Qualitative study of system-level factors related to genomic implementation

PURPOSE: Research on genomic medicine integration has focused on applications at the individual level, with less attention paid to implementation within clinical settings. Therefore, we conducted a qualitative study using the Consolidated Framework for Implementation Research (CFIR) to identify system-level factors that played a role in implementation of genomic medicine within Implementing GeNomics In PracTicE (IGNITE) Network projects. METHODS: Up to four study personnel, including principal investigators and study coordinators from each of six IGNITE projects, were interviewed using a semistructured interview guide that asked interviewees to describe study site(s), progress at each site, and factors facilitating or impeding project implementation. Interviews were coded following CFIR inner-setting constructs. RESULTS: Key barriers included (1) limitations in integrating genomic data and clinical decision support tools into electronic health records, (2) physician reluctance toward genomic research participation and clinical implementation due to a limited evidence base, (3) inadequate reimbursement for genomic medicine, (4) communication among and between investigators and clinicians, and (5) lack of clinical and leadership engagement. CONCLUSION: Implementation of genomic medicine is hindered by several system-level barriers to both research and practice. Addressing these barriers may serve as important facilitators for studying and implementing genomics in practice

Significance of vascular endothelial growth factor in growth and peritoneal dissemination of ovarian cancer

Vascular endothelial growth factor (VEGF) is a key regulator of angiogenesis which drives endothelial cell survival, proliferation, and migration while increasing vascular permeability. Playing an important role in the physiology of normal ovaries, VEGF has also been implicated in the pathogenesis of ovarian cancer. Essentially by promoting tumor angiogenesis and enhancing vascular permeability, VEGF contributes to the development of peritoneal carcinomatosis associated with malignant ascites formation, the characteristic feature of advanced ovarian cancer at diagnosis. In both experimental and clinical studies, VEGF levels have been inversely correlated with survival. Moreover, VEGF inhibition has been shown to inhibit tumor growth and ascites production and to suppress tumor invasion and metastasis. These findings have laid the basis for the clinical evaluation of agents targeting VEGF signaling pathway in patients with ovarian cancer. In this review, we will focus on VEGF involvement in the pathophysiology of ovarian cancer and its contribution to the disease progression and dissemination

Complex adaptive systems approach to Sewol ferry disaster in Korea

This paper aims to introduce the concept and characteristics of natech disaster (natural hazards triggered technological disaster) and to explore the policy issues in complex disaster management in Korea. This research examines the issues of natech complex disaster through analysis of Sewol ferry disaster. Various variables of developing the risk communication are derived using bow-tie model, and the detailed causes are derived using ABM (Agent -based model). Therefore, this study is to apply the catastrophe based approach for improving effective holistic approaches to disaster and to investigate the changing factor analysis of the risk communication with dynamic characteristics using the model of complex adaptive systems. Based on the results of analyzes, this research concludes with a few policy suggestions. First, the natech complex disaster management needs to be approached in complex adaptive perspective. Second, by psychological, social network analysis, and linking reaction after the disaster, we could cope with the physical disaster similar in the future. Thus, the concepts of hazard and vulnerability cannot be defined independently of one another. Third, the perception of vulnerability as a "psychological event" implies that disaster has a point of beginning and an end. Therefore, determines vulnerability management actions as prevention or mitigation (before), emergency response (during) and long-term rehabilitation and development (after), which together form part of the vulnerability management cycle. In conclusion, complex adaptive systems approach to the vulnerability could cause us to change our focus on preparing for the impact of events, and perhaps it should induce us to widen our horizon concerning the dynamics and implications of the natech disaster

Simultaneous Millimeter-wave, Gamma-Ray, and Optical Monitoring of the Blazar PKS 2326-502 during a Flaring State

Abstract Including millimeter-wave data in multiwavelength studies of the variability of active galactic nuclei (AGN) can provide insights into AGN physics that are not easily accessible at other wavelengths. We demonstrate in this work the potential of cosmic microwave background (CMB) telescopes to provide long-term, high-cadence millimeter-wave AGN monitoring over large fractions of sky. We report on a pilot study using data from the SPTpol instrument on the South Pole Telescope (SPT), which was designed to observe the CMB at arcminute and larger angular scales. Between 2013 and 2016, SPTpol was used primarily to observe a single 500 deg2 field, covering the entire field several times per day with detectors sensitive to radiation in bands centered at 95 and 150 GHz. We use SPT 150 GHz observations to create AGN light curves, and we compare these millimeter-wave light curves to those at other wavelengths, in particular γ-ray and optical. In this Letter, we focus on a single source, PKS 2326-502, which has extensive, day-timescale monitoring data in gamma-ray, optical, and now millimeter-wave between 2013 and 2016. We find PKS 2326-502 to be in a flaring state in the first 2 yr of this monitoring, and we present a search for evidence of correlated variability between millimeter-wave, optical R-band, and γ-ray observations. This pilot study is paving the way for AGN monitoring with current and upcoming CMB experiments such as SPT-3G, Simons Observatory, and CMB-S4, including multiwavelength studies with facilities such as Vera C. Rubin Observatories Large Synoptic Survey Telescope