905 resultados para Fabricated or induced illness by carers


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Background: Treatment of NSCLC has been revolutionized in recent years with the introduction of several targeted therapies for selected genetically altered subtypes of NSCLC. A better understanding of molecular characteristics of NSCLC, which features common drug targets, may identify new therapeutic options. Methods: Over 6,700 non-small cell lung cancer cases referred to Caris Life Sciences between 2009 and 2014. Diagnoses and history were collected from referring physicians. Specific testing was performed per physician request and included a combination of sequencing (Sanger, NGS or pyrosequencing), protein expression (IHC), gene amplification/rearrangement (CISH or FISH), and/or RNA fragment analysis. Results: Tumors profiles from patients with hormone receptor positive disease (HER2, ER, PR, or AR positive by IHC) (n=629), HER2 mutations (n=8) ALK rearrangements (n=55), ROS1 rearrangement (n=17), cMET amplification or mutation (n=126), and cKIT mutation (n=11) were included in this analysis and compared to the whole cohort. Tumors with ALK rearrangement overexpressed AR in 18% of cases, and 7% presented with concomitant KRAS mutation. Lower rates of PTEN loss, as assessed by IHC, were observed in ALK positive (20%), ROS1 positive (9%) and cKIT mutated tumors (25%) compared to the overall NSCLC population (58%). cMET was overexpressed in 66% of ROS1 translocated and 57% of HER2 mutated tumors. cKIT mutations were found co-existing with APC (20%) and EGFR (20%) mutations. Pathway analysis revealed that hormone receptor positive disease carried more mutations in the ERK pathway (32%) compared to 9% in the mTOR pathway. 25% of patients with HER2 mutations harbored a co-existing mutation in the mTOR pathway. Conclusions: Pathway profiling reveals that NSCLC tumors present more often than reported with several concomitant alterations affecting the ERK or AKT pathway. Additionally, they are also characterized by the expression of potential biological modifiers of the cell cycle like hormonal receptors, representing a rationale for dual inhibition strategies in selected patients. Further refining of the understanding of NSCLC biomarker profile will optimize research for new treatment strategies.

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The availability of stem cells is of great promise to study early developmental stages and to generate adequate cells for cell transfer therapies. Although many researchers using stem cells were successful in dissecting intrinsic and extrinsic mechanisms and in generating specific cell phenotypes, few of the stem cells or the differentiated cells show the capacity to repair a tissue. Advances in cell and stem cell cultivation during the last years made tremendous progress in the generation of bona fide differentiated cells able to integrate into a tissue after transplantation, opening new perspectives for developmental biology studies and for regenerative medicine. In this review, we focus on the main works attempting to create in vitro conditions mimicking the natural environment of CNS structures such as the neural tube and its development in different brain region areas including the optic cup. The use of protocols growing cells in 3D organoids is a key strategy to produce cells resembling endogenous ones. An emphasis on the generation of retina tissue and photoreceptor cells is provided to highlight the promising developments in this field. Other examples are presented and discussed, such as the formation of cortical tissue, the epithelial gut or the kidney organoids. The generation of differentiated tissues and well-defined cell phenotypes from embryonic stem (ES) cells or induced pluripotent cells (iPSCs) opens several new strategies in the field of biology and regenerative medicine. A 3D organ/tissue development in vitro derived from human cells brings a unique tool to study human cell biology and pathophysiology of an organ or a specific cell population. The perspective of tissue repair is discussed as well as the necessity of cell banking to accelerate the progress of this promising field.

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BACKGROUND AND PURPOSE: For the STroke Imaging Research (STIR) and VISTA-Imaging Investigators The purpose of this study was to collect precise information on the typical imaging decisions given specific clinical acute stroke scenarios. Stroke centers worldwide were surveyed regarding typical imaging used to work up representative acute stroke patients, make treatment decisions, and willingness to enroll in clinical trials. METHODS: STroke Imaging Research and Virtual International Stroke Trials Archive-Imaging circulated an online survey of clinical case vignettes through its website, the websites of national professional societies from multiple countries as well as through email distribution lists from STroke Imaging Research and participating societies. Survey responders were asked to select the typical imaging work-up for each clinical vignette presented. Actual images were not presented to the survey responders. Instead, the survey then displayed several types of imaging findings offered by the imaging strategy, and the responders selected the appropriate therapy and whether to enroll into a clinical trial considering time from onset, clinical presentation, and imaging findings. A follow-up survey focusing on 6 h from onset was conducted after the release of the positive endovascular trials. RESULTS: We received 548 responses from 35 countries including 282 individual centers; 78% of the centers originating from Australia, Brazil, France, Germany, Spain, United Kingdom, and United States. The specific onset windows presented influenced the type of imaging work-up selected more than the clinical scenario. Magnetic Resonance Imaging usage (27-28%) was substantial, in particular for wake-up stroke. Following the release of the positive trials, selection of perfusion imaging significantly increased for imaging strategy. CONCLUSIONS: Usage of vascular or perfusion imaging by Computed Tomography or Magnetic Resonance Imaging beyond just parenchymal imaging was the primary work-up (62-87%) across all clinical vignettes and time windows. Perfusion imaging with Computed Tomography or Magnetic Resonance Imaging was associated with increased probability of enrollment into clinical trials for 0-3 h. Following the release of the positive endovascular trials, selection of endovascular only treatment for 6 h increased across all clinical vignettes.

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Social insects are promising model systems for epigenetics due to their immense morphological and behavioral plasticity. Reports that DNA methylation differs between the queen and worker castes in social insects [1-4] have implied a role for DNA methylation in regulating division of labor. To better understand the function of DNA methylation in social insects, we performed whole-genome bisulfite sequencing on brains of the clonal raider ant Cerapachys biroi, whose colonies alternate between reproductive (queen-like) and brood care (worker-like) phases [5]. Many cytosines were methylated in all replicates (on average 29.5% of the methylated cytosines in a given replicate), indicating that a large proportion of the C. biroi brain methylome is robust. Robust DNA methylation occurred preferentially in exonic CpGs of highly and stably expressed genes involved in core functions. Our analyses did not detect any differences in DNA methylation between the queen-like and worker-like phases, suggesting that DNA methylation is not associated with changes in reproduction and behavior in C. biroi. Finally, many cytosines were methylated in one sample only, due to either biological or experimental variation. By applying the statistical methods used in previous studies [1-4, 6] to our data, we show that such sample-specific DNA methylation may underlie the previous findings of queen- and worker-specific methylation. We argue that there is currently no evidence that genome-wide variation in DNA methylation is associated with the queen and worker castes in social insects, and we call for a more careful interpretation of the available data.

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This chapter assesses the theories and related empirical evidence regarding the factors that explain cultural innovation by cultural organizations. It begins by defining key concepts, including what is meant by a cultural organization, cultural innovation, and the innovation referent. The chapter identifies two main disciplines that have been interested in cultural innovation or innovative programming by cultural organizations: sociology and economics. The focus, contributions, and overlap of these two disciplinary approaches to cultural innovation are discussed, and the chapter concludes by identifying some gaps and putting forward some suggestions for future research.

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The rules on prescription in Part VIII, Chapter 18, of the Proposal for a Common European Sales Law (CESL) follow the provisions of the Principles of European Contract Law (PECL) and the Draft Common Frame of Reference (DCFR), which, in general, have deserved favourable comments. Yet, a number of rules contained in those texts have been omitted. It is necessary to ascertain whether the CESL rules only apply to provisions on rights and claims resulting from sales or related services contracts, or whether they are also applicable to any other contractual right or claim and also to rights or claims of non-contractual origin. One of the most problematic issues concerns general prescription periods: firstly, because there are two general periods, a short one and a long one, without any specification about the claims or rights covered by each one of them; secondly, because neither period is suitable in case of non-conformity. There are also some interpretation problems due to missing, ambiguous or defective definitions. The systematic approach demands clarification too.

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Diplomityön ensisijaisena tavoitteena on luoda yleinen vaatimustiedon hallinnan malli, jonka avulla yrityksen toimintaympäristössä vaikuttavat vaatimukset voidaan tunnistaa ja kommunikoida koko organisaation tietoisuuteen. Kohdeyrityksen näkökulmasta mielenkiinto kohdistuu erityisesti käytännön työn kautta saataviin lopputuloksiin. Tavoitteena on luoda yritykseen pohja vaatimustiedon hallinnalle sekä samalla kehittää sähköistä vaatimustietojärjestelmää. Diplomityö on toteutettu konstruktiivisena tutkimuksena. Tutkittavasta aiheesta on saatavilla teoriatietoa hyvin rajallisesti. Tämän vuoksi vaatimustiedon hallinnan malli toteutetaan vahvasti käytännön työn havaintojen ja analysoinnin pohjalta. Lähtökohdaksi käytännön työlle esitellään laadunhallinnan, tiedonhallinnan sekä prosessien näkökulmia sekä perinteisiä vaatimusten hallinnan teorioita. Tiedot, joiden avulla valmis malli on luotu, kerättiin haastattelemalla yrityksen prosessien omistajia. Työn tuloksina esitellään vaatimustiedon hallinnan malli sekä yrityksessä saatuja käytännön työn lopputuloksia. Vaatimustiedon hallinnalla tarkoitetaan yrityksen toimintaympäristössä, prosesseissa sekä tuotteissa vaikuttavien vaatimusten saattamista organisaation tietoisuuteen mahdollisimman käyttäjäystävällisellä tavalla. Mallissa esiintyvät vaatimukset ovat sidosryhmien tai yrityksen itsensä ilmaisuja liittyen tuotteen tai palvelun ominaisuuksiin sekä suorituskykyyn. Valmis malli voidaan jakaa neljään eri vaiheeseen, jotka ovat suunnittelu ja esitutkimus, toteutus, käyttöönotto, sekä muutostenhallinta ja ylläpito. Laajimmillaan toteutettuna vaatimustiedon hallinta auttaa yritystä parhaiden käytäntöjen tunnistamisessa ja prosessien kehittämisessä, mahdollistaa tasalaatuisen toiminnan ja tuotteet sekä toimivan tiedon ja osaamisen hallinnan.

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One old dream of the chemist in the field of the drug research is to create molecules capable of reaching their target with the precision of a missile. To accomplish it these molecules must have the propriety of distinguishing qualitative differences between healthy and diseased cells. A therapy based on this principle, able of eradicating specifically defective cells, or cells affected by a pathogen has an enormous advantage with the regard to the classical approach in which the cytotoxic drugs merely exploit quantitative biochemical and kinetic differences between abnormal and normal cells. We present in this article a review on the chemical synthesis of analogues of desoxyribonucleotides and on results obtained on the specific and irreversible inhibition of undesired genetic expression using the antisense principle.

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Pollen allergy has a remarkable clinical impact all over Europe, and there are evidences that the prevalence of allergic respiratory induced reactions by pollen in Europe has been increasing in recent decades. The presence of potentially allergenic ornamental species in the town of Tiana, representing 41% of total species recorded. Approximately 28% of these species are Platanus acerifolia. This study attempts to relate the effect it has on the people’s health, the presence of certain urban ornamental plants by identifying and locating the ornamental trees in the town.

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Tutkimuksen ongelma on toimitusten ajallisen täsmällisyyden heikkeneminen kuljetuspolkujen pidentyessä ja erillisten suoritteitten lukumäärän kasvaessa. Näin usein tapahtuu toiminnan kansainvälistyessä. Tutkimuksen tavoitteena on kehittää menetelmä, jolla toimitusten ajallista täsmällisyyttä voidaan suunnitella ja ohjata sekä sen tavoitteet saavuttaa yllä todetusta kehityksestä huolimatta. Aluksi tutkimuksessa on jäsennetty toimitustäsmällisyyden nivoutumista yritys ja markkinointistrategioiden sekä tavoitteiden kokonaisuuteen. Täsmällisyyden merkitystä on myös tarkasteltu yleisesti yritysten kilpailutekijänä. Seuraavaksi on kehitetty interaktiivinen menetelmä, jonka avulla voidaan suunnitella yksittäisen toimituksen ajallista täsmällisyyttä. Toimituksen suoritteet ja niiden vaihtoehdot on kuvattu kvantifioituna, suunnattuna graafina eli verkkona. Ensin on tarkasteltu tilannetta, jossa suoritteiden kestot ovat vakiot ja sitten suoritteiden keston hajonnan huomioon ottavaa menetelmää, jonka avulla on löydettävissä kustannuksiltaan halvin, riittävän täsmällinen ja luotettava ratkaisu. Menetelmän soveltamista on tarkasteltu yleisesti sekä tulo että lähtölogistiikassa, dynaamisessa toimitussuoritetta koskevassa paatoksen teossa ja erilaisissa erityistapauksissa. Täsmällisyystavoitteitten asettamista ja muuttujia on tarkasteltu yleisesti ja käytännön soveltamisen kannalta. Käytännön soveltamista on kokeiltu valitun kohdeyrityksen esimerkkitilanteessa. Menetelmän toimivuutta on testattu simuloimalla sen ja perinteisesti suunniteltujen tehdastoimitusten sekä paikallisvarastosta tehtävien toimitusten tuloksia ja kustannuksia sekä vertaamalla niitä keskenään. Analyysin lopuksi on tarkasteltu esimerkkitilannetta logistisena kokonaisuutena lisäämällä vertailuun muitten kustannuskomponenttien ja lisäarvon vaikutus. Lopussa on käsitelty menetelmän käytännön soveltuvuusprofiilia ja jatkotutkimusaiheita. Yhteenvetona on todettu kehitetyn menetelmän tekevän täsmällisyyttä korostavan toimitusstrategian luotettavan toteuttamisen mahdolliseksi. Sen on taas todettu voivan olla edullinen vaihtoehto, jos täsmällisyydellä on markkina arvoa ja merkitystä pitkän tähtäimen menestystekijänä.

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Atropisomerism is a special kind of stereoisomeric relationship that arises from the freezing of a certain conformation of an organic molecule, associated with a high rotational barrier about a single covalent bond. Atropisomerism has been originally described in orto-functionalyzed biphenyl derivatives, but a lot of other organic functionalities can present this structural phenomenon, characterized by the presence of chiral properties in compounds that don't present classical stereogenic centers. Atropisomeric compounds, intermediates and catalysts have well-know importance in organic synthesis, but the influence of the axial chirality in substances able to modulate biological systems is still not very exploited in drug design and development. In this context, the present account describes the importance of this structural property in the medicinal chemistry of different classes of bioactive compounds or therapeutic agents, emphasizing how atropisomerism could affect the molecular recognition of a ligand or a prototype by the target bioreceptor.

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Purpose: The aim of the study was to evaluate the opinions and concerns of hospital doctors about adverse drug reactions (ADRs) and pharmacovigilance. Methods: A qualitative study was undertaken using focus groups in sessions on pharmacovigilance activities conducted in thirteen clinical services of a tertiary university hospital. A total of 296 physicians participated in these sessions by giving their opinions or expressing their doubts about ADR and pharmacovigilance activities which were recorded by different observers and subsequently analysed. Results: Doctors remarked on: a) the importance, concern, frequency and specific types of ADRs that were observed in clinical practice; b) problems of clinical decision making related to the suspected ADRs; c) methods for improving detection and reporting ADRs; d) monitoring of specific ADRs or ADRs caused by specific drugs; e) and measures to prevent and minimize the risk of ADRs. Physicians expressed doubts related to: a) the basic concepts of ADRs; b) the methods of ADR identification and evaluation; c) the objectives and procedures of pharmacovigilance programmes; d) and the impact of pharmacovigilance activities. Conclusions: Hospital doctors believe that ADRs are a matter for concern in their daily clinical practice, and monitoring ADRs as well as measures for preventing the risk of ADRs are needed. Nevertheless, doctors have doubts about what an ADR is, the accuracy of diagnostic methods, the development of pharmacovigilance activities and their impact on clinical practice. Pharmacovigilance should be better explained through a continuous feedback and close relationship with hospital doctors.

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This research work aimed at determining the UVA effectiveness (UVA I/UV ratio), by diffuse transmittance analysis, of sunscreens developed with a bioactive substance, the rutin, associating or not with organic UVB-UVA filters incorporated at a phosphate-base O/W emulsion. Sunscreens provided conflicting and unpredictable results concerning the anti-UVA protection, specially, at the UVA I region. Possible interactions among the organic UV filters and the polyphenolic bioactive substance may have accounted with improvement or reduction of UV protection by a complex and not yet elucidated mechanism, probably regarding wavelength delocalization to superior or inferior values, by resonant molecule stabilization or destabilization.

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The use of veterinary drugs in food producing animals may result in the presence of residues in foods, including milk and eggs. Immunoassay or microbiological tests are used to screen for residues, but chromatographic methods are needed to confirm positive results. In most methods, the sample is extracted with acetonitrile, submitted to clean up or directly analyzed by LC-MS/MS. Results of the Brazilian governmental monitoring programs from 2006 to 2011 have shown that the antiparasitic ivermectin was the drug most frequently found in milk. Residues in eggs are only monitored by one of the programs, and few studies have reported the incidence of veterinary drugs in this matrix in Brazil.

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Työajan seuranta ja kohdistaminen oikeisiin kustannuslajeihin on yrityksen suorituskyvyn ja kasvun kannalta usein välttämättömyys. Tässä työssä tutkitaan mobiiliteknologioiden mahdollisuuksia ja soveltuvuutta tuottaa palveluita työajan hallinnointiin, valitaan sopiva arkkitehtuuri ja kehitetään Java ME –teknologialla prototyyppi, joka on helposti integroitavissa yrityksen nykyisiin palvelinpuolen järjestelmiin ja tietokantoihin. Työn sovellusosuudessa kuvataan prototyypin ohjelmoinnissa käytetyt työkalut, menetelmät, ongelmakohdat sekä niiden ratkaisut. Suunnitelluissa käyttötapauksissa tapahtumatiedot syötetään manuaalisesti puhelimen käyttöliittymän kautta tai automatisoidummin kerätään kustannuskohdistetietoa työkohteisiin sijoitetuista NFC-tageista. Työaikaleimaamista testattiin emulaattorilla ja oikealla matkapuhelimella. Lopputuloksena asiakkaan työajanhallinnan tapahtumat siirtyvät langattomasti ja reaaliaikaisesti yrityksen webpalvelimelle JSON-formaatissa.