Colorectal cancer is the third most common form of cancer in developed countries and, despite the improvements achieved in its treatment options, remains as one of the main causes of cancer-related death. In this review, we first focus on colorectal carcinogenesis and on the genetic and epigenetic alterations involved. In addition, noncoding RNAs have been shown to be important regulators of gene expression. We present a general overview of what is known about these molecules and their role and dysregulation in cancer, with a special focus on the biogenesis, characteristics, and function of microRNAs. These molecules are important regulators of carcinogenesis, progression, invasion, angiogenesis, and metastases in cancer, including colorectal cancer. For this reason, miRNAs can be used as potential biomarkers for diagnosis, prognosis, and efficacy of chemotherapeutic treatments, or even as therapeutic agents, or as targets by themselves. Thus, this review highlights the importance of miRNAs in the development, progression, diagnosis, and therapy of colorectal cancer and summarizes current therapeutic approaches for the treatment of colorectal cancer.
Background
Spasticity is a frequent symptom of multiple sclerosis (MS), which may negatively influence daily living activities (ADL).
Objectives
To (1) explore the feasibility to conduct a structured interview by specialist nurses about limitations in ADL; (2) determine the percentage of people with MS (PwMS) with limitations in ADL related to spasticity; (3) to assess the knowledge about spasticity and describe its clinical features.
Design
Observational, cross‐sectional, multicentre study in 16 MS units of Catalonia (Spain). Participants were recruited from the outpatient facility and day‐care hospital between July 2018 and June 2019 and met the following criteria: (1) age 18 or older, (2) diagnosis of MS according to McDonald criteria 2010 and (3) no clinical relapse in previous 30 days.
Methods
Specialist nurses conducted a structured interview divided in two parts: the assessment of (1) limitations in the ADL and (2) the presence of spasticity and associated symptoms. The usefulness of this intervention was requested. This study met the STROBE reporting guidelines checklist for observational studies.
Results
Three hundred sixty eight pwMS (244 women) with a mean age of 46 years and a median Expanded Disability Status Scale score of 2.5 (range, 0–8.5) were included. 262 (71%) pwMS had limitations in the ADL, and spasticity was reported as the most limiting symptom in 59 (23%). As a result of the interview, spasticity was observed in 199 (76%) participants; 47 (24%) of them were unaware that they had spasticity and 102 (51%) would not have reported it spontaneously. The level of the interview satisfaction was high (90%).
Conclusions
Spasticity is a complex and limiting symptom in MS. The structured interview conducted by specialist nurses is feasible and has good acceptance.
Patient contribution
Specialist nurses can be proactive in MS clinical assessment, which may help to detect symptoms with negative impact on quality of life.
Organizational transformation is an interesting topic in theory and practice. Achieving organizational transformation is seen as a huge challenge for managers as there are many aspects that the organization needs to deal with. During the COVID-19 lockdown, organizations faced an urgent need to radically transform in order to survive. Moreover, the economic and social context of the Mexican economy makes it even more important to understand how organizations can radically transform as, in theory, such a context seems to be detrimental for organizational transformation. This study analyzed 21 organizations based in Mexico and pays special attention to 5 organizations that achieved radical organizational transformation. The main takeaway point from this study is that the five organizations that achieved radical transformation had at least four things in common. First, senior managers were strongly convinced that without radical transformation the firm would perish before the end of the year. Second, these five organizations quickly reshaped their management control systems. Third, the five organizations that achieved a radical change hired specialized consultants to achieve the transformation. Finally, these organizations also outsourced to external firms to complete processes where they themselves did not have any previous experience. This article contributes to a better understanding of organizational transformation.
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