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https://www.readbyqxmd.com/read/28535102/why-value-framework-assessments-arrive-at-different-conclusions-a-multiple-myeloma-case-study
#1
Kimberly Westrich, Lisabeth Buelt, Robert W Dubois
As the United States transitions from a volume-based health care system to one that rewards value, new frameworks are emerging to help patients, providers, and payers assess the value of medical services and biopharmaceutical products. These value assessment frameworks are intended to support various types of health care decision making. They have the potential to substantially affect patients, whether as tools for shared decision making with their doctors, as an input to care pathways used by providers, or through payer use of the frameworks to make coverage or reimbursement decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28532553/the-potential-impact-of-public-health-interventions-in-preventing-kidney-disease
#2
REVIEW
Rohina Joshi, Oommen John, Vivekanand Jha
The years of life lost and years lived with disability resulting from chronic kidney disease (CKD) increased globally by 90% and 49.5%, respectively, between 1990 and 2013. In addition to the traditional factors, infections, low birthweight, environmental factors, and low socioeconomic status contribute to the CKD burden in low- and middle-income countries. System-level challenges such as poor appreciation of the burden, insufficient human resources, high health care costs, poor referral pathways, unreliable health information systems, and inadequate medicine supply pose barriers to CKD control...
May 2017: Seminars in Nephrology
https://www.readbyqxmd.com/read/28532293/the-impact-of-work-related-and-personal-resources-on-older-workers-fatigue-work-enjoyment-and-retirement-intentions-over-time
#3
Dave Stynen, Nicole W H Jansen, IJmert Kant
This study aims to examine the impact of work-related and personal resources on older workers' retirement intentions by studying the pathways (fatigue and work enjoyment) from resources to retirement intentions, the buffering role of resources for psychological job demands, in a cross-sectional and longitudinal timeframe. Longitudinal results on a subsample of full-time, older workers (n=1,642) from the Maastricht Cohort Study suggest that over 4 years of follow-up personal resources like personal mastery and perceived health related to less (prolonged) fatigue and more work enjoyment...
May 22, 2017: Ergonomics
https://www.readbyqxmd.com/read/28528519/il-6-blockade-in-the-management-of-non-infectious-uveitis
#4
Giuseppe Lopalco, Claudia Fabiani, Jurgen Sota, Orso Maria Lucherini, Gian Marco Tosi, Bruno Frediani, Florenzo Iannone, Mauro Galeazzi, Rossella Franceschini, Donato Rigante, Luca Cantarini
Several pathogenetic studies have paved the way for a newer more rational therapeutic approach to non-infectious uveitis, and treatment of different forms of immune-driven uveitis has drastically evolved in recent years after the advent of biotechnological drugs. Tumor necrosis factor-α targeted therapies, the first-line recommended biologics in uveitis, have certainly led to remarkable results in patients with non-infectious uveitis. Nevertheless, the decision-making process turns out to be extremely difficult in anti-tumor necrosis factor or multidrug-resistant cases...
May 20, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/28528232/a-mathematical-and-biological-plausible-model-of-decision-execution-regulation-in-go-no-go-tasks-focusing-on-the-fronto-striatal-thalamic-pathway
#5
Golnaz Baghdadi, Farzad Towhidkhah, Reza Rostami
Discovering factors influencing the speed and accuracy of responses in tasks such as "Go/No-Go" is one of issues which have been raised in neurocognitive studies. Mathematical models are considered as tools to identify and to study decision making procedure from different aspects. In this paper, a mathematical model has been presented to show several factors can alter the output of decision making procedure before execution in a "Go/No-Go" task. The dynamic of this model has two stable fixed points, each of them corresponds to the "Press" and "Not-press" responses...
May 13, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28527407/mechanisms-of-resistance-to-systemic-therapy-in-metastatic-castration-resistant-prostate-cancer
#6
REVIEW
Giuseppe Galletti, Benjamin I Leach, Linda Lam, Scott T Tagawa
Patients with metastatic castration-resistant prostate cancer (mCPRC) now have an unprecedented number of approved treatment options, including chemotherapies (docetaxel, cabazitaxel), androgen receptor (AR)-targeted therapies (enzalutamide, abiraterone), a radioisotope (radium-223) and a cancer vaccine (sipuleucel-T). However, the optimal treatment sequencing pathway is unknown, and this problem is exacerbated by the issues of primary and acquired resistance. This review focuses on mechanisms of resistance to AR-targeted therapies and taxane-based chemotherapy...
May 8, 2017: Cancer Treatment Reviews
https://www.readbyqxmd.com/read/28525286/cancer-patient-experience-in-the-teenage-young-adult-population-key-issues-and-trends-over-time-an-analysis-of-the-united-kingdom-national-cancer-patient-experience-surveys-2010-2014
#7
Caroline L Furness, Lesley Smith, Eva Morris, Caroline Brocklehurst, Sasha Daly, Rachael E Hough
Improving outcomes for teenagers and young adults (TYA) with cancer is a key element of the national cancer strategy in England. Recognition of the unique needs of this group has led to the development of recommendations for specific models of care and delivery of this care through the provision of dedicated clinical units in principal treatment centers (PTCs) across the United Kingdom. The aim of this study was to understand the current cancer patient experience for this patient group. We aimed to determine whether treatment experience is influenced by place of treatment and whether it has changed over time using patient-reported data from national cancer patient experience surveys...
May 19, 2017: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/28521707/biologic-agents-in-systemic-dermatotherapy-cutaneous-and-systemic-side-effects
#8
George Badavanis, Efstathia Pasmatzi, Alexandra Monastirli, Dionysios Tsambaos
The recent significant breakthroughs in the understanding of the pathogenetic mechanisms of psoriasis and other immune-mediated inflammatory disorders, have led to the emergence of a wide array of biologic agents or biologics, that are especially designed to target selective intracellular or extracellular components and pathways of the dysregulated immune response. These targeted biologic agents have altered the landscape in dermatotherapy aiming to offer higher therapeutic efficacy and an alternative in patients who either failed on conventional systemic regimens or have no other therapeutic options...
May 18, 2017: Current Drug Safety
https://www.readbyqxmd.com/read/28520893/using-bayesian-modeling-in-frequentist-adaptive-enrichment-designs
#9
Noah Simon, Richard Simon
Our increased understanding of the mechanistic heterogeneity of diseases has pushed the development of targeted therapeutics. We do not expect all patients with a given disease to benefit from a targeted drug; only those in the target population. That is, those with sufficient dysregulation in the biomolecular pathway targeted by treatment. However, due to complexity of the pathway, and/or technical issues with our characterizing assay, it is often hard to characterize the target population until well into large-scale clinical trials...
May 17, 2017: Biostatistics
https://www.readbyqxmd.com/read/28520535/optimal-z-score-use-in-surgical-decision-making-in-pulmonary-atresia-with-intact-ventricular-septum
#10
Mark Nelson Awori, Nikita P Mehta, Frederick O Mitema, Naomi Kebba
OBJECTIVES: In the surgical treatment of pulmonary atresia with intact ventricular septum, the size of the tricuspid valve annulus (as measured by z-scores) has emerged as a significant factor in deciding which repair to perform. Various tricuspid valve annulus z-scores are reported as "cutoffs" for successful biventricular repair. We aimed to determine whether the use of different z-score data sets contributed to the gross variation in "cutoffs" for successful biventricular repair reported in the literature...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/28516435/management-considerations-in-cancer-patients-with-rheumatoid-arthritis
#11
Richard J Zogala, Kristina Goutsouliak, Maria E Suarez-Almazor
Rheumatoid arthritis is a common inflammatory disease that requires treatment with immunosuppressants to control symptoms and avoid joint destruction. Managing cancer in patients with concomitant rheumatoid arthritis poses special challenges that require close coordination of care between oncologists and rheumatologists. Potential clinical issues needing special consideration include: 1) perioperative management in patients undergoing cancer surgery, which often requires discontinuation of antirrheumatic therapy; 2) use of immunosuppressant therapies for rheumatoid arthritis, especially biologic agents that inhibit cytokine and immune pathways, which conceivably could affect immune-mediated antitumor responses (the issues are different in patients with active cancer vs those with a past history of cancer and no recurrences); 3) management in the palliative care setting; and 4) use of cancer immunotherapy, such as checkpoint inhibitor agents, in patients with pre-existing rheumatoid arthritis...
May 15, 2017: Oncology (Williston Park, NY)
https://www.readbyqxmd.com/read/28514312/treatment-inferred-from-mutations-identified-using-massive-parallel-sequencing-leads-to-clinical-benefit-in-some-heavily-pretreated-cancer-patients
#12
Aviad Zick, Tamar Peretz, Michal Lotem, Ayala Hubert, Daniela Katz, Mark Temper, Yakir Rottenberg, Beatrice Uziely, Hovav Nechushtan, Amichai Meirovitz, Amir Sonnenblick, Eli Sapir, David Edelman, Yael Goldberg, Alexander Lossos, Shai Rosenberg, Iris Fried, Ruth Finklstein, Eli Pikarsky, Hanoch Goldshmidt
Molecular portraits of numerous tumors have flooded oncologists with vast amounts of data. In parallel, effective inhibitors of central pathways have shown great clinical benefit. Together, this promises potential clinical benefits to otherwise end-stage cancer patients. Here, we report a clinical service offering mutation detection of archived samples using the ion Ampliseq cancer panel coupled with clinical consultation.A multidisciplinary think tank consisting of oncologists, molecular-biologists, genetic counselors, and pathologists discussed 67 heavily pretreated, advanced cancer patient cases, taking into account mutations identified using ion Ampliseq cancer panel, medical history, and relevant literature...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28513598/yap-taz-link-cell-mechanics-to-notch-signalling-to-control-epidermal-stem-cell-fate
#13
Antonio Totaro, Martina Castellan, Giusy Battilana, Francesca Zanconato, Luca Azzolin, Stefano Giulitti, Michelangelo Cordenonsi, Stefano Piccolo
How the behaviour of somatic stem cells (SCs) is influenced by mechanical signals remains a black-box in cell biology. Here we show that YAP/TAZ regulation by cell shape and rigidity of the extracellular matrix (ECM) dictates a pivotal SC decision: to remain undifferentiated and grow, or to activate a terminal differentiation programme. Notably, mechano-activation of YAP/TAZ promotes epidermal stemness by inhibition of Notch signalling, a key factor for epidermal differentiation. Conversely, YAP/TAZ inhibition by low mechanical forces induces Notch signalling and loss of SC traits...
May 17, 2017: Nature Communications
https://www.readbyqxmd.com/read/28513551/the-regulatory-capacity-of-bivalent-genes-a-theoretical-approach
#14
Torsten Thalheim, Maria Herberg, Markus Loeffler, Joerg Galle
Bivalent genes are frequently associated with developmental and lineage specification processes. Resolving their bivalency enables fast changes in their expression, which potentially can trigger cell fate decisions. Here, we provide a theoretical model of bivalency that allows for predictions on the occurrence, stability and regulatory capacity of this prominent modification state. We suggest that bivalency enables balanced gene expression heterogeneity that constitutes a prerequisite of robust lineage priming in somatic stem cells...
May 17, 2017: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/28513052/primary-care-and-cancer-facing-the-challenge-of-early-diagnosis-and-survivorship
#15
Thomas Round
With ageing populations and an increasing lifetime risk of cancer, primary care will continue to play an increasingly important role in early diagnosis and cancer survivorship, especially with the lowering of risk thresholds for referral and diagnostic investigations. However, primary care in many countries is in crisis with increasing workloads for primary care physicians. Potential solutions to these challenges will be outlined including development of multidisciplinary teams, diagnostic decision support, increasing access to diagnostics and cost-effective referral pathways...
May 17, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28510760/what-factors-hinder-the-decision-making-process-for-women-with-cancer-and-contemplating-fertility-preservation-treatment
#16
Georgina Jones, Jane Hughes, Neda Mahmoodi, Emily Smith, Jonathan Skull, William Ledger
BACKGROUND: Although fertility preservation (FP) treatment options have increased, the existing evidence suggests that many women with cancer do not feel well supported in making these decisions, but find them stressful and complex and fail to take up fertility care at this crucial time. Whilst existing reviews have all made important contributions to our understanding of the FP decision-making process, none of them examine solely and specifically these processes for women of reproductive age with a diagnosis of any cancer, leaving a gap in the knowledge base...
May 16, 2017: Human Reproduction Update
https://www.readbyqxmd.com/read/28507149/identification-of-xaf1-mt2a-mutual-antagonism-as-a-molecular-switch-in-cell-fate-decisions-under-stressful-conditions
#17
Cheol-Hee Shin, Min-Goo Lee, Jikhyon Han, Seong-In Jeong, Byung-Kyu Ryu, Sung-Gil Chi
XIAP-associated factor 1 (XAF1) is a tumor suppressor that is commonly inactivated in multiple human neoplasms. However, the molecular mechanism underlying its proapoptotic function remains largely undefined. Here, we report that XAF1 induction by heavy metals triggers an apoptotic switch of stress response by destabilizing metallothionein 2A (MT2A). XAF1 directly interacts with MT2A and facilitates its lysosomal degradation, resulting in the elevation of the free intercellular zinc level and subsequent activation of p53 and inactivation of XIAP...
May 15, 2017: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/28506868/drug-disease-modeling-in-the-pharmaceutical-industry-where-mechanistic-systems-pharmacology-and-statistical-pharmacometrics-meet
#18
Gabriel Helmlinger, Nidal Al-Huniti, Sergey Aksenov, Kirill Peskov, Melissa Hallow, Lulu Chu, David Boulton, Ulf Eriksson, Bengt Hamrén, Craig Lambert, Eric Masson, Helen Tomkinson, Donald Stanski
Modeling & simulation (M&S) methodologies are established quantitative tools, which have proven to be useful in supporting the research, development (R&D), regulatory approval, and marketing of novel therapeutics. Applications of M&S help design efficient studies and interpret their results in context of all available data and knowledge to enable effective decision-making during the R&D process. In this mini-review, we focus on two sets of modeling approaches: population-based models, which are well-established within the pharmaceutical industry today, and fall under the discipline of clinical pharmacometrics (PMX); and systems dynamics models, which encompass a range of models of (patho-)physiology amenable to pharmacological intervention, of signaling pathways in biology, and of substance distribution in the body (today known as physiologically-based pharmacokinetic models) - which today may be collectively referred to as quantitative systems pharmacology models (QSP)...
May 12, 2017: European Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28505128/a-proposal-for-a-study-on-treatment-selection-and-lifestyle-recommendations-in-chronic-inflammatory-diseases-a-danish-multidisciplinary-collaboration-on-prognostic-factors-and-personalised-medicine
#19
Vibeke Andersen, Uffe Holmskov, Signe Bek Sørensen, Mohamad Jawhara, Karina W Andersen, Anette Bygum, Lone Hvid, Jakob Grauslund, Jimmi Wied, Henning Glerup, Ulrich Fredberg, Jan Alexander Villadsen, Søren Geill Kjær, Jan Fallingborg, Seyed A G R Moghadd, Torben Knudsen, Jacob Brodersen, Jesper Frøjk, Jens F Dahlerup, Ole Haagen Nielsen, Robin Christensen, Anders Bo Bojesen, Grith Lykke Sorensen, Steffen Thiel, Nils J Færgeman, Ivan Brandslund, Allan Stensballe, Erik Berg Schmidt, Andre Franke, David Ellinghaus, Philip Rosenstiel, Jeroen Raes, Berit Heitmann, Mette Boye, Charlotte Lindgaard Nielsen, Lars Werner, Jens Kjeldsen, Torkell Ellingsen
Chronic inflammatory diseases (CIDs), including Crohn's disease and ulcerative colitis (inflammatory bowel diseases, IBD), rheumatoid arthritis, psoriasis, psoriatic arthritis, spondyloarthritides, hidradenitis suppurativa, and immune-mediated uveitis, are treated with biologics targeting the pro-inflammatory molecule tumour necrosis factor-α (TNF) (i.e., TNF inhibitors). Approximately one-third of the patients do not respond to the treatment. Genetics and lifestyle may affect the treatment results. The aims of this multidisciplinary collaboration are to identify (1) molecular signatures of prognostic value to help tailor treatment decisions to an individual likely to initiate TNF inhibitor therapy, followed by (2) lifestyle factors that support achievement of optimised treatment outcome...
May 15, 2017: Nutrients
https://www.readbyqxmd.com/read/28504911/the-value-of-sharing-information-a-neural-account-of-information-transmission
#20
Elisa C Baek, Christin Scholz, Matthew Brook O'Donnell, Emily B Falk
Humans routinely share information with one another. What drives this behavior? We used neuroimaging to test an account of information selection and sharing that emphasizes inherent reward in self-reflection and connecting with other people. Participants underwent functional MRI while they considered personally reading and sharing New York Times articles. Activity in neural regions involved in positive valuation, self-related processing, and taking the perspective of others was significantly associated with decisions to select and share articles, and scaled with preferences to do so...
May 1, 2017: Psychological Science
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