63 research outputs found

    Commentary on “Critical Appraisal of Published Systematic Reviews Assessing the Cost-Effectiveness of Telemedicine Studies”

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    Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/140283/1/tmj.2014.9980.pd

    Cytoplasmic p53 couples oncogene-driven glucose metabolism to apoptosis and is a therapeutic target in glioblastoma.

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    Cross-talk among oncogenic signaling and metabolic pathways may create opportunities for new therapeutic strategies in cancer. Here we show that although acute inhibition of EGFR-driven glucose metabolism induces only minimal cell death, it lowers the apoptotic threshold in a subset of patient-derived glioblastoma (GBM) cells. Mechanistic studies revealed that after attenuated glucose consumption, Bcl-xL blocks cytoplasmic p53 from triggering intrinsic apoptosis. Consequently, targeting of EGFR-driven glucose metabolism in combination with pharmacological stabilization of p53 with the brain-penetrant small molecule idasanutlin resulted in synthetic lethality in orthotopic glioblastoma xenograft models. Notably, neither the degree of EGFR-signaling inhibition nor genetic analysis of EGFR was sufficient to predict sensitivity to this therapeutic combination. However, detection of rapid inhibitory effects on [18F]fluorodeoxyglucose uptake, assessed through noninvasive positron emission tomography, was an effective predictive biomarker of response in vivo. Together, these studies identify a crucial link among oncogene signaling, glucose metabolism, and cytoplasmic p53, which may potentially be exploited for combination therapy in GBM and possibly other malignancies

    Integrated genomic characterization of pancreatic ductal adenocarcinoma

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    We performed integrated genomic, transcriptomic, and proteomic profiling of 150 pancreatic ductal adenocarcinoma (PDAC) specimens, including samples with characteristic low neoplastic cellularity. Deep whole-exome sequencing revealed recurrent somatic mutations in KRAS, TP53, CDKN2A, SMAD4, RNF43, ARID1A, TGFβR2, GNAS, RREB1, and PBRM1. KRAS wild-type tumors harbored alterations in other oncogenic drivers, including GNAS, BRAF, CTNNB1, and additional RAS pathway genes. A subset of tumors harbored multiple KRAS mutations, with some showing evidence of biallelic mutations. Protein profiling identified a favorable prognosis subset with low epithelial-mesenchymal transition and high MTOR pathway scores. Associations of non-coding RNAs with tumor-specific mRNA subtypes were also identified. Our integrated multi-platform analysis reveals a complex molecular landscape of PDAC and provides a roadmap for precision medicine

    Guide to Geographical Indications: Linking Products and Their Origins (Summary)

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    Microbiome to Brain:Unravelling the Multidirectional Axes of Communication

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    The gut microbiome plays a crucial role in host physiology. Disruption of its community structure and function can have wide-ranging effects making it critical to understand exactly how the interactive dialogue between the host and its microbiota is regulated to maintain homeostasis. An array of multidirectional signalling molecules is clearly involved in the host-microbiome communication. This interactive signalling not only impacts the gastrointestinal tract, where the majority of microbiota resides, but also extends to affect other host systems including the brain and liver as well as the microbiome itself. Understanding the mechanistic principles of this inter-kingdom signalling is fundamental to unravelling how our supraorganism function to maintain wellbeing, subsequently opening up new avenues for microbiome manipulation to favour desirable mental health outcome

    Factors Associated with Revision Surgery after Internal Fixation of Hip Fractures

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    Background: Femoral neck fractures are associated with high rates of revision surgery after management with internal fixation. Using data from the Fixation using Alternative Implants for the Treatment of Hip fractures (FAITH) trial evaluating methods of internal fixation in patients with femoral neck fractures, we investigated associations between baseline and surgical factors and the need for revision surgery to promote healing, relieve pain, treat infection or improve function over 24 months postsurgery. Additionally, we investigated factors associated with (1) hardware removal and (2) implant exchange from cancellous screws (CS) or sliding hip screw (SHS) to total hip arthroplasty, hemiarthroplasty, or another internal fixation device. Methods: We identified 15 potential factors a priori that may be associated with revision surgery, 7 with hardware removal, and 14 with implant exchange. We used multivariable Cox proportional hazards analyses in our investigation. Results: Factors associated with increased risk of revision surgery included: female sex, [hazard ratio (HR) 1.79, 95% confidence interval (CI) 1.25-2.50; P = 0.001], higher body mass index (fo

    Substitution of Ride-Hailing Services for More Sustainable Travel Options in the Greater Boston Region

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    The recent and dramatic growth in ride-hailing activity is a bellwether of a coming transportation revolution driven by on-demand services. The impacts of ride-hailing services on the transportation system have been immediate and major. Yet, public agencies are only beginning to understand their magnitude because the private ride-hailing industry has provided limited amounts of meaningful data. Consequently, public agencies responsible for managing congestion and providing transit services are unable to clearly determine who uses ride-hailing services and how their adoption influences established travel modes, or forecast the potential growth of this emergent mode in the future. To address these pressing questions, an intercept survey of ride-hailing passengers was conducted in the Greater Boston region in fall 2017. Ten ride-hailing drivers, recruited and trained by the authors, asked passengers to complete surveys during their ride-hailing trip. The tablet-based survey instrument recorded nearly 1,000 passenger responses with regard to socioeconomic background, mobility options, and trip context. These responses, which enabled a robust description of ride-hailing passengers for the region, were used to analyze how new on-demand mobility services such as Uber and Lyft may be substituting travel by other modes. The study substantiates previous findings and advances knowledge of who is utilizing this new mobility option and what factors influence its adoption over public and active transportation modes. The results are intended to inform public policies ensuring that shared mobility technologies will complement existing multimodal landscapes and not worsen existing environmental concerns or equity gaps related to individual mobility
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