Consecutive aquatic jump-gliding with water-reactive fuel.

Robotic vehicles that are capable of autonomously transitioning between various terrains and fluids have received notable attention in the past decade due to their potential to navigate previously unexplored and/or unpredictable environments. Specifically, aerial-aquatic mobility will enable robots to operate in cluttered aquatic environments and carry out a variety of sensing tasks. One of the principal challenges in the development of such vehicles is that the transition from water to flight is a power-intensive process. At a small scale, this is made more difficult by the limitations of electromechanical actuation and the unfavorable scaling of the physics involved. This paper investigates the use of solid reactants as a combustion gas source for consecutive aquatic jump-gliding sequences. We present an untethered robot that is capable of multiple launches from the water surface and of transitioning from jetting to a glide. The power required for aquatic jump-gliding is obtained by reacting calcium carbide powder with the available environmental water to produce combustible acetylene gas, allowing the robot to rapidly reach flight speed from water. The 160-gram robot could achieve a flight distance of 26 meters using 0.2 gram of calcium carbide. Here, the combustion process, jetting phase, and glide were modeled numerically and compared with experimental results. Combustion pressure and inertial measurements were collected on board during flight, and the vehicle trajectory and speed were analyzed using external tracking data. The proposed propulsion approach offers a promising solution for future high-power density aerial-aquatic propulsion in robotics.

The Mutational Profile of Unicystic Ameloblastoma.

BRAF V600E is the most common mutation in conventional ameloblastoma (AM) of the mandible. In contrast, maxillary AMs appear to harbor more frequently RAS, FGFR2, or SMO mutations. Unicystic ameloblastoma (UAM) is considered a less aggressive variant of ameloblastoma, amenable to more conservative treatment, and classified as a distinct entity. The aim of this study was to characterize the mutation profile of UAM ( n = 39) and to compare it to conventional AM ( n = 39). The associations between mutation status and recurrence probability were also analyzed. In the mandible, 94% of UAMs (29/31, including 8/8 luminal, 6/8 intraluminal, and 15/15 mural subtypes) and 74% of AMs (28/38) revealed BRAF V600E mutations. Among the BRAF wild-type cases, 1 UAM showed a missense SMO mutation (p.L412F), whereas 2 NRAS (p.Q61R), 2 HRAS (p.Q61R), and 2 FGFR2 (p.C383R) activating mutations were identified in AM. Of the 3 maxillary UAMs, only 1 revealed a BRAF V600E mutation. Taken together, our findings demonstrate high frequency of activating BRAF V600E mutations in both UAM and AM of the mandible. In maxillary UAMs, the BRAF V600E mutation prevalence appears to be lower as was shown for AM previously. It could therefore be argued that UAM and AM are part of the spectrum of the same disease. AMs without BRAF V600E mutations were associated with an increased rate of local recurrence ( P = 0.0003), which might indicate that routine mutation testing also has an impact on prognosis.

[The effect of FII c.1787G>A (prothrombin Belgrade) mutation on prothrombin gene expression in vitro].

The FII c.1787G>A (prothrombin Belgrade) is a novel prothrombotic mutation which leads to impaired inhibition of thrombin by antithrombin (antithrombin resistance). So far, the mechanism of this variant has not been fully elucidated. To investigate the effect of FII c.1787G>A mutation on the prothrombin gene expression, its functional analysis was performed in vitro. By Real-Time PCR, expression levels of FII gene variants were evaluated in Cos-7 cells transiently transfected with c.1787G (wild-type) and c.1787A prothrombin expression vectors, with no differences observed. The relative quantification of prothrombin protein amounts was accomplished by Western blot analysis, also with no differences observed. Therefore, the mechanism of FII c.1787G>A mutation does not alter prothrombin expression profile.

What is the fate of the cholecystostomy tube following percutaneous cholecystostomy?

INTRODUCTION: Cholecystectomy is the preferred treatment for acute cholecystitis with percutaneous cholecystostomy (PC) considered an alternative therapy in severely debilitated patients. The aim of this study was to evaluate the efficacy and outcomes of PC at a tertiary referral center. METHODS: We retrospectively reviewed all patients that had undergone PC from 2000 to 2014. Data collected included baseline demographics, comorbidities, details of PC placement and management, and post-procedure outcomes. The Charlson comorbidity index (CCI) was calculated for all patients at the time of PC. RESULTS: Four hundred and twenty-four patients underwent PC placement from 2000 to 2014, and a total of 380 patients had long-term data available for review. Within this cohort, 223 (58.7 %) of the patients were male. The mean age at the time of PC placement was 65.3 ± 14.2 years of age, and the mean CCI was 3.2 ± 2.1 for all patients. One hundred and twenty-five (32.9 %) patients went on to have a cholecystectomy following PC placement. Comparison of patients who underwent PC followed by surgical intervention revealed that they were significantly younger (p = 0.0054) and had a lower CCI (p < 0.0001) compared to those who underwent PC alone. CONCLUSIONS: PC placement appears to be a viable, long-term alternative to cholecystectomy for the management of biliary disease in high-risk patients. Old and frail patients benefit the most, and in this cohort PC may be the definitive treatment.

FTO gene variants are associated with growth and carcass traits in cattle.

An important aim in animal breeding is the improvement of growth and meat quality traits. Previous studies have demonstrated that genetic variants in the fat mass and obesity associated (FTO) gene have a relatively large effect on human obesity as well as on body composition in rodents and, more recently, in livestock. Here, we examined the effects of the FTO gene variants on growth and carcass traits in the Slovenian population of Simmental (SS) and Brown (SB) cattle. To validate and identify new polymorphisms, we used sequencing, PCR-RFLP analysis and TaqMan assays in the SS breed and FTO gene variants data from the Illumina BovineSNP50 v1 array for the SB breed. Sequencing of the eight samples of progeny-tested SS sires detected 108 single nucleotide polymorphisms (SNPs) in the bovine FTO gene. Statistical analyses between growth and carcass traits and 34 FTO polymorphisms revealed significant association of FTO variants with lean meat percentage in both breeds. Additionally, FTO SNPs analyzed in SS cattle were associated with fat percentage, bone weight and live weight at slaughter. The FTO gene can thus be regarded as a candidate gene for the marker-assisted selection programs in our and possibly other populations of cattle. Future studies in cattle might reveal novel roles for the FTO gene in shaping carcass traits in livestock species as well as body composition control in other mammals.

Socio-economic benefits from protected areas in southeastern Australia.

International case studies of protected area performance increasingly report that conservation and socio-economic outcomes are interdependent. Effective conservation requires support and cooperation from local governments and communities, which in turn requires that protected areas contribute to the economic well-being of the communities in which they are sited. Despite increasing recognition of their importance, robust studies that document the socio-economic impacts of protected areas are rare, especially in the developed world context. We proposed 3 potential pathways through which protected areas might benefit local communities in the developed world: the improved local housing value, local business stimulus, and increased local funding pathways. We examined these pathways by undertaking a statistical longitudinal analysis of 110 regional and rural communities covering an area of approximately 600,000 km(2) in southeastern Australia. We compared trends in 10 socio-economic indicators describing employment, income, housing, business development and local government revenue from 2000 to 2010. New protected areas acquisitions led to an increased number of new dwelling approvals and associated developer contributions, increased local business numbers, and increased local government revenue from user-pays services and grants. Longer-term effects of established protected areas included increased local council revenue from a variety of sources. Our findings provide support for each of our 3 proposed benefit pathways and contribute new insights into the cycling of benefits from protected areas through the economy over time. The business and legislative models in our study are typical of those operating in many other developed countries; thus, the benefit pathways reported in our study are likely to be generalizable. By identifying and communicating socio-economic benefits from terrestrial protected areas in a developed world context, our findings represent an important step in securing local support and ongoing high-level protection for key components of the world's biodiversity.

Performance analysis of jump-gliding locomotion for miniature robotics.

Recent work suggests that jumping locomotion in combination with a gliding phase can be used as an effective mobility principle in robotics. Compared to pure jumping without a gliding phase, the potential benefits of hybrid jump-gliding locomotion includes the ability to extend the distance travelled and reduce the potentially damaging impact forces upon landing. This publication evaluates the performance of jump-gliding locomotion and provides models for the analysis of the relevant dynamics of flight. It also defines a jump-gliding envelope that encompasses the range that can be achieved with jump-gliding robots and that can be used to evaluate the performance and improvement potential of jump-gliding robots. We present first a planar dynamic model and then a simplified closed form model, which allow for quantification of the distance travelled and the impact energy on landing. In order to validate the prediction of these models, we validate the model with experiments using a novel jump-gliding robot, named the 'EPFL jump-glider'. It has a mass of 16.5 g and is able to perform jumps from elevated positions, perform steered gliding flight, land safely and traverse on the ground by repetitive jumping. The experiments indicate that the developed jump-gliding model fits very well with the measured flight data using the EPFL jump-glider, confirming the benefits of jump-gliding locomotion to mobile robotics. The jump-glide envelope considerations indicate that the EPFL jump-glider, when traversing from a 2 m height, reaches 74.3% of optimal jump-gliding distance compared to pure jumping without a gliding phase which only reaches 33.4% of the optimal jump-gliding distance. Methods of further improving flight performance based on the models and inspiration from biological systems are presented providing mechanical design pathways to future jump-gliding robot designs.

Launching the AquaMAV: bioinspired design for aerial-aquatic robotic platforms.

Current Micro Aerial Vehicles (MAVs) are greatly limited by being able to operate in air only. Designing multimodal MAVs that can fly effectively, dive into the water and retake flight would enable applications of distributed water quality monitoring, search and rescue operations and underwater exploration. While some can land on water, no technologies are available that allow them to both dive and fly, due to dramatic design trade-offs that have to be solved for movement in both air and water and due to the absence of high-power propulsion systems that would allow a transition from underwater to air. In nature, several animals have evolved design solutions that enable them to successfully transition between water and air, and move in both media. Examples include flying fish, flying squid, diving birds and diving insects. In this paper, we review the biological literature on these multimodal animals and abstract their underlying design principles in the perspective of building a robotic equivalent, the Aquatic Micro Air Vehicle (AquaMAV). Building on the inspire-abstract-implement bioinspired design paradigm, we identify key adaptations from nature and designs from robotics. Based on this evaluation we propose key design principles for the design of successful aerial-aquatic robots, i.e. using a plunge diving strategy for water entry, folding wings for diving efficiency, water jet propulsion for water takeoff and hydrophobic surfaces for water shedding and dry flight. Further, we demonstrate the feasibility of the water jet propulsion by building a proof-of-concept water jet propulsion mechanism with a mass of 2.6 g that can propel itself up to 4.8 m high, corresponding to 72 times its size. This propulsion mechanism can be used for AquaMAV but also for other robotic applications where high-power density is of use, such as for jumping and swimming robots.

The 3' end prothrombin gene variants in serbian patients with idiopathic thrombophilia.

Thrombophilia is a multifactorial disorder that arises from the interaction of acquired and genetic risk factors. Despite the significant efforts made to understand the etiology of this disease, there are still a certain number of patients suffering from idiopathic thrombophilia. The aim of this study was to screen the 3' end of the prothrombin (FII) gene, which is susceptible to gain-of-function mutations due to its non canonical architecture, in patients with idiopathic thrombophilia and to determine its eventual role in the pathogenesis of thrombophilia. This study was carried out in 100 patients with idiopathic thrombophilia and 100 healthy controls. DNA variants in the 715 bp long region of the 3' end of the prothrombin gene were identified by sequencing. In our study, we detected two variants: A19911G and C20068T. The frequency of the A19911G gene variant was slightly increased in the group of patients compared to controls, however with no statistically significant difference compared to controls [odds ratio (OR) = 1.06; 95% confidence interval (95% CI) 0.53-2.13]. Heterozygous carriers of the FII C20068T gene variant were four times more frequent in patients (4.0%) than in controls (1.0%), but this difference did not reach statistical significance (OR = 4.12; 95% CI 0.45-37.57). Our findings suggest that variant A19911G is not a significant risk factor, while C20068T may represent a potential risk factor for idiopathic thrombophilia. To confirm our results, further studies should be conducted in a larger cohort of patients.

Comparison between sire-maternal grandsire and animal models for genetic evaluation of longevity in a dairy cattle population with small herds.

Survival analysis techniques for sire-maternal grandsire (MGS) and animal models were used to test the genetic evaluation of longevity in a Slovenian Brown cattle population characterized by small herds. Three genetic models were compared: a sire-MGS model for bulls and an approximate animal model based on estimated breeding values (EBV) from the sire-MGS model for cows, an animal model, and an animal model based on the estimated variance components from the sire-MGS model. In addition, modeling the contemporary group effect was defined as either a herd or a herd-year (HY) effect. With various restrictions on the minimum HY group size (from 1 to 10 cows per HY), changes in estimates of variance components, and consequently also in EBV, were observed for the sire-MGS and animal models. Variance of contemporary group effects decreased when an HY effect was fitted instead of a herd effect. In the case of a sire-MGS model, estimates of additive genetic variance were mostly robust to changes in minimum HY group size or fitting herd or HY effect, whereas they increased in the animal model when HY instead of herd effects was fitted, possibly revealing some confounding between cow EBV and contemporary group effect. Estimated heritabilities from sire-MGS models were between 0.091 and 0.119 and were mainly influenced by the restriction on the HY group size. Estimated heritabilities from animal models were higher: between 0.125 and 0.160 when herd effect was fitted and between 0.171 and 0.210 when HY effect was fitted. Rank correlations between the animal model and the approximate animal model based on EBV from the sire-MGS model were high: 0.94 for cows and 0.93 for sires when a herd effect was fitted and 0.90 for cows and 0.93 for sires when an HY effect was fitted. Validation performed on the independent validation data set revealed that the correlation between sire EBV and daughter survival were slightly higher with the approximate animal model based on EBV from the sire-MGS model compared with the animal model. The correlations between the sire EBV and daughter survival were higher when the model included an HY effect instead of a herd effect. To avoid confounding and reduce computational requirements, it is suggested that the approximate animal model based on EBV from the sire-MGS model and HY as a contemporary group effect is an interesting compromise for practical applications of genetic evaluation of longevity in cattle populations.

Technical and implementation issues in using next-generation sequencing of cancers in clinical practice.

Next-generation sequencing (NGS) of cancer genomes promises to revolutionise oncology, with the ability to design and use targeted drugs, to predict outcome and response, and to classify tumours. It is continually becoming cheaper, faster and more reliable, with the capability to identify rare yet clinically important somatic mutations. Technical challenges include sequencing samples of low quality and/or quantity, reliable identification of structural and copy number variation, and assessment of intratumour heterogeneity. Once these problems are overcome, the use of the data to guide clinical decision making is not straightforward, and there is a risk of premature use of molecular changes to guide patient management in the absence of supporting evidence. Paradoxically, NGS may simply move the bottleneck of personalised medicine from data acquisition to the identification of reliable biomarkers. Standardised cancer NGS data collection on an international scale would be a significant step towards optimising patient care.

Genome-wide in silico screening for microRNA genetic variability in livestock species.

MicroRNAs are a class of non-coding RNAs that post-transcriptionally regulate target gene expression. Previous studies have shown that microRNA gene variability can interfere with its function, resulting in phenotypic variation. Polymorphisms within microRNA genes present a source of novel biomarkers for phenotypic traits in animal breeding. However, little is known about microRNA genetic variability in livestock species, which is also due to incomplete data in genomic resource databases. Therefore, the aim of this study was to perform a genome-wide in silico screening of genomic sources and determine the genetic variability of microRNA genes in livestock species using mirna sniper 3.0 (http://www.integratomics-time.com/miRNA-SNiPer/), a new version of our previously developed tool. By examining Ensembl and miRBase genome builds, it was possible to design a tool-based generated search of 16 genomes including four livestock species: pig, horse, cattle and chicken. The analysis revealed 65 polymorphisms located within mature microRNA regions in these four species, including 28% within the seed region in cattle and chicken. Polymorphic microRNA genes in cattle and chicken were further examined for mapping to quantitative trait loci regions associated with production and health traits. The developed bioinformatics tool enables the analysis of polymorphic microRNA genes and prioritization of potential regulatory polymorphisms and therefore contributes to the development of microRNA-based biomarkers in livestock species. The assembled catalog and the developed tool can serve the animal science community to efficiently select microRNA SNPs for further quantitative and molecular genetic evaluations of their phenotypic effects and causal associations with livestock production traits.

Comparison of piecewise Weibull baseline survival models for estimation of true and functional longevity in Brown cattle raised in small herds.

Piecewise Weibull proportional hazard models were used to investigate the effect of genetic and nongenetic factors on functional and true longevity traits of the Slovenian Brown cattle breed. Records of 37 908 Brown cows from 2401 Slovenian herds were used. As these herds were characterised by a relatively small average herd size starting from 6.7 in 1999 and increasing to 8.7 Brown cows per herd in 2008, milk yield classification was made within different herd size groups. The hazard rate was the lowest in the first part of each lactation and was increasing for later stages. Culling risk was lower for cows from herds increasing in size, for cows with higher milk production and for cows from a region with smaller herd sizes and tougher conditions for cattle breeding. The latter result is surprising and may be related to better attention to maintain the animals, despite their lower milk production. The introduction of the milk quota system and drought was found to have an important effect on culling policy between the last seasons of the years 2001 and 2003. Seasonal effects were not related to the milk quota year (from April to March), but to the effect of shortage in fodder during the winter time. The effect of age at first calving and the interaction between year and milk yield class were not found to be significant. Heritability for functional and for true longevity were similar at around 10% each. Inclusion of a correction for class of milk yield to approximate functional longevity increased the herd-year random effect variance by 53%, whereas the sire variance increased by only 14%. The correlation coefficient between ranks of breeding values for functional and true longevity was high (0.91), whereas genetic trends were not found to be significant. To assess their predictive ability, models were compared looking at the survival rate of 4212 second-crop daughters not included in the initial models. The average correlation between estimated breeding values and survival at different stages was 0.39 for true longevity and 0.43 for functional longevity. Results showed that ranking milk yield at population level is appropriate to correct for voluntary culling on low production in small herds.

Detection and quantification of Campylobacter jejuni and Campylobacter coli using real-time multiplex PCR.

AIMS: We describe a real-time quantitative multiplex polymerase chain reaction (qmPCR) assay to identify and discriminate between isolates of Campylobacter jejuni and Campylobacter coli. METHODS AND RESULTS: Two novel sets of primers and hydrolysis probes were designed to amplify the unique DNA sequences within the hipO, ccoN and cadF genes that are specific to Camp. jejuni and Camp. coli. Using the designed optimized qmPCR assay conditions, the amplification efficiency is in range from 108 to 116%. These qmPCR assays are highly specific for Camp. jejuni and Camp. coli, as seen through testing of 40 Campylobacter strains and 17 non-Campylobacter strains. In chicken juice and tap water models spiked with known quantities of Camp. jejuni, qmPCR detected 10(2) -10(3) CFU ml(-1) within 4 h. CONCLUSIONS: The qmPCR assays developed in this study provide reliable and simultaneous detection and quantification of Camp. jejuni and Camp. coli, with good amplification reaction parameters. SIGNIFICANCE AND IMPACT OF THE STUDY: Following further validation, the qmPCR assay reported here has the potential to be applied to various sample types as an alternative and rapid methodology.

Miconazole and nystatin used as topical antifungal drugs interact equally strongly with warfarin.

WHAT IS KNOWN AND OBJECTIVE: Medline search disclosed 10 case reports of interactions between oral anticoagulants and miconazole oral gel, but none so far between nystatin solution and anticoagulants. We report on change in anticoagulant activity with use of different topical antifungal drugs, miconazole oral gel and vaginal suppositories, and nystatin solution. METHODS: We conducted a retrospective study that included 43 patients on stable anticoagulation before the introduction of topical antifungal drugs. Miconazole oral gel was prescribed for 32 patients, nystatin solution for eight patients and miconazole vaginal suppositories for three patients. RESULTS AND DISCUSSION: Nineteen (44·2%) of the patients reported bleeding complications and some of these were severe. Fifteen of 32 who used miconazole oral gel and four of 8 of those who used nystatin solution were affected. Before use of the antifungal drugs, the mean weekly warfarin dose in the nystatin group was 14·5 mg, and after antifungal drugs, 9 mg, P = 0·038, while the mean international normalized ratio (INR) before antifungal drugs was 2·5 (range 1·9-3·5) and afterwards it was 10·6 (range 4·5-19·3), P = 0·0001. In the miconazole oral gel group the mean weekly warfarin dose was 15·7 mg, and after 10·8 mg, P = 0·008, while the mean INR before antifungal drugs was 2·44 (range 1·92-3·18) and afterwards it was 8·8 (range 4·9-16·9), P < 0·0001. WHAT IS NEW AND CONCLUSION: Miconazole oral gel and topically applied nystatin solution have equally strong effects on warfarin activity and can provoke major bleeding. Prospective evaluation of this effect is called for. However, based on our results the warfarin dose adjustment appears necessary when the anticoagulant is used concomitantly with those topical antifungals.

Detection of fusion genes at the protein level in leukemia patients via the flow cytometric immunobead assay.

Nowadays, the presence of specific genetic aberrations is progressively used for classification and treatment stratification, because acute leukemias with the same oncogenetic aberration generally form a clinically and diagnostically homogenous disease entity with comparable prognosis. Many oncogenetic aberrations in acute leukemias result in a fusion gene, which is transcribed into fusion transcripts and translated into fusion proteins, which are assumed to play a critical role in the oncogenetic process. Fusion gene aberrations are detected by karyotyping, FISH, or RT-PCR analysis. However, these molecular genetic techniques are laborious and time consuming, which is in contrast to flow cytometric techniques. Therefore we developed a flow cytometric immunobead assay for detection of fusion proteins in lysates of leukemia cell samples by use of a bead-bound catching antibody against one side of the fusion protein and fluorochrome-conjugated detection antibody. So far, we have been able to design such fusion protein immunobead assays for BCR-ABL, PML-RARA, TEL-AML1, E2A-PBX1, MLL-AF4, AML1-ETO and CBFB-MYH11. The immunobead assay for detection of fusion proteins can be performed within 3 to 4 hours in a routine diagnostic setting, without the need of special equipment other than a flow cytometer. The novel immunobead assay will enable fast and easy classification of acute leukemia patients that express fusion proteins. Such patients can be included at an early stage in the right treatment protocols, much faster than by use of current molecular techniques. The immunobead assay can be run in parallel to routine immunophenotyping and is particularly attractive for clinical settings without direct access to molecular diagnostics.

Thrombophilia in women with pregnancy-associated complications: fetal loss and pregnancy-related venous thromboembolism.

BACKGROUND/AIMS: Existing data regarding the prevalence of thrombophilia in women with pregnancy complications are conflicting. METHODS: To investigate the relationship between pregnancy-associated complications and the presence of thrombophilia, we studied the records of 453 women with pregnancy-associated complications. In 55 women, intrauterine fetal death (fetus mortus in utero, FMU) after 20 weeks of gestation was recorded, in 231 two or more consecutive recurrent fetal losses (RFL) were recorded, while 167 had a venous thromboembolism (VTE) during one of their pregnancies. The control group consisted of 128 healthy women, with no previous history of thrombotic events or miscarriages. RESULTS: In the FMU group we found 54.5% of women had thrombophilia, in the RFL group 38%, and in the VTE group 52.7%. The most frequent thrombophilia in the VTE group was the FV Leiden (OR 17.9, 95% CI 4.2-75.9). The most frequent thrombophilia in the FMU group was the FII G20210A (OR 7.09, 95% CI 1.8-27.9). Statistical difference between RFL and the control group was observed only for FV Leiden (OR 6.8, 95% CI 1.6-29.7). CONCLUSION: Thrombophilia was found to be considerably more common in women with pregnancy-associated complications in comparison with the women with normal pregnancies, most frequently in patients with VTE or FMU.

Prognostic and predictive value of TOPK stratified by KRAS and BRAF gene alterations in sporadic, hereditary and metastatic colorectal cancer patients.

BACKGROUND: Our aim was to investigate the prognostic and predictive value of the oncogenic MAPKK-like protein T-cell-originated protein kinase (TOPK) stratified by KRAS and BRAF mutations in patients with sporadic, hereditary and metastatic colorectal cancer (CRC) treated with anti-EGFR therapy. METHODS: Immunohistochemistry (IHC) for TOPK was performed on four study groups. Group 1 included two subgroups of 543 and 501 sporadic CRC patients used to test the reliability of TOPK expression by IHC. In Group 2, representing an additional 222 sporadic CRCs, the prognostic effect of TOPK stratified by KRAS and BRAF was assessed. The prognostic effect of TOPK was further analysed in Group 3, representing 71 hereditary Lynch syndrome-associated CRC patients. In Group 4, the predictive and prognostic value of TOPK was analysed on 45 metastatic patients treated with cetuximab or panitumumab stratified by KRAS and BRAF gene status. RESULTS: In both sporadic CRC subgroups (Group 1), associations of diffuse TOPK expression with clinicopathological features were reproducible. Molecular analysis of sporadic CRCs in Group 2 showed that diffuse TOPK expression was associated with KRAS and BRAF mutations (p<0.001) and with poor outcome in patients with either mutation in univariate and multivariate analysis (P=0.017). In hereditary patients (Group 3), diffuse TOPK was linked to advanced pT stage. In metastatic patients treated with anti-EGFR therapy (Group 4), diffuse TOPK expression was linked to dismal outcome despite objective response to treatment (P=0.01). CONCLUSIONS: TOPK expression is an unfavourable prognostic indicator in sporadic patients with KRAS or BRAF mutations and also in patients with metastatic disease experiencing a response to anti-EGFR therapies. The inhibition of TOPK, which could benefit 30-40% of CRC patients, may represent a new avenue of investigation for targeted therapy.