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NCI

UAMS Scientist Takes Lead in National Tobacco Control Publication

Nov. 6, 2017 | It’s hard to quit smoking. Ask anyone who has tried and failed and tried again, sometimes in a seemingly endless cycle.

This process of quitting is important for individuals and their personal health, but there are also bigger concerns at stake — specifically how smoking affects our society as a whole.

This complex issue is of vital interest to public health researchers who spend their time trying to understand why some population groups are more likely to smoke than others and what strategies will help them quit once and for all.

Pebbles Fagan, Ph.D., M.P.H., is one of those researchers. Now entering her second year as director of the UAMS Center for the Study of Tobacco in the Fay W. Boozman College of Public Health, Fagan has devoted her career to studying tobacco control and cancer prevention. Specifically, her interest lies in reducing tobacco-related health disparities among underserved populations.

That expertise has recently resulted in the publication of a six-year-long project she conceived of while serving as a health scientist in the Tobacco Control Research Branch at the National Cancer Institute (NCI) in Bethesda, Maryland.

“A Socioecological Approach to Addressing Tobacco-Related Health Disparities” is the 22nd volume in a series of monographs addressing issues related to tobacco control. Monographs are detailed studies written about specific topics.

The NCI established the Tobacco Control Monograph series in 1991 to provide information about emerging public health issues in smoking and tobacco use control.  Fagan served as scientific advisor, writer and editor for this monograph — the first to focus on tobacco-related health disparities.

After initiating the project, Fagan asked Linda Alexander, Ed.D., associate dean of academic affairs at the West Virginia University School of Public Health, to serve as editor. Together, they recruited more than 50 subject matter experts to write and contribute chapters on the impact, causes and trends in tobacco-related health disparities.

“What’s unique about this monograph, is that it’s the first comprehensive document to focus on tobacco-related health disparities since the publication of the 1998 surgeon general’s report on tobacco and minorities,” Fagan said, adding that while that report, titled “Tobacco Use Among U.S. Racial/Ethnic Minority Groups,” focused only on racial and ethnic minorities, this monograph encompasses a broader spectrum.

“We include a focus on how issues such as poverty, educational attainment and gender affect tobacco use. We also highlight some of the issues with the LGBTQ population, as recent studies have shown this group to have a higher use of tobacco than other groups,” she said.

For Fagan, the most significant conclusion derived from the monograph centers on the varying speeds in which some groups benefit from declines in tobacco use versus others.

“Overall, tobacco use has declined, and we have evidence that shows which practices have effectively influenced this trend. This includes such things as a cigarette taxes that increase the cost of the product or receipt of advice to quit smoking from a health provider such as a doctor or dentist, , as well as statewide policies that prohibit smoking in the workplace, restaurants and bars,” she said.

What remains to be answered is why some groups benefit from these practices — and gain the resulting health benefits — more quickly than others. The answer, Fagan said, may lie in part in the applicability of different interventions for various cultural groups and the social context in which the interventions occur for different groups.

“While we know the practices that help people quit smoking, it remains to be seen if these practices work the same way for all groups or if they need to be adapted in order to be effective across cultures,” she said.

One of the groups significantly affected by smoking and tobacco-related disease is those who live in poverty. Research outlined in the monograph shows that social factors play a major role in this correlation and can run the gamut from cigarette ads at gas stations to the lack of primary care physicians in rural areas.

“In the rural Delta, for example, access to primary care providers is quite limited. People in the Delta don’t have doctors to advise them to quit or prescribe nicotine replacement therapies. This could influence why they are not benefiting from these practices at the same rate as other groups,” Fagan said.

Arkansas, and other states, also have a long way to go in implementing comprehensive clean air policies for public places, as well as encouraging families to restrict smoking in the home. These in-home practices are particularly important for African-American families, as they are twice as likely to be exposed to second-hand smoke in the home as other groups.

“We have a lot of progress to make in helping people understand that when they prohibit smoking in their home they are protecting their children from asthma, as well as protecting themselves and their children from lung cancer, heart disease and other chronic diseases caused by tobacco,” Fagan said.

In addition to the dangers of smoking, the monograph also highlights the changing landscape of tobacco control, including the rise in popularity of e-cigarettes and other new products that heat, rather than burn, tobacco.

For Fagan, the main takeaway message from all of the combined research is that regardless of any of other factors, tobacco use is dangerous.

“There is no safe use of tobacco. That’s the most important message to communicate to all groups,” she said.

Filed Under: Cancer Featured Stories, Research, UAMS News, University News Tagged With: A Socioecological Approach to Addressing Tobacco-Related Health Disparities, College of Public Health, Monograph, NCI, Pebbles Fagan, UAMS, Winthrop P. Rockefeller Cancer Institute

Cancer Imaging Archive Housed at UAMS Bolstered by $8.3 Million NCI Grant

LITTLE ROCK – The National Cancer Institute (NCI) has awarded an $8.3 million grant to the University of Arkansas for Medical Sciences (UAMS) for expansion and enhancement of an archive containing freely accessible cancer medical images and data.

The Cancer Imaging Archive (TCIA) is a free online service that hosts a large collection of cancer-related medical images available for public download. All patient identification has been removed from the images and supporting data, which include outcomes, treatment details, genetic information, pathology reports and expert analyses when available. Since its formation about seven years ago, TCIA data has been used to produce almost 500 academic papers.

In 2015, the archive moved from Washington University in St. Louis to UAMS when its lead principal investigator, Fred Prior, Ph.D., took the position as the first-ever chair of the UAMS Department of Biomedical Informatics. Prior assumed leadership of the TCIA project during his tenure at Washington University. Additional principal investigators on the project are Ashish Sharma, Ph.D., of Emory University in Atlanta and Joel Saltz, M.D., Ph.D., of Stony Brook University in Stony Brook, New York.

The grant, titled “TCIA Sustainment and Scalability: Platforms for Quantitative Imaging Informatics in Precision Medicine,” supports the TCIA by expanding its capacity to provide data-driven information and images for use in research studies; adding new high-quality data collections; and encouraging the engagement, collaboration and dissemination of information among the research community.

“Since 2011, the Cancer Imaging Archive has encouraged and supported cancer-related research by acquiring, curating, hosting and managing collections of images and other data essential to the discovery process. This grant will allow us to undergo the continuous improvements and expansion necessary to provide the large collections of data required to test and validate cancer research studies for years to come,” said Prior, professor in the Department of Bioinformatics in the UAMS College of Medicine.

Biomedical informatics uses computers, rather than traditional laboratories, to extract knowledge from large sets of data. Under Prior’s leadership, the UAMS department has grown to include about 50 faculty and staff members responsible for developing computational tools to assess and manage medical and public health information for  research programs.

The ultimate goal of the archive is the advancement of precision medicine, which allows for therapies to be tailored to the individual needs of each patient based on the specific makeup of his or her cancer. Prior and his team are accomplishing this goal by using computers to read and understand medical images in new ways and by applying these tools across multiple formats, from microscope images of tumor biopsy samples to CT images of the lung.

Prior’s research team for this grant includes Lawrence Tarbox, Ph.D.; Mathias Brochhausen, Ph.D.; Tracy Nolan; Kirk E. Smith; William C. Bennett; Roosevelt D. Dobbins; Diana Stockton; and Sean M. Berryman.

Filed Under: Cancer Featured Stories, News Release, Research, UAMS News, University News Tagged With: bioinformatics, Cancer Image Archive, Fred Prior, NCI, TCIA, UAMS

UAMS Cancer Researcher Awarded $1.7 Million NIH Grant to Study Prevention of Radiation-Induced Cancer

LITTLE ROCK — A $1.7 million grant from the National Cancer Institute of the National Institutes of Health (NIH) will allow a University of Arkansas for Medical Sciences (UAMS) researcher to study a potential new therapy to reduce the risk of blood cancer caused by ionizing radiation.

Daohong Zhou, M.D., was awarded the grant for his research team’s work addressing whether the ability to restore the fitness of a person’s blood cell-generating cells — called hematopoietic stem cells (HSCs) — after they undergo radiation can prevent blood cancers such as leukemia or bone marrow disorders known as myelodysplastic syndrome (MDS), all of which are induced by ionizing radiation.

“Earlier this year, we published a study showing that chemotherapy induces cellular aging, also called senescence, in normal tissue and promotes adverse effects such as fatigue, cancer relapse and metastasis. Now, we will test whether restoring fitness to blood cell-generating stem cells by selectively eliminating old and damaged HSCs after ionizing radiation exposure has the potential to prevent MDS and leukemia from occurring,” said Zhou, associate director for basic research in the UAMS Winthrop P. Rockefeller Cancer Institute.

To eliminate the old or senescent cells, Zhou’s team will use a senolytic drug discovered by his research group a year ago. Senolytic drugs selectively kill old or senescent cells.

Out of all cases of MDS and leukemia, up to 20 percent are considered to be caused by ionizing radiation exposure and chemotherapy. These therapy-related diseases also represent the most serious long-term complications for patients with Hodgkin and non-Hodgkin lymphoma and several other cancers.

The incidence of ionizing radiation-induced blood cancers is on the rise due in part to the increased life span of both pediatric and adults cancer survivors who require not only radiation therapy to treat their initial cancer diagnosis, but also multiple CT scans over their lifetime to monitor for a possible recurrence. Cancer patients may undergo several types of treatment and testing that uses ionizing radiation, including radiation therapy, CT scans, PET scans and X-rays.

The team of research includes staff member Jianhui Chang and postdoctoral fellow Yingying Wang, Ph.D., in Zhou’s lab, and Zhou’s collaborators, Martin Hauer-Jensen, M.D., Ph.D., and Rupak Pathak, Ph.D., at UAMS and Michael Thirman, M.D., and Roger Luo, Ph.D., at the University of Chicago.

Zhou is hopeful that his research may also have other applications.

“Cellular senescence not only occurs due to radiation exposure; it occurs when a person undergoes chemotherapy and as part of the normal aging process. We hope to show the potential of senolytic drugs to reduce malignancies of the blood caused by chemotherapy or new cancers caused by aging,” said Zhou, who holds the Distinguished Winthrop Rockefeller Endowed Chair of Leukemia and Lymphoma Research at UAMS.

Zhou is also a professor of pharmaceutical sciences and deputy director of the Division of Radiation Health in the UAMS College of Pharmacy’s Department of Pharmaceutical Sciences.

Filed Under: Cancer Featured Stories, News Release, UAMS News, University News Tagged With: Daohong Zhou, leukemia, MDS, national cancer institute, National Institutes of Health, NCI, NIH, radiation-induced cancer, UAMS, Winthrop R. Rockefeller Cancer Institute

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