Current trends in glioblastoma multiforme treatment: radiation therapy and immune checkpoint inhibitors.

Glioblastoma multiforme (GBM) is the most common primary brain cancer. Even with aggressive combination therapy, the median life expectancy for patients with GBM remains approximately 14 months. In order to improve the outcomes of patients with GBM, the development of newer treatments is critical. The concept of using the immune system as a therapeutic option has been suggested for several decades; by harnessing the body's adaptive immune mechanisms, immunotherapy could provide a durable and targeted treatment against cancer. However, many cancers, including GBM, have developed mechanisms that protect tumor cells from being recognized and eliminated by the immune system. For new immunotherapeutic regimens to be successful, overcoming immunosuppression via immune checkpoint signaling should be taken into consideration

Beta-blocker under-use in COPD patients

Background: Cardiovascular (CVS) comorbidities are common in COPD and contribute significantly to morbidity and mortality, especially following acute exacerbations of COPD (AECOPD). Beta-blockers (BBs) are safe and effective in COPD patients, with demonstrated survival benefit following myocardial infarction. We sought to determine if BBs are under-prescribed in patients hospitalized with AECOPD. We also sought to determine inpatient rates of CVS and cerebrovascular complications, and their impact on patient outcomes. Methods: Retrospective hospital data was collected over a 12-month period. The medical records of all patients 40 years of age coded with a diagnosis of AECOPD were analyzed. Prevalent use and incident initiation of BBs were assessed. Comorbidities including indications and contraindications for BB use were analyzed. Results: Of the 366 eligible patients, 156 patients (42.6%) had at least one indication for BB use – of these patients, only 53 (34.0%) were on BB therapy and 61 (39.1%) were not on BB therapy but had no listed contraindication. Prevalent use of BBs at the time of admission in all 366 patients was 19.7%, compared with 45.6%, 39.6% and 45.9% use of anti-platelets, statins and angiotensin-converting enzyme inhibitor/angiotensin II receptor blockers, respectively. CVS and cerebrovascular complications were common in this population (57 patients, 16%) and were associated with longer length of stay (p,0.01) and greater inpatient mortality (p=0.02). Conclusions: BBs are under-prescribed in COPD patients despite clear indication(s) for their use. Further work is required to explore barriers to BB prescribing in COPD patients

A hybrid EAV-relational model for consistent and scalable capture of clinical research data

Many clinical research databases are built for specific purposes and their design is often guided by the requirements of their particular setting. Not only does this lead to issues of interoperability and reusability between research groups in the wider community but, within the project itself, changes and additions to the system could be implemented using an ad hoc approach, which may make the system difficult to maintain and even more difficult to share. In this paper, we outline a hybrid Entity-Attribute-Value and relational model approach for modelling data, in light of frequently changing requirements, which enables the back-end database schema to remain static, improving the extensibility and scalability of an application. The model also facilitates data reuse. The methods used build on the modular architecture previously introduced in the CURe project

Long term cognitive outcomes of early term (37-38 weeks) and late preterm (34-36 weeks) births: a systematic review

Background: There is a paucity of evidence regarding long-term outcomes of late preterm (34-36 weeks) and early term (37-38 weeks) delivery.  The objective of this systematic review was to assess long-term cognitive outcomes of children born at these gestations. Methods: Four electronic databases (Medline, Embase, clinicaltrials.gov and PsycINFO) were searched.  Last search was 5 th August 2016.  Studies were included if they reported gestational age, IQ measure and the ages assessed.  The protocol was registered with the International prospective register of systematic reviews (PROSPERO Record CRD42015015472).  Two independent reviewers assessed the studies.  Data were abstracted and critical appraisal performed of eligible papers. Results: Of 11,905 potential articles, seven studies reporting on 41,344 children were included.  For early term births, four studies (n = 35,711) consistently showed an increase in cognitive scores for infants born at full term (39-41 weeks) compared to those born at early term (37-38 weeks) with increases for each week of term (difference between 37 and 40 weeks of around 3 IQ points), despite differences in age of testing and method of IQ/cognitive testing.  Four studies (n = 5644) reporting childhood cognitive outcomes of late preterm births (34 - 36 weeks) also differed in study design (cohort and case control); age of testing; and method of IQ testing, and found no differences in outcomes between late preterm and term births, although risk of bias was high in included studies. Conclusion:  Children born at 39-41 weeks have higher cognitive outcome scores compared to those born at early term (37-38 weeks).  This should be considered when discussing timing of delivery.  For children born late preterm, the data is scarce and when compared to full term (37-42 weeks) did not show any difference in IQ scores

Internet as a Human Right: A Practical Legal Framework to Address the Unique Nature of the Medium and to Promote Development

A Taiwanese court sentenced a blogger to 30 days of detention for her comments that a restaurant’s food was too salty and that the locale was unsanitary. In Indonesia, a woman was sentenced to six months in jail for libel after an e-mail she sent to friends about poor treatment she received in a hospital was posted on Facebook. These are not isolated cases of persecution, but part of a broad pattern of challenges facing individuals around the world. The United Nations recently released a report on legal trends involving restriction of expression on the Internet, declaring that freedom of expression on the Internet is a human right. If Internet freedom is a human right, what are the limits of that entitlement? This Essay explores existing legal models and restrictions on online communication through case studies, including discussion of restrictions in countries affected by the Arab Spring of 2011. This Essay suggests six basic elements for a legal framework that can support the unique challenges presented by the Internet as it becomes a primary mode of communication

Addressing the challenge of integrated care through digital technology

There is a need to constantly tackle a range of diverse and, sometimes, contradictory requirements of people with multiple chronic conditions. Integrated Care provides a potential solution to this need and digital technology can be the proposition for addressing its implementation challenge. Digital technology can support clinical teams to achieve care across all levels and provide independence in patients’ lives, by supporting them in enhanced and integrated activity within our societal structures

Understanding the Potential for a Hallyu “Backlash” in Southeast Asia: A Case Study of Consumers in Thailand, Malaysia and Philippines

Korean cultural products (known as Hallyu) are now the dominant incarnation of East Asian culture throughout Southeast Asia and have introduced consumers to Korean industry, cosmetics, and culture. Recent work has concentrated heavily upon this region and the new dynamics Southeast Asian countries can offer to the study of inter-Asian cultural links, particularly during the political amalgamation of the ASEAN economic community. Yet in the more developed Southeast Asian nations of Thailand, Malaysia, and the Philippines, there is some evidence of a rejection of and animosity towards Hallyu products from consumers who are beginning to question and disapprove of the high number of Korean products in their countries. Through interviews with over 70 consumers dissatisfied with Hallyu across these three nations, this project identifies three main areas under which this potential for a Hallyu “backlash” occurs: perceptions of colonial-esque attitudes and cultural imperialism from Korea; the movement of Hallyu from an innovative new “high culture” to a static and out-of-date “low culture”; and the increasing availability of new and different international products that threaten to usurp Hallyu. Such evidence represents a potential change in East and Southeast Asian relations, as well as the long term difficulties inherent in using Hallyu as a vehicle to maintain Korean influence

SUMMIT:Supporting Rural Tourism with Motivational Intelligent Technologies

Abstract — SUMMIT is a mobile app that aims to gamify the experience of walkers and hikers and benefit the local communities through which they perambulate. It encourages physical activity through gamification of the user experience by adding additional elements of social fun and motivation to walking and hiking activities. It rewards users for their physical effort by offering access to local resources, hence increasing awareness and appreciation of the local assets and heritage and contributing to the local economy. The evaluation results show that both businesses and walkers were very receptive to the idea