Medicine and Health Sciences Commons^™

Malaria Vivax Di Kabupaten Nias Selatan, Lambok Siahaan

Kesmas

Diperkirakan sekitar 2,5 milyar manusia hidup di wilayah endemis malaria dengan ± 300 juta kasus dan ± 1 juta kematian yang sebagian besar adalah anak-anak. Di Indonesia, malaria tak pernah tereradikasi dan mengalami pasang surut dari tahun ke tahun. Di Jawa-Bali, API pada tahun 2001 (0,62%) dan 2004 (0,15‰) dan di luar Jawa-Bali, AMI pada tahun 2001 (26,20‰) dan 2004 (21,20‰) terlihat menurun. Kabupaten Nias Selatan merupakan daerah endemis malaria dengan angka Monthly Malaria Incidence (MoMI) pada 2005 (124,24 ‰). Gempa bumi tektonik dan tsunami dan gempa bumi susulan yang terjadi berpengaruh meningkatkan angka insiden. Lingkungan menjadi lebih kondusif bagi …

Pengelolaan Sampah Berbasis Masyarakat Di Kampung Rawajati Jakarta Selatan, Catur Puspawati, Besral Besral

Kesmas

Kampung Rawajati di Jakarta yang menerapkan sistem pengelolaan sampah berbasis masyarakat merupakan alternatif upaya mengatasi sampah rumah tangga. Penelitian ini bertujuan mengetahui pengaruh sistem tersebut terhadap penurunan berat sampah rumah tangga. Dengan desain studi potong lintang, penelitian ini dilakukan pada sampel 175 ibu rumah tangga yang dipilih secara acak. Hasil penelitian ini menunjukan bahwa pengelolaan sampah berbasis masyarakat dapat menurunkan berat sampah sebesar 28,3%. Analisis regresi linier ganda memperlihatkan bahwa kegiatan pengelolaan yang berpengaruh terhadap penurunan berat sampah adalah kegiatan reuse, daur ulang, dan pembuatan kompos (nilai-p < 0,05). Pembuatan kompos merupakan variabel yang berkontribusi terhadap penurunan berat sampah 657,3 gram setelah dikontrol variabel perancu. Penurunan berat sampah ditemukan lebih besar pada rumah tangga yang mendapat pelatihan. Tidak ada perbedaan penurunan berat sampah menurut jumlah anggota keluarga, penghasilan rumah tangga, dan pengetahuan ibu. Disarankan agar Pemerintah DKI Jakarta dapat melakukan replikasi model pengelolaan sampah berbasis masyarakat kepada wilayah lainnya, dengan memberikan pelatihan pengelolaan sampah kepada masyarakat. Kampung Rawajati in Jakarta applies community-based solid waste management system as an alternative way to overcome household waste problem. The objective of the research is to assess the effect of community-based solid waste management on reduction of household waste weight. This study has crosssectional study design and was conducted on 175 housewife as respondent who were selected randomly. The data was collected by interview using structured questionnaire and weighing of household waste. The result shows that the community-based solid waste management can reduce 28.3% of household waste weight (weight before: 1.845 gram/house/day and after: 1.324 gram/house/day). Multiple linear regression analysis shows that variables affecting the reduction of solid waste including re-using activity, recycling, and composting (p-value <0.05). Composting represents the biggest effect to reduction (657.26 gram) after controlled by potential confounders. The reduction was higher among household with waste training and number of trained household member. It was found that number of family member, family income, and mother knowledge are not significant. It was recommended to the Government of DKI Jakarta to replicate this community-based waste management system to other regions by providing training facilities on solid waste management.

An Sp1/Sp3 Binding Polymorphism Confers Methylation Protection, Yanis A. Boumber, Yutaka Kondo, Xuqi Chen, Lanlan Shen, Yi Guo, Carmen Tellez, Marcos R H Estécio, Saira Ahmed, Jean-Pierre J. Issa

Faculty, Staff and Student Publications

Hundreds of genes show aberrant DNA hypermethylation in cancer, yet little is known about the causes of this hypermethylation. We identified RIL as a frequent methylation target in cancer. In search for factors that influence RIL hypermethylation, we found a 12-bp polymorphic sequence around its transcription start site that creates a long allele. Pyrosequencing of homozygous tumors revealed a 2.1-fold higher methylation for the short alleles (P<0.001). Bisulfite sequencing of cancers heterozygous for RIL showed that the short alleles are 3.1-fold more methylated than the long (P<0.001). The comparison of expression levels between unmethylated long and short EBV-transformed cell lines showed no difference in expression in vivo. Electrophorectic mobility shift assay showed that the inserted region of the long allele binds Sp1 and Sp3 transcription factors, a binding that is absent in the short allele. Transient transfection of RIL allele-specific transgenes showed no effects of the additional Sp1 site on transcription early on. However, stable transfection of methylation-seeded constructs showed gradually decreasing transcription levels from the short allele with eventual spreading of de novo methylation. In contrast, the long allele showed stable levels of expression over time as measured by luciferase and approximately 2-3-fold lower levels of methylation by bisulfite sequencing (P<0.001), suggesting that the polymorphic Sp1 site protects against time-dependent silencing. Our finding demonstrates that, in some genes, hypermethylation in cancer is dictated by protein-DNA interactions at the promoters and provides a novel mechanism by which genetic polymorphisms can influence an epigenetic state.

Misoprostol In Addition To Routine Treatment Of Postpartum Hemorrhage: A Hospital-Based Randomized-Controlled Trial In Karachi, Pakistan., N. F. Zuberi, Jill Durocher, Rozina Sikander, Neelofur Baber, Jennifer Blum, Gijs Walraven

Department of Obstetrics & Gynaecology

Background:Postpartum hemorrhage (PPH) remains a major killer of women worldwide. Standard uterotonic treatments used to control postpartum bleeding do not always work and are not always available. Misoprostol's potential as a treatment option for PPH is increasingly known, but its use remains ad hoc and available evidence does not support the safety or efficacy of one particular regimen. This study aimed to determine the adjunct benefit of misoprostol when combined with standard oxytocics for PPH treatment.

Methods: A randomized controlled trial was conducted in four Karachi hospitals from December 2005 - April 2007 to assess the benefit of a …

Staphylococcus Aureus Pbp4 Is Essential For Β-Lactam Resistance In Community-Acquired Methicillin-Resistant Strains, G Memmi, S R. Filipe, M G. Pinho, Z Fu, Ambrose Cheung

Dartmouth Scholarship

Recent cases of infections caused by community-acquired methicillin-resistant Staphylococcus aureus (MRSA) (CA-MRSA) strains in healthy individuals have raised concerns worldwide. CA-MRSA strains differ from hospital-acquired MRSAs by virtue of their genomic background and increased virulence in animal models.

Health And Nutritional Need Assessment Of Hispanics In South Carolina, America Chavez-Martinez

All Dissertations

From 1990 to 2000, South Carolina's Hispanic population increased 211%. Now, states such as South Carolina have the fastest growing Hispanic population in the U.S. Hispanics have a high incidence of obesity and related chronic diseases such as diabetes, stroke, hypertension and heart disease, these diseases could be avoided through diet. Meanwhile, nutrition education interventions help to reduce weight and to change behaviors, leading to better health. This study used qualitative and quantitative methods to examine Hispanics health and nutritional needs to develop a cultural compatible nutrition program for this audience. The qualitative methods explored predisposing, enabling and reinforcing factors …

Activation Of Degp Chaperone-Protease Via Formation Of Large Cage-Like Oligomers Upon Binding To Substrate Proteins, Jiansen Jiang, Xuefeng Zhang, Yong Chen, Yi Wu, Z Hong Zhou, Zengyi Chang, Sen-Fang Sui

Faculty, Staff and Student Publications

Cells use molecular chaperones and proteases to implement the essential quality control mechanism of proteins. The DegP (HtrA) protein, essential for the survival of Escherichia coli cells at elevated temperatures with homologues found in almost all organisms uniquely has both functions. Here we report a mechanism for DegP to activate both functions via formation of large cage-like 12- and 24-mers after binding to substrate proteins. Cryo-electron microscopic and biochemical studies revealed that both oligomers are consistently assembled by blocks of DegP trimers, via pairwise PDZ1-PDZ2 interactions between neighboring trimers. Such interactions simultaneously eliminate the inhibitory effects of the PDZ2 domain. …

Association Between Antipsychotics And Weight Gain Among Psychiatric Outpatients In Pakistan: A Retrospective Cohort Study., Syed Ahmer, Rashid A. M Khan, Saleem Perwaiz Iqbal

Department of Psychiatry

Background: It has been known for a long time that use of antipsychotics, particularly atypical antipsychotics, is associated with weight gain and increase in risk of metabolic disturbances. In this study we have tried to find out if use of antipsychotics is associated with increase in weight and body mass index (BMI) in the Pakistani population. Methods: We performed a case note review of all Patients who had been prescribed antipsychotic medication at the psychiatry outPatient clinic of a tertiary care university hospital in Pakistan over a 4-year period. Results: A total of 50% of Patients had a BMI in …

Identification Of Virulence Determinants For Streptococcus Sanguinis Infective Endocarditis, Lauren Turner

Theses and Dissertations

Streptococcus sanguinis is the second most common causative agent of bacterial infective endocarditis (IE). Risk of S. sanguinis IE is dependent on pre-disposing damage to the heart valve endothelium, which results in deposition of clotting factors for formation of a sterile thrombus (referred to as vegetation). Despite medical advances, high mortality and morbidity rates persist. Molecular characterization of S. sanguinis virulence determinants may enable development of prevention methods. In a previous screen for S. sanguinis virulence determinants by signature-tagged mutagenesis (STM) an attenuated mutant was identified with a transposon insertion in the nrdD gene, encoding an anaerobic ribonucleotide reductase. Evaluation …

Reuters Health: Factor Vii Curbs Bleeding In Non-Hemophiliac Trauma, Surgical Patients

Data and Test Instruments

Use of recombinant activated factor VII (rFVIIa) reduces the need for blood transfusion in patients without hemophilia and may also reduce mortality, according to pooled data from randomized placebo-controlled trials involving more than 3000 participants, Canadian researchers report. "I had found it to be effective in some combat situations in Afghanistan," senior investigator Dr. Vivian C. McAlister told Reuters Health.

Ada News - 08/16/2008, American Dental Association, Publishing Division

ADA News

Established in 1970 as the official newspaper of the American Dental Association, the ADA News serves practicing dentists and others allied to the dental profession in the U.S. and internationally. It is the No. 1 source of news and information about the many benefits and services the ADA delivers to members daily as well as timely information on scientific, social, political and economic developments affecting dentistry and health care.

The Economic And Social Burden Of Compulsive Hoarding, David F. Tolin, Randy O. Frost, Gail Steketee, Krista D. Gray, Kristin E. Fitch

Psychology: Faculty Publications

The aim of the present study was to determine the economic and social burden of compulsive hoarding in a large sample of individuals with self-identified hoarding, as well as a separate sample of family members of individuals who hoard. Self-identified hoarding participants (N = 864, 94% female, 65% met research criteria for clinically relevant compulsive hoarding) and family informants (N = 655, 58% described a relative who appeared to meet research criteria for compulsive hoarding), completed an internet survey. Questions were derived in part from those used in the National Comorbidity Survey (NCS), and when possible, hoarding participants were compared …

Cd5 Plays An Inhibitory Role In The Suppressive Function Of Murine Cd4(+) Cd25(+) T(Reg) Cells., Trivikram Dasu, Joseph E Qualls, Halide Tuna, Chander Raman, Donald A Cohen, Subbarao Bondada

Microbiology, Immunology, and Molecular Genetics Faculty Publications

A subset of CD4(+) T cells, the CD4(+) CD25(+) regulatory T (T(reg)) cells in the lymphoid organs and peripheral blood are known to possess suppressive function. Previous in vitro and in vivo studies have indicated that T cell receptor (TCR) signal is required for development of such 'natural regulatory (T(reg)) cells' and for activation of the effector function of CD4(+) CD25(+) regulatory T cells. CD5 is a cell surface molecule present on all T cells and a subtype of B lymphocytes, the B-1 cells, primarily localized to coelomic cavities, Peyer's patches, tonsils and spleen. CD5 acts as a negative regulator …

Food Group Intake And Risk Of Subtypes Of Esophageal And Gastric Cancer, Stephanie A. Navarro Silvera, Susan T. Mayne, Harvey Risch, Marilee D. Gammon, Thomas L. Vaughan, Wong-Ho Chow, Robert Dubrow, Janet B. Schoenberg, Janet L. Stanford, Brian West, Heidrun Rotterdam, William J. Blot, Joseph F. Fraumeni Jr.

Department of Public Health Scholarship and Creative Works

Incidence rates for adenocarcinomas of the esophagus and gastric cardia have been increasing rapidly, while rates for non‐cardia gastric adenocarcinoma and esophageal squamous cell carcinoma have declined. We examined food group intake as a risk factor for subtypes of esophageal and gastric cancers in a multicenter, population‐based case–control study in Connecticut, New Jersey and western Washington state. Associations between food groups and risk were estimated using adjusted odds ratios (OR), based on increasing intake of one serving per day. Total vegetable intake was associated with decreased risk of esophageal adenocarcinoma (OR = 0.85, 95% CI = 0.75, 0.96). Conversely, total …

Cd5 Plays An Inhibitory Role In The Suppressive Function Of Murine Cd4+ Cd25+ TReg Cells, Trivikram Dasu, Joseph E. Qualls, Halide Tuna, Chander Raman, Donald A. Cohen, Subbarao Bondada

Microbiology, Immunology, and Molecular Genetics Faculty Publications

A subset of CD4⁺ T cells, the CD4⁺ CD25⁺ regulatory T (T_reg) cells in the lymphoid organs and peripheral blood are known to possess suppressive function. Previous in vitro and in vivo studies have indicated that T cell receptor (TCR) signal is required for development of such ‘natural regulatory (T_reg) cells’ and for activation of the effector function of CD4⁺ CD25⁺ regulatory T cells. CD5 is a cell surface molecule present on all T cells and a subtype of B lymphocytes, the B-1 cells, primarily localized to coelomic cavities, Peyer's patches, …

Uninsured And Medicaid Patients' Access To Preventive Care: Comparison Of Health Centers And Other Primary Care Providers, Avi Dor, Yuriy Pylypchuck, Peter Shin, Sara J. Rosenbaum

Geiger Gibson/RCHN Community Health Foundation Research Collaborative

This issue of Research Briefs examines health centers' role in reducing disparities in preventive health care access by medically vulnerable and high risk populations. The analysis uses information from several national data sources to examine differences in the provision of preventive health care to Medicaid and uninsured patients between health centers and other primary care providers.

Key Findings:

• Compared to those treated by other primary care providers, Medicaid and uninsured patients treated by health centers are significantly poorer, in significantly worse health, and in the case of uninsured patients, more likely to be members of racial and ethnic minority groups. …

Development And Pilot Testing Of A Low Literacy Handout For Hispanic/Latino Caregivers To Promote Breastfeeding And Introduce Age Appropriate Foods For Infants, Judith C. Rodriguez, Nancy Correa-Matos

Florida Public Health Review

Based on input from four focus groups the authors developed a culturally and linguistically appropriate material (CLAM) that used a pictorial format to promote breast feeding and age-appropriate introduction of solids for Hispanics/Latinos that attended a public health clinic in the northeast region of Florida. The handout focused on five key, but simple educational messages. Clients were randomly assigned to receive 1) the physician's usual oral instruction or 2) instruction that incorporated the use, and provision of, the handout. Among the group (n=12) that received the handout the mean month for introduction of solids was 5 months compared to 4.07 …

A Metastasis Or A Second Independent Cancer? Evaluating The Clonal Origin Of Tumors Using Array-Cgh Data, Irina Ostrovnaya, Adam Olshen, Venkatraman E. Seshan, Irene Orlow, D G. Albertson, Colin B. Begg

Memorial Sloan-Kettering Cancer Center, Dept. of Epidemiology & Biostatistics Working Paper Series

When a cancer patient develops a new tumor it is necessary to determine if this is a recurrence (metastasis) of the original cancer, or an entirely new occurrence of the disease. This is accomplished by assessing the histo-pathology of the lesions, and it is frequently relatively straightforward. However, there are many clinical scenarios in which this pathological diagnosis is difficult. Since each tumor is characterized by a genetic fingerprint of somatic mutations, a more definitive diagnosis is possible in principle in these difficult clinical scenarios by comparing the fingerprints. In this article we develop and evaluate a statistical strategy for …

Comorbidities Of Patients With Hypertension Admitted To Emergency Departments In Florida Hospitals

Florida Public Health Review

Although essential hypertension (EHT) tends to coexist with other conditions, few studies have focused on comorbidities and symptoms among patients admitted to emergency departments (ED). The objective was to compare the characteristics, comorbidities and symptoms among patients with three types (unspecified, benign, or malignant) of EHT in Florida. A public use data set of ED patients from the Florida Agency for Health Care Administration (AHCA) from 2005 was used. Records included those with primary diagnosis of three types of EHT based on the International Classification of Diseases, 9th edition (ICD-9) code. Group comparisons were made using Chi square tests and …

Reliability Generalization Of The Alcohol Use Disorders Identification Test., Chandni Patel

Electronic Theses and Dissertations

The Alcohol Use Disorder Identification Test (AUDIT) is a brief screening instrument for assessing alcohol use problems among adults. This instrument is widely used and continued evaluation of its psychometric performance is needed. Reliability and validity are the primary psychometric characteristics of interest when evaluating psychological instruments. The focus of the present study is on reliability, which reflects the consistency or repeatability of the scores produced by a given instrument. Using meta-analytic methods, results showed that approximately 65% of previously published studies using the AUDIT did not appropriately report reliability estimates. Among the remaining studies, weighted reliability estimate centered on …

Sex Differences In Nicotine-Conditioned Hyperactivity In A Model Of Dopamine D2 Receptor Priming: Roles Of Dopamine D2 And D3 Receptor Subtypes., Ashley Brianna Sheppard

Electronic Theses and Dissertations

The aim of this investigation was to determine the effect of a nicotine-conditioned context on locomotor hyperactivity in an animal model of D2-priming, and whether conditioned hyperactivity could be blocked by the D2 antagonist eticlopride or the D3 antagonist nafadotride. D2-primed male rats showed enhanced nicotine sensitization as evidenced by statistically significant differences in horizontal activity. D2-primed female rats administered nicotine demonstrated an increased hypoactive response after initial sensitization and increased stereotypy. Eticlopride and nafadotride blocked sensitization to nicotine in both D2-primed and non D2-primed males and females. Eticlopride blocked conditioned hyperactivity in females but not in males. D2-primed female …

An Epidemiological Study Of Maternal Depression: Findings From The National Institute Of Child Health And Human Development Study Of Early Child Care And Youth Development., Liang Wang

Electronic Theses and Dissertations

This study examined maternal depression status from month 1 to 36 after birth using data from the NICHD Study of Early Child Care and Youth Development. Maternal depression was assessed with the Center of Epidemiological Studies Depression Scale. The prevalence of maternal depression was highest at 1 month, decreased at 6 months, and then kept fairly stable to 36 months. The prevalence was higher in blacks than other races, in 18-24 than 25-46 years old, and in single mothers than non-single mothers. Mothers with better physical health, social support, or employed had a lower prevalence than their counterparts. Mothers in …

Community-Based Long-Term Care In Milwaukee: Wisconsin Still Ahead, Judith D. Moore, Carol O'Shaughnessy, Lisa Sprague

National Health Policy Forum

The National Health Policy Forum has made two site visits to Wisconsin in two years. The first, in August 2007, focused on an overview of Family Care, the state's managed long-term care program, and looking at service delivery in a rural setting. The August 2008 site visit focused on the operations of MCOs and Family Care service providers in the urban environment of Milwaukee. Issues examined included the link between housing and social services, care management, capitation and rate-setting, measuring quality, and integrating people with disabilities into a program that initially targeted the elderly.

A Cyclin D1/Microrna 17/20 Regulatory Feedback Loop In Control Of Breast Cancer Cell Proliferation., Zuoren Yu, Chenguang Wang, Min Wang, Zhiping Li, Mathew C Casimiro, Manran Liu, Kongming Wu, James Whittle, Xiaoming Ju, Terry Hyslop, Peter Mccue, Richard G Pestell

Kimmel Cancer Center Faculty Papers

Decreased expression of specific microRNAs (miRNAs) occurs in human tumors, which suggests a function for miRNAs in tumor suppression. Herein, levels of the miR-17-5p/miR-20a miRNA cluster were inversely correlated to cyclin D1 abundance in human breast tumors and cell lines. MiR-17/20 suppressed breast cancer cell proliferation and tumor colony formation by negatively regulating cyclin D1 translation via a conserved 3' untranslated region miRNA-binding site, thereby inhibiting serum-induced S phase entry. The cell cycle effect of miR-17/20 was abrogated by cyclin D1 siRNA and in cyclin D1-deficient breast cancer cells. Mammary epithelial cell-targeted cyclin D1 expression induced miR-17-5p and miR-20a expression …

Strong As The Weakest Link: Medical Response To A Catastrophic Event, Eileen Salinsky

National Health Policy Forum

Natural disasters and acts of terrorism have placed a spotlight on the ability of health care providers to surge in response to catastrophic conditions. This paper reviews the status of efforts to develop the capacity and capabilities of the health care system to respond to disasters and other mass casualty events. Strategies for adapting routine medical practices and protocols to the demands posed by extraordinary circumstances and scarce resources are summarized. Existing federal roles, responsibilities, and assets relative to the contributions of state and local government and the private sector are described, including specific programmatic activities such as the Strategic …

Biology And Therapy Of Fibromyalgia. Evidence-Based Biomarkers For Fibromyalgia Syndrome, Dina Dadabhoy, Leslie J. Crofford, Michael Spaeth, I. Jon Russell, Daniel J. Clauw

Internal Medicine Faculty Publications

Researchers studying fibromyalgia strive to identify objective, measurable biomarkers that may identify susceptible individuals, may facilitate diagnosis, or that parallel activity of the disease. Candidate objective measures range from sophisticated functional neuroimaging to office-ready measures of the pressure pain threshold. A systematic literature review was completed to assess highly investigated, objective measures used in fibromyalgia studies. To date, only experimental pain testing has been shown to coincide with improvements in clinical status in a longitudinal study. Concerted efforts to systematically evaluate additional objective measures in research trials will be vital for ongoing progress in outcome research and translation into clinical …

Tell A Church - Lessons Learned From A Church-Based Tuberculosis Health Education Program

Florida Public Health Review

Historically, the church has been the center of the African American community – contributing to the spiritual and physical well-being of its congregations. Community health education outreach utilizing African American churches could prove effective but is often neutralized by historical feelings of distrust in research and outreach by secular organizations. During the summer of 2007, the “Think TB” project, a tuberculosis education program, attempted to utilize the church as a health education venue and overcome the historical hurdles that usually hamper church- based health education promotion. This paper discusses the “Think TB” program’s challenges and successes.

Properties Of Monotonic Effects On Directed Acyclic Graphs, Tyler J. Vanderweele, James M. Robins

COBRA Preprint Series

Various relationships are shown hold between monotonic effects and weak monotonic effects and the monotonicity of certain conditional expectations. Counterexamples are provided to show that the results do not hold under less restrictive conditions. Monotonic effects are furthermore used to relate signed edges on a causal directed acyclic graph to qualitative effect modification. The theory is applied to an example concerning the direct effect of smoking on cardiovascular disease controlling for hypercholesterolemia. Monotonicity assumptions are used to construct a test for whether there is a variable that confounds the relationship between the mediator, hypercholesterolemia, and the outcome, cardiovascular disease.

The Effects Of Host Physiological Conditions On The Expression Of Icsp In Shigella Flexneri, Karen Levy, Helen Wing

Undergraduate Research Opportunities Program (UROP)

Shigella flexneri is a gram-negative bacterium capable of causing diarrhea and dysentery known as shigellosis. It is estimated there are 167.4 million shigellosis episodes throughout the world each year causing 1.1 million deaths. Shigella invades cells in the lower intestine through an induced phagocytosis. Once in the cytoplasm, bacteria move from one cell to another using actin-based motility. The Shigella outer membrane protease IcsP regulates actin-based motility and cell-to-cell spread by cleaving the actin assembly protein IcsA from the bacterial cell surface. We hypothesize that IcsP may serve additional functions during infection. By examining which environmental signals trigger icsP expression, …

Characterizing And Inhibiting Two Pathways Activated In Glioblastoma Multiforme, Andrea Jydstrup, Sheri L. Holmen

Undergraduate Research Opportunities Program (UROP)

Despite major improvements in imaging, radiation, and surgery, the prognosis for patients with Glioblastoma multiforme (GBM) remains clinically challenging. New treatment strategies are badly needed to reduce the mortality and morbidity associated with this disease. The resistance of these tumors to conventional treatments makes GBM patients ideal candidates for molecularly targeted therapies and several agents are currently being developed(1). Because GBM is genetically heterogeneous, combination therapies or the use of multikinase inhibitors are more likely to achieve the greatest therapeutic benefit(2,3). However, genes that can be productively targeted for effective therapies in patients remain to be identified. The overall objective …