More Than a Backdrop: Understanding the Role of Communities in Programming for Adolescent Girls—Action Guide

The structural and social features of a girl’s community play a critical role in determining what effects programs for adolescent girls can achieve. Girls’ communities include both the physical spaces girls must navigate and adults and peers who shape their beliefs about marriage, work, and education. This action guide focuses on key questions to ask when designing programs: How many girls live in a given community? Is the community urban, peri-urban, or rural? Is it formal or informal? How stable or cohesive is a community? Who is considered a “community member”? What resources exist for girls in the community, and who has access to them? How do economic and social pressures shape community norms about marriage, education, work, and gender roles? The action guide offers tips on how to find answers and provides real-world examples that demonstrate how to use community-level insights for action for adolescent girls. It was written for people who design, manage, and assess community-based programming

Cotyledonoid dissecting leiomyoma with adipocytic differentiation: A case report

• The second case of cotyledonoid dissecting lipoleiomyoma documented in the literature is reported. • Cotyledonoid dissecting leiomyoma presents in a similar manner as aggressive malignancies; however, it is a benign lesion. • Recurrence of cotyledonoid dissecting leiomyoma is exceedingly rare with only one documented recurrence following conservative treatment

Evidence review: Promoting adolescent girls\u27 health and well-being in low-resource settings in the era of COVID-19

Adolescent girls are among the groups intended to benefit from measures governments enact to control COVID-19, such as travel restrictions and business and school closures. However, given the dual disadvantage adolescent girls face due to age and gender, even approaches that effectively reduce the threat of COVID-19 transmission may exacerbate other threats to their health, safety, and well-being. In response, governments, multilateral agencies, and non-governmental organizations have moved to address these risks, though evidence to support investment decision-making is limited. Clarity on the type, degree, and strength of the evidence in support of interventions that promote adolescent girls’ health and well-being is urgently needed. We are conducting an evidence review to meet this challenge. Based on the findings of a structured literature search of published and selected grey literature sources, we will map the current scope of evidence on relevant interventions in low- and middle-income countries. Based on this mapping, we will identify the implications for interventions and research on girls’ health and well-being as the crisis evolves across diverse contexts

Population-Based Incidence Trends of Oropharyngeal and Oral Cavity Cancers by Sex among the Poorest and Underprivileged Populations

Background Oral cancer is an important health issue, with changing incidence in many countries. Oropharyngeal cancer (OPC, in tonsil and oropharygeal areas) is increasing, while oral cavity cancer (OCC, other sites in the mouth) is decreasing. There is the need to identify high risk groups and communities for further study and intervention. The objective of this study was to determine how the incidence of OPC and OCC varied by neighbourhood socioeconomic status (SES) in British Columbia (BC), including the magnitude of any inequalities and temporal trends. Methods ICDO-3 codes were used to identify OPC and OCC cases in the BC Cancer Registry from 1981–2010. Cases were categorized by postal codes into SES quintiles (q1-q5) using VANDIX, which is a census-based, multivariate weighted index based on neighbourhood average household income, housing tenure, educational attainment, employment and family structure. Age-standardized incidence rates were determined for OPC and OCC by sex and SES quintiles and temporal trends were then examined. Results Incidence rates are increasing in both men and women for OPC, and decreasing in men and increasing in women for OCC. This change is not linear or proportionate between different SES quintiles, for there is a sharp and dramatic increase in incidence according to the deprivation status of the neighbourhood. The highest incidence rates in men for both OPC and OCC were observed in the most deprived SES quintile (q5), at 1.7 times and 2.2 times higher, respectively, than men in the least deprived quintile (q1). For OPC, the age-adjusted incidence rates significantly increased in all SES quintiles with the highest increase observed in the most deprived quintile (q5). Likewise, the highest incidence rates for both OPC and OCC in women were observed in the most deprived SES quintile (q5), at 2.1 times and 1.8 times higher, respectively, than women in the least deprived quintile (q1). Conclusion We report on SES disparities in oral cancer, emphasizing the need for community-based interventions that address access to medical care and the distribution of educational and health promotion resources among the most SES deprived communities in British Columbia

Suburbanisation of Oral Cavity Cancers: Evidence From a Geographically-Explicit Observational Study of Incidence Trends in British Columbia, Canada, 1981–2010

Background Recent studies have demonstrated an elevated risk of oral cavity cancers (OCC) among socioeconomically deprived populations, whose increasing presence in suburban neighbourhoods poses unique challenges for equitable health service delivery. The majority of studies to date have utilised aspatial methods to identify OCC. In this study, we use high-resolution geographical analyses to identify spatio-temporal trends in OCC incidence, emphasising the value of geospatial methods for public health research. Methods Using province-wide population incidence data from the British Columbia Cancer Registry (1981–2009, N  = 5473), we classify OCC cases by census-derived neighbourhood types to differentiate between urban, suburban, and rural residents at the time of diagnosis. We map geographical concentrations by decade and contrast trends in age-adjusted incidence rates, comparing the results to an index of socioeconomic deprivation. Results Suburban cases were found to comprise a growing proportion of OCC incidence. In effect, OCC concentrations have dispersed from dense urban cores to suburban neighbourhoods in recent decades. Significantly higher age-adjusted oral cancer incidence rates are observed in suburban neighbourhoods from 2006 to 2009, accompanied by rising socioeconomic deprivation in those areas. New suburban concentrations of incidence were found in neighbourhoods with a high proportion of persons aged 65+ and/or born in India, China, or Taiwan. Conclusions While the aging of suburban populations provides some explanation of these trends, we highlight the role of the suburbanisation of socioeconomically deprived and Asia-born populations, known to have higher rates of risk behaviours such as tobacco, alcohol, and betel/areca consumption. Specifically, betel/areca consumption among Asia-born populations is suspected to be a primary driver of the observed geographical shift in incidence from urban cores to suburban neighbourhoods. We suggest that such geographically-informed findings are complementary to potential and existing place-specific cancer control policy and targeting prevention efforts for high-risk sub-populations, and call for the supplementation of epidemiological studies with high-resolution mapping and geospatial analysis

Adolescent girls and COVID-19: Mapping the evidence on interventions

With the COVID-19 crisis continuing to evolve, evidence on the effectiveness of short-term emergency-oriented responses and long-term mitigation strategies is expanding but still limited. There are, and will continue to be, substantial evidence gaps on programming to address risk across outcomes of importance to adolescent girls. More evidence is needed to slow the risks posed by the pandemic for this subpopulation, which can help guide gender- and age-responsive prevention and impact mitigation investments. Evidence from approaches delivered in other unstable contexts may offer important lessons for decision-making in the current context. Recognizing this, the Population Council conducted a structured review of existing evidence collected prior to the pandemic, across low- and middle-income country contexts (under the auspices of the Adolescent Girls Investment Plan). The review aimed to advance the four goals addressed in this report: reducing girls’ risks of contracting COVID-19; identifying longer-term developmental intervention approaches that hold promise in the recovery period; mitigating the secondary effects of COVID-19 on girls; and identifying priority evidence gaps

Targeted deep sequencing of mucinous ovarian tumors reveals multiple overlapping RAS-pathway activating mutations in borderline and cancerous neoplasms

Background: Mucinous ovarian tumors represent a distinct histotype of epithelial ovarian cancer. The rarest (2-4 % of ovarian carcinomas) of the five major histotypes, their genomic landscape remains poorly described. We undertook hotspot sequencing of 50 genes commonly mutated in human cancer across 69 mucinous ovarian tumors. Our goals were to establish the overall frequency of cancer-hotspot mutations across a large cohort, especially those tumors previously thought to be “RAS-pathway alteration negative”, using highly-sensitive next-generation sequencing as well as further explore a small number of cases with apparent heterogeneity in RAS-pathway activating alterations. Methods: Using the Ion Torrent PGM platform, we performed next generation sequencing analysis using the v2 Cancer Hotspot Panel. Regions of disparate ERBB2-amplification status were sequenced independently for two mucinous carcinoma (MC) cases, previously established as showing ERBB2 amplification/overexpression heterogeneity, to assess the hypothesis of subclonal populations containing either KRAS mutation or ERBB2 amplification independently or simultaneously. Results: We detected mutations in KRAS, TP53, CDKN2A, PIK3CA, PTEN, BRAF, FGFR2, STK11, CTNNB1, SRC, SMAD4, GNA11 and ERBB2. KRAS mutations remain the most frequently observed alteration among MC (64.9 %) and mucinous borderline tumors (MBOT) (92.3 %). TP53 mutation occurred more frequently in carcinomas than borderline tumors (56.8 % and 11.5 %, respectively), and combined IHC and mutation data suggest alterations occur in approximately 68 % of MC and as many as 20 % of MBOT. Proven and potential RAS-pathway activating changes were observed in all but one MC. Concurrent ERBB2 amplification and KRAS mutation were observed in a substantial number of cases (7/63 total), as was co-occurrence of KRAS and BRAF mutations (one case). Microdissection of ERBB2-amplified regions of tumors harboring KRAS mutation suggests these alterations are occurring in the same cell populations, while consistency of KRAS allelic frequency in both ERBB2 amplified and non-amplified regions suggests this mutation occurred in advance of the amplification event. Conclusions: Overall, the prevalence of RAS-alteration and striking co-occurrence of pathway “double-hits” supports a critical role for tumor progression in this ovarian malignancy. Given the spectrum of RAS-activating mutations, it is clear that targeting this pathway may be a viable therapeutic option for patients with recurrent or advanced stage mucinous ovarian carcinoma, however caution should be exercised in selecting one or more personalized therapeutics given the frequency of non-redundant RAS-activating alterations

Clinical Characteristics and Molecular Subtyping of Vibrio vulnificus Illnesses, Israel

The genetically distinct biotype 3 has penetrated Israeli freshwaters and is causing severe illness in persons who handle tilapia or carp