A cost-effectiveness analysis of a preventive exercise program for patients with advanced head and neck cancer treated with concomitant chemo-radiotherapy

In recent years, concomitant chemo-radiotherapy (CCRT) has become an indispensable organ preserving treatment modality for advanced head and neck cancer, improving local control and overall survival in several anatomical sites [1]. Unfortunately, CCRT can have a detrimental effect on many functions of the upper respiratory and digestive system. Sequellae such as pain, oedema, xerostomia and fibrosis negatively affect mouth opening (trismus), chewing, swallowing and speech [1]. Several studies investigating long-term effects of CCRT have concluded that swallowing and nutritional dysfunction tend to be persistent and can be severe [2-4]. Not surprisingly, therefore, CCRT can have a negative effect on patients‟ quality of life (QoL) [2]. Moreover, even before onset of treatment patients may already present with pain, impaired swallowing, trismus, aspiration, dietary restrictions and tube dependency, and loss of body weight, because the tumour may disrupt the normal anatomy and thus interfere with normal function [1]. Many studies refer to the importance of rehabilitation after, and even during treatment, in order to support and improve those functions [2]. However, as yet, few studies have investigated the effects of (preventive) rehabilitation exercises on the predictable and inevitable swallowing and mouth opening problems for this patient group. In addition, little is known about the costs and benefits of such exercise programs for head and neck cancer. As the clinical effectiveness is established [4], it is now relevant to embark on cost-effectiveness as a contribution to decision making on coverage. The aim of this study was to analyze the incremental cost-effectiveness for a preventive exercise program (PREP) versus usual care (UC) for patients with advanced head and neck cancer treated at the Netherlands Cancer Institute - Antoni van Leeuwenhoek Hospital (NKI-AVL)

COMMD1-Mediated Ubiquitination Regulates CFTR Trafficking

The CFTR (cystic fibrosis transmembrane conductance regulator) protein is a large polytopic protein whose biogenesis is inefficient. To better understand the regulation of CFTR processing and trafficking, we conducted a genetic screen that identified COMMD1 as a new CFTR partner. COMMD1 is a protein associated with multiple cellular pathways, including the regulation of hepatic copper excretion, sodium uptake through interaction with ENaC (epithelial sodium channel) and NF-kappaB signaling. In this study, we show that COMMD1 interacts with CFTR in cells expressing both proteins endogenously. This interaction promotes CFTR cell surface expression as assessed by biotinylation experiments in heterologously expressing cells through regulation of CFTR ubiquitination. In summary, our data demonstrate that CFTR is protected from ubiquitination by COMMD1, which sustains CFTR expression at the plasma membrane. Thus, increasing COMMD1 expression may provide an approach to simultaneously inhibit ENaC absorption and enhance CFTR trafficking, two major issues in cystic fibrosis

Ion homeostasis in the Chloroplast

peer reviewedThe chloroplast is an organelle of high demand for macro- and micro-nutrient ions, which are required for the maintenance of the photosynthetic process. To avoid deficiency while preventing excess, homeostasis mechanisms must be tightly regulated. Here, we describe the needs for nutrient ions in the chloroplast and briefly highlight their functions in the chloroplastidial metabolism. We further discuss the impact of nutrient deficiency on chloroplasts and the acclimation mechanisms that evolved to preserve the photosynthetic apparatus. We finally present what is known about import and export mechanisms for these ions. Whenever possible, a comparison between cyanobacteria, algae and plants is provided to add an evolutionary perspective to the description of ion homeostasis mechanisms in photosynthesis

DIFFERENCES IN EXERCISE BARRIERS AMONG INDIVIDUALS OF DIFFERENT ACTIVITY LEVELS

Ashton Burkhead1, Brooklyn Pilgreen1, Larissa Boyd1, Jacilyn Olson1, & Melissa Powers1 1University of Central Oklahoma, Edmond, Oklahoma Physical Activity (PA) is especially important for individuals with sedentary jobs. University employees are often required to sit for 8+ hours a day and are faced with exercise barriers, including time constraints and an inability to follow their own programming. It is important to accumulate at least 500-1,000 MET-min-wk-1 of PA recommended by the American College of Sports Medicine and understand the barriers to meeting these guidelines. PURPOSE: The aim of this study was to determine if individuals classified into different PA levels perceive exercise barriers differently. METHODS: Employees (N=51) at a regional university were recruited via e-mail. Prior to the program, participants completed demographic questions, an informed consent, the International Physical Activity Questionnaire (IPAQ), and the Barriers Self-Efficacy Scale (BARSE). Participant activity levels were categorized by volume of MET-minutes accomplished per week reported on the IPAQ: inactive (n=17; \u3c600 MET-min-wk-1), sufficiently active (n=26; 600-2,999 MET-min-wk-1) and very active (n=8; \u3e3,000 MET-min-wk-1). The BARSE is a 13-item questionnaire scored as an average of 0%-100% confidence to overcome specific barriers to exercise. A One-Way ANOVA was used to analyze the difference in barriers confidence among inactive, sufficiently active, and very active individuals. RESULTS: No significant differences were found between groups (p=.12). The very active group had the highest perceived ability to overcome barriers (M=74.99%±13.36%), while the active group (M=61.84%±15.54%) possessed a slightly lower, but similar confidence level to the inactive group (M=63.66%±16.57%). CONCLUSIONS: Very active individuals may possess a higher level of confidence to overcome barriers, while those who meet general recommendations for fitness are no more confident than inactive individuals. Future research should examine other factors potentially responsible for differences in PA levels

Data from: Discordant introgression in a rapidly expanding hybrid swarm

The erosion of species boundaries can involve rapid evolutionary change. Consequently, many aspects of the process remain poorly understood, including the formation, expansion and evolution of hybrid swarms. Biological invasions involving hybridization present exceptional opportunities to study the erosion of species boundaries because timelines of interactions and outcomes are frequently well known. Here, we examined clinal variation across codominant and maternally inherited genetic markers as well as phenotypic traits to characterize the expansion and evolution of a hybrid swarm between native Cyprinella venusta and invasive C. lutrensis minnows. Discordant introgression of phenotype, microsatellite multilocus genotype and mtDNA haplotype indicate that the observable expansion of the C. venusta x C. lutrensis hybrid swarm is a false invasion front. Both parental and hybrid individuals closely resembling C. lutrensis are numerically dominant in the expansion wake, indicating that the non-native parental phenotype may be selectively favored. These findings show that cryptic introgression can extend beyond the phenotypic boundaries of hybrid swarms, and that hybrid swarms likely expand more rapidly than can be documented from phenotypic variation alone. Similarly, dominance of a single parental phenotype following an introduction event may lead to instances of species erosion being mistaken for species displacement without hybridization