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BackgroundEvidence-based medicine has been regarded as a prerequisite for ensuring health care quality. The increase in health care professionals’ adoption of web-based medical information and the lack of awareness of alternative access to evidence-based online resources suggest the need for an investigation of their information-searching behaviors of using evidence-based online medical databases. ObjectiveThe main purposes of this study were to (1) modify and validate the internet-specific epistemic beliefs in medicine (ISEBM) questionnaire and (2) explore the associations between health care professionals’ demographics, ISEBM, and intention to use evidence-based online medical databases for clinical practice. MethodsHealth care professionals in a university-affiliated teaching hospital were surveyed using the ISEBM questionnaire. The partial least squares-structural equation modeling was conducted to analyze the reliability and validity of ISEBM. Furthermore, the structural model was analyzed to examine the possible linkages between health professionals’ demographics, ISEBM, and intention to utilize the evidence-based online medical databases for clinical practice. ResultsA total of 273 health care professionals with clinical working experience were surveyed. The results of the measurement model analysis indicated that all items had significant loadings ranging from 0.71 to 0.92 with satisfactory composite reliability values ranging from 0.87 to 0.94 and average variance explained values ranging from 0.70 to 0.84. The results of the structural relationship analysis revealed that the source of internet-based medical knowledge (path coefficient –0.26, P=.01) and justification of internet-based knowing in medicine (path coefficient 0.21, P=.001) were correlated with the intention to use evidence-based online medical databases. However, certainty and simplicity of internet-based medical knowledge were not. In addition, gender (path coefficient 0.12, P=.04) and academic degree (path coefficient 0.15, P=.004) were associated with intention to use evidence-based online medical databases for clinical practice. ConclusionsAdvancing health care professionals’ ISEBM regarding source and justification may encourage them to retrieve valid medical information through evidence-based medical databases. Moreover, providing support for specific health care professionals (ie, females, without a master’s degree) may promote their intention to use certain databases for clinical practice.

Simple Summary: Radium 223 (Ra-223) is a radiopharmaceutical that targets tumor-induced osteoblasts (bone-forming cells). Ra-223 reduces bone pain and prolongs overall survival in men with bone-metastatic, castrate-resistant prostate cancer. However, increased fracture risk in skeletal sites with no bone metastasis has been observed in patients treated with Ra-223. The aim of this study was to examine the effects of Ra-223 on resident osteoblasts and normal bone structure in mouse models. Upon Ra-223 treatment, 70% of resident osteoblasts were reduced within 2 days, and the reduction lasted for at least 18 weeks. Ra-223 reduced the osteoblasts mainly localized in trabecular bone areas. Ra-223 also reduced bone mineral density and altered bone microstructure in the trabecular area of femurs. Furthermore, Ra-223 treatment also significantly reduced tumor-induced osteoblasts. These studies show that Ra-223 affects the structure of bones that are not involved in bone metastasis. Strategies that improve bone health may reduce fracture risk in patients receiving Ra-223. Radium 223 (Ra-223) is an α-emitting bone-homing radiopharmaceutical that targets tumor-induced osteoblasts and is used to reduce bone pain and prolong overall survival in men with bone-metastatic, castrate-resistant prostate cancer. However, increased fracture risk in skeletal sites with no bone metastasis has been observed in patients treated with Ra-223. Both luciferase- or green fluorescence protein (GFP)-labeled osteoblast reporter mice were used to monitor the effect of Ra-223 on resident osteoblasts and normal bone structure. Upon Ra-223 treatment, 70% of resident osteoblasts were reduced within 2 days, and the osteoblast reduction lasted for at least 18 weeks without detectable recovery, as measured by in vivo bioluminescent imaging. In GFP-labeled osteoblast reporter mice, Ra-223 mainly reduced osteoblasts localized in the trabecular bone areas; the osteoblasts in the growth plates were less affected. Micro-computed tomography analyses showed that Ra-223 significantly reduced bone mineral density and bone microstructure in the trabecular area of femurs but not in the cortical bone. Tumor-induced bone was generated by inoculating osteogenic TRAMP-BMP4 prostate cancer cells into the mouse femurs; Ra-223 treatment significantly reduced tumor-induced osteoblasts. Our study shows that Ra-223 affects bone structures that are not involved in bone metastasis. Strategies that improve bone health may reduce fracture risk in patients receiving Ra-223. [ABSTRACT FROM AUTHOR]

PurposeTo investigate the molecular events associated with the activation of androgen receptor (AR) as a potential therapeutic target in patients with salivary duct carcinoma (SDC).Experimental designComprehensive molecular and expression analysis of the AR gene in 35 tumor specimens (20 males and 15 females) and cell lines derived from SDC using Western blotting and RT-PCR, FISH analysis, and DNA sequencing was conducted. In vitro and in vivo animal studies were also performed.ResultsAR expression was detected in 70% of the tumors and was mainly nuclear and homogenous in both male and female SDCs, although variable cytoplasmic and/or nuclear localization was also found. We report the identification of ligand-independent AR splice variants, mutations, and extra AR gene copy in primary untreated SDC tumors. In contrast to prostate cancer, no AR gene amplification was observed. In vitro knockdown of AR in a female derived SDC cell line revealed marked growth inhibition in culture and in vivo androgen-independent tumor growth.ConclusionsOur study provides new detailed information on the molecular and structural alterations associated with AR gene activation in SDC and sheds more light on the putative functional role of AR in SDC cells. On the basis of these data, we propose that patients with SDC (male and female) can be stratified for hormone-based therapy in future clinical trials.