175 research outputs found
Frequent Disruption of Chromodomain Helicase DNA-Binding Protein 8 (CHD8) and Functionally Associated Chromatin Regulators in Prostate Cancer
AbstractAbnormal expression and function of chromatin regulators results in the altered chromatin structure seen in cancer. The chromatin regulator CTCF, its cofactor CHD8, and antagonistic paralogue BORIS have wide-ranging effects on gene regulation. Their concurrent expression and regulation was examined in benign, localized, and metastatic prostate cancer (PCa) arrays with extended follow-up using an automated quantitative imaging system, VECTRA. Epithelial staining was quantified and compared against a range of clinicopathologic variables. CHD8 expression was decreased in HGPIN, localized, and metastatic PCa compared to benign (P < .001). CHD8 promoter hypermethylation, assessed by Quantitative Pyrosequencing, occurred in over 45% of primary cancers in this population as well as the TGCA database. Treatment of cell lines with the demethylating agent 5-Aza-2′-deoxycytidine reinduced expression. An interesting dichotomy for CHD8 was observed within primary cancers, with higher nuclear protein expression associated with adverse clinical outcomes including extracapsular extension (P = .007), presence of metastases (P = .025) and worse PSA-recurrence free survival (P = .048). CHD8 outperformed Gleason score and predicted biochemical failure within intermediate grade prostate cancers. The BORIS/CTCF expression ratio increased in localized (P = .03) and metastatic PCa (P = .006) and was associated with higher Gleason score (P = .02), increased tumor volume (P = .02) and positive margins (P = .04). Per cell heterogeneity of expression revealed all protein expression to be more heterogeneous in cancerous tissue (both P < .001), especially high grade (P < .01). In the first detailed analysis in cancer, a marked loss of CHD8 expression and increased BORIS/CTCF ratio indicate frequent disruption of CTCF and its effector genes in PCa
Mindfulness-based supportive therapy on reducing suffering in patients with advanced cancer: randomised controlled trial
Objectives Suffering is common among
patients with advanced cancer. The practice of
mindfulness during patient care can potentially
reduce suffering. We aimed to examine the
efficacy of mindfulness-based supportive therapy
(MBST) on reducing suffering in patients with
advanced cancer.
Methods We conducted a parallel-group,
single-blinded, randomised controlled trial at the
University of Malaya Medical Centre, Malaysia.
Seventy-three patients with advanced cancer
with an overall suffering score ≥4/10 based on
the Suffering Pictogram were recruited and
randomly assigned into either the MBST group
(n=34) or the control group (n=39).
Results There was a statistically significant
reduction in the overall suffering score in the
MBST group compared with the control group
(U=432.5, median1
=−2.0, median2
=−1.0,
z=−2.645, p=0.008). There was also significant
improvement in the total Hospital Anxiety and
Depression Scale score (U=483.5, median1
=−4.0,
median2
=−3.0, z=−1.994, p=0.046), and the
total Functional Assessment of Chronic Illness
Therapy-Spiritual Well-Being score (U=252.0,
median1
=+14.5, median2
=+5.0, z=−4.549,
p=0.000) in the MBST group compared with the
control group.
Conclusions The results provided evidence that
the practice of MBST during patient care could
promote positive psychosocial outcome
Assessing patients’ preferences for gender, age, and experience of their urogynecologic provider
Introduction and hypothesis
Understanding patient preferences regarding provider characteristics is an under-explored area in urogynecology. This study aims to describe patient preferences for urogynecologic care, including provider gender, age, experience, and presence of medical trainees.
Methods
This was a multicenter, cross-sectional, survey-based study assessing patient preferences with a voluntary, self-administered, anonymous questionnaire prior to their first urogynecology consult. A 5-point Likert scale addressing provider gender, age, experience, and presence of trainees was used. Descriptive statistics summarized patient characteristics and provider preferences. Chi-squared (or Fisher’s exact) test was used to test for associations.
Results
Six hundred fifteen women participated from eight sites including all geographic regions across the US; 70.8% identified as white with mean age of 58.5 ± 14.2 years. Urinary incontinence was the most commonly reported symptom (45.9%); 51.4% saw a female provider. The majority of patients saw a provider 45–60 years old (42.8%) with > 15 years’ experience (60.9%). Sixty-five percent of patients preferred a female provider; 10% preferred a male provider. Sixteen percent preferred a provider 60 years old. Most patients preferred a provider with 5–15 or > 15 years’ experience (49% and 46%, respectively). Eleven percent preferred the presence of trainees while 24% preferred trainee absence.
Conclusion
Patient preferences regarding urogynecologic providers included female gender and provider age 45–60 years old with > 5 years’ experience. Further study is needed to identify qualitative components associated with these preferences
Preparedness of institutions around the world for managing patients with Ebola virus disease: an infection control readiness checklist
CITATION: Tartari, E., et al. 2015. Preparedness of institutions around the world for managing patients with Ebola virus disease: an infection control readiness checklist. Antimicrobial Resistance and Infection Control, 4:22, doi:10.1186/s13756-015-0061-8.The original publication is available at http://aricjournal.biomedcentral.comBackground: In response to global concerns about the largest Ebola virus disease (EVD), outbreak to-date in West Africa documented healthcare associated transmission and the risk of global spread, the International Society of
Chemotherapy (ISC) Infection Control Working Group created an Ebola Infection Control Readiness Checklist to
assess the preparedness of institutions around the globe. We report data from the electronic checklist that was
disseminated to medical professionals from October to December 2014 and identify action needed towards better
preparedness levels.
Findings: Data from 192 medical professionals (one third from Africa) representing 125 hospitals in 45 countries
around the globe were obtained through a specifically developed electronic survey. The survey contained 76
specific questions in 7 major sections: Administrative/operational support; Communications; Education and audit;
Human resources, Supplies, Infection Prevention and Control practices and Clinical management of patients. The
majority of respondents were infectious disease specialists/infection control consultants/clinical microbiologists
(75; 39 %), followed by infection control professionals (59; 31 %) and medical doctors of other specialties (17; 9 %).
Nearly all (149; 92 %) were directly involved in Ebola preparedness activities. Whilst, 54 % indicated that their
hospital would need to handle suspected and proven Ebola cases, the others would subsequently transfer
suspected cases to a specialized centre.
Conclusion: The results from our survey reveal that the general preparedness levels for management of potentially
suspected cases of Ebola virus disease is only partially adequate in hospitals. Hospitals designated for admitting EVD
suspected and proven patients had more frequently implemented Infection Control preparedness activities than
hospitals that would subsequently transfer potential EVD cases to other centres. Results from this first international
survey provide a framework for future efforts to improve hospital preparedness worldwide.http://aricjournal.biomedcentral.com/articles/10.1186/s13756-015-0061-8Publisher's versio
Preparedness of institutions around the world for managing patients with Ebola virus disease: An infection control readiness checklist
Background: In response to global concerns about the largest Ebola virus disease (EVD), outbreak to-date in West
Africa documented healthcare associated transmission and the risk of global spread, the International Society of
Chemotherapy (ISC) Infection Control Working Group created an Ebola Infection Control Readiness Checklist to
assess the preparedness of institutions around the globe. We report data from the electronic checklist that was
disseminated to medical professionals from October to December 2014 and identify action needed towards better
preparedness levels.
Findings: Data from 192 medical professionals (one third from Africa) representing 125 hospitals in 45 countries
around the globe were obtained through a specifically developed electronic survey. The survey contained 76
specific questions in 7 major sections: Administrative/operational support; Communications; Education and audit;
Human resources, Supplies, Infection Prevention and Control practices and Clinical management of patients. The
majority of respondents were infectious disease specialists/infection control consultants/clinical microbiologists
(75; 39 %), followed by infection control professionals (59; 31 %) and medical doctors of other specialties (17; 9 %).
Nearly all (149; 92 %) were directly involved in Ebola preparedness activities. Whilst, 54 % indicated that their
hospital would need to handle suspected and proven Ebola cases, the others would subsequently transfer
suspected cases to a specialized centre.
Conclusion: The results from our survey reveal that the general preparedness levels for management of potentially
suspected cases of Ebola virus disease is only partially adequate in hospitals. Hospitals designated for admitting EVD
suspected and proven patients had more frequently implemented Infection Control preparedness activities than
hospitals that would subsequently transfer potential EVD cases to other centres. Results from this first international
survey provide a framework for future efforts to improve hospital preparedness worldwide.
Keywords: Ebola virus disease, EVD outbreak, EVD preparedness, Personal protective equipmentWe would like to thank members of the Infection Control Association
(Singapore) for creating the basis of the checklist (Dr Moi Lin Ling, Ms Lai
Chee Lee, Ms Lily Lang, Dr Paul A. Tambyah, Dr Brenda Ang) and all those
colleagues who spent their time in completing this survey
Recommended from our members
A high-resolution map of human evolutionary constraint using 29 mammals.
The comparison of related genomes has emerged as a powerful lens for genome interpretation. Here we report the sequencing and comparative analysis of 29 eutherian genomes. We confirm that at least 5.5% of the human genome has undergone purifying selection, and locate constrained elements covering ∼4.2% of the genome. We use evolutionary signatures and comparisons with experimental data sets to suggest candidate functions for ∼60% of constrained bases. These elements reveal a small number of new coding exons, candidate stop codon readthrough events and over 10,000 regions of overlapping synonymous constraint within protein-coding exons. We find 220 candidate RNA structural families, and nearly a million elements overlapping potential promoter, enhancer and insulator regions. We report specific amino acid residues that have undergone positive selection, 280,000 non-coding elements exapted from mobile elements and more than 1,000 primate- and human-accelerated elements. Overlap with disease-associated variants indicates that our findings will be relevant for studies of human biology, health and disease
Teacher led school-based surveillance can allow accurate tracking of emerging infectious diseases - evidence from serial cross-sectional surveys of febrile respiratory illness during the H1N1 2009 influenza pandemic in Singapore
10.1186/1471-2334-12-336BMC Infectious Diseases12-BIDM
Neuroanatomical heterogeneity and homogeneity in individuals at clinical high risk for psychosis.
Individuals at Clinical High Risk for Psychosis (CHR-P) demonstrate heterogeneity in clinical profiles and outcome features. However, the extent of neuroanatomical heterogeneity in the CHR-P state is largely undetermined. We aimed to quantify the neuroanatomical heterogeneity in structural magnetic resonance imaging measures of cortical surface area (SA), cortical thickness (CT), subcortical volume (SV), and intracranial volume (ICV) in CHR-P individuals compared with healthy controls (HC), and in relation to subsequent transition to a first episode of psychosis. The ENIGMA CHR-P consortium applied a harmonised analysis to neuroimaging data across 29 international sites, including 1579 CHR-P individuals and 1243 HC, offering the largest pooled CHR-P neuroimaging dataset to date. Regional heterogeneity was indexed with the Variability Ratio (VR) and Coefficient of Variation (CV) ratio applied at the group level. Personalised estimates of heterogeneity of SA, CT and SV brain profiles were indexed with the novel Person-Based Similarity Index (PBSI), with two complementary applications. First, to assess the extent of within-diagnosis similarity or divergence of neuroanatomical profiles between individuals. Second, using a normative modelling approach, to assess the 'normativeness' of neuroanatomical profiles in individuals at CHR-P. CHR-P individuals demonstrated no greater regional heterogeneity after applying FDR corrections. However, PBSI scores indicated significantly greater neuroanatomical divergence in global SA, CT and SV profiles in CHR-P individuals compared with HC. Normative PBSI analysis identified 11 CHR-P individuals (0.70%) with marked deviation (>1.5 SD) in SA, 118 (7.47%) in CT and 161 (10.20%) in SV. Psychosis transition was not significantly associated with any measure of heterogeneity. Overall, our examination of neuroanatomical heterogeneity within the CHR-P state indicated greater divergence in neuroanatomical profiles at an individual level, irrespective of psychosis conversion. Further large-scale investigations are required of those who demonstrate marked deviation
Neuroanatomical heterogeneity and homogeneity in individuals at clinical high risk for psychosis
Individuals at Clinical High Risk for Psychosis (CHR-P) demonstrate heterogeneity in clinical profiles and outcome features. However, the extent of neuroanatomical heterogeneity in the CHR-P state is largely undetermined. We aimed to quantify the neuroanatomical heterogeneity in structural magnetic resonance imaging measures of cortical surface area (SA), cortical thickness (CT), subcortical volume (SV), and intracranial volume (ICV) in CHR-P individuals compared with healthy controls (HC), and in relation to subsequent transition to a first episode of psychosis. The ENIGMA CHR-P consortium applied a harmonised analysis to neuroimaging data across 29 international sites, including 1579 CHR-P individuals and 1243 HC, offering the largest pooled CHR-P neuroimaging dataset to date. Regional heterogeneity was indexed with the Variability Ratio (VR) and Coefficient of Variation (CV) ratio applied at the group level. Personalised estimates of heterogeneity of SA, CT and SV brain profiles were indexed with the novel Person-Based Similarity Index (PBSI), with two complementary applications. First, to assess the extent of within-diagnosis similarity or divergence of neuroanatomical profiles between individuals. Second, using a normative modelling approach, to assess the ‘normativeness’ of neuroanatomical profiles in individuals at CHR-P. CHR-P individuals demonstrated no greater regional heterogeneity after applying FDR corrections. However, PBSI scores indicated significantly greater neuroanatomical divergence in global SA, CT and SV profiles in CHR-P individuals compared with HC. Normative PBSI analysis identified 11 CHR-P individuals (0.70%) with marked deviation (>1.5 SD) in SA, 118 (7.47%) in CT and 161 (10.20%) in SV. Psychosis transition was not significantly associated with any measure of heterogeneity. Overall, our examination of neuroanatomical heterogeneity within the CHR-P state indicated greater divergence in neuroanatomical profiles at an individual level, irrespective of psychosis conversion. Further large-scale investigations are required of those who demonstrate marked deviation.publishedVersio
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