A multi-targeted approach to suppress tumor-promoting inflammation

Cancers harbor significant genetic heterogeneity and patterns of relapse following many therapies are due to evolved resistance to treatment. While efforts have been made to combine targeted therapies, significant levels of toxicity have stymied efforts to effectively treat cancer with multi-drug combinations using currently approved therapeutics. We discuss the relationship between tumor-promoting inflammation and cancer as part of a larger effort to develop a broad-spectrum therapeutic approach aimed at a wide range of targets to address this heterogeneity. Specifically, macrophage migration inhibitory factor, cyclooxygenase-2, transcription factor nuclear factor-κB, tumor necrosis factor alpha, inducible nitric oxide synthase, protein kinase B, and CXC chemokines are reviewed as important antiinflammatory targets while curcumin, resveratrol, epigallocatechin gallate, genistein, lycopene, and anthocyanins are reviewed as low-cost, low toxicity means by which these targets might all be reached simultaneously. Future translational work will need to assess the resulting synergies of rationally designed antiinflammatory mixtures (employing low-toxicity constituents), and then combine this with similar approaches targeting the most important pathways across the range of cancer hallmark phenotypes

Making effective use of healthcare data using data-to-text technology

Healthcare organizations are in a continuous effort to improve health outcomes, reduce costs and enhance patient experience of care. Data is essential to measure and help achieving these improvements in healthcare delivery. Consequently, a data influx from various clinical, financial and operational sources is now overtaking healthcare organizations and their patients. The effective use of this data, however, is a major challenge. Clearly, text is an important medium to make data accessible. Financial reports are produced to assess healthcare organizations on some key performance indicators to steer their healthcare delivery. Similarly, at a clinical level, data on patient status is conveyed by means of textual descriptions to facilitate patient review, shift handover and care transitions. Likewise, patients are informed about data on their health status and treatments via text, in the form of reports or via ehealth platforms by their doctors. Unfortunately, such text is the outcome of a highly labour-intensive process if it is done by healthcare professionals. It is also prone to incompleteness, subjectivity and hard to scale up to different domains, wider audiences and varying communication purposes. Data-to-text is a recent breakthrough technology in artificial intelligence which automatically generates natural language in the form of text or speech from data. This chapter provides a survey of data-to-text technology, with a focus on how it can be deployed in a healthcare setting. It will (1) give an up-to-date synthesis of data-to-text approaches, (2) give a categorized overview of use cases in healthcare, (3) seek to make a strong case for evaluating and implementing data-to-text in a healthcare setting, and (4) highlight recent research challenges.Comment: 27 pages, 2 figures, book chapte

Treatment Regimens and Care Models for Older Patients Living with HIV: Are We Doing Enough?

Emily Frey,1 Carrie D Johnston,2 Eugenia L Siegler3 1Department of Medicine, Weill Cornell/New York Presbyterian Hospital, New York, NY, USA; 2Division of Infectious Diseases, Weill Cornell Medicine, New York, NY, USA; 3Division of Geriatrics and Palliative Medicine, Weill Cornell Medicine, New York, NY, USACorrespondence: Emily Frey, Department of Medicine, Weill Cornell Medicine, 505 East 70th Street, New York, NY, 10021, USA, Tel +1 212 746 4749, Fax +1 212 746 4609, Email [email protected]: With improved access to antiretroviral therapy throughout the world, people are aging with HIV, and a large portion of the global population of people with HIV (PWH) is now age 50 or older. Older PWH experience more comorbidities, aging-related syndromes, mental health challenges, and difficulties accessing fundamental needs than the population of older adults without HIV. As a result, ensuring that older PWH are receiving comprehensive healthcare can often be overwhelming for both PWH and the providers. Although there is a growing literature addressing the needs of this population, gaps remain in care delivery and research. In this paper, we suggest seven key components to any healthcare program designed to address the needs of older people with HIV: management of HIV, comorbidity screening and treatment, primary care coordination and planning, attention to aging related-syndromes, optimization of functional status, support of behavioral health, and improved access to basic needs and services. We review many of the difficulties and controversies related to the implementation of these components, which include the absence of screening guidelines for this population and the challenges of care integration, and we suggest key next steps.Keywords: older people with HIV, care integration, antiretroviral therapy, multimorbidity, aging-related syndrome

How Do We Choose Among Strategies to Accomplish Cognitive Tasks? Evidence From Behavioral and Event-Related Potential Data in Arithmetic Problem Solving

International audienceWe used event-related potentials (ERPs) to determine the time course of mechanisms underlying strategy selection. Participants had to select the better strategy on multiplication problems (i.e., 51 x 27) to find approximate products. They could choose between rounding up and rounding down both operands to their nearest decades. Two types of problems were tested, homogeneous problems (e.g., 34 x 61) and heterogeneous problems (e.g., 61 x 36). Homogeneous problems are easier to solve because both operands are close to the lowest or the upper decades. Behavioral data revealed that participants selected the better strategy more often on homogeneous problems. ERPs showed that homogeneous problems elicited more positive cerebral activities than heterogeneous problems in the 0-200 and 800-1,000 ms windows, and more negative cerebral activities than heterogeneous problems in the 400-600 ms window. These findings have important theoretical implications for our understanding of the mechanisms underlying strategy selection

Evaluation of a new body-sideslip-based driving simulator motion cueing algorithm

This article has been published in the journal, Proceedings of the Institution of Mechanical Engineers, Part D: Journal of Automobile Engineering [© IMechE]. The definitive version is available at: http://dx.doi.org/10.1177/0954407012445247This paper describes a new motion cueing algorithm for motion-based driving simulators. The algorithm uses the simulated vehicle’s body sideslip angle as the demand for the motion platform’s yaw degree of freedom. The current state of the art for motion cueing algorithms involves some form of filter or controller that limits the bandwidth of the vehicle motion before using this as the motion platform demand; the algorithm is tuned such that the platform does not exceed its limits. However, this means that information about the vehicle state that is contained within the motion is removed indiscriminately. Since the body sideslip angle will fit within the platform yaw limit under normal conditions, it does not need to be filtered beforehand, and thus no information must be removed. The implementation of the body-sideslip-based algorithm is described, as is a set of tests using human participants wherein the body sideslip algorithm was compared against the three most popular existing algorithms (namely the classical, adaptive and linear quadratic regulator algorithms) for normal road driving. The results of these tests indicate that the body sideslip algorithm performs as well as, or marginally better than, the other algorithms; future work will test the algorithm under limit handling conditions, to see whether the approach of preserving vehicle state information improves the simulator driver’s perception