Disability, psychological distress and quality of life in relation to cancer diagnosis and cancer type: population-based Australian study of 22,505 cancer survivors and 244,000 people without cancer.

BACKGROUND: Improved survival means that cancer is increasingly becoming a chronic disease. Understanding and improving functional outcomes are critical to optimising survivorship. We quantified physical and mental health-related outcomes in people with versus without cancer, according to cancer type. METHODS: Questionnaire data from an Australian population-based cohort study (45 and Up Study (n = 267,153)) were linked to cancer registration data to ascertain cancer diagnoses up to enrolment. Modified Poisson regression estimated age- and sex-adjusted prevalence ratios (PRs) for adverse person-centred outcomes-severe physical functional limitations (disability), moderate/high psychological distress and fair/poor quality of life (QoL)-in participants with versus without cancer, for 13 cancer types. RESULTS: Compared to participants without cancer (n = 244,000), cancer survivors (n = 22,505) had greater disability (20.6% versus 12.6%, respectively, PR = 1.28, 95%CI = (1.25-1.32)), psychological (22.2% versus 23.5%, 1.05 (1.02-1.08)) and poor/fair QoL (15.2% versus 10.2%; 1.28 (1.24-1.32)). The outcomes varied by cancer type, being worse for multiple myeloma (PRs versus participants without cancer for disability 3.10, 2.56-3.77; distress 1.53, 1.20-1.96; poor/fair QoL 2.40, 1.87-3.07), lung cancer (disability 2.81, 2.50-3.15; distress 1.67, 1.46-1.92; poor/fair QoL 2.53, 2.21-2.91) and non-Hodgkin's lymphoma (disability 1.56, 1.37-1.78; distress 1.20, 1.05-1.36; poor/fair QoL 1.66, 1.44-1.92) and closer to those in people without cancer for breast cancer (disability 1.23, 1.16-1.32; distress 0.95, 0.90-1.01; poor/fair QoL 1.15, 1.05-1.25), prostate cancer (disability 1.11, 1.04-1.19; distress 1.09, 1.02-1.15; poor/fair QoL 1.15, 1.08-1.23) and melanoma (disability 1.02, 0.94-1.10; distress 0.96, 0.89-1.03; poor/fair QoL 0.92, 0.83-1.01). Outcomes were worse with recent diagnosis and treatment and advanced stage. Physical disability in cancer survivors was greater in all population subgroups examined and was a major contributor to adverse distress and QoL outcomes. CONCLUSIONS: Physical disability, distress and reduced QoL are common after cancer and vary according to cancer type suggesting priority areas for research, and care and support.

Smectite clay--inorganic nanoparticle mixed suspensions: phase behaviour and rheology.

Smectite clay minerals and their suspensions have long been of both great scientific and applications interest and continue to display a remarkable range of new and interesting behaviour. Recently there has been an increasing interest in the properties of mixed suspensions of such clays with nanoparticles of different size, shape and charge. This review aims to summarize the current status of research in this area focusing on phase behaviour and rheological properties. We will emphasize the rich range of data that has emerged for these systems and the challenges they present for future investigations. The review starts with a brief overview of the behaviour and current understanding of pure smectite clays and their suspensions. We then cover the work on smectite clay-inorganic nanoparticle mixed suspensions according to the shape and charge of the nanoparticles - spheres, rods and plates either positively or negatively charged. We conclude with a summary of the overarching trends that emerge from these studies and indicate where gaps in our understanding need further research for better understanding the underlying chemistry and physics.

Workforce participation in relation to cancer diagnosis, type and stage: Australian population-based study of 163,556 middle-aged people.

PURPOSE: To quantify the relationship of cancer diagnosis to workforce participation in Australia, according to cancer type, clinical features and personal characteristics. METHODS: Questionnaire data (2006-2009) from participants aged 45-64 years (n=163,556) from the population-based 45 and Up Study (n=267,153) in New South Wales, Australia, were linked to cancer registrations to ascertain cancer diagnoses up to enrolment. Modified Poisson regression estimated age- and sex-adjusted prevalence ratios (PRs) for non-participation in the paid workforce-in participants with cancer (n=8,333) versus without (n=155,223), for 13 cancer types. RESULTS: Overall, 42% of cancer survivors and 29% of people without cancer were out of the workforce (PR=1.18; 95%CI=1.15-1.21). Workforce non-participation varied substantively by cancer type, being greatest for multiple myeloma (1.83; 1.53-2.18), oesophageal (1.70; 1.13-2.58) and lung cancer (1.68; 1.45-1.93) and moderate for colorectal (1.23; 1.15-1.33), breast (1.11; 1.06-1.16) and prostate cancer (1.06; 0.99-1.13). Long-term survivors, 5 or more years post-diagnosis, had 12% (7-16%) greater non-participation than people without cancer, and non-participation was greater with recent diagnosis, treatment or advanced stage. Physical disability contributed substantively to reduced workforce participation, regardless of cancer diagnosis. CONCLUSIONS: Cancer survivors aged 45-64 continue to participate in the workforce. However, participation is lower than in people without cancer, varying by cancer type, and is reduced particularly around the time of diagnosis and treatment and with advanced disease. IMPLICATIONS FOR CANCER SURVIVORS: While many cancer survivors continue with paid work, participation is reduced. Workforce retention support should be tailored to survivor preferences, cancer type and cancer journey stage.

Rheology modification in mixed shape colloidal dispersions. Part II: mixtures.

We report the results of a comprehensive study of the rheological properties of a series of mixed colloid systems where the shape of one of the components has been varied systematically. Specifically we have measured the oscillatory, transient (creep) and continuous steady shear flow behaviour of a 2.5 wt% dispersion in water of a well-characterised hectorite clay modified by the addition of a series of aluminasol colloidal particles whose shape varies systematically from rod (boehmite) to platelet (gibbsite) to sphere (alumina-coated silica), all having essentially the same smallest dimension, which is similar to that of the hectorite. The particle characterisation and rheological properties of the pure components have recently been reported in Part I of this series (Soft Matter, 2007, 3, 1145). The mixtures show the same general behaviour as the pure systems, displaying a complex 'yield space' transition from an elastoviscous gel at low applied stresses to a viscous, weakly elastic, shear-thinning liquid at high stresses. The unifying theme of this work is that the addition of 0.25 wt% of the minor component in all cases results in dramatic enhancements to the dispersion rheological properties. At the same time the magnitude of this effect depends on the shape of the particles. Shear moduli, low stress viscosities and effective yield stresses all increase in the additive order rods < platelets < spheres, with enhancements for the latter being up to a factor of 500 and typically 20. At the same time the critical failure strains for the gels decreased in the same order - the strongest gels are also the most fragile in this sense. The physicochemical factors underlying this behaviour are discussed and a simple qualitative model described. While no complete explanation or model can be proposed at this stage, the study provides a quantitative model-system baseline for mixed colloidal dispersions already used for industrial applications (e.g. oilwell-drilling fluids) and suggests ways in which such fluids may be optimised and controlled.

Rheology modification in mixed shape colloidal dispersions. Part I: pure components.

The flow behaviour and rheology of colloidal dispersions are of considerable interest in many applications, for example colloidal clay particles find applications in oilfield and construction-drilling fluids. The rheological properties of such fluids can be enhanced significantly by adding colloidal particles of different size and shape. To gain insight into the mechanism of this phenomenon, we have studied model mineral-colloid systems whose shape changes systematically from a plate-like aluminasol (gibbsite), through a lath-like smectite clay (hectorite), to a rod-like aluminasol (boehmite).The paper presents the results of a systematic and comprehensive multi-technique study (oscillatory, transient and steady shear) of the rheology of dispersions of these model systems. This gives a detailed account of the 'yield space' that characterises the complex transition of these soft materials from elastoviscous gels to viscoelastic liquids, and of the effect of particle size and shape on this behaviour. The observed phenomena are underpinned by two competing flow-mediated microstructural rearrangements that have significantly different timescales. A physical model invoking flow-mediated building and disruption of fluid structure is described to rationalise the observed behaviour. The study also forms the baseline to a companion study (part II), which investigates the rheological behaviour of mixed anisometric colloid systems based on these pure components.

Cellular activation of proMMP-13 by MT1-MMP depends on the C-terminal domain of MMP-13.

Procollagenase-3 (proMMP-13) can be activated by soluble or cell associated membrane type matrix metalloproteinase 1 (MT1-MMP). In this study we show that the cell based activation of proMMP-13 by MT1-MMP was dependent on the C-terminal domain, as delta(249-451) proMMP-13, which lacks the haemopexin domain, and a chimaera from N-terminal MMP-13 and C-terminal MMP-19 (proMMP-13/19) were not processed by MT1-MMP expressing cells. Only the initial cleavage at Gly(35)-Ile(36) was dependent on MT1-MMP activity, as conversion to the active enzyme (Tyr(85) N-terminus) required a functional MMP-13 active site. Unlike proMMP-2 activation, this process was independent of tissue inhibitor of metalloproteinase-2 (TIMP-2) as MT1-MMP expressing cells from the TIMP-2-/- mouse efficiently activated proMMP-13.

Investigation of the role of Endo180/urokinase-type plasminogen activator receptor-associated protein as a collagenase 3 (matrix metalloproteinase 13) receptor.

Procollagenase 3 can be activated by interaction with and cleavage by the cell-associated membrane type 1 metalloproteinase (MT1 MMP; MMP 14). It has also been shown to bind to a specific receptor, and is subsequently internalized via the low-density lipoprotein-related receptor by osteoblast cell lines. The receptor was identified as a recycling glycoprotein of the macrophage mannose receptor family, Endo180. In order to ascertain whether there is a relationship between Endo180 binding and procollagenase 3 activation, we have compared procollagenase 3 activation by an HT1080 fibrosarcoma cell line overexpressing MT1 MMP, without and with overexpression of Endo180. No difference in procollagenase 3 activation was observed, and neither was the enzyme bound to the cells or internalized. In contrast, the osteoblast cell lines, MG63 and UMR-106, both bound and internalized procollagenase 3. However, immunolocalization studies showed that the Endo180 abundantly expressed by these cells did not co-localize with the procollagenase 3. In further biochemical studies we confirmed that procollagenase 3 did not bind to Endo180, using both ligand- blotting and immunoprecipitation techniques. We conclude that Endo180 is unlikely to be a receptor for collagenase 3 in relation to either its activation or cell binding and internalization, and that other interaction partners must be sought.