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1.
Proc Natl Acad Sci U S A ; 121(30): e2320068121, 2024 Jul 23.
Artigo em Inglês | MEDLINE | ID: mdl-39024108

RESUMO

Soft and biological matter come in a variety of shapes and geometries. When soft surfaces that do not fit into each other due to a mismatch in Gaussian curvatures form an interface, beautiful geometry-induced patterns are known to emerge. In this paper, we study the effect of geometry on the dynamical response of soft surfaces moving relative to each other. Using a simple experimental scheme, we measure friction between a highly bendable thin polymer sheet and a hydrogel substrate. At this soft and low-friction interface, we find a strong dependence of friction on the relative geometry of the two surfaces-a flat sheet experiences significantly larger friction on a spherical substrate than on flat or cylindrical substrate. We show that the stress developed in the sheet due to its geometrically incompatible confinement is responsible for the enhanced friction. This mechanism also leads to a transition in the nature of friction as the sheet radius is increased beyond a critical value. Our finding reveals a hitherto unnoticed mechanism based on an interplay between geometry and elasticity that may influence friction significantly in soft, biological, and nanoscale systems. In particular, it provokes us to reexamine our understanding of phenomena such as the curvature dependence of biological cell mobility.

2.
Proc Natl Acad Sci U S A ; 120(12): e2212290120, 2023 Mar 21.
Artigo em Inglês | MEDLINE | ID: mdl-36930601

RESUMO

Everyday experience confirms the tendency of adhesive films to detach from spheroidal regions of rigid substrates-what is a petty frustration when placing a sticky band aid onto a knee is a more serious matter in the coating and painting industries. Irrespective of their resistance to bending, a key driver of such phenomena is Gauss' Theorema Egregium, which implies that naturally flat sheets cannot conform to doubly curved surfaces without developing a strain whose magnitude grows sharply with the curved area. Previous attempts to characterize the onset of curvature-induced delamination, and the complex patterns it gives rise to, assumed a dewetting-like mechanism in which the propensity of two materials to form contact through interfacial energy is modified by an elastic energy penalty. We show that this approach may characterize moderately bendable sheets but fails qualitatively to describe the curvature-induced delamination of ultrathin films, whose mechanics is governed by their propensity to buckle and delaminate partially, under minute levels of compression. Combining mechanical and geometrical considerations, we introduce a minimal model for curvature-induced delamination accounting for the two buckling motifs that underlie partial delamination: shallow "rucks" and localized "folds". We predict nontrivial scaling rules for the onset of curvature-induced delamination and various features of the emerging patterns, which compare well with experiments. Beyond gaining control on the use of ultrathin adhesives in cutting-edge technologies such as stretchable electronics, our analysis is a significant step toward quantifying the multiscale morphology that emerges upon imposing geometrical and mechanical constraints on highly bendable solid objects.

3.
Proc Natl Acad Sci U S A ; 120(1): e2216001120, 2023 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-36580599

RESUMO

The recent emergence of stimuli-responsive, shape-shifting materials offers promising applications in fields as different as soft robotics, aeronautics, or biomedical engineering. Targeted shapes or movements are achieved from the advantageous coupling between some stimulus and various materials such as liquid crystalline elastomers, magnetically responsive soft materials, swelling hydrogels, etc. However, despite the large variety of strategies, they are strongly material dependent and do not offer the possibility to choose between reversible and irreversible transformations. Here, we introduce a strategy applicable to a wide range of materials yielding systematically reversible or irreversible shape transformations of soft ribbed sheets with precise control over the local curvature. Our approach-inspired by the spore-releasing mechanism of the fern sporangium-relies on the capillary deformation of an architected elastic sheet impregnated by an evaporating liquid. We develop an analytical model combining sheet geometry, material stiffness, and capillary forces to rationalize the onset of such deformations and develop a geometric procedure to inverse program target shapes requiring fine control over the curvature gradient. We finally demonstrate the potential irreversibility of the transformation by UV-curing a photosensitive evaporating solution and show that the obtained shells exhibit enhanced mechanical stiffness.


Assuntos
Robótica , Polímeros Responsivos a Estímulos , Elastômeros/química , Fenômenos Mecânicos , Engenharia Biomédica , Hidrogéis/química , Robótica/métodos
4.
Proc Natl Acad Sci U S A ; 120(11): e2216786120, 2023 Mar 14.
Artigo em Inglês | MEDLINE | ID: mdl-36897985

RESUMO

Although thin films are typically manufactured in planar sheets or rolls, they are often forced into three-dimensional (3D) shapes, producing a plethora of structures across multiple length scales. To understand this complex response, previous studies have either focused on the overall gross shape or the small-scale buckling that decorates it. A geometric model, which considers the sheet as inextensible yet free to compress, has been shown to capture the gross shape of the sheet. However, the precise meaning of such predictions, and how the gross shape constrains the fine features, remains unclear. Here, we study a thin-membraned balloon as a prototypical system that involves a doubly curved gross shape with large amplitude undulations. By probing its side profiles and horizontal cross-sections, we discover that the mean behavior of the film is the physical observable that is predicted by the geometric model, even when the buckled structures atop it are large. We then propose a minimal model for the horizontal cross-sections of the balloon, as independent elastic filaments subjected to an effective pinning potential around the mean shape. Despite the simplicity of our model, it reproduces a broad range of phenomena seen in the experiments, from how the morphology changes with pressure to the detailed shape of the wrinkles and folds. Our results establish a route to combine global and local features consistently over an enclosed surface, which could aid the design of inflatable structures, or provide insight into biological patterns.

5.
Proc Natl Acad Sci U S A ; 119(10)2022 03 08.
Artigo em Inglês | MEDLINE | ID: mdl-35193940

RESUMO

Subglacial hydrologic systems regulate ice sheet flow, causing acceleration or deceleration, depending on hydraulic efficiency and the rate at which surface meltwater is delivered to the bed. Because these systems are rarely observed, ice sheet basal drainage represents a poorly integrated and uncertain component of models used to predict sea level changes. Here, we report radar-derived basal melt rates and unexpectedly warm subglacial conditions beneath a large Greenlandic outlet glacier. The basal melt rates averaged 14 mm ⋅d-1 over 4 months, peaking at 57 mm ⋅d-1 when basal water temperature reached +0.88 ∘C in a nearby borehole. We attribute both observations to the conversion of potential energy of surface water to heat in the basal drainage system, which peaked during a period of rainfall and intense surface melting. Our findings reveal limitations in the theory of channel formation, and we show that viscous dissipation far surpasses other basal heat sources, even in a distributed, high-pressure system.

6.
Curr Issues Mol Biol ; 46(3): 2181-2208, 2024 Mar 08.
Artigo em Inglês | MEDLINE | ID: mdl-38534757

RESUMO

Despite improvements in contemporary medical and surgical therapies, cardiovascular disease (CVD) remains a significant cause of worldwide morbidity and mortality; more specifically, ischemic heart disease (IHD) may affect individuals as young as 20 years old. Typically managed with guideline-directed medical therapy, interventional or surgical methods, the incurred cardiomyocyte loss is not always completely reversible; however, recent research into various stem cell (SC) populations has highlighted their potential for the treatment and perhaps regeneration of injured cardiac tissue, either directly through cellular replacement or indirectly through local paracrine effects. Different stem cell (SC) types have been employed in studies of infarcted myocardium, both in animal models of myocardial infarction (MI) as well as in clinical studies of MI patients, including embryonic stem cells (ESCs) and induced pluripotent stem cells (iPSCs), Muse cells, multipotent stem cells such as bone marrow-derived cells, mesenchymal stem cells (MSCs) and cardiac stem and progenitor cells (CSC/CPCs). These have been delivered as is, in the form of cell therapies, or have been used to generate tissue-engineered (TE) constructs with variable results. In this text, we sought to perform a narrative review of experimental and clinical studies employing various stem cells (SC) for the treatment of infarcted myocardium within the last two decades, with an emphasis on therapies administered through thoracic incision or through percutaneous coronary interventions (PCI), to elucidate possible mechanisms of action and therapeutic effects of such cell therapies when employed in a surgical or interventional manner.

7.
Small ; : e2400159, 2024 Apr 26.
Artigo em Inglês | MEDLINE | ID: mdl-38671561

RESUMO

The creation of micrometer-sized sheets of silver at the air-water interface by direct deposition of electrospray-generated silver ions (Ag+) on an aqueous dispersion of reduced graphene oxide (RGO), in ambient conditions, is reported. In the process of electrospray deposition (ESD), an electrohydrodynamic flow is created in the aqueous dispersion, and the graphene sheets assemble, forming a thin film at the air-water interface. The deposited Ag+ coalesce to make single-crystalline Ag sheets on top of this assembled graphene layer. Fast neutralization of Ag+ forming atomic Ag, combined with their enhanced mobility on graphene surfaces, presumably facilitates the growth of larger Ag clusters. Moreover, restrictions imposed by the interface drive the crystal growth in 2D. By controlling the precursor salt concentration, RGO concentration, deposition time, and ion current, the dimensionality of the Ag sheets can be tuned. These Ag sheets are effective substrates for surface-enhanced Raman spectroscopy (SERS), as demonstrated by the successful detection of methylene blue at nanomolar concentrations.

8.
Small ; 20(2): e2305508, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-37670540

RESUMO

Single-atom catalysts (SACs) with specific N-coordinated configurations immobilized on the carbon substrates have recently been verified to effectively alleviate the shuttle effect of lithium polysulfides (LiPSs) in lithium-sulfur (Li─S) batteries. Herein, a versatile molten salt (KCl/ZnCl2 )-mediated pyrolysis strategy is demonstrated to fabricate Zn SACs composed of well-defined Zn-N4 sites embedded into porous carbon sheets with rich pyridine-N defects (Zn─N/CS). The electrochemical kinetic analysis and theoretical calculations reveal the critical roles of Zn-N4 active sites and surrounding pyridine-N defects in enhancing adsorption toward LiPS intermediates and catalyzing their liquid-solid conversion. It is confirmed by reducing the overpotential of the rate-determining step of Li2 S2 to Li2 S and the energy barrier for Li2 S decomposition, thus the Zn─N/CS guarantees fast redox kinetics between LiPSs and Li2 S products. As a proof of concept demonstration, the assembled Li─S batteries with the Zn─N/CS-based sulfur cathode deliver a high specific capacity of 1132 mAh g-1 at 0.1 C and remarkable capacity retention of 72.2% over 800 cycles at 2 C. Furthermore, a considerable areal capacity of 6.14 mAh cm-2 at 0.2 C can still be released with a high sulfur loading of 7.0 mg cm-2 , highlighting the practical applications of the as-obtained Zn─N/CS cathode in Li─S batteries.

9.
Small ; 20(24): e2308684, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38174613

RESUMO

Porous carbon has been widely focused to solve the problems of low coulombic efficiency (ICE) and low multiplication capacity of Sodium-ion batteries (SIBs) anodes. The superior energy storage properties of two-dimensional(2D) carbon nanosheets can be realized by modulating the structure, but be limited by the carbon sources, making it challenging to obtain 2D structures with large surface area. In this work, a new method for forming carbon materials with high N/S doping content based on combustion activation using the dual activation effect of K2SO4/KNO3 is proposed. The synthesized carbon material as an anode for SIBs has a high reversible capacity of 344.44 mAh g-1 at 0.05 A g-1. Even at the current density of 5 Ag-1, the capacity remained at 143.08 mAh g-1. And the ICE of sodium-ion in ether electrolytes is ≈2.5 times higher than that in ester electrolytes. The sodium storage mechanism of ether/ester-based electrolytes is further explored through ex-situ characterizations. The disparity in electrochemical performance can be ascribed to the discrepancy in kinetics, wherein ether-based electrolytes exhibit a higher rate of Na+ storage and shedding compared to ester-based electrolytes. This work suggests an effective way to develop doubly doped carbon anode materials for SIBs.

10.
Am J Ind Med ; 2024 Jun 05.
Artigo em Inglês | MEDLINE | ID: mdl-38837413

RESUMO

BACKGROUND: Engineered nanomaterials (ENMs) may pose health risks to workers. Objectives were to characterize ENM applications in construction, identify exposure scenarios, and evaluate the quality of safety data sheets (SDSs) for nano-enabled construction products. METHODS: SDSs and product data were obtained from a public database of nano-enabled construction products. Descriptive statistics were calculated for affected trades, product categories, and types of ENMs. A sample of SDSs (n = 33) was evaluated using modified criteria developed by NIOSH researchers. Bulk analysis via transmission electron microscopy characterized nanoparticles in a subset of products. RESULTS: Companies report using >50 ENMs in construction products. ENM composition could not be determined via SDSs for 38.1% of the 907 products examined. Polymers and metal oxides tied for most frequently reported ENMs (n = 87, 9.6%). Nano silica, graphene, carbon nanotubes, and silver nanoparticles were also frequently reported. Most of the products were paints and coatings (n = 483, 53.3%), followed by pre-market additives, cementitious materials, insulation, and lubricants. Workers in twenty construction trades are likely to handle nano-enabled products, these particularly encompass cement and brick masons, painters, laborers, carpenters, glaziers, and insulators. A wide range of exposure scenarios were identified. SDSs were classified as satisfactory (18%), in need of improvement (12%), or in need of significant improvement (70%). Bulk analyses revealed discrepancies between actual ENM composition and those in SDSs. DISCUSSION AND CONCLUSION: There has been significant progress investigating risks to construction workers posed by ENMs, but SDSs need major improvements. This study provides new insights on the use of ENMs in construction, exposure risks, and hazard communication.

11.
Proc Natl Acad Sci U S A ; 118(38)2021 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-34521755

RESUMO

Rechargeable magnesium batteries represent a viable alternative to lithium-ion technology that can potentially overcome its safety, cost, and energy density limitations. Nevertheless, the development of a competitive room temperature magnesium battery has been hindered by the sluggish dissociation of electrolyte complexes and the low mobility of Mg2+ ions in solids, especially in metal oxides that are generally used in lithium-ion batteries. Herein, we introduce a generic proton-assisted method for the dissociation of the strong Mg-Cl bond to enable genuine Mg2+ intercalation into an oxide host lattice; meanwhile, the anisotropic Smoluchowski effect produced by titanium oxide lattices results in unusually fast Mg2+ diffusion kinetics along the atomic trough direction with a record high ion conductivity of 1.8 × 10-4 S ⋅ cm-1 on the same order as polymer electrolyte. The realization of genuine Mg2+ storage and fast diffusion kinetics enabled a rare high-power Mg-intercalation battery with inorganic oxides. The success of this work provides important information on engineering surface and interlayer chemistries of layered materials to tackle the sluggish intercalation kinetics of multivalent ions.

12.
Proc Natl Acad Sci U S A ; 118(12)2021 03 23.
Artigo em Inglês | MEDLINE | ID: mdl-33723069

RESUMO

The synchronization of self-oscillating systems is vital to various biological functions, from the coordinated contraction of heart muscle to the self-organization of slime molds. Through modeling, we design bioinspired materials systems that spontaneously form shape-changing self-oscillators, which communicate to synchronize both their temporal and spatial behavior. Here, catalytic reactions at the bottom of a fluid-filled chamber and on mobile, flexible sheets generate the energy to "pump" the surrounding fluid, which also transports the immersed sheets. The sheets exert a force on the fluid that modifies the flow, which in turn affects the shape and movement of the flexible sheets. This feedback enables a single coated (active) and even an uncoated (passive) sheet to undergo self-oscillation, displaying different oscillatory modes with increases in the catalytic reaction rate. Two sheets (active or passive) introduce excluded volume, steric interactions. This distinctive combination of the hydrodynamic, fluid-structure, and steric interactions causes the sheets to form coupled oscillators, whose motion is synchronized in time and space. We develop a heuristic model that rationalizes this behavior. These coupled self-oscillators exhibit rich and tunable phase dynamics, which depends on the sheets' initial placement, coverage by catalyst and relative size. Moreover, through variations in the reactant concentration, the system can switch between the different oscillatory modes. This breadth of dynamic behavior expands the functionality of the coupled oscillators, enabling soft robots to display a variety of self-sustained, self-regulating moves.

13.
Int J Mol Sci ; 25(2)2024 Jan 17.
Artigo em Inglês | MEDLINE | ID: mdl-38256207

RESUMO

Up Regulation Gene seven (URG7) is the pseudogene 2 of the transporter ABCC6. The translated URG7 protein is localized with its single transmembrane α-helix in the endoplasmic reticulum (ER) membrane, orienting the N- and C-terminal regions in the lumen and cytoplasm, respectively, and it plays a crucial role in the folding of ER proteins. Previously, the C-terminal region of URG7 (PU, residues 75-99) has been shown to modify the aggregation state of α-synuclein in the lysate of HepG2 cells. PU analogs were synthesized, and their anti-aggregation potential was tested in vitro on α-synuclein obtained using recombinant DNA technology. Circular dichroism (CD), differential scanning calorimetry (DSC), Fourier-transform infrared (FTIR) spectroscopy, and microscopic techniques were used to assess the sample's behavior. The results show that the peptides studied by themselves are prone to clathrate-like structure formation of variable stability. Aggregation of α-synuclein is accompanied by desolvation of its peptide chain and an increase in intermolecular ß-sheets. The PU analogs all interact with α-synuclein aggregates and those possessing the most stable clathrate-like structures have the highest disaggregating effect. These findings suggest that the C-terminal region of URG7 may have a role in interacting and modulating α-synuclein structures and could be used to generate interesting therapeutic candidates as disaggregators of α-synuclein.


Assuntos
Proteínas Associadas à Resistência a Múltiplos Medicamentos , Peptídeos , alfa-Sinucleína , alfa-Sinucleína/genética , Hidrocarbonetos Aromáticos com Pontes , Retículo Endoplasmático , Peptídeos/farmacologia , Pseudogenes , Humanos , Células Hep G2 , Proteínas Associadas à Resistência a Múltiplos Medicamentos/genética
14.
Health Promot J Austr ; 35(1): 68-78, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-36916638

RESUMO

ISSUE ADDRESSED: Health behaviour change can be difficult to maintain. Action plans can address this issue, however, there has been little qualitative research to understand how to optimise action plan interventions. This study explored how people engage with a specific type of action plan intervention, the "volitional help sheet," in a cardiovascular disease (CVD) prevention context. METHODS: Twenty adults in the target age for CVD risk assessment (45 to 74 years) with varying health literacy participated in interviews and created an action plan to change their behaviour. Transcripts were analysed using framework analysis. RESULTS: Participants described how engagement with plans was related to how personally relevant the target behaviour and the options within the plan were. Also important was participants visualising themselves enacting the plan when deciding which option to choose. Amongst participants who already engaged in a target behaviour, some did not perceive the plan was useful; others perceived the plan as a helpful prompt or a formalisation of existing plans. For some, the barriers to behaviour change were out of the scope of an action plan, highlighting the need for alternative supports. CONCLUSION: This study provides qualitative insights into unanticipated ways that people with varying health literacy use action plans, providing new guidance for future developers. SO WHAT?: Not all action plans are created equal. Careful selection of behavioural targets and plan options and encouraging users to imagine the plan may enhance user engagement. Alternative behaviour change strategies should be available if key barriers cannot be addressed by the plan.


Assuntos
Doenças Cardiovasculares , Letramento em Saúde , Idoso , Humanos , Pessoa de Meia-Idade , Comportamentos Relacionados com a Saúde
15.
Angew Chem Int Ed Engl ; 63(6): e202311556, 2024 Feb 05.
Artigo em Inglês | MEDLINE | ID: mdl-38079027

RESUMO

Nanoscale enzymes anchored to surfaces act as chemical pumps by converting chemical energy released from enzymatic reactions into spontaneous fluid flow that propels entrained nano- and microparticles. Enzymatic pumps are biocompatible, highly selective, and display unique substrate specificity. Utilizing these pumps to trigger self-propelled motion on the macroscale has, however, constituted a significant challenge and thus prevented their adaptation in macroscopic fluidic devices and soft robotics. Using experiments and simulations, we herein show that enzymatic pumps can drive centimeter-scale polymer sheets along directed linear paths and rotational trajectories. In these studies, the sheets are confined to the air/water interface. With the addition of appropriate substrate, the asymmetric enzymatic coating on the sheets induces chemically driven, buoyancy flows that controllably propel the sheet's motion on the air/water interface. The directionality and speed of the motion can be tailored by changing the pattern of the enzymatic coating, type of enzyme, and nature and concentration of the substrate. This work highlights the utility of biocompatible enzymes for generating motion in macroscale fluidic devices and robotics and indicates their potential utility for in vivo applications.


Assuntos
Enzimas , Enzimas/química
16.
Semin Cell Dev Biol ; 120: 44-52, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-34266757

RESUMO

We review progress in active hydrodynamic descriptions of flowing media on curved and deformable manifolds: the state-of-the-art in continuum descriptions of single-layers of epithelial and/or other tissues during development. First, after a brief overview of activity, flows and hydrodynamic descriptions, we highlight the generic challenge of identifying the dependence on dynamical variables of so-called active kinetic coefficients- active counterparts to dissipative Onsager coefficients. We go on to describe some of the subtleties concerning how curvature and active flows interact, and the issues that arise when surfaces are deformable. We finish with a broad discussion around the utility of such theories in developmental biology. This includes limitations to analytical techniques, challenges associated with numerical integration, fitting-to-data and inference, and potential tools for the future, such as discrete differential geometry.


Assuntos
Hidrodinâmica , Animais , Drosophila
17.
Biochem Biophys Res Commun ; 686: 149197, 2023 12 17.
Artigo em Inglês | MEDLINE | ID: mdl-37924668

RESUMO

Various extracellular matrix (ECM) in the lungs regulate tissue development and homeostasis, as well as provide support for cell structures. However, few studies regarding the effects of lung cell differentiation using lung-derived ECM (LM) alone have been reported. The present study investigated the capability of lung-derived matrix sheets (LMSs) to induce lung cell differentiation using mouse embryonic stem (ES) cells. Expressions of lung-related cell markers were significantly upregulated in ES-derived embryoid bodies (EBs) cultured on an LMS for two weeks. Moreover, immunohistochemical analysis of EBs grown on LMSs revealed differentiation of various lung-related cells. These results suggest that an LMS can be used to promote differentiation of stem cells into lung cells.


Assuntos
Corpos Embrioides , Células-Tronco Embrionárias , Animais , Camundongos , Diferenciação Celular/fisiologia , Células Cultivadas , Pulmão
18.
Small ; 19(48): e2303295, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37525337

RESUMO

Twisting has recently been demonstrated as an effective strategy for tuning the interactions between particles or quasi-particles in layered materials. Motivated by the recent experimental synthesis of pentagonal NiN2 sheet [ACS Nano 2021, 15, 13539], for the first time, the response of phonon coherence to twisting in bilayer penta-NiN2 , going beyond the particle-like phonon transport is studied. By using the unified theory of phonon transport and high order lattice anharmonicity, together with the self-consistent phonon theory, it is found that the lattice thermal conductivity is reduced by 80.6% from 33.35 to 6.47 W m-1 K-1 at 300 K when the layers are twisted. In particular, the contribution of phonon coherence is increased sharply by an order of magnitude, from 0.21 to 2.40 W m-1 K-1 , due to the reduced differences between the phonon frequencies and enhanced anharmonicity after the introduction of twist. The work provides a fundamental understanding of the phonon interaction in twisted pentagonal sheets.

19.
Small ; 19(24): e2300051, 2023 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-36896999

RESUMO

Cobalt phthalocyanine (CoPc) has attracted particular interest owing to its excellent activity during the electrochemical CO2 conversion to CO. However, the efficient utilization of CoPc at industrially relevant current densities is still a challenge owing to its nonconductive property, agglomeration, and unfavorable conductive substrate design. Here, a microstructure design strategy for dispersing CoPc molecules on a carbon substrate for efficient CO2 transport during CO2 electrolysis is proposed and demonstrated. The highly dispersed CoPc is loaded on a macroporous hollow nanocarbon sheet to act as the catalyst (CoPc/CS). The unique interconnected and macroporous structure of the carbon sheet forms a large specific surface area to anchor CoPc with high dispersion and simultaneously boosts the mass transport of reactants in the catalyst layer, significantly improving the electrochemical performance. By employing a zero-gap flow cell, the designed catalyst can mediate CO2 to CO with a high full-cell energy efficiency of 57% at 200 mA cm-2 .

20.
Support Care Cancer ; 31(10): 608, 2023 Oct 04.
Artigo em Inglês | MEDLINE | ID: mdl-37792118

RESUMO

PURPOSE: People treated for head and neck cancer (HNC) face various barriers in communicating concerns with consultants. Our aim was to investigate the number of concerns raised between patients using the Patient Concerns Inventory (PCI) and those who did not. The PCI is a 57-item prompt list used in routine HNC follow-up clinics. Additionally, we aimed to examine whether who initiated the concerns differed between groups and the factors that may predict this initiation. METHODS: Secondary data analysis included 67 participants across 15 HNC consultants from specialist cancer centres in Liverpool and Leeds. Seven consultants utilised the PCI and eight did not, assigned by preferential and random assignment. RESULTS: Patients in the PCI group raised on average 2.5 more concerns than patients in the non-PCI group (p < .001). There was no significant relationship between group and who initiated the first concern (p = .28). A mixed-effects logistic regression was found to significantly predict who initiated the first concern in consultations (p < .05). DISCUSSION: The number of concerns raised by patients increased when the PCI was introduced pre-HNC consultation. A number of factors were shown to predict the number of concerns raised in consultations by both patient and consultant. As concerns may not be raised further following the concern mentioned, we propose that the discussion of concerns needs to be maintained by the clinician throughout the consultation and not solely at the start. CONCLUSION: The PCI promoted the sharing of concerns in follow-up consultations between patient and consultant.


Assuntos
Instituições de Assistência Ambulatorial , Neoplasias de Cabeça e Pescoço , Humanos , Seguimentos , Neoplasias de Cabeça e Pescoço/terapia , Serviços de Saúde , Encaminhamento e Consulta
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