Fatigue in patients with COPD participating in a pulmonary rehabilitation program

Cindy J Wong1, Donna Goodridge1, Darcy D Marciniuk2, Donna Rennie1,31College of Nursing, 2College of Medicine, 3Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, CanadaBackground: Fatigue is a distressing, complex, multidimensional sensation common in individuals with chronic obstructive pulmonary disease (COPD). While fatigue negatively impacts functional performance and quality of life, there has been little study of the fatigue that affects participants in pulmonary rehabilitation programs. The purpose of this study was to examine the emotional, behavioral, cognitive, and physical dimensions of fatigue and their relationships to dyspnea, mental health, sleep, and physiologic factors.Patients and methods: A convenience sample of 42 pulmonary rehabilitation participants with COPD completed self-report questionnaires which measured dimensions of fatigue using the Multidimensional Fatigue Inventory, anxiety and depression using the Hospital Anxiety and Depression Scale, and sleep quality using the Pittsburgh Sleep Quality Index. Data on other clinical variables were abstracted from pulmonary rehabilitation program health records.Results: Almost all (95.3%) participants experienced high levels of physical fatigue. High levels of fatigue were also reported for the dimensions of reduced activity (88.1%), reduced motivation (83.3%), mental fatigue (69.9%), and general fatigue (54.5%). Close to half (42.9%) of participants reported symptoms of anxiety, while almost one quarter (21.4%) reported depressive symptoms. Age was related to the fatigue dimensions of reduced activity (ρ = 0.43, P < 0.01) and reduced motivation (ρ = 0.31, P < 0.05). Anxiety was related to reduced motivation (ρ = -0.47, P < 0.01). Fatigue was not associated with symptoms of depression, sleep quality, gender, supplemental oxygen use, smoking status, or Medical Research Council dyspnea scores.Conclusions: Fatigue (particularly the physical and reduced motivation dimensions of fatigue) was experienced by almost all participants with COPD attending this pulmonary rehabilitation program. Fatigue affected greater proportions of participants than either anxiety or depression. The high prevalence of fatigue may impact on enrolment, participation, and attrition in pulmonary rehabilitation programs. Further investigation of the nature, correlates, and impact of fatigue in this population is required.Keywords: COPD, fatigue, pulmonary rehabilitation, anxiety, depression, sleep qualit

TOX3 mutations in breast cancer

TOX3 maps to 16q12, a region commonly lost in breast cancers and recently implicated in the risk of developing breast cancer. However, not much is known of the role of TOX3 itself in breast cancer biology. This is the first study to determine the importance of TOX3 mutations in breast cancers. We screened TOX3 for mutations in 133 breast tumours and identified four mutations (three missense, one in-frame deletion of 30 base pairs) in six primary tumours, corresponding to an overall mutation frequency of 4.5%. One potentially deleterious missense mutation in exon 3 (Leu129Phe) was identified in one tumour (genomic DNA and cDNA). Whilst copy number changes of 16q12 are common in breast cancer, our data show that mutations of TOX3 are present at low frequency in tumours. Our results support that TOX3 should be further investigated to elucidate its role in breast cancer biology.Breast Cancer Research Foundation grant; University of Cambridge; Cancer Research UK; Hutchison Whampoa Limited; NIHR Cambridge Biomedical Research Centre; Marie Curie Career Integration Grant; Cancer Research UK [16942]; National Institute for Health Research [NF-SI-0611-10154

A comparison of motion sickness prevalence between seafarers and non-seafarers onboard naval platforms

Background: Motion sickness may crucially affect the operational performance of soldiers at sea and this differs between individuals and environments. Objectives: To report on the prevalence and understand the risk factors for motion sickness among Singaporean sailors (seafarers) and attached army servicemen (nonseafarers) onboard naval platforms. Methodology: Cross sectional study using self-administered survey of 503 personnel over the monsoon period from January to April 2001. Results: The prevalence of motion sickness was distinctly higher in the army (59.2%) personnel compared with the navy (38.3%) over a series of sea states. The most common symptoms were headache, nausea and dizziness. The Motion Sickness Susceptibility Questionnaire was used to score susceptibility and appeared to correlate better among non-seafarers rather than seafarers. The discomfort experienced in one's environment was perceived to contribute towards onset and smoking appeared to be protective against motion sickness. Regular sailing appears to be an important factor in minimising motion sickness. Conclusion: While we understand motion sickness to be a continuum of physiological responses to the whole body vibration, it is especially apparent among the non-seafarers. Seafarers by themselves will become less susceptible with regular sailing and they are also more cognizant of the modalities available to alleviate symptoms

Single cell analysis shows decreasing FoxP3 and TGFβ1 coexpressing CD4+CD25+ regulatory T cells during autoimmune diabetes

Natural CD4+CD25+ regulatory T (CD4+CD25+ T reg) cells play a key role in the immunoregulation of autoimmunity. However, little is known about the interactions between CD4+CD25+ T reg cells and autoreactive T cells. This is due, in part, to the difficulty of using cell surface markers to identify CD4+CD25+ T reg cells accurately. Using a novel real-time PCR assay, mRNA copy number of FoxP3, TGFβ1, and interleukin (IL)-10 was measured in single cells to characterize and quantify CD4+CD25+ T reg cells in the nonobese diabetic (NOD) mouse, a murine model for type 1 diabetes (T1D). The suppressor function of CD4+CD25+CD62Lhi T cells, mediated by TGFβ, declined in an age-dependent manner. This loss of function coincided with a temporal decrease in the percentage of FoxP3 and TGFβ1 coexpressing T cells within pancreatic lymph node and islet infiltrating CD4+CD25+CD62Lhi T cells, and was detected in female NOD mice but not in NOD male mice, or NOR or C57BL/6 female mice. These results demonstrate that the majority of FoxP3-positive CD4+CD25+ T reg cells in NOD mice express TGFβ1 but not IL-10, and that a defect in the maintenance and/or expansion of this pool of immunoregulatory effectors is associated with the progression of T1D

PGX Technology: Novel tailor-made and tuneable Delivery Systems for poorly water-soluble Bioactives

The delivery of poorly water-soluble bioactives, including active pharmaceutical ingredients (API) and nutraceutical components is of great interest for existing drugs and new drug developments, cosmetic formulations, functional foods and nutraceuticals. This article presents a novel patented technology called PGX Technology, which utilizes pressurized gas expanded (PGX) liquids to dry, micronize, purify and functionalize water-soluble polymers. PGX Technology can generate open-porous nanostructured polymer carriers composed of one or several water-soluble polymers forming powders, granules, nano-fibrils, aerogels and exfoliated nano-composites with specific surface areas (SSA) ranging from tens to several hundred m2/g. Such mesoporous water-soluble carrier systems can be impregnated with a bioactive by means of adsorptive precipitation, utilizing supercritical carbon dioxide, leading to the uniform deposition of nano-scale particles (<120 nm) throughout the porous matrix, forming a bioactive-polymer complex, for example coenzyme Q10 on β-glucan (CoQ10-iBG). A nano-dispersion of CoQ10 is formed when such CoQ10-iBG complex is dissolved in water, which is stable over 6 months at room temperature. The bioavailability of the CoQ10-iBG complex tested in rats compared favorably with a positive control (CoQ10 in triolein) and a commercial CoQ10-cyclodextrin complex

The emergent community of esports fans in Japan: an analysis of motivations and preferences

Purpose/Rationale This study examines esports players’ and viewers’ motivations in Japan to inform market segmentation and strategy for industry stakeholders. Design/methodology/approach Employing purposive sampling, data from 500 Japanese esports participants were collected through an online survey including behavioural, motivational, and demographic factors. Cluster analysis was applied to identify distinct groups. Findings Results revealed three unique clusters each for players (all-rounder players, immersive fun seekers, and skill-based players) and viewers (casual viewers, entertainment-excitement seekers and skill appreciation seekers), with each exhibiting distinct motivations and preferences. Socio-economic factors did not significantly differentiate clusters, but fan behavioural patterns were useful in characterising them. Practical Implications Our study provides insights into Japan’s market preferences for console gaming and skill development and guides stakeholders in targeted strategy development for market engagement and growth. Research Contribution By applying the Uses and Gratifications theory within the Japanese context, this study enhances esports online community research by revealing distinct segment characteristics in a culturally unique setting and enriches esports interaction understanding. Originality/value This study sheds light on the motivations and preferences of esports players and viewers in Japan’s emerging market, offering valuable insights for stakeholders to better understand and engage their audience

Are grassroots sports events good for migrant cities' sustainable development? A case study of the Shenzhen 100 km Hikathon

Compared to official sports mega events, grassroots sports events are attractive to participants because of their universality, accessibility, and casual nature. Taking the Shenzhen 100 km Hikathon as an example, this study investigates the effect of grassroots sports events on sustainable development in migrant cities through residents&rsquo; perceptions of such events, and how these affect support. We collected 59 questionnaires in a pre-survey and 612 surveys for formal analysis, and used SPSS and AMOS software to construct a structural equation model. The results indicate that the Hikathon&rsquo;s popularity, low media impact, small scale of investment and construction, and short duration had fewer negative effects and was beneficial to sustainable development for the migrant city. Residents perceived more positive benefits (improved city image and economic, environmental and cultural benefits) and less negative costs (environmental and traffic costs), which lead to broader support for such events. Among residents&rsquo; sociodemographic characteristics, only age was found to moderate the relationship between perceived effects and support. The findings suggest that residents generally perceive grassroots sports events positively, especially in migrant cities, such as Shenzhen, where community events are considered to serve an important role in the construction of place identity

Half brain irradiation in a murine model of breast cancer brain metastasis: Magnetic resonance imaging and histological assessments of dose-response

Background: Brain metastasis is becoming increasingly prevalent in breast cancer due to improved extra-cranial disease control. With emerging availability of modern image-guided radiation platforms, mouse models of brain metastases and small animal magnetic resonance imaging (MRI), we examined brain metastases\u27 responses from radiotherapy in the pre-clinical setting. In this study, we employed half brain irradiation to reduce inter-subject variability in metastases dose-response evaluations. Methods: Half brain irradiation was performed on a micro-CT/RT system in a human breast cancer (MDA-MB-231-BR) brain metastasis mouse model. Radiation induced DNA double stranded breaks in tumors and normal mouse brain tissue were quantified using γ-H2AX immunohistochemistry at 30 min (acute) and 11 days (longitudinal) after half-brain treatment for doses of 8, 16 and 24 Gy. In addition, tumor responses were assessed volumetrically with in-vivo longitudinal MRI and histologically for tumor cell density and nuclear size. Results: In the acute setting, γ-H2AX staining in tumors saturated at higher doses while normal mouse brain tissue continued to increase linearly in the phosphorylation of H2AX. While γ-H2AX fluorescence intensities returned to the background level in the brain 11 days after treatment, the residual γ-H2AX phosphorylation in the radiated tumors remained elevated compared to un-irradiated contralateral tumors. With radiation, MRI-derived relative tumor growth was significantly reduced compared to the un-irradiated side. While there was no difference in MRI tumor volume growth between 16 and 24 Gy, there was a significant reduction in tumor cell density from histology with increasing dose. In the longitudinal study, nuclear size in the residual tumor cells increased significantly as the radiation dose was increased. Conclusions: Radiation damages to the DNAs in the normal brain parenchyma are resolved over time, but remain unrepaired in the treated tumors. Furthermore, there is a radiation dose response in nuclear size of surviving tumor cells. Increase in nuclear size together with unrepaired DNA damage indicated that the surviving tumor cells post radiation had continued to progress in the cell cycle with DNA replication, but failed cytokinesis. Half brain irradiation provides efficient evaluation of dose-response for cancer cell lines, a pre-requisite to perform experiments to understand radio-resistance in brain metastases

Just-in-Time Decision Making: Preliminary Findings of a Goals of Care Rapid Response Team

CONTEXT: The COVID-19 pandemic placed the issue of resource utilization front and center. Our comprehensive cancer center developed a Goals of Care Rapid Response Team (GOC RRT) to optimize resource utilization balanced with goal-concordant patient care. OBJECTIVES: Primary study objective was to evaluate feasibility of the GOC RRT by describing the frequency of consultations that occurred from those requested. Secondary objectives included adherence to consultation processes in terms of core team member participation and preliminary efficacy in limiting care escalation. METHODS: We conducted a retrospective chart review of patients referred to GOC RRT (3/23/2020-9/30/2020). Analysis was descriptive. Categorical variables were compared with Fisher\u27s exact or Chi-Square tests and continuous variables with Mann-Whitney U tests. RESULTS: A total of 89 patients were referred. Eighty-five percent (76 of 89) underwent a total of 95 consultations. Median (range) patient age was 61 (49, 69) years, 54% (48 of 89) male, 19% (17 of 89) Hispanic, 48% (43/89) White, 73% (65 of 89) married/partnered and 66% (59 of 89) Christian. Hematologic malignancies and solid tumors were evenly balanced (53% [47/89] vs. 47% [42 of 89, P = 0.199]). Most patients (82%, 73 of 89) had metastatic disease or relapsed leukemia. Seven percent (6 of 89) had confirmed COVID-19. Sixty-nine percent (61 of 89) died during the index hospitalization. There was no statistically significant difference in demographic or clinical characteristics among groups (no consultation, 1 consultation, \u3e1 consultation). Core team members were present at 64% (61 of 95) of consultations. Care limitation occurred in 74% (56 of 76) of patients. CONCLUSION: GOC RRT consultations were feasible and associated with care limitation. Adherence to core team participation was fair