Thesis Objectives. To identify epigenetic changes related to breast cancer treatment and their relationship to persistent inflammation and CRF in patients, Xxxxx et al. examined DNA methylation in peripheral blood mononuclear cells (PBMCs) isolated from breast cancer patients undergoing treatment at Xxxxxxx Cancer Institute between 2010 and 2011 after obtaining Emory Institutional Review Board approval. Women between ages 18-75 with stage 0-IIIA breast cancer were eligible. In total, 61 patients were treated with standard breast conserving surgery and lymph node evaluation. Depending on stage and subtype, 22 patients received neoadjuvant (n=15) or adjuvant (n=7) chemotherapy prior to radiotherapy and enrollment. Patients with medical conditions that may interfere with the relationship between fatigue and inflammation were excluded. These conditions include chronic infections, uncontrolled cardiovascular disease, mental issues such as bipolar disorder and schizophrenia, and medications that affect the immune system (Xxxxx et al.,). Xxxxx et al. discovered that patients who received chemotherapy exhibited significantly lower methylation at 8 CpG sites compared to those who did not receive chemotherapy. Lower methylation at each CpG site was further associated with increased inflammatory markers, and increased inflammatory markers were correlated with fatigue symptom. The comparatively lower methylation level in the chemotherapy treated group, the association between lower methylation level and increased inflammatory markers, and the correlation between increased inflammatory markers and fatigue symptoms all persisted after 6 months with moderate decay (Xxxxx et al., 2014). Interestingly, 6 of the 8 CpG sites identified by Xxxxx et al. are located in or near important regulatory genes such as XXX0, XXXX0, VMP1, and miR-21. This provides 3 regions of interest for further investigation. Importantly, although Xxxxx et al. examined 2 time points, both were cross-sectional studies where DNA methylation levels were aggregated and compared between chemotherapy and non-chemotherapy groups. There were 2 important issues: 1, although the non-chemotherapy group served as a negative control, chemotherapy was already administered prior to the baseline time point, meaning that the chemotherapy group could not compare its post-chemotherapy state to its pre-chemotherapy state to infer any possible causal changes induced by chemotherapy; 2, there could be confounding factors such as prior DNA...
Thesis Objectives. The overall aim of the thesis is to explore the use of mindfulness within a football academy context and to investigate whether this concept can be embedded into the culture of a Premier League Football Club. Through four studies the following research objectives will be addressed:
