Chasing the personalized medicine dream through biomarker validation in colorectal cancer.

Colorectal cancer (CRC) is a major health burden worldwide. The optimal approach to the diagnosis, management, and treatment of CRC involves multidisciplinary and integrated management practices. The field is rapidly changing because of recent advancements in delineating the molecular basis of tumorigenesis, introduction of targeted therapy, varied patient response to mainstay chemotherapeutics, biological drugs, and the effective combination regimes being used for treatment. Recent meta-analysis studies, which tend to establish few clinically useful predictor biomarkers, identify inconsistent results and limitations of the trials. Therefore, molecular pathological epidemiology discipline initiatives are promising. Here, we provide an overview of the potential of biomarker validation for personalized medicine by focusing largely on metastatic (m)CRC. We also highlight new candidate predictive and prognostic biomarkers.

Reaching out to promote physical activity in Australia: a statewide randomized controlled trial of a stage-targeted intervention

Purpose. This study examined the broader use of a print-media intervention, which was previously shown to be effective at promoting physical activity to participants recruited from a regional Australian community, as a strategy suitable for a more diverse statewide population sample.
Methods. Participants were randomly selected adults who responded to a telephone interview conducted by the New South Wales Health Department and consented to Participate in a randomized controlled trial. Consenters were allocated to either intervention (n = 361) or control (n = 358) conditions. The intervention, a personalized letter plus stage-targeted booklets, was sent 1 week postbaseline. Data were collected via telephone interview at baseline and 2 and 8 months and were analyzed using repeated measures analysis of variance (ANOVA) and mean squared statistics.
Results. The groups were similar at baseline (mean age 43 +/- 3 years; 64 % women). Process evaluation showed high intervention recall (76 % at 2 months) and high follow-up response rates (> 85 % at 8 months) were achieved. Nonsignificant increases in physical activity were observed (Fl,719 = 2.18, p = .14).
Discussion. A single mailing of stage-targeted print materials was not effective in promoting increases in physical activity among participants selected from the statewide population. Future research could examine how the effectiveness of print media might be enhanced, possibly by using supplementary media, community-based prompts, or other incentives.

Enhancing web-based adaptive learning with colored timed petri net

One of the issues for Web-based learning applications is to adaptively provide personalized instructions for different learning activities. This paper proposes a high level colored timed Petri Net based approach to providing some level of adaptation for different users and learning activities. Examples are given to demonstrate how to realize adaptive interfaces and personalization. Future directions are also discussed at the end of this paper.

A gene expression signature for insulin resistance

Insulin resistance is a heterogeneous disorder caused by a range of genetic and environmental factors, and we hypothesize that its aetiology varies considerably between individuals. This heterogeneity provides significant challenges to the development of effective therapeutic regimes for long-term management of type 2 diabetes. We describe a novel strategy, using large-scale gene expression profiling, to develop a Gene Expression Signature (GES) that reflects the overall state of insulin resistance in cells and patients. The GES was developed from 3T3-L1 adipocytes that were made ‘insulin resistant’ by treatment with tumour necrosis factor-alpha (TNFα) and then reversed with aspirin and troglitazone (‘re-sensitized’). The GES consisted of five genes whose expression levels best discriminated between the insulin resistant and insulin re-sensitized states. We then used this GES to screen a compound library for agents that affected the GES genes in 3T3- L1 adipocytes in a way that most closely resembled the changes seen when insulin resistance was successfully reversed using aspirin and troglitazone. This screen identified both known and new insulin sensitizing compounds including non-steroidal anti inflammatory agents, β-adrenergic antagonists, beta-lactams and sodium channel blockers. We tested the biological relevance of this GES in participants in the San Antonio Family Heart Study (n = 1,240) and showed that patients with the lowest GES scores were more insulin resistant (according to HOMA_IR and fasting plasma insulin levels, P < 0.001). These findings show that GES technology can be used for both the discovery of insulin sensitizing compounds and the characterization of patients into subtypes of insulin resistance according to GES scores, opening the possibility of developing a personalized medicine approach to type 2 diabetes.

Spamcooling : a parallel heterogeneous ensemble spam filtering system based on active learning techniques

Anti-spam technology is developing rapidly in recent years. With the emerging applications of machine learning in diverse fields, researchers as well as manufacturers around the world have attempted a large number of related algorithms to prevent spam. In this paper, we designed an effective anti-spam protection system, SpamCooling, based on the mechanism of active learning and parallel heterogeneous ensemble learning techniques. The system adopts a batch method to filter spam and can be easily incorporated with existing mail clients (MUA). It can actively obtain user feedbacks for providing users with personalized spam filtering experiences. The parallel heterogeneous ensemble method can help system achieve high spam detection rate as well as low ham misclassification rate.

A conceptual framework for the implementation of enterprise information portals in large organizations

Addressing the diversity in information requirements across the enterprise is a central challenge in enterprise content management. Enterprise information portals (EIPs) hold promise in this regard, offering each user a gateway to customized and personalized content. However, in large organizations EIP implementers face the complexity of tailoring portals for potentially thousands of users. A conceptual framework based on marketing fundamentals is developed to inform EIP implementation in this respect. It is argued that EIP implementers should view their user community as a number of distinct segments in order to address divergent needs more specifically (as opposed to a ‘one size fits all’ approach). For each identified segment, a ‘mix’ of content (product), distribution (place), promotion and price (cost) should be considered. The framework is applied to two cases of EIP implementation in large organizations. It is proposed that segmentation enables better planning of the overall EIP implementation effort. Considerations such as the number of user segments, customization, and personalization of content, and the funding of EIP development in large organizations are also discussed. The concepts elaborated here also hold theoretical relevance for other IS implementation contexts that involve very large usercommunities with diverse information

Apoptosis goes on a chip : advances in the microfluidic analysis of programmed cell death

Recent years have brought enormous progress in cell-based lab-on-a-chip technologies, allowing dynamic studies of cell death with an unprecedented accuracy. As interest in the microfabricated technologies for cell-based bioassays is rapidly gaining momentum, we highlight the most promising technologies that provide a new outlook for the rapid assessment of programmed and accidental cell death and are applicable in drug discovery, high-content drug screening, and personalized clinical diagnostics.

Associations of the SREBP-1c gene polymorphism with gender-specific changes in serum lipids induced by a high-carbohydrate diet in healthy Chinese youth

We investigated the possible association between the sterol regulatory element-binding protein-1c gene (SREBP-1c) rs2297508 polymorphism and the changes in lipid profiles in a high-carbohydrate and low-fat (high-CHO/LF) diet in a Chinese population well characterized by a lower incidence of coronary heart disease and a diet featuring higher carbohydrate and lower fat. Fifty-six healthy youth (aged 22.89 ± 1.80 years) were given wash-out diets of 31% fat and 54% carbohydrate for 7 days, followed by the high-CHO/LF diet of 15% fat and 70% carbohydrate for 6 days, without total energy restriction. Fasting blood samples were collected. Serum variables of lipid and glucose metabolism after the wash-out and high-CHO/LF diets, as well as the rs2297508 polymorphism, were analyzed. Compared with the male subjects on the wash-out diet, significantly elevated levels of high-density lipoprotein cholesterol (HDL-C) and decreased levels of apolipoprotein B-100 were observed in the male carriers of the C allele after the high-CHO/LF diet. In the female subjects, significantly increased triacylglycerol levels, insulin, and homeostasis model assessment of insulin resistance (HOMA-IR) were found in the GG genotype after the high-CHO/LF diet. These results suggest that the C allele of the rs2297508 polymorphism is associated with a retardation of the increases in serum triacylglycerol, serum insulin, and HOMA-IR in females and with the elevated serum HDL-C in males after the high-CHO/LF diet.

Website physical activity interventions : preferences of potential users

Information and communication technologies (particularly websites and e-mail) have the potential to deliver health behavior change programs to large numbers of adults at low cost. Controlled trials using these new media to promote physical activity have produced mixed results. User-centered development methods can assist in understanding the preferences of potential participants for website functions and content, and may lead to more effective programs. Eight focus group discussions were conducted with 40 adults after they had accessed a previously trialed physical activity website. The discussions were audio taped, transcribed and interpreted using a themed analysis method. Four key themes emerged: structure, interactivity, environmental context and content. Preferences were expressed for websites that include simple interactive features, together with information on local community activity opportunities. Particular suggestions included online community notice boards, personalized progress charts, e-mail access to expert advice and access to information on specific local physical activity facilities and services. Website physical activity interventions could usefully include personally relevant interactive and environmentally focused features and services identified through a user-centered development process.

"You Tube and I Find" - personalizing multimedia content access

Recent growth in broadband access and proliferation of small personal devices that capture images and videos has led to explosive growth of multimedia content available everywhereVfrom personal disks to the Web. While digital media capture and upload has become nearly universal with newer device technology, there is still a need for better tools and technologies to search large collections of multimedia data and to find and deliver the right content to a user according to her current needs and preferences. A renewed focus on the subjective dimension in the multimedia lifecycle, fromcreation, distribution, to delivery and consumption, is required to address this need beyond what is feasible today. Integration of the subjective aspects of the media itselfVits affective, perceptual, and physiological potential (both intended and achieved), together with those of the users themselves will allow for personalizing the content access, beyond today’s facility. This integration, transforming the traditional multimedia information retrieval (MIR) indexes to more effectively answer specific user needs, will allow a richer degree of personalization predicated on user intention and mode of interaction, relationship to the producer, content of the media, and their history and lifestyle. In this paper, we identify the challenges in achieving this integration, current approaches to interpreting content creation processes, to user modelling and profiling, and to personalized content selection, and we detail future directions. The structure of the paper is as follows: In Section I, we introduce the problem and present some definitions. In Section II, we present a review of the aspects of personalized content and current approaches for the same. Section III discusses the problem of obtaining metadata that is required for personalized media creation and present eMediate as a case study of an integrated media capture environment. Section IV presents the MAGIC system as a case study of capturing effective descriptive data and putting users first in distributed learning delivery. The aspects of modelling the user are presented as a case study in using user’s personality as a way to personalize summaries in Section V. Finally, Section VI concludes the paper with a discussion on the emerging challenges and the open problems.

A model for enhancing empowerment in farmers using mobile based information system

Farmers living in rural villages of Sri Lanka do not have proper access to information to make informed decisions about their livelihoods and as a result they face constant hardships in their lives. They use mobile phones to communicate but these are not currently connected to the Internet. We are investigating how to provide personalized information to farmers with the aim of empowering them to make informed decisions and take appropriate actions. In this paper we propose an empowerment model that has been designed to achieve their goals which have been identified using a scenario-based approach. The model examines several empowerment processes and supporting tools that would help them to achieve their goals with the hope that they would have an increased sense of control, self-efficacy, knowledge and competency. This empowerment model is applied to the development of a mobile based information system that is being developed by an international collaborative research group to address the issues of the farmers.

Nanotechnology based platforms for survivin targeted drug discovery

Introduction: Development of an effective, safe and targeted drug delivery system to fight cancer and other diseases is a prime focus in the area of drug discovery. The emerging field of nanotechnology has revolutionised the way cancer therapy and diagnosis is achieved primarily due to the recent advances in material engineering and drug availability. Further, the recognition of the crucial role played by anti-apoptotic proteins such as survivin, has initiated the development of therapeutics that can target this protein as an attempt to develop alternative cancer therapies. However, a key challenge faced in drug development is the efficient delivery of survivin-targeted molecules to specific areas in the body.Areas covered: This review primarily focuses on the different strategies employing nanotechnology for targeting survivin expressed in human cancers. Different nanomaterials incorporating nucleic molecules or drugs targeted at survivin are discussed and the results obtained from studies are highlighted.Expert opinion: There are extensive studies reporting different treatment regimens for cancer, however, they still result in systemic toxicity, reduced bioavailability and ineffective delivery. Novel approaches involve the use of biocompatible nanomaterials together with gene or drug molecules to target proteins such as survivin, which is overexpressed in cancerous cells. These nanoformulations allow the benefits of protecting easily degradable molecules, allow controlled release, and enhance targeted delivery and effectiveness. Hence, nanotherapy utilizing survivin targeting can be considered to play a key role in the development of personalized nanomedicine for cancer.

Genetic basis for the increased expression of vacuolar H+ translocating ATPase genes upon imatinib treatment in human lymphoblastoid cells

Purpose The role of v-ATPases in cancer biology is being increasingly recognized. Yeast studies indicate that the tyrosine kinase inhibitor imatinib may interact with the v-ATPase genes and alter the course of cancer progression. Data from humans in this regard are lacking.

Methods We constructed 55 lymphoblastoid cell lines from pedigreed, cancer-free human subjects and treated them with IC20 concentration of imatinib mesylate. Using these cell lines, we (i) estimated the heritability and differential expression of 19 genes encoding several subunits of the v-ATPase protein in response to imatinib treatment; (ii) estimated the genetic similarity among these genes; and (iii) conducted a high-density scan to find cis-regulating genetic variation associated with differential expression of these genes.

Results We found that the imatinib response of the genes encoding v-ATPase subunits is significantly heritable and can be clustered to identify novel drug targets in imatinib therapy. Further, five of these genes were significantly cis-regulated and together represented nearly half-log fold change in response to imatinib (p = 0.0107) that was homogenous (p = 0.2598).

Conclusions Our results proffer support to the growing view that personalized regimens using proton pump inhibitors or v-ATPase inhibitors may improve outcomes of imatinib therapy in various cancers.

Is diagnosis enough to guide interventions in mental health? Using case formulation in clinical practice

While diagnosis has traditionally been viewed as an essential concept in medicine, particularly when selecting treatments, we suggest that the use of diagnosis alone may be limited, particularly within mental health. The concept of clinical case formulation advocates for collaboratively working with patients to identify idiosyncratic aspects of their presentation and select interventions on this basis. Identifying individualized contributing factors, and how these could influence the person's presentation, in addition to attending to personal strengths, may allow the clinician a deeper understanding of a patient, result in a more personalized treatment approach, and potentially provide a better clinical outcome.

Prevention of diabetes in rural India with a telemedicine intervention

Background : Diabetes care is not presently available, accessible, or affordable to people living in rural areas in developing countries, such as India. The Chunampet Rural Diabetes Prevention Project (CRDPP) was conceived with the aim of implementing comprehensive diabetes screening, prevention, and treatment using a combination of telemedicine and personalized care in rural India.

Methods : This project was undertaken in a cluster of 42 villages in and around the Chunampet village in the state of Tamil Nadu in southern India. A telemedicine van was used to screen for diabetes and its complications using retinal photography, Doppler imaging, biothesiometry, and electrocardiography using standardized techniques. A rural diabetes center was set up to provide basic diabetes care.

Results : Of the total 27,014 adult population living in 42 villages, 23,380 (86.5%) were screened for diabetes, of which 1138 (4.9%) had diabetes and 3410 (14.6%) had prediabetes. A total of 1001 diabetes subjects were screened for complications (response rate of 88.0%). Diabetic retinopathy was detected in 18.2%, neuropathy in 30.9%, microalbuminuria in 24.3%, peripheral vascular disease in 7.3%, and coronary artery disease in 10.8%. The mean hemoglobin A1c levels among the diabetes subjects in the whole community decreased from9.3 ± 2.6% to 8.5 ± 2.4% within 1 year. Less than 5% of patients needed referral for further management to the tertiary diabetes hospital in Chennai.