Factors associated with the efficacy of polyp detection during routine flexible sigmoidoscopy

Objective: Flexible sigmoidoscopy reduces the incidence of colonic cancer through the detection and removal of premalignant adenomas. However, the efficacy of the procedure is variable. The aim of the present study was to examine factors associated with the efficacy of detecting polyps during flexible sigmoidoscopy. Design and patients: Retrospective observational cohort study of all individuals undergoing routine flexible sigmoidoscopy in NHS Greater Glasgow and Clyde from January 2013 to January 2016. Results: A total of 7713 patients were included. Median age was 52 years and 50% were male. Polyps were detected in 1172 (13%) patients. On multivariate analysis, increasing age (OR 1.020 (1.016–1.023) p<0.001), male sex (OR 1.23 (1.10–1.38) p<0.001) and the use of any bowel preparation (OR 3.55 (1.47–8.57) p<0.001) were associated with increasing numbers of polyps being detected. There was no significant difference in the number of polyps found in patients who had received an oral laxative preparation compared with an enema (OR 3.81 (1.57–9.22) vs 3.45 (1.43–8.34)), or in those who received sedation versus those who had not (OR 1.00 vs 1.04 (0.91–1.17) p=0.591). Furthermore, the highest number of polyps was found when the sigmoidoscope was inserted to the descending colon (OR 1.30 (1.04–1.63)). Conclusions: Increasing age, male sex and the utilisation of any bowel preparation were associated with an increased polyp detection rate. However, the use of sedation or oral laxative preparation appears to confer no additional benefit. In addition, the results indicate that insertion to the descending colon optimises the efficacy of flexible sigmoidoscopy polyp detection

Vena Cava Filter Complications:: Aortic Pseudoaneurysm Presenting as a Gastrointestinal Bleed

Vena cava filters (VCFs) have been employed at a rapidly growingpace over the last two decades.1,2 In fact, VCFs are placed in patientsin the United States at an estimated rate of 25 times that in Europe.3Likewise, the number of reported complications from VCFs alsohas increased significantly.1,4 The growing collection of literature onVCFs has led to an increased awareness of potential adverse outcomesafter filter insertion, and emphasis on appropriate preventionand treatment of these complications. We present an unusual case ofabdominal aortic pseudoaneurysm resulting from VCF perforationin a young patient who presented with hematemesis

IL-17 Receptor Signaling in Oral Epithelial Cells Is Critical for Protection against Oropharyngeal Candidiasis

Signaling through the IL-17 receptor (IL-17R) is required to prevent oropharyngeal candidiasis (OPC) in mice and humans. However, the IL-17-responsive cell type(s) that mediate protection are unknown. Using radiation chimeras we were able to rule out a requirement for IL-17RA in the hematopoietic compartment. We saw remarkable concordance of IL-17-controlled gene expression in C. albicans-infected human oral epithelial cells (OECs) and in tongue tissue from mice with OPC. To interrogate the role of the IL-17R in OECs, we generated mice with conditional deletion of IL-17RA in superficial oral and esophageal epithelial cells (Il17ra(ΔK13)). Following oral Candida infection, Il17ra(ΔK13) mice exhibited fungal loads and weight loss indistinguishable from Il17ra(−/−) mice. Susceptibility in Il17ra(ΔK13) mice correlated with expression of the antimicrobial peptide β-defensin 3 (BD3, Defb3). Consistently, Defb3(−/−) mice were susceptible to OPC. Thus, OECs dominantly control IL-17R-dependent responses to OPC through regulation of BD3expression

Metformin Decreases Glucose Oxidation and Increases the Dependency of Prostate Cancer Cells on Reductive Glutamine Metabolism

Metformin inhibits cancer cell proliferation, and epidemiology studies suggest an association with increased survival in patients with cancer taking metformin; however, the mechanism by which metformin improves cancer outcomes remains controversial. To explore how metformin might directly affect cancer cells, we analyzed how metformin altered the metabolism of prostate cancer cells and tumors. We found that metformin decreased glucose oxidation and increased dependency on reductive glutamine metabolism in both cancer cell lines and in a mouse model of prostate cancer. Inhibition of glutamine anaplerosis in the presence of metformin further attenuated proliferation, whereas increasing glutamine metabolism rescued the proliferative defect induced by metformin. These data suggest that interfering with glutamine may synergize with metformin to improve outcomes in patients with prostate cancer.German Science Foundation (Grant FE1185)National Institutes of Health (U.S.)Glenn Foundation for Medical ResearchNational Institutes of Health (U.S.) (Grant 5-P50-090381-09)National Institutes of Health (U.S.) (Grant 5-P30-CA14051-39)Burroughs Wellcome FundSmith Family FoundationDamon Runyon Cancer Research FoundationNational Institutes of Health (U.S.) (Grant 1R01DK075850-01)National Institutes of Health (U.S.) (Grant 1R01CA160458-01A1

A co-clinical approach identifies mechanisms and potential therapies for androgen deprivation resistance in prostate cancer

Here we report an integrated analysis that leverages data from treatment of genetic mouse models of prostate cancer along with clinical data from patients to elucidate new mechanisms of castration resistance. We show that castration counteracts tumor progression in a Pten-loss driven mouse model of prostate cancer through the induction of apoptosis and proliferation block. Conversely, this response is bypassed upon deletion of either Trp53 or Lrf together with Pten, leading to the development of castration resistant prostate cancer (CRPC). Mechanistically, the integrated acquisition of data from mouse models and patients identifies the expression patterns of XAF1-XIAP/SRD5A1 as a predictive and actionable signature for CRPC. Importantly, we show that combined inhibition of XIAP, SRD5A1, and AR pathways overcomes castration resistance. Thus, our co-clinical approach facilitates stratification of patients and the development of tailored and innovative therapeutic treatments

The Morpheus Visualization System : a general-purpose RDF results browser

Thesis (M. Eng.)--Massachusetts Institute of Technology, Dept. of Electrical Engineering and Computer Science, 2009.Cataloged from PDF version of thesis.Includes bibliographical references (p. 69-72).As the amount of information available on the deep web grows, finding ways to make this information accessible is growing increasingly problematic. As some have estimated that the content in the deep web is several orders of magnitude greater than that in the shallow web, there is a clear need for an effective tool to search the deep web. While many have attempted a solution, none have been successful in effectively addressing the problem of deep web searching. The Morpheus project presents a unique approach to the problem as it integrates the deep web with the shallow web while preserving the semantics of the deep web sites it accesses. At the heart Morpheus is its visualization system which allows users to access the deep web information. The visualization system makes use of clustering algorithms, visual information techniques, as well as the semantics of the deep web sites stored by Morpheus to present deep web results to users in an effective manner. User testing was also conducted to identify problematic areas of the system during development as well as to evaluate the usability of the system's design. Results indicate that users find that the Morpheus visualization system is a highly usable and learnable interface for searching the deep web for results as well as for processing those results.by Akash G. Shah.M.Eng

ANALYSING CYBERCRIME UNDERGROUND ECONOMY USING DATA ANALYTICS

Given the rapid acceleration of digital hazards, little work has been carried out into the subject's institutions or procedures that could help to guide scientists and specialists in Information Systems that handle digital security. There is also no discussion of Crime as a Service that is a criminal action program which facilitates decentralized cyber-crime. The examination whole and useful cyber- crime issue that we see has persuaded us to research underground cybercrime economy by adopting information research strategy from a scientific point of view of the structure. To accomplish this objective, we will propose 1. a structure to information investigation to break down the underground cyber-crime, 2. CaaS and product definitions for wrong-doing and 3. a model for related order. Furthermore, 4. Create a software web-app to show how the proposed system and request structure can really be actualized. At that point, we will use web applications to explore the under-ground economy of cyber-crime by breaking down a huge data-set from the web-based network. In implementing the strategy- based structure science review, this review applies objects, institutions, and strategies to the project here. It also gives professional expertise to recommend rules on how governments and associations can plan underground cybercrime assaults in all businesses