GSE75184 A transcriptional regulatory network connects mitochondrial biogenesis and metabolic shift with stem cell commitment to hepatic differentiation

Contributors : Anaïs Wanet ; Patricia Renard
Series Type : Expression profiling by high throughput sequencing
Organism : Homo sapiens

Mitochondrial biogenesis and metabolism recently emerged as critical modulators of stemness properties and differentiation programmes. The increase in mitochondrial biogenesis and metabolic shift toward increased oxidative phosphorylations (OXPHOS) appear as hallmarks of stem cell differentiation processes. While several mechanisms support the involvement of mitochondrial biogenesis and function in the regulation of stem cell differentiation, the mechanisms triggering mitochondrial biogenesis in the context of cell differentiation remain elusive. In this study, we performed transcriptomic and bioinformatic analyses in order to get deeper insights into the cross-regulation of mitochondrial biogenesis and hepatogenic differentiation of human bone marrow mesenchymal stem cells (BM-MSCs). We identified a transcriptional regulatory network involved in the co-regulation of stem cell differentiation and mitochondrial biogenesis.

from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader

GSE95367 Gene expression profiling of multiple tissue types from three species of cobweb weaving spiders

Contributors : Nadia A Ayoub ; Thomas H Clarke ; Jessica E Garb ; Cheryl Y Hayashi
Series Type : Expression profiling by high throughput sequencing
Organism : Latrodectus geometricus ; Latrodectus hesperus ; Steatoda grossa

Spider silk synthesis is an emerging model for the evolution of tissue-specific gene expression and the role of gene duplication in functional novelty, but its potential has not been fully realized. Accordingly, we quantified transcript (mRNA) abundance in seven silk gland types and three non-silk gland tissues for three cobweb-weaving spider species. Evolutionary analyses based on expression levels of thousands of homologous transcripts and phylogenetic reconstruction of 605 gene families demonstrated conservation of expression for each gland type among species. Despite serial homology of all silk glands, the expression profiles of the glue-forming aggregate glands were divergent from fiber-forming glands. Also surprising was our finding that shifts in gene expression among silk gland types were not necessarily coupled with gene duplication, even though silk-specific genes belong to multi-paralog gene families. Our results challenge widely accepted models of tissue specialization and significantly advance efforts to replicate silk-based high-performance biomaterials.

from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader

Core Outcome Domains for early phase clinical trials of sound-, psychology-, and pharmacology-based interventions to manage chronic subjective tinnitus in adults: the COMIT’ID study protocol for using a Delphi process and face-to-face meetings to establish consensus



The reporting of outcomes in clinical trials of subjective tinnitus indicates that many different tinnitus-related complaints are of interest to investigators, from perceptual attributes of the sound (e.g. loudness) to psychosocial impacts (e.g. quality of life). Even when considering one type of intervention strategy for subjective tinnitus, there is no agreement about what is critically important for deciding whether a treatment is effective. The main purpose of this observational study is, therefore to, develop Core Outcome Domain Sets for the three different intervention strategies (sound, psychological, and pharmacological) for adults with chronic subjective tinnitus that should be measured and reported in every clinical trial of these interventions. Secondary objectives are to identify the strengths and limitations of our study design for recruiting and reducing attrition of participants, and to explore uptake of the core outcomes.


The ‘Core Outcome Measures in Tinnitus: International Delphi’ (COMIT’ID) study will use a mixed-methods approach that incorporates input from health care users at the pre-Delphi stage, a modified three-round Delphi survey and final consensus meetings (one for each intervention). The meetings will generate recommendations by stakeholder representatives on agreed Core Outcome Domain Sets specific to each intervention. A subsequent step will establish a common cross-cutting Core Outcome Domain Set by identifying the common outcome domains included in all three intervention-specific Core Outcome Domain Sets. To address the secondary objectives, we will gather feedback from participants about their experience of taking part in the Delphi process. We aspire to conduct an observational cohort study to evaluate uptake of the core outcomes in published studies at 7 years following Core Outcome Set publication.


The COMIT’ID study aims to develop a Core Outcome Domain Set that is agreed as critically important for deciding whether a treatment for subjective tinnitus is effective. Such a recommendation would help to standardise future clinical trials worldwide and so we will determine if participation increases use of the Core Outcome Set in the long term.

Trial registration

This project has been registered (November 2014) in the database of the Core Outcome Measures in Effectiveness Trials (COMET) initiative.

from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader

Using routinely recorded data in the UK to assess outcomes in a randomised controlled trial: The Trials of Access



In the UK, routinely recorded data may benefit prospective studies including randomised controlled trials (RCTs). In an on-going study, we aim to assess the feasibility of access and agreement of routinely recorded clinical and non-clinical data compared to data collected during a RCT using standard prospective methods. This paper will summarise available UK routinely recorded data sources and discuss our experience with the feasibility of accessing routinely recorded data for participants of a RCT before finally proposing recommendations for improving the access and implementation of routinely recorded data in RCTs.


Setting: the case study RCT is the Standard and New Antiepileptic Drugs II (SANAD II) trial, a pragmatic, UK, multicentre, phase IV RCT assessing the clinical and cost-effectiveness of antiepileptic drug treatments for newly diagnosed epilepsy.

Participants: 98 participants have provided written consent to permit the request of routinely recorded data.

Study procedures: routinely recorded clinical and non-clinical data were identified and data requested through formal applications from available data holders for the duration that participants have been recruited into SANAD II. The feasibility of accessing routinely recorded data during a RCT is assessed and recommendations for improving access proposed.


Secondary-care clinical and socioeconomic data is recorded on a national basis and can be accessed, although there are limitations in the application process. Primary-care data are recorded by a number of organisations on a de-identified basis but access for specific individuals has not been feasible. Access to data recorded by non-clinical sources, including The Department for Work and Pensions and The Driving and Vehicle Licensing Agency, was not successful.


Recommendations discussed include further research to assess the attributes of routinely recorded data, an assessment of public perceptions and the development of strategies to collaboratively improve access to routinely recorded data for research.

Trial registration

International Standard Randomised Controlled Trials, ISRCTN30294119. Registered on 3 July 2012. EudraCT No: 2012-001884-64. Registered on 9 May 2012.

from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader

Perioperative antibiotic prophylaxis in the treatment of acute cholecystitis (PEANUTS II trial): study protocol for a randomized controlled trial



The additional value of perioperative antibiotic prophylaxis in preventing infectious complications after emergency cholecystectomy for acute cholecystitis is a much-debated subject in the surgical community. Evidence-based guidelines are lacking, and consequently the use of antibiotic prophylaxis varies greatly among surgeons and hospitals. Recently, high-level evidence became available demonstrating that postoperative antibiotic prophylaxis in patients with acute cholecystitis does not reduce the risk of infectious complications. Preoperative antibiotic prophylaxis in relation to the risk of infectious complications, however, has never been studied.


The PEANUTS II trial is a randomized, controlled, multicenter, open-label noninferiority trial whose aim is to determine the utility of preoperative antibiotic prophylaxis in patients undergoing emergency cholecystectomy for acute calculous cholecystitis. Patients with mild or moderate acute cholecystitis, as defined according the Tokyo Guidelines, will be randomly assigned to a single preoperative dose of antibiotic prophylaxis (2000 mg of first-generation cephalosporin delivered intravenously) or no antibiotic prophylaxis before emergency cholecystectomy. The primary endpoint is a composite endpoint consisting of all postoperative infectious complications occurring during the first 30 days after surgery. Secondary endpoints include all the individual components of the primary endpoint, all other complications, duration of hospital stay, and total costs. The hypothesis is that the absence of antibiotic prophylaxis is noninferior to the presence of antibiotic prophylaxis. A noninferiority margin of 10% is assumed. With a 1-sided risk of 2.5% and a power of 80%, a total of 454 subjects will have to be included. Analysis will be performed according to the intention-to-treat principle.


The PEANUTS II trial will provide evidence-based advice concerning the utility of antibiotic prophylaxis in patients undergoing emergency cholecystectomy for acute calculous cholecystitis.

Trial registration

Netherlands Trial Register, NTR5802. Registered on 4 June 2016.

from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader

Radiation Therapy With Durvalumab or Cetuximab in Treating Patients With Stage III-IVB Head and Neck Cancer Who Cannot Take Cisplatin

Conditions:   Head and Neck Squamous Cell Carcinoma;   Stage III Hypopharyngeal Squamous Cell Carcinoma AJCC v7;   Stage III Laryngeal Squamous Cell Carcinoma AJCC v6 and v7;   Stage III Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7;   Stage III Oropharyngeal Squamous Cell Carcinoma AJCC v7;   Stage IVA Hypopharyngeal Squamous Cell Carcinoma AJCC v7;   Stage IVA Laryngeal Squamous Cell Carcinoma AJCC v7;   Stage IVA Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7;   Stage IVA Oropharyngeal Squamous Cell Carcinoma AJCC v7;   Stage IVB Hypopharyngeal Squamous Cell Carcinoma AJCC v7;   Stage IVB Laryngeal Squamous Cell Carcinoma AJCC v7;   Stage IVB Oral Cavity Squamous Cell Carcinoma AJCC v6 and v7;   Stage IVB Oropharyngeal Squamous Cell Carcinoma AJCC v7
Interventions:   Biological: Cetuximab;   Biological: Durvalumab;   Radiation: Intensity-Modulated Radiation Therapy;   Other: Laboratory Biomarker Analysis;   Other: Quality-of-Life Assessment;   Other: Questionnaire Administration
Sponsor:   National Cancer Institute (NCI)
Not yet recruiting – verified August 2017

from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader

Citing Health Benefits, New Parents Eating Umbilical Cord Stumps

“From the moment I gazed into Andromeda’s perfect eyes, I knew I wanted only the best for her,” says new mom Rochelle Wilson. “Her umbilical cord nourished her from the beginning, selflessly providing life itself. How better to honor this wondrous organ other than by eating it?”

umbilical stumpDon’t let your stump get too dried up like this. It loses flavor!

“In deference to our animal ancestors, I chewed off the cord myself,” says Rochelle. Although she considered lotus birth, i.e., leaving the cord and placenta intact after birth until it naturally detaches, Rochelle ultimately settled on a celestial birth.

“Since Andromeda is a constellation, and we hope she will one day be an astronaut, we dried out my placenta, placed it in a high-flying drone and launched it toward space.”

It seemed a natural progression for the Wilsons to eat the stump after she chewed it off.

“It tasted pretty good, maybe a little rubbery,” says Ian, Andromeda’s dad. “Cooking it helps.”

Foodies are now weighing in. Celebrity Chef Jacques Pernod dismisses the idea of the lotus birth as “preposterous.”

“When you allow the umbilical cord to stay attached to the baby and placenta for 6 days, it dries out and has the consistency of wire. You lose the delicious Wharton’s jelly, a substance of gelatinous goodness made largely from mucopolysaccharides.”

Parents and foodies alike are discovering the culinary delights of umbilical cord stump.

With very few calories and a mouthfeel that is strikingly like calamari, the possibilities are endless.

“What I do is fry it up with some bacon and onion and just a little bit of panko breadcrumbs. It makes it so umami,” says Pernod. “If I add a dash of fresh vernix or a drizzle of meconium, it gives it a certain “je ne sais quoi.”

For those who are a little squeamish about eating fresh umbilical cord, there are professional certified umbilical cord encapsulators and qualified herbalists at the ready. For a price, they will put the umbilical cord stump into pill form or even give you a recipe for a smoothie.

The FDA has cautioned breastfeeding mothers from consuming umbilical cord with fava beans and a nice Chianti, since it takes a few weeks for a newborn screen to show whether a baby has G-6-PD deficiency.

Some new moms are dismissive of the warnings.


**Obvious satire just in case anybody thinks this is real.  Please don’t eat umbilical cords**

The post Citing Health Benefits, New Parents Eating Umbilical Cord Stumps appeared first on GomerBlog.

from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader

Lame PCP Doctor hasn’t even tried PCP

Madison, WI – Quick hide your beer, get the visine, because it’s time to meet Dr. Dud. Well her real name is Dr. Brice. Dr. Brice refers to herself as a PCP doctor, and hasn’t even tried PCP. What! How is that possible?

Dr. Lamo

This square spent 11 years after high school training to become a PCP doctor, and much of it in a library! No summers in Nevada at Burning Man. No nipple pasties. She has never walked into the woods in-search of the Willow people who helped saved dinkle from the evil Lord Mashal. (Who would be also out to capture her… Shhh) She has never made a make-shift fortress out of branches and leaves to hide from Mashal when, in reality, it was actually a squirrel. Nope, never been on the PCP train.

She cannot even hear colors. Sad.

C’mon at least go to a Phish show and let the world in man [woman].

The only time this doctor had a trip, it wasn’t from smokin a dippie, it was an extreme sense of paranoia after taking STEP 1 USMLE board exam. She was telling everyone “Oh I definitely failed, there is no way I passed.” Turns out she had the highest score in the class. Yeah, lets get a urine screen pal.

All her patients love her, but they would probably love her more if she tapped into some angel dust every once in a while.

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from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader

Medical Student Mob Tears down statue of Andrew Wakefield

Cleveland, OH – An angry mob of medical students tore down a statue of Andrew Wakefield in front of the Cleveland Clinic Saturday. This Anti-Vax champion was best known for a falsified study linking the MMR vaccine to autism, and later a movie claiming the same. Cleveland clinic has been a vocal critic of Vaccines despite all of the evidence.

As the mighty statue was brought down chants of “Your lies can no longer kill our children!”  and “Down with pseudoscience!” Even broke-out in song: “You take the good, you take the bad, the Vax of life, the Vax of life!”

An anonymous medical student told reporters: “We were tired of the lies of the AntiVax movement and the rise of measles in America!”

The statue was ripped from its base, hit with stethoscopes and tuning forks for about an hour, then dragged through town from a 2001 Honda Accord with a missing passenger side mirror, most likely a medical student’s car.

Critics upset with this measure aren’t necessarily Anti-vax, but worry that this Anti-Vax movement, which is killing children, is part of our history.

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from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader

Surgical and pathological outcomes of robotic-assisted radical cystectomy for bladder cancer in the community setting


Robotic-assisted radical cystectomy (RARC) with urinary diversion is commonly performed in community hospitals. While little data exist on RARC outcomes in this setting, community hospitals may improve access to care for bladder cancer patients. We conducted a retrospective review of 76 patients who underwent RARC between 2006 and 2016 by two robotic-trained surgeons in two local community hospitals. A total of 76 patients (60 males and 16 females; ages 46–89) underwent RARC with extended pelvic lymphadenectomy and urinary diversion (69 ileal conduits, 7 neobladders) for muscle-invasive bladder carcinoma (79%), recurrent high-grade carcinoma (17%), unresectable tumor (2%), or refractory gross hematuria from chemotherapy (2%). Median-estimated surgical blood loss (EBL) was 400 mL, and median operating time was 386 min. Transfusion rate was 22% and median length of hospital stay was 6 days. Our 90-day complication rate was 47%, with no mortalities in the 90-day post-operative period. The majority of complications (58%) were Clavien grade 1–2. We observed a significant difference in incidence of complications among patients receiving neobladder vs. ileal conduit (p = 0.002). On pathology, zero patients had positive bladder specimen margins. Among 28 patients with at least 3-year follow-up, overall survival was 85.7%, and among 9 patients with at least 5-year follow-up, overall survival was 100%. Contrary to some studies, our findings suggest similar short-term surgical and pathologic outcomes for RARC performed in the community hospital setting compared to high volume centers. We defined several criteria for low volume centers to effectively and safely perform RARC.

from # All Medicine by Alexandros G. Sfakianakis via alkiviadis.1961 on Inoreader