An Exploratory Study of the Likelihood of Adopting Genetic Counseling and Testing for Lynch Syndrome-related Colorectal Cancer Among Primary Care Physicians in Florida

Genetic counseling and testing for inherited cancer syndromes have the potential to save lives and may be an avenue for addressing health care disparities among African Americans newly diagnosed with colorectal cancer (CRC); and their close relatives. African Americans are more likely to be diagnosed with CRC at younger ages (under age 50 years), and diagnosed at later stages when cancer is more aggressive and difficult to treat, which are factors associated with hereditary cancers such as Lynch syndrome-related CRC. Considering the benefits of genetic testing for hereditary cancer syndromes - risk stratification, preventive surveillance, targeted treatment, and subsequent reduction in morbidity and mortality among patients by up to 60% - it appears that genetic testing may have a role in prevention, early intervention and reduction of CRC disparities in African Americans. Primary care physicians (PCPs), often the access point to the healthcare system, were anticipated to be at the forefront of genetic counseling and testing. However, a growing body of literature indicates that PCPs see genetic testing as the role of a specialist. This quantitative survey research study, based on the constructs of the Diffusion of Innovation Theory (Rogers, 2003), explored the factors which influence the likelihood of adoption of genetic counseling and testing for Lynch syndrome-related colorectal cancer among PCPs in Florida

Attention-based High-order Feature Interactions to Enhance the Recommender System for Web-based Knowledge-Sharing Servic

Providing personalized online learning services has become a hot research topic. Online knowledge-sharing services represents a popular approach to enable learners to use fragmented spare time. User asks and answers questions in the platform, and the platform also recommends relevant questions to users based on their learning interested and context. However, in the big data era, information overload is a challenge, as both online learners and learning resources are embedded in data rich environment. Offering such web services requires an intelligent recommender system to automatically filter out irrelevant information, mine underling user preference, and distil latent information. Such a recommender system needs to be able to mine complex latent information, distinguish differences between users efficiently. In this study, we refine a recommender system of a prior work for web-based knowledge sharing. The system utilizes attention-based mechanisms and involves high-order feature interactions. Our experimental results show that the system outperforms known benchmarks and has great potential to be used for the web-based learning service

Exploring the Association of Physician Characteristics to Patient Requests for Genetic Testing

Background: Cancer genomic testing improves health outcomes for individuals at risk, drives cost-efficiency, and facilitates healthcare equity; however, little is known about how physician demographic and practice characteristics influence patient requests for genetic testing. Purpose: To explore whether (and to what extent) physician demographic and practice characteristics are associated with patient requests for cancer genetic testing. Methods: A cross-sectional quantitative design survey was distributed to 1240 primary care physicians registered with the state health department who had active licenses and main practices in Florida. Primary care physicians were defined as those who practice family medicine, internal medicine, obstetrics, and gynecology. The survey tool was developed from a search of the literature and two previously validated surveys. It was administered using a modified Dillmanstrategy. The study sample size was 317 physicians, with an 85% response rate based upon a targeted sample of 372. Statistical calculations were performed using SPSS version 27 and STATA release 17.Results: Logistic regression model found significant associations between patient requests and physicians\u27 race and professional practice size. Physicians identified as White were 1.840 times as likely to have patient requests for genetic testing (p=.036) than physicians whose race was other than White. Physicians whose professional practices were solo or small groups were 2.39 times as likely to have patient requests (p=.001) than physicians affiliated with larger practices. Discussion: Patient requests may be leveraged by physicians, other healthcare providers, and public health professionals; patient requests present a significant opportunity for increasing genetic testing and thus promoting better health outcomes for patients with Lynch syndrome-related colorectal cancer

The potential of epigallocatechin gallate in the chemoprevention and therapy of hepatocellular carcinoma

Hepatocellular carcinoma (HCC), one of the most notorious malignancies globally, has a high fatality and poor prognosis. Though remarkable breakthroughs have been made in the therapeutic strategies recently, the overall survival of HCC remains unsatisfactory. Consequently, the therapy of HCC remains a great challenge. Epigallocatechin gallate (EGCG), a natural polyphenol extracted from the leaves of the tea bush, has been extensively investigated for its antitumor effects. In this review, we summarize the previous literature to elucidate the roles of EGCG in the chemoprophylaxis and therapy of HCC. Accumulating evidence has confirmed EGCG prevents and inhibits the hepatic tumorigenesis and progression through multiple biological mechanisms, mainly involving hepatitis virus infection, oxidative stress, proliferation, invasion, migration, angiogenesis, apoptosis, autophagy, and tumor metabolism. Furthermore, EGCG enhances the efficacy and sensitivity of chemotherapy, radiotherapy, and targeted therapy in HCC. In conclusion, preclinical studies have confirmed the potential of EGCG for chemoprevention and therapy of HCC under multifarious experimental models and conditions. Nevertheless, there is an urgent need to explore the safety and efficacy of EGCG in the clinical practice of HCC

The crosstalk among the physical tumor microenvironment and the effects of glucose deprivation on tumors in the past decade

The occurrence and progression of tumors are inseparable from glucose metabolism. With the development of tumors, the volume increases gradually and the nutritional supply of tumors cannot be fully guaranteed. The tumor microenvironment changes and glucose deficiency becomes the common stress environment of tumors. Here, we discuss the mutual influences between glucose deprivation and other features of the tumor microenvironment, such as hypoxia, immune escape, low pH, and oxidative stress. In the face of a series of stress responses brought by glucose deficiency, different types of tumors have different coping mechanisms. We summarize the tumor studies on glucose deficiency in the last decade and review the genes and pathways that determine the fate of tumors under harsh conditions. It turns out that most of these genes help tumor cells survive in glucose-deprivation conditions. The development of related inhibitors may bring new opportunities for the treatment of tumors

Crosstalk between the CBM complex/NF-κB and MAPK/P27 signaling pathways of regulatory T cells contributes to the tumor microenvironment

Regulatory T cells (Tregs), which execute their immunosuppressive functions by multiple mechanisms, have been verified to contribute to the tumor microenvironment (TME). Numerous studies have shown that the activation of the CBM complex/NF-κB signaling pathway results in the expression of hypoxia-inducible factor-1 (HIF-1α) and interleukin-6 (IL-6), which initiate the TME formation. HIF-1α and IL-6 promote regulatory T cells (Tregs) proliferation and migration through the MAPK/CDK4/6/Rb and STAT3/SIAH2/P27 signaling pathways, respectively. IL-6 also promotes the production of HIF-1α and enhances the self-regulation of Tregs in the process of tumor microenvironment (TME) formation. In this review, we discuss how the crosstalk between the CARMA1–BCL10–MALT1 signalosome complex (CBM complex)/NF-κB and MAPK/P27 signaling pathways contributes to the formation of the TME, which may provide evidence for potential therapeutic targets in the treatment of solid tumors

Single cell atlas for 11 non-model mammals, reptiles and birds.

The availability of viral entry factors is a prerequisite for the cross-species transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Large-scale single-cell screening of animal cells could reveal the expression patterns of viral entry genes in different hosts. However, such exploration for SARS-CoV-2 remains limited. Here, we perform single-nucleus RNA sequencing for 11 non-model species, including pets (cat, dog, hamster, and lizard), livestock (goat and rabbit), poultry (duck and pigeon), and wildlife (pangolin, tiger, and deer), and investigated the co-expression of ACE2 and TMPRSS2. Furthermore, cross-species analysis of the lung cell atlas of the studied mammals, reptiles, and birds reveals core developmental programs, critical connectomes, and conserved regulatory circuits among these evolutionarily distant species. Overall, our work provides a compendium of gene expression profiles for non-model animals, which could be employed to identify potential SARS-CoV-2 target cells and putative zoonotic reservoirs

Resilience of an Earthquake-Stricken Rural Community in Southwest China: Correlation with Disaster Risk Reduction Efforts

Disaster risk reduction (DRR) activities have given growing attention to building community resilience, but the effects of such efforts on community resilience are still under-investigated, especially in China where the concept of community resilience has only just emerged. Using the Communities Advancing Resilience Toolkit Assessment Survey, data on self-perceived community resilience were collected in 2017 from a post-disaster Chinese rural community in Yingxiu Town, which was the epicenter of the Wenchuan earthquake (Magnitude = 8.0) in the year 2008. Linear regression analyses were conducted to explore the correlations between residents’ DRR behaviors and perceived community resilience with the control of their socio-demographic characteristics including age, ethnicity, gender, education, income level, employment status and marital status. Results indicate that residents who volunteered for DRR activities, received geological disaster education, participated in evacuation drills, and reported higher income levels had a perception of higher community resilience. Practice research is suggested to help clarify the cause and effect of DRR work on the enhancement of community resilience to disasters in China and abroad. Attention is also called to the development of a Chinese indigenous community resilience concept and assessment instrument

Assisting Open Education Resource Providers and Instructors to Deal With Cold Start Problem in Adaptive Micro Learning: a Service Oriented Solution

Various prior studies have leveraged cloud computing and big data techniques to promote adaptive micro open learning. However, this novel way of open education resource (OER) delivery and access suffers from the cold start problem of learner information. In this paper, we introduce a service oriented solution to assist OER providers and instructors to deal with the sparsity of data in OER recommendation using an ontological approach. Learners' features are predicted by spreading activation and demographic similarity based inference. An evolutionary algorithm is provided to realize the OER recommendation in terms of heuristic rules

Ontological Learner Profile Identification for Cold Start Problem in Micro Learning Resources Delivery

Open learning is a rising trend in the educational sector and it attracts millions of learners to be engaged to enjoy massive latest and free open education resources (OERs). Through the use of mobile devices, open learning is often carried out in a micro learning mode, where each unit of learning activity is commonly shorter than 15 minutes. Learners are often at a loss in the process of choosing OER leading to their long term objectives and short term demands. Our pilot work, namely MLaaS, proposed a smart system to deliver personalized OER with micro learning to satisfy their real-time needs, while its decision-making process is scarcely supported due to the lack of historical data. Inspired by this, MLaaS now embeds a new solution to tackle the cold start problem, by opening up a brand new profile for each learner and delivering them the first resources in their fresh start learning journey. In this paper, we also propose an ontology-based mechanism for learning prediction and recommendation