Behavioral Predictive Analytics towards Personalization for Self-Management – a Use Case on Linking Health-Related Social Needs

The objective of this research is to investigate the feasibility of applying behavioral predictive analytics to optimize patient engagement in diabetes self-management, and to gain insights on the potential of infusing a chatbot with NLP technology for discovering health-related social needs. In the U.S., less than 25% of patients actively engage in self-health management even though self-health management has been reported to associate with improved health outcomes and reduced healthcare costs. The proposed behavioral predictive analytics relies on manifold clustering to identify subpopulations segmented by behavior readiness characteristics that exhibit non-linear properties. For each subpopulation, an individualized auto-regression model and a population-based model were developed to support self-management personalization in three areas: glucose self-monitoring, diet management, and exercise. The goal is to predict personalized activities that are most likely to achieve optimal engagement. In addition to actionable self-health management, this research also investigates the feasibility of detecting health-related social needs through unstructured conversational dialog. This paper reports the result of manifold clusters based on 148 subjects with type 2 diabetes and shows the preliminary result of personalization for 22 subjects under different scenarios, and the preliminary results on applying Latent Dirichlet Allocation to the conversational dialog of 10 subjects for discovering social needs in five areas: food security, health (insurance coverage), transportation, employment, and housing

The ETS family member GABPα modulates androgen receptor signalling and mediates an aggressive phenotype in prostate cancer

In prostate cancer (PC), the androgen receptor (AR) is a key transcription factor at all disease stages, including the advanced stage of castrate-resistant prostate cancer (CRPC). In the present study, we show that GABP alpha, an ETS factor that is up-regulated in PC, is an AR-interacting transcription factor. Expression of GABP alpha enables PC cell lines to acquire some of the molecular and cellular characteristics of CRPC tissues as well as more aggressive growth phenotypes. GABP alpha has a transcriptional role that dissects the overlapping cistromes of the two most common ETS gene fusions in PC: overlapping significantly with ETV1 but not with ERG target genes. GABP alpha bound predominantly to gene promoters, regulated the expression of one-third of AR target genes and modulated sensitivity to AR antagonists in hormone responsive and castrate resistant PC models. This study supports a critical role for GABP alpha in CRPC and reveals potential targets for therapeutic intervention

European Archives of Psychiatry and Clinical Neuroscience

The aim of the present study was to explore the characteristics of psychotropic treatment and of psychosocial functioning associated with self-reported medication adherence in persons with psychosis engaged in rehabilitation. The study was performed in the REHABase cohort including persons referred to a French network of psychosocial rehabilitation centers. Treatment adherence was assessed using the Medication Adherence Rating Scale (MARS). The associations between MARS score (categorized as “low” < 7 vs. “high” ≥ 7) and functioning or psychotropic treatment characteristics were explored using multivariate analyses in 326 participants with schizophrenia spectrum disorders. Regarding psychotropic treatment, high anticholinergic load was the only characteristic associated with poor medication adherence (adjusted OR, aOR 1.98, 95% CI 1.07–3.66). Regarding functioning measures, participants with poor medication adherence were more likely to present with lower stage of recovery (aOR 2.38, 95% CI 1.31–4.32), poor quality of life (aOR 2.17, 95% CI 1.27–3.71), mental well-being (aOR 1.68, 95% CI 1.03–2.72) and self-esteem (aOR 1.74, 95% CI 1.05–2.87), and higher internalized stigma (aOR 1.88, 95% CI 1.09–3.23). Self-reported poor medication adherence is a marker of poor functioning in persons with psychosis. The MARS is a quick and simple measure of adherence that may be helpful in clinical and rehabilitation settings to identify persons with specific rehabilitation needs

Des collections J.-J. Pouech aux fouilles récentes dans la grotte du Mas d'Azil (Ariège, France) : nouveaux regards sur l'outillage lithique magdalénien

National audienceBulletin de la Société Préhistorique Ariège-Pyrénées, Tome LXXI-71, p. 81-105Les niveaux archéologiques stratifiés du Mas d’Azil attribués au Magdalénien, tant en rive droite qu’en rive gauche, sont connus pour avoir livré un mobilier archéologique considérable, réuni au fil de recherches débutées dans ce site dès le milieu du 19e siècle, et dont celles de Piette puis des époux Péquart constituent le point d’orgue. Toutefois, leurs études ont surtout mis l’accent sur les vestiges osseux et, en particulier, sur le mobilier orné issu de ces fouilles successives. Réciproquement, les ensembles lithiques qui leur étaient associés, issus de ces diverses opérations archéologiques, ont peu fait l’objet d’une analyse poussée, encore moins par des méthodes modernes, à l’exception du travail de l’un d’entre nous (SL). Nous présentons ici les résultats d’une étude réalisée sur deux ensembles lithiques distincts de la grotte du Mas d’Azil. Ce travail, mené sur les collections réunies par l’abbé J.-J. Pouech lors de ses fouilles en rive droite du Mas d’Azil durant les années 1860 ainsi que sur le matériel lithique issu de remblais de fouilles anciennes de ce même secteur dit de la salle du Théâtre, mis au jour lors d’opérations archéologiques récentes, apporte de nouveaux éclairages sur les occupations magdaléniennes de la cavité. Ces deux lots montrent des affinités qui les rendent, tout en conservant certaines réserves, conjointement attribuables à la phase moyenne de cette culture, et offrent de nouveaux éléments de comparaison avec des ensembles similaires à l’échelle régionale. Ces éléments, associés aux premiers résultats des recherches récentes conduites dans d'autres loci du site, renouvellent l’approche spatiale des occupations humaines attribuées au Magdalénien moyen dans la grotte du Mas d’Azil

HES6 drives a critical AR transcriptional programme to induce castration-resistant prostate cancer through activation of an E2F1-mediated cell cycle network

Castrate-resistant prostate cancer (CRPC) is poorly characterized and heterogeneous and while the androgen receptor (AR) is of singular importance, other factors such as c-Myc and the E2F family also play a role in later stage disease. HES6 is a transcription co-factor associated with stem cell characteristics in neural tissue. Here we show that HES6 is up-regulated in aggressive human prostate cancer and drives castration-resistant tumour growth in the absence of ligand binding by enhancing the transcriptional activity of the AR, which is preferentially directed to a regulatory network enriched for transcription factors such as E2F1. In the clinical setting, we have uncovered a HES6-associated signature that predicts poor outcome in prostate cancer, which can be pharmacologically targeted by inhibition of PLK1 with restoration of sensitivity to castration. We have therefore shown for the first time the critical role of HES6 in the development of CRPC and identified its potential in patient-specific therapeutic strategies