Evaluating a prescription clinic at a primary health centre

Introduction: One of the pillars of a good primary health system is the establishment of a good doctor- patients relation. Amongst other things, this will result in mutually accepted treatment plans, which are understood by all parties involved. This study aimed to describe and analyze one particular aspect of this care delivery, namely the repeat prescription clinic. In this clinic, which is run on an appointment basis, prescriptions are issued on a regular basis to patients and their relatives. Method: A piloted questionnaire describing patients' demographics, diseases and treatment knowledge, was filled in during three randomly chosen clinics in November 2011. Results: The clinic is attended by a relative majority of male clients, but both genders showed a peak attendance in the 60-69 age group. An average of 4 medications per person were prescribed and treatment in each patients was aimed at an average of 3 co-existent disease states. 56% of female attendees knew the complete list of their respective treatment as opposed to 45% of males attendees. Unfortunately, 73% of patients did not know the treatment they were on and did not have an up-to-date treatment list. Conclusion: This study highlights the lack of knowledge of patients with respect to their treatment. However it can also be argued that this is a reflection of inadequate care being provided by doctors in the various fields. The clinic takes care of a significant number of patients whose treatment is not accounted for. This raises issues of safe prescribing. There is a need that all patients have an up-to-date treatment card, and a need for improvement in communication between all health care workers is noted, so as to improve the safety of all prescription practices in the island. This will lead to better disease control, less treatment interactions, and prescription errors.peer-reviewe

Opening address by H.E. Marie Louise Coleiro Preca, President of Malta

Opening Address by H.E. Marie Louise Coleiro Preca for the European Conference “Between Two Synods: Journeying Together,” which the Faculty of Theology, at the University of Malta, convened in conjunction with the European Society of Catholic Theology, on 20 February 2015, at the sixteenth-century Verdala Palace.peer-reviewe

A novel spontaneous model of epithelial-mesenchymal transition (EMT) using a primary prostate cancer derived cell line demonstrating distinct stem-like characteristics

Cells acquire the invasive and migratory properties necessary for the invasion-metastasis cascade and the establishment of aggressive, metastatic disease by reactivating a latent embryonic programme: epithelial-to-mesenchymal transition (EMT). Herein, we report the development of a new, spontaneous model of EMT which involves four phenotypically distinct clones derived from a primary tumour-derived human prostate cancer cell line (OPCT-1), and its use to explore relationships between EMT and the generation of cancer stem cells (CSCs) in prostate cancer. Expression of epithelial (E-cadherin) and mesenchymal markers (vimentin, fibronectin) revealed that two of the four clones were incapable of spontaneously activating EMT, whereas the others contained large populations of EMT-derived, vimentin-positive cells having spindle-like morphology. One of the two EMT-positive clones exhibited aggressive and stem cell-like characteristics, whereas the other was non-aggressive and showed no stem cell phenotype. One of the two EMT-negative clones exhibited aggressive stem cell-like properties, whereas the other was the least aggressive of all clones. These findings demonstrate the existence of distinct, aggressive CSC-like populations in prostate cancer, but, importantly, that not all cells having a potential for EMT exhibit stem cell-like properties. This unique model can be used to further interrogate the biology of EMT in prostate cancer

Groundwater erosion of coastal gullies along the Canterbury coast (New Zealand): a rapid and episodic process controlled by rainfall intensity and substrate variability

Gully formation has been associated to groundwater seepage in unconsolidated sand- to gravel-sizedsediments. Our understanding of gully evolution by groundwater seepage mostly relies on experiments and nu-merical simulations, and these rarely take into consideration contrasts in lithology and permeability. In addition,process-based observations and detailed instrumental analyses are rare. As a result, we have a poor understandingof the temporal scale of gully formation by groundwater seepage and the influence of geological heterogeneityon their formation. This is particularly the case for coastal gullies, where the role of groundwater in their for-mation and evolution has rarely been assessed. We address these knowledge gaps along the Canterbury coastof the South Island (New Zealand) by integrating field observations, luminescence dating, multi-temporal un-occupied aerial vehicle and satellite data, time domain electromagnetic data and slope stability modelling. Weshow that gully formation is a key process shaping the sandy gravel cliffs of the Canterbury coastline. It is anepisodic process associated to groundwater flow that occurs once every 227 d on average, when rainfall intensi-ties exceed 40 mm d−1. The majority of the gullies in a study area southeast (SE) of Ashburton have undergoneerosion, predominantly by elongation, during the last 11 years, with the most recent episode occurring 3 yearsago. Gullies longer than 200 m are relict features formed by higher groundwater flow and surface erosion>2 kaago. Gullies can form at rates of up to 30 m d−1via two processes, namely the formation of alcoves and tunnelsby groundwater seepage, followed by retrogressive slope failure due to undermining and a decrease in shearstrength driven by excess pore pressure development. The location of gullies is determined by the occurrenceof hydraulically conductive zones, such as relict braided river channels and possibly tunnels, and of sand lensesexposed across sandy gravel cliffs. We also show that the gully planform shape is generally geometrically similarat consecutive stages of evolution. These outcomes will facilitate the reconstruction and prediction of a prevalenterosive process and overlooked geohazard along the Canterbury coastline

PI3K inhibition circumvents resistance to SHP2 blockade in metastatic triple-negative breast cancer.

The protein tyrosine phosphatase SHP2 activates oncogenic pathways downstream of most receptor tyrosine kinases (RTK) and has been implicated in various cancer types, including the highly aggressive subtype of triple-negative breast cancer (TNBC). Although allosteric inhibitors of SHP2 have been developed and are currently being evaluated in clinical trials, neither the mechanisms of the resistance to these agents, nor the means to circumvent such resistance have been clearly defined. The PI3K signaling pathway is also hyperactivated in breast cancer and contributes to resistance to anticancer therapies. When PI3K is inhibited, resistance also develops for example via activation of RTKs. We therefore assessed the effect of targeting PI3K and SHP2 alone or in combination in preclinical models of metastatic TNBC. In addition to the beneficial inhibitory effects of SHP2 alone, dual PI3K/SHP2 treatment decreased primary tumor growth synergistically, blocked the formation of lung metastases, and increased survival in preclinical models. Mechanistically, transcriptome and phospho-proteome analyses revealed that resistance to SHP2 inhibition is mediated by PDGFRβ-evoked activation of PI3K signaling. Altogether, our data provide a rationale for co-targeting of SHP2 and PI3K in metastatic TNBC

Live slow-frozen human tumor tissues viable for 2D, 3D, ex vivo cultures and single-cell RNAseq

Biobanking of surplus human healthy and disease-derived tissues is essential for diagnostics and translational research. An enormous amount of formalin-fixed and paraffin-embedded (FFPE), Tissue-Tek OCT embedded or snap-frozen tissues are preserved in many biobanks worldwide and have been the basis of translational studies. However, their usage is limited to assays that do not require viable cells. The access to intact and viable human material is a prerequisite for translational validation of basic research, for novel therapeutic target discovery, and functional testing. Here we show that surplus tissues from multiple solid human cancers directly slow-frozen after resection can subsequently be used for different types of methods including the establishment of 2D, 3D, and ex vivo cultures as well as single-cell RNA sequencing with similar results when compared to freshly analyzed material