Advancing Cancer Prevention Practice Facilitation Work in Rural Primary Care During COVID-19

COVID-19 and the response to slow the virus spread in West Virginia (WV), including a statewide stay-at-home order, presented challenges to rural primary care clinics on the frontlines. These challenges affected critical quality improvement work, including cancer screening services. In this commentary, the authors present the results of a survey of WV primary care practices that highlight potential long-term implications and identifies opportunities for practice facilitators to partner with rural primary care clinics to address them

Case Study of a Comprehensive Team-Based Approach to Increase Colorectal Cancer Screening

Introduction: Colorectal cancer is the second leading cause of cancer deaths among men and women in West Virginia. In addition, 51% of all colorectal cancers diagnosed in West Virginia from 2012 to 2016 were detected at either regional (31%) or distant (20%) stages indicating a need for improved early detection. Methods: West Virginia University Cheat Lake Physicians participated in the West Virginia Program to Increase Colorectal Cancer Screening, a program of Cancer Prevention and Control at the WVU Cancer Institute. As a result, Cheat Lake Physicians assembled a team of health care professionals to implement evidence-based interventions and system changes including provider assessment and feedback, patient reminders, accurate data capture, and tracking of CRC screening tests. Results: These efforts resulted in a 15.8% increase in colorectal cancer screening rates within one year of implementation. Additionally, the clinic achieved a 66% return rate for Fecal Immunochemical Test kits, an inexpensive, stool-based colorectal cancer screening test. Implications: The utilization of a team-based approach to patient care yields positive results that can be carried over to other cancer and disease prevention efforts in primary care clinics

Leveraging Electronic Health Records Data for Enhanced Colorectal Cancer Screening Efforts

Introduction: Colorectal cancer is the third most common type of cancer in the United States for men and women combined. While the current threat of disease nationally is significant, the majority of colorectal cancer cases and deaths could be prevented through established screening tests and guidelines. Within the Appalachian region and West Virginia in particular, colorectal cancer is a significant public health problem. A more systematic, comprehensive approach to preventing and controlling cancer is essential. Methods: Through the West Virginia Program to Increase Colorectal Cancer Screening, primary care systems across the state received data-informed practice facilitation designed to increase screening rates. Results: Year-1 cohort health systems had an overall baseline screening rate of 28.4% during calendar year 2014. This rate increased and remained steady during the three follow-up measurement time periods, with a rate of 49.5% during calendar year 2018. This increase is notably greater than comparable health systems not part of the initiative. Implications: Lessons learned in increasing colorectal cancer screening rates are applicable to other priority health needs as well

Phytosterol crystallisation within bulk and dispersed triacylglycerol matrices as influenced by oil droplet size and low molecular weight surfactant addition

peer-reviewedPhytosterols can lower LDL-cholesterol and are frequently used by the functional food industry. However, little is known regarding how phytosterol crystallisation can be controlled, despite solubilised phytosterols having improved bioaccessibility. This study investigates phytosterol crystallisation in bulk milk fat and in model dairy emulsion systems at two average droplet sizes, 1.0 and 0.2 µm. The effect of lecithin and monoacylglycerol addition on phytosterol crystallisation for both emulsion and bulk systems was also evaluated. Results demonstrated that lecithin and monoacylglycerols enrichment into the bulk system minimised phytosterol crystallisation. However, in emulsions, phytosterol crystallisation was mainly influenced by decreasing the droplet size. Smaller emulsion droplets containing lecithin showed the greatest potential for decreasing phytosterol crystallisation and had improved physicochemical stability. This information can be employed by the functional food industry to minimise phytosterol crystallisation and possibly improve bioaccessibility.The authors would like to thank the Teagasc Food Research Centre for assistance in funding this collaborative project (Teagasc Project 6412: “Structured Dairy Emulsions”), and the Australian Synchrotron for beamline access (proposal M10097). The authors would also like to acknowledge the Australian Research Council, Australia, as Dr. Charlotte Conn is the recipient of a DECRA Fellowship DE160101281

Secrets of Successful Short Grant Applications

Nursing doctoral programs prepare students for research-focused careers within academic settings. The purpose of this Editorial Board Special Article is to provide PhD students and advisors with suggestions for making the most of their doctoral experience. Editorial Board members provide their individual insights on the skills and attributes students must acquire during the course of their doctoral education in order to succeed. The authors provide practical tips and advice on how to excel in a PhD program, including how to select an advisor and a dissertation committee, the importance of attending conferences to increase visibility and develop a network of colleagues, presenting and publishing research while still a student, and balancing work and personal life. Students who take full advantage of the opportunities available to them during the course of their doctoral programs will graduate well prepared to take on the multiple responsibilities of research, teaching, and leadership

Venezuela's humanitarian crisis, resurgence of vector-borne diseases, and implications for spillover in the region.

In the past 5-10 years, Venezuela has faced a severe economic crisis, precipitated by political instability and declining oil revenue. Public health provision has been affected particularly. In this Review, we assess the impact of Venezuela's health-care crisis on vector-borne diseases, and the spillover into neighbouring countries. Between 2000 and 2015, Venezuela witnessed a 359% increase in malaria cases, followed by a 71% increase in 2017 (411 586 cases) compared with 2016 (240 613). Neighbouring countries, such as Brazil, have reported an escalating trend of imported malaria cases from Venezuela, from 1538 in 2014 to 3129 in 2017. In Venezuela, active Chagas disease transmission has been reported, with seroprevalence in children (<10 years), estimated to be as high as 12·5% in one community tested (n=64). Dengue incidence increased by more than four times between 1990 and 2016. The estimated incidence of chikungunya during its epidemic peak is 6975 cases per 100 000 people and that of Zika virus is 2057 cases per 100 000 people. The re-emergence of many vector-borne diseases represents a public health crisis in Venezuela and has the possibility of severely undermining regional disease elimination efforts. National, regional, and global authorities must take action to address these worsening epidemics and prevent their expansion beyond Venezuelan borders

INVASIVESNET towards an International Association for Open Knowledge on Invasive Alien Species

In a world where invasive alien species (IAS) are recognised as one of the major threats to biodiversity, leading scientists from five continents have come together to propose the concept of developing an international association for open knowledge and open data on IAS—termed “INVASIVESNET”. This new association will facilitate greater understanding and improved management of invasive alien species (IAS) and biological invasions globally, by developing a sustainable network of networks for effective knowledge exchange. In addition to their inclusion in the CBD Strategic Plan for Biodiversity, the increasing ecological, social, cultural and economic impacts associated with IAS have driven the development of multiple legal instruments and policies. This increases the need for greater co-ordination, co-operation, and information exchange among scientists, management, the community of practice and the public. INVASIVESNET will be formed by linking new and existing networks of interested stakeholders including international and national expert working groups and initiatives, individual scientists, database managers, thematic open access journals, environmental agencies, practitioners, managers, industry, non-government organisations, citizens and educational bodies. The association will develop technical tools and cyberinfrastructure for the collection, management and dissemination of data and information on IAS; create an effective communication platform for global stakeholders; and promote coordination and collaboration through international meetings, workshops, education, training and outreach. To date, the sustainability of many strategic national and international initiatives on IAS have unfortunately been hampered by time-limited grants or funding cycles. Recognising that IAS initiatives need to be globally coordinated and ongoing, we aim to develop a sustainable knowledge sharing association to connect the outputs of IAS research and to inform the consequential management and societal challenges arising from IAS introductions. INVASIVESNET will provide a dynamic and enduring network of networks to ensure the continuity of connections among the IAS community of practice, science and management

Multiple novel prostate cancer susceptibility signals identified by fine-mapping of known risk loci among Europeans

Genome-wide association studies (GWAS) have identified numerous common prostate cancer (PrCa) susceptibility loci. We have fine-mapped 64 GWAS regions known at the conclusion of the iCOGS study using large-scale genotyping and imputation in 25 723 PrCa cases and 26 274 controls of European ancestry. We detected evidence for multiple independent signals at 16 regions, 12 of which contained additional newly identified significant associations. A single signal comprising a spectrum of correlated variation was observed at 39 regions; 35 of which are now described by a novel more significantly associated lead SNP, while the originally reported variant remained as the lead SNP only in 4 regions. We also confirmed two association signals in Europeans that had been previously reported only in East-Asian GWAS. Based on statistical evidence and linkage disequilibrium (LD) structure, we have curated and narrowed down the list of the most likely candidate causal variants for each region. Functional annotation using data from ENCODE filtered for PrCa cell lines and eQTL analysis demonstrated significant enrichment for overlap with bio-features within this set. By incorporating the novel risk variants identified here alongside the refined data for existing association signals, we estimate that these loci now explain ∼38.9% of the familial relative risk of PrCa, an 8.9% improvement over the previously reported GWAS tag SNPs. This suggests that a significant fraction of the heritability of PrCa may have been hidden during the discovery phase of GWAS, in particular due to the presence of multiple independent signals within the same regio

AI is a viable alternative to high throughput screening: a 318-target study

: High throughput screening (HTS) is routinely used to identify bioactive small molecules. This requires physical compounds, which limits coverage of accessible chemical space. Computational approaches combined with vast on-demand chemical libraries can access far greater chemical space, provided that the predictive accuracy is sufficient to identify useful molecules. Through the largest and most diverse virtual HTS campaign reported to date, comprising 318 individual projects, we demonstrate that our AtomNet® convolutional neural network successfully finds novel hits across every major therapeutic area and protein class. We address historical limitations of computational screening by demonstrating success for target proteins without known binders, high-quality X-ray crystal structures, or manual cherry-picking of compounds. We show that the molecules selected by the AtomNet® model are novel drug-like scaffolds rather than minor modifications to known bioactive compounds. Our empirical results suggest that computational methods can substantially replace HTS as the first step of small-molecule drug discovery

Advancing Biological Understanding and Therapeutics Discovery with Small-Molecule Probes

Small-molecule probes can illuminate biological processes and aid in the assessment of emerging therapeutic targets by perturbing biological systems in a manner distinct from other experimental approaches. Despite the tremendous promise of chemical tools for investigating biology and disease, small-molecule probes were unavailable for most targets and pathways as recently as a decade ago. In 2005, the U.S. National Institutes of Health launched the decade-long Molecular Libraries Program with the intent of innovating in and broadening access to small-molecule science. This Perspective describes how novel small-molecule probes identified through the program are enabling the exploration of biological pathways and therapeutic hypotheses not otherwise testable. These experiences illustrate how small-molecule probes can help bridge the chasm between biological research and the development of medicines, but also highlight the need to innovate the science of therapeutic discovery.Chemistry and Chemical Biolog