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Regulating firms’ culture - The increasing focus by financial regulators internationally on supervising firms’ culture

Introduction Financial services firms’ corporate governance and risk cultures is a ‘hot’ topic with financial regulators globally. Regulators have noted that serious corporate governance and conduct failings of financial services f...




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Latam: Renewable Energy is Looking Good in Latin America

The Energy & Infrastructure team is delighted to launch its third edition of the Renewable Energy is Looking Good in Latin America brochure. Latin American countries represent 4 of the top 20 most attractive renewable energy markets in the world...




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Bubble gum becomes a prized commodity in Ninjala and PlatinumGames celebrates two birthdays

Ninjala is sure to deliver Splatoon fans a new mess of fun and the rest of the world gets a peek at the buzz behind ...




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Regulating Special Revelation

In the lead-up to the Truth Matters conference in October, we will be focusing our attention on the sufficiency, authority, and clarity of Scripture. One of our previous blog series, Looking for Truth in All the Wrong Places, strongly emphasizes those doctrines. The following entry from that series originally appeared on June 21, 2017. -ed.

If God is still speaking to His people today—particularly through mental impressions and premonitions—how can believers exercise discernment when it comes to interpreting and applying these divine messages? Put simply, how is following the private, subjective “leading” of the Lord any more reliable than gazing into a crystal ball?

As we saw last time, biblical discernment runs contrary to the kind of subjective mysticism many promote in the church today. Without any objective criteria, there is no means for determining truth from error. Such blithe subjectivity leaves people at the mercy of whatever mystical “voice” they’re listening to.

Upper Abdominal Distress

It is therefore ironic that advocates of mysticism inevitably treat discernment itself as if it were some kind of subjective, mystical ability. One author speaks of discernment as “a spiritual function,” by which he evidently means that discernment does not involve the intellect. [1] William DeArteaga, Quenching the Spirit (Lake Mary, FL: Creation House, 1992), 55. For a further discussion of DeArteaga’s work, see chapter 6 of Reckless Faith. In one of my earlier books I quoted Bill Hamon, one of the leading proponents of modern revelatory prophecy. Hamon’s recipe for discernment is a classic case of mystical anti-intellectualism. He believes prophecies can be properly evaluated only by people willing to set reason and logic aside:

I have sometimes heard people say, “I did not witness with that prophecy.” But after questioning them, I discovered that what they really meant was that the prophecy did not fit their theology, personal desires or goals, or their emotions reacted negatively to it. They failed to understand that we do not bear witness with the soul—the mind, emotions or will.

Our reasoning is in the mind, not the spirit. So our traditions, beliefs and strong opinions are not true witnesses to prophetic truth. The spirit reaction originates deep within our being. Many Christians describe the physical location of its corresponding sensation as the upper abdominal area.

A negative witness—with a message of “no,” “be careful” or “something’s not right”—usually manifests itself with a nervous, jumpy or uneasy feeling. There is a deep, almost unintelligible sensation that something is wrong. This sense can only be trusted when we are more in tune with our spirit than with our thoughts. If our thinking is causing these sensations, then it could be only a soulish reaction.

On the other hand, when God’s Spirit is bearing witness with our spirit that a prophetic word is right, is of God and is according to His will and purpose, then our spirit reacts with the fruit of the Holy Spirit. We have a deep, unexplainable peace and joy, a warm, loving feeling—or even a sense of our spirit jumping up and down with excitement. This sensation lets us know that the Holy Spirit is bearing witness with our spirit that everything is in order, even though we may not understand everything that is being said, or our soul may not be able to adjust immediately to all the thoughts being presented. [2] Bill Hamon, “How to Receive a Personal Prophecy,” Charisma (April 1991), 68 (emphasis added).

Notice that Hamon’s emphasis is entirely on feeling, while he derides the intellect, theology, reason, understanding, and by implication, true biblical wisdom. A reaction in the upper abdominal region is supposed to be a more reliable gauge of truth than all those things.

But that is superstition, not discernment. How your upper abdomen feels about a thing is certainly no measure of truth or falsehood. Neither is “a nervous, jumpy, or uneasy feeling” apart from any rational cause. “A deep, unexplainable peace and joy, a warm, loving feeling—or even a sense of [your] spirit jumping up and down with excitement” is no proof that a supposed prophecy is reliable. Those who practice this sort of “discernment” epitomize reckless faith.

And those who seek truth by analyzing inner feelings are likely to wind up with nothing but confusion.

Dueling Prophets

My editor once attended a service at the Anaheim Vineyard where two “prophets” gave contradictory prophecies. It happened in a Sunday morning worship service. When the congregational singing was over, John Wimber stepped to the platform. Before he could say anything, a young man in the congregation stood and began loudly to prophesy judgment against the leaders of the church. “Jerusalem! Jerusalem!” he began, echoing Luke 13:34, “you persecute My prophets and stone My messengers. My displeasure burns hot toward the leadership of this church for the way you have scorned My prophets and ignored My prophecies. . . .” and so on. The man evidently was disgruntled at the treatment he had received at the hands of church leaders, and this “prophecy” seemed to be his way of striking back. He prophesied in that manner for five minutes or more, earnestly calling the elders of the church to repentance. His entire message was in first person as if from God.

Immediately when he finished, before John Wimber could respond, another “prophet” from the other side of the congregation popped up and began to prophesy exactly the opposite message. This prophet began with a loose paraphrase of Jeremiah 29:11: “Oh, pastors and leaders of this church, I know My thoughts toward you—thoughts of mercy, and not of judgment. I have loved you with an everlasting love and have laid up for you a crown in heaven, My beloved. You have done according to all My good pleasure, and henceforth all men will rise up and call you blessed. . . .” etcetera, etcetera.

When the second man finished, a woman stood and sang a song, another person spoke in tongues, and one or two others quoted Bible verses or shared something brief. Then the service continued with Wimber making announcements. No reference was made to the two contradictory prophecies. No attempt was made to explain the dilemma or interpret either prophecy. Members of the congregation were simply left to draw their own conclusions about which, if either, of the two prophecies was correct.

That illustrates the impossible situation that arises when people are encouraged to voice their own subjective impressions as if they were divine prophecy. And it also reveals the predicament we are placed in if we must allow a sensation in our upper abdominal area to determine the truth or falsehood of a prophetic message.

Notice that both prophets’ messages echoed biblical terminology. Both of them were delivered with great conviction. Both of them employed first-person pronouns, as if God Himself were doing the speaking. Yet they flatly contradicted each other. They might both be false prophecies, but there is no way they could both be true. How were the people in the congregation supposed to determine which, if either, was correct? If they followed the gut-feeling approach, all the disgruntled people in the church undoubtedly opted for the first prophecy, believing they now had a word from the Lord to confirm their displeasure with their leaders.

The obvious fact is that once we stray into the realm of subjectivity, we have no way to determine what is really true.

(Adapted from Reckless Faith.)




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Toward the indispensable political, economic and social integration of Latin America and the Caribbean

CARICOM-CUBA SUMMIT Toward the indispensable political, economic and social integration of Latin America and the Caribbean Key remarks by President Raúl Castro opening the Fifth CARICOM-Cuba Summit in Havana, December 8, 2014




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Antarctic researchers are now isolating within isolation

In the frozen and desolate expanse of Antarctica, Davis station leader David Knoff and other expeditioners are well aware of what it takes to live this way.




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India escalating tension at LoC

ISLAMABAD: The Foreign Office on Friday said it had summoned a senior Indian diplomat to register a strong protest over the Indian ceasefire violations along the Line of Control .The statement by the FO said that in the unprovoked Indian firing across the LoC in Nezapir and Rakchikri sectors, six...




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India escalating tension at LoC

ISLAMABAD: The Foreign Office on Friday said it had summoned a senior Indian diplomat to register a strong protest over the Indian ceasefire violations along the Line of Control .The statement by the FO said that in the unprovoked Indian firing across the LoC in Nezapir and Rakchikri sectors, six...




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How to make noodles: the art and science of manipulating gluten

It's easy and fun to make hand-pulled noodles, especially if you understand how gluten is acting inside the dough to make it stretch y and elastic, says Sam Wong




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SLFN11 Expression in Advanced Prostate Cancer and Response to Platinum-based Chemotherapy

Expression of the DNA/RNA helicase schlafen family member 11 (SLFN11) has been identified as a sensitizer of tumor cells to DNA-damaging agents including platinum chemotherapy. We assessed the impact of SLFN11 expression on response to platinum chemotherapy and outcomes in patients with metastatic castration-resistant prostate cancer (CRPC). Tumor expression of SLFN11 was assessed in 41 patients with CRPC treated with platinum chemotherapy by RNA sequencing (RNA-seq) of metastatic biopsy tissue (n = 27) and/or immunofluorescence in circulating tumor cells (CTC; n = 20). Cox regression and Kaplan–Meier methods were used to evaluate the association of SLFN11 expression with radiographic progression-free survival (rPFS) and overall survival (OS). Multivariate analysis included tumor histology (i.e., adenocarcinoma or neuroendocrine) and the presence or absence of DNA repair aberrations. Patient-derived organoids with SLFN11 expression and after knockout by CRISPR-Cas9 were treated with platinum and assessed for changes in dose response. Patients were treated with platinum combination (N = 38) or platinum monotherapy (N = 3). Median lines of prior therapy for CRPC was two. Median OS was 8.7 months. Overexpression of SLFN11 in metastatic tumors by RNA-seq was associated with longer rPFS compared with those without overexpression (6.9 vs. 2.8 months, HR = 3.72; 95% confidence interval (CI), 1.56–8.87; P < 0.001); similar results were observed for patients with SLFN11-positive versus SLFN11-negative CTCs (rPFS 6.0 vs. 2.2 months, HR = 4.02; 95% CI, 0.77–20.86; P = 0.002). A prostate-specific antigen (PSA) decline of ≥50% was observed in all patients with SLFN11 overexpression. No association was observed between SLFN11 expression and OS. On multivariable analysis, SLFN11 was an independent factor associated with rPFS on platinum therapy. Platinum response of organoids expressing SLFN11 was reduced after SLFN11 knockout. Our data suggest that SLFN11 expression might identify patients with CRPC with a better response to platinum chemotherapy independent of histology or other genomic alterations. Additional studies, also in the context of PARP inhibitors, are warranted.




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EPSIN1 Contributes to Plant Immunity by Modulating the Abundance of Pattern Recognition Receptors at the Plasma Membrane




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AKT Regulates Mitotic Progression of Mammalian Cells by Phosphorylating MASTL, Leading to Protein Phosphatase 2A Inactivation [Research Article]

Microtubule-associated serine/threonine kinase like (MASTL), also known as Greatwall (Gwl) kinase, has an important role in the regulation of mitosis. By inhibiting protein phosphatase 2A (PP2A), it plays a crucial role in activating one of the most important mitotic kinases, known as cyclin-dependent kinase 1 (CDK1). MASTL has been seen to be upregulated in various types of cancers and is also involved in tumor recurrence. It is activated by CDK1 through phosphorylations in the activation/T-loop, but the complete mechanism of its activation is still unclear. Here, we report that AKT phosphorylates MASTL at residue T299, which plays a critical role in its activation. Our results suggest that AKT increases CDK1-mediated phosphorylation and hence the activity of MASTL, which, in turn, promotes mitotic progression through PP2A inhibition. We also show that the oncogenic potential of AKT is augmented by MASTL activation, since AKT-mediated proliferation in colorectal cell lines can be attenuated by inhibiting and/or silencing MASTL. In brief, we report that AKT plays an important role in the progression of mitosis in mammalian cells and that it does so through the phosphorylation and activation of MASTL.




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The tethering function of mitofusin2 controls osteoclast differentiation by modulating the Ca2+-NFATc1 axis [A2;A22]

Dynamic regulation of the mitochondrial network by mitofusins (MFNs) modulates energy production, cell survival, and many intracellular signaling events, including calcium handling. However, the relative importance of specific mitochondrial functions and their dependence on MFNs vary greatly among cell types. Osteoclasts have many mitochondria, and increased mitochondrial biogenesis and oxidative phosphorylation enhance bone resorption, but little is known about the mitochondrial network or MFNs in osteoclasts. Because expression of each MFN isoform increases with osteoclastogenesis, we conditionally deleted MFN1 and MFN2 (double conditional KO (dcKO)) in murine osteoclast precursors, finding that this increased bone mass in young female mice and abolished osteoclast precursor differentiation into mature osteoclasts in vitro. Defective osteoclastogenesis was reversed by overexpression of MFN2 but not MFN1; therefore, we generated mice lacking only MFN2 in osteoclasts. MFN2-deficient female mice had increased bone mass at 1 year and resistance to Receptor Activator of NF-κB Ligand (RANKL)-induced osteolysis at 8 weeks. To explore whether MFN-mediated tethering or mitophagy is important for osteoclastogenesis, we overexpressed MFN2 variants defective in either function in dcKO precursors and found that, although mitophagy was dispensable for differentiation, tethering was required. Because the master osteoclastogenic transcriptional regulator nuclear factor of activated T cells 1 (NFATc1) is calcium-regulated, we assessed calcium release from the endoplasmic reticulum and store-operated calcium entry and found that the latter was blunted in dcKO cells. Restored osteoclast differentiation by expression of intact MFN2 or the mitophagy-defective variant was associated with normalization of store-operated calcium entry and NFATc1 levels, indicating that MFN2 controls mitochondrion–endoplasmic reticulum tethering in osteoclasts.




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Inhibition of glycosphingolipid biosynthesis reverts multidrug resistance by differentially modulating ABC transporters in chronic myeloid leukemias [Cell Biology]

Multidrug resistance (MDR) in cancer arises from cross-resistance to structurally- and functionally-divergent chemotherapeutic drugs. In particular, MDR is characterized by increased expression and activity of ATP-binding cassette (ABC) superfamily transporters. Sphingolipids are substrates of ABC proteins in cell signaling, membrane biosynthesis, and inflammation, for example, and their products can favor cancer progression. Glucosylceramide (GlcCer) is a ubiquitous glycosphingolipid (GSL) generated by glucosylceramide synthase, a key regulatory enzyme encoded by the UDP-glucose ceramide glucosyltransferase (UGCG) gene. Stressed cells increase de novo biosynthesis of ceramides, which return to sub-toxic levels after UGCG mediates incorporation into GlcCer. Given that cancer cells seem to mobilize UGCG and have increased GSL content for ceramide clearance, which ultimately contributes to chemotherapy failure, here we investigated how inhibition of GSL biosynthesis affects the MDR phenotype of chronic myeloid leukemias. We found that MDR is associated with higher UGCG expression and with a complex GSL profile. UGCG inhibition with the ceramide analog d-threo-1-(3,4,-ethylenedioxy)phenyl-2-palmitoylamino-3-pyrrolidino-1-propanol (EtDO-P4) greatly reduced GSL and monosialotetrahexosylganglioside levels, and co-treatment with standard chemotherapeutics sensitized cells to mitochondrial membrane potential loss and apoptosis. ABC subfamily B member 1 (ABCB1) expression was reduced, and ABCC-mediated efflux activity was modulated by competition with nonglycosylated ceramides. Consistently, inhibition of ABCC-mediated transport reduced the efflux of exogenous C6-ceramide. Overall, UGCG inhibition impaired the malignant glycophenotype of MDR leukemias, which typically overcomes drug resistance through distinct mechanisms. This work sheds light on the involvement of GSL in chemotherapy failure, and its findings suggest that targeted GSL modulation could help manage MDR leukemias.




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Pro-515 of the dynamin-like GTPase MxB contributes to HIV-1 inhibition by regulating MxB oligomerization and binding to HIV-1 capsid [Microbiology]

Interferon-regulated myxovirus resistance protein B (MxB) is an interferon-induced GTPase belonging to the dynamin superfamily. It inhibits infection with a wide range of different viruses, including HIV-1, by impairing viral DNA entry into the nucleus. Unlike the related antiviral GTPase MxA, MxB possesses an N-terminal region that contains a nuclear localization signal and is crucial for inhibiting HIV-1. Because MxB previously has been shown to reside in both the nuclear envelope and the cytoplasm, here we used bioinformatics and biochemical approaches to identify a nuclear export signal (NES) responsible for MxB's cytoplasmic location. Using the online computational tool LocNES (Locating Nuclear Export Signals or NESs), we identified five putative NES candidates in MxB and investigated whether their deletion caused nuclear localization of MxB. Our results revealed that none of the five deletion variants relocates to the nucleus, suggesting that these five predicted NES sequences do not confer NES activity. Interestingly, deletion of one sequence, encompassing amino acids 505–527, abrogated the anti-HIV-1 activity of MxB. Further mutation experiments disclosed that amino acids 515–519, and Pro-515 in particular, regulate MxB oligomerization and its binding to HIV-1 capsid, thereby playing an important role in MxB-mediated restriction of HIV-1 infection. In summary, our results indicate that none of the five predicted NES sequences in MxB appears to be required for its nuclear export. Our findings also reveal several residues in MxB, including Pro-515, critical for its oligomerization and anti-HIV-1 function.




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Dimethyl fumarate suppresses granulocyte macrophage colony-stimulating factor-producing Th1 cells in CNS neuroinflammation

Objective

To study the immunomodulatory effect of dimethyl fumarate (DF) on granulocyte macrophage colony-stimulating factor (GM-CSF) production in CD4+ T cells in experimental autoimmune encephalomyelitis (EAE) and human peripheral blood mononuclear cells (PBMCs).

Methods

We collected splenocytes and CD4+ T cells from C57BL/6 wild-type and interferon (IFN)-–deficient mice. For human PBMCs, venous blood was collected from healthy donors, and PBMCs were collected using the Percoll gradient method. Cells were cultured with anti-CD3/28 in the presence/absence of DF for 3 to 5 days. Cells were stained and analyzed by flow cytometry. Cytokines were measured by ELISA in cell supernatants. For in vivo experiments, EAE was induced by myelin oligodendrocyte glycoprotein35–55 and mice were treated with oral DF or vehicle daily.

Results

DF acts directly on CD4+ T cells and suppresses GM-CSF–producing Th1 not Th17 or single GM-CSF+ T cells in EAE. In addition, GM-CSF suppression depends on the IFN- pathway. We also show that DF specifically suppresses Th1 and GM-CSF–producing Th1 cells in PBMCs from healthy donors.

Conclusions

We suggest that DF exclusively suppresses GM-CSF–producing Th1 cells in both animal and human CD4+ T cells through an IFN-–dependent pathway. These findings indicate that DF has a better therapeutic effect on patients with Th1-dominant immunophenotype. However, future longitudinal study to validate this finding in MS is needed.




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Circular RNA hsa_circ_0014130 Inhibits Apoptosis in Non-Small Cell Lung Cancer by Sponging miR-136-5p and Upregulating BCL2

Previous studies indicated that circular RNAs (circRNA) played vital roles in the development of non–small cell lung cancer (NSCLC). Although hsa_circ_0014130 might be a potential NSCLC biomarker, its function in NSCLC remains unknown. Thus, this study aimed to investigate the role of hsa_circ_0014130 in the progression of NSCLC. The levels of hsa_circ_0014130 in NSCLC tissues and adjacent normal tissues were determined by qRT-PCR. In addition, the expressions of Bcl-2 and cleaved caspase-3 in A549 cells were detected with Western blot analysis. Meanwhile, the dual luciferase reporter system assay was used to determine the interaction of hsa_circ_0014130 and miR-136-5p or Bcl-2 and miR-136-5p in NSCLC, respectively. The level of hsa_circ_0014130 was significantly upregulated in NSCLC tissues. Downregulation of hsa_circ_0014130 markedly inhibited the proliferation and invasion of A549 cells via inducing apoptosis. In addition, downregulation of hsa_circ_0014130 inhibited the tumorigenesis of subcutaneous A549 xenograft in mice in vivo. Meanwhile, mechanistic analysis indicated that downregulation of hsa_circ_0014130 decreased the expression of miR-136-5p–targeted gene Bcl-2 via acting as a competitive "sponge" of miR-136-5p. In this study, we found that hsa_circ_0014130 was upregulated in NSCLC tissues. In addition, hsa_circ_0014130 functions as a tumor promoter in NSCLC to promote tumor growth through upregulating Bcl-2 partially via "sponging" miR-136-5p.

Implications:

In conclusion, hsa_circ_0014130 might function as a prognostic factor for patients with NSCLC and might be a therapeutic target for the treatment of NSCLC in future.




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Diabetes, Cognitive Decline, and Mild Cognitive Impairment Among Diverse Hispanics/Latinos: Study of Latinos-Investigation of Neurocognitive Aging Results (HCHS/SOL)

OBJECTIVE

Hispanics/Latinos are the largest ethnic/racial group in the U.S., have the highest prevalence of diabetes, and are at increased risk for neurodegenerative disorders. Currently, little is known about the relationship between diabetes and cognitive decline and disorders among diverse Hispanics/Latinos. The purpose of this study is to clarify these relationships in diverse middle-aged and older Hispanics/Latinos.

RESEARCH DESIGN AND METHODS

The Study of Latinos–Investigation of Neurocognitive Aging (SOL-INCA) is an ancillary study of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). HCHS/SOL is a multisite (Bronx, NY; Chicago, IL; Miami, FL; and San Diego, CA), probability-sampled (i.e., representative of targeted populations), and prospective cohort study. Between 2016 and 2018, SOL-INCA enrolled diverse Hispanics/Latinos aged ≥50 years (n = 6,377). Global cognitive decline and mild cognitive impairment (MCI) were the primary outcomes.

RESULTS

Prevalent diabetes at visit 1, but not incident diabetes at visit 2, was associated with significantly steeper global cognitive decline (βGC = –0.16 [95% CI –0.25; –0.07]; P < 0.001), domain-specific cognitive decline, and higher odds of MCI (odds ratio 1.74 [95% CI 1.34; 2.26]; P < 0.001) compared with no diabetes in age- and sex-adjusted models.

CONCLUSIONS

Diabetes was associated with cognitive decline and increased MCI prevalence among diverse Hispanics/Latinos, primarily among those with prevalent diabetes at visit 1. Our findings suggest that significant cognitive decline and MCI may be considered additional disease complications of diabetes among diverse middle-aged and older Hispanics/Latinos.




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Long-term outcome of a randomized controlled study in patients with newly diagnosed severe aplastic anemia treated with antithymocyte globulin and cyclosporine, with or without granulocyte colony-stimulating factor: a Severe Aplastic Anemia Working Party

This follow-up study of a randomized, prospective trial included 192 patients with newly diagnosed severe aplastic anemia receiving antithymoglobulin and cyclosporine, with or without granulocyte colony-stimulating factor (G-CSF). We aimed to evaluate the long-term effect of G-CSF on overall survival, event-free survival, probability of secondary myelodysplastic syndrome (MDS) or acute myeloid leukemia (AML), clinical paroxysmal nocturnal hemoglobinuria, relapse, avascular osteonecrosis and chronic kidney disease. The median follow-up was 11.7 years (95% CI, 10.9-12.5). The overall survival rate at 15 years was 57±12% in the group given G-CSF and 63±12% in the group not given G-CSF (P=0.92); the corresponding event-free survival rates were 24±10% and 23±10%, respectively (P=0.36). In total, 9 patients developed MDS or AML, 10 only a clonal cytogenetic abnormality, 7 a solid cancer, 18 clinical paroxysmal nocturnal hemoglobinuria, 8 osteonecrosis, and 12 chronic kidney disease, without any difference between patients treated with or without G-CSF. The cumulative incidence of MDS, AML or isolated cytogenetic abnormality at 15 years was 8.5±3% for the G-CSF group and 8.2±3% for the non-G-CSF group (P=0.90). The cumulative incidence of any late event including myelodysplastic syndrome or acute myeloid leukemia, isolated cytogenetic abnormalities, solid cancer, clinical paroxysmal nocturnal hemoglobinuria, aseptic osteonecrosis, chronic kidney disease and relapse was 50±12% for the G-CSF group and 49±12% for the non-G-CSF group (P=0.65). Our results demonstrate that it is unlikely that G-CSF has an impact on the outcome of severe aplastic anemia; nevertheless, very late events are common and eventually affect the prognosis of these patients, irrespectively of their age at the time of immunosuppressive therapy (NCT01163942).




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Circulating Uromodulin and Risk of Cardiovascular Events and Kidney Failure




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Levothyroxine prescribing and laboratory test use after a minor change in reference range for thyroid-stimulating hormone [Research]

BACKGROUND:

Prescribing of levothyroxine and rates of thyroid function testing may be sensitive to minor changes in the upper limit of the reference range for thyroid-stimulating hormone (TSH) that increase the proportion of abnormal results. We evaluated the population-level change in levothyroxine prescribing and TSH testing after a minor planned decrease in the upper limit of the reference range for TSH in a large urban centre with a single medical laboratory.

METHODS:

Using provincial administrative data, we compared predicted volumes of TSH tests with actual TSH test volumes before and after a planned change in the TSH reference range. We also determined the number of new levothyroxine prescriptions for previously untreated patients and the rate of changes to the prescribed dose for those on previously stable, long-term levothyroxine therapy before and after the change in the TSH reference range.

RESULTS:

Before the change in the TSH reference range, actual and predicted monthly volumes of TSH testing followed an identical course. After the change, actual test volumes exceeded predicted test volumes by 7.3% (95% confidence interval [CI] 5.3%–9.3%) or about 3000 to 5000 extra tests per month. The proportion of patients with newly "abnormal" TSH results almost tripled, from 3.3% (95% CI 3.2%–3.4%) to 9.1% (95% CI 9.0%–9.2%). The rate of new levothyroxine prescriptions increased from 3.24 (95% CI 3.15–3.33) per 1000 population in 2013 to 4.06 (95% CI 3.96–4.15) per 1000 population in 2014. Among patients with preexisting stable levothyroxine therapy, there was a significant increase in the number of dose escalations (p < 0.001) and a total increase of 500 new prescriptions per month.

INTERPRETATION:

Our findings suggest that clinicians may have responded to mildly elevated TSH results with new or increased levothyroxine prescriptions and more TSH testing. Knowledge translation efforts may be useful to accompany minor changes in reference ranges.




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Beneficial Agents for Patients With Type 2 Diabetes and Cardiovascular Disease or Obesity: Utilization in an Era of Accumulating Evidence

This study was an analysis of a national sample of U.S. medical office visits from 2014 to 2016, a period when evidence of effectiveness was emerging for a variety of beneficial type 2 diabetes agents with regard to potential reduction in diabetes comorbidities. Ideal therapy was defined as an American Diabetes Association–identified beneficial agent plus metformin. The associations between atherosclerotic cardiovascular disease or obesity and use of these agents were explored.




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Prediagnostic Circulating Levels of Sex Steroid Hormones and SHBG in Relation to Risk of Ductal Carcinoma In Situ of the Breast among UK Women

Background:

Sex steroid hormones and sex hormone–binding globulin (SHBG) have been implicated in the etiology of invasive breast cancer, but their associations with risk of the precursor lesion, ductal carcinoma in situ (DCIS) of the breast, remain unclear.

Methods:

We used Cox proportional hazards regression models to estimate the associations of serum levels of estradiol (premenopausal women only), testosterone, and/or SHBG with DCIS risk among 182,935 women. After a median follow-up of 7.1 years, 186 and 531 DCIS cases were ascertained in premenopausal and postmenopausal women, respectively.

Results:

Total and free estradiol were positively associated with risk of DCIS among premenopausal women. The HRs for the highest versus the lowest tertiles were 1.54 (1.06–2.23) and 1.72 [95% confidence interval (CI), 1.15–2.57], respectively. Among postmenopausal women, elevated levels of free testosterone (FT), and to a lesser extent, total testosterone, were positively associated with DCIS risk. The HRs for the highest versus the lowest quartiles were 1.42 (95% CI, 1.09–1.85) and 1.16 (95% CI, 0.91–1.48), respectively. Serum SHBG levels were inversely associated with risk of DCIS among postmenopausal women (HRq4 vs. q1: 0.75; 95% CI, 0.56–0.99).

Conclusions:

This study suggests that elevated levels of estradiol are associated with increased risk of DCIS among premenopausal women, and that among postmenopausal women, elevated levels of testosterone, and particularly those of FT, are associated with increased DCIS risk, while elevated levels of SHBG are associated with reduced risk.

Impact:

These findings may be helpful in developing prevention strategies aimed at reducing breast cancer risk among premenopausal and postmenopausal women.




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Genetic and Circulating Biomarker Data Improve Risk Prediction for Pancreatic Cancer in the General Population

Background:

Pancreatic cancer is the third leading cause of cancer death in the United States, and 80% of patients present with advanced, incurable disease. Risk markers for pancreatic cancer have been characterized, but combined models are not used clinically to identify individuals at high risk for the disease.

Methods:

Within a nested case–control study of 500 pancreatic cancer cases diagnosed after blood collection and 1,091 matched controls enrolled in four U.S. prospective cohorts, we characterized absolute risk models that included clinical factors (e.g., body mass index, history of diabetes), germline genetic polymorphisms, and circulating biomarkers.

Results:

Model discrimination showed an area under ROC curve of 0.62 via cross-validation. Our final integrated model identified 3.7% of men and 2.6% of women who had at least 3 times greater than average risk in the ensuing 10 years. Individuals within the top risk percentile had a 4% risk of developing pancreatic cancer by age 80 years and 2% 10-year risk at age 70 years.

Conclusions:

Risk models that include established clinical, genetic, and circulating factors improved disease discrimination over models using clinical factors alone.

Impact:

Absolute risk models for pancreatic cancer may help identify individuals in the general population appropriate for disease interception.




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Circulating Biomarker Score for Visceral Fat and Risks of Incident Colorectal and Postmenopausal Breast Cancer: The Multiethnic Cohort Adiposity Phenotype Study

Background:

Visceral adipose tissue (VAT) may play a greater role than subcutaneous fat in increasing cancer risk but is poorly estimated in epidemiologic studies.

Methods:

We developed a VAT prediction score by regression equations averaged across 100 least absolute shrinkage and selection operator models in a cross-sectional study of 1,801 older adults in the Multiethnic Cohort (MEC). The score was then used as proxy for VAT in case–control studies of postmenopausal breast (950 case–control pairs) and colorectal (831 case–control pairs) cancer in an independent sample in MEC. Abdominal MRI–derived VAT; circulating biomarkers of metabolic, hormonal, and inflammation dysfunctions; and ORs for incident cancer adjusted for BMI and other risk factors were assessed.

Results:

The final score, composed of nine biomarkers, BMI, and height, explained 11% and 15% more of the variance in VAT than BMI alone in men and women, respectively. The area under the receiver operator curve for VAT >150 cm2 was 0.90 in men and 0.86 in women. The VAT score was associated with risk of breast cancer [OR (95% confidence interval [CI]) by increasing tertiles: 1.00, 1.09 (0.86–1.39), 1.48 (1.16–1.89); Ptrend = 0.002] but not with colorectal cancer (P = 0.84), although an association [1.00, 0.98 (0.68–1.39), 1.24 (0.88–1.76); Ptrend = 0.08] was suggested for this cancer after excluding cases that occurred within 7 years of blood draw (Pheterogeneity = 0.06).

Conclusions:

The VAT score predicted risks of postmenopausal breast cancer and can be used for risk assessment in diverse populations.

Impact:

These findings provide specific evidence for a role of VAT in breast cancer.




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Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer Is Associated with Indigenous American Ancestry in Latin American Women

Women of Latin American origin in the United States are more likely to be diagnosed with advanced breast cancer and have a higher risk of mortality than non-Hispanic White women. Studies in U.S. Latinas and Latin American women have reported a high incidence of HER2 positive (+) tumors; however, the factors contributing to this observation are unknown. Genome-wide genotype data for 1,312 patients from the Peruvian Genetics and Genomics of Breast Cancer Study (PEGEN-BC) were used to estimate genetic ancestry. We tested the association between HER2 status and genetic ancestry using logistic and multinomial logistic regression models. Findings were replicated in 616 samples from Mexico and Colombia. Average Indigenous American (IA) ancestry differed by subtype. In multivariate models, the odds of having an HER2+ tumor increased by a factor of 1.20 with every 10% increase in IA ancestry proportion (95% CI, 1.07–1.35; P = 0.001). The association between HER2 status and IA ancestry was independently replicated in samples from Mexico and Colombia. Results suggest that the high prevalence of HER2+ tumors in Latinas could be due in part to the presence of population-specific genetic variant(s) affecting HER2 expression in breast cancer.Significance:The positive association between Indigenous American genetic ancestry and HER2+ breast cancer suggests that the high incidence of HER2+ subtypes in Latinas might be due to population and subtype-specific genetic risk variants.




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Circulating Immune Cell Composition and Cancer Risk: A Prospective Study Using Epigenetic Cell Count Measures

Although ample evidence indicates that immune cell homeostasis is an important prognostic outcome determinant in patients with cancer, few studies have examined whether it also determines cancer risk among initially healthy individuals. We performed a case–cohort study including incident cases of breast (n = 207), colorectal (n = 111), lung (n = 70), and prostate (n = 201) cancer as well as a subcohort (n = 465) within the European Prospective Investigation into Cancer and Nutrition-Heidelberg cohort. Relative counts of neutrophils, monocytes, and lymphocyte sublineages were measured by qRT-PCR. HRs and 95% confidence intervals were used to measure the associations between relative counts of immune cell and cancer risks. When relative counts of immune cell types were taken individually, a significant positive association was observed between relative counts of FOXP3+ regulatory T cells (Tregs) and lung cancer risk, and significant inverse associations were observed between relative CD8+ counts and risks of lung and breast cancer (overall and ER+ subtype). Multivariable models with mutual adjustments across immune markers showed further significant positive associations between higher relative FOXP3+ T-cell counts and increased risks of colorectal and breast cancer (overall and ER− subtype). No associations were found between immune cell composition and prostate cancer risk. These results affirm the relevance of elevated FOXP3+ Tregs and lower levels of cytotoxic (CD8+) T cells as risk factors for tumor development.Significance:This epidemiologic study supports a role for both regulatory and cytotoxic T cells in determining cancer risk among healthy individuals.See related commentary by Song and Tworoger, p. 1801




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[PERSPECTIVES] Regulating Preimplantation Genetic Testing across the World: A Comparison of International Policy and Ethical Perspectives

Preimplantation genetic testing (PGT) is a reproductive technology that, in the course of in vitro fertilization (IVF), allows prospective parents to select their future offspring based on genetic characteristics. PGT could be seen as an exercise of reproductive liberty, thus potentially raising significant socioethical and legal controversy. In this review, we examine—from a comparative perspective—variations in policy approaches to the regulation of PGT. We draw on a sample of 19 countries (Australia, Austria, Belgium, Brazil, Canada, China, France, Germany, India, Israel, Italy, Japan, Mexico, Netherlands, Singapore, South Korea, Switzerland, United Kingdom, and the United States) to provide a global landscape of the spectrum of policy and legislative approaches (e.g., restrictive to permissive, public vs. private models). We also explore central socioethical and policy issues and contentious applications, including permissibility criteria (e.g., medical necessity), nonmedical sex selection, and reproductive tourism. Finally, we further outline genetic counseling requirements across policy approaches.




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Isolating finds himself on a haunted night-drive in ‘But Please’

Found footage from many hours of trawling through night-drive ghost sighting videos on YouTube while on lockdown. The Golden Filter’s Stephen Hindman takes us on a haunted night-drive in the video for ‘But Please’, a new track released under his Isolating alias. ‘But Please’ appears on his new EP for Optimo Music Digital Danceforce, System. […]

The post Isolating finds himself on a haunted night-drive in ‘But Please’ appeared first on FACT Magazine.




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US Surgeon General Jerome Adams defends drug and drinking coronavirus advice to black and Latino people

Follow our live coronavirus updates HERE Coronavirus: the symptoms




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Food For London Now donations reach £3m but warning remains of escalating hunger crisis

Barclays donates £250,000 to help our appeal to tackle hunger in virus crisis But demand grows amid growing reports one in five at risk of food poverty You can donate here virginmoneygiving.com/fund/FoodforLondonNOW





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What Would A Sharp Decline In Remittances Mean For Latin America

Immigrants in the U.S. sent an estimated $150 billion to their home countries in 2019 — half to Latin America and the Caribbean. The World Bank is predicting a sharp decline in remittances this year.




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Amid coronavirus fears, people download epidemic-simulating video game Plague Inc.

Plague Inc. is an app and online game in which users play the role of a disease set on infecting the world with a pathogen.

      




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The 15 best podcasts to listen to while you&apos;re self-isolating

From the intricate storytelling of online culture podcast 'Reply All' to the relaxed gossip of reality star Gemma Collins, Annie Lord ranks the best podcasts to listen to while in quarantine




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Good Morning Britain viewers question why Susanna Reid isn&apos;t self-isolating after Piers Morgan coronavirus test

Morgan announced he'd be taking a leave of absence from the show until he receives the results of a Covid-19 test




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The Race Across the World contestants&apos; guide to visiting Latin America

They travelled the length of Central and South America for the BBC's Race Across the World, so who better to ask for travel tips?




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Jose Mourinho self-isolating with three Tottenham coaches in rented house

EXCLUSIVE




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Black and Latino New Yorkers get vast majority of social distancing summonses




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NYPD Caught Punching Man For Violating Social Distance Order



The enforcement was meant to protect from coronavirus spread




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COVID-19 losses just the start of Westpac's woes amid escalating money laundering, tax problems

Westpac joins ANZ in deferring its interim dividend as it braces for the financial impact of COVID-19, but mounting issues around money laundering and tax reporting may cost it almost as much.




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Roger Federer gives social media tennis lesson while self-isolating during coronavirus pandemic

Professional tennis is on hold because of the coronavirus pandemic, but that does not stop 20-time major singles champion Roger Federer reaching out to his legion of fans with a bit of friendly advice on how to improve their game while stuck at home.




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TS health dept contemplating to home deliver medicines to patients suffering from chronic diseases




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Comets Prevent Ether from Accumulating in Space

Originally published in January 1859

-- Read more on ScientificAmerican.com




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Chicago Police Officer Pleads Guilty to Violating Federal Civil Rights of a Man Beaten While Restrained in a Wheelchair

A Chicago police officer pleaded guilty today to violating the federal civil rights of a man whom the officer struck repeatedly with a dangerous weapon while the man was handcuffed and shackled in a wheelchair.



  • OPA Press Releases

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United States Files Complaint Against Forest Laboratories for Allegedly Violating the False Claims Act

A complaint was unsealed today in U.S. District Court in Massachusetts against a New York pharmaceutical company for alleged False Claims Act violations arising from the company’s marketing the drugs Celexa and Lexapro for unapproved pediatric use and for paying kickbacks to induce physicians to prescribe the drugs.



  • OPA Press Releases

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Wyoming Highway Patrol Trooper Arrested for Violating Civil Rights by Kidnapping

Agents with the FBI, Immigration and Customs Enforcement and the Wyoming Department of Criminal Justice arrested Wyoming Highway Patrol Trooper Franklin Joseph Ryle late yesterday in Douglas, Wyo., on criminal civil rights charges.



  • OPA Press Releases

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Latin Node Inc., Pleads Guilty to Foreign Corrupt Practices Act Violation and Agrees to Pay $2 Million Criminal Fine

Latin Node Inc. (Latinode), a privately held Florida corporation, pleaded guilty today to violating the Foreign Corrupt Practices Act (FCPA) in connection with improper payments in Honduras and Yemen. At a hearing before U.S. District Judge Paul Courtney Huck in the Southern District of Florida, Latinode pleaded guilty to a one-count information charging a criminal violation of the FCPA’s anti-bribery provisions.



  • OPA Press Releases

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Eight “Almighty Latin King and Queen Nation” Gang Members Plead Guilty to Drug Conspiracy and Related Charges

Eight members of the violent gang known as the "Almighty Latin King and Queen Nation" (ALKQN) have pleaded guilty to a variety of charges, including drug conspiracy and weapons trafficking.



  • OPA Press Releases

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Chicago Police Officer Sentenced for Violating Federal Civil Rights of a Man Beaten While Restrained in a Wheelchair

William Cozzi, a Chicago police officer, was sentenced today to 40 months in federal prison for violating the federal civil rights of a man whom the officer struck repeatedly with a dangerous weapon while the man was handcuffed and shackled in a wheelchair.



  • OPA Press Releases