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Breast cancer-induced angiogenesis: multiple mechanisms and the role of the microenvironment
Nancy Boudreau, Connie Myers
Breast Cancer Research , 2003, DOI: 10.1186/bcr589
Abstract: Like most solid tumors, breast cancers require new blood vessel growth (neovascularization) if they are to grow beyond a few millimeters in diameter [1]. The new vessels not only help to meet the growing metabolic demands of the tumor by supplying additional nutrients, but also provide potential routes for tumor dissemination and metastasis.In breast cancers, tumor-induced angiogenesis is first evident at the pre-invasive stage of high-grade ductal carcinoma in situ. In this instance, a characteristic rim of microvessels is formed around the ducts that are filled with proliferating epithelial cells [2]. As the tumor continues to progress, so does the degree of neovascularization. Not surprisingly, poor breast cancer prognosis has been shown to correlate with increasing microvascular density or production and with factors that stimulate new vessel growth [3,4]. Accordingly, an extensive body of research has focused on identifying the factors in the tumor microenvironment that promote and support angiogenesis, with the hope of limiting neovascularization and ultimately tumor growth and metastasis. Moreover, anti-angiogenic therapy is particularly attractive, because, unlike the tumor cells, which are genetically unstable and can rapidly acquire resistance to many therapeutic agents, the normal vascular endothelium does not harbor mutations that would facilitate acquisition of drug resistance. Both strands of research are reviewed in this article.In normal, quiescent capillaries, the endothelial cells are in contact with a laminin-rich basement membrane and a 1- to 2-cell-thick layer of supporting pericytes. During angiogenesis, the connections between the adjacent pericytes must be weakened and the surrounding basement membrane must be degraded. Endothelial cells re-enter the cell cycle and invade the surrounding stromal matrix; this invasion is facilitated by the integrin adhesion receptors [5]. The endothelial cells begin to resynthesize a basement membrane, which p
A Cross-Sectional Study: Chest Tube Drainage Practice Patterns among Canadian Thoracic Surgeons Following Pulmonary Surgery  [PDF]
Samarpita Das, Kyle Grant, Connie Drewbrook, Dorsa Mousadoust, Renelle Myers, Basil Nasir, John Yee, Anna McGuire
Open Journal of Thoracic Surgery (OJTS) , 2017, DOI: 10.4236/ojts.2017.71003
Abstract: Background: High chest tube drainage following lung surgery is a rate-limiting step to discharge, increasing length of hospital stay. There is a paucity of evidence-based clinical research on safe maximal daily chest tube drainage prior to removal. Objectives: To describe the practice patterns of Canadian thoracic surgeons with respect to daily chest tube drainage after routine pulmonary surgery. Methods: A self-reported electronic questionnaire was administered to members of the Canadian Association of Thoracic Surgeons (CATS). Data was tabulated on the primary outcome of acceptable maximal daily pleural output prior to chest tube removal, and secondary outcomes of: years in clinical practice, academic versus community setting and rational for chest tube management. Descriptive and univariate analysis was conducted for each response by maximal daily pleural drainage category. Results: A total of 124 surveys were distributed. Response rate was 56%, with a 93% completion rate. Acceptable maximal pleural drainage among surgeons was highly variable. Rationale for tube removal was also variable, including individual clinical experiences (n = 23, 33%), evidence based guidelines (n = 18, 26%), and group practice pattern (n = 12, 17%). Academic surgeons comprised 72% of respondents. Community based surgeons were more likely to remove tubes at a lower mean volume. Years in clinical practice did not influence acceptable daily pleural drainage. Conclusion: There is great variability in post-operative management of chest tube fluid output among Canadian thoracic surgeons. Future research on this topic is warranted, with the aim of developing an evidence-based chest tube management algorithm incorporating daily chest tube drainage volumes as a key variable.
Evaluation of normalization methods for cDNA microarray data by k-NN classification
Wei Wu, Eric P Xing, Connie Myers, I Saira Mian, Mina J Bissell
BMC Bioinformatics , 2005, DOI: 10.1186/1471-2105-6-191
Abstract: Ten location normalization methods that adjust spatial- and/or intensity-dependent dye biases, and three scale methods that adjust scale differences were applied, individually and in combination, to five distinct, published, cancer biology-related cDNA microarray data sets. Leave-one-out cross-validation (LOOCV) classification error was employed as the quantitative end-point for assessing the effectiveness of a normalization method. In particular, a known classifier, k-nearest neighbor (k-NN), was estimated from data normalized using a given technique, and the LOOCV error rate of the ensuing model was computed. We found that k-NN classifiers are sensitive to dye biases in the data. Using NONRM and GMEDIAN as baseline methods, our results show that single-bias-removal techniques which remove either spatial-dependent dye bias (referred later as spatial effect) or intensity-dependent dye bias (referred later as intensity effect) moderately reduce LOOCV classification errors; whereas double-bias-removal techniques which remove both spatial- and intensity effect reduce LOOCV classification errors even further. Of the 41 different strategies examined, three two-step processes, IGLOESS-SLFILTERW7, ISTSPLINE-SLLOESS and IGLOESS-SLLOESS, all of which removed intensity effect globally and spatial effect locally, appear to reduce LOOCV classification errors most consistently and effectively across all data sets. We also found that the investigated scale normalization methods do not reduce LOOCV classification error.Using LOOCV error of k-NNs as the evaluation criterion, three double-bias-removal normalization strategies, IGLOESS-SLFILTERW7, ISTSPLINE-SLLOESS and IGLOESS-SLLOESS, outperform other strategies for removing spatial effect, intensity effect and scale differences from cDNA microarray data. The apparent sensitivity of k-NN LOOCV classification error to dye biases suggests that this criterion provides an informative measure for evaluating normalization methods. All the
The Cis-regulatory Logic of the Mammalian Photoreceptor Transcriptional Network
Timothy H.-C. Hsiau, Claudiu Diaconu, Connie A. Myers, Jongwoo Lee, Constance L. Cepko, Joseph C. Corbo
PLOS ONE , 2007, DOI: 10.1371/journal.pone.0000643
Abstract: The photoreceptor cells of the retina are subject to a greater number of genetic diseases than any other cell type in the human body. The majority of more than 120 cloned human blindness genes are highly expressed in photoreceptors. In order to establish an integrative framework in which to understand these diseases, we have undertaken an experimental and computational analysis of the network controlled by the mammalian photoreceptor transcription factors, Crx, Nrl, and Nr2e3. Using microarray and in situ hybridization datasets we have produced a model of this network which contains over 600 genes, including numerous retinal disease loci as well as previously uncharacterized photoreceptor transcription factors. To elucidate the connectivity of this network, we devised a computational algorithm to identify the photoreceptor-specific cis-regulatory elements (CREs) mediating the interactions between these transcription factors and their target genes. In vivo validation of our computational predictions resulted in the discovery of 19 novel photoreceptor-specific CREs near retinal disease genes. Examination of these CREs permitted the definition of a simple cis-regulatory grammar rule associated with high-level expression. To test the generality of this rule, we used an expanded form of it as a selection filter to evolve photoreceptor CREs from random DNA sequences in silico. When fused to fluorescent reporters, these evolved CREs drove strong, photoreceptor-specific expression in vivo. This study represents the first systematic identification and in vivo validation of CREs in a mammalian neuronal cell type and lays the groundwork for a systems biology of photoreceptor transcriptional regulation.
The Hole in Holistic Patient Care  [PDF]
Connie Drury, Jennifer Hunter
Open Journal of Nursing (OJN) , 2016, DOI: 10.4236/ojn.2016.69078
Abstract: Throughout its history, the nursing profession has claimed to provide holistic patient care, which is defined as bio-psycho-socio-spiritual care. Today, however, many nurses do not feel comfortable with the “spiritual” element of care and are uncertain about their professional role in the assessment and delivery of spiritual care. Discomfort and avoidance of attending to the spiritual needs of human beings creates “a hole” in holistic patient care. Contributing factors to the “hole in holistic patient care” include: 1) blurring of boundaries in the language and definitions of “spirituality” and “religion”, 2) insufficient attention to definitions of spirituality and spiritual distress; 3) confusion and role conflict with professional identity among disciplines related to responsibility for spiritual care; 4) insufficient education and skill development for nurses and other healthcare professionals in the assessment, intervention and appropriate referral of patients experiencing spiritual distress. The purpose of this article is to explore the history of holistic nursing as it pertains to the human dimension of spirituality and conclude with practice models for spiritual assessment and spiritual care that can “fill” the hole in holistic nursing care.
Medical Ethics: Context Is the Key Word  [PDF]
John Myers
International Journal of Clinical Medicine (IJCM) , 2014, DOI: 10.4236/ijcm.2014.516134

Medical Ethics is no different to Ethics, but relates specifically to the doctor-patient relationship. This relationship is based on mutual trusttrust in the doctor’s expertise and knowledge and trust that the patient is consulting the doctor, for his/her/their own health, wellbeing and welfare, without agenda or bias. In other words, the basis of the doctor-patient relationship is one of mutual trust and confidence. Thus, what is imparted between them is held in the strictest confidence. The doctor must act within the law. No third party influence can be brought to bear on this relationship without the patient’s consent. In the case of minors the relationship is between the child’s guardians as well as the doctor who must act within the law. In the category of “elderly” or adult guardianship or advocacy, those appointed and in positions of trust must take the person’s wishes into account if the patient has capacity to make decisions or has indicated their wish prior to any such appointment. Capacity is defined as consistent belief or wish, awareness of what one does not wish for, satisfaction when wishes are respected and fulfilled and the opposite when they are not. Ethical practice is determined by taking context into account in decision-making and ensuring the sanctity of the patient’s rights and wishes. Abuse is just the opposite, where actions taken or not taken are against a person’s wishes. Personal wish determines best interest. Best interest may also be defined in terms of social functioning and psychological wellbeing. Discussion of ethics in terms of General Systems Theory is also addressed, and affects an action on the environment or others, i.e. ethics in the wider medical context may pertain if the person has a contagious disease and a period of quarantine or “isolation” or barrier” nursing is required, and where precedent is given to society’s best interest over the person’s wishes, as part of an educational process and as required for strategic disease management.

A General Framework For Determining the Temporal and Evolutionary Dynamics of Religion-Based Website Popularity on the Internet  [PDF]
Michael R. Golinski, Connie Petersen
Open Journal of Statistics (OJS) , 2012, DOI: 10.4236/ojs.2012.24052
Abstract: Religion-based websites are fast becoming a major pipeline for disseminating religious information to broad populations of individuals in the United States.Both mainstream religions and fringe religions are easily accessible to a large population of internet users. The purpose of this review is to develop and examine a general framework that uses simple mathematical and statistical models to interpret and measure temporal ‘snap shots’ in the popularity of religious websites. We extend this framework to include an evolutionary model that has the potential to predict long-term shifts or changes in the popularity of religious websites over time. Ultimately, the goal of this review is to introduce a new modeling framework for research into how the internet is changing the accessibility and views of populations of individuals who follow various religions on the internet and how this may in-turn affect the distribution of religion in the ‘real world’.
Connie Susilawati
Civil Engineering Dimension , 2005,
Abstract: The opening of free market in 2003, leads into the stridently escalating business competition both in domestic and global market. The company, therefore, is trying to win the competition by obtaining ISO 9000 certification which can be applied in the construction business. The purpose of the research is to investigate the reason, the obstacles, the gap between expectation and reality of using ISO 9000, as well as the main priority to be implemented in the company. This research uses survey on contractor companies in Surabaya and Gresik which has implemented ISO 9000. The statistical results show that the main reason to implement ISO 9000 is to increase consistency and to improve its quality. Meanwhile, the main obstacle is time constraint to complete the implementation. Companies still need to increase customer satisfaction and attend on customer focus principle to increase the quality of their outcomes. Abstract in Bahasa Indonesia : Akibat terbukanya perdagangan bebas di tahun 2003, persaingan bisnis makin meningkat tajam baik di pasar domestik (nasional) maupun global (internasional). Salah satu upaya perusahaan untuk memenangkan persaingan dengan peningkatan mutu produk atau jasa adalah mendapatkan sertifikasi ISO 9000 yang dapat diterapkan juga dalam bisnis konstruksi. Adapun tujuan penelitian ini untuk mengetahui alasan, hambatan, perbedaaan antara harapan dan realita, dan prioritas utama ISO 9000 yang harus diterapkan oleh perusahaan. Penelitian ini menggunakan survei terhadap perusahaan-perusahaan kontraktor di Surabaya dan Gresik yang sudah menerapkan ISO 9000. Hasil analisa statistik menunjukkan bahwa perusahaan menerapkan ISO 9000 terutama agar mencapai konsistensi dalam pelaksanaan dan memperbaiki mutu. Sedangkan hambatan terbesar yaitu waktu yang diperlukan untuk melengkapi penerapan. Perusahaan-perusahaan kontraktor tersebut masih perlu meningkatkan kepuasan pelanggan dan menerapkan prinsip fokus pelanggan sebagai prioritas utama untuk meningkatkan mutu perusahaan.
Connie Susilawati
Civil Engineering Dimension , 2001,
Abstract: Dormitory is a very important facility which have to be provided by a university. A survey to Petra Christian University’s students has been conducted to understand the required facilities and their financial ability. Linear programming has been used to calculate number of rooms and area of each facility which could satisfy the constraints and to obtain optimum profit. Number of bedrooms, number of bathrooms, and area of each facility, such as: living room, dining room, common room, cafeteria, book shop, mini market, phone booths, sport facilities, and parking space are recommended. Since the investment is financially feasible, the dormitory could be built in the future.
Connie Susilawati
Civil Engineering Dimension , 2002,
Abstract: Petra Christian University plans to build a Student Center, which functions as a place for students to gather in an informal meeting, a place for student activities, and a place with social and cultural facilities for students, but still fit with the purpose of the university. To prepare a more suitable plan for the students as the main users, their voices should be considered. A survey to 1087 students has been done to gather their voices. This study evaluates level of need and level of importance of the room that will be provided in the Student Centre. The level of satisfaction of the existing facilities’ size has been evaluated to the student guild. This study has recommended rooms under seven categories which have to be provided, such as: rooms for student union, academic support, administration, social, religious rooms, commercial room and some complementary rooms Abstract in Bahasa Indonesia : Universitas Kristen Petra merencanakan untuk mendirikan Student Center yang merupakan tempat berkumpulnya mahasiswa dan sivitas akademika dalam pertemuan informal, tempat aktivitas mahasiswa dan tempat yang menyediakan fasilitas rekreasi, sosial, dan kultural sesuai dengan dasar dan tujuan universitas. Agar perencanaanya lebih sesuai dengan kebutuhan pengguna utamanya, yaitu mahasiswa, maka pendapat mereka perlu menjadi bahan pertimbangan. Untuk mengetahui pendapat mahasiswa telah dilakukan survey kepada 1087 responden mahasiswa aktifis dan non aktifis. Studi ini menilai tingkat kebutuhan dan tingkat kepentingan dari ruangan yang akan disediakan di dalam Student Center tersebut. Mengingat sebagian ruangan-ruangan tersebut sudah ada, maka dilakukan juga evaluasi kepuasan pengguna ruangan terhadap luas ruangan yang diwakili oleh aktivis mahasiswa. Hasil akhir dari penelitian ini adalah rekomendasi ruangan yang perlu disediakan dapat dikategorikan sebagai ruangan untuk organisasi mahasiswa, ruang penunjang akademik, ruang spriritual, ruang administrasi, ruang sosial dan dilengkapi dengan beberapa ruang komersial serta ruang pelengkap.
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