<div>Abstract<p><b>Purpose:</b> Cancer diagnosis and treatment imparts chronic stressors affecting quality of life (QOL) and basic physiology. However, the capacity to increase survival by improving QOL is controversial. Patients with cervical cancer, in particular, have severely compromised QOL, providing a population well-suited for the evaluation of novel psychosocial interventions and the exploration of mechanisms by which modulation of the psychoneuroimmune axis might result in improved clinical outcomes.</p><p><b>Experimental Design:</b> A randomized clinical trial was conducted in cervical cancer survivors that were enrolled at ≥13 and <22 months after diagnosis (<i>n</i> = 50), comparing a unique psychosocial telephone counseling (PTC) intervention to usual care. QOL and biological specimens (saliva and blood) were collected at baseline and 4 months post-enrollment.</p><p><b>Results:</b> The PTC intervention yielded significantly improved QOL (<i>P</i> = 0.011). Changes in QOL were significantly associated with a shift of immune system T helper type 1 and 2 (Th1/Th2) bias, as measured by IFN-γ/interleukin-5 ELISpot T lymphocyte precursor frequency; improved QOL being associated with increased Th1 bias (<i>P</i> = 0.012). Serum interleukin-10 and the neuroendocrine variables of cortisol and dehydroepiandrosterone revealed trends supporting this shift in immunologic stance and suggested a PTC-mediated decrease of the subject's chronic stress response.</p><p><b>Conclusions:</b> This study documents the utility of a unique PTC intervention and an association between changes in QOL and adaptive immunity (T helper class). These data support the integration of the chronic stress response into biobehavioral models of cancer survivorship and suggests a novel mechanistic hypotheses by which interventions leading to enhanced QOL could result in improved clinical outcome including survival.</p></div>
<div>Abstract<p>Shortened telomere length is associated with increased cancer incidence and mortality. Populations experiencing chronic stress have accelerated telomere shortening. In this exploratory study, we examined associations between longitudinal changes in patient reported outcomes (PRO) of psychologic distress and peripheral blood mononuclear cell (PBMC) telomere length to test the hypothesis that modulation of the chronic stress response would also modulate telomere dynamics. Archived PBMC specimens (<i>N</i> = 22) were analyzed from a completed and reported randomized, longitudinal trial that showed a psychosocial telephone counseling intervention improved quality of life (QOL) and modulated stress-associated biomarkers in cervical cancer survivors. PROs and biospecimens were collected at baseline and 4 months postenrollment. Telomere length of archived PBMCs was evaluated using the flow-FISH assay. Longitudinal changes in psychologic distress, measured by the Brief Symptom Inventory-18, were significantly associated with increased telomere length within the CD14<sup>+</sup> (monocyte) population (<i>r</i> = −0.46, <i>P</i> = 0.043); a similar trend was observed for the CD14<sup>−</sup> population. Longitudinal changes in telomere length of the CD14<sup>−</sup> subset, primarily T lymphocytes, were associated with longitudinal increases in the naive T-cell population (<i>r</i> = 0.49, <i>P</i> = 0.052). Alterations in the chronic stress response were associated with modulation of telomere length in PBMCs, with evidence for mobilization of “younger” cells from progenitor populations. These data provide preliminary support for the (i) capacity to modulate the chronic stress response and the associated accelerated telomere shortening, (ii) inclusion of telomere length in the biobehavioral paradigm, and (iii) potential link between the chronic stress response and biologic mechanisms responsible for genomic integrity and carcinogenesis. <i>Cancer Prev Res; 5(10); 1173–82. ©2012 AACR</i>.</p></div>
<p>PDF file, 83K, Supplementary Figure 1. Longitudinal association of QOL and telomere MFI index of CD14+ and CD14- subsets.</p>
Synopsis: Starting from the general requirements imposed on the transmitting medium, this paper discusses the engineering of a radio system for television purposes and describes the radio facilities actually employed for the recent Bell System demonstration. The tests to which the system was submitted to determine its suitability are outlined and the measured frequency‐response characteristics are shown. An interesting phenomenon due to multi‐path transmission, the production of positive and negative secondary images, is reported. A brief series of experiments concerned with the transmission of both voice and image “on a single wave‐length” is also described.
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