2,656 research outputs found

    Molecular basis for resistance of acanthamoeba tubulins to all major classes of antitubulin compounds

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    Tubulin is essential to eukaryotic cells and is targeted by several antineoplastics, herbicides, and antimicrobials. We demonstrate that Acanthamoeba spp. are resistant to five antimicrotubule compounds, unlike any other eukaryote studied so far. Resistance correlates with critical amino acid differences within the inhibitor binding sites of the tubulin heterodimers

    Minimum Information about a Neuroscience Investigation (MINI) Electrophysiology

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    This module represents the formalized opinion of the authors and the CARMEN consortium, which identifies the minimum information required to report the use of electrophysiology in a neuroscience study, for submission to the CARMEN system (www.carmen.org.uk).
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    Testing general relativity with accretion onto compact objects

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    The X-ray emission of neutron stars and black holes presents a rich phenomenology that can lead us to a better understanding of their nature and to address more general physics questions: Does general relativity apply in the strong gravity regime? Is spacetime around black holes described by the Kerr metric? This white paper considers how we can investigate these questions by studying reverberation mapping and quasi-periodic oscillations in accreting systems with a combination of high-spectral and high-timing resolution. In the near future, we will be able to study compact objects in the X-rays in a new way: advancements in transition-edge sensors (TES) technology will allow for electron-volt-resolution spectroscopy combined with nanoseconds-precision timing.Comment: White paper submitted for Astro2020 Decadal Survey. 8 pages, 2 figure

    Adalimumab for Treating Moderate-to-Severe Hidradenitis Suppurativa: An Evidence Review Group Perspective of a NICE Single Technology Appraisal

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    As part of its single technology appraisal (STA) process, the UK National Institute for Health and Care Excellence (NICE) invited the manufacturer of adalimumab (AbbVie) to submit evidence on the clinical effectiveness and cost effectiveness of adalimumab for the treatment of moderate-to-severe hidradenitis suppurativa (HS). The appraisal assessed adalimumab as monotherapy in adult patients with an inadequate response to conventional systemic HS therapy. The School of Health and Related Research Technology Appraisal Group was commissioned to act as the independent Evidence Review Group (ERG). The ERG produced a critical review of the evidence for the clinical effectiveness and cost effectiveness of the technology based on the company’s submission to NICE. The evidence was mainly derived from three randomised controlled trials comparing adalimumab with placebo in adults with moderate-to-severe HS. The clinical-effectiveness review found that significantly more patients achieved a clinical response in the adalimumab groups than in the control groups but that the treatment effect varied between trials and there was uncertainty regarding its impact on a range of other relevant outcomes as well as long-term efficacy. The company’s submitted Markov model assessed the incremental cost effectiveness of adalimumab versus standard care for the treatment of HS from the perspective of the UK NHS and Personal Social Services (PSS) over a lifetime horizon. The original submitted model, including a patient access scheme (PAS), suggested that the incremental cost-effectiveness ratio (ICER) for adalimumab versus standard care was expected to be £16,162 per quality-adjusted life-year (QALY) gained. Following a critique of the model, the ERG’s preferred base case, which corrected programming errors and structural problems surrounding discontinuation rules and incorporated a lower unit cost for HS surgery, resulted in a probabilistic ICER of £29,725 per QALY gained. Based on additional analyses undertaken by the company and the ERG following the publication of the appraisal consultation document (ACD), the Appraisal Committee concluded that the maximum possible ICER for adalimumab compared with supportive care was between £28,500 and £33,200 per QALY gained but was likely to be lower. The Appraisal Committee recommended adalimumab (with the PAS) for the treatment of active moderate-to-severe HS in adults whose disease has not responded to conventional systemic therapy

    Primary care management of hidradenitis suppurativa: a cross-sectional survey of UK GPs

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    Background Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease that causes painful discharging nodules and skin tunnels. HS has associations with several systemic diseases, including cardiovascular disease (CVD), anxiety, and depression. High levels of chronic morbidity suggest an important role for primary care. However, little evidence exists regarding current management of HS and its comorbidities in UK general practice.Aim To describe current practice among UK GPs in treating and referring people with HS.Design & setting A web-based survey was circulated to UK Primary Care Dermatology Society (PCDS) members and GPs in Forth Valley, Scotland.Method Survey responses were analysed with descriptive statistics.Results A total of 134 UK GPs completed the survey. Seventy per cent (n = 94) saw at least one patient with HS in the previous month. Ninety-four per cent (n = 125/133) reported confidence in diagnosis, and 89% (n = 120/134) in initial treatment of HS. Most GPs initiated topical treatments and extended courses of oral antibiotic for HS, and many gave advice on adverse lifestyle factors. A minority provided analgesia, or screening for CVD risk factors, and depression. Most GPs referred to dermatology if secondary care input was required, with few referrals to specialised multidisciplinary services.Conclusion GPs regularly diagnose and manage uncomplicated HS, but screening for important comorbidities associated with HS is not common practice

    Rapid reduction versus abrupt quitting for smokers who want to stop soon: a randomised controlled non-inferiority trial

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    Background: The standard way to stop smoking is to stop abruptly on a quit day with no prior reduction in consumption of cigarettes. Many smokers feel that reduction is natural and if reduction programmes were offered, many more might take up treatment. Few trials of reduction versus abrupt cessation have been completed. Most are small, do not use pharmacotherapy, and do not meet the standards necessary to obtain a marketing authorisation for a pharmacotherapy.\ud Design/Methods: We will conduct a non-inferiority andomised trial of rapid reduction versus standard abrupt cessation among smokers who want to stop smoking. In the reduction arm,participants will be advised to reduce smoking consumption by half in the first week and to 25% of baseline in the second, leading up to a quit day at which participants will stop smoking completely.This will be assisted by nicotine patches and an acute form of nicotine replacement therapy. In the abrupt arm participants will use nicotine patches only, whilst smoking as normal, for two weeks prior to a quit day, at which they will also stop smoking completely. Smokers in either arm will have standard withdrawal orientated behavioural support programme with a combination of nicotine patches and acute nicotine replacement therapy post-cessation.\ud Outcomes/Follow-up: The primary outcome of interest will be prolonged abstinence from smoking, with secondary trial outcomes of point prevalence, urges to smoke and withdrawal\ud symptoms. Follow up will take place at 4 weeks, 8 weeks and 6 months post-quit day

    Proteomic profiling of high risk medulloblastoma reveals functional biology

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    Genomic characterization of medulloblastoma has improved molecular risk classification but struggles to define functional biological processes, particularly for the most aggressive subgroups. We present here a novel proteomic approach to this problem using a reference library of stable isotope labeled medulloblastoma-specific proteins as a spike-in standard for accurate quantification of the tumor proteome. Utilizing high-resolution mass spectrometry, we quantified the tumor proteome of group 3 medulloblastoma cells and demonstrate that high-risk MYC amplified tumors can be segregated based on protein expression patterns. We cross-validated the differentially expressed protein candidates using an independent transcriptomic data set and further confirmed them in a separate cohort of medulloblastoma tissue samples to identify the most robust proteogenomic differences. Interestingly, highly expressed proteins associated with MYC-amplified tumors were significantly related to glycolytic metabolic pathways via alternative splicing of pyruvate kinase (PKM) by heterogeneous ribonucleoproteins (HNRNPs). Furthermore, when maintained under hypoxic conditions, these MYC-amplified tumors demonstrated increased viability compared to non-amplified tumors within the same subgroup. Taken together, these findings highlight the power of proteomics as an integrative platform to help prioritize genetic and molecular drivers of cancer biology and behavior
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