Nevertheless, the elevation of BIRC6 in castrationresistant cancers suggests that the protein may provide a potential therapeutic target for the disease. Targeting BIRC6 as an inhibitor of apoptosis and potential enhancer of autophagy may be useful for sensitizing prostate cancer cells to anti-cancer therapies. It may be noted that drugs targeting other IAP family members, e.g., XIAP and survivin, have shown promise for use as sensitizers in prostate cancer therapy. Antisense inhibitors of XIAP led to sensitization of castration-resistant prostate cancer cells to cisplatin and TNFrelated apoptosis-inducing ligand ; in PC3 prostate cancer xenografts, they caused sustained tumor regression in combination with docetaxel. In conclusion, the present study indicates for the first time that the BIRC6 gene and its product are potentially valuable targets for treatment of prostate cancers showing elevated BIRC6 expression. Overuse of healthcare services is often cited as a driver of 
rising healthcare costs and is an indicator of poor quality care. Anecdotal reports and studies of select populations suggest that the use of proton pump inhibitors has increased since their introduction in the late 1980s. PPIs are used to treat gastrointestinal conditions such as MK-1775 gastroesophageal reflux disease and peptic ulcer disease or in patients who may be at high risk for these diseases. Although PPIs are generally believed to be safe medications, recent studies indicate that there may be harms associated with their use such as pneumonia and fracture. Overuse of PPIs may put patients at unnecessary risk for these harms and may also contribute to rising health care costs. One study has documented increased PPI use in the U.S. outpatient setting but to our knowledge, no studies have examined very recent national trends in PPI use in the U.S. outpatient setting, the characteristics of patients on PPIs, the characteristics of physicians who prescribe PPIs, and trends in Regorafenib indications for their use. Knowledge of these trends and characteristics may inform patients, physicians, payers, and policymakers who want to receive or deliver high quality, high value care. We used data from two national surveys of visits to ambulatory physicians to describe recent trends in the use of PPIs in the ambulatory setting. We explored potential reasons for these trends by looking at changes in the prevalence of newly prescribed PPIs, changes in histamine blocker use, and changes in the prevalence of indications for their use. The NAMCS and NHAMCS use a three-stage sampling design. The first stage is based on geographic location, the second stage identifies offices in each geographic location, and the third stage samples visits within each office. The visits sampled take place during a one week period that is randomly assigned for each practice. Between 20% and 100% of the visits that week are sampled depending on the size of the practice. The NCHS weighs each visit so that the data can be used for national estimates. Each visit weight accounts for selection probability, adjusts for nonresponse, and accounts for other factors so that the national estimates properly reflect the scope of ambulatory visits in the U.S. Physicians in the fields of anesthesiology, radiology, and pathology are excluded from the survey. Physicians who participate in the survey cannot participate again for at least three years. There has been no change in the sampling design for our study period.