• Title/Summary/Keyword: risk-sensitive

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Immunosignature: Serum Antibody Profiling for Cancer Diagnostics

  • Chapoval, Andrei I;Legutki, J Bart;Stafford, Philip;Trebukhov, Andrey V;Johnston, Stephen A;Shoikhet, Yakov N;Lazarev, Alexander F
    • Asian Pacific Journal of Cancer Prevention
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    • v.16 no.12
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    • pp.4833-4837
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    • 2015
  • Biomarkers for preclinical diagnosis of cancer are valuable tools for detection of malignant tumors at early stages in groups at risk and screening healthy people, as well as monitoring disease recurrence after treatment of cancer. However the complexity of the body's response to the pathological processes makes it virtually impossible to evaluate this response to the development of the disease using a single biomarker that is present in the serum at low concentrations. An alternative approach to standard biomarker analysis is called immunosignature. Instead of going after biomarkers themselves this approach rely on the analysis of the humoral immune response to molecular changes associated with the development of pathological processes. It is known that antibodies are produced in response to proteins expressed during cancer development. Accordingly, the changes in antibody repertoire associated with tumor growth can serve as biomarkers of cancer. Immunosignature is a highly sensitive method for antibody repertoire analysis utilizing high density peptide microarrays. In the present review we discuss modern methods for antibody detection, as well as describe the principles and applications of immunosignature in research and clinical practice.

"All This is Indeed Brahman" Rammohun Roy and a 'Global' History of the Rights-Bearing Self

  • Banerjee, Milinda
    • Asian review of World Histories
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    • v.3 no.1
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    • pp.81-112
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    • 2015
  • This essay interrogates the category of the 'global' in the emerging domain of 'global intellectual history'. Through a case study of the Indian social-religious reformer Rammohun Roy (1772/4-1833), I argue that notions of global selfhood and rights-consciousness (which have been preoccupying concerns of recent debates in intellectual history) have multiple conceptual and practical points of origin. Thus in early colonial India a person like Rammohun Roy could invoke centuries-old Indic terms of globality (vishva, jagat, sarva, sarvabhuta, etc.), selfhood (atman/brahman), and notions of right (adhikara) to liberation/salvation (mukti/moksha) as well as late precolonial discourses on 'worldly' rights consciousness (to life, property, religious toleration) and models of participatory governance present in an Indo-Islamic society, and hybridize these with Western-origin notions of rights and liberties. Thereby Rammohun could challenge the racial and confessional assumptions of colonial authority and produce a more deterritorialized and non-sectarian idea of selfhood and governance. However, Rammohun's comparativist world-historical notions excluded other models of selfhood and globality, such as those produced by devotional Vaishnava, Shaiva, and Shakta-Tantric discourses under the influence of non-Brahmanical communities and women. Rammohun's puritan condemnation of non-Brahmanical sexual and gender relations created a homogenized and hierarchical model of globality, obscuring alternate subaltern-inflected notions of selfhood. Class, caste, and gender biases rendered Rammohun supportive of British colonial rule and distanced him from popular anti-colonial revolts and social mobility movements in India. This article argues that today's intellectual historians run the risk of repeating Rammohun's biases (or those of Hegel's Weltgeschichte) if they privilege the historicity and value of certain models of global selfhood and rights-consciousness (such as those derived from a constructed notion of the 'West' or from constructed notions of various 'elite' classicized 'cultures'), to the exclusion of models produced by disenfranchised actors across the world. Instead of operating through hierarchical assumptions about local/global polarity, intellectual historians should remain sensitive to and learn from the universalizable models of selfhood, rights, and justice produced by actors in different spatio-temporal locations and intersections.

Markov's Modeling for Screening Strategies for Colorectal Cancer

  • Barouni, Mohsen;Larizadeh, Mohammad Hassan;Sabermahani, Asma;Ghaderi, Hossien
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.10
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    • pp.5125-5129
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    • 2012
  • Economic decision models are being increasingly used to assess medical interventions. Advances in this field are mainly due to enhanced processing capacity of computers, availability of specific software to perform the necessary tasks, and refined mathematical techniques. We here estimated the incremental cost-effectiveness of ten strategies for colon cancer screening, as well as no screening, incorporating quality of life, noncompliance and data on the costs and profit of chemotherapy in Iran. We used a Markov model to measure the costs and quality-adjusted life expectancy of a 50-year-old average-risk Iranian without screening and with screening by each test. In this paper, we tested the model with data from the Ministry of Health and published literature. We considered costs from the perspective of a health insurance organization, with inflation to 2011, the Iranian Rial being converted into US dollars. We focused on three tests for the 10 strategies considered currently being used for population screening in some Iranians provinces (Kerman, Golestan Mazandaran, Ardabil, and Tehran): low-sensitivity guaiac fecal occult blood test, performed annually; fecal immunochemical test, performed annually; and colonoscopy, performed every 10 years. These strategies reduced the incidence of colorectal cancer by 39%, 60% and 76%, and mortality by 50%, 69% and 78%, respectively, compared with no screening. These approaches generated ICER (incremental cost-effectiveness ratios) of $9067, $654 and $8700 per QALY (quality-adjusted life year), respectively. Sensitivity analyses were conducted to assess the influence of various scales on the economic evaluation of screening. The results were sensitive to probabilistic sensitivity analysis. Colonoscopy every ten years yielded the greatest net health value. Screening for colon cancer is economical and cost-effective over conventional levels of WTP8.

Significance of Human Telomerase RNA Gene Amplification Detection for Cervical Cancer Screening

  • Chen, Shao-Min;Lin, Wei;Liu, Xin;Zhang, You-Zhong
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.2063-2068
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    • 2012
  • Aim: Liquid-based cytology is the most often used method for cervical cancer screening, but it is relatively insensitive and frequently gives equivocal results. Used as a complementary procedure, the high-risk human papillomavirus (HPV) DNA test is highly sensitive but not very specific. The human telomerase RNA gene (TERC) is the most often amplified oncogene that is observed in cervical precancerous lesions. We assessed genomic amplification of TERC in liquid-based cytological specimens to explore the optimal strategy of using this for cervical cancer screening. Methods: Six hundred and seventy-one residual cytological specimens were obtained from outpatients aged 25 to 64 years. The specimens were evaluated by the Digene Hybrid Capture 2 (HC2) HPV DNA test and fluorescence in situ hybridization (FISH) with a chromosome probe to TERC (3q26). Colposcopic examination and histological evaluation were performed where indicated. Results: The TERC positive rate was higher in the CIN2+ (CIN2, CIN3 and SCC) group than in the normal and CIN 1 groups (90.0% vs. 10.4%, p < 0.01). In comparison with the HC2 HPV DNA test, the TERC amplification test had lower sensitivity but higher specificity (90.0% vs. 100.0%, 89.6% vs. 44.0%, respectively). TERC amplification test used in conjunction with the HC2 HPV DNA test showed a combination of 90.0% sensitivity and 92.2% specificity. Conclusion: The TERC amplification test can be used to diagnose cervical precancerous lesions. TERC and HPV DNA co-testing shows an optimal combination of sensitivity and specificity for cervical cancer screening.

Repeat Colonoscopy Every 10 Years or Single Colonoscopy for Colorectal Neoplasm Screening in Average-risk Chinese: A Cost-effectiveness Analysis

  • Wang, Zhen-Hua;Gao, Qin-Yan;Fang, Jing-Yuan
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.5
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    • pp.1761-1766
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    • 2012
  • Background: The appropriate interval between negative colonoscopy screenings is uncertain, but the numbers of advanced neoplasms 10 years after a negative result are generally low. We aimed to evaluate the cost-effectiveness of colorectal neoplasm screening and management based on repeat screening colonoscopy every 10 years or single colonoscopy, compared with no screening in the general population. Methods and materials: A state-transition Markov model simulated 100,000 individuals aged 50-80 years accepting repeat screening colonoscopy every 10 years or single colonoscopy, offered to every subject. Colorectal adenomas found during colonoscopy were removed by polypectomy, and the subjects were followed with surveillance every three years. For subjects with a normal result, colonoscopy was resumed within ten years in the repeat screening strategy. In single screening strategy, screening process was terminated. Direct costs such as screening tests, cancer treatment and costs of complications were included. Indirect costs were excluded from the model. The incremental cost-effectiveness ratio was used to evaluate the cost-effectiveness of the different screening strategies. Results: Assuming a first-time compliance rate of 90%, repeat screening colonoscopy and single colonoscopy can reduce the incidence of colorectal cancer by 65.8% and 67.2% respectively. The incremental cost-effectiveness ratio for single colonoscopy (49 Renminbi Yuan [RMB]) was much lower than that for repeat screening colonoscopy (474 RMB). Single colonoscopy was a more cost-effective strategy, which was not sensitive to the compliance rate of colonoscopy and the cost of advanced colorectal cancer. Conclusion: Single colonoscopy is suggested to be the more cost-effective strategy for screening and management of colorectal neoplasms and may be recommended in China clinical practice.

Clinical Prediction Based on HPV DNA Testing by Hybrid Capture 2 (HC2) in Combination with Liquid-based Cytology (LBC)

  • Junyangdikul, Pairoj;Tanchotsrinon, Watcharaporn;Chansaenroj, Jira;Nilyaimit, Pornjarim;Lursinsap, Chidchanok;Poovorawan, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.2
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    • pp.903-907
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    • 2013
  • Primary screening by HPV DNA testing is an effective method for reducing cervical cancer and has proven more sensitive than cytology. To advance this approach, many molecular methods have been developed. Hybrid capture 2 provides semi-quantitative results in ratios of relative light units and positive cutoff values (RLU/PC). Twenty-five thousand and five patients were included in this study to analyze the correlation between the ratio of RLU/PC and stage of cervical dysplasia. The results show that the RLU/PC ratios ranged from 0-3500 while almost normal cases, ASC-US and ASC-H, had values below 200. Of those samples negative for cytology markers, 94.6% were normal and their RLU/PC ratios were less than 4. With an RLU/PC ratio greater than 4 and less than or equal to 300, the percentages in all age groups were normal 53.6%, LSIL 20.2%, ASC-US 17.2%, HSIL 6.13%, ASC-H 2.72%, and AGC 0.11%, respectively. In contrast, 64.0% of samples with a RLU/PC ratio greater than 300 and less than or equal to 3500 were LSIL. These results should contribute to cost effective cervical cancer management strategies. Further studies of associations with particular HPV genotypes would be useful to predict the risk of progression to cancer.

Anxiety Disorders after Traumatic Brain Injury (외상성 뇌손상 후의 불안장애)

  • Kim, Young-Chul
    • Korean Journal of Biological Psychiatry
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    • v.7 no.1
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    • pp.46-54
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    • 2000
  • Traumatic brain injury(TBI) is generally considered to be a risk factor for psychiatric disorders, especially depression and anxiety disorder. Despite the anxiety disorders are frequent sequelae after traumatic brain injury, the patients have not been payed medical attention and treated by doctors properly. The factors of precipitating and sustaining the anxiety disorders after TBI are brain injury itself, and the patient's or caregiver's response to the disability after TBI. To diagnose and treat them effectively, the knowledge about the mechanisms of and symptoms after TBI have to be needed. Psychiatrist should be a supportive and good listener to the patients who are complaining anxiety symptoms and differentiate whether the psychiatric symptoms are due to TBI or not. Because the TBI patients are very sensitive to drug side effects, doctors have to be familiar with the side effects as well as the mechanisms of action of the common psychotropics.

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Breast abscess caused by Staphylococcus aureus in 2 adolescent girls with atopic dermatitis

  • Park, Sung Man;Choi, Won Sik;Yoon, YoonSun;Jung, Gee Hae;Lee, Chang Kyu;Ahn, So Hyun;Yoon, Wonsuck;Yoo, Young
    • Clinical and Experimental Pediatrics
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    • v.61 no.6
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    • pp.200-204
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    • 2018
  • Atopic dermatitis (AD) is a chronic inflammatory skin disease in children. Patients with AD experience a high rate of colonization of the skin surface by Staphylococcus aureus. Because of a skin barrier defect, there is a potential risk of staphylococcal invasive infection in patients with AD. Here, we present 2 cases of breast abscess caused by S. aureus in 2 adolescent girls with severe AD. Methicillin-sensitive S. aureus was identified from the breast abscess material. They were treated with appropriate antibiotics, however surgical drainage of the abscess was needed in case 1. Identical strains were found from the breast abscess material as well as the lesional and the nonlesional skin of the patients through matrix-assisted laser desorption/ionization time-of-flight analysis. We characterized the differential abundance of Firmicutes phylum in patients' skin in microbiota analysis. In particular, S. aureus, a member of Firmicutes, differed significantly between the lesional and the normal-appearing skin. Our cases demonstrate the potential severity of bacterial deep tissue infection in AD and the dysbiosis of skin microbiota may be involved in inflammation in AD.

Uncertainty Analysis on the Simulations of Runoff and Sediment Using SWAT-CUP (SWAT-CUP을 이용한 유출 및 유사모의 불확실성 분석)

  • Kim, Minho;Heo, Tae-Young;Chung, Sewoong
    • Journal of Korean Society on Water Environment
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    • v.29 no.5
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    • pp.681-690
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    • 2013
  • Watershed models have been increasingly used to support an integrated management of land and water, non-point source pollutants, and implement total daily maximum load policy. However, these models demand a great amount of input data, process parameters, a proper calibration, and sometimes result in significant uncertainty in the simulation results. For this reason, uncertainty analysis is necessary to minimize the risk in the use of the models for an important decision making. The objectives of this study were to evaluate three different uncertainty analysis algorithms (SUFI-2: Sequential Uncertainty Fitting-Ver.2, GLUE: Generalized Likelihood Uncertainty Estimation, ParaSol: Parameter Solution) that used to analyze the sensitivity of the SWAT(Soil and Water Assessment Tool) parameters and auto-calibration in a watershed, evaluate the uncertainties on the simulations of runoff and sediment load, and suggest alternatives to reduce the uncertainty. The results confirmed that the parameters which are most sensitive to runoff and sediment simulations were consistent in three algorithms although the order of importance is slightly different. In addition, there was no significant difference in the performance of auto-calibration results for runoff simulations. On the other hand, sediment calibration results showed less modeling efficiency compared to runoff simulations, which is probably due to the lack of measurement data. It is obvious that the parameter uncertainty in the sediment simulation is much grater than that in the runoff simulation. To decrease the uncertainty of SWAT simulations, it is recommended to estimate feasible ranges of model parameters, and obtain sufficient and reliable measurement data for the study site.

Toxic effects of Aroclor 1016 and bisphenol A on marine green algae Tetraselmis suecica, diatom Ditylum brightwellii and dinoflagellate Prorocentrum minimum (해양 녹조류 Tetraselmis suecica, 규조류 Ditylum brightwellii, 와편모조류 Prorocentrum minimum에 대한 Aroclor 1016과 비스페놀 A의 독성 효과)

  • Ebenezer, Vinitha;Ki, Jang-Seu
    • Korean Journal of Microbiology
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    • v.52 no.3
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    • pp.306-312
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    • 2016
  • Microalgae are the potential bioindicators of environmental changes, for the environmental risk assessment as well as to set limits for toxic chemical release in the aquatic environment. Here, we evaluated the effects of two endocrine disrupting chemicals (EDCs), namely bisphenol A (BPA) and Aroclor 1016, on the green algae Tetraselmis suecica, diatom Ditylum brightwellii, and dinoflagellate Prorocentrum minimum. Each species showed wide different sensitivity ranges when exposed to these two EDCs; the 72 h effective concentration ($EC_{50}$) for these test species showed that Aroclor 1016 was more toxic than BPA. $EC_{50}$ values for the diatom D. birghtwellii were calculated at 0.037 mg/L for BPA and 0.002 mg/L for Aroclor 1016, representing it was the most sensitive when compared to the other species. In addition, these results suggest that these EDC discharge beyond these concentrations into the aquatic environments may cause harmful effect to these marine species.