Investigating the dietary knowledge, attitudes, and beliefs of Australian patients with cancer.

BACKGROUND: There is evidence linking diet to the risk of developing cancer and preventing recurrence, but the therapeutic value of food in treating cancer remains unclear. Therefore, guidelines for well-nourished patients with cancer are based on general healthy eating recommendations. This study aims to describe patients' knowledge, attitudes, and beliefs towards the role of diet and cancer. METHODS: A cross-sectional survey was undertaken between July 2016 and January 2017. Patients being reviewed by Medical Oncology at a tertiary cancer service were invited to complete a questionnaire. RESULTS: One hundred and nine patients participated, with 61% receiving curative treatment. Median body mass index was 26.9 kg/m2 . A high frequency reported weight change (72%) and dietary modifications (reduction in overall intake; 62%). Patients were more likely to modify their diet if they had experienced weight change [odds ratio (OR): 3.59, 95% confidence interval (CI): 1.49-8.63], had malignancy-related anorexia (OR: 2.38, 95% CI: 1.06-5.32), strongly believed that diet contributed to their cancer (OR: 9.09, 95% CI: 2.55-32.44) or felt that nutrition played an important role in treatment (OR: 4.50, 95% CI: 1.95-10.40). Dietary information was largely sought from their hospital dietitian (51%), the Internet (39%), or treating oncologist (35%), of whom 47% and 57% found the information from their hospital dietitian and oncologist helpful, respectively. CONCLUSIONS: Our survey confirms patients place great importance on diet as part of their cancer management. Evidence-based dietetic services currently focus on managing malnutrition during treatment, but this study has identified hospital clinicians are not necessarily providing dietary information to meet patient expectations and thus a potential gap in patient-centred nutrition services for this patient population.

Predictors associated with prefrailty in older Taiwanese individuals with type 2 diabetes.

Type 2 diabetes (T2DM) is one of the most well-studied and important factors that increase the risk of prefrailty in older people in Taiwan. This study was conducted to examine whether metabolic biomarkers, lifestyle behaviors, body composition, and chronic diseases are associated with frailty in older people with T2DM. We also observed how people manage their T2DM related to prefrailty. This study investigated a total of 201 participants diagnosed with T2DM who received care in our hospital from September 2018 to February 2019. Patients were divided into 3 groups (not frail, prefrail, and frail), and frailty was measured with the 5-item FRAIL scale. Socioeconomic characteristics, metabolic biomarkers, lifestyle behaviors, body composition, and chronic diseases were assessed at enrollment. No participants who we tested met the criteria for frailty. Based on the results of chi-square tests, prefrailty was associated with female sex, middle school education, unemployment, alcohol use, high body fat percentage, above-normal waist circumference, obesity, cardiovascular disease, and hypertension. Logistic regression analyses identified a significant correlation of prefrailty with the type of job from which they retired, cardiovascular disease, and hypertension. An important and surprising finding of this study was that the unemployed group was at high risk for prefrailty, which was not observed in previous research. The groups engaged in manual and professional jobs had better hand grip strength, a slower walking speed, and less risk of prefrailty than the unemployed group.

Personality as a predictor of HbA1c level in patients with type 2 diabetes mellitus.

ABSTRACT: Type 2 diabetes mellitus (T2DM) is the most common type of diabetes, accounting for around 90% of all cases worldwide. One means to strengthen the prevention and treatment of diabetes is via changes in self-management and lifestyle behaviors. However, lifestyle and personal health behaviors are strongly influenced by personality traits, and thus personality may play a significant role in such aspects as medication compliance, exercise habits, blood glucose monitoring, diet control, and maintenance of an ideal body weight.In this study, we examined whether certain personality traits of patients with T2DM are correlated with higher glycohemoglobin (HbA1c) levels.A total of 214 participants with T2DM were recruited from an outpatient setting. χ2 test and logistic regression analyses with 5 models were employed.The OR for the "neuroticism" trait was 3.199 (95% CI = 1.228-8.331, P = .017), and those with this trait were 3.199 times more likely to have higher HbA1c levels than those with the "openness-extraversion" personality trait. This strong relationship between neuroticism and a higher HbA1c level was also evident in models 2, 3, 4, and 5. One-way ANOVA also indicated that the group with the neuroticism personality trait had significantly different mean fasting glucose, HbA1c, triglyceride, and high-density lipoprotein cholesterol levels.We found that a personality characterized by neuroticism is an independent predictor of higher HbA1c level in this study. We also found that people in the pre-contemplation and contemplation stages of exercise have higher HbA1c levels.

Psychometric properties of the Chinese version thriving of older people assessment scale.

BACKGROUND: The Thriving of Older People Assessment Scale has Scandinavian, Norwegian and English versions but does not yet have a Chinese version that can be used in Chinese populations and compared to global data. OBJECTIVES: To evaluate the psychometric properties of the translated Chinese version of the Thriving of Older People Assessment Scale. METHODS: The English version of the Thriving of Older People Assessment Scale was translated into Chinese using a forward and backward translation method. A convenience sampling strategy was used to recruit participants from five long-term care facilities in northern Taiwan (N = 285). Confirmatory factor analysis was then performed to confirm the theory of the Thriving of Older People Assessment Scale Chinese version. RESULTS: The Thriving of Older People Assessment Scale Chinese version consists of 32 items loading across five domains, namely, 'resident attitudes towards being in long-term care', 'quality of care and caregivers', 'resident engagement and peer relationships', 'keeping in touch with people and places' and 'quality of the physical environment', with good internal consistency (0.971). Confirmatory factor analysis results showed that χ2 = 2255.58 (df = 459, p < .00), χ2 /df = 4.91, CFI = 0.96, IFI = 0.96, NNFI = 0.96 and SRMR = 0.074, indicating a good model fit to previous factor structures. CONCLUSIONS: The Thriving of Older People Assessment Scale Chinese version is a tentatively reliable and valid tool for measuring the experience of thriving in Chinese language older people in long-term care facilities. IMPLICATIONS FOR PRACTICE: The Chinese version of Thriving of Older people Assessment scale can be used to describe the levels of place-related well-being among older Chinese people living in long-term care. Further research and improvements of the Thriving of Older People Assessment Scale Chinese version in diversified Chinese contexts will enable a more comprehensive understanding of older Chinese people's experiences of thriving in long-term care.

Metastatic colorectal cancer during pregnancy: A tertiary center experience and review of the literature.

BACKGROUND: Colorectal cancer during pregnancy is rare. Diagnosis may be delayed and clinicians are faced with unique challenges when formulating management plans, having to consider the well-being of both fetus and mother. CASES: Our series outlines five cases of metastatic colorectal cancer during pregnancy. There was one patient who presented in each of the first, second and third trimesters, whilst the remaining were post-partum. Diagnosis was difficult as the patients were either asymptomatic or their symptoms were misconstrued as features of pregnancy. Two patients received chemotherapy while pregnant but only one had a successful delivery. Survival of patients in this series ranged between 1 and 35 months from diagnosis. CONCLUSION: Women with gestational colorectal cancer are often diagnosed at an advanced stage and have a poor prognosis.

Predicting Glucose Effectiveness in Chinese Participants Using Routine Measurements.

BACKGROUND: Glucose effectiveness (GE) is the capacity of glucose to increase its own uptake and to maintain endogenous hepatic glucose output under basal insulin levels. In addition to decreased insulin sensitivity (IS) and impaired insulin secretion, GE plays a critical role in glucose balance in patients with type 2 diabetes (T2DM). In the study, we developed an equation for predicting GE. METHODS: We enrolled 227 participants with glucose tolerances ranging from normal glucose tolerance to diabetes. Of the participants, 75% (171) participants were randomly assigned to the study group, whose data were used to construct the equation for estimating GE. The remaining 56 participants comprised the validation group. All participants underwent a frequently sampled intravenous glucose tolerance test; IS, GE, and the acute insulin response after the glucose load were determined. RESULTS: Age, triglyceride (TG), and fasting plasma glucose (FPG) were independently correlated with GE and selected for inclusion in multiple linear regression analysis. We constructed the following equation: GE = (29.196 - 0.103 × age - 2.722 × TG - 0.592 × FPG) × 10-3. Using this same equation, we also calculated the GE of the validation group. The calculated GE was significantly correlated with the measured GE (r = 0.430, P = 0.001). CONCLUSIONS: Using the equation based on routine measurements enabled the GE to be predicted with acceptable accuracy (r = 0.430). This method of predicting GE may aid clinicians in further understanding the underlying pathological mechanisms of T2DM.

Mutation Profile of the MUT Gene in Chinese Methylmalonic Aciduria Patients.

The mut-type methylmalonic aciduria (MMA, MIM 251000) is caused by a deficiency of mitochondrial methylmalonyl-CoA mutase (MCM, E.C. 5.4.99.2) activity, which results from defects in the MUT gene. To elucidate the mutation spectrum of the MUT gene in Chinese MMA patients, 13 exons of the MUT gene, including untranslated regions, were analyzed by PCR-based sequencing for 42 unrelated Chinese MMA patients. All the 42 patients were found to have at least one MUT mutation. A total of 41 mutations were identified. Of these mutations, 20 were novel ones, including one nonsense mutation (c.103C>T), 12 missense mutations (c.316A>C, c.424A>G, c.494A>G, c.554C>T, c.599T>C, c.919T>C, c.1009T>C, c.1061C>T, c.1141G>A, c.1208G>A, c.1267G>A, and c.1295A>C), one duplication (c.755dupA), three small deletions (c.398_399delGA, c.1046_1058del, and c.1835delG), two mutations that might affect mRNA splicing (c.754-1G>A and c.1084-10A>G), and one major deletion. Among the mutations identified, the c.1280G>A (15.5%), c.729_730insTT (10.7%), c.1106G>A (4.8%), c.1630_1631GG>TA (4.8%), and c.2080C>T (4.8%) accounted for 40% of the diseased alleles. The c.1280G>A and c.729_730insTT mutations were found to be the most frequent mutations in Southern and Northern Chinese, respectively. The results of microsatellite analysis suggest that the spread of c.729_730insTT among the Northern Chinese and of c.1280G>A and c.1630_1631GG>TA among the Southern Chinese may have undergone founder effects. This mutation analysis of the gene responsible for mut-type MMA will help to provide a molecular diagnostic aid for differential diagnosis of MMA and could be applied for carrier detection and prenatal diagnosis among Chinese family at risk of mut-type MMA.

Poor-prognosis estrogen receptor-positive breast cancer identified by histopathologic subclassification.

PURPOSE: Identification of biologically and clinically distinct breast cancer subtypes could improve prognostic assessment of primary tumors. The characteristics of "molecular" breast cancer subtypes suggest that routinely assessed histopathologic features in combination with limited biomarkers may provide an informative classification for routine use. EXPERIMENTAL DESIGN: Hierarchical cluster analysis based on components of histopathologic grade (tubule formation, nuclear pleomorphism, and mitotic score), expression of ER, cytokeratin 5/6, and HER2 amplification identified four breast cancer subgroups in a cohort of 270 cases. Cluster subgroup membership was compared with observed and Adjuvant! Online predicted 10-year survival. Survival characteristics were confirmed in an independent cohort of 300 cases assigned to cluster subgroups using a decision tree model. RESULTS: Four distinct breast cancer cluster subgroups (A-D) were identified that were analogous to molecular tumor types and showed a significant association with survival in both the original and validation cohorts (P < 0.001). There was a striking difference between survival for patients in cluster subgroups A and B with ER(+) breast cancer (P < 0.001). Outcome for all tumor types was well estimated by Adjuvant! Online, with the exception of cluster B ER(+) cancers where Adjuvant! Online was too optimistic. CONCLUSIONS: Breast cancer subclassification based on readily accessible pathologic features could improve prognostic assessment of ER(+) breast cancer.

Differential expression of antioxidant enzymes in various hepatocellular carcinoma cell lines.

Recent evidence suggests that reactive oxygen species (ROS) play an important role in the pathogenesis of various illnesses, and the ROS and antioxidant enzymes are highly associated with cell differentiation and diseases. In this study, we tested the hypothesis that specific antioxidant enzymes are differentially expressed in hepatocellular carcinoma (HCC) cell lines with various degrees of differentiation. We compared the expression of several antioxidant enzymes including catalase (CAT), superoxide dismutase (SOD), glutathione reductase (GRx), and glutathione peroxidase (GPx) in five HCC cell lines with well (Hep G2 and Hep 3B) or poor (HA22T/VGH, HA55T/VGH, and SK-Hep-1) differentiation. Our results showed that both well-differentiated HCC cell lines expressed extremely higher CAT and GRx enzyme activities than all three poorly differentiated ones. Moreover, the protein and mRNA levels of CAT were much higher in two well-differentiated HCC cell lines than in all three poorly differentiated ones. Both well-differentiated HCC cell lines also showed a higher protein or mRNA expression of Cu/ZnSOD and MnSOD than three poorly differentiated ones. Our results demonstrate that specific antioxidant enzymes (especially, CAT and GRx) are differentially expressed in HCC cell lines with well or poor differentiation. These findings suggest that CAT and GRx are two potential differentiation markers for HCC.

Chitinibacter tainanensis gen. nov., sp. nov., a chitin-degrading aerobe from soil in Taiwan.

Five strains with strong chitinolytic activity were isolated from a soil sample collected from southern Taiwan. The strains shared more than 92% DNA-DNA similarity, indicating membership of the same genospecies. This close relationship was supported by high similarities in fatty acid composition and biochemical characteristics. A 16S rRNA gene sequence analysis indicated that the isolates were members of the class 'Betaproteobacteria', in which they formed an individual subline of descent that was distantly related (<94% similarity) to lineages defined by Formivibrio citricus DSM 6150T and Iodobacter fluviatilis DSM 3764T. On the basis of the phylogenetic and phenotypic distinctness of these novel chitin-degrading organisms, a new genus, Chitinibacter, is proposed, with Chitinibacter tainanensis (type strain, S1T=BCRC 17254T=DSM 15459T) as the type species.

Novel KRT14 mutation in a Taiwanese patient with epidermolysis bullosa simplex (Köbner type).

Epidermolysis bullosa simplex (EBS) is a group of hereditary bullous diseases characterized by intraepidermal blistering due to mechanical stress-induced degeneration of basal keratinocytes. Three major subtypes have been identified with autosomal dominant inheritance: the Weber-Cockayne type, the Köbner type (EBS-K), and the Dowling-Meara type. All three EBS subtypes are caused by mutations in either keratin 5 or keratin 14, the major keratins expressed in the basal layer of the epidermis. We describe a 25-year-old male with easy blistering after trauma over the whole body from the age of 4 to 5 years. According to the clinicopathologic findings, EBS-K was diagnosed. Mutational analysis revealed a novel keratin 14 mutation (1237G-->A) that produces a conservative amino acid change (alanine to threonine) at position 413 (A413T) of the 2B helix.