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BACKGROUND: Epidermal growth factor receptor (EGFR) mutation and c-ros oncogene 1 (ROS1) rearrangement are key genetic alterations and predictive tumor markers for non-small cell lung cancer (NSCLC) and are typically considered to be mutually exclusive. EGFR/ROS1 co-mutation is a rare event, and the standard treatment approach for such cases is still equivocal. CASE SUMMARY: Herein, we report the case of a 64-year-old woman diagnosed with lung adenocarcinoma, with concomitant EGFR L858R mutation and ROS1 rearrangement. The patient received two cycles of chemotherapy after surgery, but the disease progressed. Following 1-month treatment with gefitinib, the disease progressed again. However, after switching to crizotinib, the lesion became stable. Currently, crizotinib has been administered for over 53 months with a remarkable treatment effect. CONCLUSION: The efficacy of EGFR tyrosine kinase inhibitors and crizotinib was vastly different in this NSCLC patient with EGFR/ROS1 co-mutation. This report will aid future treatment of such patients.
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Objective: To explore the relationship between physical exercise and life satisfaction among college students and test the dual mediating role of self-control and psychological distress between them. Methods: A sample of 526 Chinese college students completed questionnaires regarding physical exercise, life satisfaction, self-control and psychological distress, of which 38.4% were boys. Results: Path analyzes indicated that physical exercise was positively correlated with life satisfaction, and this link could be mediated by self-control and psychological distress. Conclusion: The present study identifies the potential underlying mechanism by which physical exercise is associated with the life satisfaction of college students, which has important implications for theory and prevention.
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STUDY OBJECTIVES: Patients with schizophrenia often suffer from sleep disturbance. Music therapy, as a non-invasive intervention, may have benefit on sleep problem in such population. Our study aimed to investigate the efficacy of music therapy on sleep disturbance among patients with schizophrenia. METHOD: This prospective study recruited participants with schizophrenia along with sleep disturbances in the chronic wards. Patients in the control group received standard care, and those in the intervention group received additional music therapy before sleeping at night for four weeks. The Pittsburgh Sleep Quality Index (PSQI) was used to measure the severity of sleep disturbance. The generalized estimating equation (GEE) was used to analyze measure the difference of change in PSQI scores between both groups at the baseline and four weeks later. It was also applied to find the predictors of treatment efficacy within intervention group. FINDINGS: A total of 66 (31 in control group and 35 in intervention group) participants were recruited. After adjusting with the demographic variables, the change of PSQI among intervention group was significantly more than the change among control group (Group × time; Estimate = -7.05, p < 0.001), indicating the efficacy of music therapy. In addition, irreligious patients and those with chronic medical disease predicted better efficacy. Whereas, elderly patients had compromising efficacy of music therapy. CONCLUSION: Music therapy demonstrated its merit on sleep disturbance among patients with schizophrenia. Whereas, healthcare workers should consider the variability of severity in schizophrenia during clinical practice.
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Musicoterapia , Esquizofrenia , Trastornos del Sueño-Vigilia , Anciano , Enfermedad Crónica , Humanos , Estudios Prospectivos , Esquizofrenia/complicaciones , Esquizofrenia/terapia , Sueño , Trastornos del Sueño-Vigilia/terapiaRESUMEN
The morphology and metal oxidation states of atmospheric aerosols are pertinent to their formation processes and ensuing interactions with surrounding gases, vapors and other environments upon deposition, such as human respiratory tract, soil and water. Although much progress has been made in recent years through single-particle techniques, considerably less is known with respect to the three-dimensional (3D) internal morphology of single atmospheric aerosol particles due to the limited penetration depth of electron microscopy. In this study, for the first time, a novel synchrotron-based transmission X-ray microscopy (TXM) methodology has been developed to visualize the 3D internal chemical mixing state and structure of single particles. The results show that the TXM is more applicable to the imaging of solid particles containing high-density elements, e.g., iron (Fe), aluminum (Al), silicone (Si), carbon (C) and sulfur (S), and/or solid particles of sizes larger than about 100 nm. In addition, the TXM is capable to reveal the fine 3D topographic features of single particles. The derived 3D internal and external information would be difficult to discern in the 2D images from electron microscopy. The TXM 3D images illustrate that aerosol particles exhibit complex internal mixing state and structure, e.g., homogeneously-, heterogeneously-mixed, multiple inclusions, fibrous, porous, and core-shell configuration. When coupled with the synchrotron-based X-ray fluorescence spectrometry (XRF) and absorption near-edge spectroscopy (XANES) of an X-ray nanoprobe in the energy range of 4-15 keV, the 3D morphology of single particles is further supplemented with the spatial distribution and oxidation sates of selected elements, including Fe, vanadium (V), manganese (Mn), chromium (Cr) and arsenic (As). The presented cross-platform, synchrotron-based methodology shows promise in complementing existing single-particle techniques and providing new insights to the heterogeneity of single-particle micro-physicochemical states relevant to the aerosol chemistry, optical properties, and their environmental and health impacts.
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Arsénico , Manganeso , Aerosoles/análisis , Aluminio/análisis , Carbono , Cromo/análisis , Gases/análisis , Humanos , Hierro/química , Manganeso/análisis , Siliconas , Suelo , Azufre , Sincrotrones , Vanadio/análisis , Agua/análisisRESUMEN
The objective of this study was to apply a machine learning method to evaluate the risk factors associated with serious adverse events (SAEs) and predict the occurrence of SAEs in cancer inpatients using antineoplastic drugs. A retrospective review of the medical records of 499 patients diagnosed with cancer admitted between January 1 and December 31, 2017, was performed. First, the Global Trigger Tool (GTT) was used to actively monitor adverse drug events (ADEs) and SAEs caused by antineoplastic drugs and take the number of positive triggers as an intermediate variable. Subsequently, risk factors with statistical significance were selected by univariate analysis and least absolute shrinkage and selection operator (LASSO) analysis. Finally, using the risk factors after the LASSO analysis as covariates, a nomogram based on a logistic model, extreme gradient boosting (XGBoost), categorical boosting (CatBoost), adaptive boosting (AdaBoost), light-gradient-boosting machine (LightGBM), random forest (RF), gradient-boosting decision tree (GBDT), decision tree (DT), and ensemble model based on seven algorithms were used to establish the prediction models. A series of indicators such as the area under the ROC curve (AUROC) and the area under the PR curve (AUPR) was used to evaluate the model performance. A total of 94 SAE patients were identified in our samples. Risk factors of SAEs were the number of triggers, length of stay, age, number of combined drugs, ADEs occurred in previous chemotherapy, and sex. In the test cohort, a nomogram based on the logistic model owns the AUROC of 0.799 and owns the AUPR of 0.527. The GBDT has the best predicting abilities (AUROC = 0.832 and AUPR = 0.557) among the eight machine learning models and was better than the nomogram and was chosen to establish the prediction webpage. This study provides a novel method to accurately predict SAE occurrence in cancer inpatients.
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AIMS: To explore the risk factors of falls and the gender differences based on demographic and disease characteristics, physical capability, and fear of falling in older adults with diabetes visiting outpatient clinics in Taiwan. DESIGN: Cross-sectional design. METHODS: A total of 485 patients with type 2 diabetes aged between 65 and 80 years were recruited from three endocrine outpatient clinics in Taiwan. Demographic and disease characteristics, fall history in the previous one year and fear of falling were collected by a self-reported questionnaire. Calf circumference, handgrip strength, one-leg standing and time up-and-go tests were all performed to assess the physical capability of participants. Data were collected from May 2019 to May 2020. RESULTS: Female gender (OR = 1.75), handgrip strength (OR = 2.43) and fear of falling (OR = 3.38) were important risk factors of falls overall, although fear of falling (OR = 4.69) was the only important risk factor of falls in males, while handgrip strength (OR = 3.48) and fear of falling (OR = 2.86) were important risk factors of falls in females. The sensitivity of simultaneous screening handgrip strength and fear of falling were 85.7, 86.4 and 86.2 in males, females and older adults overall with diabetes, respectively. CONCLUSION: Fear of falling was an important risk factor of falls in both genders, especially in males. Handgrip strength was an important risk factor of falls specifically for females. By simultaneously screening fear of falling and handgrip strength, risk of falls in older adults with diabetes at outpatient clinics could be identified in a more timely manner. Impact Nurses could periodically and simultaneously assess fear of falling and handgrip strength of older adults with diabetes at outpatient clinics. For those are identified at risk of falls on either fear of falling or handgrip strength, nurses could provide corresponding interventions to reduce the fear of falling or improve muscle strength to prevent such falls.
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Diabetes Mellitus Tipo 2 , Fuerza de la Mano , Anciano , Anciano de 80 o más Años , Instituciones de Atención Ambulatoria , Estudios Transversales , Miedo , Femenino , Humanos , Masculino , Factores de Riesgo , Caracteres Sexuales , Taiwán/epidemiologíaRESUMEN
This study investigated the potential cumulative effect of maternal exposure to violence both at home and in community on children. This study used the data (N = 2506) from the Fragile Families and Child Wellbeing study. We found that maternal nonphysical victimization, either by witnessing violence in the community or by experiencing psychological domestic violence, had a direct negative effect on children's depression and anxiety. Maternal nonphysical victimization also indirectly elevated child's aggression through mother's use of psychological and physical aggression toward the child. Witnessing community violence by mothers, directly and indirectly, worsened the child's withdrawal behaviors through the mother's psychological aggression toward the child. Mother's direct victimization by community violence and physical domestic violence was not related to child's behavioral outcomes after controlling for other risk factors. This study points to important considerations for devising intervention and prevention for mothers and children. Implications for research and practice are discussed.
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Víctimas de Crimen , Violencia Doméstica , Agresión , Trastornos de Ansiedad , Niño , Femenino , Humanos , MadresRESUMEN
AIMS AND OBJECTIVES: To construct a path model addressing influences of diabetes distress, self-efficacy of injecting insulin, resilience and decisional balance of injecting insulin to quality of life (QoL) in insulin-treated patients with type 2 diabetes (T2DM). BACKGROUND: Insulin regimens more negatively impact QoL than oral medication treatments in patients with T2DM. Understanding the factors and influencing pathways associated with subsequent QoL will help nurses design timely interventions to improve QoL of insulin-treated T2DM patients. DESIGN: A 9-month prospective design was employed in this study. METHODS: Self-reported questionnaires were used to collect data from 185 insulin-treated T2DM patients. At baseline, diabetes distress and self-efficacy of injecting insulin were collected, while QoL, resilience and decisional balance of injecting insulin were collected 9 months later. Data were collected from February 2017 to February 2018. Structural equation modelling was used for analysis. This study was conducted based on the STROBE. RESULTS: Low baseline diabetes distress and high 9-month decisional balance of injecting insulin directly associated with high 9-month QoL. High baseline self-efficacy of injecting insulin and high 9-month resilience directly associated with high 9-month decisional balance of insulin injection and indirectly associated with high 9-month QoL. High baseline diabetes distress directly and indirectly associated with poor 9-month QoL. CONCLUSIONS: Diabetes distress, self-efficacy of injecting insulin, resilience and decisional balance of injecting insulin play different roles in associating with QoL in insulin-treated T2DM patients. RELEVANCE TO CLINICAL PRACTICE: Nurses could provide educational programs focusing on enhancing decisional balance of injecting insulin to improve QoL in insulin-treated patients. Improving self-efficacy of injecting insulin and resilience could be promising strategies to improve the decisional balance of injecting insulin. More timely assessment of diabetes distress and intervention might be powerful strategies to improve subsequent QoL in these patients.
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Diabetes Mellitus Tipo 2 , Calidad de Vida , Diabetes Mellitus Tipo 2/tratamiento farmacológico , Diabetes Mellitus Tipo 2/enfermería , Humanos , Insulina/uso terapéutico , Estudios Prospectivos , Autoeficacia , Encuestas y CuestionariosRESUMEN
Background: With the increasing incidence of mobile phone addiction, the potential risk factors of mobile phone addiction have attracted more and more researchers' attention. Although various personality trait factors have been proven to be significant predictors of mobile phone addiction, limited attention has been paid to preference for solitude. Considering the adverse impacts of preference for solitude in the context of collectivistic societies and its possible negative effect on mobile phone addiction, this study was designed to examine the relationship between preference for solitude and mobile phone addiction, and to test the mediating role of psychological distress and the moderating role of mindfulness in this relationship. Methods: Data were collected through convenience sampling from a comprehensive university in China. A total of 927 Chinese college students (371 males and 556 females), aged from 16 to 24 (M age = 19.89 years, SD = 1.22), participated in this study. Their preference for solitude, psychological distress, mindfulness, and mobile phone addiction were measured using well-validated self-report questionnaires. Results: Correlational analyses, sobel test, SPSS macro PROCESS (Model 8) and simple slopes analyses were used for major data analysis. Results showed that preference for solitude was significantly and positively associated with mobile phone addiction, and this link could be mediated by psychological distress. Moreover, the indirect effect of psychological distress in this link was moderated by mindfulness, with this effect being stronger for college students with lower levels of mindfulness. However, mindfulness can not moderate the direct relation between preference for solitude and mobile phone addiction. Conclusion: The present study broadened our knowledge of how and when (or for whom) preference for solitude is related to mobile phone addiction. Education professionals and parents should pay special attention to the psychological distress and mobile phone addiction of college students with high levels of preference for solitude, particularly for those with lower levels of mindfulness.
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Research on the impact of exposure to community violence tends to define victimization as a single construct. This study differentiates between direct and indirect violence victimization in their association with mental health problems and mental health service use. This study includes 8947 individuals from four waves of the National Longitudinal Study of Adolescent to Adult Health and examines (1) whether sub-types of adolescent victimization are linked to depressive symptoms; (2) whether adolescent victimization is linked with mental health service use; and (3) the role of mental health service use in attenuating symptoms arising from victimizations. Adolescents witnessing community violence were more likely to experience depressive symptoms during adolescence but not during their young adulthood; direct exposure to violence during adolescence does not predict depressive symptoms in adolescence but does in adulthood. Use of mental health service mediates report of depressive symptoms for adolescent witnessing community violence.
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Depresión/fisiopatología , Servicios de Salud Mental/estadística & datos numéricos , Violencia/psicología , Adolescente , Adulto , Víctimas de Crimen/psicología , Bases de Datos Factuales , Femenino , Humanos , Estudios Longitudinales , Masculino , Adulto JovenRESUMEN
BACKGROUND: Chemotherapy (CT) is the first priority treatment for advanced stage lung cancer. However, symptom distress, impaired ability to conduct daily activities, and post-CT care needs are potential side effects of CT. PURPOSE: To explore the factors related to the care needs of post-chemotherapy lung cancer patients. METHODS: A cross-sectional study was used. One hundred and twenty-one adult patients who had been diagnosed with advanced-stage lung cancer and who had undergone CT using the Platinum and Docetaxel doublet regimen were recruited from a medical center in southern Taiwan. The instruments used included a nursing care needs survey, symptoms distress scale, daily activity interference scale, and patient characteristics datasheet. RESULTS: Participants self-prioritized their emergency management, health consultation, and emotional support activities based on their perceived care needs. The top three post-CT symptoms in terms of severity were: fatigue, appetite change, and sleep disorder. Primary disruptions in daily activities during the post-CT period related to: holding social activities, work, and stair climbing. Significant and positive correlations were found among daily activity interference (r = .30, p < .01), symptoms distress (r = .23, p < .01), and care needs. The regression model indicated daily activity interference as a predictor of care needs, accounting for 10.7% of the total variance. CONCLUSIONS/IMPLICATIONS FOR PRACTICE: These results highlight the relationships among care needs, symptom distress, and daily activity interference in post-chemotherapy lung-cancer patients. The present study provides a reference for nursing care to reduce the symptom distress, to enhance the performance of daily activities, and to meet the care needs of lung-cancer patients.
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Necesidades y Demandas de Servicios de Salud , Neoplasias Pulmonares/tratamiento farmacológico , Adulto , Anciano , Femenino , Humanos , Neoplasias Pulmonares/enfermería , Masculino , Persona de Mediana EdadRESUMEN
Magnesium isoglycyrrhizinate (MI) has been complementarily used for restoring the hepatic impairments caused by taxol plus platinum based chemotherapies in China. Due to the hepatic dependence of paclitaxel elimination, this pilot clinical study aimed to investigate the influence of MI on the pharmacokinetics of paclitaxel in epithelial ovarian cancer patients. During the standard chemotherapy of intravenous paclitaxel (125 mg/m(2) infused over a 3-h period) and intraperitoneal cisplatin (60 mg/m(2)) for patients with FIGO stage II epithelial ovarian cancer, 9 each of total 18 patients were respectively treated with intravenous MI (100 mg) or vehicle control for 4 days. Plasma paclitaxel was analyzed by HPLC and the pharmacokinetic parameters were calculated with non-compartmental analysis. The hematological, hepatic and renal status was monitored before and 3 days after paclitaxel administration. It was observed the terminal t 1/2 and MRT of paclitaxel were significantly (p = 0.002 and 0.001) reduced by MI, respectively, from 11.0 ± 2.2 and 5.6 ± 1.0 h to 7.7 ± 1.7 and 4.0 ± 0.3 h. Hematological toxicity indicated by platelet count and hepatic events marked with ALT, AST and γ-GT were significant in both groups. In spite of the insignificance of decreased system exposure of paclitaxel and recovered hepatic function by MI, they did correlate with each other. It was therefore deduced that the liver toxicities of paclitaxel plus cisplatin chemotherapy potentially decrease hepatic elimination and increase system exposure of paclitaxel, and the recovery of liver function by MI helps to restore hepatic clearance of paclitaxel. The clinical significance of this pharmacokinetic interaction requires further studies with larger population size.
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Protocolos de Quimioterapia Combinada Antineoplásica/farmacocinética , Hígado/efectos de los fármacos , Neoplasias Glandulares y Epiteliales/tratamiento farmacológico , Neoplasias Ováricas/tratamiento farmacológico , Saponinas/uso terapéutico , Triterpenos/uso terapéutico , Protocolos de Quimioterapia Combinada Antineoplásica/efectos adversos , Área Bajo la Curva , Carcinoma Epitelial de Ovario , Cromatografía Líquida de Alta Presión , Cisplatino/administración & dosificación , Esquema de Medicación , Interacciones Farmacológicas , Femenino , Semivida , Humanos , Infusiones Intravenosas , Hígado/metabolismo , Tasa de Depuración Metabólica , Modelos Biológicos , Estadificación de Neoplasias , Neoplasias Glandulares y Epiteliales/metabolismo , Neoplasias Glandulares y Epiteliales/patología , Neoplasias Ováricas/metabolismo , Neoplasias Ováricas/patología , Paclitaxel/administración & dosificación , Paclitaxel/farmacocinética , Proyectos PilotoRESUMEN
In this work, we developed a low-cost, facile, sensitive, and selective colorimetric method for the quantitative determination of dopamine, based on 4-amino-3-hydrazino-5-mercapto-1,2,4-triazol (AHMT) functionalized gold nanoparticles (AHMP-AuNPs) as a model probe. Dopamine could induce the aggregation of the AHMT-AuNPs through hydrogen-bonding interactions, which caused the colloidal solution changed from red to blue. And the color change was in situ monitored for the quantitative determination of dopamine in human serum and urine samples. The developed approach is simple, without using complex financial instruments and adding other metal salts or ions for improving sensitivity.
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Colorimetría/métodos , Dopamina/análisis , Oro/química , Enlace de Hidrógeno , Nanopartículas del Metal , Dopamina/sangre , Dopamina/orina , Humanos , Concentración de Iones de Hidrógeno , Límite de Detección , Microscopía Electrónica de TransmisiónRESUMEN
Although fathers are increasingly a focus of attention in research, there is a dearth of research on depressive symptoms among fathers, especially young fathers with toddlers. This study used longitudinal data to examine what risk factors, including the age status of fathers (e.g., late adolescence, emerging adulthood, and adulthood), may be associated with depressive symptoms of fathers when their children were 3 and 5 years of age. A subsample of families for which complete data were available on all variables was used in the analyses (n = 1,403). About 46% of study sample was African American, 27% White, 23% Hispanic, and 4% other race/ethnicity. Paternal depressive symptoms were measured using Composite International Diagnostic Interview-Short Form (CIDI-SF). Late adolescent fatherhood was significantly associated with third-year paternal depressive symptoms but not with fifth-year depressive symptoms. Those who reported low social support were more likely to be depressed at both times. Fathers who did not work for regular pay were more likely to be depressed at the third-year follow-up, but not at the fifth-year follow-up. Parenting stress and being booked/charged with a crime were not associated with third-year paternal depressive symptoms, but were with fifth-year paternal depressive symptoms. This study emphasizes the importance of screening for depressive symptoms of fathers even before the birth of their child and monitoring and treating postpartum depressive symptoms, as first-year depressive symptoms was a significant predictor for third- and fifth-year depressive symptoms. Service providers should focus on the mental health of fathers as well as mothers to promote healthy environments for their children.
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Depresión/psicología , Relaciones Padre-Hijo , Padre/psicología , Relaciones Interpersonales , Conducta Paterna/psicología , Apoyo Social , Adolescente , Adulto , Factores de Edad , Actitud Frente a la Salud , Niño , Crianza del Niño/psicología , Depresión/epidemiología , Padre/estadística & datos numéricos , Femenino , Humanos , Masculino , Análisis Multivariante , Responsabilidad Parental/psicología , Factores Socioeconómicos , Estados Unidos/epidemiología , Adulto JovenRESUMEN
Placed in the historical context of government funding ofacademic research, this critical analysis identifies the complexities and implications of schools of social work pursuing federal grants for research. Schools of social work with particular organizational characteristics are better able to compete for federal grants, incurring lower opportunity costs than others. The low probability of grant success for most schools, the organizational adaptations needed for success, and the narrow epistemology of many funding programs call into question whether federal funding of research should be considered the sine qua non for academic social work.
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Financiación Gubernamental , Apoyo a la Investigación como Asunto , Servicio Social , Universidades , Investigación Conductal/economía , Humanos , National Institutes of Health (U.S.)/economía , Estados UnidosRESUMEN
Exposure to community violence can seriously threaten healthy adolescent development. This longitudinal study examines the relationship between exposure to violence in the community and the internalizing behaviors of Asian American and African American adolescents. Data analyzed was from 901 adolescents (57.9% female and 42.1% male, and 84.7% African American and 15.3% Asian American) who had participated in both Wave I and II interviews of the National Longitudinal Survey of Adolescent Health conducted between 1994 and 1996. Being female, having prior internalizing behaviors at baseline, and being exposed to violence significantly predicted African American adolescents' subsequent report of internalizing behaviors and their symptoms. Being female and having prior internalizing behaviors also predicted Asian American adolescents' subsequent internalizing behaviors and their symptoms. However, exposure to violence was not associated with Asian American adolescents' internalizing behaviors. Findings suggested a need to conceptualize mental health risk in a more nuanced context of cultural diversity.