Precision medicine in cancer: Challenges and recommendations from an EU-funded cervical cancer biobanking study

Background:Cervical cancer (CC) remains a leading cause of gynaecological cancer-related mortality worldwide. CC pathogenesis is triggered when human papillomavirus (HPV) inserts into the genome, resulting in tumour suppressor gene inactivation and oncogene activation. Collecting tumour and blood samples is critical for identifying these genetic alterations.Methods:BIO-RAIDs is the first prospective molecular profiling clinical study to include a substantial biobanking effort that used uniform high-quality standards and control of samples. In this European Union (EU)-funded study, we identified the challenges that were impeding the effective implementation of such a systematic and comprehensive biobanking effort.Results:The challenges included a lack of uniform international legal and ethical standards, complexities in clinical and molecular data management, and difficulties in determining the best technical platforms and data analysis techniques. Some difficulties were encountered by all investigators, while others affected only certain institutions, regions, or countries.Conclusions:The results of the BIO-RAIDs programme highlight the need to facilitate and standardise regulatory procedures, and we feel that there is also a need for international working groups that make recommendations to regulatory bodies, governmental funding agencies, and academic institutions to achieve a proficient biobanking programme throughout EU countries. This represents the first step in precision medicine

Standing on the shoulders of tech giants: Media delivery, streaming television, and the rise of global suppliers

This article uses the case study of Internet Protocol (IP) delivery for streaming television to demonstrate how technology and globalization combine to change what media firms do, how they create value, and with whom. Media delivery - the sum of the value-adding tasks necessary to transfer content from source to audience - has become a mosaic of technologies that sustain a complex and fast-evolving video ecosystem. Broadcasters had been in charge of the full transmission process once, of tasks deemed core to their business. Today, media delivery is externalized to the market and devolved to a network of suppliers. These suppliers are no ordinary firms, but tech giants that have developed deep global capabilities. They gain further leverage by being cross-sectoral, serving clients across multiple industries. Who are these suppliers? What makes them unique? And what are the implications for the television industry

Vascular Remodeling in Health and Disease

The term vascular remodeling is commonly used to define the structural changes in blood vessel geometry that occur in response to long-term physiologic alterations in blood flow or in response to vessel wall injury brought about by trauma or underlying cardiovascular diseases.1, 2, 3, 4 The process of remodeling, which begins as an adaptive response to long-term hemodynamic alterations such as elevated shear stress or increased intravascular pressure, may eventually become maladaptive, leading to impaired vascular function. The vascular endothelium, owing to its location lining the lumen of blood vessels, plays a pivotal role in regulation of all aspects of vascular function and homeostasis.5 Thus, not surprisingly, endothelial dysfunction has been recognized as the harbinger of all major cardiovascular diseases such as hypertension, atherosclerosis, and diabetes.6, 7, 8 The endothelium elaborates a variety of substances that influence vascular tone and protect the vessel wall against inflammatory cell adhesion, thrombus formation, and vascular cell proliferation.8, 9, 10 Among the primary biologic mediators emanating from the endothelium is nitric oxide (NO) and the arachidonic acid metabolite prostacyclin [prostaglandin I2 (PGI2)], which exert powerful vasodilatory, antiadhesive, and antiproliferative effects in the vessel wall

A new prime minister meets old constraints

When Boris Johnson achieved his long-standing ambition of becoming prime minister in July 2019, he inherited a government in political disarray and without a parliamentary majority. His predecessor Theresa May had badly split Conservative MPs with her definition of Brexit, which had encouraged MPs to vote against the government in sufficient numbers to defeat Downing Street proposals

Beyond Brexit in a world of interdependence

The bounds that interdependence places on the UK are not the result of democratic choice. They are the unintended consequence of decisions taken by generations of Britain’s governors as they adapted to changes in the world since Queen Victoria’s time. By taking back powers it had ceded to the European Union, the British Parliament can claim it has regained sovereignty in the Victorian sense of the term. But the government’s experience in negotiating Brexit illustrates that constraints of interdependence have hollowed out the meaning of national sovereignty. Moreover, the British government faces fresh constraints as it seeks to build new ties to replace those with Europe that are reduced by Brexit

MED6/357: Looking over the Horizon: An Internet-based International Course in Comparative Healthcare Management

INTRODUCTION: In 1998, the unique and experimental "Looking over the horizon - An Internet-based International Course in Comparative Healthcare Management" started. The course is a component of the larger project on "Promoting International Co-operation and Understanding in Healthcare Management". It is funded by the Canada-European Community Program for Co-operation in Higher Education and Training - a joint initiative between the Canadian Government and the European Commission. METHODS: The purpose of the course is to enable graduate students from participating countries - Canada, Germany, Finland, and Ireland - to become better healthcare managers by learning more about their own and each others' healthcare systems and management processes. The course is structured around an introductory module (Healthcare Systems) and four theme modules: Financing and Funding, Healthcare Delivery Issues, Impact of Health System Reform, and Evidence-based Management. The technology used for the delivery of the course is WebCT, a web-based distance learning software developed at the University of British Colombia. WebCT provides a large number of functions both for students - e.g., e-mail, bulletin boards, chat rooms, and calendar - and for instructors - e.g., student tracking, page tracking, chat room log files, and marking management. Instructors are able to design the whole course, receive students' assignments, and post their assessments, via the World Wide Web. RESULTS: From January to April 1999, 25 students participated in the second course (19 students in the first course in 1998). The tracking function of the WebCT system was used to get some data about the students' activities. In 15 weeks, the students read an average number of 585 (min. 137, max. 806) contributions -- i.e. the sometimes very profound messages posted by students and instructors --, whereas they posted 26 (min. 6, max. 67) own contributions. The high activity of students is a typical characteristic of this student-centred course. Students have the opportunity and responsibility to be both students and teachers for the others. The role of the instructor, however, changes from that of the source of knowledge to that of a supervisor. Therefore students themselves can significantly increase the quality of the course. DISCUSSION: So far, 44 students participated in the course. For all of them, it has been a valuable experience of learning, which both increased their knowledge of national and international management issues and improved their technical skills on the field of the new medium Internet. The possibility to provide international courses via the Internet gives a new dimension to world-wide medical education and should be used very intensively. For the part of "Looking over the Horizon", the course is planned to expand on more students and even more countries