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Zembowicz A.,Lahey Clinic | Zembowicz A.,Harvard University | Zembowicz A.,Tufts University | Scolyer R.A.,Melanoma Institute Australia | And 2 more authors.
Archives of Pathology and Laboratory Medicine | Year: 2011

Context.-Until recently, the prevailing paradigm in classification and clinical management of melanocytic proliferations mandated dichotomous classification of all melanocytic lesions as either entirely benign (nevus) or entirely malignant (melanoma). However, some diagnostically challenging lesions cannot be unequivocally classified as nevus or melanoma by histologic evaluation of the primary tumor. Such lesions have been referred to as borderline or melanocytic tumors of uncertain malignant potential. Objective.-To review and update the problem of diagnostically difficult melanocytic proliferations and recent concepts regarding borderline melanocytic tumors. Data Sources.-Published literature and personal experience of the authors. Conclusions.-Preliminary evidence indicates that it may be appropriate to expand the classification scheme of melanocytic neoplasms to include a third diagnostic category of melanocytic lesions of intermediate malignant potential that are capable of metastasis to regional lymph nodes but have limited potential for distant spread. We propose the term melanocytoma for this group of lesions. We believe that a nevus/melanocytoma/melanoma paradigm may provide a useful intellectual framework to understand, research, and clinically manage borderline melanocytic tumors. Source


Carroll A.P.,Hunter Medical Research Institute | Goodall G.J.,Center for Cancer Biology | Goodall G.J.,University of Adelaide | Liu B.,University of New South Wales | Liu B.,Cancer Institute New South Wales
Wiley Interdisciplinary Reviews: RNA | Year: 2014

In recent times, microRNA (miRNA) have emerged as primary regulators of fundamental biological processes including cellular differentiation, proliferation, apoptosis, as well as synaptic plasticity. However, miRNAs bind their targets with only partial complementarity, making it very challenging to determine exactly how a miRNA is functioning in specific biological environments. This review discusses key principles of miRNA target recognition and function which have emerged through the progressive advancement of biological and bioinformatics approaches. Ultimately, the integration of gene expression and biochemical methods with sequence- and systems-based bioinformatics approaches will reveal profound insights regarding the importance of target contextual features in determining miRNA target recognition and regulatory outcome, as well as the importance of RNA interaction networks in enabling miRNA to regulate different target genes and functions in specific biological contexts. There is therefore a demand for the elegant design of future experiments such that principles of context-specific miRNA target recognition and regulatory outcome can be accurately modeled in normal developmental and disease states. For further resources related to this article, please visit the WIREs website. Conflict of interest: The authors have declared no conflicts of interest for this article. © 2014 John Wiley & Sons, Ltd. Source


Ugalde A.,Peter MacCallum Cancer Center | Ugalde A.,University of Melbourne | Aranda S.,Peter MacCallum Cancer Center | Aranda S.,University of Melbourne | And 6 more authors.
Supportive Care in Cancer | Year: 2012

Purpose: People with lung cancer report a higher burden of unmet needs, specifically psychological and daily living unmet needs. They experience more psychological distress and more physical hardship than other tumour sites. This study examined the levels of unmet need and psychological distress in inoperable lung cancer patients at the start of treatment. Methods: A cross-section survey methodology was employed using baseline data from a randomised controlled trial designed to evaluate a supportive care intervention. Eligible lung cancer patients were approached to participate at the start of treatment. Consenting patients completed questionnaires prior to or just after the commencement of treatment. Reliable and valid measures included Needs Assessment for Advanced Lung Cancer Patients, Hospital Anxiety and Depression Scale and Brief Distress Thermometer. Results: Of the 108 patients participating, the top unmet need was 'Dealing with concerns about your family's fears and worries' (62%); with the next four also coming from the psychological/emotional domain, but, on average, most needs related to medical communication. Thirty two percent of patients reported clinical or subclinical anxiety and 19% reported HADS scores suggestive of clinical or subclinical depression. Moreover, 39.8% of the sample reported distress above the cut-off on the distress thermometer and this was associated with higher needs for each need subscale (p < 0.05). Conclusions: People with lung cancer have high levels of unmet needs especially regarding psychological/emotional or medical communication. People with lung cancer who are classified as distressed have more unmet needs. © 2011 Springer-Verlag. Source


Brennan E.,Cancer Council Victoria | Durkin S.J.,Cancer Council Victoria | Cotter T.,Cancer Institute New South Wales | Harper T.,VicHealth | Wakefield M.A.,Cancer Council Victoria
Tobacco Control | Year: 2011

Background In Australia, introduction of pictorial health warnings on cigarette packets was supported by a televised media campaign highlighting illnesses featured in two of the warning labelsdgangrene and mouth cancer. Methods Two studies examined whether the warnings and the television advertisements complemented one another. Population telephone surveys of two cross-sections of adult smokers measured changes in top-of-mind awareness of smoking-related health effects from before (2005; n=587) to after the pack warnings were introduced (2006; n=583). A second study assessed cognitive and emotional responses and intentions to quit after smokers watched one of the campaign advertisements, comparing outcomes of those with and without prior pack warning exposure. Results Between 2005 and 2006, the proportion of smokers aware that gangrene is caused by smoking increased by 11.2 percentage points (OR=23.47, p=0.000), and awareness of the link between smoking and mouth cancer increased by 6.6 percentage points (OR=2.00, p=0.006). In contrast, awareness of throat cancer decreased by 4.3 percentage points, and this illness was mentioned in the pack warnings but not the advertisements. In multivariate analyses, smokers who had prior exposure to the warnings were significantly more likely to report positive responses to the advertisements and stronger post-exposure quitting intentions. Conclusions Television advertisements and pictorial health warnings on cigarette packets may operate in a complementary manner to positively influence awareness of the health consequences of smoking and motivation to quit. Jurisdictions implementing pictorial warnings should consider the benefits of supportive mass media campaigns to increase the depth, meaning and personal relevance of the warnings. Source


Wakefield M.,Center for Behavioural Research in Cancer | Bayly M.,Center for Behavioural Research in Cancer | Durkin S.,Center for Behavioural Research in Cancer | Cotter T.,Cancer Institute New South Wales | And 2 more authors.
Tobacco Control | Year: 2013

Background While television advertisements (ads) that communicate the serious harms of smoking are effective in prompting quitting-related thoughts and actions, little research has been conducted among smokers in low- to middle-income countries to guide public education efforts. Method 2399 smokers aged 18e34 years in 10 low- to middle-income countries (Bangladesh, China, Egypt, India, Indonesia, Mexico, Philippines, Russia, Turkey and Vietnam) viewed and individually rated the same five anti-smoking ads on a standard questionnaire and then engaged in a structured group discussion about each ad. Multivariate logistic regression analysis, with robust SEs to account for the same individual rating multiple ads, was performed to compare outcomes (message acceptance, perceived personalised effectiveness, feel uncomfortable, likelihood of discussing the ad) across ads and countries, adjusting for covariates. Ads by country interactions were examined to assess consistency of ratings across countries. Results Three ads with graphic imagery performed consistently highly across all countries. Two of these ads showed diseased human tissue or body parts, and a third used a disgust-provoking metaphor to demonstrate tar accumulation in smokers' lungs. A personal testimonial ad performed more variably, as many smokers did not appreciate that the featured woman's lung cancer was due to smoking or that her altered physical appearance was due to chemotherapy. An ad using a visual metaphor for lung disease was also more variable, mostly due to lack of understanding of the term 'emphysema'. Conclusion Television ads that graphically communicate the serious harms of tobacco use are likely to be effective with smokers in low- to middle-income countries and can be readily translated and adapted for local use. Ads with complex medical terms or metaphors, or those that feature personal testimonials, are more variable and at least require more careful pre-testing and adaptation to maximise their potential. Source

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