Lung cancer (NSCLC) is the leading cause of cancer related mortality. Lung cancer screening aims to detect treatable cancers, however survival advantage will only be seen with early and appropriate stage-directed therapy. This study aims to understand recent rates of therapy for early-stage lung cancer in Kentucky, and to explore potential sources of disparities in treatment and outcomes. A Kentucky Cancer Registry query was performed of all NSCLC cases treated in the state from 2005-2014. Of 39,763 lung cancer patients, 10,622 were clinically operable. Of these, overall 40% did not receive surgery, while 16% did not receive any stage-appropriate local therapy. Wide variation was noted in rates of surgery and local therapy at the county level. Increased age, non-private insurance status, non-white race, male gender, and non-married status were less likely to receive surgery. Median survival in patients who underwent surgery was 59.1 months vs 16 months (p< 0.001). Appropriate stage-directed local therapy is a very important factor in survival of patients with early stage NSCLC. County-level variation in rates of therapy need further study. Demographic factors continue to drive disparities in therapy and outcomes in Kentucky and should inform health policy and ongoing research and education efforts.

Mikrobielle Rhodopsine sind Membranproteine, die Lichtsensitivität mit sensorischer, enzymatischer oder ionenleitender Funktion in einem Protein vereinen. Ihre strukturelle Kompaktheit macht lichtgetriebene Ionenpumpen und lichtgesteuerte Kanalrhodopsine (ChRs) zu weit verbreiteten optogenetischen Werkzeugen in der biologischen Forschung. Die Entdeckung und Entwicklung weiterer Ionenselektivitäten eröffnet neue Möglichkeiten der optogenetischen Manipulation des Membranpotentials elektrogener Zellen wie Neuronen. Seit langem wird an lichtgesteuerten K+-selektiven Ionenkanälen geforscht, um biologisch kompatible inhibierende Proteine zu kreieren. Eine Punktmutation im Rhodopsin KR2, einer lichtgesteuerten Na+-Pumpe aus dem Meeresbakterium Dokdonia eikasta, induzierte K+-selektive Leckströme. In dieser Studie wurden die Limitationen dieser KR2-R109Q-Mutante mithilfe elektrophysiologischer Methoden experimentell charakterisiert, begleitet von computergestützten pKa-Vorhersagen und MD-Simulationen. Eine Mutationsstudie offenbarte die molekularen Ursachen für die nachteilige pH-Abhängigkeit und die verbleibende Na+-Pumpaktivität. Durch Kombination von Schlüsselmutationen im Extrazellularraum des Proteins konnten diese Einschränkungen reduziert werden und größere K+-Leitfähigkeit unter physiologischen Bedingungen erzielt werden. Währenddessen wurden die ersten K+-selektiven ChRs unter physiologischen Bedingungen entdeckt, die KCRs. HcKCR1 aus der stramenopilen Alge Hyphochytrium catenoides und Mutanten der Ionenleitpore wurden elektrisch charakterisiert, unterstützt durch strukturelle Vorhersagen. Ein neuartiger hydrophober Selektivitätsfilter wurde identifiziert und seine Konservierung in verwandten Stramenopilen-ChRs nachgewiesen. WiChR aus Wobblia lunata zeigte hierbei eine beispiellose K+-Permeabilität und erreichte in Herzmuskelzellen und Neuronen hohe Eignung in Ein- und Zweiphotoneninhibition bei niedriger Lichtintensität und geringer Gewebeerwärmung. / Microbial rhodopsins are light-sensitive membrane proteins found in all domains of life. They combine photosensitivity with sensory, enzymatic or ion-translocating functions. Their structural simplicity makes light-driven ion pumps and light-gated channelrhodopsins (ChRs) valuable optogenetic tools for controlling cellular activity with light. Discovering and engineering new forms of ion selectivity expands possibilities for manipulating the membrane potential of electrogenic cells like neurons. Light-sensitive K+-selective ChRs have been highly anticipated as inhibitory optogenetic tools. A point mutation in the central gate of KR2, a light-driven Na+-pump rhodopsin from the marine bacterium Dokdonia eikasta, resulted in K+-selective leak photocurrents. This study experimentally characterized the main limitations of this KR2-R109Q variant using two-electrode and whole-cell voltage-clamp methods, supported by computational pKa prediction and classical MD simulations. An extensive mutational study revealed the molecular cause for the detrimental pH-sensitivity and residual Na+-pumping activity. Combining key mutations in the extracellular part of the protein reduced these limitations, yielding larger K+-selective photocurrents under physiological conditions. During this study, a novel ChR family with superior properties, Kalium ChRs (KCRs) was discovered, representing the first K+-selective ChRs under physiological conditions. HcKCR1 from the stramenopile alga Hyphochytrium catenoides and mutants of its putative ion conduction pore were electrically characterized in WCVC experiments, supported by structural predictions. A novel type of hydrophobic selectivity filter was identified and found to be conserved in related stramenopile ChRs. Among them, WiChR from Wobblia lunata exhibited an unmatched preference for K+ over Na+ and favorable performance in cardiac myocytes and neurons, allowing single- and two-photon inhibition at low irradiance and reduced tissue heating.