Irradiation Dose to the Swallowing Muscles Impacts Nutritional Status in Head and Neck Cancer Patients: The Prospective Randomized HEADNUT Trial

PURPOSE/OBJECTIVE(S)

To evaluate the influence of radiation dose on swallowing muscles and associated side effects as well as on nutritional status in patients with head and neck cancer undergoing primary or adjuvant (chemo)radiotherapy.

MATERIALS/METHODS

Between 2018 and 2020, sixty-one patients were prospectively randomized into the so-called HEADNUT-trial (HEAD and neck cancer patients undergoing NUTritional intervention). Follow-up was continued until 2022. Contouring of the swallowing apparatus included and the swallowing muscles with the superior (scm), middle (mcm), and inferior constrictor muscle (icm), the cricopharyngeal muscle and the inlet of the esophagus. Nutritional status was assessed by bioelectrical impedance analysis (BIA) at the beginning and the end of radiotherapy. The post-therapeutic nutritional status was evaluated by the BIA-derived FFMI (fat-free mass index; kg/m²). Malnutrition was assumed at FFMI values of <15 (♀) and <17 (♂) kg/m². To find differences between dosimetric parameters in well- and malnourished patients, Mann-Whitney-U-test was used. To estimate the relationship between malnutrition and its influencing variables a logistic regression model was built.

RESULTS

The following structures differed between well- and malnourished patients at the end of therapy: icm (Dmean, V40Gy (%), V50Gy (%), V60Gy (%)) and cricopharyngeal muscle (V40Gy (%)). After entering these parameters into a multivariable logistic regression model icm Dmean (b = -0.12; Exp(b) = 0.88; 95%-CI: 0.78-1.0; p = 0.06) and icm V40Gy (%) (b = 0.06; Exp(b) = 1.07; 95%-CI: 1-1.13; p = 0.04) proved to be independent predictors of malnutrition. We only determined the cut-off value for icm V40Gy (%) since it was the only parameter which met p<0.05. The optimal cut-off value for the predictor V40Gy (%) based on the Youden Index was 85.6%.

CONCLUSION

Adherence to dose constraints for the swallowing apparatus may prevent malnutrition in head and neck cancer patients at the end of therapy. Specifically, we suggest an icm V40Gy (%) of more than 86% being predictive for nutritional complications.

In ovo application of a live infectious bursal disease vaccine to commercial broilers confers proper immunity

Infectious bursal disease (IBD) is an economically important disease of young chickens caused by the Avibirnavirus infectious bursal disease virus (IBDV). Besides biosecurity, vaccination is the most important measure for IBDV control. Sufficient levels of maternally derived antibodies (MDA) protect against early challenge and also interfere with the take of live conventional vaccines. Recently, the field surveys conducted in four countries, published by Ashash, U., Noach, C., Perelman, B., Costello, C., Sansalone, P., Brazil, T. & Raviv, Z. [(2019). In ovo and day of hatch application of a live infectious bursal disease virus vaccine to commercial broilers. Avian Diseases, 63, 713-720] using the MB-1 vaccine strain by in ovo application or sub-cutaneous route at the day of hatch seem to conflict with the rule that very early application of a conventional live vaccine in birds with significant levels of MDA has very little chance of a successful immune response. An in ovo vaccination-challenge controlled experiment with MB-1 vaccine was performed using commercial broilers with high levels of MDA against IBDV and a vvIBDV challenge at 22 or 36 days of age. Clinical signs, bursa-bodyweight ratios, histology, serology, RT-PCR, Sanger- and deep sequencing were used to study the efficacy and safety of the in ovo-applied MB1 vaccine in comparison to an established immuno-complex vaccine. The study findings confirmed that the in ovo application of the live MB-1 vaccine in commercial broilers was successful and induced full protection against a vvIBDV challenge at 22 and 36 days of age, demonstrated by the bursa lesion score and qPCR and IBDV genotyping. Comparable to the field studies, a delayed viral replication of 2-3 weeks, following the in ovo administration of the MB1 vaccine, was observed.

Significant plastic accumulation on the Cocos (Keeling) Islands, Australia

For over 60 years, our oceans have been a reservoir for exponentially increasing amounts of plastic waste. Plastic has been documented at all levels of the marine food web, from the deepest oceanic trenches to the most far-flung beaches. Here, we present data on the presence of significant quantities of plastic on the remote Cocos (Keeling) Island group, located 2,100 km off the northwest coast of Australia. From our comprehensive surveys of debris on the beach surface, buried, and beach-back vegetation, we estimate there are 414 million anthropogenic debris items, weighing 238 tonnes, currently deposited on the Cocos (Keeling) Island group. Of the identifiable items, ~25% were classified as disposable plastics, including straws, bags, and toothbrushes. Debris buried up to 10 cm below the surface is estimated to account for 93% (~383 million items) of all debris present on Cocos, the majority of which (~60%) is comprised of micro-debris (2–5 mm). In the absence of meaningful change, debris will accumulate rapidly on the world’s beaches. Small, buried items pose considerable challenges for wildlife, and volunteers charged with the task of cleaning-up, thus preventing new items from entering the ocean remains key to addressing this issue.

Ana o 3-specific IgE is a good predictor for clinically relevant cashew allergy in children

INTRODUCTION

Component-resolved diagnostics using specific IgE to 2 S albumins has shown to be a valuable new option in diagnostic procedure. Ana o 3 is a 2 S albumin from cashew. The aim of this study was to investigate the role of Ana o 3-specific serum IgE in the diagnosis of cashew allergy and to identify cut-off levels to replace oral food challenges. Moreover, the value of additional determination of total IgE has been investigated.

METHODS

In a multicentre study, we analysed specific IgE to cashew extract and Ana o 3 as well as total IgE in children with suspected cashew allergy using the ImmunoCAP-FEIA and a standardized diagnostic procedure including oral challenges where indicated.

RESULTS

A total of 61 patients were included in the study. Forty-two were allergic to cashew, and 19 were tolerant. In receiver operating curves, Ana o 3 discriminates between allergic and tolerant children better than cashew-specific IgE with an area under the curve of 0.94 vs 0.78. The ratio of Ana o 3-specific IgE to total IgE did not further improve the diagnostic procedure. Probability curves for Ana o 3-specific IgE have been calculated, and a 95% probability could be estimated at 2.0 kU/l.

CONCLUSION

Specific IgE to Ana o 3 is a valuable tool for the diagnosis of cashew allergy. Considering its positive predictive value, it might allow to make a considerable number of oral challenges superfluous.

The role of the bursa of Fabricius in the immune response to vaccinal antigens and the development of immune tolerance in chicks (Gallus domesticus) vaccinated at a very young age

Vaccination is recognized to be the most cost-effective means of preventing, controlling, and even eradicating infectious diseases. Conventional poultry are vaccinated through various routes including eye/nose drops, drinking water, vent brush, or injection. Efficient vaccination is an essential part of any good poultry management.The bursa of Fabricius is intimately connected to the cloaca and the intestinal system. It is well-known as a primary lymphoid organ in the chicken and a major channel through which environmental antigens stimulate the immune system. In this study we tested whether direct instillation of various viral vaccines and antigens into the cloaca (per bursam), could stimulate higher antibody titers and generate improved protection. Despite the very rapid absorption of the vaccines or antigens from the cloaca to the lumen of the Bursa of Fabricius, per bursam inoculation failed to generate a satisfactory immune response. In contrast conventional administration of live or inactivated commercial vaccines led to an acceptable level of seroconversion and protection against challenge.An interesting finding in this study was the fact that administration of a single priming dose of antigenic material at age 1 or 5 days, did not improve the response to a second administration at 14 days of age as expected. Instead, in most cases there was a reduced serum antibody response suggesting the induction of tolerance. This was true for all routes of administration (intramuscular, per ocular and per bursam) and for all formulations of vaccine.The current study reveals: 1) no advantage for direct application of live or inactivated vaccines or antigens into the bursa of Fabricius compared to common routes of vaccination, 2) that apparent desensitization or tolerance effects have important implications for poultry management, since in many countries, vaccination of day old chicks is compulsory or a well-accepted part of flock vaccination.According to our results, early vaccination can in fact reduce or inhibit a secondary immune response to subsequent vaccination and increase susceptibility to disease agents.

Predictive values of component-specific IgE for the outcome of peanut and hazelnut food challenges in children

BACKGROUND

Oral challenges are the gold standard in food allergy diagnostic, but time-consuming. Aim of the study was to investigate the role of peanut- and hazelnut-component-specific IgE in the diagnostics of peanut and hazelnut allergy and to identify cutoff levels to make some challenges superfluous.

METHODS

In a prospective and multicenter study, children with suspected peanut or hazelnut allergy underwent oral challenges. Specific IgE to peanut, hazelnut, and their components (Ara h 1, Ara h 2, Ara h 3, and Ara h 8, Cor a 1, Cor a 8, Cor a 9, and Cor a 14) were determined by ImmunoCAP-FEIA.

RESULTS

A total of 210 children were challenged orally with peanut and 143 with hazelnut. 43% of the patients had a positive peanut and 31% a positive hazelnut challenge. With an area under the curve of 0.92 and 0.89, respectively, Ara h 2 and Cor a 14-specific IgE discriminated between allergic and tolerant children better than peanut- or hazelnut-specific IgE. For the first time, probability curves for peanut and hazelnut components have been calculated. A 90% probability for a positive peanut or hazelnut challenge was estimated for Ara h 2-specific IgE at 14.4 kU/l and for Cor a 14-specific IgE at 47.8 kU/l. A 95% probability could only be estimated for Ara h 2 at 42.2 kU/l.

CONCLUSIONS

Ara h 2- and Cor a 14-specific IgE are useful to estimate the probability for a positive challenge outcome in the diagnostic work-up of peanut or hazelnut allergy making some food challenges superfluous.

Changes in the group associations of free-ranging beef cows at calving

Dyadic association between individuals forms the basis of group structures for herding animals. Group associations and social bonds are dynamic and can result in the establishment of new subgroups. The onset of parturition and the introduction of an offspring create a social change for a mother that is part of a herd. There is a need to nurture the young, develop and maintain a strong maternal bond, and build or maintain social networks within the larger herd. The present study explored associations within a herd of cattle that included pregnant cows and cows with calves (maternal cows). Group dynamics were determined by daily observations of group associations over an 11-week period. During the period, some pregnant cows calved and it was possible to quantify their associations before and post-calving. The associations between individual cows were quantified using a half-weight index (HWI). The HWI data for the maternal and pregnant class of cows were compared. The overall HWI data and the individual class data (pregnant or maternal) were tested against a random model, using data that were generated using permutation methods. There were significant differences in the associations of the pregnant and maternal cows; the maternal cows had stronger associations with other maternal cows while the pregnant cows showed evidence of weaker associations with other pregnant cows and the maternal cows. As pregnant cows calved, they developed stronger associations with other maternal cows. The present study provided evidence that pregnant cows prefer to maintain a degree of isolation, but strengthen their social bonds with other mothers as they enter a maternal phase.

Forest fragmentation genetics in a formerly widespread island endemic tree: Vateriopsis seychellarum (Dipterocarpaceae)

Habitat fragmentation and changed land use have seriously reduced population size in many tropical forest tree species. Formerly widespread species with limited gene flow may be particularly vulnerable to the negative genetic effects of forest fragmentation and small population size. Vateriopsis seychellarum (Dipterocarpaceae) is a formerly widespread canopy tree of the Seychelles, but is now reduced to 132 adult individuals distributed in eleven sites. Using ten microsatellite loci, a genetic inventory of all adult trees and a sample of 317 progeny, we demonstrate that despite its restricted range, overall genetic diversity was relatively high (H(E) : 0.56). The juvenile cohort, however, had significantly lower allelic richness (adults R(S) : 3.91; juveniles R(S) : 2.83) and observed heterozygosity than adult trees (adults H(O) : 0.62; juveniles H(O) : 0.48). Rare alleles were fewer and kinship between individuals was stronger in juveniles. Significant fine-scale spatial genetic structure was observed in remnant adults, and parentage analysis indicated that more than 90% of sampled progeny disperse <25 m and pollen dispersed <50 m. The molecular data confirmed that two populations were derived entirely from self-fertilized offspring from a single surviving mother tree. These populations produce viable offspring. Despite this extreme genetic bottleneck, self-compatibility may provide V. seychellarum with some resistance to the genetic consequences of habitat fragmentation, at least in the short term. We discuss our findings in the context of other rare and threatened dipterocarp species which are vulnerable to miss-management of genetic resources and population fragmentation.

Back from the brink: potential for genetic rescue in a critically endangered tree

Rare plant species are vulnerable to genetic erosion and inbreeding associated with small population size and isolation due to increasing habitat fragmentation. The degree to which these problems undermine population viability remains debated. We explore genetic and reproductive processes in the critically endangered long-lived tropical tree Medusagyne oppositifolia, an endemic to the Seychelles with a naturally patchy distribution. This species is failing to recruit in three of its four populations. We evaluate whether recruitment failure is linked to genetic problems associated with fragmentation, and if genetic rescue can mitigate such problems. Medusagyne oppositifolia comprises 90 extant trees in four populations, with only the largest (78 trees) having successful recruitment. Using 10 microsatellite loci, we demonstrated that genetic diversity is high (H(E) : 0.48-0.63; H(O) : 0.56-0.78) in three populations, with only the smallest population having relatively low diversity (H(E) : 0.26 and H(O) : 0.30). All populations have unique alleles, high genetic differentiation, and significant within population structure. Pollen and seed dispersal distances were mostly less than 100 m. Individuals in small populations were more related than individuals in the large population, thus inbreeding might explain recruitment failure in small populations. Indeed, inter-population pollination crosses from the large donor population to a small recipient population resulted in higher reproductive success relative to within-population crosses. Our study highlights the importance of maintaining gene flow between populations even in species that have naturally patchy distributions. We demonstrate the potential for genetic and ecological rescue to support conservation of plant species with limited gene flow.

A subunit vaccine against hemorrhagic enteritis adenovirus

Hemorrhagic enteritis virus (HEV) is an adenovirus that infects turkeys and causes immunosuppression and mortality. The virus used for the inactivated vaccine is extracted from spleens of infected turkeys, since its propagation in tissue cultures or embryonated eggs is unsuitable for mass production. The aim of this study was to develop a subunit vaccine based on a capsid protein of the virus. The knob protein, together with an adjacent part of the shaft domain pertaining to the fiber protein of HEV, was expressed in Escherichia coli and tested as a vaccine. Vaccination with this recombinant protein conferred protection against challenge in controlled and in floor-pen experiments. This finding suggests that the knob protein may be used as safe and efficient vaccine against hemorrhagic enteritis of turkeys. The possibility that the knob proteins of other adenoviruses may be protective and serve as vaccine is also discussed.

Der3p/Hrd1p is required for endoplasmic reticulum-associated degradation of misfolded lumenal and integral membrane proteins

We have studied components of the endoplasmic reticulum (ER) proofreading and degradation system in the yeast Saccharomyces cerevisiae. Using a der3-1 mutant defective in the degradation of a mutated lumenal protein, carboxypeptidase yscY (CPY*), a gene was cloned which encodes a 64-kDa protein of the ER membrane. Der3p was found to be identical with Hrd1p, a protein identified to be necessary for degradation of HMG-CoA reductase. Der3p contains five putative transmembrane domains and a long hydrophilic C-terminal tail containing a RING-H2 finger domain which is oriented to the ER lumen. Deletion of DER3 leads to an accumulation of CPY* inside the ER due to a complete block of its degradation. In addition, a DER3 null mutant allele suppresses the temperature-dependent growth phenotype of a mutant carrying the sec61-2 allele. This is accompanied by the stabilization of the Sec61-2 mutant protein. In contrast, overproduction of Der3p is lethal in a sec61-2 strain at the permissive temperature of 25 degrees C. A mutant Der3p lacking 114 amino acids of the lumenal tail including the RING-H2 finger domain is unable to mediate degradation of CPY* and Sec61-2p. We propose that Der3p acts prior to retrograde transport of ER membrane and lumenal proteins to the cytoplasm where they are subject to degradation via the ubiquitin-proteasome system. Interestingly, in ubc6-ubc7 double mutants, CPY* accumulates in the ER, indicating the necessity of an intact cytoplasmic proteolysis machinery for retrograde transport of CPY*. Der3p might serve as a component programming the translocon for retrograde transport of ER proteins, or it might be involved in recognition through its lumenal RING-H2 motif of proteins of the ER that are destined for degradation.

ER degradation of a misfolded luminal protein by the cytosolic ubiquitin-proteasome pathway

Secretion of proteins is initiated by their uptake into the endoplasmic reticulum (ER), which possesses a proteolytic system able to degrade misfolded and nonassembled proteins. The ER degradation system was studied with yeast mutants defective in the breakdown of a mutated soluble vacuolar protein, carboxypeptidase yscY (CPY*). The ubiquitin-conjugating enzyme Ubc7p participated in the degradation process, which was mediated by the cytosolic 26S proteasome. It is likely that CPY* entered the ER, was glycosylated, and was then transported back out of the ER lumen to the cytoplasmic side of the organelle, where it was conjugated with ubiquitin and degraded.

Der1, a novel protein specifically required for endoplasmic reticulum degradation in yeast

The endoplasmic reticulum (ER) of the yeast Saccharomyces cerevisiae contains of proteolytic system able to selectively degrade misfolded lumenal secretory proteins. For examination of the components involved in this degradation process, mutants were isolated. They could be divided into four complementation groups. The mutations led to stabilization of two different substrates for this process. The mutant classes were called 'der' for 'degradation in the ER'. DER1 was cloned by complementation of the der1-2 mutation. The DER1 gene codes for a novel, hydrophobic protein, that is localized to the ER. Deletion of DER1 abolished degradation of the substrate proteins. The function of the Der1 protein seems to be specifically required for the degradation process associated with the ER. The depletion of Der1 from cells causes neither detectable growth phenotypes nor a general accumulation of unfolded proteins in the ER. In DER1-deleted cells, a substrate protein for ER degradation is retained in the ER by the same mechanism which also retains lumenal ER residents. This suggests that DER1 acts in a process that directly removes protein from the folding environment of the ER.

Analysis of two mutated vacuolar proteins reveals a degradation pathway in the endoplasmic reticulum or a related compartment of yeast

The fate of a mutant form of each of the two yeast vacuolar enzymes proteinase yscA (PrA) and carboxypeptidase yscY (CPY) has been investigated. Both mutant proteins are rapidly degraded after entering the secretory pathway. Mutant PrA is deleted in 37 amino acids spanning the processing site region of the PrA pro-peptide. The mutant enzyme shows no activity towards maturation of itself or other vacuolar hydrolases, a function of wild-type PrA. Mutant CPY carries an Arg instead of a Gly residue in a highly conserved region, two positions distant from the active-site Ser. In contrast to wild-type CPY, the mutant form was quickly degraded by trypsin in vitro, indicating an altered structure. Using antisera specific for alpha-1-->6 and alpha-1-->3 outer-chain mannose linkages, no Golgi-specific carbohydrate modification could be detected on either mutant protein. Subcellular fractionation studies located both mutant enzymes in the endoplasmic reticulum. Degradation kinetics of both proteins show the same characteristics, indicating similar degradation pathways. The degradation process was shown to be independent of a functional sec18 gene product and takes place before Golgi-specific carbohydrate modifications occur. The proteasome, the major proteolytic activity of the cytoplasm, is not involved in this degradation event. All degradation characteristics of the two mutant proteins are consistent with a degradation process within the endoplasmic reticulum ('ER degradation').

Determination of flavone C-glycosides in tea

An HPLC method for the determination of flavone C-glycosides (FCG) from black tea has been developed. Sample clean-up was accomplished by means of polyamide column chromatography, followed by enzyme hydrolysis of interfering compounds such was flavonol glycosides and a second polyamide column chromatographic step. Using HPLC with gradient elution and photodiode array detection eight FCG were separated. Seven FCG were isolated by means of preparative HPLC. Identification was carried out using co-chromatography, FAB(Fast Atom Bombardment)-mass spectrometry and various nuclear magnetic resonance techniques. Apigenin 6-C-glucosyl-8-arabinoside (schaftoside) and apigenin 6-C-arabinosyl-8-C-glucoside (isoschaftoside) as well as luteolin 8-C-glucoside (orientin) and luteolin 6-C-glucoside (isoorientin) have been detected in tea for the first time. Three of the other compounds have been identified as apigenin 8-C-glucoside (vitexin), apigenin 6-C-glucoside (isovitexin) and apigenin 6,8-di-C-glucoside (vicenin-2). Their occurrence in tea has been previously reported. From its UV spectrum another compound was concluded to be an apigenin glycoside. The FCG were quantified in a variety of teas of different origins (16 black, two green and one oolong). The total amounts of the FCG were 0.48-2.69 g/kg dry weight. The FCG pattern of teas of different origins were similar to each other and no origin-dependent characteristics have yet been observed. Small amounts of FCG (1.2-2.2 mg/kg) were detected in hydrolysates of high relative molecular mass fractions (Mr > 5000) of a black tea liquor.

Chromatography of tea constituents

Modern chromatographic techniques such as high-performance liquid chromatography are currently the most helpful approach to the routine analysis of and research of non-volatile tea constituents. Using these techniques some errors in the more classical analytical techniques could be detected. Unfortunately, some of these methods of analysis are still in widespread use, even as official methods. However, knowledge of especially the polyphenols in tea is still lacking, and for many of the minor polyphenols no chromatographic methods for the determination exist.

Antibiotic sensitivity of gonococci in South Australia, 1974 to 1975

Routine testing of gonococci isolated from patients attending the Venereal Diseases Control Centre in Adelaide during the year July, 1974 to June, 1975, with a plate dilution method, showed that 93-8% of the 947 infecting strains were relatively sensitive to penicillin at a minimum inhibitory concentration (MIC) of 0-12 units/ml or less, and that 90% of the 648 strains tested were relatively sensitive to tetracycline at an MIC of 1-0 mug/ml or less. A small proportion only of isolates were relatively insensitive to penicillin and/or tetracycline. The routine treatment schedules which were used at the Centre proved adequate for infections over the whole range of sensitivities encountered. A significant proportion of the less sensitive strains were isolated from people infected in South-East Asia, most of whom had been inadequately treated there.