Construction of an artificial phosphoketolase pathway that efficiently catabolizes multiple carbon sources to acetyl-CoA.

The canonical glycolysis pathway is responsible for converting glucose into 2 molecules of acetyl-coenzyme A (acetyl-CoA) through a cascade of 11 biochemical reactions. Here, we have designed and constructed an artificial phosphoketolase (APK) pathway, which consists of only 3 types of biochemical reactions. The core enzyme in this pathway is phosphoketolase, while phosphatase and isomerase act as auxiliary enzymes. The APK pathway has the potential to achieve a 100% carbon yield to acetyl-CoA from any monosaccharide by integrating a one-carbon condensation reaction. We tested the APK pathway in vitro, demonstrating that it could efficiently catabolize typical C1-C6 carbohydrates to acetyl-CoA with yields ranging from 83% to 95%. Furthermore, we engineered Escherichia coli stain capable of growth utilizing APK pathway when glycerol act as a carbon source. This novel catabolic pathway holds promising route for future biomanufacturing and offering a stoichiometric production platform using multiple carbon sources.

Polychromatic Dual-Mode Imaging with Structured Chiral Photonic Crystals.

Optical spatial differentiation is a typical operation of optical analog computing and can single out the edge to accelerate the subsequent image processing, but in some cases, overall information about the object needs to be presented synchronously. Here, we propose a multifunctional optical device based on structured chiral photonic crystals for the simultaneous realization of real-time dual-mode imaging. This optical differentiator is realized by self-organized large-birefringence cholesteric liquid crystals, which are photopatterned to encode with a special integrated geometric phase. Two highly spin-selective modes of second-order spatial differentiation and bright-field imaging are exhibited in the reflected and transmitted directions, respectively. Two-dimensional edges of both amplitude and phase objects have been efficiently enhanced in high contrast and the broadband spectrum. This work extends the ingenious building of hierarchical chiral nanostructures, enriches their applications in the emerging frontiers of optical computing, and boasts considerable potential in machine vision and microscopy.

Nitrogen adsorption on Nb2C6H4+ cations: the important role of benzyne (ortho-C6H4).

N2 adsorption is a prerequisite for activation and transformation. Time-of-flight mass spectrometry experiments show that the Nb2C6H4+ cation, resulting from the gas-phase reaction of Nb2+ with C6H6, is more favorable for N2 adsorption than Nb+ and Nb2+ cations. Density functional theory calculations reveal the effect of the ortho-C6H4 ligand on N2 adsorption. In Nb2C6H4+, interactions between the Nb-4d and C-2p orbitals enable the Nb2+ cation to form coordination bonds with the ortho-C6H4 ligand. Although the ortho-C6H4 ligand in Nb2C6H4+ is not directly involved in the reaction, its presence increases the polarity of the cluster and brings the highest occupied molecular orbital (HOMO) closer to the lowest occupied molecular orbital (LUMO) of N2, thereby increasing the N2 adsorption energy, which effectively facilitates N2 adsorption and activation. This study provides fundamental insights into the mechanisms of N2 adsorption in "transition metal-organic ligand" systems.

Consecutive Reduction of Five Carbon Dioxide Molecules by Gas-Phase Niobium Carbide Cluster Anions Nb3C4-: Unusual Mechanism for Enhanced Reactivity by the Carbon Ligands.

Studying the cleavage of the C═O bond during CO2 activation at room temperature is highly significant for comprehending the CO2 conversion processes. Herein, mass spectrometry experiments and density functional theory calculations indicate that the niobium carbide anions Nb3C4- can continuously convert five CO2 molecules to CO under thermal collision conditions, while the other clusters with less carbon ligands Nb3C1-3- reduce fewer CO2 molecules. Size-dependent reactivity of Nb3C1-4- cluster anions toward CO2 is observed. Interestingly, the carbon atoms in Nb3C4- not only act as highly active adsorption sites for CO2 but also serve as electron donors to reduce CO2. The stored electrons are released through a carbon-carbon coupling process. Our findings on the role of carbon ligands in enhancing transition metal carbide reactivity can offer new insights for designing active sites on catalysts with both high activity and selectivity.

A FRET-based multifunctional fluorescence probe for the simultaneous detection of sulfite and viscosity in living cells.

Viscosity and sulfur dioxide derivatives were significant indicators for the assessment of health threat and even cancers, therefore, on-site and real time detection of viscosity and sulfur dioxide derivatives has obtained considerable attentions. An FRET-based fluorescence probe JZX was designed and synthesized based on a novel energy donor of N,N-diethyl-4-(1H-phenanthro[9,10-d]imidazol-2-yl)benzamide fluorophore. JZX exhibited a large Stokes shift (230 nm), high energy transfer efficiency, wide emission channel gap (135 nm) and excellent stability and biocompatibility. JZX detected sulfur dioxide with low detection limit (55 nM), fast responding (16 min), high selectivity and sensitivity. Additionally, JZX tend to target endoplasmic reticulum of which normal metabolism will be disturbed by the abnormal levels of viscosity and sulfur dioxide derivatives. Prominently, JZX could concurrently detect viscosity and sulfur dioxide derivatives depending on different fluorescence signals in living cells for the screening of cancer cells. Hence, probe JZX will be a promising candidate for the detection of viscosity and sulfur dioxide derivatives, and even for the diagnosis of liver cancers.

Effect of telehealth interventions on adherence to endocrine therapy among patients with breast cancer: a systematic review and meta-analysis.

PURPOSE: To evaluate the effect of telehealth interventions on adherence to endocrine therapy among patients with breast cancer. METHODS: A systematic search of five English databases (PubMed, Web of Science, Embase, the American Psychological Association PsycNet, and the Cochrane Library) and four Chinese databases (Chinese National Knowledge Infrastructure, SinoMed, WanFang Data, and WeiPu Data) was performed from inception to March 31, 2023. Two investigators independently screened the available studies for eligibility and extracted relevant data. Quality assessment was conducted using the Cochrane Risk of Bias Tool. The effect size was computed based on the risk ratio for dichotomous data and standardized mean difference for continuous data using Review Manager 5.4. RESULTS: A total of 1,780 participants from eight randomized controlled trials were included. These studies involved treatment with aromatase inhibitors only (n = 3) or aromatase inhibitors plus tamoxifen (n = 5). Telehealth interventions involved web-based interventions, telephone-based interventions, interventions via mobile applications, and interventions based on technology. In three studies, subjective measures were used, while objective measures were utilized in another three. Two studies incorporated a combination of both subjective and objective measures. The duration of the interventions varied among studies, ranging from a week to 36 months. The follow-up duration ranged from 4 weeks to 36 months. The quality of included studies was moderate to high. The meta-analysis of the five studies reporting dichotomous data showed that telehealth interventions had a significant effect on adherence to endocrine therapy (RR = 0.86, 95% CI = 0.76-0.97). Moreover, four studies reported continuous data. The meta-analysis demonstrated that telehealth interventions significantly improved adherence to endocrine therapy at 1 month (SMD = 0.50, 95% CI = 0.10-0.90), 3 months (SMD = 0.58, 95% CI = 0.17-0.99), and 6 months (SMD = 0.27, 95% CI = 0.08-0.47) of follow-up. CONCLUSION: Telehealth interventions may facilitate adherence to endocrine therapy among patients with breast cancer. Further research should adopt a theory-based design and explore the longer-term effects.

PRMT5 inhibition induces pro-inflammatory macrophage polarization and increased hepatic triglyceride levels without affecting atherosclerosis in mice.

Protein arginine methyltransferase 5 (PRMT5) controls inflammation and metabolism through modulation of histone methylation and gene transcription. Given the important role of inflammation and metabolism in atherosclerotic cardiovascular disease, here we examined the role of PRMT5 in atherosclerosis using the specific PRMT5 inhibitor GSK3326595. Cultured thioglycollate-elicited peritoneal macrophages were exposed to GSK3326595 or DMSO control and stimulated with either 1 ng/mL LPS or 100 ng/mL interferon-gamma for 24 h. Furthermore, male low-density lipoprotein (LDL) receptor knockout mice were fed an atherogenic Western-type diet and injected intraperitoneally 3×/week with a low dose of 5 mg/kg GSK3326595 or solvent control for 9 weeks. In vitro, GSK3326595 primed peritoneal macrophages to interferon-gamma-induced M1 polarization, as evidenced by an increased M1/M2 gene marker ratio. In contrast, no difference was found in the protein expression of iNOS (M1 marker) and ARG1 (M2 marker) in peritoneal macrophages of GSK3326595-treated mice. Also no change in the T cell activation state or the susceptibility to atherosclerosis was detected. However, chronic GSK3326595 treatment did activate genes involved in hepatic fatty acid acquisition, i.e. SREBF1, FASN, and CD36 (+59%, +124%, and +67%, respectively; p < 0.05) and significantly increased hepatic triglyceride levels (+50%; p < 0.05). PRMT5 inhibition by low-dose GSK3326595 treatment does not affect the inflammatory state or atherosclerosis susceptibility of Western-type diet-fed LDL receptor knockout mice, while it induces hepatic triglyceride accumulation. Severe side effects in liver, i.e. development of non-alcoholic fatty liver disease, should thus be taken into account upon chronic treatment with this PRMT5 inhibitor.

Alignment rule and geometric confinement lead to stability of a vortex in active flow.

Vortices are hallmarks of a wide range of nonequilibrium phenomena in fluids at multiple length scales. In this work, we numerically study the whirling motion of self-propelled soft point particles confined in circular domain, and aim at addressing the stability issue of the coherent vortex structure. By the combination of dynamical and statistical analysis at the individual particle level, we reveal the persistence of the whirling motion resulting from the subtle competition of activity and geometric confinement. In the stable whirling motion, the scenario of the coexistence of the irregular microscopic motions of individual particles and the regular global whirling motion is fundamentally different from the motion of a vortex in passive fluid. Possible orientational order coexisting with the whirling are further explored. This work shows the stability mechanism of vortical dynamics in active media under the alignment rule in confined space and may have implications in creating and harnessing macroscale coherent dynamical states by tuning the confining geometry.

Metformin treatment and acute ischemic stroke outcomes in patients with type 2 diabetes: a retrospective cohort study.

BACKGROUND AND PURPOSE: Preclinical studies have shown that metformin has neuroprotective actions in stroke. However, the optimal treatment timing and duration remain unknown. Herein, we examined the efficacy of metformin treatment on prognosis in acute ischemic stroke (AIS) patients, and assessed the optimal treatment timing and duration. METHODS: AIS patients with type 2 diabetes mellitus were retrospectively enrolled. Patients were grouped into those who never received metformin (MET - group), those who received metformin continuously before stroke and after admission (pre-stroke + /post-stroke + group), those who only received metformin before stroke onset (pre-stroke + /post-stroke - group), and those who only received metformin after admission (pre-stroke - /post-stroke + group). The all MET + group represents the sum of the three metformin treatment groups. The efficacy outcome was the 90-day modified Rankin Scale (mRS) score. RESULTS: In total, 309 eligible patients were included (MET - [N = 130], pre-stroke + /post-stroke + [N = 94], pre-stroke + /post-stroke - [N = 30], pre-stroke - /post-stroke + [N = 55]; all MET + [N = 179]). The all MET + group had a trend toward a lower 90-day mRS score compared with that in the MET - group (1 [0-2] vs 1 [0-3], unadjusted odds ratio [OR] = 0.652, P = 0.041; adjusted OR = 0.752, P = 0.218). In the three metformin treatment groups, only the pre-stroke + /post-stroke + group had a significantly lower 90-day mRS score (1 [0-1] vs 1 [0-3], adjusted OR = 0.497, 95%CI = 0.289-0.854; P = 0.011) and higher proportion of mRS score 0-1 (78.7% vs. 61.5%, adjusted OR = 2.278, 95%CI = 1.108-4.680; P = 0.025) than the MET - group. CONCLUSION: AIS patients with type 2 diabetes mellitus who receive continuous metformin treatment before stroke onset and after admission have improved functional outcome at 90 days.

Design, Synthesis and Antitumor Activity of FAK/PLK1 Dual Inhibitors with Quinazolinone as the Skeleton.

Febrifugine is a kind of quinazolinone compound with high biological activity from a Chinese herb called Chang Shan (Dichroa febrifuga). Febrifugine and its derivatives possess extensive biological activities, some of which exhibited anti-tumor activities as FAK inhibitors. However, they are not very effective at inhibiting tumor metastasis, perhaps because tumors gain energy through compensatory activation of other signaling pathways that promote cell migration and invasion. Therefore, seventeen novel febrifugine derivatives with quinazolinone skeleton were designed, synthesized and acted as potential FAK/PLK1 dual inhibitors. These compounds were determined by 1 H-NMR, 13 C-NMR and MS. Most of the compounds exhibited good inhibitory activity against cancer cell lines by computer-assisted screening, antitumor activity test and FAK/PLK1 inhibitory activity test, wherein compound 3b was screened as a high-efficiency lead compound.

Why breast cancer patients avoid communicating disease-related information to their dependent children: A qualitative study.

AIM AND OBJECTIVES: This qualitative study explores why breast cancer patients do not share disease-related information with their dependent children. BACKGROUND: 'Open' communication between breast cancer patients and their children is beneficial to both. However, some still try to avoid discussing their diagnosis and related information with their children. Some worries lie in communicating with dependent children, but the underlying cause remains unclear. DESIGN: Qualitative descriptive study. METHODS: Semi-structured interview was used in this study. Twenty breast cancer patients with children (aged 8-18 years) were recruited at two urban tertiary hospitals in mainland China. Qualitative content analysis was conducted to analyse and identify themes and subthemes. This study followed the COREQ checklist for qualitative studies. RESULTS: Three main themes were identified: (1) Uncertainty about the future: Their struggles with cancer remain a sensitive subject with their children. They described the uncertainty surrounding their disease prognosis and their children's response. They were also unsure whether, when and how to inform their children of their conditions; (2) Useless and risky for their children to know the truth: They considered it useless because their children can neither understand nor change the existing facts. They were concerned that it could affect their children's emotional state, character and academic performance; and (3) All for their children's sake: They were willing to take care of their affairs without troubling their dependent children as much as possible. CONCLUSION: Most mothers delayed communicating disease-related information to their dependent children. However, they often underestimated children's abilities and ignored their thoughts and wishes. Motherhood leads to avoidance and concealment in discussing health issues with their children. RELEVANCE TO CLINICAL PRACTICE: Mothers should try to understand their children's views towards cancer earlier. Healthcare professionals, especially nurses, should provide further consultation and intervention services to assist mothers and their children.

Enzymatic Electrosynthesis of Glycine from CO2 and NH3.

Enzymatic electrosynthesis has gained more and more interest as an emerging green synthesis platform, particularly for the fixation of CO2 . However, the simultaneous utilization of CO2 and a nitrogenous molecule for the enzymatic electrosynthesis of value-added products has never been reported. In this study, we constructed an in vitro multienzymatic cascade based on the reductive glycine pathway and demonstrated an enzymatic electrocatalytic system that allowed the simultaneous conversion of CO2 and NH3 as the sole carbon and nitrogen sources to synthesize glycine. Through effective coupling and the optimization of electrochemical cofactor regeneration and the multienzymatic cascade reaction, 0.81 mM glycine was yielded with a highest reaction rate of 8.69 mg L-1 h-1 and faradaic efficiency of 96.8 %. These results imply a promising alternative for enzymatic CO2 electroreduction and expand its products to nitrogenous chemicals.

Factors associated with returning to work and work ability of colorectal cancer survivors.

PURPOSE: The objective of this current study was to describe the status of returning to work and work ability of colorectal cancer survivors and identify the key factors associated with returning to work and work ability of Chinese colorectal cancer patients. METHODS: A cross-sectional observational study was performed in 212 colorectal cancer survivors who have worked before their colorectal cancer diagnosis. We evaluated patient's return to work (Yes/No), work ability, and factors by questionnaires of the Work Ability Index (WAI), M. D. Anderson Symptom Inventory for Gastrointestinal (MDASI-GI), and the Self-Report Psychosocial Adjustment to Illness Scale (PAIS-SR). Logistic regression analysis and linear regression were used to find the potential predictors with returning to work and work ability. RESULTS: Participants mostly 145 have returned to work (68.4%). Work ability and psychosocial adjustment of colorectal cancer survivors were at a moderate level. After completing treatment, the patient still had many symptoms, and these symptoms were distress to live. In the two models, survivors with higher family monthly income per capita and lower psychosocial adjustment scores were more likely to have higher work ability and return to work. Survivors with lower symptom distress were more likely to have higher work ability (r = - 0.038, p = 0.010). Survivors with higher work ability were more likely to return to work (OR = 1.193, 95% CI = (1.116,1.274)). CONCLUSION: This study confirmed that symptom distress and psychosocial adjustment were significantly associated with colorectal cancer survivors' returning to work and work ability, which should be considered in future intervention research.

Effects of the appearance care on psychosocial outcomes for breast cancer: a systematic review and meta-analysis.

PURPOSE: To synthesize the evidence for the immediate and short-term effects of appearance care on psychosocial outcomes in breast cancer patients in order to inform the design of future research and clinical practice. METHODS: A search of four databases (PubMed, Embase, Cochrane Central Register of Controlled Trials, and Web of Science). The JBI Critical Appraisal Checklists were used by two reviewers to assess methodology quality. Subgroup analysis was conducted for the different time points measured after intervention. RESULTS: Seven studies were eligible for the meta-analysis, including two RCTs and five quasi-experimental studies, from 1994 to 2022. The type of intervention was mainly grouped education, led by beauty specialists, and the dose and frequency varied. The quality of included studies was moderate to high. The results showed that appearance care had positive immediate effect on self-esteem (SMD = 0.63, 95% CI 0.37 to 0.89), anxiety (SMD = - 0.46, 95% CI - 0.60 to - 0.31), and depression (SMD = - 0.41, 95% CI - 0.62 to - 0.19), with short-term effects on anxiety (SMD = - 0.42, 95% CI - 0.54 to - 0.34), depression (SMD = - 0.41, 95% CI - 0.55 to - 0.26), and sexual function (SMD = 0.50, 95% CI 0.18 to 0.81).The effect of appearance care on body image and quality of life was uncertain. CONCLUSION: Appearance care could be a promising intervention to improve self-esteem, anxiety, depression, and sexual function among patients with breast cancer. More high-quality RCTs are needed to validate these findings. Online appearance care programs and exploration of long-term effects should also be considered.

Engineering of a thermophilic dihydroxy-acid dehydratase toward glycerate dehydration for in vitro biosystems.

Dihydroxy-acid dehydratase (DHAD) plays an important role in the utilization of glycerol or glucose for the production of value-added chemicals in the in vitro synthetic enzymatic biosystem. The low activity of DHAD in the dehydration of glycerate to pyruvate hampers its applications in biosystems. Protein engineering of a thermophilic DHAD from Sulfolobus solfataricus (SsDHAD) was performed to increase its dehydration activity. A triple mutant (I161M/Y145S/G205K) with a 10-fold higher activity on glycerate dehydration was obtained after three rounds of iterative saturation mutagenesis (ISM) based on computational analysis. The shrunken substrate-binding pocket and newly formed hydrogen bonds were the reason for the activity improvement of the mutant. For the in vitro synthetic enzymatic biosystems of converting glucose or glycerol to L-lactate, the biosystems with the mutant SsDHAD showed 3.32- and 2.34-fold higher reaction rates than the wild type, respectively. This study demonstrates the potential of protein engineering to improve the efficiency of in vitro synthetic enzymatic biosystems by enhancing the enzyme activity of rate-limited enzymes. KEY POINTS: • A screening method was established for the protein engineering of SsDHAD. • A R3 mutant of SsDHAD with 10-fold higher activity was obtained. • The R3 mutant exhibits higher productivity in the in vitro biosystems.

The construction of preclinical evidence for the treatment of liver fibrosis with quercetin: A systematic review and meta-analysis.

Quercetin (3,3',4',5,7-pentahydroxyflavone), a flavonoid, is widely found in fruits and vegetables and exerts broad-spectrum pharmacological effects in the liver. Many studies have explored the bioactivity of quercetin in the treatment of liver fibrosis. Hence, through a systematic review and biological mechanism evaluation, this study aimed to construct a body of preclinical evidence for the treatment of liver fibrosis using quercetin. The literature used in this study was mainly obtained from four databases, and the SYRCLE list (10 items) was used to evaluate the quality of the included literature. A meta-analysis of HA, LN, and other indicators was performed via STATA 15.0 software. Subgroup analyses based on animal species and model protocol were performed to further obtain detailed results. Moreover, the therapeutic mechanism of quercetin was summarized in a directed network form based on a comprehensive search of the literature. After screening, a total of 14 articles (comprising 15 studies) involving 254 animals were included. The results from the analysis showed that the corresponding liver function indexes, such as the levels of HA and LN, were significantly improved in the quercetin group compared with the model group, and liver function, such as the levels of AST and ALT, were also improved in the quercetin group. The species- and model-based subgroup analyses of AST and ALT revealed that quercetin exerts a significant effect. The therapeutic mechanism of quercetin was shown to be related to multiple pathways involving anti-inflammatory and antioxidant activities and lipid accumulation, including regulation of the TGF-ß, α-SMA, ROS, and P-AMPK pathways. The results showed that quercetin exerts an obvious effect on liver fibrosis, and more prominent improvement effects on liver function and liver fibrosis indicators were obtained with a dose of 5-200 mg during a treatment course ranging from 4 to 8 weeks. Quercetin might be a promising therapeutic for liver fibrosis.

Design, Synthesis and Molecular Docking of Novel Quinazolinone Hydrazide Derivatives as EGFR Inhibitors.

A series of novel quinazolinone hydrazide derivatives were designed and synthesized as EGFR inhibitors. The results indicated that most of the aimed compounds had potential anti-tumor cell proliferation and EGFR inhibitory activities. In the comprehensive analysis of all the tested compounds, the target compound 9c showed the best anti-tumor cell proliferation activity, (IC50 =1.31 µM for MCF-7, IC50 =1.89 µM for HepG2, IC50 =2.10 µM for SGC), and IC50 =0.59 µM for the EGFR inhibitory activity. Docking results showed that compound 9c could ideally insert the active site and interact with the critical amino acid residues (Val702, Lys721, Met769, Asp831) in the active site.

Barriers to family intervention to promote child and adolescent vision health: A qualitative study based on community practice in China.

PURPOSE: Child and adolescent myopia is a widespread public health problem worldwide, with high incidence, low age at onset, and severe symptoms. Family management plays a very important role in the prevention and management of myopia in children and adolescents; however, even with knowledge of the health risks of myopia, parents still continue to selectively ignore the importance of visual health, resulting in difficulties with family care related to childhood and adolescent myopia. The purpose of this study was to explore the barriers to family intervention for child and adolescent vision. METHODS: This was a qualitative phenomenological research study that used in-depth semi-structured interviews to explore the experiences of 20 parents whose children had been diagnosed with myopia in Shenzhen, China. Data were analyzed using thematic analysis methods. RESULTS: Three themes emerged: Vision health: neglected care, Going outdoors: the forgotten activity, Education: the top priority. CONCLUSIONS: Our analysis revealed that several factors contributed to barriers to promotion of visual health. One was an incorrect perception of myopia, including the effects of myopia, its non-lethality, and a view that it has minimal impact on daily life. Additionally, when parents faced a conflict between education and vision care, they tended to choose current education and ignore future development of visual problems. PRACTICE IMPLICATIONS: The findings suggest that future family intervention for child and adolescent myopia can be based on the perspective of parental health education, Simultaneously, it should also focus on the balance between education and vision care.

Platelet Distribution Width: A Significant Predictor of Poor Outcome After Mechanical Thrombectomy.

OBJECTIVES: Elevated platelet distribution width (PDW) is a recognized marker of platelet activity. Herein, we investigated the association between admission PDW values and clinical outcome at 3 months in acute ischemic stroke (AIS) patients undergoing mechanical thrombectomy (MT). MATERIALS AND METHODS: We retrospectively collected consecutive patients diagnosed with AIS following MT from two stroke centers. PDW was measured on admission. Subjects were divided into two groups according to the clinical outcome using the modified Rankin Scale at 3 months. Multiple regression analyses and receiver operating characteristic (ROC) curves were performed to determine the associations between admission PDW values, clinical parameters, and functional outcome. RESULTS: A total of 162 subjects were enrolled. Patients in the poor outcome group had a significantly higher percentage of PDW >16.0 fL compared with the good outcome group (57.3% vs. 26.9%, P < 0.001). After adjusting for a range of confounding factors, multiple regression analysis showed that PDW >16.0 fL was an independent predictor of poor outcome at 3 months (odds ratio 4.572, 95% confidence interval 1.896-11.026, P = 0.001). ROC curve analysis revealed that PDW >16.0 fL predicted poor outcome with 57.3% sensitivity and 73.1% specificity (the area under the ROC curve 0.637, 95% confidence interval 0.558-0.711, P = 0.004). CONCLUSIONS: Elevated PDW is an independent predictor of poor functional outcome in patients with anterior circulation AIS undergoing MT at 3 months.

Effect of hospital-based case management on psychosocial wellbeing and treatment outcomes in colorectal cancer patients: A quasi-experimental study.

BACKGROUND: Case management has been regarded as the front line of necessary change for fragmented healthcare system. AIM: This study proposed a case management intervention that is suitable for Chinese colorectal cancer patients and explored its effectiveness over a 12-month follow-up. METHODS: A quasi-experimental study was conducted in an oncology hospital in China. A total of 188 patients were recruited from May 2015 to February 2017; 85 patients in the control group and 80 patients in the intervention group were included in data analysis. The intervention group was managed for 1 year by a case manager who organized the multidisciplinary team, provided regular assessment, a consulting service and referrals. Quality of life, anxiety and depression, symptom distress, treatment adherence and unplanned readmission rates were measured. RESULTS: Repeated measurement ANOVA showed significant intervention and time effects in global quality of life, anxiety and depression, symptom distress and oral chemotherapy adherence. The intervention group showed statistically significantly better overall treatment adherence and lower unplanned readmission rate. CONCLUSION: Nurse-led case management was effective in improving psychosocial outcomes, treatment adherence and unplanned readmission rate of colorectal cancer patients. A case management model is feasible and effective in colorectal cancer patients and in hospital-dominated healthcare systems where primary care is underutilized.