Patient's needs and preferences in routine follow-up after treatment for breast cancer

The purpose of the study was to analyse the needs of women who participated in a routine follow-up programme after treatment for primary breast cancer. A cross-sectional survey was conducted using a postal questionnaire among women without any sign of relapse during the routine follow-up period. The questionnaire was sent 2-4 years after primary surgical treatment. Most important to patients was information on long-term effects of treatment and prognosis, discussion of prevention of breast cancer and hereditary factors and changes in the untreated breast. Patients preferred additional investigations (such as X-ray and blood tests) to be part of routine follow-up visits. Less satisfaction with interpersonal aspects and higher scores on the Hospital Anxiety and Depression Scale (HADS) scale were related to stronger preferences for additional investigation. Receiving adjuvant hormonal or radiotherapy was related to a preference for a more intensive follow-up schedule. There were no significant differences between patients treated with mastectomy compared to treated with breast-conserving therapy. During routine follow-up after a diagnosis of breast cancer, not all patients needed all types of information. When introducing alternative follow-up schedules, individual patients' information needs and preferences should be identified early and incorporated into the follow-up routine care, to target resources and maximise the likelihood that positive patient outcomes will result

Periostin Responds to Mechanical Stress and Tension by Activating the MTOR Signaling Pathway

Current knowledge about Periostin biology has expanded from its recognized functions in embryogenesis and bone metabolism to its roles in tissue repair and remodeling and its clinical implications in cancer. Emerging evidence suggests that Periostin plays a critical role in the mechanism of wound healing; however, the paracrine effect of Periostin in epithelial cell biology is still poorly understood. We found that epithelial cells are capable of producing endogenous Periostin that, unlike mesenchymal cell, cannot be secreted. Epithelial cells responded to Periostin paracrine stimuli by enhancing cellular migration and proliferation and by activating the mTOR signaling pathway. Interestingly, biomechanical stimulation of epithelial cells, which simulates tension forces that occur during initial steps of tissue healing, induced Periostin production and mTOR activation. The molecular association of Periostin and mTOR signaling was further dissected by administering rapamycin, a selective pharmacological inhibitor of mTOR, and by disruption of Raptor and Rictor scaffold proteins implicated in the regulation of mTORC1 and mTORC2 complex assembly. Both strategies resulted in ablation of Periostin-induced mitogenic and migratory activity. These results indicate that Periostin-induced epithelial migration and proliferation requires mTOR signaling. Collectively, our findings identify Periostin as a mechanical stress responsive molecule that is primarily secreted by fibroblasts during wound healing and expressed endogenously in epithelial cells resulting in the control of cellular physiology through a mechanism mediated by the mTOR signaling cascade.This work was funded by the National Institutes of Health (NIH/NCI) P50-CA97248 (University of Michigan Head and Neck SPORE)

Evidence-based management and intervention for autism spectrum disorders

info:eu-repo/semantics/publishe

Cooperative courtship display in Long-tailed Manakins Chiroxiphia linearis: predictors of courtship success revealed through full characterization of display

The Pipridae comprise 52 species of manakins with a wide variety of courtship behaviours, ranging from solitary display, to traditional leks, to cooperative display. Long-tailed Manakins (Chiroxiphia linearis) exhibit an exploded lek-breeding system wherein two unrelated males cooperate to perform complex courtship displays for females. Our objectives in this study were to fully characterize the courtship display of Long-tailed Manakins, to evaluate the sequence and stereotypy of the display, and to investigate specific predictors of copulation success. Whereas the display of Long-tailed Manakins has traditionally been divided into two major parts, the hopping display and the butterfly display, we identified and characterized 16 individual display elements within these larger components of the display. We also determined that some aspects of the display are highly structured and stereotypical in performance, such that certain elements of the display are highly likely to be preceded or followed by particular elements. Nevertheless, other aspects of the display were much more flexible in terms of element sequence. We also found that the length and rate of performance of individual display elements were highly variable across displays. We therefore evaluated whether individual elements of the display could predict courtship success. Our results show that a number of highly correlated elements, namely upright postures, bounces, angel flights, and bows, can predict whether a display ends in copulation with a female. This research enhances our understanding of male display behaviour and female choice in Long-tailed Manakins, and may shed some light on the evolution of complex courtship displays in birds