Potential role of miR-9 and miR-223 in recurrent ovarian cancer

<p>Abstract</p> <p>Background</p> <p>MicroRNAs (miRNAs) are small, noncoding RNAs that negatively regulate gene expression by binding to target mRNAs. miRNAs have not been comprehensively studied in recurrent ovarian cancer, yet an incurable disease.</p> <p>Results</p> <p>Using real-time RT-PCR, we obtained distinct miRNA expression profiles between primary and recurrent serous papillary ovarian adenocarcinomas (n = 6) in a subset of samples previously used in a transcriptome approach. Expression levels of top dysregulated miRNA genes, miR-223 and miR-9, were examined using TaqMan PCR in independent cohorts of fresh frozen (n = 18) and FFPE serous ovarian tumours (n = 22). Concordance was observed on TaqMan analysis for miR-223 and miR-9 between the training cohort and the independent test cohorts. Target prediction analysis for the above miRNA "recurrent metastatic signature" identified genes previously validated in our transcriptome study. Common biological pathways well characterised in ovarian cancer were shared by miR-9 and miR-223 lists of predicted target genes. We provide strong evidence that miR-9 acts as a putative tumour suppressor gene in recurrent ovarian cancer. Components of the miRNA processing machinery, such as Dicer and Drosha are not responsible for miRNA deregulation in recurrent ovarian cancer, as deluded by TaqMan and immunohistochemistry.</p> <p>Conclusion</p> <p>We propose a miRNA model for the molecular pathogenesis of recurrent ovarian cancer. Some of the differentially deregulated miRNAs identified correlate with our previous transcriptome findings. Based on integrated transcriptome and miRNA analysis, miR-9 and miR-223 can be of potential importance as biomarkers in recurrent ovarian cancer.</p

Structural Competency: Curriculum for Medical Students, Residents, and Interprofessional Teams on the Structural Factors That Produce Health Disparities

Introduction: Research on disparities in health and health care has demonstrated that social, economic, and political factors are key drivers of poor health outcomes. Yet the role of such structural forces on health and health care has been incorporated unevenly into medical training. The framework of structural competency offers a paradigm for training health professionals to recognize and respond to the impact of upstream, structural factors on patient health and health care. Methods: We report on a brief, interprofessional structural competency curriculum implemented in 32 distinct instances between 2015 and 2017 throughout the San Francisco Bay Area. In consultation with medical and interprofessional education experts, we developed open-ended, written-response surveys to qualitatively evaluate this curriculum\u27s impact on participants. Qualitative data from 15 iterations were analyzed via directed thematic analysis, coding language, and concepts to identify key themes. Results: Three core themes emerged from analysis of participants\u27 comments. First, participants valued the curriculum\u27s focus on the application of the structural competency framework in real-world clinical, community, and policy contexts. Second, participants with clinical experience (residents, fellows, and faculty) reported that the curriculum helped them reframe how they thought about patients. Third, participants reported feeling reconnected to their original motivations for entering the health professions. Discussion: This structural competency curriculum fills a gap in health professional education by equipping learners to understand and respond to the role that social, economic, and political structural factors play in patient and community health

Shifting the Paradigm: Antiracist Education for Advanced Practice Nursing Providers.

INTRODUCTION: Racism in the United States adversely impacts health outcomes. Achieving health equity will require an explicitly antiracist approach to the education of health care providers (HCPs). This article examines a required course that focuses on teaching advanced practice nursing students about the structural foundations of racism. This approach shifts significantly away from teaching race-based medicine (which assumes a biological basis for disparities) and the social determinants of health (which often blames individuals for disparities). METHODS: A mixed methods evaluation was conducted to understand the change in learners understanding of (1) structural racism and (2) the role that HCPs can play in addressing structural racism. Anonymous surveys asked the following: (1) What are three examples of structural racism in the context of health care? and (2) What is the HCPs role in addressing structural racism? RESULTS: Statistically significant increases were observed. The percentage of students who could provide at least one example of structural racism increased from 41% to 70%. Significant increases were also found in students abilities to identify structural and institutional antiracist interventions. DISCUSSION: This project yields important data that can inform educational efforts focused on structural racism. The results strongly suggest that the course resulted in a change in student understanding of racism in health care and strategies to address it. HEALTH EQUITY IMPLICATIONS: The development of a required course for advanced practice nurses focused on structural racism, including attention to social and institutional interventions, can significantly shift HCP understanding and is one strategy to move us toward health equity

External validation of a subset of upregulated genes in cohort 2 that validated in cohort 1

<p><b>Copyright information:</b></p><p>Taken from "An integrative model for recurrence in ovarian cancer"</p><p>http://www.molecular-cancer.com/content/7/1/8</p><p>Molecular Cancer 2008;7():8-8.</p><p>Published online 22 Jan 2008</p><p>PMCID:PMC2248209.</p><p></p> Bars indicate the relative overexpression of target genes in recurrent vs primary tumors. IL1R2 and ZNF218 gave the best distinction between recurrent and primary tumors with greater than twofold changes

Gene families involved in the molecular regulation of recurrence in ovarian cancer

<p><b>Copyright information:</b></p><p>Taken from "An integrative model for recurrence in ovarian cancer"</p><p>http://www.molecular-cancer.com/content/7/1/8</p><p>Molecular Cancer 2008;7():8-8.</p><p>Published online 22 Jan 2008</p><p>PMCID:PMC2248209.</p><p></p> Some of the upregulated genes in recurrent compared to primary ovarian carcinomas that we validated in cohort 2 belong in the same gene families with some of the upregulated genes validated in cohort 1. Upregulation of tight junction proteins and EGFR ligands, development of a cytokine response via interleukin receptors and intracellular signaling via calcium binding S100 proteins seem to contribute to the "recurrent" signature and possibly have a role in drug resistance

Structural Competency: Curriculum for Medical Students, Residents, and Interprofessional Teams on the Structural Factors That Produce Health Disparities.

IntroductionResearch on disparities in health and health care has demonstrated that social, economic, and political factors are key drivers of poor health outcomes. Yet the role of such structural forces on health and health care has been incorporated unevenly into medical training. The framework of structural competency offers a paradigm for training health professionals to recognize and respond to the impact of upstream, structural factors on patient health and health care.MethodsWe report on a brief, interprofessional structural competency curriculum implemented in 32 distinct instances between 2015 and 2017 throughout the San Francisco Bay Area. In consultation with medical and interprofessional education experts, we developed open-ended, written-response surveys to qualitatively evaluate this curriculum's impact on participants. Qualitative data from 15 iterations were analyzed via directed thematic analysis, coding language, and concepts to identify key themes.ResultsThree core themes emerged from analysis of participants' comments. First, participants valued the curriculum's focus on the application of the structural competency framework in real-world clinical, community, and policy contexts. Second, participants with clinical experience (residents, fellows, and faculty) reported that the curriculum helped them reframe how they thought about patients. Third, participants reported feeling reconnected to their original motivations for entering the health professions.DiscussionThis structural competency curriculum fills a gap in health professional education by equipping learners to understand and respond to the role that social, economic, and political structural factors play in patient and community health

Structural Competency: Curriculum for Medical Students, Residents, and Interprofessional Teams on the Structural Factors That Produce Health Disparities.

IntroductionResearch on disparities in health and health care has demonstrated that social, economic, and political factors are key drivers of poor health outcomes. Yet the role of such structural forces on health and health care has been incorporated unevenly into medical training. The framework of structural competency offers a paradigm for training health professionals to recognize and respond to the impact of upstream, structural factors on patient health and health care.MethodsWe report on a brief, interprofessional structural competency curriculum implemented in 32 distinct instances between 2015 and 2017 throughout the San Francisco Bay Area. In consultation with medical and interprofessional education experts, we developed open-ended, written-response surveys to qualitatively evaluate this curriculum's impact on participants. Qualitative data from 15 iterations were analyzed via directed thematic analysis, coding language, and concepts to identify key themes.ResultsThree core themes emerged from analysis of participants' comments. First, participants valued the curriculum's focus on the application of the structural competency framework in real-world clinical, community, and policy contexts. Second, participants with clinical experience (residents, fellows, and faculty) reported that the curriculum helped them reframe how they thought about patients. Third, participants reported feeling reconnected to their original motivations for entering the health professions.DiscussionThis structural competency curriculum fills a gap in health professional education by equipping learners to understand and respond to the role that social, economic, and political structural factors play in patient and community health