Personalizing HIV therapy, mission impossible?

Sustained HIV suppression depends on a number of factors including therapy adherence, management of side effects, viral resistance and individual characteristics of patients and therapeutic settings. Treatment response rates range up to 90% in therapy naïve patients but decline to approximately 50% in patients who received several antiretrovirals during treatment history. Furthermore, HIV protease inhibitors (PI) and non nucleoside reverse transcriptase inhibitors (NNRTI) plasma concentrations display high inter- and intra individual variability and the therapeutic window is comparably narrow. In this therapeutic setting the personalization of dosing regimens has been suggested in many cases to tailor the ARV plasma concentrations with the intention to maximize therapy success and minimize side effects in the individual. However, personalizing therapy by modifying the dosing regimen bears the danger of losing therapeutic efficacy, increasing side effects or causing viral resistance. This topical review identifies pharmacokinetic and pharmacodynamic models of antiretroviral therapy appraising the potential application to HIV therapy and discusses its future in the light of new drug classes and fix-dose combinations

Tyrosine kinase inhibitors for the therapy of anaplastic thyroid cancer

Anaplastic thyroid cancer (ATC) is often incurable so new therapeutic approaches are needed. Tyrosine kinases inhibitors (such as imanitib, sunitinib or sorafenib) are under evaluation for the treatment of ATC. Other vascular disrupting agents, such as combretastatin A4 phosphate, and antiangiogenic agents, such as aplidin, PTK787/ZK222584 and human VEGF monoclonal antibodies (bevacizumab, cetuximab), have been evaluated. Small-molecule adenosine triphosphate competitive inhibitors directed intracellularly at EGFRs tyrosine kinase, such as erlotinib or gefitinib, are also studied. Furthermore, new molecules have been shown to be active against ATC, such as CLM94 and CLM3. However, more research is needed to finally identify therapies able to control and to cure this disease

WIRELESS ADVERTISING: A STUDY OF MOBILE PHONE USERS

Using a qualitative methodology, this study attempts to provide a general framework of the functions of mobile communication, and to identify the specific preferences of mobile phone users regarding the commercial messages received on their personal devices. Research objectives: (1) To identify the specific characteristics of mobile communication as perceived by mobile users; (2) to define and analyze the functions of wireless communication as perceived by mobile phone users; and (3) to investigate users' preference regarding the content of commercial wireless communication. Previous research: Bauer et al. (2002) identified time, location, information and personalization as relevant acceptance factors for mobile advertising. Barwise and Strong (2002) developed a conceptual model, arguing that social norms, user's motives, mode, time, location and personal characteristics will affect the processing of mobile information by consumers. Tsang et al. (2004) evidenced the influence of entertainment, informativeness and irritation, while Bauer et al. (2005) argued that consumer attitudes are influenced by perceived information, entertainment, and social utility. In a similar study, Xu and Gutierrez (2006) tested the effect of entertainment, irritation, informativeness, credibility and personalization on the attitudes of Chinese consumers. Research methodology: First, a series of academic and practical articles and reports have been accessed in order to assess the existing knowledge on this topic. Second, five focus groups have been organized with six mobile phone users, aged between 20 and 40 years old. Each focus group comprised an equal number of male and female participants. The focus groups lasted between 45 and 60 minutes and addressed three main issues: the specific characteristics of the mobile phones as a commercial communication media, the functions of mobile phone communication, and the specific preferences of mobile phones users regarding the content of commercial messages. Findings: The participants demonstrated an active attitude regarding mobile advertising, which they think it has the potential to revolutionize the practice of commercial communication, by focusing more on consumer's personal needs and circumstances. Implications: This transformation cannot be realized without increasing the interactive control of mobile phone users' over the functionality and content advertising messages. Although the required technology already exists, it seems necessary to create new applications that can combine the advantages of customer-, product- and location- centered communication. Original contribution: Previous studies often used an analytical approach, highlighting specific variables regarding consumer perception or technology adoption. Using a qualitative methodology, this study provides a general framework of the functions of mobile communication, and identifies the specific preferences of mobile phone users regarding the commercial messages received on their personal devices.wireless advertising, mobile phones, functionality, content, users' opinions

Breast cancer relatives' physical activity intervention needs and preferences: qualitative results.

BackgroundWhile many risk factors for breast cancer, such as family history, are not modifiable, some, however, can be modified. The study used formative qualitative research to learn about the physical activity intervention preferences and needs of first-degree female relatives (FDFRs) of breast cancer patients; that information was then used to develop a targeted physical activity intervention.MethodsTwenty FDFRs first completed a 12-week physical activity intervention and then attended two sequential focus groups (7 groups total). In the first set of focus groups participants provided feedback on the intervention. In the follow-up focus groups, proposed changes based on collected responses from the first groups were presented and participants provided feedback to further refine the intervention.ResultsOverall, we found strong interest for an intervention using breast cancer-related health concerns to promote positive behavior change. A theme underlying all of the feedback was the desire for a personalized intervention that was directly relevant to their lives. Participants wanted this personalization achieved through individually tailored content and incorporation of stories from other FDFRs. In order to successfully use concerns about breast cancer to motivate behavior change, participants also wanted a discussion about their individual risk factors for breast cancer including, but not limited to, lack of physical activity.ConclusionsThis study demonstrates women's interest in receiving personalized information and highlights specific ways to individualize an intervention that increases motivation and engagement. Using a sequential qualitative approach was effective for formative intervention development.Trial registration numberNCT03115658 (Retrospectively registered 4/13/17)

Towards Evidence Based M-Health Application Design in Cancer Patient Healthy Lifestyle Interventions

Cancer is one of the most prevalent diseases in Europe and the world. Significant correlations between dietary habits and cancer incidence and mortality have been confirmed by the literature. Physical activity habits are also directly implicated in the incidence of cancer. Lifestyle behaviour change may be benefited by using mobile technology to deliver health behaviour interventions. M-Health offers a promising cost-efficient approach to deliver en-masse interventions. Smartphone apps with constructs such as gamification and personalized have shown potential for helping individuals lose weight and maintain healthy lifestyle habits. However, evidence-based content and theory-based strategies have not been incorporated by those apps systematically yet. The aim of the current work is to put the foundations for a methodologically rigorous exploration of wellness/health intervention literature/app landscape towards detailed design specifications for connected health m-apps. In this context, both the overall work plan is described as well as the details for the significant steps of application space and literature space review. Both strategies for research and initial outcomes of it are presented. The expected evidence based design process for patient centered health and wellness interventions is going to be the primary input in the implementation process of upcoming patient centered health/wellness m-health interventions.ENJECT COST-STSM-ECOST-STSM-TD1405-220216-07045

Radiomics strategies for risk assessment of tumour failure in head-and-neck cancer

Quantitative extraction of high-dimensional mineable data from medical images is a process known as radiomics. Radiomics is foreseen as an essential prognostic tool for cancer risk assessment and the quantification of intratumoural heterogeneity. In this work, 1615 radiomic features (quantifying tumour image intensity, shape, texture) extracted from pre-treatment FDG-PET and CT images of 300 patients from four different cohorts were analyzed for the risk assessment of locoregional recurrences (LR) and distant metastases (DM) in head-and-neck cancer. Prediction models combining radiomic and clinical variables were constructed via random forests and imbalance-adjustment strategies using two of the four cohorts. Independent validation of the prediction and prognostic performance of the models was carried out on the other two cohorts (LR: AUC = 0.69 and CI = 0.67; DM: AUC = 0.86 and CI = 0.88). Furthermore, the results obtained via Kaplan-Meier analysis demonstrated the potential of radiomics for assessing the risk of specific tumour outcomes using multiple stratification groups. This could have important clinical impact, notably by allowing for a better personalization of chemo-radiation treatments for head-and-neck cancer patients from different risk groups.Comment: (1) Paper: 33 pages, 4 figures, 1 table; (2) SUPP info: 41 pages, 7 figures, 8 table