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Drinking Water Distribution System in Clinton City, Utah

Environmental Technology Unit 4 Case Study

This paper will focus on drinking water distribution system in Clinton City, Utah. Clinton is a lively Utah Community containing a total of 21000 residents who experience high quality of life in a family oriented, safe rural atmosphere. Clinton city is situated just southwest of Ogden and North of Salt Lake City; nestled between the Great Salt Lake and Wasatch Mountains. The city drinking water system is maintained and operated by the Clinton City Water Department. The city water system on average delivers 1.5 million gallons of water daily to the city resident, which amount to a total of 554 million gallons every year for drinking water only; does not include secondary water system which cater for irrigation (Clinton City, 2018a).

Read also Water Supply and Management In Michigan

The city main source of drinking water is from Weber Basin where the city purchases the highest percentage of drinking water from Weber Basin Water Conservancy District. The water is the distributed through a system that is operated and owned by Clinton City. To supplement the purchased water, Clinton city water department also created and operates a deep water well which is 1100 feet deep and generated more than 1200 gallons of crystal clear water per minute. The two sources of water are used to ensure the city has enough drinking water (Clinton City, 2018b).

Read also Will the Earth run out of Clean Water?

The city drinking water system contains over 80 miles of piping, 834 Fire Hydrants, 1100 control valves and storage tanks with a capacity 6 million gallons in total. The piping system is meant to ensure that the water is able to flow from Weber Basin to the city. The city’s water department uses metallic pipes; ductile-iron pipe to draw water from Weber basin and to distribute it to the residents. However, PVC pipes have highly been used in the distribution system in the city (City of Clinton, 2017).  The pipes drawing water from Weber basin contain a larger diameter compared to the pipes distributing water to the residents. This is done to ensure control on water pressure. The pressure of the water is highly determined by the depth of the pipe on the ground and the diameter of the branching pipe. The pipes diameter range from 3-inch to 64-inch based on the position of the pipe in the system and the number of people it intends to supply with water. The recommended standard diameter for distribution pipe is 8-inch though 6-inch pipes can be used in different occasions (Clinton Utilities, 2009).

Read also Water and Sanitation in Haiti : A Global Health Issue

Clinton Water Department ensures that Clinton residents get well treated clean water to drink. To guarantee high water quality, the water is tested very frequently by the department where by a total of 27 samples are taken every month to test for the presence of any harmful bacteria. Many other samples are drawn to assess other water contaminants needed by the Clean Water Act to ensure that the water provided to the residents is clean. In addition to this, the department uses chlorine to kill viruses and bacteria which would be found in the water. The department considers chlorine as the best disinfectant since it has a history of 100 years of efficiency in ending epidemics of diseases recorded before its application. Other than chlorine, the department also adds fluoride into the water supply after realizing that the city water source does not contain enough fluoride to offer oral health benefits. Thus fluoride is added in water supply to ensure it is in suitable level which assists in preventing tooth decay.  The average level of fluoride in the city is about 1.0 part in every million which is similar to a single drop in every 3.2 water gallons. It is also similar to one inch in every 16 miles (Clinton City, 2018a).

Read also Clean Water Act

The special attributes which make Clinton city proud is that their tap water is clean and preferable for drinking compared to bottled water. This safe people cost in purchasing bottled water which is considerably expensive compared to tap water. Having high quality tap water ensures good health to all including low income families that cannot afford to purchase bottled water. The city water department has ensured that the drinking water provided in homes taps is of high quality and has adhered to Federal drinking water quality standards. The water is regularly tested and treated with chlorine to eliminate pathogens. The water is also supplemented with fluoride to improve its benefits and quality. In addition Clinton city drinking water is hard water containing a good percentage of magnesium and calcium elements which play a great role in enhancing human health (Clinton City, 2018a). Although the hardness may impact the water usage in washing, the hardness is highly beneficial to the human body. In addition to this, the city water department employs great effort to ensure that the drinking water distribution system up to the meter point is working effectively and hence it fixes leakages, blockage or any other piping issues for the resident up to the meter point where the residential owner is left responsible for the repair and maintenance of the part after the meter.

Company With Best Innovation – Amazon

AMAZON.COM – Innovation Audit

            Innovation audit is the inspection of an organization’s innovation capabilities with the aim of discovering exact strengths and weaknesses of innovation processes and practices, as well as determining the best way of improving performance. This document presents innovation audit for It begins by describing organizational background and history. The subsequent sections focus on key drivers of innovation at the company, sources of innovation, innovation capability mapping, and hindrances to innovation.

Organizational Background

            Amazon is the world’s largest online retailer. Officially launched in 1994, the company started as a book seller before transforming into a provider of a broad range of products and services through its multiple websites. Today the company operates via three segments based on product offerings and strategic regions of its market: (1) Amazon Web Services (AWS), (2) North America, and (3) International services (Amazon Inc., 2014). Primary products and services include merchandise and content that the firm purchases from vendors for resale and stocks offered by third-party sellers. Recently, Amazon has ventured in the manufacture and sale of electronic devices such as the popular Amazon Alexa smart speaker. Through its many subsidiaries like the Whole Foods Market, the company is also involved in the sale of organic foods and staples. The North America segment focuses on consumer products, including those from sellers, and subscriptions through websites like The international segment comprises retail sales and subscriptions via international-focused websites while the AWS segment deals with the sale of computing, storage, database, and web-based products.

Current State

            Amazon retains the title of the largest retail business in the world. It is one of the highest grossing online companies with an approximated annual sales of $180 billion. Over the past decade the firm has increased its sales by almost $150 billion (Wearetop10, 2018). In 2008, sales totaled $19 billion while in 2017, they amounted to $177 billion. The total market share value for the company’s stock is estimated to be 669.8 billion (Wearetop10, 2018). Comparing this value to the Gross domestic Product of countries, Amazon emerges wealthier than 16 nations. With an estimated 12 million products, excluding books, wine, media, and services, and 341 million more from third-party sellers, the firm’s customer base is exceptionally diverse and the target market includes all consumers around the globe.

Read also Amazon’s SWOT , PESTEL Analysis and Porter’s Five Force Appraisal Analysis

Over 1000 million customers use the company’s Prime service. 72% of all amazon customers usually end up spending between $100 and $500 on the Amazon’s websites annually and half of web shoppers visit the sites to search for products (Wearetop10, 2018). Amazon webs services and products, including Prime Video service, Amazon Alexa, and renewable energy solutions have also attracted a large audience worldwide. The company’s workforce currently stands at 117,000 workers worldwide. Evidently, Amazon has demonstrated to be an innovative company and a prime contender in the online market place. The firm continues to grow through development, acquisitions, and new products and services.

Drivers of Innovation

            Innovation refers to the process of transforming an idea into a valuable service or product. One of the principal factors behind Amazon’s success is its innovation. Drivers of innovation at the firm range from technological advancement, new social norms, to organizational culture.

Read also Innovation Planning and Design Process

Technology (Information and Communication Technology)

            Technology was not only a key driver in the formation Amazon, but also in the exponential growth of the company. In fact, Amazon is considered as one of the Big Four Horsemen of technology along with Alphabet, Apple, and Facebook. Before the company’s launch, Jeff Bezos, the founder, visualized the internet as an opportunity to open an online store. He initially launched the firm as a website for selling books. Nevertheless, he had a vision for growth and even aspired to expand the business into an all-inclusive store with a range of products. Later, Amazon included new product lines with music CDs, DVDs, videotapes, and software in its stock. The list grew quickly to incorporate baby products, apparel, electronics, beauty products, and even groceries. In essence, Amazon was an early adopter of the internet as a commerce platform (Chaffey, 2018). The firm launched in 1994, only three years after the internet was opened for commercial use. With E-commerce, users could traverse geographical barriers to get what they wanted and use electronic payments that did not require physical presence. Through time, Amazon has capitalized on every new technology in the internet, including security protocols and Artificial Intelligence (AI) to raise value for its customers which is one of the critical reasons for its grate success (Cloud, 2008).


            Competition is a major driver of innovation at Amazon just as it is a central factor in novelty in other businesses and industries. After the launch of Amazon, many entrepreneurs decided to espouse e-commerce in order to traverse geographical boundaries and reach a wider customer base. This competition meant that every business was aiming to provide the latest and most valuable products and services to customers (vickery, 2018). Amazon innovated various strategies to outsmart its competitors such as incorporation of user friendly websites, broader product assortments, highly competitive pricing, and greater convenience in delivery and sale. Product and service differentiation has been a chief element of Amazon’s competitive edge and marketing strategies. By retaining creativity in its products, customer-orientation, and a focus on quality, Amazon has carved out its own image in a crowded marketplace.

Human Capital

            Amazon’s innovative organizational culture enables the company to seek talented employees who are bold enough to take risks and create new ideas (vickery, 2018). This is facilitated by availability of a skilled workforce with key prerequisites for innovation in the technology and originality frontiers. In the modern business environment, workers are not only required to create but also learn new production techniques. Moreover, the percentage of people with university degrees has risen in the recent decade. This reflects a high availability of skills in the market which in turn, shape human capital at Amazon.

Economic Climate and Market Conditions

            A culture of innovation is easiest to maintain where market conditions reinforce the confidence to take risks (Gewirtz, 2016).  Although the economy was plagued by the 2008 financial crisis, Amazon succeeded in exploiting economic and market enablers of its enterprise, particularly those related to e-commerce. Furthermore, the U.S. economy promotes investment and entrepreneurship by according the private sector with economic freedom and the autonomy to choose the direction and scale of production. With regard to the market, the recent period has seen a significant shift from conventional to online shopping where a majority of millennials prefer to order products online at their convenience. This change has not only allowed amazon to innovate it offerings but also personalize shopping experiences.

Sources of Innovation

            Sources of innovations in the case of amazon vary greatly depending on the context. The main sources include incongruity in the market, process need, market structure, and demographics.

Incongruity in the Market

            The need for diverse products and services has shaped innovation in many ways. For instance, the frustrating experience of typing and waiting for online search results to load prompted Amazon to develop a device that could listen and answer questions immediately. The Amazon Echo device, which is powered by an AI assistant, is personable and connects to Amazon’s cloud service in order to work (Bausch, 2017). It delivers what Google could not deliver in its conventional search engine. It is a common trait for human beings to fill incongruities that they notice around them.

Process Need

            Amazon regularly identified weak spots in its processes and redesigns or corrects them. This is a task-oriented solution that creates an innovative culture from existing capabilities. A case in point is the use of robots to carry stock around Amazon’s expansive stores. The company owns over 100,000 robots that help in sorting, packing, and relocating stock.

Market Structure and Demographics

            The expansive retail industry in which amazon operates is in continual flux. Some products lines expand while other shrink. This is especially true with technology products which quickly evolve. Additionally, regulations change abruptly, often requiring Amazon to be innovative in order to guarantee survival (vickery, 2018). By the same token, demographic factors command businesses like Amazon to adopt new ways of service. A fitting example is the use of web-based service platforms to serve the modern generation of shoppers.

Innovation Capability Mapping

            Amazon relies on knowledge sharing and collaboration among its employees to fuel innovation (Gewirtz, 2016). The company provides various types of access to its employees including graphics user interfaces. These user-friendly interfaces allow the workforce to participate in mass collaborative knowledge processing. The user interface is adequate for most workers, although requesters occasionally need versatile services. In such cases, the user resorts to program interfaces to consult, submit, and design new bits of knowledge. Generally, the company relies on a custom system that connects departments and teams in accordance with functions and hierarchy. New bits of knowledge submitted by employees is used to design new processes, solve problems, and perform continuous improvements.

Hindrances to Innovation

            Barriers to Amazon’s innovation are not related to the organization per se but rather to the external environment. For instance, the current business environment evolves so fast that it becomes a challenge for organizations to keep up. As a large, process-driven firm, Amazon struggles to keep up with changes, especially in technology because of ‘liabilities’ such as a large base of existing customers, highly scaled leveraged processes, and brand equity. Fortunately, the company does not rely on legacy tech. Another challenge concerns high levels of regulation in the market. A majority of amazon services depend on data sharing which is increasingly being regulated aby authorities, thus impending innovation.


            In order to secure its position in the marketplace, Amazon needs to continue utilizing innovation in its operations. The following recommendations will serve as strategies for improvement:

  • Amazon should continue to focus on quality rather than branding.
  • Amazon should entice new shoppers as consumers are less interested in value ranges.
  • The company should create a flexible organizational culture to allow for innovation.

BEM 4351 – Environmental Technology Unit 3 Questions Answered

Explain what a point source is in regards to water pollution.

Point source pollution refers to any particular identifiable pollution source from which pollutants are discharged. Point source discharges pollutants from distinct conveyances. Point source can include factory or ship smokestack, ditch or pipe.  

Discuss the roles of pathogenic organisms, inorganic chemicals, and sediment in water pollution.

Pathogenic micro-organisms are essential biological pollutants which are responsible for various human water borne diseases which include dysentery, cholera, hepatitis, and typhoid infections. Pathogen contamination that includes viruses, protozoa, and bacteria poses a serious threat to water resources. There is also pathogens transport to groundwater from surface water which increases the groundwater vulnerability.  Pathogens that include viruses are of much less quantity in water compared to protozoa and bacteria and majority can possibly reach groundwater via porous matrices of soil. Inorganic substances contain by far the highest percentage of drinking water chemical contaminants. Inorganic substances are in greatest quantity as natural processes consequences though a number of essential contaminants are present due to man’s activities.

Read also Clean Water Act

Some most significant inorganic chemicals originate from plumbing material where water is passed. Inorganic chemical contaminants are the most significant determinants of suitability to the consumer, impacting color, taste and scale deposition on fittings and pipes (Fawell, 1993). Sediment is the loose sand, silt, clay and other particles of soil that settle at the bottom of a water body. Sediment can originate from soil erosion or from animals and plants decomposition. Wind, ice and water help carry these particles to streams, lakes and rivers. Sediment impacts the aquatic life sometimes where by high volume of sediments chock coral reefs, seagrass beds and other sensitive habitats of the sea.  Sediments also silt the water bodies sometimes forming sediments rocks.

Why is thermal pollution a contributor to water pollution?

Thermal pollution is regarded as sudden decrease or increase in the natural water body temperature which might be pond, ocean, river, or lake by human influence. This usually takes place when a facility or plant takes in water from natural resources, alters the temperature through heating or cooling it using machines and puts it back to its natural source. Thermal pollution by heating the water oxygen reduces oxygen in water impacting the composition of the ecosystem. Organisms and fish adapted to specific temperature range can die due to abrupt water temperature change or thermal shock.  The change of oxygen content and altering of temperature which impact water organisms is what makes thermal change of water to be regarded as pollution (Nathanson & Schneider, 2014).

How do sediment basins and channel stabilization help reduce erosion?

Sediment basins and channel refers man-made structure at agricultural operations, construction sites, and other unsettled regions to offer temporal pools for runoffs which permit sediment to settle prior to discharging of runoff water into a landscape, stream or river. Sediment basins trap sediment as well as other coarse materials, preventing soil erosion. Basins and channels help in slowing down runoff flows giving time for eroded soil to settle down and to discharge the water at a slow pace back to the river or close natural water body (Nathanson & Schneider, 2014).

Explain how streams “self-purify.”

A river is capable of purifying itself using complex physical, chemical and biological processes. The river is involved in biological processes of self-purification through total decomposition of organic matters by bacteria, fungi and other microorganisms, and through the utilization of various functional biological filters. The stream also goes through chemical processes that include photochemical, hydrolysis, and oxidation among others and physical processes that include aeration, evaporation, adsorption and sedimentation. All these process assist in stream self-purification (Fisenko, 2006). 

Why does dissolved oxygen “sag”

Dissolved oxygen sags when the biological contaminants need oxygen to decompose and hence reducing the amount of dissolved oxygen in the water for aquatic life. During this stage, oxygen demand is higher than the supply since the waste also needs to be supplied with high content of oxygen to enhance the decomposition process. This results to continuous decrease of dissolved oxygen, causing sag (Nathanson & Schneider, 2014).

Discuss seasonal stratification of lakes including why there is a “fall overturn” and a “spring overturn.

A lake develops vertical stratification due to differences in density between bottom and surface waters. These differences in density can be as a result of biological, chemical or physical processes. The most common form of seasonal stratification in lakes is initiated by the surface water differential heating, making the surface water to be buoyant and less dense above denser colder water. Introduction of water containing saline variation from those of the lake can as well result to impart stratification. Also salts production by processes of biological decomposition can in addition create differences in density, thus causing lake stratification. During stratification fall overturn or spring overturn can be experienced. Fall overturn happens when upper surface of water cools turning to be denser that water in lower surface. As a result, water in upper surface sinks. During the sinking process, the nutrients move up while the dissolved oxygen moves down.  In spring overturn oxygen dissolved from the surface shifts to deep water while there is release of nutrients created through decomposition to the surface (Bade, 2005).

Explain how hydraulic fracturing can lead to groundwater pollution.

Hydraulic fracturing refers to the process of natural gas or oil extraction by use of fracking fluids to inject wells containing toxic chemicals, sand, and water, at very high pressure. Freshwater is injected in hydraulic well, and contaminated water is left on the well after the extraction process. IN case the well is not properly constructed, the contaminated water can infiltrate to other underground water sources causing contamination. In addition, the water may manage to spill off and join other surface water sources by joining the runoffs (Nathanson & Schneider, 2014).

Read also Types of Sources of Environmental Pollution And Effects of Environmental Pollution on Human and Ecosystem Health

 Discuss the typical differences in treating surface water versus groundwater for drinking water

Generally surface water contains a lot of contaminants compared to groundwater. Therefore, the two types of water are treated differently. Ground water is first tested for E. coli and other physical and chemical characteristics which include salinity and radioactivity. Retesting should be done in case of any modification in water quality based on color, taste and odors.  The adapted water treatment system should be guided by the types of identified contaminants. UV disinfection can be used to kills protozoa, viruses and bacteria in water. Filtration should be done to eliminate specific maters from the water. Chlorine disinfection should then be done to treat water over harmful giardia, viruses and chemical. On the contrary surface water is first coagulated where positive charges are introduced in the water to neutralize dirt negative charges in the water. This is followed by sedimentation where sediments are settled at the bottom of the supply of the water.  Filtration is then done where the clean water from sedimentation stage is passed through filtration system eliminate dissolved particles that include chemicals, viruses, parasite and dust.  The water is then disinfected using chloramine or chlorine so as to kill the remaining viruses, bacteria, and parasite and to safeguard water from germs (CDC, 2015).

List one health effect of too much exposure to each of the following: nitrate, selenium, and benzene.

Excessive exposure to selenium can result to organs damage. It can also result to development of diabetes, increase risks of development of selenium toxicity which characterized by fatigue,, nausea, irritability, hair loss, and nail inflammation. Excessive exposure to selenium can also result to blood clotting issues, facial flushing, lightheadedness, tremor, and muscle tenderness. Excess exposure to nitrate can resulted to acute methemoglobinemia, hypotension, increased risks of complications during pregnancy, increased danger of developing diabetes mellitus and has also been identified as a carcinogen. Benzene has been documented as a carcinogen and hence high exposure to benzene can increase the risk of developing cancer. Benzene can as well result to genetic defects, while repeated or prolonged exposure can result to organs damage (Nathanson & Schneider, 2014).

A sedimentation tank for water treatment is designed to have a detention time of four hours. If the flow rate entering the tank is 20 ft3/s, what is the tank volume required in cubic feet?

Detention time = volume /Flow rate

Volume = detention time x flow rate

1 hour -60minutes

1minutes -60 seconds

60mins – 3600 seconds

So 1 hour – 3600 seconds and thus 4 hours = 14400 seconds

Volume = 14400 x 23 ft/s

=331200 ft3

Explain the coagulation / flocculation process including when and why it is used.

The flocculation refers to process employed when there is a high turbidity level in water or when liquids must be separated from solids. Flocculation is effective in removing colloidal material, solids and color and reducing turbidity from water. Flocculation involves four main steps that include coagulation where chemical coagulants are input in water with intention of destabilizing finely divided materials and colloidal making them to start aggregating. This is followed by flax mixer where water with coagulant chemicals is mixed forcefully and quickly to ensure the chemicals are distributed evenly in the water. This is followed by flocculation which starts through a gentler, slower mixing which brings the fine particles created in coagulation step into contact with one another. The speed changes in every compartment and the entire phase takes 30 to 45 minutes. The last stage is clarification where clarifiers with basins or tanks hold wastewater or water for enough time to permit settling of floc; bacteria and impurities clumps bound together in a cluster, as well as other suspended materials at the bottom. This stage ensures removing all forms of sediments, particles, color, natural organic matter and oil (Filtronics, 2012).  

If a rapid sand filter is to be operated at 2 gpm/ft2 (gallons per minute per square foot of surface area), what filter surface area (in square feet) is required to treat 200,000 gpd (gallons per day)?

Surface loading rate, gpd/ft2 = flow, gallons/day/ surface area, ft2

1 day = 24 hours

I hour = 60 minutes

24 hours = 1440 minutes

1 minutes – 2gp/ft2

1440 minutes – 2880gp/ft2

SLR = 2880 gpd/ft2

2880gpd/ft2 = 200000/surface area

Surface area= 200000/2880

surface area = 69.44 ft2

Discuss the chlorination process.

Chlorination refers to the process of adding chlorine to drinking water to kill germs and disinfect it. In this process chlorine compounds that include solid calcium hypochlorite and sodium hypochlorite or chlorine itself can be added at the right dose in water. The compound is mixed in water and spread all through resulting to destruction of germs without causing harm to the water user (Nathanson & Schneider, 2014).

Explain the lime-soda method of water softening.

Precipitation of chemicals is one of the most common techniques employed to soften water. Calcium hydroxide also known as lime is one of the most common chemicals used in water softening. Lime is utilized to eliminate chemicals which yield to carbonate hardness. When lime is added into the water the calcium hydroxide combines with hardness causing chemical compound creating calcium carbonate precipitation or magnesium carbonate precipitation, softening the water (Nathanson & Schneider, 2014).

The Molecular Basis of Cancer


Cancer refers to a group of diseases typified by unregulated growth of cell and the spread and invasion of cells from the primary site or site of origin to other parts of the body. Cancer development involves a multistep process which needs the multiple genetic mutations accumulation in a single cell which presents neoplastic cell typical features. Tumor cells are characteristically different from normal cell since they demonstrate uncontrolled growth.

Read also Cancer Diagnosis and Staging, Complications And Treatment Side Effects

About 85% of cancers happen in epithelial cells and are grouped as carcinomas. However, cancer can occur in other cells including mesoderm cells, and glandular tissues. Cancers can be of distinct features and origin. In addition, the main factor which causes cancer in every target tissues varies extensively. Moreover, there are variations in the molecular mechanisms engaged in carcinogenesis in each type of cell and the cells spread pattern from the primary site. Hence different treatment may be needed for different cases. This paper focuses on summarizing the cancer biology.


Cancer results from DNA sequence alterations. A large quantity of evidence demonstrates that the tumor cells DNA has a number of alterations ranging from large chromosomal aberrations that include chromosomal translocations and deletions to subtle point mutation. The cell mutations accumulation over time stands for a multi-step process which inspires carcinogenesis.

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The requirement for mutations accumulation over time explicates why there is increased cancer risk with age. About all tumor cells identified mutations are somatic mutations where in the somatic cell DNA has been damaged. The mutations however are not inherited by next generation of offspring, though after cell division, they are passed to daughter cells. Inheritable chromatin and genome structure modifications also play a part in carcinogenesis. Therefore at cellular level, cancer is regarded to be a genome disease, and thus only egg or sperm cells DNA alterations will be inherited by offspring.

Loss of genes Functions

There are three essential processes which contribute to the general net number of cells in an individual. These processes include cell proliferation which involves division of cells to create two daughter cells. This is followed by cells elimination through programmed death of cell which also affects net number of cells. The finally, the inactive phase which cells enter during cells differentiation process which can as well impact the net number of cells. The DNA mutation which can change the normal function of genes involved in differentiation, apoptosis, or growth can affect the cell numbers balance in the body and result to unregulated growth (). Cancer originates from a cell which has obtained genetic mutations in main genes regulating DNA repair, cell death pathways, and cell cycle. Consequently, tumors will progress to have cytogenetically diverse clones due to genetic instability initiated by the first mutations. It has been demonstrated that instability of chromosomes is an essential feature of a various kinds of cancer. It has been clear in the recent past that double stranded break of DNA and abnormalities of enzyme repair can enhance carcinogenesis. Actually, there is evidence demonstrating that deregulation of enzymes liable for DNA breaks repair can introduce lesions that might result to extensive genomic instability, resulting to cancer. This might happen when breakage of DNA strand happens and repair is bypassed and not done, if the cycle of the cell progresses either because of P53 signaling pathway abnormalities. The yielding cell clones are destined to have inherited some kinds of genomic perturbations.  


Most of solid and haematological tumors are initiated by specific gene which enhances carcinogenesis usually regarded as oncogenes. These oncogenes are liable for production of genes, transcription factors, receptors, and growth factors engaged in apoptosis regulatory and chromatin remodeling factors. It is usually accepted that oncogenes are the main genes causing cancer. A study involving single cultured cells mined from non-transgenic mammary gland of mice and that assessed the oncogenes role in carcinogenesis and suppression of cancer in primary cancer cells was conducted with intention of determining the role of oncogenes in cancer development. 

Read also The Role of Infectious Agents in Oncogenesis

The study established that cells of mammary gland from mice expressing doxycycline controlled oncogenes kras and myc, lost their acini divisions and had augmented rate of cell proliferation, filling up the glands lumen, proposing cell cycle control loss and augmented cell proliferation. Moreover, when oncogenes are eliminated, the cells demonstrated a substantial decline in cell proliferation and the cells which filled up the lumen earlier went through programmed death of cell, with exception of cells located at the edge of the tumor. The study evidently illustrated that oncogenes play a great role in tumor regression and carcinogenesis. The study in addition demonstrates that cells at the tumor edge might survive the oncogene withdrawal effects by remaining in dormancy state till further events have taken place before another growth episode can happen. This mostly contributes in relapse of the tumor.

Tumor Suppressor

Tumor suppressor refers to molecules that are normally engaged in blocking tumor triggering signals. Various tumor suppressor genes have been evaluated for an obligation in cancer etiology for instance loss of mutation function in gene NF1 tumor suppressor that encodes neurofibromin has been said to initiate inherited cancer regarded as neurofibromatosis type 1. NF1 is also related to glioma development3. NFI has also been demonstrated to be created during progression cell cycle and degraded by Ras prompted during protein Kinase C (PKC) activation and hence PKC inhibition result to stabilization and accumulation of NF1 in various glioblatoma human cells in vitro.

Read also The Tumor Microenvironment – A Scientific Brief

Tumor suppressor genes that are thought to be engaged in normal cellular proliferation suppression and employ a negative cell cycle regulation are usually inactivated in tumors. This function loss is either as a result of mutations, epigenetic changes or/and deletions. Mutations of tumor suppressor gene are recessive to usual allele therefore, imposing the second eilde-type allele inactivation for tumor formation. The determinants of germline of about all familial cancers are established to be mutant tumor suppressor genes alleles. Since there are safeguards created into the system, two or more mutations have to take place before formation of cancer.  


The molecular basis of cancer also involves understanding apoptosis. Apoptosis refers to a programed death of cell that is usually involved in the maintenance and development of an organism. Apoptosis might be induced after a cell turns to be abnormal particularly during tumor and maybe during malignancy thus causing the death of abnormal cell. Nevertheless, the abnormal cell may fail to as a result of mutation which results to either malfunction of this kind of tumor gene suppressor as p53 gene, which is a gene which initiates apoptosis or excessive expression of this kind of proto-oncogene such as bcl-2 that generate large volumes of bcl-2 protein that deactivate apoptotic program. Lymphomas malignant originating from changed b-lymphocyte is initiated by bcl-2 gene mutation. 

Telomerase Activities

Molecular basis of cancer can also be explained in telomerase activities. Telomerase refers to RNA-related enzyme which synthesis telomeres, specific DNA sequences found at the chromosome tip that prevent the continuous DNA loss during the cell replication process. A norm cell contains replication period, and only stop diving when it ages. Tolemeres partially regulate the cell dying and aging process as they shorten each time cell divides and chromosomes replicate6. Once telomeres are shortened to a specific size, the cell attains a crisis point where it is prohibited from dividing anymore and hence it dies, thus working as tumor suppressor by initiating cell death. Equally, the telomeres shorting in a cell going through replication can be prohibited either through expression of oncogenic or tumor suppression activity inactivation. Telomeres in the transformed cell do shorten, though as the crisis point becomes closer, a telomerase enzyme which was previously inactive is activated and therefore stopping telomeres from further shortening thus prolonging the cell life. Actually activity of telomerase has been identified in over 90% of human cancer tumors that include ovarian, breast, prostrate, and colon cancers. Telomerase might in addition act to enhance tumor genesis through mechanisms which do not rely on telomere length. Therefore, tolemere length maintenance and telomerase activity are important replicative ability maintenance in cancer cells.  Once the telomeres are reduced past a specific point in normal cells, the telomere function loss results to activation of cell-cycle checkpoints which are dependent on p53, resulting to apoptosis or proliferative arrest. Transformed cells might however contain defects in checkpoints of cell-cycle, permitting critical shortening of telomere in dividing cells. These cells might survive with defects of chromosome that result to instability of genomic or die through apoptosis. Telomerase reactivation in cells containing abnormal genomes deliberates unlimited proliferative cells capacity which contains tumouri-genic ability. 

Epigenetic Perturbation

Epigenetic perturbation is another molecular basis process of cancer where expression of gene can be changed without altering the DNA sequence. It has more recently become clear that changes of epigenetic in the CpG islands close to the tumor suppressor genes promoter areas might as well add to genetic instability. Most of the researches have demonstrated that loci epigenetic changes that control various unique factors of transcription might yield to miss-interpretation of various histone codes and generate aspects that can dysregulate control machinery of cell cycle resulting to cancer. The research on the subject demonstrated that instability of chromosomes as a result of translocations might result to factors promotion which can disrupt methylation-readout or methylation status of some essential loci in the DNA resulting to cancer. Therefore, epigenetic perturbation might contain some significant implications in initiation of cancer.


Agiogenesis is another aspect involved in molecular basis of cancer. Based on research the survival and function of cell depend on nutrients and oxygen offered by the surrounding vasculature. This is factual not just for normal cells but their malignant counterparts too. Agiogenesis is said to play a vital role for tumor explants explosive growth. In addition, the research has also demonstrated that anti-VEGF antibody do impair neovascularization and growth of mice subcutaneous tumors. The angiogenic-switch, which refers to aptitude to sustain and induce angiogenesis appear to be a discrete step in development of tumor, resulting to an alteration in the inducers balance and angiogenesis inhibitor.

Read also Tumor Angiogenesis

Most tumors have been demonstrated to have an increased FGF or/and VEGF expression, which are both strong angiogenesis stimulators, comparative to their non-malignant equivalents, while others show a decreased angiogenesis inhibits expressions that include interferon β2 and thrombospondin- 1. The mechanisms fundamental to these shifts in expression of gene are not effectively understood. However, since tumor angiogenesis might play part in majority of solid tumors, it provides an attractive therapeutic objective and the anti-angiogenic strategies research has already resulted to multiple clinical trials.

Metastasis and Invasion

Metastatic disease represents 90% of adults’ cancer deaths. Although this might not be the case with children who the main malignancies are brain tumors and leukemia, it still shows the situation among children established to have solid tumors. To fruitfully produce a metastatic tumor, beyond the already discussed characteristic of cancerous tumor, the malignant cell requires the aptitude to leave the basic tumor, drift into blood circulation, live there, exit the blood circulation system and proliferate and settle in a new microenvironment. Although the extra cellular integrins, cadherins, and pro-invasion is being invested intensively, the molecular mechanism and regulatory circuits controlling this process persist to be elusive. 

Targeted Molecular Therapy

Agents utilized in targeted cancer therapy inhibit specific signaling pathways and receptors which enhance growth of tumor cells. These agents comprise of tyrosine kinase inhibitors (TKIs) small molecule and monoclonal antibodies. The tyrosine kinase family receptor includes families of platelet-derived growth factor receptor (PDGFR), epidermal growth factor (EGF), vascular endothelial growth factor receptor (VEGFR) and epidermal growth factor receptor (EGFR). These therapeutic agents obstruct signaling of receptor tyrosine kinase by binding to the growth receptors extracellular component. The agents can bind the ligand which initiates the bind or receptor intracellular sites which interfere with downstream events of signaling. The targeted agents’ toxicity profiles differ considerably from those of standard chemotherapy since they do not obstruct DNA replication.

Physiologic Basis of the Different Types of Hormonal Birth Control

Hormonal contraception is a method of preventing pregnancy that acts on the endocrine system, which is essentially the body’s chemical messenger system. Administered via oral, patches, implants or depot injection method, hormonal birth control methods alter the level of estrogen and progestin analogs. The contraceptive effect is facilitated by negative feedback in the hypothalamus which leads to reduced secretion of luteinizing hormone (LH) and follicle stimulating hormone (FSH). This alteration obstructs the process of ovulation and ultimately prevents pregnancy. In other cases, progestin hormone thickens cervical mucus, decreases tubal motility, and inhibits endometrial proliferation, thus decreasing the chances of implantation. For each dosage, a woman may receive progesterone or a combination of estrogen and progesterone. A combination of the two hormones suppresses ovulation by inhibiting gonadotropin secretion.  Since hormonal contraceptives alter endometrial growth, they can theoretically block conception by impeding implantation.

Read also Landmark Cases – Birth Control and Abortion

As discussed above, there are two types of contraceptives: Combination contraceptives and Progesterone-only contraceptives. The former contain progestin and estrogen. The role of progestin is to bind progesterone receptors. Combination contraceptives are the most widely used. Dosage is more often than not administered every day for three weeks after which placebo pills are administered in the remaining week of the month. It is common for users to experience withdrawal bleeds, which signifies that pregnancy has not occurred, in the week they are taking placebo pills. There are variants of combination pills that eliminate the use of placebo pills. Such pills are clinically suited for women who suffer from painful menstruation (dysmenorrhea) and excessive menstrual bleeding (menorrhagia). It is important to note that steroid hormones are nonpolar. Thus, they may be delivered topically (applying them to body surfaces like the skin or mucous membranes). Combination contraceptives that are administered via this method comprise a patch that is replaced on a weekly basis and a vaginal ring that is worn for three weeks for replacement.

Progesterone-only contraceptives exist in two variants: low-dose pills and long-acting methods. Low-dose pill methods may be effective for women who want to avoid pregnancy in short time spans while long-acting methods are suited for those who cannot or do not want to remember to take a regular dose. Low-dose pills are less effective than combination contraceptives and are primarily aimed at preventing ovulation. Their effectiveness is subject to the ability of progesterone to alter cervical mucus. As a result, it is necessary for the user to take these contraceptives regularly, preferably at the same time every day. This ensures that the plasma level of progestin is enough for altering cervical mucus. The low-dose pill method is recommended for women who want to avoid estrogen or those who are lactating and don’t want to become pregnant since high progesterone and estrogen levels can inhibit milk synthesis. The long-acting variant of progesterone-only contraceptive is the most effective type of hormonal contraception. These methods comprise an injection that is given once every 3 months, intrauterine device that releases a progestin, and an implantable rod that secretes progestin. The implantable rod and intrauterine device are more effective as they work for years once they are inserted. The method works by releasing a steady dose of progestin which prevents ovulation via negative feedback inhibition.

Breast Cancer – Detailed Research Paper


Breast cancer is among the most common causes of cancer among women and among the main cause of cancer related death in the world. Breast cancer is named after the organ where cancer originated, though it may spread to other parts of the body surrounding the breast. Breast cancer affects both men and women, though it is more common to women than men. Women can get breast cancer at any age, though it is more common among older women from age 50 to 74. Women of this age are thus needed to take breast screen after every two years to enhance its early diagnosis and effective treatment.

Read also Human Breast Anatomy – Detailed Research Paper

Breast Cancer Types/ Forms

Breast cancers can be groups as non-invasive and invasive. Non-invasive breast cancer refers to a form of cancer where the cancer cells are limited to the ducts and hence they do not invade surrounding breast connective and fatty tissues. There are two main forms of non-invasive breast cancers which include ductal carcinoma in situ (DCIS) which is the most popular form of non-invasive breast cancer, accounting for about 90% of non-invasive cancer cases in the world. The other form is lobular carcinoma in situ (LCIS).  Invasive breast cancer cells on the other hand break through the lobular wall and duct and attack the surrounding breast connective and fatty tissues.

Read also Inflammatory Pathology of the Human Breast

The most common form of invasive cancer is infiltrating ductal carcinoma (IDC) that starts in breast milk ducts and penetrates the duct walls invading breast fatty tissues and other probable areas of the body. This cancer accounts for 80% all cases of diagnosed breast cancer. Another form of invasive breast cancer is infiltrating lobular carcinoma which starts at the milk glands and metastasizes to other body areas. This accounts to 10-15% of all cases of breast cancer.  The least frequently occurring forms of breast cancers include medullary carcinoma which is a form of invasive cancer, mutinous carcinoma which a rare kind of breast cancer created by mucus-producing cancer cell, and tubular carcinoma which is an invasive breast cancer. Others include inflammatory breast cancer which starts as inflamed breast with thick ridges or dimples initiated by cancer cells blocking lymph channels or vessels over the breast skin. There is also the nipple paget’s disease which is a rear kind of breast cancer that starts at the milk duct and spreads to areola and nipple skin, and finally phylloides tumor that can be either malignant or benign. Phylloides tumors generate in the breast connective tissues and might be treated through surgical removal. This form of cancer is quite rare.  


Breast cancer affects both men and women, though the cancer is more common to women and quite rare in men. Breast cancer is the most popular reason of cancer death among women in about 140 out of 184 countries in the world. Breast cancer is the most often diagnosed form of cancer among women, and it currently represents a quarter of all cancers in women. Breast cancer is the main reason for women death in ages 40 to 59. Cases of breast cancer are high in developing countries compared to developed countries, but still remain the leading cause of women death in both situations. The women lifetime risk of getting invasive breast cancer is 12.6%, and one out of eight women in the United States will develop breast cancer at a certain stage in her lifetime.

Risk Factors

The risk factors for breast cancer include environmental factors which include being exposed to ionizing radiation as a result of therapeutic procedures, medical diagnostic procedures, gadgets use or nuclear war increase breast cancer development risks. Another risk factor is sociobiological factors that include age and gender. Breast cancer is more common to women aged 50 and above. Thus being a female and at older age increases risk of developing breast cancer. Nutrition is another factor where by high fats, red meat and caffeine intake increases breast cancer developing risks, while high consumption of vegetables and fruits might reduce breast cancer development risks. Other factors include physiological factors where moderate physical exercise or activities reduce breast cancer risks. Genetic factor where 5 of  6% of occurring cases of cancers are regarded to be hereditary and also family risk factor where cancer history in the family create a possibility of cancer development among other family members. Alcohol is also said to increase breast cancer risks. Individual history of breast cancer increase risks of developing second case of breast cancer. Hormonal history of a woman is also a risk factor where risk increase with number of individual menstrual cycle in a lifetime2. Other risk factors include poor immune system, use of oral contraceptives and hormone replacement therapy, exposure to carcinogens, use of tobacco, the breast pathogenic diseases, chronic breast inflammation, conducting induced abortion, not breastfeeding or breastfeeding for a shorter period, and number of life birth where the more the life birth are the lower the risk of developing breast cancer.   


Breast cancer pathobiology is complex compared to other cancers. Mammary disseminated tumor cells have the ability to remain dormant for a number of years. Nevertheless, the systematic growth of tumor resumes eventually, resulting to clinically recurrent disease. Breast cancer possibly includes over 20 subsets of tumor that affect the disease course. Such subsets of tumor are typified by specific immunological, hormonal and biochemical features.  Subclinical metastasis exists already in most patients during diagnosis time. Cancer cells hematogenous dissemination probably starts after doubling of 20 tumors. 

Molecular Basis of the Cancer

The molecular mechanisms fundamental to the breast cancer development in general and associated breast carcinogenesis in specific are not well understood. It breast cancer initiation is generally believed to emanate from aberrant programmed apoptosis or death of cell or/and uncontrolled proliferation of cell due to collective genetic damages which result to changes of genetics that yield to proto activation which implies inactivation and oncogenes of tumor suppressor genes. Genetic changes in turn can be attained as somatic mutations or be inherited as mutation of gremlin. The somatic mutations may happen due to exposure to biological, chemical or physical environmental carcinogens.

Clinical Manifestation

The breast cancer clinical manifestation include swelling or thickening of some breast parts, new lump underarm or in the breast, and dimpling or irritation of breast skin. Others include flaky skin or redness of the breast or nipple area, pain in the area of the nipple or nipple pulling in. Other signs include other nipple discharge than milk which include blood, change in the breast shape or size or breast pain. Other than visible changes, the presence of breast cancer can be determined by conducting various tests which include mammogram screening, breast biopsy, magnetic resonance imaging (MRI), molecular breast imaging, and blood-based essay. 

Biomarkers and Cytogenetic Laboratory Features

Biomaker analysis in breast cancer is a routine practice. It initially focused on hormone receptor expression testing to guide tamoxifen therapy. It then advanced to human epidermal growth factor receptor 2 (HER 2) target treatment. Biomaker testing has also been integrated in genetic platform dsigned to hhelp prognosis and chemotherapy response prediction in patient with hormone receptors tumor but without lymph-node metastases.

Read also The Role of Biomarkers in Oncology

Other biomarker tests in breast cancer include ki-67 that determines breast cancer proliferative activity, and progesterone and estrogen receptors which predict hormone therapy response (Colomer et al., 2017). Complex karyotypes have been related with unfavorable breast cancer result. Modern methods that include relative genomic hybridization (CGH) and cDNA microarrays have additionally identified complex defects of genetics related with adverse prognosis. 


Metastasis is mechanically described as tumor cells migration from the primary tumor, subsequent by extravasation, survival, intravasation of circulatory system and advanced colonization of a detached site. Tumor cells thus spread extensively through the body, though only grow in supportive location. Breast cancer metastasis is also denoted by pathways redundancy that mediates its component steps or process. Genes enhancing flourishing of breast cancer metastasis include IDI, ERBB2, MET, CTNNBU, SNAI2, KRAS, SNAI1, PI3KCA, TWIST1, EGFR and MMYC. Metastasis complicates the cancer treatment process due to its innate or acquired resistance to therapies. In breast cancer metastasis occurs at the last stages of the cancer and is regarded as the leading cause of death among breast cancer patients.


Breast cancer can either be in situ or not invasive or invasive. In situ is the first stage of breast cancer and it is denoted by stage O. From there the cancer can be in stage I where the tumor diameter is about 2 cm and is confined within the breast. Stage IIA the tumor diameter is about 2cm and has spread to not more than three armpit lymph nodes. Stage IIB tumor diameter is less than 2 inches and has spread to not more than three armpit lymph nodes or the tumor diameter is more than 2 inches though still confined in the breast. Stage IIIA the tumor diameter is about 2 inches and has spread to not more than nine armpit lymph nodes. Stage IIIB the tumor has spread to the skin or chest wall or initiated breast inflammation, or has spread to 10 and above armpit lymph nodes. Stage IIIC, The tumor has reached lymph nodes above or below collar bone or it has enlarged in one lymph node  to the same size as the tumor in the breast.

Screening/ Prevention

Women at high risk of getting breast cancer who include women aged between 50 and 75 years should have mammogram screening once per every two years. Women at all ages are also encouraged to engage in physical activities, check on their weight, eat healthy by avoiding fats, caffeine and red meat and increasing vegetables and fruits in their diet. Women are also encouraged to avoid oral contraceptive and hormonal therapies, to consider breastfeeding their children for long and to minimize exposure to carcinogens.

Read also Developing a Health Advocacy Campaign – Breast Cancer

Cancer Therapy

Breast cancer can be treated using various methods based on the stage of development. Surgery may be done to remove the tumor or the entire breast and surrounding tissues based on the level of development. Radiation therapy can also be used where high X-ray energy or other forms of radiation are used to suppress the growth or kill cancer cells. Chemotherapy may also be used where drugs are used to stop cancer cells growth, either through killing them or preventing their division. Hormonal therapy may also be used to block hormones actions or remove them and stop growth of cancer cells. Target therapy may also be applied where drugs are applied to attack and identify particular cancer cells without damaging normal cells.


Breast cancer is the leading cause of malignancy death among women. Individual survival rate depend on the type of breast cancer on is suffering from; invasive or non-invasive, where those diagnosed with non-invasive or in situ cancer have a higher survival rate. Metastasis is the leading cause of breast cancer death, thus those diagnosed by cancer at its advance stages have lower chances of survival; mostly less than 3 years. However, some may survive with the tumor for over 10 years when in situ. The survival rate decrease with young age diagnosis; women below 40 years have higher death risk than women diagnose at older age. Early diagnosis; at early cancer stage increases chances of survival, while late diagnosis reduces survival rate. In addition, survival rate of women with BRCA2 mutation is lower compared to those without BRCA2 mutation.

Current/ Future Research

A lot has been done in trying to understand breast cancer. There has been research on the main risk factors and how to reduce them, different types of breast cancer and how they manifest themselves, best form of treatment, cancer stages and the best treatment based on the stage among other things. However, there is little understanding on the molecular basis of the breast cancer which is said to be considerably complex. Understanding this may play a great role in treating and preventing breast cancer and hence this topic needs to be given extra consideration in future research.

Popularity of Energy Drinks Among Young People in the US – Biomedical Research

Biomedical Research Paper Instructions

You have been hired as an expert biomedical research consultant to offer expert advise to the office of the surgeon general on the popularity of energy drinks among young people in the US. Your task on this panel includes to;

  • Identify the common contents of popular energy drinks.
  • Describe the physiologic effects of the substances as well as their mechanisms of action.
  • Identify their physiologic benefits and health risks (using data from previous studies).
  • Give your expert biomedical recommendations (at least 3) to the Surgeon General’s office.

Popularity of Energy Drinks Among Young People in the US

Common Contents of Popular Energy Drinks

Energy drinks refers to a category of beverages taken to offer extra boost in mood enhancement, energy, provide cognitive, promote wakefulness, and maintain alertness. Energy drinks such as Red Bull usually contain vitamins, caffeine, glucuronolactone, taurine, milk thistle, acal berry, ginkgo biloba, carbohydrates, L-carnitine, L-theanine, sugar additives, guarana and ginseng among other herbal supplements. Additives that include kola nut, cocoa, and yerba mate may also be included1.

Physiologic Effects of the Substances and their Mechanisms of Action

Energy drinks are said to enhance mental performance especially memory and concentration.
Caffeine in energy drink is said to induce different acute cardiovascular impacts that include an up circulating catecholamines regulation. It can also yield to endothelium dependent vasodilation and arterial stiffness, resulting to increase in diastolic and systolic blood pressure. Energy drinks with high caffeine dosage is related with numerous cardiac comorbidities that include ventricular ectopy, atrial superventricular and fibrillation and palpitations. Effect of caffeine is said to increase blood pressure acutely, a situation that is believed to stress the cardiovascular system, increasing the possibility of causing arrhythmia2. Energy drink can also result to an increase in the rate of respiration based on the level of plasma caffeine. Caffeine also promotes levels of circulating catecholamme, a mechanism that augment basal metabolic rate. Caffeine in energy drinks is also said to excite the small intestine, resulting to sodium and water secretion, which result to pharmacological effect such as diuresis3. Energy drink consumption can also induce mental illness based on how caffeine impact neurotransmitters. Caffeine inhibits adenosine inhibitory effects on dopamine, thus augmenting the dopaminergic system psychoactivity, affecting behaviors regulation, mood, cognition, executive functioning, and salience attribution. Caffeine is also demonstrated to induce psychosis and manic symptoms to individuals without previous psychotic disorders4

Physiologic Benefits and Health Risks

The large caffeine content in energy drinks gives consumer the desirable effect of enhanced memory, elevated mood and increased alertness. The research demonstrates that energy drink enhance aerobic endurance by maintaining a heart rate of about 65-75% and upholding maximum speed in aerobic performance on cycle ergometers. Mental including memory, concentration and choice reaction are also said to increase significantly. A different study demonstrated that energy drinking increases the endurance of upper body muscle in repeated Wingate performance cycle5. The benefits and harmful effect of energy drink depends on the level of caffeine and quantity taken per day. The safe caffeine intake per day should be less than 400mg. Acute clinical toxicity starts at 1g, and becomes lethal at 5 to 10g. Caffeine physiologically results to cerebral and coronary vasoconstrictions, stimulated skeletal muscle, relaxes smooth muscle and has cardiac inotropic and chronotropic effects, modulates expression of gene in premature neonates, and reduces sensitivity of insulin. High caffeine content increase flow of urine and excretion of swear and change levels of blood electrolyte. Taking more than 4mg/kg of caffeine has been related with unsuitable symptoms that include jitteriness and anxiety. Common caffeine withdrawal symptoms include fatigue and headache1.

Biomedical Recommendations to the Surgeon General’s Office

Energy drink has various benefits to the body while taken in the limited amount. However, taking excess amount of energy drink increases the caffeine in the blood causing various health risks. Energy drink is found to interfere with cardiovascular operation and hence a person who had consumed energy drink recently should not be operated to prevent serious complications, unless ascertained that the caffeine effect did not take part in the cardiovascular system. Excess intake of energy drink may result to diuresis which may result to dehydration, a dangerous situation during surgery and hence, surgeon should wait until the effect of the drink is over and the patient is well hydrated during operation to reduce chances of low blood pressure in the body.  A through clinical investigation is needed on any patients who have recently consumed energy drinks before surgery to ensure one does not have any caffeine effect that would complicate the process or risk the patient life. Content of caffeine in the blood must be determined for such parents.

The Role of Biomarkers in Oncology


A cancer biomarker is a substance or process that signposts the presence of a cancerous tumor in the body. It can be genetic, glycomic, proteonic, or epigenetic. Imaging biomarkers and processes like apoptosis, proliferation, and angiogenesis may also be used to detect tumors. Typical biomarkers are produced by tumor cells or healthy cells in response to tumorous growths in the body and can be found in tissues, fluids, and cell lines. According to the Cancer institute (NCI), a biomarker can be used to detect a normal or abnormal process in the body or to study how well the body reacts to treatment for condition. The use of biomarkers is established on the fact that each cell has a unique molecular composition with specific traits like proteins, genes, and molecules.

Read also How Useful Are Interferons in Oncology

Thus, biomarkers can aid in the identification of cancerous cells and diagnosis of cancer in patients. Although numerous drawbacks hinder the application of biomarker research in clinical practice, clinicians have already used various biomarkers at the point of care. Examples include BCR-ABL for Chronic Myeloid Leukemia, AFP for Liver Cancer, BRAF V600E for Colorectal Cancer, CA-125 for ovarian Cancer, CA19.9 for Pancreatic Cancer, CEA for Colorectal Cancer, KIT for Gastrointestinal stromal tumor, and BRCA2 for Ovarian Cancer, among others. A good biomarker is easily measurable, reliable, and cost-effective.

Historical Background

The first reference to biomarkers is attributed to ancient Egyptians who attempted to find biomarkers for malignancy. They wanted to distinguish between breast cancer and mastitis. However, the use of cancer biomarkers in clinical practice was not achieved until roughly two centuries ago when Sir Bence Jones identified a protein in the urine of myeloma patients in 1847.3 The protein, which has since been named Bence-Jones protein, was identifiable through its special heat coagulation properties. It was a tumor-produced light chain antibody of antibody of immunoglobulin G. The next significant attempt at identifying a biomarker occurred in 1867 when Sir Michael Foster introduced amylase as a potential biomarker for patients with pancreatic cancer. It was later ascertained that production of large amounts of amylase enzyme can occur in large tumors that impinge on acinar cells. In the next century, research on biomarkers continued. Researchers studied hormones like catecholamines in neuroblastoma and pheochromocytoma, chorionic gonadotropin in choriocarcinoma and enzymes such as alkaline phosphatase in bone tumors and acid phosphatase in prostate cancer. The creation of the term immunoassays in the 1950s further fueled the pursuit of knowledge in the field of cancer biomarkers using polyclonal antibodies. What ensured was the introduction of several immunoassays and tumor antigens in testing. These, along with recent molecular biology breakthroughs, have contributed to the discovery and realization of putative functions of cancer biomarkers as tumor suppressor oncogenes, genes, telomerase, and nuclear proteins. Emerging technologies such as proteomics and genomics are expected to yield new information on biomarkers.

Key Uses of Biomarkers

Biomarkers have a range of uses in oncology among which include risk assessment, diagnosis, prognosis, treatment predictions, pharmacodynamics and pharmacokinetics, monitoring of treatment responses, and recurrence. Cancer biomarkers, especially those connected to epigenetic alterations and genetic mutations, are a practical way of determining when an individual is exposed to cancer risk. Biomarkers are also useful in diagnosis of specific types of cancers. Diagnostic biomarkers have been remarkably used to differentiate the origin of tumors as either primary or metastatic. To identify the difference researchers usually screen chromosomal alterations that are found in the cells at the primary tumor site versus those found at the secondary location. Matching alterations are interpreted as metastatic while differing alterations are considered as distinct primary tumors.

Another key use of biomarkers is for cancer prognosis which usually takes place after a positive diagnosis.2 Here, doctors use biomarkers to assess the severity and aggressiveness of a cancer and its likely response to a certain treatment. Tumors that show specific biomarkers might be responsive to treatment options that are related to the presence of those biomarkers. Examples include elevated estrogen receptor (ER) expression which is linked to better survival in breast cancer patients and elevated metallopeptidase inhibitor 1 (TIMP1) which is linked to aggressive multiple myeloma. The use of biomarkers in pharmacodynamics and pharmacokinetics are connected with the identification of the most effective treatment solution for a particular cancer.1 Differences in genetic makeup of individuals means that different people react differently to different chemical structures of drugs. In some cases, certain drugs can create dangerous conditions upon metabolizing slowly. Screening for such biomarkers is therefore necessary. Biomarkers also have a potential in monitoring the progress of treatment program. This role of biomarkers is currently under research since cancer biomarkers could significantly reduce costs in patient care. Currently, CT and MRI technologies have proven highly costly in monitoring tumor status. Finally, biomarkers can help in the prediction of recurrence of a tumor.


            Biomarkers play a critical role in oncology, especially in clinical risk assessment, screening, diagnosis, prognosis, response treatment, and other diagnostic tools. They also have a potential significance in enabling the much sought-after molecular definition of cancer. However, it is necessary for healthcare providers and clinicians to have a comprehensive understanding about the molecular characteristics of each biomarker in order to identify circumstances under which it could become useful in clinical care. Biomarkers are definitely a prospective solution in personalized medicine.

How Useful Are Interferons in Oncology

Interferon Definition

Interferons refer to glycoproteins which are synthesized by different cells in reaction to specific chemical inducers, immune stimulation, and viral infection. Interferon seems to act in a paracrine ability in the immune system, with an extensive range of impacts which imitates the endocrine system diversity. There are currently 20 identified interferons in human, which can only be categorized in three extensive groups. Majority of the subtypes fit in the alpha class, two beta subtypes (1 and 2) have been defined and there is just one species of gamma.

Read also The Role of Biomarkers in Oncology

Both Beta and Alpha interferons were initially named based on their early production methods which include fibroblast-derived beta and leukocyte-derived alpha, though they actually seem to be virtually synthesized by each cell in the body. However, Gamma interferon is a lymphokine that is solely secreted by T cells. There are obvious homologies between human beta and alpha interferons such that they share a surface of cell receptor preset on chromosome 21 and their genes cluster on chromosome 9. On the contrary, their gamma gene is on chromosome 12 and demonstrates no homology with beta and alpha interferons. The receptor is position on chromosome 6 and seems to vary from that of beta and alpha interferons.

Interferons Contribution to Oncogenesis

Interferons can trigger biological signaling pathways plethora in tumor cells which include cell invasion, survival, and differentiation. Interferon can actually impact proliferation of cell in tumor cells by blocking or prolonging the cycle of the cell, regulating CRKL, p38 MAPK, or p21, which consequently interacts with RAP1A; suppressor of a tumor which antagonizes RAS. Interferons can as well control the apoptotic machinery by managing the intrinsic and extrinsic apoptotic pathways. The type I interferon genes deletion and the interferon receptors down-regulation or signaling molecule engaged in the cascade of interferon that include STAT 1 can cause tumor cell to bypass regulatory impacts. This explains the restricted failure of interferon applied to control proliferation of cancer cell in various models.

Read also The Role of Infectious Agents in Oncogenesis

Beside the above highlighted direct effects, interferons can also control tumor cell growth indirectly, impacting varying biological process engaged in progression of tumor, that include immunity and angiogenesis. The initial illustration of interferons indirect effect demonstrated that interferons administration enhanced the survival of mice impacted by lymphocytic leukemia, irrespective of intrinsic tumor cells sensibility to IFN preparations. Actually, interferons act as various immune cells activators which include T cells, B cells, NKs, DCs, and macrophages. It has lately been illustrated that DCs creating type I interferons prompt an antitumor effect in mice impacted by melanoma. On the contrary, infiltrating DCs accumulation was related with a poor breast cancer prognosis. These seemingly conflicting outcomes can be explained by recent outcomes that illustrate that deficit of alpha interferons in tumor related DCs amass in aggressive tumors and result to regulatory T cells expansion which contribute to immune tolerance of tumor and a poor clinical results. It has been illustrated that tumor cells normally abrogate production of interferon to successful metastasize. The interferons immunoregulatory effect includes the tumor antigen up-regulation expression, the presentation of the DCs tumor antigen to T cells, the CD8+ T cells effector phenotype acquisition, the T cells down regulation, the myeloid-derived suppressor cells amass inhibition, and differentiation of the monocyte in M1-polarized macrophages of immunostimulatory. In addition, interferons can augment the antigen presentation of the main histocompatinility complex (MHC), the ligands expression engaged in immune checkpoint that include the programmed protein 1 cell death, and the cytokines release. 

Pro-Apoptosis Antitumor Effects of interferons

Apoptosis is an extra mechanism applied to control tissues cell number and eliminate particular cells which threatened the survival of the host. Interferon type I is related with apoptosis brought about by DNA damage or other stimuli. When presented with an activated oncogene, wild-typed MEFs undergo apoptosis rather than arrest of cell cycle when treated with ionizing radiation or anti-cancer drugs. Apoptosis is a tumor suppression hallmark and is dependent on p53 and interferons type I in this case. However apoptosis induced by damage of DNA in mitogenically triggered mature T lymphocyts is reliant on interferon type I though independent of p53.

Read also Tumor Angiogenesis

The research demonstrates that interferon type I is vital for p53-independent apoptosis promotion in acutely destroyed human mammary basal form of epithelial cell, creating evidence that interferon type 1 loss is a short-term indicator of early risk of basal-form of breast cancer. The research indicates that interferon type 1 protein ectopic expression yields to surviving protein downregulation expression which is p53 independent and enhance death of breast cancer cell.

Immune Antitumor Effects of interferons

Type I interferons are acknowledged for mediating effects of antineoplastic over a number of malignancies that is clinically significant activity which has been accredited to their immune-stimulatory roles. Experimental data strongly propose the existence of a process in which the immune system in the external manipulation absence safeguards the host over oncogenesis and manages the developing tumor immunological features. The process that is regarded as cancer immunoediting contains three phases.

Read also The Tumor Microenvironment – A Scientific Brief

In the first phase involves malignant cells elimination through immune system. In the second phase the equilibrium establishment between the immune system and unstable malignant cells that reflects the immunoediting imposed on cancer cells by the immune system. In the third phase the variants of neoplastic cell escape with minimized immunogenicity that eventually form neoplasms which are clinically manifested. The interferons type I intervene in all the three faces.

Inhibition of Metastasis Antitumor Effects of interferons

Interferons is also said to play a vital role in inhibiting tumor metastasis in nasopharyngeal carcinoma (NPC) which is frequently metastasized and highly malignant tumor, with very poor prognosis when distant metastases take place. The alpha and beta interferons antitumor effects were examined on NPC. The outcome demonstrated that recombinant human alpha and beta interferon suppress growth of cell, induced cell cycle of G1-phase arrest in vitro augmented the pRb and p16 expression, and reduced the CDK6 and CCCNDI expression. In vivo analysis demonstrated that either beta and alpha 1 interferon or recombinant adeno-related virus alpha 1 and beta virus treatment inhibited tumor metastasis and growth, lowered microvessel density of intratumoral, increased cell necrosis and apoptosis and induced elongated survival. The research proposed that alpha I and beta interferon acts as a multipurpose antitumor agent in NPC that might contain significant therapeutic implications.  

Inhibition of Angiogenesis Antitumor Effects of interferons

Interferon gamma has been said play a vital role in suppressing tumor angiogenesis. Interferon gamma secreted by both NK cells and NKT cells plays an essential role in facilitating the alpha-galactosylceramide effect. The research shows that tumor angiogenesis inhibition by interferon gamma induced by alpha-galactosylceramide (α-GakCer). Mice with tumor induced angiogenesis and subcutaneous tumor were treated using α-GakCer where the growth of the tumors were inhibited in interferon gamma dependent way. This proposed that interferon gamma mediated tumor angiogenesis inhibition is critically engaged in the antitumor effects effector mechanism initiated by α-GakCer.

Inflammatory Pathology of the Human Breast


Inflammation breast cancer (IBC) refers to a rare and highly aggressive disease where lymph vessels are blocked by cancer cells in the breast skin. This form of cancer is regarded as inflammatory since the breast frequently seems inflamed, red or swollen. IBC is rare form of breast cancer which accounts for 1 to 5% of all diagnosed breast cancers in the United States. Majority of IBC are invasive ductal carcinoma which implies that they developed from breast milk ducts and then spread past the ducts. IBC progress drastically, mostly within weeks or months, and thus most patients are normally at stage III or IV during diagnosis.  This paper analyses the IBC pathology.

Read also Human Breast Anatomy – Detailed Research Paper


IBC is said to be more common to Black women than white women, such that blacks are said to have 50% higher incidences compared to whites. IBC is said to be record at younger age in both groups compared to non-inflammatory breast cancers. Inflammation breast cancer patients are said to have a shorter survival rate compared non-IBC breast cancer patients. Hispanic women are said to have the youngest IBC onset age of around 50.5 years, contrasted to black women with onset age of 55.2 and white women onset age of 58.1. The cases of IBC are also increasing with time compared to cases of non-inflammatory breast cancer. IBC also has a tumor with more estrogen receptor (ER)-negative and higher tumor grade compared to non-inflammatory breast cancer where ER- and ER+ tumors incidences are equal. IBC is said to account for 2.5% of all breast cancer cases incident. IBC is also highly common among women with obesity.


IBC is said to be caused by infectious virus which include mouse mammary tumor-like viruses (MMTV), and human papillomavirus (HPV). A provirus structure containing 96% homology containing MMTV referred to as HCMV, Epstein-Barr virus (EBV), and human mammary tumor virus (HMTV) were also related with development of IBC tumor.  Other organisms detected in IBC tumors include Bartonella henselae; a gram-negative bacteria, and Brucella sp, also a gram-ve bacteria which is said to cause medulloblastomas. IBC is also associated with environmental factors, climatic factors and poor social economic factors that encourage the spread of infections.

Inflammation breast Cancer Types/Classification

Inflammatory breast cancer can be classified into three main stages. These stages include stage IIIB, stage IIIC, and stage IV. IBC is said to be in stage IIIB when the cancer has spread to tissues surrounding the breast for instance chest wall, ribs, muscles, skin or lymph nodes at the armpit. IBC is said to be in IIIC stage when it has reached the lymph nodes below collarbone and close to the neck and also to other areas identified in IIIB. IBC is said to be in stage IV if it has reached other organs such as brain, liver, lungs, or bones and also neck lymph nodes.   

Inflammation Breast Cancer Signs/Symptoms

IBC signs and symptoms include breast pain, itching of the breast, self-diagnosed and rapidly growing breast lump. The may as well report enlarged, firm or tender breast. The skin covering the breast thicken and becomes warm and its color also changes from initial discoloration of pink flush to purplish or redness kind that appears to represent ecchymosis. Nipple may appear retract, flattening, blistering, erythema, or crusting Most women with IBC experience lymph node and about 33% do report distant metastases. Thus some patients might report localizing pain or swollen lymph nodes. Symptoms may vary among patients based on extent and location of metastatic disease. In most cases patient are given antibiotics to treat assumed mastitis with no improvement initiating further assessment.

Pathologic Features/ Genetic Basis of Disease

There are no unique known genetic risks for IBC. However, genetic factors which increase risks of an individual for developing other forms of cancer that include breast cancer gene one, (BRCA1) or breast cancer gene two (BRCA 2), might also increase breast cancer inflammatory. Breast cancer mutations susceptibility genes which include BRCA2 and BRCA1 are responsible for the most of hereditary incidences of breast cancer.

Laboratory Features

IBC symptoms that include nipple discharge or skin change can be evaluated in the triple test. This involves breast examination by the doctor, breast imaging via ultrasound or mammography, and breast tissues sampling with open biopsy, core biopsy or fine needle aspiration (FNA). Blood tests which include liver function tests and full blood count test may be done to determine whether the cancer has reached the bone marrow or liver.

Differential Diagnosis

The differential diagnosis for breast inflammation includes benign disease as well as other malignancies. Lactation mastitis happens to about 10% of lactating women and is related to leukocytosis, fever, and localized tenderness which is features which assist in differentiating it from IBC. The erythema is related with tenderness and inhabits a wedge-shaped breast quadrant, and the patient seems unwell. Nonlactating breast benign entity is duct ectasia which influences postmenopausal and perimenopausal women. It happens after fatty material clog duct beneath the nipples creating a lump. Other IBC benign entities include fat necrosis and mondor disease. Malignant entities which imitator IBC is leukemic breast infiltration.

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Inflammation Breast Cancer Management/Treatment

IBC patients need coordination of radiation, surgical and medical oncology care and nursing. IBC management entails modality combined therapy. Preoperative chemotherapy is thus standard care. Chemotherapy is regarded as optimal measure since it treat both main cancer tumor and any other cancer cells which might have broken and spread to other body parts. Surgery may follow the chemo therapy after the patients’ condition has improved. Hormonal therapy should also be done and target therapy. Radiation therapy can also be used to enhance IBC treatment.

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IBC is a complicated condition to treat especially because it is highly aggressive and spread out much quickly. It is therefore considerably hard to manage it using surgical procedures. Moreover, reconstructive surgery may not be appropriate due to the spread out even after a successful surgery. Moreover, there are common chemotherapy side effects which include febrile neutropenia risk, vomiting and nausea, and alopecia. Other possible complications include severe fever, myalgias or bony pain.   


Women suffering from IBC present serious prognoses compared to women suffering from other breast cancer. In addition about 25% of women have incurable, metastatic disease. The IBC patients’ general survival rate ranges between 29 and 4.2 years, and has not demonstrated any significant change for the last 30 years. Novel biological agents that include lapatinib and trastuzumab may enhance IBC patients’ results.

Current/Future There have been a number of researches in the past focusing on establishing ways to enhance diagnosis of IBC at its early stages to eliminate the mastitis pre-assumption that gives the condition a chance to spread further before right diagnosis is done. However, more research is required to enhance establishment of molecular principles differentiating IBC from non-inflammatory breast cancer. These criteria would be useful for development and diagnosis of new targeted therapy. Inflammation breast cancer patients’ survival rate has been below 5 years for over three decades despite of improved IBC treatment techniques in the recent past. Thus more research is needed to determine the cause of this and what can be done to improve the situation.