Metacognitions associated with reproductive concerns: A cross-sectional study of young adult female cancer survivors in China

Objective

Cancer and its treatments affect patients’ fertility potential. This study examined the prevalence of reproductive concerns and their relationship with metacognitions among Chinese young adult female cancer survivors (YAFCS).

Methods

A total of 318 YAFCS (aged 18–39) completed an online survey from March to December 2021. Participants reported sociodemographic characteristics, reproductive concerns and metacognitions. Reproductive concerns were measured using the Reproductive Concerns after Cancer scale (RCAC), and metacognitions were measured by the Short Form of Metacognitions Questionnaire (MCQ-30). We used Pearson correlation analysis to examine associations between metacognitions and reproductive concerns across multiple domains and multivariable linear regression to determine the influencing factors of reproductive concerns.

Results

The mean score of reproductive concern among YAFCS was 49.97 ± 12.52. A total of 57.9% of participants reported a high level of concern regarding at least one dimension of reproductive concerns, and they were most concerned about their child’s health and least concerned about partner disclosure of fertility status. We also found a moderate association between RCAC and MCQ-30 scores (r = 0.408, p < 0.001). In multivariate analyses, metacognitions, especially negative metacognitive beliefs had an impact on reproductive concerns among YAFCS (p < 0.001).

Conclusion

Higher reproductive concerns were associated with higher metacognitions among YAFCS, especially with negative metacognitive beliefs. Oncology professionals should pay attention to assessing reproductive concerns in patients who want to have children or who have no children. Moreover, metacognitive beliefs may be an intervention target for alleviating reproductive concerns among YAFCS.

The prevalence of thyroid nodules and its factors among Chinese adult women: A cross-sectional study

OBJECTIVE

To determine the prevalence of thyroid nodules in Chinese adult women. To analyze the relationships between lifestyle, metabolic syndrome and thyroid nodules.

METHODS

We conducted a retrospective cross-sectional study in the tertiary hospital from 2017 to 2019. Included participants underwent thyroid color Doppler ultrasonography, lipids examination, and dietary evaluation.

RESULTS

Totally 2,784 participants were included, and 933 participants were found to have thyroid nodule(s) by B-ultrasound. The prevalence of thyroid nodules was 33.3%. Women in 50-59 years (OR: 1.746, 95% CI [1.356-2.249]), older than 60 (2.147 [1.540-2.993]) and occupations with mainly manual work (1.780 [1.367-2.317]) were risk factors for thyroid nodules, while moderate dietary diversity (0.624 [0.476-0.817]) and normal triglycerides level (0.739 [0.604-0.905]) were protective factors.

CONCLUSION

Women over 50 and those whose jobs are mainly manual should enhance screening, follow-up and health management of thyroid nodules. Higher dietary diversity is protective measures against thyroid nodules for adult women and should consider dietary balance and the food varieties, not just increased quantities.

Driver assessment service for people with mental illness

Mental illness often leads to functional deficits that likely affect one’s driving performance and may even pose threat to other road users. However, having a mental illness does not automatically preclude one from driving which is essential to mobility and productivity. Indeed, evaluating their fitness-to-drive would be of necessary. Despite that, there is still a lack of a local driving evaluation service that specifically addresses the impact of mental illness on driving capacity. This paper discusses the needs to evaluate the fitness-to-drive of people with mental illness. It advocates the development of such specific driver assessment service with a local example as illustration. Lastly, some of the challenges related to the drivers’ responsibility to declare personal health status and large variety of assessment approaches are also discussed.

Abstract P1-06-02: Mismatch repair protein loss in breast cancer: Clinicopathological associations in a large British Columbia cohort

Background: Alterations to mismatched repair (MMR) pathways are a known cause of cancer (particularly colorectal and endometrial). Recently, the FDA approved pembrolizumab for use in MMR-deficient (MMRD) cancers of any type, and the diagnosis can be made by immunohistochemistry (IHC) or genomic methods. In breast cancer, mutational process analyses indicate MMRD occurs in about 2% of breast cancer (Cancer Res; 77; 4755-62, 2017) and recent functional studies have shown associations with resistance to endocrine therapy and sensitivity to CDK4/6 inhibitors (Cancer Discov; 7; 1168-83, 2017). To date, insufficient cases have been assembled to power meaningful associative or survival studies. Herein, the strong correlation between IHC-determined loss of MLH1, PMS2, MSH2 or MSH6 and genomic evidence allowed the assessment of MMRD on a large tissue microarray (TMA) series linked to detailed biomarkers and long-term outcome data.

Methods: IHC markers MLH1, PMS2, MSH2 and MSH6 were optimized on the Ventana automated stainer for application to breast cancer TMAs. The patient cohort consists of females from British Columbia diagnosed with primary invasive breast carcinoma in 1986-1992, referred to the British Columbia Cancer Agency for treatment and follow-up. TMA blocks were sectioned and stained. Slides were scored by a pathologist and only nuclear positivity was evaluated positive. Loss of nuclear positivity for any one of the four tested marker defined MMRD. Clinicopathological associations were tested by Chi-square, and survival by Kaplan-Meier plot with log rank test.

Result: 1635 cases were interpretable for all MMR markers. 31 cases (1.9%) met criteria for MMRD. 6 cases had paired losses (4 MLH1-PMS2 loss, 2 MSH2-MSH6 loss) and the remaining 25 cases had singular MMR loss (11 PMS2 loss, 10 MLH1 loss, 3 MSH6 loss, 1 MSH2 loss). Deficiency of the the MutL complex (MLH1/PMS2) predominated over the MutS complex (MSH2/MSH6).

Among the demographic and pathological variables assessed – age, grade, tumour size, lymphovascular invasion, nodal and menstrual status – high grade is associated with MMRD (p=0.014). In terms of biomarker, MMRD is significantly associated with PR negativity (p=0.003) and PD-L1 expression (p=0.049), but not with ER, Her2, Ki67, or basal breast cancer IHC markers, nor does MMRD significantly correlate with any of the established major intrinsic subtypes of breast cancer. Tumor infiltrating lymphocyte (TIL) counts are higher in MMRD cases (p=0.009). Although statistically not significant (small numbers), Kaplan-Meier plots of survival analysis demonstrated a trend for MMR loss to be associated with decreased breast cancer disease-specific and overall survival.

Conclusion: This large series assessed by IHC corroborates findings from smaller genomic series that MMRD is present in about 2% of breast cancers. MMRD tumors are more likely to be high grade, low PR and immunologically active (higher PD-L1 expression and TIL counts). MMR deficiency is present across all major molecular subtypes (luminal, HER2, basal). Given the efficacy of PD1/PDL1 targeting agents in MMR deficient tumors of other types, evidence for the activity of these agents in MMR deficient breast cancers should be actively sought.

Citation Format: Cheng AS, Leung SC, Gao D, Anurag M, Nielsen T, Ellis MJ. Mismatch repair protein loss in breast cancer: Clinicopathological associations in a large British Columbia cohort [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-06-02.

Title: Cervical cancer survivors' perceived cognitive complaints and supportive care needs in mainland China: a qualitative study

OBJECTIVES

This study explores Chinese cervical cancer survivors' perceived cognitive complaints and relevant supportive care needs after primary cancer treatment.

DESIGN

This study utilised a qualitative research design. A semi-structured interview was used to probe cervical cancer patients' perceived cognitive complaints and supportive care needs.

SETTING

This study was conducted at a secondary cancer care centre located in South China.

PARTICIPANTS

31 women with cervical cancer after primary cancer treatment, aged 18-60 years, were purposively selected using non-random sampling procedures.

RESULTS

31 cervical cancer survivors joined this study. Of these, 20 women (64.5%) reported cognitive complaints after cancer treatment. The most common complaint was loss of concentration (n=17, 85.0%). Perceived contributing factors to these cognitive complaints included chemotherapy (n=15, 75.0%) and ageing (n=8, 40.0%). These cognitive problems most commonly impacted daily living (n=20, 100%). Common supportive care needs included symptom management strategies (n=11, 55.0%) and counselling services (n=8, 40.0%).

CONCLUSION

This study adds new insight into the growing body of research on cognitive complaints by cancer survivors, in particular Chinese cervical cancer survivors. Improved understanding of cognitive complaints could subsequently facilitate the development of relevant therapeutic interventions for prevention as well as the provision of supportive care services, such as educational and counselling services, to reduce cognitive impairment in women with cervical cancer.

Transcriptional regulation of parathyroid hormone-related protein promoter P2 by NF-kappaB in adult T-cell leukemia/lymphoma

Parathyroid hormone-related protein (PTHrP) plays a primary role in the development of humoral hypercalcemia of malignancy (HHM) that occurs in the majority of patients with adult T-cell leukemia/lymphoma (ATLL) due to human T-cell lymphotropic virus type-1 (HTLV-1) infection. We previously showed that ATLL cells constitutively express high levels of PTHrP via activation of promoters P2 and P3, resulting in HHM. In this study, we characterized a nuclear factor-kappaB (NF-kappaB) binding site in the P2 promoter of human PTHrP. Using electrophoretic mobility shift assays, we detected a specific complex in Tax-expressing human T cells composed of p50/c-Rel, and two distinct complexes in ATLL cells consisting of p50/p50 homodimers and a second unidentified protein(s). Chromatin immunoprecipitation assays confirmed in vivo binding of p50 and c-Rel on the PTHrP P2 promoter. Using transient co-transfection with NF-kappaB expression plasmids and PTHrP P2 luciferase reporter-plasmid, we showed that NF-kappaB p50/p50 alone and p50/c-Rel or p50/Bcl-3 cooperatively upregulated the PTHrP P2 promoter. Furthermore, inhibition of NF-kappaB activity by Bay 11-7082 reduced PTHrP P2 promoter-initiated transcripts in HTLV-1-infected T cells. In summary, the data demonstrated that transcriptional regulation of PTHrP in ATLL cells can be controlled by NF-kappaB activation and also suggest a Tax-independent mechanism of activation of PTHrP in ATLL.

Inhibition of prostate cancer cell growth by human secreted PDZ domain-containing protein 2, a potential autocrine prostate tumor suppressor

A possible role of the PDZ domain-containing protein 2 (PDZD2) in prostate tumorigenesis has been suggested. Besides, PDZD2 is posttranslationally cleaved by a caspase-dependent mechanism to form a secreted PDZ domain-containing protein 2 (sPDZD2) with unknown functions in humans. In this study, we demonstrate the endogenous expression of PDZD2 and secretion of sPDZD2 in cancerous DU145, PC-3, 22Rv1, LNCaP, and immortalized RWPE-1 prostate epithelial cells. Inhibition of endogenous sPDZD2 production and secretion by DU145, PC-3, 22Rv1, and RWPE-1 cells via the caspase-3 inhibitor Z-DEVD-FMK resulted in increased cell proliferation, which was abrogated by treatment with exogenous recombinant sPDZD2. Whereas sPDZD2-induced antiproliferation in DU145, PC-3, and 22Rv1 cells, it induced apoptosis in LNCaP cells. The data suggest that endogenous sPDZD2, produced by caspase-3-mediated cleavage from PDZD2, may function as a novel autocrine growth suppressor for human prostate cancer cells. The antiproliferative effect of sPDZD2 was apparently mediated through slowing the entry of DU145, PC-3, and 22Rv1 cells into the S phase of the cell cycle. In DU145 cells, this can be attributed to stimulated p53 and p21(CIP1/WAF1) expression by sPDZD2. On the other hand, the apoptotic effect of sPDZD2 on LNCaP cells was apparently mediated via p53-independent Bad stimulation. Together our results indicate the presence of p53-dependent and p53-independent PDZD2/sPDZD2 autocrine growth suppressive signaling pathways in human prostate cancer cells and suggest a novel therapeutic approach of harnessing the latent tumor-suppressive potential of an endogenous autocrine signaling protein like sPDZD2 to inhibit prostate cancer growth.

A prospective study of early tactile stimulation after digital nerve repair

Forty-nine patients with 65 digital nerve injuries were randomized into two groups after nerve repair. Group 1 received early tactile stimulation and Group 2 was a control group. The patients were assessed prospectively for 6 months for recovery of functional sensibility. Tactile stimulation in Group 1 was provided from 3 weeks after nerve repair with a specially designed rotating tactile stimulator and a pocket tactile stimulator. Constant two-point discrimination, moving two-point discrimination, and cutaneous pressure threshold were measured and sensibility was graded with the Medical Research Council (UK) sensibility grading. At 6 months, 68.8% of patients in Group 1 had a Medical Research Council grading of S3+ or S4 sensibility compared with 36 % in Group 2. With this prospective randomized study, the value of sensory reeducation in improving sensibility after digital nerve injury was confirmed. Starting tactile stimulation from the early postoperative period is recommended; however, use of the rotating tactile stimulator and pocket tactile stimulation need additional study.

Expression and cellular localization of COX-1 and -2 in Helicobacter pylori gastritis

BACKGROUND

There are conflicting reports on the expression of cyclooxygenase in Helicobacter pylori infection.

AIM

To evaluate the expression of COX-1 and COX-2 in H. pylori gastritis at messenger RNA (mRNA) and protein levels.

METHODS

Endoscopic gastric biopsies were obtained from patients with non-ulcer dyspepsia. The levels of COX-1 and COX-2 mRNA were compared between H. pylori-infected and uninfected specimens using reverse transcription-polymerase chain reaction. The immunohistochemical findings were correlated with the cellular localization of cyclooxygenase mRNA using in situ hybridization.

RESULTS

A total of 40 H. pylori-infected and 40 uninfected specimens were studied. mRNA of COX-2 but not COX-1 was elevated in H. pylori-infected mucosa. COX-1 was localized to the mononuclear inflammatory, endothelial and smooth muscle cells in the lamina propria. COX-2 was barely detectable in uninfected mucosa but was strongly expressed in the foveolar and glandular epithelia in H. pylori gastritis.

CONCLUSION

Cyclooxygenase-1 is expressed in the mononuclear inflammatory, endothelial and smooth muscle cells in the lamina propria irrespective of the H. pylori status. By contrast, H. pylori induces COX-2 expression in the foveolar and glandular epithelia.

Up-regulation of cyclooxygenase-1 and -2 in human gastric ulcer

BACKGROUND

The expression of cyclooxygenase (COX) in human gastric ulcers is unknown.

AIM

To study the expression and cellular localization of cyclooxygenase in human gastric ulcers.

METHODS

A total of 38 surgical gastric ulcer specimens were studied; 20 were Helicobacter pylori-positive and 18 were associated with NSAID use. Twenty non-ulcerated, histologically normal gastric specimens were used as controls. The cellular localization of COX-1 and COX-2 were determined by immunohistochemistry and double immunofluorescence. Cyclooxygenase messenger RNA (mRNA) was measured by reverse transcription-polymerase chain reaction and localized by in situ hybridization.

RESULTS

In control specimens, COX-1 was detected in stromal cells in the lamina propria. There was focal and weak immunostaining for COX-2 in the foveolar epithelium. At the ulcer edge, COX-1 was significantly increased in lamina propria cells whereas COX-2 was strongly expressed in the hyperplastic foveolar epithelium in H. pylori- and non-steroidal anti-inflammatory drugs (NSAID)-associated ulcers. At the ulcer base, there was strong expression of COX-1 and COX-2 in myofibroblasts, macrophages and endothelial cells in the granulation tissue, irrespective of H. pylori status or NSAID use. Messenger RNA of COX-1 and COX-2 were demonstrated by reverse transcription-polymerase chain reaction. Double immunofluorescence and in situ hybridization confirmed the cellular localization of cyclooxygenase at protein and mRNA levels, respectively.

CONCLUSION

Both COX-1 and COX-2 are up-regulated in human gastric ulcers.

Cyclooxygenase-2 expression in Helicobacter pylori-associated premalignant and malignant gastric lesions

Expression of cyclooxygenase-2 (COX-2) in various stages of the Helicobacter pylori-associated gastric carcinogenesis pathway has not been elucidated. We investigated the distribution and intensity of COX-2 expression in premalignant and malignant gastric lesions, and monitored the changes after H. pylori eradication. Gastric biopsies from H. pylori-infected patients with chronic active gastritis, gastric atrophy, intestinal metaplasia (IM), gastric adenocarcinoma, and noninfected controls were studied. Expression of COX-2 was evaluated by immunohistochemistry and in situ hybridization. Endoscopic biopsies were repeated 1 year after successful eradication of H. pylori in a group of IM patients for comparing COX-2 expression and progression of IM. In all H. pylori-infected patients, COX-2 expression was predominantly found in the foveolar and glandular epithelium and, to a lesser extent, in the lamina propria. In the noninfected group, only 35% of cases demonstrated weak COX-2 expression. Intensity of COX-2 was not significantly different between the chronic active gastritis, gastric atrophy, IM, and gastric adenocarcinoma groups. In 17 patients with IM, COX-2 expressions in the epithelial cells and stromal cells were reduced 1 year after H. pylori eradication. However, the changes in COX-2 expression did not correlate with progression/regression of IM. Both premalignant and malignant gastric lesions demonstrate strong COX-2 expression. Successful eradication of H. pylori leads to down-regulation of COX-2 expression but failed to reverse IM at 1 year.

Use of early tactile stimulation in rehabilitation of digital nerve injuries

OBJECTIVE

Digital nerves are the most frequently injured peripheral nerve. To improve the recovery of functional sensibility of digital nerve injuries, a prospective randomized controlled study was conducted to see the effect of using early tactile stimulation in rehabilitation of digital nerve injuries.

METHOD

Two specific tactile stimulators were made and prescribed for patients with digital nerve-injury. Twenty-four participants with 32 digital nerve injuries received the prescribed tactile stimulators (experimental group), and another 25 participants with 33 digital nerve injuries received only routine conventional therapy (control group).

RESULTS

A significant difference (p < .05) was seen in the experimental group, although there were some variations between the different classes of associated injuries, with least benefit observed in the combined nerve, tendon, and bone injury class.

CONCLUSION

Use of early tactile stimulation as described in this study can be considered an effective way to improve both quality and quantity of recovery of functional sensibility in digital nerve injuries without combined nerve, tendon, and bone injuries.

State Forest Practice Regulatory Programs: An Approach to ImplementingEcosystem Management on Private Forest Lands in the United States

/ Implemented in the context of a long history ofintense public debate, forestry practices applied on private forest land areregulated in some form by 38 states. State regulatory activities can involvemany agencies implementing numerous regulatory laws, a single forestry agencyadministering a comprehensive regulatory program, or a combination of thetwo. Regulatory programs are designed to protect resources such as soils,water, wildlife, and scenic beauty. Program administration often involvesrule promulgation, harvest plan reviews, coordination of interagency reviews,and pre- and postharvest on-site inspections. Forest practice rules usuallyfocus on reforestation, forest roads, harvest procedures, and wildlifehabitat protection. Emerging regulatory trends include growth of multiagencyregulatory authority and associated jurisdictional conflicts, increasedtendencies to narrowly specify standards in statutes and rules, emergence ofcontingent regulations, growing sensitivity to processes enabling theadoption of new forest practice technologies and an ability to addresscumulative effects, interest in collaborative rule-making stemming fromheightened concern over legalization of administration processes, and growingconcern over the constitutional foundations for regulatory programs and thegovernment and private sector cost of implementing such programs.KEY WORDS: Ecosystem management; Forestry practices; Private landowners;Regulatory programs; State government

Preliminary results from a field study of wild Guizhou snub-nosed monkeys (Rhinopithecus brelichi)

The Guizhou snub-nosed monkey, Rhinopithecus brelichi, is a large-bodied colobine confined to the subtropical semi-deciduous forests of Fanjing Mountain Reserve in Guizhou province, southwest China. Field work beginning in 1979 and including 10 months of intensive study in 1991 has revealed several aspects of the behavior and ecology of this species that are distinct from other colobines, including the closely related species R. roxellana and R. bieti. The Guizhou snub-nosed monkey is arboreal, traveling through the trees by quadrupedal walking, climbing, leaping, semibrachiation and (occasionally) by full brachiation. Terrestrial locomotion is use occasionally. Social organization centers around family groups of 5-10 individuals with a single adult male. Many family groups range and rest together in large, semicohesive bands. These bands may split up or coalesce temporarily to form large aggregations of over 400 animals and perhaps more. All-male groups of 2-5 adult or subadult males are found on the periphery of the bands.

Visual losses in early age-related maculopathy

Age-related maculopathy (ARM) can be considered a transition from normal retinal changes to pathological processes. It is important to recognize patients who have progressed beyond a normal state in order to provide appropriate clinical management. This pilot study considers the clinical dilemma of diagnosing and monitoring early ARM. We carried out a controlled study and tested the visual functions of 11 pre-ARM (PARM) and 11 early ARM subjects. Apart from compromised visual acuity, losses in central visual field, color vision, and visual adaptation were also recorded in our ARM subjects. We found a low contrast (LC) Amsler grid to be most sensitive to central field defects and that the desaturated panel D-15 gave too many false positives among normal elderly subjects. Our results indicate foveal sparing in early ARM and question the capacity of acuity assessment to reflect early functional changes adequately. A clinical battery is recommended to detect and monitor ARM.

Relative legibility study using Chinese optotypes

Traditionally, visual acuity test charts have been constructed using the English alphabet. It is desirable to have charts made in the native language of the Chinese and Asian populations. Previous efforts in this respect have not considered the relative legibility of Chinese optotypes. In this study, twelve Chinese optotypes were constructed according to the Snellen principle and subjected to a relative legibility trial. This study provides a basis on which Chinese optotypes of near-equal legibility may be selected.

Immunologic changes in children with Henoch-Schonlein purpura in the acute stage

T-lymphocyte subsets, B-lymphocyte, immunoglobulins and complement were studied in 38 children with Henoch Schonlein Purpura (HSP) in the acute stage. They had significantly lower CD3 percentage and lymphocyte blastogenesis rate, greater CD8 variation coefficient and B-lymphocyte percentage and higher levels immunoglobulins (IgA, IgG, IgM) and complement 3 than the controls. 21 (55%) of them had a low CD8 percentage. The results indicated that children with HSP had low T-lymphocyte percentages and function, increased B-lymphocyte percentage and function, high immunoglobulins, normal or elevated complement. On the other hand, no significant differences were found in the T-lymphocyte subsets values among healthy children aged 7-11 years. The normal values of T cell subsets in 35 normal controls were CD3 66-70%, CD4 37-41%, CD8 28-32%, respectively.