Oesophagectomy remains the only curative intervention for oesophageal cancer, with defined nutritional and health-related quality of life (HR-QOL) consequences. It follows therefore that there is a ...significant risk of decline in physical wellbeing with oesophagectomy however this has been inadequately quantified. This study prospectively examines change in physical functioning and habitual physical activity participation, from pre-surgery through 6-months post-oesophagectomy.
Patients scheduled for oesophagectomy with curative intent were recruited. Key domains of physical functioning including exercise tolerance (six-minute walk test (6MWT)) and muscle strength (hand-grip strength), and habitual physical activity participation, including sedentary behaviour (accelerometry) were measured pre-surgery (T0) and repeated at 1-month (T1) and 6-months (T2) post-surgery. HR-QOL was measured using the EORTC-QOL C30.
Thirty-six participants were studied (mean age 62.4 (8.8) years, n = 26 male, n = 26 transthoracic oesophagectomy). Mean 6MWT distance decreased significantly from T0 to T1 (p = 0.006) and returned to T0 levels between T1 and T2 (p < 0.001). Percentage time spent sedentary increased throughout recovery (p < 0.001) and remained significantly higher at T2 in comparison to T0 (p = 0.003). In contrast, percentage time spent engaged in either light or moderate-to-vigorous intensity activity, all reduced significantly (p < 0.001 for both) and remained significantly lower at T2 in comparison to T0 (p = 0.009 and p = 0.01 respectively). Patients reported deficits in multiple domains of HR-QOL during recovery including global health status (p = 0.04), physical functioning (p < 0.001) and role functioning (p < 0.001). Role functioning remained a clinically important 33-points lower than pre-operative values at T2.
Habitual physical activity participation remains significantly impaired at 6-months post-oesophagectomy. Physical activity is a measurable and modifiable target for physical rehabilitation, which is closely aligned with patient-reported deficits in role functioning. Rehabilitation aimed at optimising physical health in oesophageal cancer survivorship is warranted.
Cost-effective fractionation (pretreatment) of lignocellulosic biomass is necessary to enable its large-scale use as a source of liquid fuels, bio-based materials and bio-derived chemicals. While a ...number of ionic liquids (ILs) have proven capable of highly effective pretreatment, their high cost presents a barrier to commercial viability. In this study, we investigate in detail the application of the low-cost (ca. $1 kg-1) ionic liquid triethylammonium hydrogen sulfate for the fractionation of the grass Miscanthus x giganteus into a cellulose rich pulp, a lignin and a distillate. We found that up to 85% of the lignin and up to 100% of the hemicellulose were solubilized into the IL solution. The hemicellulose dissolved mainly in monomeric form, and pentoses were partially converted into furfural. Up to 77% of the glucose contained in the biomass could be released by enzymatic saccharification of the pulp. The IL was successfully recovered and reused four times. A 99% IL recovery was achieved each time. Effective lignin removal and high saccharification yields were maintained during recycling, representing the first demonstration that repeated IL use is feasible due to the self-cleaning properties of the non-distillable solvent. We further demonstrate that furfural and acetic acid can be separated quantitatively from the non-volatile IL by simple distillation, providing an easily recoverable, valuable co-product stream, while IL degradation products were not detected. We further include detailed mass balances for glucose, hemicellulose and lignin, and a preliminary techno-economic estimate for the fractionation process. This is the first demonstration of an efficient and repeated lignocellulose fractionation with a truly low-cost IL, and opens a path to an economically viable IL-based pretreatment process.
Persistent infection with oncogenic Human Papillomavirus (HPV) is necessary for cervical carcinogenesis. Although evidence suggests that the vaginal microbiome plays a functional role in the ...persistence or regression of HPV infections, this has yet to be described in women with cervical intra-epithelial neoplasia (CIN). We hypothesised that increasing microbiome diversity is associated with increasing CIN severity. llumina MiSeq sequencing of 16S rRNA gene amplicons was used to characterise the vaginal microbiota of women with low-grade squamous intra-epithelial lesions (LSIL; n = 52), high-grade (HSIL; n = 92), invasive cervical cancer (ICC; n = 5) and healthy controls (n = 20). Hierarchical clustering analysis revealed an increased prevalence of microbiomes characterised by high-diversity and low levels of Lactobacillus spp. (community state type-CST IV) with increasing disease severity, irrespective of HPV status (Normal = 2/20,10%; LSIL = 11/52,21%; HSIL = 25/92,27%; ICC = 2/5,40%). Increasing disease severity was associated with decreasing relative abundance of Lactobacillus spp. The vaginal microbiome in HSIL was characterised by higher levels of Sneathia sanguinegens (P < 0.01), Anaerococcus tetradius (P < 0.05) and Peptostreptococcus anaerobius (P < 0.05) and lower levels of Lactobacillus jensenii (P < 0.01) compared to LSIL. Our results suggest advancing CIN disease severity is associated with increasing vaginal microbiota diversity and may be involved in regulating viral persistence and disease progression.
Purpose
Preoperative chemo(radio)therapy for oesophageal cancer (OC) may have an attritional impact on body composition and functional status, impacting postoperative outcome. Physical decline with ...skeletal muscle loss has not been previously characterised in OC and may be amenable to physical rehabilitation. This study characterises skeletal muscle mass and physical performance from diagnosis to post-neoadjuvant therapy in patients undergoing preoperative chemo(radio)therapy for OC.
Methods
Measures of body composition (axial computerised tomography), muscle strength (handgrip), functional capacity (walking distance), anthropometry (weight, height and waist circumference), physical activity, quality-of-life and nutritional status were captured prospectively. Sarcopenia status was defined as pre-sarcopenic (low muscle mass only), sarcopenic (low muscle mass and low muscle strength or function) or severely sarcopenic (low muscle mass and low muscle strength and low muscle function).
Results
Twenty-eight participants were studied at both time points (mean age 62.86 ± 8.18 years,
n
= 23 male). Lean body mass reduced by 4.9 (95% confidence interval 3.2 to 6.7) kg and mean grip strength reduced by 4.3 (2.5 to 6.1) kg from pre- to post-neoadjuvant therapy. Quality-of-life scores capturing gastrointestinal symptoms improved. Measures of anthropometry, walking distance, physical activity and nutritional status did not change. There was an increase in sarcopenic status from diagnosis (pre-sarcopenic
n
= 2) to post-treatment (pre-sarcopenic
n
= 5, severely sarcopenic
n
= 1).
Conclusions
Despite maintenance of body weight, functional capacity and activity habits, participants experience declines in muscle mass and strength. Interventions involving exercise and/or nutritional support to build muscle mass and strength during preoperative therapy, even in patients who are functioning normally, are warranted.
This paper describes a new Heterodyne Array Receiver Program (HARP) and Auto-Correlation Spectral Imaging System (ACSIS) that have recently been installed and commissioned on the James Clerk Maxwell ...Telescope. The 16-element focal-plane array receiver, operating in the submillimetre from 325 to 375 GHz, offers high (three-dimensional) mapping speeds, along with significant improvements over single-detector counterparts in calibration and image quality. Receiver temperatures are ∼120 K across the whole band, and system temperatures of ∼300 K are reached routinely under good weather conditions. The system includes a single-sideband (SSB) filter so these are SSB values. Used in conjunction with ACSIS, the system can produce large-scale maps rapidly, in one or more frequency settings, at high spatial and spectral resolution. Fully sampled maps of size can be observed in under 1 h. The scientific need for array receivers arises from the requirement for programmes to study samples of objects of statistically significant size, in large-scale unbiased surveys of galactic and extra-galactic regions. Along with morphological information, the new spectral imaging system can be used to study the physical and chemical properties of regions of interest. Its three-dimensional imaging capabilities are critical for research into turbulence and dynamics. In addition, HARP/ACSIS will provide highly complementary science programmes to wide-field continuum studies and produce the essential preparatory work for submillimetre interferometers such as the Submillimeter Array (SMA) and Atacama Large Millimeter/Submillimeter Array (ALMA).
Using immunocytochemistry and in situ hybridization, we have examined the expression of brain-derived neurotrophic factor (BDNF) and of neurotrophin receptors in dorsal root ganglion cells. In the ...adult rat, BDNF mRNA and protein were found mainly in the subpopulation of cells that express the nerve growth factor (NGF) receptor trkA and the neuropeptide calcitonin gene-related peptide (CGRP). NGF increased BDNF within the trkA/CGRP cells to the extent that almost 90% of trkA cells contained BDNF mRNA after intrathecal NGF treatment, and 80-90% of BDNF-expressing cells contained trkA. Non-trkA cells that expressed BDNF included some trkC cells and some small cells that labeled with the lectin Griffonia simplicifolia IB4, a marker for cells that do not express trks. However, very few trkB cells expressed either BDNF mRNA or protein, and NGF did not increase BDNF expression in non-trkA cells. BDNF protein was anterogradely transported both peripherally and centrally. The central transport resulted in BDNF immunoreactivity in CGRP containing terminal arbors in the dorsal horn of the spinal cord, and this immunoreactivity was increased by NGF treatment. Electron microscopic analysis revealed that the BDNF immunoreactivity was present in finely myelinated and unmyelinated axons and in axon terminals, where it was most concentrated over dense-cored vesicles. Our data do not support an autocrine or paracrine role for BDNF within normal dorsal root ganglia, but indicate that BDNF may act as an anterograde trophic messenger. NGF levels in the periphery could influence dorsal horn neurons via release of BDNF from primary afferents.
A cross-sectional analysis explored nutritional intakes and gastrointestinal (GI) symptoms among esophagogastric cancer survivors up to 12, 13-36, and 37+ months post-surgery. Participants were ...identified from the Upper GI Cancer Registry at St James' Hospital, Ireland. The Short Nutritional Assessment Questionnaire, European Prospective Investigation of Cancer Food Frequency Questionnaire, World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) Score, and Gastrointestinal Symptoms Rating Scale assessed malnutrition risk, nutritional intake, adherence to (secondary) cancer prevention recommendations, and GI symptoms, respectively. Most (82.5%, n33) participants (n40) were male. Mean age was 65.5 ± 9.3 years. Time post-surgery ranged from 6-62 months. Half (50.0%, n20) had a BMI in the healthy range. A quarter (27.5%, n11) were at risk of malnutrition. Intakes of meat and meat products exceeded recommendations and intakes of fruits, vegetables, and fiber were below recommendations, with no significant between-group differences. The mean WCRF/AICR score was 3.6 ± 1.1, indicating adherence to 3.6 of 7 cancer prevention recommendations. It was not significantly different between subgroups. Minor to mild GI discomfort was reported, with no significant between-group differences in symptoms. As rates of long-term survivorship continue to increase, survivors must be supported to sustain behaviors that enhance quality of life and reduce secondary cancer risk.
Many birds show a surprising degree of intraspecific variability in migratory tendency and choice of wintering site. In this study, we tracked the seasonal movements of 35 nonbreeding Black-browed ...Albatrosses Thalassarche melanophrys from South Georgia, including 24 birds followed in two consecutive years. This revealed consistent patterns of status-related, sex-specific, and individual variation in wintering strategies, and provided the first description of the summer distribution of failed/deferring breeders. Individuals exhibited a striking degree of site fidelity, returning to the same region (southwest Africa or Australia) and showing correlated centers of distribution, as well as remarkable consistency in the chronology of their movements, in consecutive years. Nonetheless, a degree of behavioral flexibility remained, and particularly on the return migration, birds moved between, or bypassed, alternative intermediate staging sites depending on local circumstances. Initiation of the outward migration varied according to breeding status, timing of failure, and sex: deferring breeders and those that failed early departed two months before successful birds, and successful females departed 1-2 weeks earlier than males. Sex-related latitudinal variation in distribution was also apparent, with females wintering farther north within the Benguela system. Moreover, the only migrant to Australia was a male, supporting an apparent tendency for male-biased breeding dispersal inferred from genetic analyses. Distribution and timing of movements appeared in general to relate to avoidance of competition from congeners and conspecifics from other populations. From a conservation perspective, the study indicated that, for the declining Black-browed Albatross population at South Georgia, the primary focus should be toward improving the management (especially reducing bycatch levels) of fisheries in the central and eastern South Atlantic.
It is well known that an observer will attend to the location cued by another’s eye gaze and that in some circumstances, this effect is enhanced when the emotion expressed is threat-related. This ...study explored whether attention to the gaze of threat-related faces is potentiated in the luteal phase of the menstrual cycle when detection of threat is suggested to be enhanced, compared to the follicular phase. Female participants were tested on a gaze cueing task in their luteal (
N
= 13) or follicular phase (
N
= 15). Participants were presented with various emotional expressions with an averted eye gaze that was either spatially congruent or incongruent with a forthcoming target. Females in the luteal phase responded faster overall to targets on trials with a 200-ms stimulus onset asynchrony interval. The results suggest that during the luteal phase, females show a general and automatic hypersensitivity to respond to stimuli associated with socially and emotionally relevant cues. This may be a part of an adaptive biological mechanism to protect foetal development.
We report the analysis of additional multiband photometry and spectroscopy and new adaptive optics (AO) imaging of the nearby planetary microlensing event TCP J05074264+2447555 (Kojima-1), which was ...discovered toward the Galactic anticenter in 2017 (Nucita et al.). We confirm the planetary nature of the light-curve anomaly around the peak while finding no additional planetary feature in this event. We also confirm the presence of apparent blending flux and the absence of significant parallax signal reported in the literature. The AO image reveals no contaminating sources, making it most likely that the blending flux comes from the lens star. The measured multiband lens flux, combined with a constraint from the microlensing model, allows us to narrow down the previously unresolved mass and distance of the lens system. We find that the primary lens is a dwarf on the K/M boundary (0.581 0.033 M ) located at 505 47 pc, and the companion (Kojima-1Lb) is a Neptune-mass planet (20.0 2.0 M⊕) with a semimajor axis of au. This orbit is a few times smaller than those of typical microlensing planets and is comparable to the snow-line location at young ages. We calculate that the a priori detection probability of Kojima-1Lb is only ∼35%, which may imply that Neptunes are common around the snow line, as recently suggested by the transit and radial velocity techniques. The host star is the brightest among the microlensing planetary systems (Ks = 13.7), offering a great opportunity to spectroscopically characterize this system, even with current facilities.
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