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Personalized Medicine and Neurosurgery

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889453368 Year: Pages: 133 DOI: 10.3389/978-2-88945-336-8 Language: English
Publisher: Frontiers Media SA
Subject: Medicine (General) --- Surgery
Added to DOAB on : 2018-02-27 16:16:45
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The Precision Medicine Initiative, which was instituted by President Barack Obama on January 20, 2015, highlighted the importance that advances in genomics and related “-omic” approaches have made to science and medicine, and it set the stage for their federally funded and mandated integration into the delivery of health care. Whether these advances comprise large-scale approaches, such as The Cancer Genome Atlas, which provides a modern classification of cancers based on molecular profiles, or genealogy initiatives, which seek to trace the movement of our early ancestors out of Africa, genomic technology has taken us closer to developing targeted therapies and a refined understanding of our evolutionary journey. It is against this backdrop that we summarized some of the recent advances in the field of precision medicine, or personalized medicine, as they pertain to neurosurgery. In this e-Book collection provided by Frontiers in Surgery: Neurosurgery, we present a collection of articles by leaders in the field of neurosurgery that highlight domains using a personalized approach for the treatment of patients or avenues when personalization is possible and when it will likely alter the care of patients with neurological diseases.

Drug-Diagnostics Co-Development in Oncology

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889193325 Year: Pages: 111 DOI: 10.3389/978-2-88919-332-5 Language: English
Publisher: Frontiers Media SA
Subject: Oncology --- Medicine (General) --- Therapeutics --- Science (General)
Added to DOAB on : 2016-03-10 08:14:32
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The idea of combining drugs and diagnostics in oncology is not new. When the selective estrogen receptor modulator tamoxifen was developed in the 1970’s for the treatment of breast cancer a positive correlation between receptor status and treatment outcome was found. As a result of this research, it was suggested to use the estrogen-receptor assay as a diagnostic test for selection of patients for tamoxifen treatment. Despite this suggestion was put forward nearly 40 years ago the adaptation of the drug-diagnostic co-development model has been relatively slow and it is only within the last decade that it has gained more widespread acceptance. The parallel development of the monoclonal antibody trastuzumab (Herceptin®, Roche/Genentech) and the immunohistochemistry assay for HER2 protein overexpression (HercepTest™, Dako) seems to have served as an inspiration to a number of stakeholders such as pharma and diagnostic companies, regulatory agencies, and academia. In recent years we have seen an increasing number of oncology drug development projects that have taken advantage of the drug-diagnostic co-development model, as outline below. Most of the new targeted anti-cancer drugs that have been introduced in recent years, such as BRAF-, ALK-, EGFR- and HER2-inhibitors, are more or less all a product of the drugdiagnostic co-development model. These drugs have shown remarkable high response rates in selected groups of patients within cancer diseases with great unmet medical needs. This Research Topic on Drug-Diagnostic Co-Development in Oncology aims to provide you with an insight into some of the diverse activities that constitute this new research area.

The Impact of Systems Medicine on Human Health and Disease

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889451401 Year: Pages: 96 DOI: 10.3389/978-2-88945-140-1 Language: English
Publisher: Frontiers Media SA
Subject: Physiology --- Neurology --- Science (General)
Added to DOAB on : 2017-07-06 13:27:36
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Complex diseases including diabetes, neurological disorders and cancer are results from a combination of genetic, environmental and lifestyle factors, and development of new prognostic tools for the treatment of such diseases requires a deep understanding of the mechanisms underlying cell functions. With the advances in high throughput technologies, biological components of cells can be measured with a very high resolution and these data can be used for investigating whole systems properties using a network-based approach. Systems medicine provides an integrative platform for studying the interactions between the biological components of the cell using a holistic approach and generating mechanistic explanations for the emergent systems properties. This inter-disciplinary field of study allows for understanding biological processes of cells in health and disease states, gaining new insights into what drives the appearance of the disease and finally identifying proteins and metabolites implicated in human disease. Systems medicine utilizes mathematical approaches to generate models which can be employed for designing new sets of experiments and for mapping the response of the system to perturbations quantitatively. These models, as well as the developed tools, can accelerate the emergence of personalized medicine which can transform the practice of medicine and offer better targets for drug development with minimum side effects. In this Research Topic, we aim to review the recently developed tools for modeling the cell behavior in normal and pathological states, recent advances and findings which increase our understanding of the molecular mechanisms involved in the progression of the diseases.

Machine Learning With Radiation Oncology Big Data

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889457304 Year: Pages: 146 DOI: 10.3389/978-2-88945-730-4 Language: English
Publisher: Frontiers Media SA
Subject: Medicine (General) --- Oncology
Added to DOAB on : 2019-01-23 14:53:43
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Radiation oncology is uniquely positioned to harness the power of big data as vast amounts of data are generated at an unprecedented pace for individual patients in imaging studies and radiation treatments worldwide. The big data encountered in the radiotherapy clinic may include patient demographics stored in the electronic medical record (EMR) systems, plan settings and dose volumetric information of the tumors and normal tissues generated by treatment planning systems (TPS), anatomical and functional information from diagnostic and therapeutic imaging modalities (e.g., CT, PET, MRI and kVCBCT) stored in picture archiving and communication systems (PACS), as well as the genomics, proteomics and metabolomics information derived from blood and tissue specimens. Yet, the great potential of big data in radiation oncology has not been fully exploited for the benefits of cancer patients due to a variety of technical hurdles and hardware limitations.With recent development in computer technology, there have been increasing and promising applications of machine learning algorithms involving the big data in radiation oncology. This research topic is intended to present novel technological breakthroughs and state-of-the-art developments in machine learning and data mining in radiation oncology in recent years.

Prenatal Beginnings for Better Health

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889455096 Year: Pages: 107 DOI: 10.3389/978-2-88945-509-6 Language: English
Publisher: Frontiers Media SA
Subject: Science (General) --- Therapeutics --- Medicine (General) --- Pediatrics
Added to DOAB on : 2019-01-23 14:53:42
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Pregnancy has significant short- and long-term health impacts for mother and child, which may lead to pediatric- and adult-onset diseases. Understanding these gestational origins of disease and currently existing platforms for prenatal care has resulted in significant advances to detect and prevent adverse maternal and fetal outcomes. Existing and emerging prenatal interventions that are instituted at critical times in gestation take advantage of unique therapeutic windows and provide an opportunity to modify the risks. This research topic encompasses a variety of approaches and interventions, such as maternal screening for fetal disease, advanced fetal imaging, biomarker development, stem cell or gene therapies, and others.

Homeostasis and Allostasis of Thyroid Function

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889455706 Year: Pages: 107 DOI: 10.3389/978-2-88945-570-6 Language: English
Publisher: Frontiers Media SA
Subject: Medicine (General) --- Internal medicine
Added to DOAB on : 2019-01-23 14:53:43
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The discovery of the negative feedback of thyroid hormones on pituitary thyroid-stimulating hormone (TSH) secretion, a classical endocrine feedback control system, has shaped diagnosis and treatment of thyroid disease for the last decades. Based on this concept, a unique diagnostic category of subclinical thyroid disorders was introduced, being defined exclusively by an abnormal TSH response in the presence of thyroid hormone concentrations within the reference range. Although this approach was able to deliver a conceptually straightforward disease definition problems surfaced in clinical practice as neither the diagnostic reference range nor the appropriate threshold for initiating substitution treatment are universally agreed upon for subclinical thyroid disorders. The situation is further aggravated by the so-called syndrome T, which comprises a substantial but heterogeneous group of L-T4 treated patients with hypothyroidism with reduced quality of life despite “normal” TSH values.

A limited understanding of the physiological relationships between TSH and thyroid hormones may be a main reason for clinical difficulties in dealing with the causes of syndrome T and tailoring substitution therapy for hypothyroid patients with subclinical thyroid disorders.

Feedback regulation has recently been shown to be much more complex than previously assumed. The concept of homeostatic control has also been extended to include the lesser known but equally important allostatic thyroid regulation.The latter aims at adaptive homeostasis or stability through changing setpoints and modulating structural parameters of feedback control, as may be appropriate to adapt to a vast array of conditions spanning from fetal life, aging, pregnancy, exercise, starvation, obesity, psychiatric disorders to the severe non-thyroidal illness syndrome.

A better understanding of homeostatic and allostatic mechanisms, which govern the behaviour of pituitary-thyroid feedback control, is on the horizon. This promises to improve the diagnostic utility of laboratory methods, laying the foundation for personalised methods to optimise dosage and modality of substitution therapy. The emerging new world of thyroid physiology is reflected on the side of clinical medicine in a new, relational paradigm for diagnosis and treatment.

Considerable progress has been made in this respect in the following key areas:

• the significance of complementary information processing structures within the feedback loop, in particular ultrashort feedback of TSH on its own secretion and the action of a TSH-T3 shunt unburdening the thyroid from T4 synthesis in imminent thyroid failure,

• the unravelling of spatio-temporal dynamics of hormone concentrations ranging from ultradian to circannual rhythms and including hysteresis effects,

• the emergence of “non-canonical” mechanisms of thyroid hormone signalling beyond transcriptional control of gene expression,

• the physiological actions of thyronine metabolites, which have been previously regarded as biologically inactive, such as thyronamines and iodothyroacetates,

• the characterisation of distinct patterns in the adaptive processes to stress and strain and their conclusive explanation through reactions to type 1 and type 2 allostatic load.

This collective volume contains the contributions to the Research Topic “Homeostasis and Allostasis of Thyroid Function”, which was originally published by the journal Frontiers in Endocrinology. Authored by an international team of experts from three continents ,the book provides a comprehensive overview on thyroid control from recent research in basic, computational and clinical thyroidology. Many aspects addressed here can be expected to stimulate future research. A more comprehensive view and better integration of in-vitro, in-silico and in-vivo investigations will be invaluable in paving the way to this new world of thyroidology.

Systems Biology Approaches to Understanding the Cause and Treatment of Heart, Lung, Blood, and Sleep Disorders

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889192496 Year: Pages: 180 DOI: 10.3389/978-2-88919-249-6 Language: English
Publisher: Frontiers Media SA
Subject: Biotechnology --- General and Civil Engineering --- Physiology --- Science (General)
Added to DOAB on : 2015-11-16 15:44:59
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Development of powerful new high- throughput technologies for probing the transcriptome, proteome and metabolome is driving the rapid acquisition of information on the function of molecular systems. The importance of these achievements cannot be understated - they have transformed the nature of both biology and medicine. Despite this dramatic progress, one of the greatest challenges that continues to confront modern biology is to understand how behavior at the level of genome, proteome and metabolome determines physiological function at the level of cell, tissue and organ in both health and disease. Because of the inherent complexity of biological systems, the development, analysis, and validation of integrative computational models based directly on experimental data is necessary to achieve this understanding. This approach, known as systems biology, integrates computational and experimental approaches through iterative development of mathematical models and experimental validation and testing. The combination of these approaches allows for a mechanistic understanding of the function of complex biological systems in health and their dysfunction in disease. The National Heart, Lung, and Blood Institute (NHLBI) has recognized the importance of the systems biology approach for understanding normal physiology and perturbations associated with heart, lung, blood, and sleep diseases and disorders. In 2006, NHLBI announced the Exploratory Program in Systems Biology, followed in 2010 by the NHLBI Systems Biology Collaborations. The goal of these programs is to support collaborative teams of investigators in using experimental and computational strategies to integrate the component parts of biological networks and pathways into computational models that are based firmly on and validated using experimental data. These validated models are then applied to gain insights into the mechanisms of altered system function in disease, to generate novel hypotheses regarding these mechanisms that can be tested experimentally, and to then use the results of experiments to refine the models. The purpose of this Research Topic is to present the range of innovative, new approaches being developed by investigators working in areas of systems biology that couple experimental and modeling studies to understand the cause and possible treatment of heart, lung, blood and sleep diseases and disorders. This Research Topic will be of great interest to the cardiovascular research community as well as to the general community of systems biologists.

Innovative Radiopharmaceuticals in Oncology and Neurology

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889451746 Year: Pages: 114 DOI: 10.3389/978-2-88945-174-6 Language: English
Publisher: Frontiers Media SA
Subject: Medicine (General)
Added to DOAB on : 2017-08-28 14:01:09
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The aim of this Research Topic was to assemble a series of articles describing basic, preclinical and clinical research studies on radiopharmaceuticals and nuclear medicine. The articles were written by attendees of the third Nuclear Technologies for Health Symposium (NTHS, 10th-11th March 2015, Nantes, Frances) under the auspices of the IRON LabEx (Innovative Radiopharmaceuticals for Oncology and Neurology Laboratory of Excellence). This French network, gathering approximately 160 scientists from 12 academic research teams (Funded by “investissements d’Avenir”), fosters transdisciplinary projects between teams with expertise in chemistry, radiochemistry, radiopharmacy, formulation, biology, nuclear medicine and medical physics. The 12 articles within this resulting eBook present a series of comprehensive reviews and original research papers on multimodality imaging and targeted radionuclide therapy; illustrating the different facets of studies currently conducted in these domains.

International Partnerships for Strengthening Health Care Workforce Capacity: Models of Collaborative Education

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889455157 Year: Pages: 246 DOI: 10.3389/978-2-88945-515-7 Language: English
Publisher: Frontiers Media SA
Subject: Medicine (General) --- Public Health
Added to DOAB on : 2019-01-23 14:53:42
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A critical problem in resource-scarce countries across the globe is the shortage of appropriately trained health care providers. According to the World Health Organization, the current global health workforce shortage of 7.2 million providers is estimated to increase to 12.9 million by 2035. This disproportionately affects resource-scarce countries, denying basic health care to millions and limiting access to life-saving treatments. Due to limited resources in these countries, not enough health professionals receive training, few have the opportunity for continuing education, and the ability to develop or implement educational programs and curricula is constrained. Additionally, many existing providers choose to emigrate in pursuit of professional advancement opportunities, contributing to the overall shortage of qualified health care providers in these environments. Efforts to strengthen health workforce capacity not only increases access, safety and availability of care, but is critical to building resilient health systems capable of caring for the world’s neediest populations. This requires not only cultivating new health care providers, but also providing ongoing professional development to retain and support current providers, advancing the level of practice in accordance with current clinical science, cultivating educators, and enhancing training curricula. It is critical also to contribute to the limited body of research documenting the effectiveness and impact of various models of collaborative education and partnership to improve health worker training and retention. This Research Topic examines strategies for building health workforce capacity through the prism of educational partnerships, offering significant examples of effective models of international collaborative education as well as insight and guidance on the structure and operation of successful global partnerships. Collectively, the 31 articles accepted and included in this eBook represent a diversity of health professions and geographies across academic, non-governmental organizations and other global partnership forms. The published manuscripts highlight various elements of partnerships with several consistent themes emerging: capacity building, local empowerment, mutual trust and respect, long-term commitment, equity, collaboration, and the importance of integrating theory and practice, for a balance of academic and clinical development. The manuscripts provide examples of partnership and educational programs that are in the formative, early stages of implementation and others which have been sustained long term, some for decades.The following eBook is divided into two parts, with each part broken down into sections. Part I of the eBook includes 18 manuscripts that showcase long-term educational programs that strongly exemplify multiple, foundational aspects of international partnerships in education including mutual collaboration and project management, empowerment of host partners to lead and sustain programs, and capacity building. While individual manuscripts included in Part I look broadly at multiple aspects of successful, international partnerships in education, Part II manuscripts focus intently on one-two elements. Part II includes 13 articles that highlight partnership through short- rather than long-term educational initiatives as well as program development and broad academic partnerships.This Research Topic was sponsored by Health Volunteers Overseas – a United States based non-profit that collaborates with over eighty international universities and health institutions to send volunteer health professionals to low-resource countries to provide continuing education, train the trainer courses, professional support, and consultation on academic program and curricula development.

Mathematics for Healthcare

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Book Series: Frontiers Research Topics ISSN: 16648714 ISBN: 9782889455775 Year: Pages: 284 DOI: 10.3389/978-2-88945-577-5 Language: English
Publisher: Frontiers Media SA
Subject: Science (General) --- Physiology
Added to DOAB on : 2019-01-23 14:53:43
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In 1996, and with extraordinary prescience, Panfilov and Holden had highlighted in their seminal book 'Computational Biology of the Heart' that biology was, potentially, the most mathematical of all sciences. Fast-forward 20 years and we have seen an explotion of applications of mathematics in not only biology, but healthcare that has already produced significant breakthroughs not imaginable more than 20 years ago. Great strides have been made in explaining through quantitative methods the underlying mechanisms of human disease, not without considerable ingenuity and effort. Biological mechanisms are bewildering: complex, ever evolving, multi-scale, variable, difficult to fully access and understand. This poses immense challenges to the computational physiology community that, nevertheless, has developed an impressive arsenal of tools and methods in a vertiginous race to combat disease with the tall order of improving human healthcare. Mechanistic models are now contending with the advent of machine learning in healthcare and the hope is that both approaches will be used synergistically since the complexity of human patophysiology and the difficulty of acquiring human datasets will require both, deductive and inductive methods. This Research Topic presents work that is currently at the frontier in computational physiology with a striking range of applications, from diabetes to graft failure and using a multitude of mathematical tools. This collection of articles represents a snapshot in a field that is moving a dizzying speed, bringing understanding of fundamental mechanism and solutions to healthcare problems experienced by healthcare systems all over the world.

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