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discover biology 5th edition pdf download zip
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Mathematics for Biomedical Physics is an open access peer-reviewed textbook geared to introduce several mathematical topics at the rudimentary level so that students can appreciate the applications of mathematics to the interdisciplinary field of biomedical physics. Most of the topics are presented in their simplest but rigorous form so that students can easily understand the advanced form of these topics when the need arises. Several end-of-chapter problems and chapter examples relate the applications of mathematics to biomedical physics. After mastering the topics of this book, students would be ready to embark on quantitative thinking in various topics of biology and medicine
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We show that variability in general levels of drug sensitivity in pre-clinical cancer models confounds biomarker discovery. However, using a very large panel of cell lines, each treated with many drugs, we could estimate a general level of sensitivity to all drugs in each cell line. By conditioning on this variable, biomarkers were identified that were more likely to be effective in clinical trials than those identified using a conventional uncorrected approach. We find that differences in general levels of drug sensitivity are driven by biologically relevant processes. We developed a gene expression based method that can be used to correct for this confounder in future studies.
We strongly emphasize that there are two crucial reasons why controlling for GLDS in the pre-clinical biomarker discovery phase will improve clinical translation. First, cancer drug biomarkers, discovered in pre-clinical data, are often subsequently tested on relapsed patients, who have undergone multiple rounds of chemotherapy and developed resistance to many drugs (i.e. high levels of MDR). We showed above that patterns of GLDS were evident in pre-clinical data and are likely related to clinical MDR. Thus, the variability in GLDS in pre-clinical data acts as a confounding factor in discovery of biomarkers relevant in the refractory clinical setting. Second, and perhaps even more important, new drugs are often tested in addition to existing standard-of-care multi-drug regimes. In this scenario, only the drug-specific effect, independent of the drugs already used in the treatment, is relevant in predicting response following the addition of a new drug. Controlling for GLDS will allow the identification of drug markers relevant independent of the general effects of chemotherapeutic regimes that are already being used, thus identifying compounds likely to actually improve the effectiveness of existing regimes.
Controlling for general levels of drug sensitivity substantially affects biomarker discovery in the CGP cell lines. a Dot-plot showing the change in P values for the top 25 associations for all sequenced cancer genes across all drugs in CGP. Results are plotted when controlling for GLDS and for an uncorrected approach. Also included are the results when controlling for GLDS estimated from expression data. The triangle is pointing in the direction of the effect (i.e. a triangle pointing up indicates a positive effect). b A similar dot-plot for the 18 novel associations identified in CGP when controlling for GLDS
Countless proposed cancer biomarkers and novel targeted therapeutics have failed and in this study we have elucidated an important reason why this is the case and developed a widely applicable method to solve this problem. Using the largest available sets of cell line screening data, we found that general levels of drug sensitivity vary in pre-clinical data. Integrative analysis with gene expression data suggests that this phenomenon is likely related to clinical MDR. Many of the biomarkers identified using these cell line data were confounded by this signal, which we have referred to as GLDS. This confounding is highly problematic, because biomarkers (for new or existing drugs) are often tested: (1) on refractory patients (who will typically have developed high levels of MDR); or (2) in conjunction with the current standard of care, whereby only a drug-specific signal is likely to be predictive of response given the addition of the new drug. We showed that it is possible to estimate GLDS in these data and to condition on this signal to identify biomarkers of clinical relevance. Overall, while the reasons for controlling for GLDS are clear, the improved results that we presented were highly predictive of clinical biomarker success, demonstrating the utility of the approach. Indeed, a recent study has also suggested that, similar to GLDS, explicitly controlling for growth rate in these types of assays improved discovery [38]; although our GLDS approach may take this a step further by additionally controlling for other key processes in an unbiased and unsupervised manner. We showed that the expression of various genes, processes, and mutations were associated with GLDS, many of which are also related to clinical MDR; in future it may be possible to derive a model from such a set of mutations and/or expression estimates, which may be useful as an in vivo pan-cancer prognostic indicator. We also showed that it is possible to apply our findings in a broader context, by using our proposed gene expression based signature. This would mean avoiding much of the costs associated with ultimately unsuccessful clinical trials. This study elucidated the nature of GLDS using cell lines; but crucially, relevant biological processes underlie the signal. Thus, a similar bias will almost certainly be evident in other pre-clinical models (e.g. mouse xenografts) and in data derived directly from clinical studies. Larger datasets will allow these hypotheses to be tested for these platforms, but in the meantime these types of studies should carefully consider our findings.
In conclusion, we have identified variability in GLDS as a novel phenomenon confounding biomarker discovery. We have developed methods to estimate and remove this confounder and overall, these findings can potentially dramatically improve the clinical success rate of drug discovery and repurposing. 2ff7e9595c
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