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1.
Innov Pharm ; 13(2)2022.
Artigo em Inglês | MEDLINE | ID: mdl-36654708

RESUMO

Pharmacy students at the University of Kansas School of Pharmacy's regional campus were exposed to the Medical Reserve Corps (MRC), a volunteer-based network that organizes locally to improve the health and safety of their communities. The school partnered with the local Medical Reserve Corps to provide students' opportunities to fulfill co-curricular requirements and facilitate an application-based learning environment for public health concepts. The objective of the study was to explore the relationship between volunteering in the MRC and pharmacy students' ability to meet educational outcomes and reinforce beliefs about their profession's role in public health. Twenty-one students completed a survey addressing their ability to meet educational outcomes and identify the role of pharmacists in public health. Pharmacy students strongly agreed their past participation (mean 4.57) and future volunteering (mean 4.48) within the MRC would continue to help them better understand their role in public health. Pharmacy students strongly agreed (means ranging from 4.43 to 4.71) that they were able to fulfill educational outcomes related to knowledge, skills, and attitudes pharmacy graduates should possess. The positive responses gathered warrants expanding the partnership to include more student healthcare disciplines as well as looking for further opportunities to engage students in public health initiatives. Pharmacy schools should look to adopt similar partnerships with MRC units.

2.
Cancers (Basel) ; 13(15)2021 Jul 29.
Artigo em Inglês | MEDLINE | ID: mdl-34359722

RESUMO

We have recently identified ZIP4 as a novel cancer stem cell (CSC) marker in high-grade serous ovarian cancer (HGSOC). While it converts drug-resistance to cisplatin (CDDP), we unexpectedly found that ZIP4 induced sensitization of HGSOC cells to histone deacetylase inhibitors (HDACis). Mechanistically, ZIP4 selectively upregulated HDAC IIa HDACs, with little or no effect on HDACs in other classes. HDAC4 knockdown (KD) and LMK-235 inhibited spheroid formation in vitro and tumorigenesis in vivo, with hypoxia inducible factor-1 alpha (HIF1α) and endothelial growth factor A (VEGFA) as functional downstream mediators of HDAC4. Moreover, we found that ZIP4, HDAC4, and HIF1α were involved in regulating secreted VEGFA in HGSOC cells. Furthermore, we tested our hypothesis that co-targeting CSC via the ZIP4-HDAC4 axis and non-CSC using CDDP is necessary and highly effective by comparing the effects of ZIP4-knockout/KD, HDAC4-KD, and HDACis, in the presence or absence of CDDP on tumorigenesis in mouse models. Our results showed that the co-targeting strategy was highly effective. Finally, data from human HGSOC tissues showed that ZIP4 and HDAC4 were upregulated in a subset of recurrent tumors, justifying the clinical relevance of the study. In summary, our study provides a new mechanistic-based targeting strategy for HGSOC.

3.
Am J Pathol ; 191(7): 1281-1291, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-33882289

RESUMO

Oncogenic KRAS mutations are a common finding in endometrial cancers. Recent sequencing studies indicate that loss-of-function mutations in the ARID1A gene are enriched in gynecologic malignant tumors. However, neither of these genetic insults alone are sufficient to develop gynecologic cancer. To determine the role of the combined effects of deletion of Arid1a and oncogenic Kras, Arid1aflox/flox mice were crossed with KrasLox-Stop-Lox-G12D/+ mice using progesterone receptor Cre (PgrCre/+). Histologic analysis and immunohistochemistry of survival studies were used to characterize the mutant mouse phenotype. Hormone dependence was evaluated by ovarian hormone depletion and estradiol replacement. Arid1aflox/flox; KrasLox-Stop-Lox-G12D/+; PgrCre/+ mice were euthanized early because of invasive vaginal squamous cell carcinoma. Younger mice had precancerous intraepithelial lesions. Immunohistochemistry supported the pathological diagnosis with abnormal expression and localization of cytokeratin 5, tumor protein P63, cyclin-dependent kinase inhibitor 2A, and Ki-67, the marker of proliferation. Ovarian hormone deletion in Arid1aflox/flox; KrasLox-Stop-Lox-G12D/+; PgrCre/+ mice resulted in atrophic vaginal epithelium without evidence of vaginal tumors. Estradiol replacement in ovarian hormone-depleted Arid1aflox/flox; KrasLox-Stop-Lox-G12D/+; PgrCre/+ mice resulted in lesions that resembled the squamous cell carcinoma in intact mice. Therefore, this mouse can be used to study the transition from benign precursor lesions into invasive vaginal human papillomavirus-independent squamous cell carcinoma, offering insights into progression and pathogenesis of this rare disease.


Assuntos
Carcinoma de Células Escamosas/genética , Proteínas de Ligação a DNA/genética , Modelos Animais de Doenças , Proteínas Proto-Oncogênicas p21(ras)/genética , Receptores de Progesterona/genética , Fatores de Transcrição/genética , Neoplasias Vaginais/genética , Animais , Carcinoma de Células Escamosas/patologia , Progressão da Doença , Feminino , Integrases , Camundongos , Lesões Intraepiteliais Escamosas/genética , Lesões Intraepiteliais Escamosas/patologia , Neoplasias Vaginais/patologia
4.
Epigenetics ; 16(11): 1201-1216, 2021 11.
Artigo em Inglês | MEDLINE | ID: mdl-33289590

RESUMO

High-grade serous ovarian cancer (HGSOC) harbours aberrant epigenetic features, including DNA methylation. In this study we delineate pathways and networks altered by DNA methylation and associated with HGSOC initiation and progression to a platinum-resistant state. By including tumours from patients who had been treated with the hypomethylating agent (HMA) guadecitabine, we also addressed the role of HMAs in treatment of HGSOC. Tumours from patients with primary (platinum-naïve) HGSOC (n = 20) were compared to patients with recurrent platinum-resistant HGSOC and enrolled in a recently completed clinical trial (NCT01696032). Human ovarian surface epithelial cells (HOSE; n = 5 samples) served as normal controls. Genome-wide methylation profiles were determined. DNA methyltransferase (DNMT) expression levels were examined by immunohistochemistry and correlated with clinical outcomes. Cancer-related and tumorigenesis networks were enriched among differentially methylated genes (DMGs) in primary OC vs. HOSE. When comparing platinum-resistant and primary tumours, 452 CpG island (CGI)-containing gene promoters acquired DNA methylation; of those loci, decreased (P < 0.01) methylation after HMA treatment was observed in 42% (n = 189 CGI). Stem cell pluripotency and cytokine networks were enriched in recurrent platinum-resistant OC tumours, while drug metabolism and transport-related networks were downregulated in tumours from HMA-treated patients compared to HOSE. Lower DNMT1 and 3B protein levels in pre-treatment tumours were associated with improved progression-free survival. The findings provide important insight into the DNA methylation landscape of HGSOC tumorigenesis, platinum resistance and epigenetic resensitization. Epigenetic reprogramming plays an important role in HGSOC aetiology and contributes to clinical outcomes.


Assuntos
Cistadenocarcinoma Seroso , Neoplasias Ovarianas , Ilhas de CpG , Cistadenocarcinoma Seroso/genética , Metilação de DNA , Resistencia a Medicamentos Antineoplásicos , Humanos , Recidiva Local de Neoplasia , Neoplasias Ovarianas/genética
5.
Cancers (Basel) ; 12(12)2020 Dec 09.
Artigo em Inglês | MEDLINE | ID: mdl-33316986

RESUMO

High-grade serous ovarian cancer (HGSOC) is one of the most deadly and heterogenic cancers. We have recently shown that ZIP4 (gene name SLC39A4), a zinc transporter, is functionally involved in cancer stem cell (CSC)-related cellular activities in HGSOC. Here, we identified ZIP4 as a novel CSC marker in HGSOC. Fluorescence-activated cell sorter (FACS)-sorted ZIP4+, but not ZIP4- cells, formed spheroids and displayed self-renewing and differentiation abilities. Over-expression of ZIP4 conferred drug resistance properties in vitro. ZIP4+, but not ZIP4- cells, formed tumors/ascites in vivo. We conducted limiting dilution experiments and showed that 100-200 ZIP4+ cells from both PE04 and PEA2 cells formed larger tumors than those from 100-200 ALDH+ cells in mice. Mechanistically, we found that ZIP4 was an upstream regulator of another CSC-marker, NOTCH3, in HGSOC cells. NOTCH3 was functionally involved in spheroid formation in vitro and tumorigenesis in vivo in HGSOC. Genetic compensation studies showed that NOTCH3, but not NOTCH1, was a critical downstream mediator of ZIP4. Furthermore, NOTCH3, but not NOTCH1, physically bound to ZIP4. Collectively, our data suggest that ZIP4 is a novel CSC marker and the new ZIP4-NOTCH3 axis represents important therapeutic targets in HGSOC.

6.
Proc Natl Acad Sci U S A ; 117(50): 31993-32004, 2020 12 15.
Artigo em Inglês | MEDLINE | ID: mdl-33262282

RESUMO

Effective cancer prevention requires the discovery and intervention of a factor critical to cancer development. Here we show that ovarian progesterone is a crucial endogenous factor inducing the development of primary tumors progressing to metastatic ovarian cancer in a mouse model of high-grade serous carcinoma (HGSC), the most common and deadliest ovarian cancer type. Blocking progesterone signaling by the pharmacologic inhibitor mifepristone or by genetic deletion of the progesterone receptor (PR) effectively suppressed HGSC development and its peritoneal metastases. Strikingly, mifepristone treatment profoundly improved mouse survival (∼18 human years). Hence, targeting progesterone/PR signaling could offer an effective chemopreventive strategy, particularly in high-risk populations of women carrying a deleterious mutation in the BRCA gene.


Assuntos
Proteína BRCA1/genética , Cistadenocarcinoma Seroso/prevenção & controle , Mifepristona/farmacologia , Neoplasias Ovarianas/prevenção & controle , Progesterona/antagonistas & inibidores , Adulto , Animais , Mama/patologia , Neoplasias da Mama/genética , Neoplasias da Mama/patologia , Neoplasias da Mama/prevenção & controle , Cistadenocarcinoma Seroso/química , Cistadenocarcinoma Seroso/genética , Cistadenocarcinoma Seroso/patologia , Modelos Animais de Doenças , Estradiol/administração & dosagem , Feminino , Humanos , Camundongos , Pessoa de Meia-Idade , Mifepristona/uso terapêutico , Mutação , Neoplasias Experimentais/induzido quimicamente , Neoplasias Experimentais/genética , Neoplasias Experimentais/patologia , Neoplasias Experimentais/prevenção & controle , Neoplasias Ovarianas/induzido quimicamente , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologia , Ovário/patologia , Ovário/cirurgia , Progesterona/administração & dosagem , Progesterona/metabolismo , Receptores de Progesterona/genética , Receptores de Progesterona/metabolismo , Salpingo-Ooforectomia , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/genética
7.
Oncogene ; 39(40): 6286-6299, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32843721

RESUMO

Endometrial cancer remains the most common gynecological malignancy in the United States. While the loss of the tumor suppressor, PTEN (phosphatase and tensin homolog), is well studied in endometrial cancer, recent studies suggest that DICER1, the endoribonuclease responsible for miRNA genesis, also plays a significant role in endometrial adenocarcinoma. Conditional uterine deletion of Dicer1 and Pten in mice resulted in poorly differentiated endometrial adenocarcinomas, which expressed Napsin A and HNF1B (hepatocyte nuclear factor 1 homeobox B), markers of clear-cell adenocarcinoma. Adenocarcinomas were hormone-independent. Treatment with progesterone did not mitigate poorly differentiated adenocarcinoma, nor did it affect adnexal metastasis. Transcriptomic analyses of DICER1 deleted uteri or Ishikawa cells revealed unique transcriptomic profiles and global miRNA downregulation. Computational integration of miRNA with mRNA targets revealed deregulated let-7 and miR-16 target genes, similar to published human DICER1-mutant endometrial cancers from TCGA (The Cancer Genome Atlas). Similar to human endometrial cancers, tumors exhibited dysregulation of ephrin-receptor signaling and transforming growth factor-beta signaling pathways. LIM kinase 2 (LIMK2), an essential molecule in p21 signal transduction, was significantly upregulated and represents a novel mechanism for hormone-independent pathogenesis of endometrial adenocarcinoma. This preclinical mouse model represents the first genetically engineered mouse model of poorly differentiated endometrial adenocarcinoma.


Assuntos
Adenocarcinoma de Células Claras/patologia , Diferenciação Celular/genética , RNA Helicases DEAD-box/genética , Neoplasias do Endométrio/patologia , PTEN Fosfo-Hidrolase/genética , Ribonuclease III/genética , Adenocarcinoma de Células Claras/genética , Animais , Linhagem Celular Tumoral , RNA Helicases DEAD-box/metabolismo , Modelos Animais de Doenças , Neoplasias do Endométrio/genética , Endométrio/patologia , Feminino , Regulação Neoplásica da Expressão Gênica , Técnicas de Silenciamento de Genes , Técnicas de Inativação de Genes , Humanos , Quinases Lim/genética , Camundongos , Camundongos Transgênicos , MicroRNAs/metabolismo , PTEN Fosfo-Hidrolase/metabolismo , RNA-Seq , Ribonuclease III/metabolismo
8.
PLoS Genet ; 16(6): e1008808, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32497036

RESUMO

Metastasis is responsible for 90% of human cancer mortality, yet it remains a challenge to model human cancer metastasis in vivo. Here we describe mouse models of high-grade serous ovarian cancer, also known as high-grade serous carcinoma (HGSC), the most common and deadliest human ovarian cancer type. Mice genetically engineered to harbor Dicer1 and Pten inactivation and mutant p53 robustly replicate the peritoneal metastases of human HGSC with complete penetrance. Arising from the fallopian tube, tumors spread to the ovary and metastasize throughout the pelvic and peritoneal cavities, invariably inducing hemorrhagic ascites. Widespread and abundant peritoneal metastases ultimately cause mouse deaths (100%). Besides the phenotypic and histopathological similarities, mouse HGSCs also display marked chromosomal instability, impaired DNA repair, and chemosensitivity. Faithfully recapitulating the clinical metastases as well as molecular and genomic features of human HGSC, this murine model will be valuable for elucidating the mechanisms underlying the development and progression of metastatic ovarian cancer and also for evaluating potential therapies.


Assuntos
Antineoplásicos/farmacologia , Cistadenocarcinoma Seroso/genética , Neoplasias Ovarianas/patologia , Neoplasias Peritoneais/genética , Animais , Antineoplásicos/uso terapêutico , Linhagem Celular Tumoral , Instabilidade Cromossômica , Cistadenocarcinoma Seroso/tratamento farmacológico , Cistadenocarcinoma Seroso/secundário , RNA Helicases DEAD-box/genética , Reparo do DNA , Modelos Animais de Doenças , Resistencia a Medicamentos Antineoplásicos/genética , Ensaios de Seleção de Medicamentos Antitumorais/métodos , Estudos de Viabilidade , Feminino , Humanos , Camundongos , Camundongos Knockout , Mutação , Gradação de Tumores , Metástase Neoplásica/genética , Neoplasias Ovarianas/tratamento farmacológico , Neoplasias Ovarianas/genética , PTEN Fosfo-Hidrolase/genética , Neoplasias Peritoneais/tratamento farmacológico , Neoplasias Peritoneais/secundário , Cultura Primária de Células , Ribonuclease III/genética , Proteína Supressora de Tumor p53/genética
9.
Case Rep Oncol Med ; 2020: 4674871, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32373377

RESUMO

This case report describes a 63-year-old female with a locally advanced esophageal carcinoma cuniculatum treated with definitive chemoradiation who had a rapid and early response. This case is illustrative of an aggressive behavior with rapid response and rapid recurrence. The cases of esophageal carcinoma cuniculatum as well as the closely related clinical entity of verrucous carcinoma are reviewed suggesting good clinical outcomes after definitive therapy with chemoradiation and/or surgery.

10.
Appl Immunohistochem Mol Morphol ; 27(2): 119-124, 2019 02.
Artigo em Inglês | MEDLINE | ID: mdl-30688675

RESUMO

OBJECTIVE: The aim of this study was to investigate epidermal growth factor receptor (EGFR) gene mutations and anaplastic lymphoma kinase (ALK) gene rearrangements using cytological specimens from the patients with a diagnosis of primary or metastatic lung non-small cell carcinoma. MATERIALS AND METHODS: A total 307 cases were submitted for EGFR mutational analysis and 265 cases for ALK analysis. The cytological specimen sources included lung, lymph node, liver, bone, adrenal gland, mesentery mass, and body fluids/bronchial brushing. EGFR mutations in the exons 18 to 21 were analyzed with Qiagen EGFR Pyro Kits. Fluorescence in situ hybridization (FISH) studies for ALK rearrangement inv(2)(p21; p23) were performed on the paraffin-embedded cell block sections utilizing dual-color Vysis LSI ALK Break Apart Probe Kit. RESULTS: Among 307 fine needle aspirate cases for EGFR analysis, 302 cases (269 from cell blocks, 33 from direct smears) had sufficient material for EGFR test. Five cases failed due to inadequate cellularity. Twenty six of 302 (8.6%) cases were positive for EGFR mutations. A total of 265 cases submitted for ALK analysis included 240 cases of fine needle aspirate, 25 cases of pleural fluid/pericardial fluid/bronchial washings. Eight cases failed because of low cellularity, whereas 257 of 265 cases had sufficient material for ALK FISH study. Nine of 257 cases (3.5%) revealed ALK rearrangement by FISH. CONCLUSIONS: The current study demonstrates that cytological specimens can yield sufficient material for EGFR mutations and ALK rearrangement test. Our study reveals that 8.6% of EGFR mutation rate and 3.5% of ALK rearrangement rate in the cytology specimens from the patients with primary or metastatic lung non-small cell carcinoma.


Assuntos
Quinase do Linfoma Anaplásico/genética , Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Neoplasias Pulmonares/diagnóstico , Mutação/genética , Idoso , Biópsia por Agulha Fina , Carcinoma Pulmonar de Células não Pequenas/genética , Análise Mutacional de DNA , Receptores ErbB/genética , Feminino , Rearranjo Gênico , Humanos , Neoplasias Pulmonares/genética , Masculino , Pessoa de Meia-Idade , Patologia Molecular , Estudos Retrospectivos
11.
J Vis Impair Blind ; 113(3): 235-247, 2019 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-33828348

RESUMO

INTRODUCTION: The modern long cane has been used by people who are blind for traveling for decades. This article describes parameters surrounding the collection of over 10,000 trials of people walking with the long cane to detect drop-offs or obstacles. METHODS: The data include 10,069 trials representing 101 different participants in 366 conditions over 11 studies spanning the 9 years from 2007 to 2016. Each of the studies investigated different participant or cane characteristics or both in terms of their effect on either drop-off or obstacle detection. Results of detection performance in these studies appear in other articles. This article describes biomechanical measures derived from 3-D motion analysis equipment used during the studies. RESULTS: Initial treatment of the large data set indicated that participants tended to not center their cane arc laterally on their body, deviating up to about 20 centimeters from midline. Arc widths averaged almost a meter, and arcs were generally centered. Participants were generally poor at being in step or having consistent rhythm. Coverage rates averaged about 85%. DISCUSSION: Although participants might have demonstrated artificially high skill performance due to being in a research study, data do offer insights into mechanical performance of skills. This survey of the data set indicates that not centering the hand holding the cane does not decrease body coverage less than about 85%. However, further analyses will be conducted to delve more deeply into all aspects of the data. IMPLICATIONS FOR PRACTITIONERS: Basic cane skills can be taught with short sessions and massed practice. Novices can acquire basic cane skills on par with cane users who are blind, but individual differences exist and the interplay of biomechanical variables needs to more fully understood.

12.
Lancet Psychiatry ; 5(11): 895-904, 2018 11.
Artigo em Inglês | MEDLINE | ID: mdl-30270033

RESUMO

BACKGROUND: We previously showed, in two separate cohorts, that high-risk infants who were later diagnosed with autism spectrum disorder had abnormally high extra-axial cerebrospinal fluid (CSF) volume from age 6-24 months. The presence of increased extra-axial CSF volume preceded the onset of behavioural symptoms of autism and was predictive of a later diagnosis of autism spectrum disorder. In this study, we aimed to establish whether increased extra-axial CSF volume is found in a large, independent sample of children diagnosed with autism spectrum disorder, whether extra-axial CSF remains abnormally increased beyond infancy, and whether it is present in both normal-risk and high-risk children with autism. METHODS: In this case-control MRI study, children with autism spectrum disorder or with typical development aged 2-4 years were recruited from the community to the UC Davis MIND Institute Autism Phenome Project, based in Sacramento, CA, USA. The autism spectrum disorder group comprised children with autism spectrum disorder who were either normal risk (ie, from simplex families) or high risk (ie, from multiplex families). Measurements of extra-axial CSF volume, brain volume, head circumference, sleep problems, and familial risk status were derived from MRI and behavioural assessments. We applied a previously validated machine learning algorithm based on extra-axial CSF volume, brain volume, age, and sex to the current dataset. FINDINGS: Between July 20, 2007, and Dec 13, 2012, 159 children with autism spectrum disorder (132 male, 27 female) and 77 with typical development (49 male, 28 female) underwent MRI scans. The autism spectrum disorder group had an average of 15·1% more extra-axial CSF than controls after accounting for differences in brain volume, weight, age, and sex (least-squares mean 116·74 cm3 [SE 3·33] in autism group vs 101·40 cm3 [3·93] in typical development group; p=0·007; Cohen's d = 0·39). Subgroups of normal-risk (n=132) and high-risk (n=27) children with autism spectrum disorder had nearly identical extra-axial CSF volumes (p=0·78), and both subgroups had significantly greater volumes than controls. Both extra-axial CSF volume (p=0·004) and brain volume (p<0·0001) uniquely contributed to enlarged head circumference in the autism spectrum disorder group (p=0·04). Increased extra-axial CSF volume was associated with greater sleep disturbances (p=0·03) and lower non-verbal ability (p=0·04). The machine learning algorithm correctly predicted autism spectrum disorder diagnosis with a positive predictive value of 83% (95% CI 76·2-88·3). INTERPRETATION: Increased extra-axial CSF volume is a reliable brain anomaly that has now been found in three independent cohorts, comprising both high-risk and normal-risk children with autism spectrum disorder. Increased extra-axial CSF volume is detectable using conventional structural MRI scans from infancy through to age 3 years. These results suggest that increased extra-axial CSF volume could be an early stratification biomarker of a biologically based subtype of autism that might share a common underlying pathophysiology. FUNDING: US National Institutes of Health.


Assuntos
Transtorno do Espectro Autista/líquido cefalorraquidiano , Transtorno do Espectro Autista/diagnóstico por imagem , Líquido Cefalorraquidiano/diagnóstico por imagem , Encéfalo , Estudos de Casos e Controles , Pré-Escolar , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino
13.
Artigo em Inglês | MEDLINE | ID: mdl-30603730

RESUMO

Solitary fibrous tumor (SFT) is a rare tumor of mesenchymal origin that account for less than 2% of all soft tissue masses. Initially identified in the pleura, SFT has been identified in multiple anatomic locations and can arise anywhere in the body. The varying histologic features along with non-specific means of identification have led SFT to be associated with several different names. Over the last several decades, sustained advances through research and technology have led to more reliable methods for differentiating this distinct soft tissue tumor. Advances specifically in immunohistochemistry and molecular diagnostics have identified CD34 as the most consistent marker in SFT, however even this lacks specificity to conclusively narrow down the broad differential for exact identification. More recently the discovery of the NAB2-STAT6 fusion gene has led to more precise diagnosis of SFT. Like many other soft tissue tumors, surgical management is the mainstay of treatment for SFT with emphasis on obtaining tumor-negative margins. Radiation therapy and chemotherapy regimens have not demonstrated global effectiveness, and thus no standardized treatments have been identified. Given the rarity of SFT and current supportive evidence for therapies, management should be focused on tumor extirpation. Nonetheless, individualized therapy, determined within a multidisciplinary setting should be considered.

14.
J Vis Impair Blind ; 112(5): 435-446, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-30923414

RESUMO

INTRODUCTION: The purpose of this study was to investigate the effect of cane tip design and cane technique modification on obstacle detection performance as they interact with the size, height, and position of obstacles. METHODS: A repeated-measures design with block randomization was used for the study. In experiment one, participants attempted to detect obstacles with either a marshmallow tip or a bundu basher tip. In experiment two, participants were asked to detect obstacles using either the constant-contact technique or a modified constant-contact technique. RESULTS: As predicted, the obstacle detection rate with the bundu basher tip (M = 66.1%, SD = 7.4%) was significantly higher than that with the marshmallow tip (M = 54.6%, SD =6.8%), F(1, 11) = 24.19, p < .001, r = .83. However, contrary to our hypothesis, the obstacle detection rate with the modified constant-contact technique (M =56.0%, SD = 7.4%) was significantly lower than that with the constant-contact technique (M = 61.3%, SD = 5.2%), F(1, 13) = 6.49, p = .024, r = .58. In addition, participants detected the obstacles that were positioned at the center of their walking path (M = 61.9%, SD = 6.6%) at a significantly higher rate than those positioned slightly off to the side (M = 55.4%, SD = 7.3%), F(1, 13) =10.73, p = .006, r = .67. DISCUSSION: A bundu basher tip was more advantageous than the marshmallow tip for detecting obstacles. IMPLICATIONS FOR PRACTITIONERS: Given the findings of the study, cane users and orientation and mobility (O&M) specialists should consider using or recommending a bundu basher tip (or a similar tip that has an increased contact area with the walking surface), particularly when the traveling environment often presents unexpected obstacles that may trip the cane user.

15.
Eur Urol Focus ; 4(6): 880-888, 2018 12.
Artigo em Inglês | MEDLINE | ID: mdl-28753872

RESUMO

BACKGROUND: Small-cell carcinoma (SCC) of the urinary bladder frequently appears alongside urothelial carcinoma, suggesting common clonality. TERT promoter mutations have been recently implicated in urothelial carcinogenesis. OBJECTIVE: To investigate the degree to which TERT promoter mutations are involved in SCC of the urinary bladder, the linked tumorigenesis between urothelial carcinoma and SCC of the urinary bladder, and the molecular distinctions between SCC of the urinary bladder and of the prostate. DESIGN, SETTING, AND PARTICIPANTS: We investigated TERT promoter mutations in 53 cases of SCC of the urinary bladder and in 26 cases of SCC of the prostate using laboratory-based studies of tissue samples and clinical data. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: We measured the frequency of TERT promoter mutations in SCCs of the urinary bladder and prostate, and concordance of the mutation status between concurrent urinary bladder SCC and urothelial carcinoma. RESULTS AND LIMITATIONS: TERT promoter mutations were detected in 29/53 (55%) cases of urinary bladder and 0/26 (0%) cases of prostate SCC. Of 25 cases with concurrent urinary bladder SCC and non-small-cell components, all cases harbored identical TERT promoter mutation status in both phenotypes. CONCLUSIONS: TERT promoter mutations are found in more than half of urinary bladder SCCs. Mutation status is also identical in urothelial carcinoma and SCC components of concomitant malignancies, providing evidence of a common clonality. TERT promoter mutation status can differentiate SCC of the urinary bladder from prostate SCC, suggesting potential diagnostic use. PATIENT SUMMARY: Small-cell carcinoma of the urinary bladder shares a common clonal origin with conventional urothelial carcinoma and may arise from a heterogeneous subclone. TERT promoter mutations may have utility as a differential biomarker for determining the primary site of a genitourinary small-cell carcinoma.


Assuntos
Carcinoma de Células Pequenas/genética , Carcinoma de Células de Transição/genética , Neoplasias da Próstata/genética , Telomerase/genética , Neoplasias da Bexiga Urinária/genética , Idoso , Carcinoma de Células Pequenas/patologia , Carcinoma de Células de Transição/patologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Regiões Promotoras Genéticas/genética , Neoplasias da Próstata/patologia , Neoplasias da Bexiga Urinária/patologia
16.
Assist Technol ; 30(5): 219-225, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-28506151

RESUMO

This article describes pilot testing of an adaptive mobility device-hybrid (AMD-H) combining properties of two primary mobility tools for people who are blind: the long cane and adaptive mobility devices (AMDs). The long cane is the primary mobility tool used by people who are blind and visually impaired for independent and safe mobility and AMDs are adaptive devices that are often lightweight frames approximately body width in lateral dimension that are simply pushed forward to clear the space in front of a person. The prototype cane built for this study had a wing apparatus that could be folded around the shaft of a cane but when unfolded, deployed two wheeled wings 25 cm (9.8 in) to each side of the canetip. This project explored drop-off and obstacle detection for 6 adults with visual impairment using the deployed AMD-H and a standard long cane. The AMD-H improved obstacle detection overall, and was most effective for the smallest obstacles (2 and 6 inch diameter). The AMD-H cut the average drop off threshold from 1.79 inches (4.55 cm) to .96 inches (2.44 cm). All participants showed a decrease in drop off detection threshold and an increase in detection rate (13.9% overall). For drop offs of 1 in (2.54 cm) and 3 in (7.62 cm), all participants showed large improvements with the AMD-H, ranging from 8.4 to 50%. The larger drop offs of 5 in (12.7 cm) and 7 in (17.8 cm) were well detected by both types of canes.


Assuntos
Bengala , Tecnologia Assistiva , Processamento de Sinais Assistido por Computador/instrumentação , Pessoas com Deficiência Visual/reabilitação , Adulto , Desenho de Equipamento , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Limitação da Mobilidade
17.
Child Dev ; 89(2): e60-e73, 2018 03.
Artigo em Inglês | MEDLINE | ID: mdl-28295208

RESUMO

Children's early language environments are related to later development. Little is known about this association in siblings of children with autism spectrum disorder (ASD), who often experience language delays or have ASD. Fifty-nine 9-month-old infants at high or low familial risk for ASD contributed full-day in-home language recordings. High-risk infants produced more vocalizations than low-risk peers; conversational turns and adult words did not differ by group. Vocalization differences were driven by a subgroup of "hypervocal" infants. Despite more vocalizations overall, these infants engaged in less social babbling during a standardized clinic assessment, and they experienced fewer conversational turns relative to their rate of vocalizations. Two ways in which these individual and environmental differences may relate to subsequent development are discussed.


Assuntos
Transtorno do Espectro Autista/fisiopatologia , Desenvolvimento Infantil/fisiologia , Comportamento do Lactente/fisiologia , Irmãos , Comportamento Social , Comportamento Verbal/fisiologia , Feminino , Humanos , Lactente , Masculino , Risco , Processamento de Sinais Assistido por Computador
18.
Cereb Cortex ; 28(2): 750-763, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29186388

RESUMO

Infant gross motor development is vital to adaptive function and predictive of both cognitive outcomes and neurodevelopmental disorders. However, little is known about neural systems underlying the emergence of walking and general gross motor abilities. Using resting state fcMRI, we identified functional brain networks associated with walking and gross motor scores in a mixed cross-sectional and longitudinal cohort of infants at high and low risk for autism spectrum disorder, who represent a dimensionally distributed range of motor function. At age 12 months, functional connectivity of motor and default mode networks was correlated with walking, whereas dorsal attention and posterior cingulo-opercular networks were implicated at age 24 months. Analyses of general gross motor function also revealed involvement of motor and default mode networks at 12 and 24 months, with dorsal attention, cingulo-opercular, frontoparietal, and subcortical networks additionally implicated at 24 months. These findings suggest that changes in network-level brain-behavior relationships underlie the emergence and consolidation of walking and gross motor abilities in the toddler period. This initial description of network substrates of early gross motor development may inform hypotheses regarding neural systems contributing to typical and atypical motor outcomes, as well as neurodevelopmental disorders associated with motor dysfunction.


Assuntos
Encéfalo/diagnóstico por imagem , Encéfalo/crescimento & desenvolvimento , Desenvolvimento Infantil/fisiologia , Rede Nervosa/diagnóstico por imagem , Rede Nervosa/crescimento & desenvolvimento , Caminhada/fisiologia , Transtorno do Espectro Autista/diagnóstico por imagem , Transtorno do Espectro Autista/fisiopatologia , Pré-Escolar , Feminino , Humanos , Lactente , Estudos Longitudinais , Imageamento por Ressonância Magnética/tendências , Masculino , Vias Neurais/diagnóstico por imagem , Vias Neurais/crescimento & desenvolvimento
19.
Cancer Lett ; 414: 190-204, 2018 02 01.
Artigo em Inglês | MEDLINE | ID: mdl-29174800

RESUMO

Metastatic colonization involves paracrine/juxtacrine interactions with the microenvironment inducing an adaptive response through transcriptional regulation. However, the identities of transcription factors (TFs) induced by the metastatic microenvironment in ovarian cancer (OC) and their mechanism of action is poorly understood. Using an organotypic 3D culture model recapitulating the early events of metastasis, we identified ETS1 as the most upregulated member of the ETS family of TFs in metastasizing OC cells as they interacted with the microenvironment. ETS1 was regulated by p44/42 MAP kinase signaling activated in the OC cells interacting with mesothelial cells at the metastatic site. Human OC tumors had increased expression of ETS1, which predicted poor prognosis. ETS1 regulated OC metastasis both in vitro and in mouse xenografts. A combination of ChIP-seq and RNA-seq analysis and functional rescue experiments revealed FAK as the key transcriptional target and downstream effector of ETS1. Taken together, our results indicate that ETS1 is an essential transcription factor induced in OC cells by the microenvironment, which promotes metastatic colonization though the transcriptional upregulation of its target FAK.


Assuntos
Quinase 1 de Adesão Focal/genética , Regulação Neoplásica da Expressão Gênica , Neoplasias Ovarianas/genética , Proteína Proto-Oncogênica c-ets-1/genética , Microambiente Tumoral/genética , Animais , Linhagem Celular Tumoral , Movimento Celular/genética , Feminino , Quinase 1 de Adesão Focal/metabolismo , Humanos , Estimativa de Kaplan-Meier , Camundongos Nus , Metástase Neoplásica , Neoplasias Ovarianas/metabolismo , Neoplasias Ovarianas/patologia , Proteína Proto-Oncogênica c-ets-1/metabolismo , Interferência de RNA , Transplante Heterólogo
20.
Br J Vis Impair ; 35(3): 217-231, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29276326

RESUMO

A repeated-measures design with block randomization was used for the study, in which 15 adults with visual impairments attempted to detect the drop-offs and obstacles with the canes of different lengths, swinging the cane in different widths (narrow vs wide). Participants detected the drop-offs significantly more reliably with the standard-length cane (79.5% ± 6.5% of the time) than with the extended-length cane (67.6% ± 9.1%), p <.001. The drop-off detection threshold of the standard-length cane (4.1 ± 1.1 cm) was also significantly smaller than that of the extended-length cane (6.5±1.8cm), p <.001. In addition, participants detected drop-offs at a significantly higher percentage when they swung the cane approximately 3 cm beyond the widest part of the body (78.6% ± 7.6%) than when they swung it substantially wider (30 cm; 68.5% ± 8.3%), p <.001. In contrast, neither cane length (p =.074) nor cane swing arc width (p =.185) had a significant effect on obstacle detection performance. The findings of the study may help orientation and mobility specialists recommend appropriate cane length and cane swing arc width to visually impaired cane users.

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