Implementing Shared Medical Appointments for Cancer Patients to Cancer Survivors: An Evidence-Based Project for Breast Cancer Survivorship

More than 2 million new cancer cases are expected by 2024 in the United States. The fast-growing cancer survivors are estimated to be up to 18.4 million, 5.4% of the population in the United States, by 2032. Breast cancer is the most common cancer in women, following skin cancers in the United States. Breast cancer survivors often struggle with physical, mental, psychosocial, and financial difficulties following cancer treatments. The implementation of SMA for breast cancer survivorship is an evidence-based quality improvement initiative. Shared medical appointments (SMAs) for breast cancer survivorship can provide effective and efficient survivorship care to address unmet survivorship needs. The 90-minute survivorship SMA consists of an individual visit with a clinician and comprehensive education, counseling, and peer support with multidisciplinary oncology providers in groups of three patients. Three multidisciplinary-led SMA sessions weekly provided a comprehensive survivorship care plan for nine patients at a community cancer center. Following the SMA session, all patients received a treatment summary and individualized survivorship care plan. Eleven of the sixty-eight eligible breast cancer patients agreed and scheduled for SMAs, and nine patients (82%) attended the SMA sessions. Most participants expressed high satisfaction with SMA, rated 3.64 out of 4. Overall, most participants indicated a gain in knowledge through SMA sessions, with post-survey knowledge scores increasing by an average of 17%. Multidisciplinary-driven SMA can provide comprehensive survivorship care and individualized care plans to address difficulties during the cancer journey.No embarg

The Equilibrium of Tumor Suppression: DUBs As Active Regulators of PTEN

PTEN is among the most commonly lost or mutated tumor suppressor genes in human cancer. PTEN, a bona fide lipid phosphatase that antagonizes the highly oncogenic PI3K-AKT-mTOR pathway, is considered a major dose-dependent tumor suppressor. Although PTEN function can be compromised by genetic mutations in inherited syndromes and cancers, posttranslational modifications of PTEN may also play key roles in the dynamic regulation of its function. Notably, deregulated ubiquitination and deubiquitination lead to detrimental impacts on PTEN levels and subcellular partitioning, promoting tumorigenesis. While PTEN can be targeted by HECT-type E3 ubiquitin ligases for nuclear import and proteasomal degradation, studies have shown that several deubiquitinating enzymes, including HAUSP/USP7, USP10, USP11, USP13, OTUD3 and Ataxin-3, can remove ubiquitin from ubiquitinated PTEN in cancer-specific contexts and thus reverse ubiquitination-mediated PTEN regulation. Researchers continue to reveal the precise molecular mechanisms by which cancer-specific deubiquitinases of PTEN regulate its roles in the pathobiology of cancer, and new methods of pharmacologically for modulating PTEN deubiquitinases are critical areas of investigation for cancer treatment and prevention. Here, we assess the mechanisms and functions of deubiquitination as a recently appreciated mode of PTEN regulation and review the link between deubiquitinases and PTEN reactivation and its implications for therapeutic strategies

Analysis of Building Energy Savings Potential for Metal Panel Curtain Wall Building by Reducing Thermal Bridges at Joints Between Panels

AbstractTo achieve national greenhouse gas reduction in the building sector, heating and cooling energy in buildings should be reduced. The government has strengthened regulations on insulation performance for building energy savings. However, the building envelope has various thermal bridges. In particular, a metal panel curtain wall comprises a number of thermal bridges at joints between the panels and the fixing units, thus degrading the overall thermal performance. To reduce building energy, it is necessary to reduce thermal bridges in building envelopes. This study aims to analyze the energy saving potential achieved by reducing thermal bridges. For this, the insulation performance and building energy needs of the existing and alternative metal panel curtain wall were evaluated. The alternative metal panel curtain wall that uses plastic molds at joints between panels and the thermally-broken brackets was suggested to reduce heat loss through thermal bridges. As results, the effective U-value of the alternative metal panel curtain wall was reduced by 72% compared with the existing metal panel curtain wall. In addition, annual heating energy needs of the alternative metal panel curtain wall building was reduced by 26%, and annual total energy needs was reduced by 6% because annual cooling energy needs of it slightly increased compared with the existing metal panel curtain wall. In conclusion, the alternative metal panel curtain wall considerably influenced the savings in building energy needs by reducing thermal bridges

Identification of the optimal hiit protocol for fatigue resistance in adolescent athletes: a randomized controlled trial

The combat sports athletes developed great gains in both muscular function and fatigue resistance by utilizing high-intensity interval training (HIIT). However, it has not been investigated fully whether different work-to-rest ratios of HIIT show the effectiveness on muscle function in adolescent athletes. The purpose of the study was to compare different work-to-rest ratios by applying different rest times in response to the identical work time during HIIT on muscle function in adolescent taekwondo athletes. Forty-seven adolescent male taekwondo athletes (mean age: 16.7±0.8 years) were randomly assigned to the control group (n=11) vs. three HIIT groups by work-to-rest ratios; (1) 1:2 [30s:60s] (n=12), (2) 1:4 [30s:120s] (n=12), and (3) 1:8 [30s:240s] (n=12). All groups completed 10 experimental sessions over four weeks, while the control group maintained their regular taekwondo training. Muscular functions were measured by assessing isokinetic muscle strength and endurance of the knee extensor and flexor. The participants performed three sets of twenty maximal extension and flexion contractions at 120°s-1 with a 1-min interval between the sets for fatigue resistance. Blood samples were collected to measure free-testosterone, cortisol, creatine kinase, and urea as stress-to-recovery indicators. A positive effect on improving muscle fatigue resistance was observed at the first set of assessments in the HIIT with 1:4 (Δ10.2%, p<.05) and 1:8 groups (Δ8.6%, p<.05). Additionally, the 1:4 group exhibited fatigue resistance improvement in the second set (Δ7.7%, p<.01) without any changes of stress-to-recovery indicators, while the other groups did not show any improvement. The 30s all-out work with 120s rest time, lasting over a brief 4-week period, improved participants’ fatigue resistance. A certain amount of rest time between high-intense movements is required to optimize muscle development in adolescent athletes compared with insufficient rest time

Newly designed coil tube for bowel decompression in patients with small bowel obstructions

AbstractBackgroundThe purpose of this study was to clinically evaluate a coil tube that we recently designed for bowel decompression in patients with a small bowel obstruction.MethodsThe coil tube was composed of a stainless steel coil, a polyolefin tube, and a rubber adaptor. The tube was inserted under fluoroscopic guidance in 14 consecutive patients with small bowel obstructions. Technical success was defined as insertion of the distal end of the tube into at least the proximal jejunum, and clinical success was defined as intestinal decompression and relief of obstructive symptoms.ResultsThe technical success rate was 100%. Clinical success was achieved in 12 patients (86%). The clinical failures were a patient with peritoneal carcinomatosis and an ileocolic fistula, and a patient with bezoars following intestinal hemorrhage. No coil-related complications occurred.ConclusionOur newly designed coil tube was safe and effective in patients with bowel decompression associated with a small bowel obstruction. In addition, our tube has several advantages over other currently used tube types

Staphylococcal enterotoxin sensitization in a community-based population : a potential role in adult-onset asthma

Background: Recent studies suggest that Staphylococcus aureus enterotoxin sensitization is a risk factor for asthma. However, there is a paucity of epidemiologic evidence on adult-onset asthma in community-based populations. Objective: We sought to evaluate the epidemiology and the clinical significance of staphylococcal enterotoxin sensitization in community-based adult populations. Methods: The present analyses were performed using the baseline data set of Korean adult population surveys, consisting of 1080 adults (mean age=60.2years) recruited from an urban and a rural community. Questionnaires, methacholine challenge tests, and allergen skin tests were performed for defining clinical phenotypes. Sera were analysed for total IgE and enterotoxin-specific IgE using ImmunoCAP. Results: Staphylococcal enterotoxin sensitization (0.35kU/L) had a prevalence of 27.0%. Risk factors were identified as male sex, current smoking, advanced age (61years), and inhalant allergen sensitization. Current asthma was mostly adult onset (18years old) and showed independent associations with high enterotoxin-specific IgE levels in multivariate logistic regression tests. In multivariate linear regressions, staphylococcal enterotoxin-specific IgE level was identified as the major determinant factor for total IgE level. Conclusions and Clinical Relevance: Staphylococcal enterotoxin sensitization was independently associated with adult-onset asthma in adult community populations. Strong correlations between the enterotoxin-specific IgE and total IgE levels support the clinical significance. The present findings warrant further studies for the precise roles of staphylococcal enterotoxin sensitization in the asthma pathogenesis

Flightless-I Controls Fat Storage in Drosophila

Triglyceride homeostasis is a key process of normal development and is essential for the maintenance of energy metabolism. Dysregulation of this process leads to metabolic disorders such as obesity and hyperlipidemia. Here, we report a novel function of the Drosophila flightless-I (fliI) gene in lipid metabolism. Drosophila fliI mutants were resistant to starvation and showed increased levels of triglycerides in the fat body and intestine, whereas fliI overexpression decreased triglyceride levels. These flies suffered from metabolic stress indicated by increased levels of trehalose in hemolymph and enhanced phosphorylation of eukaryotic initiation factor 2 alpha (eIF2??). Moreover, upregulation of triglycerides via a knockdown of fliI was reversed by a knockdown of desat1 in the fat body of flies. These results indicate that fliI suppresses the expression of desat1, thereby inhibiting the development of obesity; fliI may, thus, serve as a novel therapeutic target in obesity and metabolic diseases