. [...]it helps to identify medical practitioners\" assumptions and biases, enhancing self-awareness. [...]reading literature fosters critical thinking and empathetic awareness about moral issues in the field of medicine.

Recent literature shows changing trends in use of breast conservation surgery (BCS), mastectomy, and contralateral prophylactic mastectomy (CPM) in women with early-stage breast cancer (ESBC). We analyzed factors associated with selection of these treatment modalities in a rural West Virginia tertiary care hospital. We conducted a 10-year analysis of women treated for ESBC at our institution from the institutional cancer registry. Variables were compared between patients choosing BCS versus mastectomy. In women who chose mastectomy, predictors for choice of CPM were also examined. Variables with P < 0.05 on univariate analysis were entered into a multivariate logistic regression model to define independent predictors of treatment choice. The mastectomy rate increased from 18.0 per cent in 2006 to 40.2 per cent in 2013. On multivariate analysis, insurance status (P < 0.001), comorbidities (P = 0.001), and surgeon graduation after 1987—a surrogate for surgeon age—(P = 0.010) predicted receipt of mastectomy. Of those receiving mastectomy, 106 (25.1%) elected CPM. CPM rates increased from 8.0 per cent in 2006 to 45.0 per cent in 2013. Younger age at diagnosis (P < 0.001) and use of preoperative MRI (P = 0.012) independently predicted use of CPM versus unilateral mastectomy. Rates of mastectomy and CPM in ESBC have increased in West Virginia over time. Independent predictors of selecting mastectomy over BCS included insurance status, surgeon age, and associated comorbidities. Younger patients and patients receiving preoperative MRI were more likely to choose CPM. Awareness of these factors will aid in counseling women with ESBC and allow clinicians to address potential biases or disparities that may affect treatment choices. Further prospective study of these findings is warranted.

HPV vaccination series completion rates have increased steadily in the USA, yet specific areas continue to be burdened by HPV-related cancers, including rural areas of Virginia. The primary purpose of this study is to compare the impact of an community driven educational film about HPV on intention to vaccinate and knowledge gained in urban and rural areas of Virginia. From October 2016 to September 2019, the CDC-approved documentary “Someone You Love: The HPV Epidemic” was screened and followed by a Q&A session. Intention to vaccinate and knowledge gained after seeing the DVD intervention were measured through a pre-post-survey and analyzed data using chi-squared tests. The sample included males and females of all races and ages 18+ that identified as either student, parent/guardian, and/or healthcare provider from rural and urban geographical areas. Changes in knowledge about HPV were statistically significant in two out of seven questions (p < 0.05). Changes in attitude were statistically significant in every attitude-based question about HPV (p < 0.05). There were significant differences in knowledge gained and attitudes towards the HPV vaccine when comparing urban and rural locations as well. More research is needed to explore the efficacy of community-based interventions to increase uptake and series completion of HPV vaccination, particularly in rural areas most impacted by HPV-associated cancers.

The decision to pursue immediate postmastectomy breast reconstruction (IBR) is not uniform across all groups of women in the United States. We sought to investigate if the challenges of caring for a socioeconomically and geographically challenged rural population affected the incidence of IBR and to identify predictive factors of IBR in this population. Using our institution's cancer registry, we conducted a 10-year review of women with early-stage, unilateral breast cancer who received mastectomy. Demographics, insurance status, comorbidities, and surgeon graduation year were compared for patients receiving IBR versus no reconstruction. Variables with P < 0.05 on univariate analysis were included into a multivariate logistic regression model to determine independent predictors of IBR. From 2006 to 2015, 53/423 (12.5%) patients underwent IBR. On multivariate analysis, three factors independently predicted the decision to undergo IBR: age (P = 0.004), insurance type (P = 0.034), and use of contralateral prophylactic mastectomy (CPM, P < 0.001). Our data indicate that age, insurance type, and utilization of CPM influence the decision to pursue reconstruction. Additionally, the rate of IBR was found to be much lower in our West Virginia population than reported nationally, suggesting disparities in the care of women with early-stage, unilateral breast cancer in a rural population, even in a tertiary care environment.