Management of the respiratory distress symptom cluster in lung cancer: a randomised controlled feasibility trial.

BACKGROUND: Breathlessness, cough and fatigue are distressing symptoms for patients with lung cancer. There is evidence that these three symptoms form a discreet symptom cluster. This study aimed to feasibly test a new non-pharmacological intervention for the management of the Respiratory Distress Symptom Cluster (breathlessness-cough-fatigue) in lung cancer. METHOD: This was a multi-centre, randomised controlled non-blinded parallel group feasibility trial. Eligible patients (patients with primary lung cancer and 'bothered' by at least two of the three cluster symptoms) received usual care plus a multicomponent intervention delivered over two intervention training sessions and a follow-up telephone call or usual care only. Follow-up was for 12 weeks, and end-points included six numerical rating scales for breathlessness severity, Dyspnoea-12, Manchester Cough in Lung Cancer scale, FACIT-Fatigue scale, Hospital Anxiety and Depression scale, Lung Cancer Symptom Scale and the EQ-5D-3L, collected at baseline, week 4 and week 12. RESULTS: One hundred seven patients were randomised over 8 months; however, six were removed from further analysis due to protocol violations (intervention group n = 50 and control group n = 51). Of the ineligible patients (n = 608), 29 % reported either not experiencing two or more symptoms or not being 'bothered' by at least two symptoms. There was 29 % drop-out by week 4, and by week 12, a further two patients in the control group were lost to follow-up. A sample size calculation indicated that 122 patients per arm would be needed to detect a clinically important difference in the main outcome for breathlessness, cough and fatigue. CONCLUSIONS: The study has provided evidence of the feasibility and acceptability of a new intervention in the lung cancer population and warrants a fully powered trial before we reach any conclusions. The follow-on trial will test the hypothesis that the intervention improves symptom cluster of breathlessness, cough and fatigue better than usual care alone. Full economic evaluation will be conducted in the main trial

Fiber Attachment Module Experiment (FAME): Using a Multiplexed Miniature Hollow Fiber Membrane Bioreactor Solution for Rapid Process Testing

Bioreactor research is mostly limited to continuous stirred-tank reactors (CSTRs) which are not an option for microgravity (g) applications due to the lack of a gravity gradient to drive aeration as described by the Archimedes principle. Bioreactors and filtration systems for treating wastewater in g could avoid the need for harsh pretreatment chemicals and improve overall water recovery. Solution: Membrane Aerated Bioreactors (MABRs) for g applications, including possible use for wastewater treatment systems for the International Space Station (ISS)

LOX-1 genotype, dietary fat intake, and aerobic exercise training: Influence on endothelial function, oxidative stress, lipoprotein-lipids, and soluble LOX-1

The lectin-like oxidized LDL receptor (LOX-1) is the major receptor for oxidized LDL (ox-LDL) in endothelial cells and plays a major role in the initiation and progression of atherosclerosis. Ox-LDL via LOX-1 causes endothelial activation and injury, induces lipid peroxidation, and alters inflammatory gene expression, and variation in the LOX-1 gene has been associated with cardiovascular disease risk. In addition, a soluble form of LOX-1 has been identified in plasma and may predict atherosclerotic disease progression. Thus, the purpose of this study was to investigate the effect of the LOX-1 3'UTR C/T and G501C polymorphisms on endothelial function, oxidative stress, plasma lipoprotein-lipids, and soluble LOX-1. The effect of these polymorphisms on the responses to dietary fat intake and aerobic exercise training was also examined. Forearm blood flow was measured using venous occlusion plethysmography at rest and during reactive hyperemia, and plasma levels of nitrates/nitrites, nitrotyrosine, ox-LDL, total antioxidant capacity, lipoprotein-lipids, and soluble LOX-1 were measured before and after six months of aerobic exercise training. The dietary ratio of polyunsaturated fat to saturated fat (P:S ratio) was determined using 7-day food records. The 3'UTR/CC and 501GC+CC groups had significantly higher baseline soluble LOX-1 levels than the CT/TT and GG groups, respectively. The G501C polymorphism was a significant predictor of baseline soluble LOX-1 levels, even after accounting for age, gender, race, BMI, and the 3'UTR polymorphism (p=0.024). There was a significant interaction between the 3'UTR polymorphism and dietary fat intake for plasma ox-LDL levels (p=0.011). At a high P:S ratio, the 3'UTR/CC group had significantly higher ox-LDL levels than the TT group (p=0.025). The opposite relationship was found at a low P:S ratio (p=0.044). The 3'UTR polymorphism also influenced changes in plasma TG levels with exercise training (p=0.036), while the G501C polymorphism influenced changes in soluble LOX-1 levels (p=0.012). In conclusion, variation in the LOX-1 gene does not appear to be associated with endothelial function, oxidative stress, or plasma lipid levels, but may influence changes in these variables in response to dietary fat intake and exercise training. Moreover, polymorphisms in LOX-1, especially the G501C polymorphism, may regulate circulating levels of soluble LOX-1

A Mouse Model of Harlequin Ichthyosis Delineates a Key Role for Abca12 in Lipid Homeostasis

Harlequin Ichthyosis (HI) is a severe and often lethal hyperkeratotic skin disease caused by mutations in the ABCA12 transport protein. In keratinocytes, ABCA12 is thought to regulate the transfer of lipids into small intracellular trafficking vesicles known as lamellar bodies. However, the nature and scope of this regulation remains unclear. As part of an original recessive mouse ENU mutagenesis screen, we have identified and characterised an animal model of HI and showed that it displays many of the hallmarks of the disease including hyperkeratosis, loss of barrier function, and defects in lipid homeostasis. We have used this model to follow disease progression in utero and present evidence that loss of Abca12 function leads to premature differentiation of basal keratinocytes. A comprehensive analysis of lipid levels in mutant epidermis demonstrated profound defects in lipid homeostasis, illustrating for the first time the extent to which Abca12 plays a pivotal role in maintaining lipid balance in the skin. To further investigate the scope of Abca12's activity, we have utilised cells from the mutant mouse to ascribe direct transport functions to the protein and, in doing so, we demonstrate activities independent of its role in lamellar body function. These cells have severely impaired lipid efflux leading to intracellular accumulation of neutral lipids. Furthermore, we identify Abca12 as a mediator of Abca1-regulated cellular cholesterol efflux, a finding that may have significant implications for other diseases of lipid metabolism and homeostasis, including atherosclerosis

One Hundred Voices: Harrisburg\u27s Historic African American Community, 1850-1920

In 2020, a coalition of citizens, organizers, legislators, and educators came together to commemorate the Fifteenth and Nineteenth Amendments by establishing a new monument in Harrisburg, Pennsylvania. This would be a memorial dedicated to the capital city’s significant African American community and its historic struggle for the vote. The Commonwealth Monument, located on the Irvis Equality Circle on the South Lawn of Pennsylvania’s State Capitol Grounds, features a bronze pedestal inscribed with one hundred names of change agents who pursued the power of suffrage and citizenship between 1850 and 1920. This book is a companion to this monument and tells the stories of those one hundred freedom seekers, abolitionists, activists, suffragists, moralists, policemen, masons, doctors, lawyers, musicians, poets, publishers, teachers, preachers, housekeepers, janitors, and business leaders, among many others. In their committed advocacy for freedom, equality, and justice, these inspiring men and women made unique and lasting contributions to the standing and life of African Americans—and, indeed, the political power of all Americans—within their local communities and across the country.https://mosaic.messiah.edu/onehundredvoices/1003/thumbnail.jp

Cultural Identity Predicts Resilience in Maltreated Youth

Literature suggests that a stronger sense of cultural identity predicts higher levels of resilience following a traumatic event. However, there are limited studies that examine this relationship in children. The present research analyzes the relationship between cultural identity and resilience in a sample of maltreated youth. Participants included youth (n=65) aged 11-17 years in Department of Family Services (DFS) custody following removal from their home after substantiated child maltreatment. Cultural identity and resilience were both assessed by the Nevada Child and Adolescent Needs and Strengths (NV- CANS). A linear regression indicated a significant predictive relationship between cultural identity and resilience, F (1, 63) = 16.073, p=.001. Results suggest that 20.3% (Adjusted R² = 19.1%) of the variance in resilience could be explained by the variance in cultural identity. Specifically, according to the unstandardized regression coefficients, an increase in cultural identity predicted an increase in resilience (B =.322, SEculturalidentity = 0.08, t = 4.009, p=.001, 95% CI [.161, .482]). Overall, these findings suggest that cultural identity predicts levels of resilience in maltreated youth. This is a critical finding in expanding the literature and improving clinical outcomes, suggesting clinicians should take cultural factors into consideration and work with youth to build cultural support networks and a sense of belonging.https://oasis.library.unlv.edu/durep_posters/1006/thumbnail.jp