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1.
J Colloid Interface Sci ; 613: 337-348, 2022 Jan 11.
Artigo em Inglês | MEDLINE | ID: mdl-35051719

RESUMO

Effective removal of polybrominated diphenyl ethers (PBDEs) from the environment is essential for the ecosystem and human health. Reductive debromination of PBDEs by nanoscale zerovalent iron (nZVI) has become an important technology. However, the agglomeration and low persistence catalytic activity of nZVI particles have become urgent problems to be improved. Herein, we report the first application of a new organo-attapulgite (OA) supported Fe/Pd nanoparticles (OA-Fe/Pd) composite for decabromodiphenyl ether (BDE209) removal. BDE209 was efficiently removed using OA-Fe/Pd with a reaction rate that was 9.97 times greater than that of the nZVI due to the synergetic effect of support material OA and Pd loading. OA could prevent nZVI particles from agglomeration and adsorb BDE209 molecules to its surface. Pd could supply atomic hydrogen and also prevent the oxidation of nZVI particles. The degradation of BDE209 by OA-Fe/Pd was affected by many factors and followed pseudo first-order kinetics. The degradation of BDE209 by OA-Fe/Pd underwent a stepwise debromination manner with the H-transfer dominant mechanism. BDE209 (25 mg∙L-1) could be degraded to penta-BDEs to diphenyl ether (DE) by 3.0 g∙L-1 OA-Fe/Pd within 240 min under neutral condition. This study provides some inspiration for improving the removal efficiency of PBDEs with nZVI-based materials.

2.
Support Care Cancer ; 2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-35059866

RESUMO

PURPOSE: Chemotherapy-induced peripheral neuropathy (CIPN) is a common side effect of anticancer treatment based on neurotoxic agents, which may affect function and health-related quality of life (HRQoL) in patients with cancer. This exploratory study aimed to identify the phenotype of CIPN and examine the association of CIPN with general symptoms and HRQoL in patients with cancer. METHODS: A secondary analysis was performed on the baseline multimodal assessment data of 87 patients with cancer who participated in a randomized trial examining the effectiveness of an 8-week acupuncture protocol in managing CIPN. The data used for this study include patient-reported CIPN, general symptoms, and HRQoL, neurological examinations, and clinician-based grading of CIPN. Descriptive statistics, non-parametric tests, and hierarchical cluster analysis were used for data analysis. RESULTS: Patients with CIPN experienced a series of symptoms, with numbness, tingling, and discomfort in the hands and feet being the most prominent descriptors pertaining to CIPN. Increased severity of CIPN was associated with higher distress from general symptoms and lower physical well-being. These CIPN-specific and general symptoms formed five independent symptom clusters, including two sensory neuropathy symptom clusters, a sensorimotor neuropathy one, a neuro-psychological one, and an autonomic symptom cluster. Painful CIPN was significantly associated with higher symptom burden, lower physical well-being, and impaired tendon reflex. No significant difference was found between type of neurotoxic agents in symptom burden, neurological signs, and HRQoL. CONCLUSION: Researchers and clinicians should pay attention to the characteristics and impact of CIPN from multiple aspects, so as to develop targeted interventions to meet patients' holistic needs. Painful CIPN warrants particular attention as it is associated with higher symptom burden and lower physical well-being in patients with cancer.

3.
JBI Evid Synth ; 2022 Jan 10.
Artigo em Inglês | MEDLINE | ID: mdl-35013041

RESUMO

OBJECTIVE: The objective of this review is to determine the effectiveness of behavioral economic interventions for promoting uptake of and adherence to cancer screening recommended by guidelines. INTRODUCTION: Cancer screening has been found to help reduce incidence of and mortality from advanced cancer. However, adherence to recommended cancer screening services is low in asymptomatic adults with average risk possibly due to systematic decision biases. The findings of this review will demonstrate whether interventions informed by behavioral economic insights can help improve uptake of and adherence to cancer screening. INCLUSION CRITERIA: This review will consider studies that meet the following inclusion criteria: experimental, quasi-experimental, and analytical observational studies that i) evaluate the effects of behavioral economic interventions in adults eligible for guideline-recommended cancer screening, and that ii) report the number/percentage of individuals who used screening services; number/percentage of individuals who completed screening recommended by guidelines; participant self-reported intentions, choice, and satisfaction regarding the use of screening services; detection rates of early-stage cancers; use of early intervention for cancers; and cancer-related mortality. METHODS: A systematic literature search will be performed by one reviewer. After removing duplicates, two reviewers will independently screen and appraise eligible studies according to the JBI methodology for systematic reviews of effectiveness. Five databases will be searched: CINAHL, the Cochrane Library, PsycINFO, PubMed, and Web of Science. Sources of gray literature and registered clinical trials will also be searched for potential studies. There will be no limits to publication date or language. Data synthesis will be conducted using meta-analysis and narrative synthesis where appropriate. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021258370.

4.
Biofabrication ; 14(2)2022 Jan 24.
Artigo em Inglês | MEDLINE | ID: mdl-35008080

RESUMO

Thrombosis in the circulation system can lead to major myocardial infarction and cardiovascular deaths. Understanding thrombosis formation is necessary for developing safe and effective treatments. In this work, using digital light processing (DLP)-based 3D printing, we fabricated sophisticatedin vitromodels of blood vessels with internal microchannels that can be used for thrombosis studies. In this regard, photoacoustic microscopy (PAM) offers a unique advantage for label-free visualization of the 3D-printed vessel models, with large penetration depth and functional sensitivity. We compared the imaging performances of two PAM implementations: optical-resolution PAM and acoustic-resolution PAM, and investigated 3D-printed vessel structures with different patterns of microchannels. Our results show that PAM can provide clear microchannel structures at depths up to 3.6 mm. We further quantified the blood oxygenation in the 3D-printed vascular models, showing that thrombi had lower oxygenation than the normal blood. We expect that PAM can find broad applications in 3D printing and bioprinting forin vitrostudies of various vascular and other diseases.

5.
ACS Synth Biol ; 11(1): 317-324, 2022 Jan 21.
Artigo em Inglês | MEDLINE | ID: mdl-34915706

RESUMO

Current tools for detecting transgenic crops, such as polymerase chain reaction (PCR), require professional equipment and complex operation. Herein, we introduce a clustered regularly interspaced short palindromic repeats (CRISPR)/Cas system to analyze transgenes by designing an isothermal amplification to serve as the amplified reporter, allowing an isothermal and label-free detection of transgenic crops. The use of Cas12a allowed direct and specific recognition of transgenes. To enhance the sensitivity of the assay, we used rolling circle amplification (RCA) to monitor the recognition of transgenes by designing the RCA primer as the cleavage substrate of Cas12a. The presence of transgenes can be detected by monitoring the G-quadruplex in RCA amplicon using a G-quadruplex binding dye, N-methyl mesoporphyrin IX (NMM). We termed the assay as isoCRISPR and showed that the assay allowed distinguishing transgenic corn cultivars ("Bt11" and "MON89034") from nontransgenic corn cultivars ("yellow", "shenyu", "xianyu", and "jingke"). The isoCRISPR assay will enrich the toolbox for transgenic crop identification and broaden the application of CRISPR/Cas in food authenticity and safety.

6.
J Pharm Biomed Anal ; 207: 114342, 2022 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-34634530

RESUMO

Artesunate-mefloquine is one of the commonly-used artemisinin-based combination therapies (ACTs). Given the significance of drug quality in the management of malaria cases, the objective of this study was to develop antibody-based assays as the point-of-care (POC) tests for monitoring the quality of this ACT. Using mefloquine conjugated to a carrier protein as the immunogen, we selected a specific monoclonal antibody (mAb) against mefloquine with no cross-reactivity to other antimalarial drugs. Using this mAb, we developed a direct competitive enzyme-linked immunosorbent assay (dcELISA) and a lateral flow immunoassay (LFIA) to measure the mefloquine contents. The dcELISA for mefloquine showed a 50% inhibitory concentration (IC50) and a working range of 2.79 ng/mL and 0.58-16.37 ng/mL, respectively. With the aid of a portable optical scanner, the LFIA had a working range of 0.15-2.67 µg/mL for mefloquine. When used to measure mefloquine contents in commercial drugs, the dcELISA and LFIA results were compatible with those determined using high-performance liquid chromatography. Using the same LFIA format, we developed a combination LFIA, which correctly estimated the artesunate and mefloquine contents in commercial ACTs. Therefore, both LFIAs could be used as POC devices for rapid quality control of artesunate and mefloquine in ACTs.


Assuntos
Antimaláricos , Antimaláricos/uso terapêutico , Artesunato , Quimioterapia Combinada , Imunoensaio , Mefloquina , Controle de Qualidade
7.
Drug Des Devel Ther ; 15: 4849-4863, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34876807

RESUMO

Type 2 diabetes mellitus (T2DM) is a widespread metabolic disease characterized by chronic hyperglycemia. Human microbiota, which is regarded as a "hidden organ", plays an important role in the initiation and development of T2DM. In addition, anti-hyperglycemic agents and traditional Chinese medicine may affect the composition of gut microbiota and consequently improve glucose metabolism. However, the relationship between gut microbiota, T2DM and anti-hyperglycemic agents or traditional Chinese medicine is poorly understood. In this review, we summarized pre-clinical and clinical studies to elucidate the possible underlying mechanism. Some anti-hyperglycemic agents and traditional Chinese medicine may partly exert hypoglycemic effects by altering the gut microbiota composition in ways that reduce metabolic endotoxemia, maintain the integrity of intestinal mucosal barrier, promote the production of short-chain fatty acids (SCFAs), decrease trimethylamine-N-oxide (TMAO) and regulate bile acid metabolism. In conclusion, gut microbiota may provide some new therapeutic targets for treatment of patients with diabetes mellitus.

8.
FEMS Microbiol Lett ; 2021 Dec 04.
Artigo em Inglês | MEDLINE | ID: mdl-34864963

RESUMO

Aiming to reveal the molecular mechanisms involved in right- and left-sided colorectal cancer (CRC) development, CRC gene expression data and a microorganism atlas were downloaded from The Cancer Genome Atlas and The Cancer Microbiome Atlas, respectively. The R package was used to screen differentially expressed genes (DEGs) between right- and left-sided CRC samples and identify those related to prognosis, a correlation analysis was performed between DEGs and prognosis-related microbiota, and an interaction network was created using Cytoscape. Finally, a taxon set enrichment analysis of the microbiota was performed and a gene-genus-pathway network was constructed after GO and KEGG analyses. In total, 9 out of 1557 identified DEGs had a significant correlation with prognosis, whereas 3 out of 211 bacterial genera (Fusobacterium, Bacteroides, and Parabacteroides) showed a significant correlation with prognosis. DEGs were mainly enriched in the PPAR pathway and vitamin metabolic and transport processes. According to a taxon set enrichment analysis, the microbes in the integrated network were significantly abundant in 28 host-intrinsic, 2 host-extrinsic, and 1 environment taxon sets. This study provides new insights for understanding the molecular mechanisms of left- and right- CRC.

9.
Mater Today Bio ; 12: 100162, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34870141

RESUMO

Biofabrication via light-based 3D printing offers superior resolution and ability to generate free-form architectures, compared to conventional extrusion technologies. While extensive efforts in the design of new hydrogel bioinks lead to major advances in extrusion methods, the accessibility of lithographic bioprinting is still hampered by a limited choice of cell-friendly resins. Herein, we report the development of a novel set of photoresponsive bioresins derived from ichthyic-origin gelatin, designed to print high-resolution hydrogel constructs with embedded convoluted networks of vessel-mimetic channels. Unlike mammalian gelatins, these materials display thermal stability as pre-hydrogel solutions at room temperature, ideal for bioprinting on any easily-accessible lithographic printer. Norbornene- and methacryloyl-modification of the gelatin backbone, combined with a ruthenium-based visible light photoinitiator and new coccine as a cytocompatible photoabsorber, allowed to print structures resolving single-pixel features (∼50 â€‹µm) with high shape fidelity, even when using low stiffness gels, ideal for cell encapsulation (1-2 â€‹kPa). Moreover, aqueous two-phase emulsion bioresins allowed to modulate the permeability of the printed hydrogel bulk. Bioprinted mesenchymal stromal cells displayed high functionality over a month of culture, and underwent multi-lineage differentiation while colonizing the bioresin bulk with tissue-specific neo-deposited extracellular matrix. Importantly, printed hydrogels embedding complex channels with perfusable lumen (diameter <200 â€‹µm) were obtained, replicating anatomical 3D networks with out-of-plane branches (i.e. brain vessels) that cannot otherwise be reproduced by extrusion bioprinting. This versatile bioresin platform opens new avenues for the widespread adoption of lithographic biofabrication, and for bioprinting complex channel-laden constructs with envisioned applications in regenerative medicine and hydrogel-based organ-on-a-chip devices.

10.
Adv Healthc Mater ; : e2102411, 2021 Dec 03.
Artigo em Inglês | MEDLINE | ID: mdl-34860472

RESUMO

The 3D bioprinting technologies have attracted increasing attention due to their flexibility in producing architecturally relevant tissue constructs. Here, a vertical embedded extrusion bioprinting strategy using uniaxial or coaxial nozzles is presented, which allows formation of vertical structures of homogeneous or heterogeneous properties. By adjusting the bioprinting parameters, the characteristics of the bioprinted vertical patterns can be precisely controlled. Using this strategy, two proof-of-concept applications in tissue biofabrication are demonstrated. Specifically, intestinal villi and hair follicles, two liner-shaped tissues in the human body, are successfully generated with the vertical embedded bioprinting method, reconstructing some of their key structures as well as restoring partial functions in vitro. Caco-2 cells in the bioprinted intestinal villus constructs proliferated and aggregated properly, also showing functional biomarker expressions such as ZO-1 and villin. Moreover, preliminary hair follicle structures featuring keratinized human keratinocytes and spheroid-shaped human dermal papilla cells are formed after vertical bioprinting and culturing. In summary, this vertical embedded extrusion bioprinting technique harnessing a uniaxial or coaxial format will likely bring further improvements in the reconstruction of certain human tissues and organs, especially those with a linear structure, potentially leading to wide utilities in tissue engineering, tissue model engineering, and drug discovery.

11.
Adv Mater ; : e2108931, 2021 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-34935203

RESUMO

Due to poor mechanical properties of many hydrogel bioinks, conventional three-dimensional (3D) extrusion bioprinting is usually conducted based on the X-Y plane, where the deposited layers are stacked in the Z direction with or without the support of prior layers. Herein, we report a technique taking advantage of a cryoprotected bioink to enable direct extrusion bioprinting in the vertical direction in the presence of cells, using a freezing plate with precise temperature-control. Of interest, vertical 3D cryobioprinting concurrently allows the user to create freestanding filamentous constructs containing interconnected, anisotropic microchannels featuring gradient sizes aligned in the vertical direction, also associated with enhanced mechanical performances. Skeletal myoblasts within the 3D-cryobioprinted hydrogel constructs show enhanced cell viability, spreading, and alignment, compared to the same cells in the standard hydrogel constructs. This method is further extended to a multi-material format, finding potential applications in interface tissue engineering, such as creation of the muscle-tendon unit and the muscle-microvascular unit. The unique vertical 3D cryobioprinting technique presented here suggests improvements in robustness and versatility to engineer certain tissue types especially those anisotropic in nature, and may extend broad utilities in tissue engineering, regenerative medicine, drug discovery, and personalized therapeutics. This article is protected by copyright. All rights reserved.

13.
Anal Bioanal Chem ; 2021 Nov 30.
Artigo em Inglês | MEDLINE | ID: mdl-34846541

RESUMO

Amodiaquine (AQ) is a commonly used antimalarial drug, and N-desethyl-AQ (N-DEAQ) is an active metabolite of AQ. Given the significance of drug quality in the management of malaria cases, this study aims to develop antibody-based assays for the detection and quantitation of AQ without the need for sophisticated equipment. Two monoclonal antibodies (mAbs) against AQ, designated as JUN7 and TE7, were selected, which showed 72.7% and 9.5% cross-reactivity to N-DEAQ, respectively. These mAbs showed <0.1% cross-reactivity to other commonly used antimalarial drugs. An indirect competitive enzyme-linked immunosorbent assay (icELISA) based on JUN7 showed a 50% inhibitory concentration (IC50) of 0.16 ng/mL and a working range of 0.06-0.46 ng/mL. A lateral flow immunoassay (LFIA) based on JUN7 was also developed with a working range of 2.58-30.86 ng/mL. The icELISA and LFIA were applied for the quantification of AQ in commercial drugs, and the results were comparable to those determined using high-performance liquid chromatography. In addition, a combination dipstick for simultaneous, qualitative analysis of AQ and artesunate was developed. All immunoassays based on JUN7 can be applied for quality control of AQ-containing artemisinin-based combination therapies. As TE7 showed low cross-reactivity to N-DEAQ, an icELISA based on TE7 was developed with an IC50 of 0.38 ng/mL and a working range of 0.14-1.67 ng/mL. The TE7 icELISA was applied for the study of pharmacokinetics of AQ in rat serum after intragastric administration, and the results were consistent with those of previous studies.

14.
Artigo em Inglês | MEDLINE | ID: mdl-34776375

RESUMO

To understand the stability of protein in confined environment, the near-infrared (NIR) spectra of aqueous solutions and reverse micelles (RMs) containing bovine serum albumin (BSA), human serum albumin (HSA) and ovalbumin (OVA) were measured at different temperature. With the resolution enhanced spectra calculated by continuous wavelet transform (CWT), the intensity change of the α-helix band at 4617 cm-1 with temperature shows a clear denaturation of the protein in aqueous solution but not in RMs. The effect of the confined environment on the stability of the proteins is indicated. More importantly, the intensity change of the spectral bands of water around 6956 and 6842 cm-1 provide an evidence for the denaturation, suggesting that water can be a probe exhibiting the structural change of proteins. Furthermore, comparing the spectral features of different water structures obtained by principal component analysis (PCA) from the spectra of RM with and without BSA, it is demonstrated that the bridging water connecting NH in protein and SO in the inner surface of RM may be the reason for the stabilization.

15.
Se Pu ; 39(11): 1213-1221, 2021 Nov.
Artigo em Chinês | MEDLINE | ID: mdl-34677016

RESUMO

As among the most widely used pesticides in agriculture, plant growth regulators (PGRs) have a positive influence on plants. However, the overuse of PGRs may induce toxicity in food and even be hazardous to human health. Numerous studies have investigated the presence and residues of PGRs on vegetables and fruits. Animal-derived foods are one of the most dominant food sources providing nutrients to fulfil the daily dietary intake, and could also be potentially contaminated by PGRs. However, there is little information on PGR residues in animal-derived foods. Standardization also lacks among the techniques for PGR determination in animal-derived foods, thereby restricting the further establishment of pesticide usage and food safety regulations. Therefore, in this study, a rapid and effective method for analyzing chlormequat chloride, thidiazuron, and paclobutrazol in animal-derived food samples was established. The method primarily involves high performance liquid chromatography-tandem mass spectrometry combined with the use of isotope-labeled internal standards. The extraction and clean-up procedures were based on the QuEChERS method. The analytes were extracted from pork, beef, chicken, pork liver, egg, and milk samples using acetonitrile, followed by 4 g anhydrous magnesium sulfate (MgSO4), and 1 g sodium chloride (NaCl). The supernatant was removed using a mixture of 50 mg N-propyl ethylenediamine (PSA), 50 mg octadecyl silane (C18), and 150 mg MgSO4, and then passed through a 0.22 µm membrane filter before determination. The Agilent ZORBAX Eclipse Plus C18 column (150 mm×3.0 mm, 1.8 µm) was used to separate the analytes under a gradient elution program, with acetonitrile and 5 mmol/L ammonium acetate solution as mobile phases. The analytes were detected by mass spectrometry using the positive and negative electrospray ionization modes under the multiple reaction monitoring mode. Matrix-matched calibration combined with internal standards was used to quantify the PGRs. The linear regression correlation coefficients (r2) for the PGRs were all greater than 0.990 in the corresponding linear concentration ranges. Chlormequat chloride, thidiazuron, and paclobutrazol showed good linearities in the range of 0.1-100 µg/L for the egg and pork liver samples and 0.1-50 µg/L for the pork, beef, and chicken samples. For the milk samples, thidiazuron and paclobutrazol showed good linearities in the range of 0.05-10 µg/L, while chlormequat chloride showed linearity in the range of 0.05-5 µg/L. The limit of detection (LOD) and limit of quantification (LOQ) for each PGR were based on the signal-to-noise (S/N) ratios. Under optimal conditions, the LODs ranged from 0.01 µg/kg to 0.1 µg/kg, where the LOD was defined as the amount of the tested compound that generated an S/N ratio higher than 3. In addition, the LOQs were in the range of 0.5-5 µg/kg, with an S/N ratio higher than 10. The precision and accuracy were evaluated by recovery experiments. At the LOQ, twice the LOQ, and 10 times the LOQ, the mean recoveries were in the range of 70.0%-117.4%, and the relative standard deviations (RSDs) ranged from 0.8% to 16.1%. The results indicated that the proposed method is accurate and reliable. This method is a modification of the QuEChERS method, and is advantageous owing to its simplicity and high sensitivity. The use of matrix-matching calibration curves and internal standards can eliminate matrix interference, thereby increasing the accuracy of the method. This method satisfies the testing requirements for chlormequat chloride, thidiazuron, and paclobutrazol residues in animal-derived foods, and is promising for the determination of other PGRs or other types of pesticides in animal-derived foods.


Assuntos
Reguladores de Crescimento de Plantas , Espectrometria de Massas em Tandem , Animais , Bovinos , Cromatografia Líquida de Alta Pressão , Humanos , Isótopos , Padrões de Referência , Extração em Fase Sólida
16.
Diabetes Metab Syndr Obes ; 14: 4297-4306, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34703262

RESUMO

Background: Although the concentrations of progesterone (P4) and 17-hydroxyprogesterone (17-OHP) have been correlated with some characteristics of metabolic syndrome (MetS), the relationships with MetS are inconclusive. Therefore, we investigated the relationship between P4 and 17-OHP with MetS. Methods: In all, the present study includes 4807 participants. Serum P4 and 17-OHP were measured through liquid chromatography-tandem mass spectrometry. Logistic regression and restricted cubic splines were used to assess the independent and combined effects of P4 and 17-OHP on MetS. Results: After adjusting for multiple variables, the positive association of P4 with MetS was observed in postmenopausal women (Third tertiles vs First tertiles: OR = 1.49, 95% CI: 1.20-1.86) and the negative association of 17-OHP with MetS was observed in men (Third tertiles vs First tertiles: OR = 0.43, 95% CI: 0.32-0.58). Compared with the combination of low P4 and low 17-OHP, the combination of high P4 and high 17-OHP were significantly related to MetS in postmenopausal women (OR = 1.71, 95% CI: 1.18-2.48). Moreover, the combination of low P4 and high 17-OHP was negatively associated with MetS in men (OR = 0.41, 95% CI: 0.24-0.69). Conclusion: The association between P4 and MetS in postmenopausal women was positive, whereas 17-OHP was negatively associated with MetS in men. Additionally, their combination has a synergistic effect on MetS in postmenopausal women and an antagonistic effect on MetS in men.

17.
Lung Cancer ; 162: 1-8, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34634754

RESUMO

OBJECTIVES: Patients with lung cancer have high symptom burden and diminished quality of life. Electronic patient-reported outcome (PRO) platforms deliver repeated longitudinal surveys via web or telephone to patients and alert clinicians about concerning symptoms. This study aims to determine feasibility of electronic PRO monitoring in lung cancer patients receiving treatment in community settings. METHODS: Adults receiving treatment for advanced or metastatic lung cancer at 26 community sites were invited to participate in a prospective trial of weekly electronic PRO symptom monitoring for 12 months (NCT03249090). Surveys assessing patients' satisfaction with the electronic PRO system were administered at 3 months. Descriptive statistics were generated for demographics, survey completion rates, symptom occurrence, and provider PRO alert management approaches. Pairwise relationships between symptom items were evaluated using intra-individual repeated-measures correlation coefficients. RESULTS: Lung cancer patients (n = 118) participating in electronic PROs were older (mean 64.4 vs 61.9 years, p = 0.03), had worse performance status (p = 0.002), more comorbidities (p = 0.02), and less technology experience than patients with other cancers. Of delivered weekly PRO surveys over 12 months, 91% were completed. Nearly all (97%) patients reported concerning (i.e., severe or worsening) symptoms during participation, with 33% of surveys including concerning symptoms. Pain was the most frequent and longest lasting symptom and was associated with reduced activity level. More than half of alerts to clinicians for concerning symptoms led to intervention. The majority (87%) would recommend using electronic PRO monitoring to other lung cancer patients. CONCLUSIONS: Remote longitudinal weekly monitoring of patients with lung cancer using validated electronic PRO surveys was feasible in a multicenter, community-based pragmatic study. A high symptom burden specific to lung cancer was detected and clinician outreach in response to alerts was frequent, suggesting electronic PROs may be a beneficial strategy for identifying actionable symptoms and allow opportunities to optimize well-being in this population.

18.
Stat Methods Med Res ; 30(12): 2604-2618, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-34617840

RESUMO

The use of patient-reported outcomes measures is gaining popularity in clinical trials for comparing patient groups. Such comparisons typically focus on the differences in group means and are carried out using either a traditional sum-score-based approach or item response theory (IRT)-based approaches. Several simulation studies have evaluated different group mean comparison approaches in the past, but the performance of these approaches remained unknown under certain uninvestigated conditions (e.g. under the impact of differential item functioning (DIF)). By incorporating some of the uninvestigated simulation features, the current study examines Type I error, statistical power, and effect size estimation accuracy associated with group mean comparisons using simple sum scores, IRT model likelihood ratio tests, and IRT expected-a-posteriori scores. Manipulated features include sample size per group, number of items, number of response categories, strength of discrimination parameters, location of thresholds, impact of DIF, and presence of missing data. Results are summarized and visualized using decision trees.

19.
Am J Hosp Palliat Care ; : 10499091211049801, 2021 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-34619978

RESUMO

PURPOSE: When patients with advanced cancer have minor children (age < 18), their health-related quality of life is closely linked to their concerns about the impact of progressive illness and death on their children. The Parenting Concerns Questionnaire (PCQ), a validated measure for parents with cancer, does not capture the full range of concerns in advanced cancer. The aim of this was study was to adapt and establish psychometrics for the PCQ for advanced disease (PCQ-AD). METHODS: After generating an initial item-bank, we conducted concept elicitation interviews with clinicians (n = 8) and cognitive interviews with patients (n = 23) for face validity. New items addressed concerns about impact of parental death, making every moment count, communication, and financial impact of cancer on children. We administered 21 candidate items to 151 parents with advanced cancer. We conducted confirmatory factor analysis (CFA), calculated internal consistency, and assessed convergent and known-groups validity. RESULTS: We removed 8 redundant items due to residual covariation between items. CFA of the 13-item PCQ-AD demonstrated satisfactory fit (CFI = 0.971, TLI = 0.966, RMSEA = 0.081) and high internal consistency (Cronbach's alpha = 0.94, composite reliability = 0.95). The PCQ-AD demonstrated convergent validity and known-groups validity; patients with poor functional status reported higher scores than patients with better functional status (Cohen's d = 0.56, p = 0.002). CONCLUSION: Adaptation of the PCQ yielded the addition of constructs important in advanced cancer. The PCQ-AD appears to be a reliable and valid measure of parenting concerns in advanced cancer, but future studies are needed to examine measure performance in diverse populations and responsiveness of the PCQ-AD to interventions.

20.
Heart Surg Forum ; 24(5): E797-E800, 2021 Sep 13.
Artigo em Inglês | MEDLINE | ID: mdl-34623256

RESUMO

BACKGROUND: Cardiac papillary fibroelastoma is a rare, benign primary cardiac tumor that remains asymptomatic. Severe complications have been reported in some cases. The only effective therapy is surgical excision. CASE PRESENTATION: Here, we report a case of cardiac papillary fibroelastoma with the initial symptom of chest pain and a first diagnosis of acute left main coronary artery disease. This patient eventually underwent tumor excision surgery and recovered well. CONCLUSION: For patients with symptomatic cardiac papillary fibroelastoma, we provide a series of comprehensive data from before, during, and after surgery. This might be helpful for the future diagnosis and treatment of these tumors.

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