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Coleman C.N.,International Cancer Expert Corps | Formenti S.C.,New York University | Williams T.R.,Lynn Cancer Institute at Boca Raton Regional Hospital | Petereit D.G.,American Indian Walking Forward Program | And 16 more authors.
Frontiers in Oncology | Year: 2014

The growing burden of non-communicable diseases including cancer in low- and lower-middle income countries (LMICs) and in geographic-access limited settings within resource-rich countries requires effective and sustainable solutions. The International Cancer Expert Corps (ICEC) is pioneering a novel global mentorship-partnership model to address workforce capability and capacity within cancer disparities regions built on the requirement for local investment in personnel and infrastructure. Radiation oncology will be a key component given its efficacy for cure even for the advanced stages of disease often encountered and for palliation. The goal for an ICEC Center within these health disparities settings is to develop and retain a high-quality sustainable workforce who can provide the best possible cancer care, conduct research, and become a regional center of excellence. The ICEC Center can also serve as a focal point for economic, social, and healthcare system improvement. ICEC is establishing teams of Experts with expertise to mentor in the broad range of subjects required to establish and sustain cancer care programs. The Hubs are cancer centers or other groups and professional societies in resource-rich settings that will comprise the global infrastructure coordinated by ICEC Central. A transformational tenet of ICEC is that altruistic, human-service activity should be an integral part of a healthcare career. To achieve a critical mass of mentors ICEC is working with three groups: academia, private practice, and senior mentors/retirees. While in-kind support will be important, ICEC seeks support for the career time dedicated to this activity through grants, government support, industry, and philanthropy. Providing care for people with cancer in LMICs has been a recalcitrant problem. The alarming increase in the global burden of cancer in LMICs underscores the urgency and makes this an opportune time fornovel and sustainable solutions to transform cancer care globally. © 2014 Coleman, Formenti, Williams, Petereit, Soo, Wong, Chao, Shulman, Grover, Magrath, Hahn, Liu, DeWeese, Khleif, Steinberg, Roth, Pistenmaa, Love, Mohiuddin and Vikram.


Love R.R.,International Breast Cancer Research Foundation | Coleman C.N.,U.S. National Cancer Institute | Vikram B.,U.S. National Cancer Institute | Petereit D.G.,Rapid City Regional Hospital
Journal of Cancer Policy | Year: 2013

While there is increasing attention to cancer among underserved populations globally, recent publications have suggested that discussions often ignore the broad but critical issues and lack due diligence. This communication considers these subjects. We all seek honest governments, recognition of women's and other human rights, protection of minorities, the fostering of education for all, and the rendering of fair justice. Absence of these overwhelms efforts in cancer care. Massive rural-urban migration and the majority of cancer burdens globally occurring among the huge populations of poor Asians are also dominating realities. In-depth understanding of how people actually live must ground our efforts. Weak governments, weak health systems, and widespread corruption adversely impact work to improve cancer outcomes. Some implications of these painful circumstances are first that cancer-specific, top-down approaches may be less suitable and less effective than locally defined efforts sensitive to particular broad issues. Second, that widespread drug availability may be less an economic issue than a social systems issue. Third, patient education about cancer signs and symptoms may be less useful than direct efforts targeting broad human rights issues to give patients real choices to seek care. We suggest that addressing cancer control for underserved populations needs to be more of an exercise in addressing the major societal issues, living noble values, investigating to see things as they really are, and acting from a model of intervention suitable to the broad complex challenges. © 2013 The Authors.


Love R.R.,International Breast Cancer Research Foundation | Young G.S.,Ohio State University | Laudico A.V.,Philippine General Hospital | Van Dinh N.,Hospital K | And 11 more authors.
Cancer | Year: 2013

BACKGROUND In premenopausal women treated for breast cancer, loss of bone mineral density (BMD) follows from menopause induced by chemotherapy or loss of ovarian function biochemically or by surgical oophorectomy. The impact on BMD of surgical oophorectomy plus tamoxifen therapy has not been described. METHODS In 270 Filipino and Vietnamese premenopausal patients participating in a clinical trial assessing the impact of the timing in the menstrual cycle of adjuvant surgical oophorectomy on breast cancer outcomes, BMD was measured at the lumbar spine and femoral neck before this treatment, and at 6, 12, and 24 months after surgical and tamoxifen therapies. RESULTS In women with a pretreatment BMD assessment and at least 1 other subsequent BMD assessment, no significant change in femoral neck BMD was observed over the 2-year period (-0.006 g/cm 2, -0.8%, P =.19), whereas in the lumbar spine, BMD fell by 0.045 g/cm2 (4.7%) in the first 12 months (P <.0001) and then began to stabilize. CONCLUSIONS Surgically induced menopause with tamoxifen treatment is associated with loss of BMD at a rate that lessens over 2 years in the lumbar spine and no significant change of BMD in the femoral neck. Cancer 2013;119:3746-3752. © 2013 American Cancer Society.


Ginsburg O.M.,University of Toronto | Chowdhury M.,mPower Social Enterprises | Wu W.,University of Toronto | Chowdhury T.I.,mPower Social Enterprises | And 10 more authors.
Oncologist | Year: 2014

Objective. To demonstrate proof of concept for a smart phone-empowered community health worker (CHW) model of care for breast health promotion, clinical breast examination (CBE), and patient navigation in rural Bangladesh. Methods. This study was a randomized controlled trial; July 1 to October 31, 2012, 30 CHWs conducted door-to-door interviews of women aged 25 and older in Khulna Division. Only women who disclosed a breast symptom were offered CBE. Arm A: smart phone with applications to guide interview, report data, show motivational video, and offer appointment for women with an abnormal CBE. Arm B: smart phone/ applications identical to Arm A plus CHW had training in "patient navigation" to address potential barriers to seeking care. Arm C: control arm (no smart phone; same interview recorded on paper). Outcomes are presented as the "adherence" (to advice regarding a clinic appointment) for women with an abnormal CBE. This study was approved by Women's College Hospital Research Ethics Board (Toronto, Ontario, Canada) and district government officials (Khulna, Bangladesh). Funded by Grand Challenges Canada. Results. In 4 months, 22,337 women were interviewed; <1% declined participation, and 556 women had an abnormal CBE. Control group CHWs completed fewer interviews, had inferior data quality, and identified significantly fewer women with abnormal breast exams compared with CHWs in arms A and B. Arm B had the highest adherence. Conclusion. CHWs guided by our smart phone applications were more efficient and effective in breast health promotion compared with the control group. CHW "navigators" were most effective in encouraging women with an abnormal breast examination to adhere to advice regarding clinic attendance. © AlphaMed Press 2014.


Adibuzzaman M.,Marquette University | Ahamed S.I.,Marquette University | Love R.,International Breast Cancer Research Foundation
Proceedings of the ACM Symposium on Applied Computing | Year: 2014

Smart phones with optical sensors have created new opportunities for low cost and remote monitoring of vital signs. In this paper, we present a novel approach to find heart rate, perfusion index and oxygen saturation using the video images captured by the camera of the smart phones with mathematical models. We use a technique called principal component analysis (PCA) to find the band that contain most plethysmographic information. Also, we showed a personalized regression model works best for accurately detecting perfusion index and oxygen saturation. Our model has high accuracy of the physiological parameters compared to the traditional pulse oxymeter. Also, an important relationship between frame rate for image capture, minimum peak to peak distance in the pulse wave form and accuracy has been established. We showed that there is an optimal value for minimum peak to peak distance for detecting heart rate accurately. Moreover, we present the evaluation of our personalized models. Copyright 2014 ACM.


Kawsar F.,Marquette University | Ahamed S.,Marquette University | Love R.,International Breast Cancer Research Foundation
Lecture Notes in Computer Science (including subseries Lecture Notes in Artificial Intelligence and Lecture Notes in Bioinformatics) | Year: 2015

Automatic activity detection is important for remote monitoring of elderly people or patients, for context-aware applications, or simply to measure one’s activity level. Recent studies have started to use accelerometers of smart phones. Such systems require users to carry smart phones with them which limit the practical usability of these systems as people place their phones in various locations depending on situation, activity, location, culture and gender. We developed a prototype for shoe based activity detection system that uses pressure data of shoe and showed how this can be used for remote monitoring. We also developed a multimodal system where we used pressure sensor data from shoes along with accelerometers and gyroscope data from smart phones to make a robust system. We present the details of our novel activity detection system, its architecture, algorithm and evaluation. © Springer International Publishing Switzerland 2015.


Kawsar F.,Marquette University | Hasan M.K.,Marquette University | Love R.,International Breast Cancer Research Foundation | Ahamed S.I.,Marquette University
Proceedings - International Computer Software and Applications Conference | Year: 2015

Physical activities detection plays a vital role to healthcare professionals who would like to monitor patients remotely and to develop context-sensitive systems. Major number of physical activity detection systems use accelerometers to collect data from different parts of the body. Since those approaches have limitations from users' point of view, we have used smart phones that are coming with built-in accelerometers and gyroscopes. We have proposed and developed three novel approaches for activity recognition. Firstly, we have developed a multimodal system where we used pressure sensor data from shoes along with accelerometers and gyroscope data from smart phone. Again, we have presented the details of our novel activity detection system along with evaluation. In the second approach, we considered our sensor data as time series shapelets and apply recently developed algorithms to differentiate those shapelets. Finally, we applied Gaussian Mixture Models with time-delay embedding for detecting different activities. © 2015 IEEE.


Ginsburg O.M.,University of Toronto | Ginsburg O.M.,Womens College Research Institute | Love R.R.,Ohio State University | Love R.R.,International Breast Cancer Research Foundation
Breast Journal | Year: 2011

Recent progress with declines in mortality in some high-income countries has obscured the fact that for the majority of women worldwide who are newly diagnosed, breast cancer is a neglected disease in the context of other numerically more frequent health problems. For this growing majority, it is also an orphan disease, in that detailed knowledge about tumor characteristics and relevant host biology necessary to provide even basic care is absent. With the possible exception of nutritional recommendations, current international cancer policy and planning initiatives are irrelevant to breast cancer. The progress that has occurred in high-income countries has come at extraordinary fiscal expense and patient toxicity, which of themselves suggest nonrelevance to women and healthcare practitioners in middle- and low-income countries. The implications of these circumstances appear clear: if the promise of the now 60-year-old Declaration of Human Rights that the fruits of medical science accrue to all mankind is to be realized with respect to breast cancer, a basic and translational global research initiative should be launched. © 2011 Wiley Periodicals, Inc.


Love R.R.,Ohio State University | Love R.R.,International Breast Cancer Research Foundation
ONCOLOGY | Year: 2010

Reviews of issues around adjuvant hormonal therapies for breast cancer in premenopausal women often focus on recent and current large clinical trials, and fail to address other subjects that are very germane to evidence-based and investigatory clinical practice. These topics include: (1) the descriptive epidemiology of breast cancer globally, (2) critical issues in tumor hormone receptor testing, (3) compelling data demonstrating that hormone receptorpositive breast cancer is a chronic disease, (4) data supportive of combined hormonal therapy with tamoxifen as the standard of care, and the limited justifications for awaiting the SOFT and TEXT trial results, (5) pharmacogenetic hypotheses with tamoxifen, (6) ethical issues in ovarian suppression vs ablative treatment, and (7) emerging data about the importance of primary tumor removal surgery itself and surgical stress in solid tumor management.


PubMed | International Breast Cancer Research Foundation
Type: | Journal: International journal of breast cancer | Year: 2012

Women in low- and middle-income countries (LMICs) have yet to benefit from recent advances in breast cancer diagnosis and treatment now experienced in high-income countries. Their unique sociocultural and health system circumstances warrant a different approach to breast cancer management than that applied to women in high-income countries. Here, we present experience from the last five years working in rural Bangladesh. Case and consecutive series data, focus group and individual interviews, and clinical care experience provide the basis for this paper. These data illustrate a complex web of sociocultural, economic, and health system conditions which affect womens choices to seek and accept care and successful treatment. We conclude that health system, human rights, and governance issues underlie high mortality from this relatively rare disease in Bangladesh.

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