<p>Ionizing radiation is without a doubt an invaluable tool in diagnostic imaging as well as radiation therapy. With the growing number of medical and occupational exposures, together with challenges against the LNT model, low dose exposures and non-targeted effects have been subject to intensive research. Additionally, with the advances in the field of radiation therapy and longer life expectancy after the treatment, the risks associated with second malignancies following radiation therapy for various cancers has received a tremendous amount of attention. On the other hand, nicotine, as the addictive component of tobacco has been known for its adverse health effects and its relation to various types of cancers, accounting for one in 10 adult deaths worldwide. Both nicotine and low doses of radiation are amongst the stressors that widely affect the public. Surprisingly, the interactions between low-dose effects and nicotine exposure have not received the proper scientific attention. Our group has been involved in investigation of the non-targeted effects of radiation with a variety of endpoints. Different natural compounds and signalling molecules have also been studied in our lab for their possible role or contribution to bystander signalling. This research involves the study of the impact of nicotine on radiation-induced bystander effects and also radioadaptive responses. Different concentrations of nicotine were used to study the kinetics of the drug as well as any detrimental or modifying effects when used together with radiation. It was shown that nicotine has a protective effect on survival of the cells in certain concentrations that follows a biphasic model. Similar bimodal behaviour was observed with bystander effect. No adaptation to a challenge dose of radiation occurred as a result of incubation with varying concentrations of nicotine, nor was such an effect shown with a priming dose of radiation. The results of the present study suggest that nicotine has a complicated effect on the cells which can vary significantly depending on the concentrations used and also the duration of exposure. nAChRs may have an important role in the response of the bystander cells when nicotine is involved as the results showed a shift in the response of the receptors to nicotine. This thesis is aimed to shed light on the impact of nicotine and initiate more detailed investigations on pathways through which these effects are mediated.</p> / Master of Science (MSc)

Despite advances in nuclease-based genome editing technologies, correcting human disease-causing genomic inversions remains a challenge. Here, we describe the potential use of a recombinase-based system to correct the 140 kb inversion of the F8 gene frequently found in patients diagnosed with severe Hemophilia A. Employing substrate-linked directed molecular evolution, we develop a coupled heterodimeric recombinase system (RecF8) achieving 30% inversion of the target sequence in human tissue culture cells. Transient RecF8 treatment of endothelial cells, differentiated from patient-derived induced pluripotent stem cells (iPSCs) of a hemophilic donor, results in 12% correction of the inversion and restores Factor VIII mRNA expression. In this work, we present designer-recombinases as an efficient and specific means towards treatment of monogenic diseases caused by large gene inversions.

The field of biomedical sciences has been expanded through the introduction of a novel cohort of soft and intelligent microrobots that can be remotely operated and controlled through the use of external stimuli, such as ultrasound, magnetic fields, or electric fields, or internal stimuli, such as chemotaxis. The distinguishing factor of these microrobots lies in their propulsion system, which may encompass chemical, physical, or biohybrid mechanisms. Particularly, microrobots propelled by motile cells or microorganisms have found extensive usage because they combine the control/steerability and image-enhancement capabilities of the synthetic microstructures with the taxis and cell-interaction capabilities of the biological components. Spermatozoa (sperms), among other types of motile microorganisms and cells, are promising biological materials for building biohybrid microrobots because they are inherently designed to swim through complex fluids and organs, like those in the reproductive system, without triggering negative immune responses. Sperms are suitable for a variety of gynecological healthcare applications due to their drug encapsulating capability and high drug-carrying stability, in addition to their natural role of fertilization. One objective of this project is to help sperms reach the site of fertilization in vivo where the sperm count is low (20 million sperm per mL), a condition known as oligospermia. In order to reach this goal, we are developing alternative strategies for transporting a significant number of sperms, as well as improving the functionality of sperm-hybrid microcarriers. Here, we use a thermoresponsive hydrogel made of poly(N-isopropylacrylamide) (PNIPAM) and a non-stimuli-responsive polymer (IPS photoresist) to create four dimensional (4D)-printed sperm-hybrid microcarriers via two-photon polymerization (TPP). We present a multifunctional microcarrier that can: i) transport and deliver multiple motile sperms to increase the likelihood of fertilization, ii) capacitate/hyperactivate the sperms in situ through the local release of heparin, and iii) assist the degradation of the hyaluronic acid (HA), present in extracellular matrix (ECM) of oocyte-cumulus surrounded the Egg. HA degradation occurs through the local action of hyaluronidase-loaded polymersomes (HYAL-Psomes) that have been immobilized on the microcarrier's surface. Dual ultrasonic (US)/photoacoustic (PA) imaging technology can also be used to visualize a swarm of microcarriers, making them ideal candidates for upcoming in vivo applications. In addition, as a second objective, we demonstrate that similar sperm-hybrid microcarriers can be utilized to deliver targeted enzymes and medication for the treatment of gynecological cancer. As proof of concept, we show that combined therapy using enzymes and anti-cancer drugs is an appealing strategy for disrupting the tumor tissue microenvironment and inducing cell apoptosis, thereby offering a more effective cancer therapy. To achieve this, we functionalize the microcarriers with polymersomes loaded with enzymes (such as hyaluronidase and collagenase) and anti-cancer drugs (such as curcumin), respectively, and demonstrate their cargo-release capability, enzyme function, and therapeutic effect for targeting cervical cancer cells in vitro.:Abstract iv 1 Introduction 1 1.1 Motivation 1 1.2 Objectives 3 1.3 Structure of this dissertation 4 2 Background 5 2.1 Introduction on additive manufacturing technology 5 2.2 Direct laser writing (DLW) based on two-photon polymerization 6 2.2.1 Writing principles of two-photon lithography 8 2.2.2 Available materials for two-photon lithography 9 2.2.3 Engineering (Preprogrammed designs) 12 2.3 4D Lithography 13 2.3.1 Biodegradable microrobot 13 2.3.2 Stimuli-responsive micromotors 15 2.3.3 Other 4D-printing approaches 17 2.4 Motion at the microscale (Micromotility) 21 2.4.1 Physical propelled micromotors 23 2.4.2 Chemical propelled micromotors 32 2.4.3 Biohybrid micromotors 34 2.5 Other two-photon polymerized microrobots and their biomedical applications 35 2.5.1 Functionalized carriers 36 2.5.2 Multiple-cell carrying scaffolds 38 2.5.3 Single particle and cell transporters 39 2.6 Comparison of 3D and 4D-lithography with other fabrication methods 42 3 Materials and methods 44 3.1 Synthesis and fabrication 44 3.1.1 Synthesis of PNIPAM 44 3.1.2 Fabrication of microcarrier 44 3.1.3 Preparation of sperm medium and sperm solution 45 3.1.4 Preparation and composition of different body fluids 45 3.1.5 Fluidics channels 46 3.1.6 In situ preparation of microcarriers and sperms 46 3.1.7 Loading of microcarriers with heparin 46 3.1.8 Synthesis of block copolymers (BCPs) 47 3.1.9 Fabrication of Empty-Psomes A and D 48 3.1.10 Preparation of Curcumin complex CU(βCD)2 and calibration curve 49 3.1.11 Fabrication of cargo-loaded Psomes with enzymes and antitumoral drug 50 3.2 Characterization 51 3.2.1 MTS-Assay 51 3.2.2 Toluidine blue assay 52 3.2.3 Characterization of Empty-Psomes A and D: pH cycles and pH titration by dynamic light scattering (DLS) 53 3.2.4 Characterization of cargo-loaded Psomes with enzymes and antitumoral drug 54 3.2.5 Loading efficiency of HYAL-Psomes 55 3.2.6 Loading efficiency of MMPsomes 56 3.2.7 Loading efficiency, stability and release study of CU(βCD)2-Psomes 57 3.2.8 Size and polydispersity analysis of cargo-loaded Psomes in different simulated body fluids by DLS 58 3.2.9 Conformation and stability study of cargo-loaded Psomes in different simulated body fluids by asymmetric flow field flow fractionation (AF4) 59 3.2.10 Immobilization of the cargo-loaded Psomes on the surfaces 61 3.2.11 Enzymatic assay of HYAL for enzyme activity measurement 62 3.2.12 Enzymes assay in different simulated body fluids 64 3.2.13 Stability study of RhB-HYAL-Psomes in different pH 65 3.2.14 Calculation of the magnetic field flux of an external hand-held magnet 66 3.3 Temperature actuation and imaging 67 3.3.1 Temperature actuation test of PNIPAM and video recording 67 3.3.2 Hybrid ultrasound (US) and photoacoustic (PA) Imaging 67 3.4 Other useful information 68 3.4.1 pH and temperature through the female reproductive tract 68 3.4.2 Calculation of the light-to-heat conversion during imaging process 69 4 Multifunctional 4D-printed sperm-hybrid microcarriers for assisted reproduction 72 4.1 Background 72 4.2 Concept and fabrication of the 4D-printed microcarriers 74 4.3 Sperm coupling and geometrical optimization of microcarrier 77 4.4 Characterization of the 4D-printed streamlined microcarriers 78 4.5 Microcarrier loaded with heparin for in situ sperm capacitation 82 4.6 Microcarriers decorated with HYAL-Psomes for in situ degradation of the HA-cumulus complex 86 4.6.1 Immobilization of HYAL-Psomes on the microcarrier’s surface 89 4.6.2 Qualitative study of cumulus cell removal 90 4.7 Sperm-microcarrier motion performance in oviduct-mimicking fluids 91 4.7.1 Capture, transport, and release of sperms 92 4.7.2 Sperm-microcarrier motion performance on ex vivo oviduct tissue 93 4.8 Tracking of a swarm of microcarriers with a dual ultrasound (US) and photoacoustic (PA) imaging system 95 4.9 Summary 96 5 Polymersomes-decorated micromotors with multiple cargos for gynecological cancer therapy 98 5.1 Background 98 5.2 Characterization and size quantification of Psomes before and after loading of cargoes by DLS, and Cryo-TEM 103 5.3 Characterization and size quantification of cargo-loaded Psomes by DLS, and Cryo-TEM in different simulated bodily fluids 104 5.4 Immobilization and characterization of cargo-loaded Psomes on the microcarrier’s surface 106 5.5 Immobilization and characterization of dual cargo-loaded Psomes on the microcarrier’s surface 108 5.6 Investigation of ECM degradation and antitumoral effect of cargo-loaded Psomes 110 5.7 Magnetic and bio-hybrid guidance of microcarriers toward targeted cargo delivery 115 5.8 Summary 117 6 Conclusion and Outlook 119 6.1 Achievements 119 6.2 Outlook 121 Bibliography I List of Figures and Tables XXI Acknowledgements and funding XXIV Scientific publications and contributions XXVI Curriculum Vitae XXVII

No / The identification of an agent that is selectively activated by a cytochrome P450 (CYP) has the potential for tissue specific dose intensification as a means of significantly improving its therapeutic value. Towards this goal, we disclose evidence for the pathway of activation of a duocarmycin analogue, ICT2700, which targets CYP1A1 for biological activity.

Glioblastoma is the most commonly diagnosed central nervous system primary malignancy and it is considered a terminal diagnosis with few treatment options available. Glioblastoma tumors frequently develop treatment resistance due in part to their highly heterogenic nature. The heterogeneity of glioblastoma is partially attributed to the presence of glioma stem-like cells (GSC), which are highly invasive and resistant to chemotherapy and irradiation treatments. Signaling of the receptor tyrosine kinase MET is a known regulator of GSC. Glioblastoma patients have an increasingly poor prognosis that corresponds with increasing MET expression. Both GSC and MET are known to contribute to treatment resistance in glioblastoma and several MET alterations have been observed in glioblastoma. In these studies, we investigated MET alterations that are commonly found in glioblastoma. Using patient-derived xenograft (PDX) lines, the MET alterations were characterized and confirmed to be MET positive, MET amplified, or harbor a PTPRZ1-MET fusion. We also included a MET null glioblastoma PDX line. The PDX lines demonstrated markers for GSC potential with all showing neurosphere formation, the ability to initiate tumor growth in immune-compromised mice, and expression of GSC markers GFAP, Sox2, and nestin. The MET alterations were further examined by examining tyrosine kinase inhibitors' effect on viability and MET signaling. Oncogene addiction through MET amplification was found to have the best response to inhibition. The MET fusion bearing line demonstrated less sensitivity to inhibition than has been shown in other studies, indicating a need for further research into co-mutations that increase sensitivity to MET inhibition. We also investigated the efficacy of novel MET-targeting chimeric antigen receptor T cells (MET.CART cells). The MET.CART cells were able to specifically target and successfully kill MET-expressing glioblastoma cells. Together these results imply the need for more personalized treatment of glioblastoma based on the molecular biology of the tumor.

This study examines the business model of Meta called “Pay or OK”, a subscription modelthat offers users the choice to either consent to the use of Meta’s services and be subjected totargeted advertising or to use the service without personalized advertising for a fee. In the eraof digital transformation, where data has become a significant competitive advantage forlarge online platforms, the introduction of regulations like GDPR and DMA has beeninstrumental in protecting personal integrity and ensuring fair competition. This study utilizesqualitative and EU legal methods to analyze the “Pay or OK” business model from a legalperspective and also analyze if data could create competitive advantage for Meta,incorporating theories such as the resource-based view and the VRIO framework. The resultsof this study bring to the forefront the intriguing and contrasting opinions on the value ofpersonal data and the profound impact of regulations on the business landscape.

A single case study was used to examine two middle grades mathematics teachers' use of short-cycle formative assessment strategies. Data was collected using multiple sources to provide a description of this single case. Participant change in knowledge of short-cycle formative assessment strategies was collected and analyzed through participant pre- and post-interviews and targeted instructional support was provided through professional development sessions designed to meet diverse needs of participants. Participant change in use of short-cycle formative assessment strategies was collected and analyzed through classroom observations using Assess Today observation protocol and targeted instructional support was provided through post-observation conferences with written feedback. Findings from the study verified that changes in teachers' use of short-cycle formative assessment strategies were positively influenced by the targeted instructional support provided to each participant during the study. The study further indicated that an assessment of teacher's present knowledge and use of short-cycle formative assessment strategies should be considered before providing targeted instructional support to maximize the learning potential for each teacher. Future research is needed regarding the importance of building student self-efficacy through teacher use of short-cycle formative assessment, as well as the importance of involving students in the formative assessment process.

Preface: The research about product development of a prosthetic socket was conducted by two students from Mälardalen University, department of Innovation, Design, and Technology. Background: The most recent public survey shows that an estimated 5 million people in China are amputees, out of which a significantly large portion are below-elbow amputees. Sockets sold to below-elbow amputees are equipped with only two surface electromyography sensors, has low comfortability, has problems with perspiration, and a high weight. The current standard for socket manufacturing has not changed in decades. Research Questions: The following research questions have determined the direction of the research: (1) What measurable factors contribute to a convenient and ergonomic feature design in prosthetic socket from the end-user’s perspective? (2) How can the weight and functionality be improved to achieve a prosthetic socket more suited to the end-user, with respect to the existing prosthetic socket? (3) Which material and manufacturing method is suitable for producing cost-effective and customized prosthetic sockets? Research Method: The research was guided by the 5th edition of Product Design and Development by Ulrich &amp; Eppinger (2012) where the product development process described in five of the six phases from planning to test and refinement were utilized. The data collection and analysis techniques performed in this research was guided by Research Methods for Students, Academics and Professionals by Williamson &amp; Bow (2002). Interviews were conducted with five different stakeholders to find specifications of requirements and concretize subjectivism of what defines quality and ergonomics. Implementation: Currently, below-elbow amputees order sockets from orthopedic clinics. The socket was identified as a product of Ottobock. Investigations were made to find optimal solutions to the specification of requirements. Results: The development of a socket concept was designed for additive manufacturing using a multi-jet fusion printer. Analysis: This concept had significant improvements to parameters: higher grade of customizability, 30 % reduced weight, 48 % cost reduction, a new production workflow with 93,5 % automation, and a 69 % reduction in manual work hours. Conclusions: The data of the research strongly indicate existing potentials in enhancing socket design techniques and outputs by implementation of additive manufacturing processes. This can prove to be beneficial for achieving more competitive prosthetics and associated services. / Förord: Denna forskning om produktutvecklingsprocessen av en armprotes genomfördes av två studenter från Mälardalens universitet, avdelningen för innovation, design och teknik. Bakgrund: Den senaste offentliga undersökningen visar att cirka 5 miljoner människor i Kina är amputerade, varav en betydligt stor del är under-armbågsamputerade. Armproteser som säljs till underarmsamputerade individer är utrustade med endast två yt-elektromyografiska sensorer, har låg komfort, har problem med perspiration och hög vikt. Den nuvarande standarden för armproteser har inte förändrats under årtionden. Forskningsfrågor: Följande forskningsfrågor har bestämt riktningen för forskningen: (1) Vilka mätbara faktorer bidrar till en praktisk och ergonomisk funktionsdesign i underarmsproteser ur slutanvändarens perspektiv? (2) Hur kan vikten och funktionaliteten förbättras för att åstadkomma en underarmsprotes som är bättre anpassad för slutanvändaren med avseende på den befintliga underarmsprotesen? (3) Vilket material och tillverkningsmetod är lämpligt för att producera kostnadseffektiva och anpassade underarmsproteser? Forskningsmetod: Forskningsmetoden styrdes av den femte upplagan av Product Design and Development av Ulrich &amp; Eppinger (2012) där produktutvecklingsprocessen är uppdelad i sex faser. I denna forskning användes de fem första faserna från planering till testning och justering. Tekniker för datainsamling och analys som användes i denna forskning styrdes av Research Methods for Students, Academics and Professionals av Williamson &amp; Bow (2002). Intervjuer genomfördes med fem olika intressenter för att hitta kravspecifikationer och för att konkretisera subjektivitet för vad som definierar kvalitet och ergonomi. Implementering:  Underarmsamputerade individer beställer för närvarande armproteser från ortopediska kliniker. Armprotesen identifierades som en produkt av Ottobock. Undersökningar gjordes för att hitta optimala lösningar för kravspecifikationen. Resultat: Konceptutvecklingen av en armprotes utformades för additiv tillverkning med hjälp av en multi-jet-fusion-skrivare. Analys: Det här konceptet hade betydande förbättringar av parametrar: högre grad av anpassningsbarhet, 30 % minskad vikt, 48 % kostnadsreduktion, ett nytt produktionsflöde med 93,5 % automatisering och en 69 % minskning av manuella arbetstider. Slutsatser: Data från denna forskning indikerar att det finns starkt potential för att förbättra designtekniker och utgångar av underarmsproteser genom implementering av additiva tillverkningsprocesser. Detta kan visa sig vara fördelaktigt för att uppnå mer konkurrenskraftiga proteser och tillhörande tjänster.

Oral squamous cell carcinoma (OSCC) is the most common head and neck cancer, with a worldwide incidence of 275,000 new cases annually (Warnakulasuriya, 2009). Globally, the head and neck carcinoma represents a major cause of morbidity and mortality and is the sixth most commonly occurring cancer (Warnakulasuriya, 2009). A majority (>90%) of the head and neck cancers are squamous in origin and thus are linguistically referred to as head and neck squamous cell carcinoma (HNSCC) (Warnakulasuriya, 2009). HNSCC includes cancers of the oral cavity, larynx and pharynx; oral cancer being the most common (Warnakulasuriya, 2009). Although, HNSCC is the sixth most common cancer globally (Warnakulasuriya, 2009), the Indian scenario is graver. According to GLOBOCAN 2008 (http://globocan.iarc.fr), the worldwide age standardized incidence rate (ASR) for HNSCC (and thus OSCC) is 5.3 and 2.5 per 100,000 males and females respectively (Ferlay et al., 2010). In India, the ASR is 9.8 and 5.2 per 100,000 males and females respectively, clearly demonstrating a remarkably high incidence rate of OSCC (Ferlay et al., 2010; http://globocan.iarc.fr). OSCC is a peculiar cancer which is largely preventable and rarely presents as a familial disorder. The most common etiological factors associated with OSCC include tobacco and alcohol consumption (Johnson, 2001). Additionally, high risk human papillomaviruses (HPV strains 16 and 18) as well as genetic predispositions have been implicated. The treatment of OSCC mainly relies on surgical resection of the tumor. The site, size, depth of infiltration and proximity to the bone of the tumor determine whether a combination of surgery with radiation therapy or chemotherapy would be advised (Scully and Bagan, 2009). The concomitant chemo-radiation therapy is the most commonly used strategy in locally advanced cancer. Taxanes (e.g., paclitaxel and docetaxel) and platinum-based induction chemotherapy (e.g., cisplatin) are the options in the treatment of locally advanced cancer. Epidermal growth factor receptor (EGFR) targeted with cetuximab in combination with radiotherapy has been successfully tested in a large randomized trial and thus is currently a new option (Scully and Bagan, 2009). The success of cetuximab has paved the path for the development and implementation of molecules targeting various signaling pathways. Despite extensive research on oral squamous cell carcinoma (OSCC), the five-year survival rate has not changed in several decades with the exception of the targeted treatment strategies involving cetuximab as discussed above. The current chemotherapeutic approaches lack selectivity and are flagitious. Thus, effective treatment of OSCC requires the identification of molecular targets to design appropriate therapeutic strategies. To this end, the present study took three distinct approaches in order to validate the use of existing targets and to reveal novel prognostic biomarkers and therapeutic targets. 1) Targeting the PI3K-AKT-MTOR pathway in OSCC and identification of determinants of its sensitivity. 2) Gene expression analysis of ectopically overexpressed TSC2 to identify new therapeutic targets and prognostic biomarkers as well as to elucidate the genes regulated by it. 3) Expression profiling of CYP1B1 in order to validate the use of CYP1B1 based prodrug therapy in OSCC. Investigations pertaining to the changes in gene and protein expression profiles in malignant as well as pre-malignant lesions have documented the deregulation of the PI3K-AKT-MTOR (phosphoinositide 3-kinase-AKT-mechanistic target of rapamycin) and EGFR (epidermal growth factor receptor) pathways in OSCC which are being widely targeted in many therapeutic strategies (Molinolo et al., 2007; Chakraborty et al., 2008; Matta and Ralhan, 2009; Molinolo et al., 2009; Stransky et al., 2011). The PI3K-AKT-MTOR pathway is a central hub for controlling cellular proliferation and growth in response to various intracellular as well as extracellular stimuli. Crucial signaling cascades including WNT, RAS, HIF-1α and AMPK cross-talk with the PI3K-AKT-MTOR pathway at a variety of molecular junctions. Thus, making this pathway sensitive to perceiving various growth modulatory conditions, ranging from the presence of growth factors to hypoxia and nutrient deprivation (Sengupta et al., 2010; Yang and Guan, 2007). The aberrant expression of the PI3K-AKT-MTOR pathway in OSCC advocated the targeting of this coveted pathway (Chakraborty et al., 2008). In various cancers, the monotherapeutic treatments with inhibitors like LY294002 (PI3K inhibitor) and rapamycin (MTOR inhibitor) demonstrated reduced efficacies. Such reduced efficacies were attributed to the drug toxicity and non-specific action of LY294002 (Davies et al., 2000; Sun et al., 2005; Ikezoe et al., 2007; Wang et al., 2008; Liu et al., 2009), or the ablation of a feedback inhibition loop leading to the reactivation of the PI3K-AKT-MTOR pathway by rapamycin (O'Reilly et al., 2006; Carracedo et al., 2008). Thus, rapamycin or its analogues demonstrated mediocre efficacy due to cytostatic effects in clinical trials, primarily due to the paradoxical activation of major survival kinases namely MAPK and AKT (O'Reilly et al., 2006; Carracedo et al., 2008). The present study aimed at increasing the efficacy of these drugs by incorporating a combinatorial approach. The MTT assay demonstrated that prolonged monotherapeutic treatments with rapamycin led to a modest growth inhibition in three OSCC (KB, SCC131 and SCC084) and HeLa cell lines. Western blot analysis of the phosphorylation status of AKT and RPS6KB1 revealed that monotherapeutic treatments with rapamycin for 96 hr led to the reactivation of the PI3K-AKT-MTOR pathway. Thus, the modest growth inhibitory effect of rapamycin was attributed to the reactivation of the PI3K-AKT-MTOR pathway. A combinatorial treatment approach was hence believed to circumvent this problem in order to increase the efficacy of targeting the PI3K-AKT-MTOR pathway. The PI3K inhibitor LY294002 was used combinatorially with rapamycin. This prolonged dual combinatorial treatment regime was distinctly more efficacious than either of the drugs alone and led to a reduction in cellular viability accompanied by increased sub-G1 population, indicating marked cell death that was characterized as caspase-3 dependent apoptosis. The differential sensitivity of the cell lines towards this combinatorial treatment revealed a novel determinant of the sensitivity, the transactivation of EGFR. The cell lines (SCC131 and SCC084) that were capable of transactivating EGFR were relatively resistant to the dual targeting of PI3K and MTOR in comparison to cell lines that did not transactivate EGFR (HeLa and KB). Further, targeting PI3K, MTOR and EGFR simultaneously was more efficacious in the presence of EGFR transactivation than dually targeting PI3K and MTOR. The results conclusively proved that the combinatorial therapeutic approach dually targeting PI3K and MTOR is a promising treatment strategy as compared to a monotherapeutic treatment and a major factor determining the sensitivity towards this treatment is the status of autophosphorylation of EGFR (Tyr1173) which governs the potential for EGFR transactivation by the combinatorial treatment. Thus, this study demonstrated that the status of EGFR autophosphorylation (Tyr1173) can be used as a biomarker to predict the sensitivity towards the combinatorial targeting of PI3K and MTOR in OSCC. The PI3K-AKT-MTOR pathway is negatively regulated by TSC2 (tuberous sclerosis complex 2; tuberin) (Tee et al., 2002). The importance of the TSC2 gene in the regulation of cell growth and proliferation is irrefutable. TSC2 facilitates the crosstalk between a variety of cellular signals, making it a crucial hub where many cellular networks integrate like AKT, MAPK and AMPK (Clements et al., 2007; Rosner et al., 2007; Rosner et al., 2008). It is a tumor suppressor gene and is downregulated in many cancers including OSCC (Chakraborty et al., 2008). In order to identify the genes regulated by TSC2 in OSCC, we stably overexpressed TSC2 in KB cells and the changes in the gene expression profiles caused by this ectopic overexpression were observed using a whole genome expression microarray. The results showed differential regulation of 268 genes (107 genes were upregulated and 161 genes were downregulated, p<0.05, fold change ≥ 1.5). A majority of these genes were functionally associated with transcription, cell growth and proliferation, apoptosis, cell cycle and neurogenesis. Functional annotation and network analysis was performed by using the DAVID v6.7 and IPA version 8.7 softwares. The microarray data revealed a novel aspect in the crosstalk between WNT signaling and TSC2, namely the transcriptional regulation of WNT signaling by TSC2. Further, in the context of therapeutic applications, the microarray analysis revealed multiple genes that were functionally categorized to be involved in response to radiation, UV and drugs (e.g., SERPINB13 and IL1B). Future studies on the regulation of such genes that are involved in responses to drugs and radiation may give insights into the role of TSC2 in resistance or sensitivity towards chemotherapy and radiation therapy. Moreover, EREG, a member of the epidermal growth factor family, was found to be the most downregulated gene in the microarray analysis. Previous reports have documented elevated levels of EREG in tuberous sclerosis lesions and its association with poor clinical prognosis in OSCC patients (Li et al., 2008; Shigeishi et al., 2008), making its regulatory aspects intriguing. Additionally, published data on the transcriptional functions of TSC2 instigated us to analyze the role of TSC2 in the regulation of EREG. TSC2 has been shown to modulate the transcription mediated by members of the steroid receptor superfamily of genes (Henry et al., 1998) and was shown to bind specifically to ERα and inhibit estrogen induced proliferation (Finlay et al., 2004). Also, TSC2 has been shown to possess C-terminal transcriptional activation domains (Tsuchiya et al., 1996). We have therefore attempted to investigate the transcription related functional aspects of TSC2 by exploiting the observed transcriptional repression of EREG. The physiological roles of TSC1 and TSC2 that are independent of the PI3K-AKT-MTOR pathway have been termed as ‘non-canonical’ (Neuman and Henske, 2011). The repression of EREG by TSC2 was observed to be insensitive to rapamycin, suggesting that it was independent of MTORC1 and thus a non-canonical function of TSC2. To determine whether the repression in EREG was at the level of the promoter, we performed a dual luciferase reporter assay. The results showed that the EREG promoter was repressed by stable as well as transient overexpression of TSC2. In order to elucidate the mechanism of transcriptional regulation by TSC2, we performed the ChIP analysis to observe the in vivo binding of TSC2 to the EREG promoter. In the ChIP analysis with the anti-TSC2 antibody, we observed that TSC2 did not bind to the EREG promoter between the regions -857 bp to -302 bp or -325 bp to +165 bp. Further, in silico analysis revealed an interesting trend among the transcription factors that were differentially regulated by TSC2 and had putative binding sites on the EREG promoter. A majority of these transcription factors (17/21) were downregulated by the overexpression of TSC2. This observation suggested that the repression of EREG could be an indirect effect due to repression of transcription factors caused by overexpression of TSC2. On the whole, this study revealed novel functions of TSC2 in OSCC with implications in determining novel biomarkers and therapeutic targets. As discussed previously, OSCC has a very flagitious treatment regime. A prodrug approach is thought to aid in targeting chemotherapy (Rooseboom et al., 2004). CYP1B1, a member of the cytochrome P450 family, has been implicated in chemical carcinogenesis (Bandiera et al., 2005; Sliwinski et al., 2010). There exists a general accordance that this protein is overexpressed in a variety of cancers (e.g., colon, lung, renal, bladder, prostate, breast, endometrial and esophageal cancers), making it an ideal candidate for a prodrug therapy (McFadyen et al., 1999; Murray et al., 2001; McFadyen et al., 2004; Sissung et al., 2006; Wen and Walle, 2007; Sliwinski et al., 2010). The activation of the prodrug facilitated by CYP1B1 would enable the targeting of chemotherapy to tumor tissues in which CYP1B1 is specifically overexpressed as a result reducing the non-specific side effects that the current chemotherapy elicits (Rooseboom et al., 2004). This study was aimed at validating the use of CYP1B1 as a target for the prodrug therapy in OSCC. The expression profile of CYP1B1 was analysed in a panel of 51 OSCC tumors, their corresponding normal tissues, an epithelial dysplasia lesion and its matched normal tissue by qRT-PCR, Western blotting and Immunohistochemistry. Counterintuitively, CYP1B1 was found to be downregulated in 77.78% (28/36) tumor tissues in comparison to their corresponding normal tissues as well as in the epithelial dysplasia lesion compared to its matched normal tissue at the transcriptional level, and in 92.86% (26/28) of tumor tissues at the protein level. This clearly demonstrated the downregulation of CYP1B1 at the transcriptional and translational levels in tumor tissues in comparison to their corresponding normal tissues. These observations indicate that caution should be observed as this therapy may not be applicable universally to all cancers. Since CYP1B1 has been shown to be involved in the activation of pro-carcinogens (Murray et al., 2001; Bandiera et al., 2005; Sissung et al., 2006), its inhibition could facilitate the development of a prophylactic therapy for oral cancer. Overall, this study has identified the transactivation of EGFR as a determinant of sensitivity towards combinatorial targeting of PI3K and MTOR in OSCC and has demonstrated that the autophosphorylation of EGFR (Tyr1173) can be used as a marker to judge the sensitivity towards this treatment. In the clinical perspective, the identification of such markers would aid in predicting the efficacy of targeted therapies. Such investigations would enable the strategic treatment of OSCC patients, thus decreasing the time lost in trial and errors for determining the appropriate treatment. Additionally, this study elucidated a novel role of TSC2 in the transcriptional repression of EREG, a prognostic biomarker for OSCC. Further, the study revealed potential prognostic biomarkers as well as therapeutic targets that are regulated by TSC2 by using a whole genome expression microarray. Moreover, the counterintuitive downregulation of CYP1B1 in OSCC tumors suggested the possibility of a prophylactic therapy for oral cancer but also advised a precautionary note for the application of prodrug treatments based on CYP1B1 overexpression in OSCC.

The thesis analyses the legality of the use of drones in warfare based on the examination of three specific case studies. Firstly the use of armed drones in Afghanistan 2001 and 2002, then Pakistan drone strikes ongoing since 2004 and lastly the Yemen case study. A developed legal framework is used to assess the legality of the use of drones. Furthermore, it briefly touches upon the aspects of morality and ethics of the use of the unmanned aerial vehicles in combat.