Clopidogrel use and cancer-specific mortality: a population-based cohort study of colorectal, breast and prostate cancer patients

PURPOSE: Concerns were raised about the safety of antiplatelet thienopyridine derivatives after a randomized control trial reported increased risks of cancer and cancer deaths in prasugrel users. We investigate whether clopidogrel, a widely used thienopyridine derivative, was associated with increased risk of cancer-specific or all-cause mortality in cancer patients.

METHODS: Colorectal, breast and prostate cancer patients, newly diagnosed from 1998 to 2009, were identified from the National Cancer Data Repository. Cohorts were linked to the UK Clinical Practice Research Datalink, providing prescription records, and to the Office of National Statistics mortality data (up to 2012). Unadjusted and adjusted hazard ratios (HRs) for cancer-specific and all-cause mortality in post-diagnostic clopidogrel users were calculated using time-dependent Cox regression models.

RESULTS: The analysis included 10 359 colorectal, 17 889 breast and 13 155 prostate cancer patients. There was no evidence of an increase in cancer-specific mortality in clopidogrel users with colorectal (HR = 0.98 95% confidence interval (CI) 0.77, 1.24) or prostate cancer (HR = 1.03 95%CI 0.82, 1.28). There was limited evidence of an increase in breast cancer patients (HR = 1.22 95%CI 0.90, 1.65); however, this was attenuated when removing prescriptions in the year prior to death.

CONCLUSIONS: This novel study of large population-based cohorts of colorectal, breast and prostate cancer patients found no evidence of an increased risk of cancer-specific mortality among colorectal, breast and prostate cancer patients using clopidogrel.

A multi-agent-based evolution model of innovation networks in dynamic environments

An innovation network can be considered as a complex adaptive system with evolution affected by dynamic environments. This paper establishes a multi-agent-based evolution model of innovation networks under dynamic settings through computational and logical modeling, and a multi-agent system paradigm. This evolution model is composed of several sub-models of agents' knowledge production by independent innovations in dynamic situations, knowledge learning by cooperative innovations covering agents' heterogeneities, decision-making for innovation selections, and knowledge update considering decay factors. On the basis of above-mentioned sub-models, an evolution rule for multi-agent based innovation network system is given. The proposed evolution model can be utilized to simulate and analyze different scenarios of innovation networks in various dynamic environments and support decision-making for innovation network optimization.

Occupational exposure to environmental tobacco smoke in hospitality venues: are genetic- or proteomics-based biomarkers predictive of respiratory diseases?

Environmental tobacco smoke (ETS) is recognized as an occupational hazard in the hospitality industry. Although Portuguese legislation banned smoking in most indoor public spaces, it is still allowed in some restaurants/bars, representing a potential risk to the workers’ health, particularly for chronic respiratory diseases. The aims of this work were to characterize biomarkers of early genetic effects and to disclose proteomic signatures associated to occupational exposure to ETS and with potential to predict respiratory diseases development. A detailed lifestyle survey and clinical evaluation (including spirometry) were performed in 81 workers from Lisbon restaurants. ETS exposure was assessed through the level of PM 2.5 in indoor air and the urinary level of cotinine. The plasma samples were immunodepleted and analysed by 2D-SDSPAGE followed by in-gel digestion and LC-MS/MS. DNA lesions and chromosome damage were analysed innlymphocytes and in exfoliated buccal cells from 19 cigarette smokers, 29 involuntary smokers, and 33 non-smokers not exposed to tobacco smoke. Also, the DNA repair capacity was evaluated using an ex vivo challenge comet assay with an alkylating agent (EMS). All workers were considered healthy and recorded normal lung function. Interestingly, following 2D-DIGE-MS (MALDI-TOF/TOF), 61 plasma proteins were found differentially expressed in ETS-exposed subjects, including 38 involved in metabolism, acute-phase respiratory inflammation, and immune or vascular functions. On the other hand, the involuntary smokers showed neither an increased level of DNA/chromosome damage on lymphocytes nor an increased number of micronuclei in buccal cells, when compared to non-exposed non-smokers. Noteworthy, lymphocytes challenge with EMS resulted in a significantly lower level of DNA breaks in ETS-exposed as compared to non-exposed workers (P<0.0001) suggestive of an adaptive response elicited by the previous exposure to low levels of ETS. Overall, changes in proteome may be promising early biomarkers of exposure to ETS. Likewise, alterations of the DNA repair competence observed upon ETS exposure deserves to be further understood. Work supported by Fundação Calouste Gulbenkian, ACSS and FCT/Polyannual Funding Program.

A Clinical Support System Based on Quality of Life Estimation

Quality of life is a concept influenced by social, economic, psychological, spiritual or medical state factors. More specifically, the perceived quality of an individual's daily life is an assessment of their well-being or lack of it. In this context, information technologies may help on the management of services for healthcare of chronic patients such as estimating the patient quality of life and helping the medical staff to take appropriate measures to increase each patient quality of life. This paper describes a Quality of Life estimation system developed using information technologies and the application of data mining algorithms to access the information of clinical data of patients with cancer from Otorhinolaryngology and Head and Neck services of an oncology institution. The system was evaluated with a sample composed of 3013 patients. The results achieved show that there are variables that may be significant predictors for the Quality of Life of the patient: years of smoking (p value 0.049) and size of the tumor (p value < 0.001). In order to assign the variables to the classification of the quality of life the best accuracy was obtained by applying the John Platt's sequential minimal optimization algorithm for training a support vector classifier. In conclusion data mining techniques allow having access to patients additional information helping the physicians to be able to know the quality of life and produce a well-informed clinical decision.

Representation of motor habit in a sequence of repetitive reach and grasp movements performed by macaque monkeys: evidence for a contribution of the dorsolateral prefrontal cortex.

In the context of an autologous cell transplantation study, a unilateral biopsy of cortical tissue was surgically performed from the right dorsolateral prefrontal cortex (dlPFC) in two intact adult macaque monkeys (dlPFC lesioned group), together with the implantation of a chronic chamber providing access to the left motor cortex. Three other monkeys were subjected to the same chronic chamber implantation, but without dlPFC biopsy (control group). All monkeys were initially trained to perform sequential manual dexterity tasks, requiring precision grip. The motor performance and the prehension's sequence (temporal order to grasp pellets from different spatial locations) were analysed for each hand. Following the surgery, transient and moderate deficits of manual dexterity per se occurred in both groups, indicating that they were not due to the dlPFC lesion (most likely related to the recording chamber implantation and/or general anaesthesia/medication). In contrast, changes of motor habit were observed for the sequential order of grasping in the two monkeys with dlPFC lesion only. The changes were more prominent in the monkey subjected to the largest lesion, supporting the notion of a specific effect of the dlPFC lesion on the motor habit of the monkeys. These observations are reminiscent of previous studies using conditional tasks with delay that have proposed a specialization of the dlPFC for visuo-spatial working memory, except that this is in a different context of "free-will", non-conditional manual dexterity task, without a component of working memory.

A new class of isothiocyanate-based irreversible inhibitors of macrophage migration inhibitory factor.

Macrophage migration inhibitory factor (MIF) is a homotrimeric multifunctional proinflammatory cytokine that has been implicated in the pathogenesis of several inflammatory and autoimmune diseases. Current therapeutic strategies for targeting MIF focus on developing inhibitors of its tautomerase activity or modulating its biological activities using anti-MIF neutralizing antibodies. Herein we report a new class of isothiocyanate (ITC)-based irreversible inhibitors of MIF. Modification by benzyl isothiocyanate (BITC) and related analogues occurred at the N-terminal catalytic proline residue without any effect on the oligomerization state of MIF. Different alkyl and arylalkyl ITCs modified MIF with nearly the same efficiency as BITC. To elucidate the mechanism of action, we performed detailed biochemical, biophysical, and structural studies to determine the effect of BITC and its analogues on the conformational state, quaternary structure, catalytic activity, receptor binding, and biological activity of MIF. Light scattering, analytical ultracentrifugation, and NMR studies on unmodified and ITC-modified MIF demonstrated that modification of Pro1 alters the tertiary, but not the secondary or quaternary, structure of the trimer without affecting its thermodynamic stability. BITC induced drastic effects on the tertiary structure of MIF, in particular residues that cluster around Pro1 and constitute the tautomerase active site. These changes in tertiary structure and the loss of catalytic activity translated into a reduction in MIF receptor binding activity, MIF-mediated glucocorticoid overriding, and MIF-induced Akt phosphorylation. Together, these findings highlight the role of tertiary structure in modulating the biochemical and biological activities of MIF and present new opportunities for modulating MIF biological activities in vivo.

Online problem-based learning : perceptions of nursing educators /

A qualitative study was conducted to detennine 5 nursing educators' perceptions about the online application of a problem-based learning strategy in undergraduate nursing education. The question asked in the study was: Can the essential elements of face-to-face problem-based learning be supported in an online format? The data for this study came from 2 individual tape-recorded interviews with each of the 5 participants over a 3-month period and from a researchjournaI. The educators felt that student-centered learning and critical thinking could be supported within an online format. However, they noted that challenges could exist in terms of developing tutor roles, fostering student self-direction, facilitating group process and connections, and incorporating a nursing philosophy of online learning. The importance of tailoring an online problem-based learning course to reflect educators' philosophies and values in nursing emerged as an important theme from the interview responses. Overall, the participants suggested that an ideal environment would blend both face-to-face and online elements and that fewer elements would be offered in the first 2 years of the nursing program. They described a hybrid model of problem-based learning in which the online component could be used to support face-to-face sessions.

THE ASSOCIATION OF SEQUENCE OF HIRING PRACTICE AND BIOPHYSICAL COMPONENTS IN SCREENING PROBATIONARY FIREFIGHTERS

Variation in hiring procedures occurs within fire service human resource departments. In this study, City 1 and City 2 applicants were required to pass their biophysical assessments prior to being hired as firefighters at the beginning and end of the screening process, respectively. City 1 applicants demonstrated significantly lower resting heart rate (RHR), resting diastolic blood pressure (RDBP), body fat% (BF) and higher z-scores for BF, trunk flexibility (TF) and overall clinical assessment (p<0.05). Regression analysis found that age and conducting the biophysical assessment at the end of the screening process explained poorer biophysical assessment results in BF% (R2=21%), BF z-score (R2=22%), TF z-score (R2=10%) and overall clinical assessment z-score (R2=7%). Each of RHR (OR=1.06, CI=1.01-1.10), RDBP (OR=1.05, CI=1.00-1.11) and BF% (OR=1.20, CI=1.07-1.37) increased the odds of being a City 2 firefighter (p<0.05). Biophysical screening at the end of the hiring process may result in the hiring of a less healthy firefighter.

Complete Genome Sequence of Erwinia amylovora Bacteriophage

The complete genome of an Erwinia amylovora bacteriophage, vB_EamM_Ea35-70 (Ea35-70), is 271,084 bp, encodes 318 putative proteins, and contains one tRNA. Comparative analysis with other Myoviridae genomes suggests that Ea35-70 is related to the Phikzlikevirus genus within the family Myoviridae, since 26% of Ea35-70 proteins share homology to proteins in Pseudomonas phage φKZ.

Information Discovery in Distributed Systems-A Novel Concept Based on Modelling of Information Elements

Sharing of information with those in need of it has always been an idealistic goal of networked environments. With the proliferation of computer networks, information is so widely distributed among systems, that it is imperative to have well-organized schemes for retrieval and also discovery. This thesis attempts to investigate the problems associated with such schemes and suggests a software architecture, which is aimed towards achieving a meaningful discovery. Usage of information elements as a modelling base for efficient information discovery in distributed systems is demonstrated with the aid of a novel conceptual entity called infotron.The investigations are focused on distributed systems and their associated problems. The study was directed towards identifying suitable software architecture and incorporating the same in an environment where information growth is phenomenal and a proper mechanism for carrying out information discovery becomes feasible. An empirical study undertaken with the aid of an election database of constituencies distributed geographically, provided the insights required. This is manifested in the Election Counting and Reporting Software (ECRS) System. ECRS system is a software system, which is essentially distributed in nature designed to prepare reports to district administrators about the election counting process and to generate other miscellaneous statutory reports.Most of the distributed systems of the nature of ECRS normally will possess a "fragile architecture" which would make them amenable to collapse, with the occurrence of minor faults. This is resolved with the help of the penta-tier architecture proposed, that contained five different technologies at different tiers of the architecture.The results of experiment conducted and its analysis show that such an architecture would help to maintain different components of the software intact in an impermeable manner from any internal or external faults. The architecture thus evolved needed a mechanism to support information processing and discovery. This necessitated the introduction of the noveI concept of infotrons. Further, when a computing machine has to perform any meaningful extraction of information, it is guided by what is termed an infotron dictionary.The other empirical study was to find out which of the two prominent markup languages namely HTML and XML, is best suited for the incorporation of infotrons. A comparative study of 200 documents in HTML and XML was undertaken. The result was in favor ofXML.The concept of infotron and that of infotron dictionary, which were developed, was applied to implement an Information Discovery System (IDS). IDS is essentially, a system, that starts with the infotron(s) supplied as clue(s), and results in brewing the information required to satisfy the need of the information discoverer by utilizing the documents available at its disposal (as information space). The various components of the system and their interaction follows the penta-tier architectural model and therefore can be considered fault-tolerant. IDS is generic in nature and therefore the characteristics and the specifications were drawn up accordingly. Many subsystems interacted with multiple infotron dictionaries that were maintained in the system.In order to demonstrate the working of the IDS and to discover the information without modification of a typical Library Information System (LIS), an Information Discovery in Library Information System (lDLIS) application was developed. IDLIS is essentially a wrapper for the LIS, which maintains all the databases of the library. The purpose was to demonstrate that the functionality of a legacy system could be enhanced with the augmentation of IDS leading to information discovery service. IDLIS demonstrates IDS in action. IDLIS proves that any legacy system could be augmented with IDS effectively to provide the additional functionality of information discovery service.Possible applications of IDS and scope for further research in the field are covered.

Information discovery in distributed systems - A novel concept based on modelling of information elements

This thesis attempts to investigate the problems associated with such schemes and suggests a software architecture, which is aimed towards achieving a meaningful discovery. Usage of information elements as a modelling base for efficient information discovery in distributed systems is demonstrated with the aid of a novel conceptual entity called infotron. The investigations are focused on distributed systems and their associated problems. The study was directed towards identifying suitable software architecture and incorporating the same in an environment where information growth is phenomenal and a proper mechanism for carrying out information discovery becomes feasible. An empirical study undertaken with the aid of an election database of constituencies distributed geographically, provided the insights required. This is manifested in the Election Counting and Reporting Software (ECRS) System. ECRS system is a software system, which is essentially distributed in nature designed to prepare reports to district administrators about the election counting process and to generate other miscellaneous statutory reports.

Content-Based Image Retrieval of Axial Brain Slices Using a Novel LBP with a Ternary Encoding

Retrieval of similar anatomical structures of brain MR images across patients would help the expert in diagnosis of diseases. In this paper, modified local binary pattern with ternary encoding called modified local ternary pattern (MOD-LTP) is introduced, which is more discriminant and less sensitive to noise in near-uniform regions, to locate slices belonging to the same level from the brain MR image database. The ternary encoding depends on a threshold, which is a user-specified one or calculated locally, based on the variance of the pixel intensities in each window. The variancebased local threshold makes the MOD-LTP more robust to noise and global illumination changes. The retrieval performance is shown to improve by taking region-based moment features of MODLTP and iteratively reweighting the moment features of MOD-LTP based on the user’s feedback. The average rank obtained using iterated and weighted moment features of MOD-LTP with a local variance-based threshold, is one to two times better than rotational invariant LBP (Unay, D., Ekin, A. and Jasinschi, R.S. (2010) Local structure-based region-of-interest retrieval in brain MR images. IEEE Trans. Inf. Technol. Biomed., 14, 897–903.) in retrieving the first 10 relevant images

Content Based Image Retrieval of Brain MR Images across Different Classes

Magnetic Resonance Imaging play a vital role in the decision-diagnosis process of brain MR images. For an accurate diagnosis of brain related problems, the experts mostly compares both T1 and T2 weighted images as the information presented in these two images are complementary. In this paper, rotational and translational invariant form of Local binary Pattern (LBP) with additional gray scale information is used to retrieve similar slices of T1 weighted images from T2 weighted images or vice versa. The incorporation of additional gray scale information on LBP can extract more local texture information. The accuracy of retrieval can be improved by extracting moment features of LBP and reweighting the features based on users’ feedback. Here retrieval is done in a single subject scenario where similar images of a particular subject at a particular level are retrieved, and multiple subjects scenario where relevant images at a particular level across the subjects are retrieved