The efficacy, challenges, and facilitators of telemedicine in post-treatment cancer survivorship care: an overview of systematic reviews.

BACKGROUND: Telemedicine services have been increasingly used to facilitate post-treatment cancer survivorship care, including improving access; monitoring health status, health behaviors, and symptom management; enhancing information exchange; and mitigating the costs of care delivery, especially since the COVID-19 pandemic. To inform guidance for the use of telemedicine in the post-COVID era, the aim of this overview of systematic reviews (SRs) was to evaluate the efficacy of, and survivor engagement in, telemedicine interventions in the post-treatment survivorship phase, and to consider implementation barriers and facilitators. METHODS: PubMed, Cochrane CENTRAL, CINAHL, Embase, and Web of Science databases were searched. SRs that examined the use of telemedicine in the post-treatment phase of cancer survivorship, published between January 2010 and April 2021, were included. Efficacy data were synthesized narratively. Implementation barriers and facilitators were synthesized using the Consolidated Framework for Implementation Research. RESULTS: Twenty-nine SRs were included. A substantive body of evidence found telemedicine to benefit the management of psychosocial and physical effects, particularly for improving fatigue and cognitive function. There was a lack of evidence on the use of telemedicine in the prevention and surveillance for recurrences and new cancers as well as management of chronic medical conditions. This overview highlights a range of diverse barriers and facilitators at the patient, health service, and system levels. CONCLUSIONS: This review highlights the benefits of telemedicine in addressing psychosocial and physical effects, but not in other areas of post-treatment cancer survivorship care. This large review provides practical guidance for use of telemedicine in post-treatment survivorship care.

The prevalence of unsuspected onychomycosis and its causative organisms in a multicentre Canadian sample of 30 000 patients visiting physicians' offices.

BACKGROUND: Onychomycosis is difficult to treat and a concern for many patients. Prevalence estimates of onychomycosis in North American clinic samples have been higher than what has been reported for general populations. OBJECTIVE: A large, multicentre study was conducted to estimate the prevalence of toenail onychomycosis in the Canadian population. METHODS: Patients were recruited from the offices of three dermatologists and one family physician in Ontario, Canada. Nail samples for mycological testing were obtained from normal and abnormal-looking nails. This sample of 32 193 patients includes our previous published study of 15 000 patients. RESULTS: Abnormal nails were observed in 4350 patients. Of these, the prevalence of culture-confirmed toenail onychomycosis was estimated to be 6.7% (95% CI, 6.41-6.96%). Following sex and age adjustments for the general population, the estimated prevalence of toenail onychomycosis in Canada was 6.4% (95% CI, 6.12%-6.65%). The distribution of fungal organisms in culture-confirmed onychomycosis was 71.9% dermatophytes, 20.4% non-dermatophyte moulds and 7.6% yeasts. Toenail onychomycosis was four times more prevalent in those over the age of 60 years than below the age of 60 years. CONCLUSION: The present data highlights that onychomycosis may be a growing medical concern among ageing patients.

Engineering the optical response of a-Se thin films by employing morphological disorder.

In this article, we experimentally demonstrate for the first time that photobleaching (PB) can be induced in morphologically disordered a-Se thin film, an observation which is opposite of the previously well-known photodarkening (PD) effects in morphologically ordered films. Further, the optical response of the film shows many fold increase with increase in control beam intensity. To explain the observed extraordinary phenomenon, we have proposed a model based on the morphological disorder of a modified surface and its subsequent photo-annealing. Our results demonstrate an efficient and yet simple new method to engineer the optical response of photosensitive thin films. We envision that this process can open up many avenues in optical field-enhanced absorption-based technologies.

Study of Ga incorporation in glassy arsenic selenides by high-resolution XPS and EXAFS.

Effect of Ga addition on the structure of vitreous As2Se3 is studied using high-resolution X-ray photoelectron spectroscopy and extended X-ray absorption fine structure techniques. The "8-N" rule is shown to be violated for Ga atoms and, possibly, for certain number of As atoms. On the contrary, Se keeps its 2-fold coordination according to "8-N" rule in the amorphous phase throughout all the compositions. Crystalline inclusions appear in the amorphous structure of the investigated glasses at Ga concentrations greater than 3 at. %. These inclusions are presumably associated with Ga2Se3 crystallites and transition phases/defects formed at the boundaries of these crystallites and host amorphous matrix. The existence of Ga-As and Se-Se bonds in the samples with higher Ga content is supported by present studies.

Treatment results in advanced stage Hodgkin's lymphoma: a retrospective study.

BACKGROUND: Hodgkin's lymphoma displays distinct epidemiological attributes in Asian population thus making it relevant to study whether there are any differences in treatment outcomes too when treated with current standard of care. AIM: To evaluate the treatment outcomes of de-novo advanced stage HL in adults. MATERIALS AND METHODS: This retrospective study included de-novo advanced stage HL patients (≥15 years) registered at our center from January 2004 to December 2007. Treatment outcomes were measured in terms of response rates, overall survival (OS) and progression-free survival (PFS). Overall and PFS were calculated with Kaplan-Meier methodology and Cox-proportional hazards model was used for multivariate analysis to identify prognostic factors. RESULTS: There were 125 patients (males 77%) who received minimum one cycle of chemotherapy with median age of 32 years (Range 15-65 years). Stage IV disease was seen in (46 patients) 37%; 75% (94 patients) patients had B symptoms. International prognostic score (IPS) ≤4 was seen in 95/112 (85%) patients. ABVD (adriamycin, bleomycin, vinblastine, dacarbazine) chemotherapy was given to 94%. Radiation to residual/bulky sites was given to 36% (45 patients). Response data was available for 112 patients; complete response in 76%; partial response in 10 % and progressive disease in 3 patients. Nineteen deaths (progressive disease-7, toxicity-8, unrelated cause-4) were observed. At median follow-up of 28 months, estimated 5-year OS and PFS were 60% and 58%, respectively. On multivariate analysis, IPS and response to treatment were significant factors for both OS and PFS. CONCLUSIONS: The treatment outcomes in this study are comparable with the published literature with limited follow-up data.

Complex structural rearrangements in As-Se glasses.

Structural relaxation of As-Se glasses through the glass-to-supercooled liquid transition interval is studied with temperature-modulated differential scanning calorimetry. It is shown that connectivity of glass network and long-term physical ageing change not only the full width at half maximum of the out-of-phase component of complex heat capacity, which is conventionally used for analysis, but also its asymmetry value. The latter is shown to carry very important information on the dynamic heterogeneity in glasses. Raman spectroscopy is used as complementary technique to reveal possible structural rearrangements in the investigated glass network.

Structural evolution of Ga-Ge-Te glasses by combined EXAFS and XPS analysis.

The structural evolution of GaxGeyTe100-x-y glasses in the vicinity of GeTe4-GaTe3 pseudo-binary tie-line is determined with high-resolution X-ray photoelectron (XPS) and extended X-ray absorption fine structure (EXAFS) spectroscopies. The analysis of XPS data is complicated by similar electronegativity values for the constituent chemical elements, but then the interpretation is facilitated by information from complementary EXAFS analysis of the structure around each element independently. The results show 4∕4∕2 coordination for Ga∕Ge∕Te atoms and absence of Ga(Ge)-Ge(Ga) bonds or extended Te clusters in significant concentrations within the whole range of studied composition. The observed structural features correlate well with the measured basic physical properties of Ga-containing germanium telluride glasses.

Hepatic Vascular Variants in Hereditary Haemorrhagic Telangiectasia: Imaging findings.

Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant disorder characterised by vascular dysplasia. Hepatic vascular malformations (VMs) range from small telangiectases to significant vascular shunting. Here we report two cases of HHT. Case 1 had diffuse ectasia of the hepatic artery along its intrahepatic and extrahepatic course with a hepatic arterial aneurysm. Case 2 presented with ileal and hepatic telangiectases. Knowledge of these vascular variants is indispensable for clinicians and radiologists in aiding diagnosis and surgical and interventional management.

Coexistence of fast photodarkening and slow photobleaching in Ge19As21Se60 thin films.

We experimentally demonstrate the coexistence of two opposite photo-effects, viz. fast photodarkening (PD) and slow photobleaching (PB) in Ge(19)As(21)Se(60) thin films, when illuminated with a laser of wavelength 671 nm. PD appears to begin instantaneously upon light illumination and saturates in tens of seconds. By comparison, PB is a slower process that starts only after PD has saturated. Both PD and PB follow stretched exponential dependence on time. Modeling of overall change as a linear sum of two contributions suggests that the changes in As and Ge parts of glass network respond to light effectively independent of each other.

Fabrication of nano-macroporous glass-ceramic bioscaffold with a water soluble pore former.

Recently, several methods have been reported for fabricating tailored amorphous multi porosity bioscaffolds for bone regeneration and tissue engineering. In particular, the melt-quench-heat-etch method appears attractive for making large and/or complex shape structures or fibers for flexible products. However, often the macropore size has been limited to <100 µm. In this paper we report an improved method for fabricating nano-macroporous soda lime phosphosilicate glass using sucrose as a macropore former. The composite compact consisting of soda lime phosphosilicate glass and sucrose powders is pressed in a die at room temperature. 3D interconnected macroporous structure is formed first by dissolving the sucrose part in water at room temperature, and then sintering the compact at temperatures above the glass transition temperature. Thus, interconnected macropores with controlled size (≥100 microns) are formed readily. The sintering heat-treatment also induces nanoscale phase separation, which is then exploited for introducing nanoscale porosity. For the latter goal, the sample is leached in HCl under optimized conditions to yield desired nano-macroporous glass for bone scaffold or other applications.

Impact of contact inhibition on collective cell migration and proliferation.

Contact inhibition limits migration and proliferation of cells in cell colonies. We consider a multiphase field model to investigate the growth dynamics of a cell colony, composed of proliferating cells. The model takes into account the mechanism of contact inhibition of proliferation by local mechanical interactions. We compare nonmigrating and migrating cells, in order to provide a quantitative characterization of the dynamics and analyze the velocity of the colony boundary for both cases. Additionally, we measure single cell velocities, number of neighbor distributions, as well as the influence of stress and age on positions of the cells and with respect to each other.

Evaluation of 3D nano-macro porous bioactive glass scaffold for hard tissue engineering.

Recently, nano-macro dual-porous, three-dimensional (3D) glass structures were developed for use as bioscaffolds for hard tissue regeneration, but there have been concerns regarding the interconnectivity and homogeneity of nanopores in the scaffolds, as well as the cytotoxicity of the environment deep inside due to limited fluid access. Therefore, mercury porosimetry, nitrogen absorption, and TEM have been used to characterize nanopore network of the scaffolds. In parallel, viability of MG 63 human osteosarcoma cells seeded on scaffold surface was investigated by fluorescence, confocal and electron microscopy methods. The results show that cells attach, migrate and penetrate inside the glass scaffold with high proliferation and viability rate. Additionally, scaffolds were implanted under the skin of a male New Zealand rabbit for in vivo animal test. Initial observations show the formation of new tissue with blood vessels and collagen fibers deep inside the implanted scaffolds with no obvious inflammatory reaction. Thus, the new nano-macro dual-porous glass structure could be a promising bioscaffold for use in regenerative medicine and tissue engineering for bone regeneration.

Optimization of process parameters for osmotic dehydration of papaya cubes.

Process temperature (30, 40 and 50 °C), syrup concentration (50, 60 and 70(o) Brix) and process time (4, 5 and 6 h) for osmotic dehydration of papaya (Carica papaya) cubes were optimized for the maximum water loss and optimum sugar gain by using response surface methodology. The peeled and pre-processed papaya cubes of 1 cm size were immersed in sugar syrup at constant temperature water bath having syrup to papaya cubes ratio of 4:1 (w/w). The cubes were removed from bath at pre-decided time, rinsed with water and weighed. Initial moisture content of papaya samples were 87.5-88.5% (wb), which was reduced to 67.6-81.1% after osmotic dehydration in various experiments showing mass reduction, water loss and sugar gain in the range of 20.6-36.4, 23.2-44.5 and 2.5-8.1%, respectively. The weight reduction, water loss and sugar gain data were statistically analyzed and regression equation of second order were found the best fit for all the experimental data. Maximum water loss of 28% with optimum sugar gain of 4% was predicted for the 60(o)Brix syrup concentration at 37 °C for syrup to fruit ratio as 4:1 in 4.25 h of osmotic dehydration.

Studies on moisture sorption isotherms for osmotically dehydrated papaya cubes and verification of selected models.

The water desorption properties of osmotically dehydrated papaya cubes at various temperatures were studied by fitting experimental isotherms in Henderson, Oswin, Chen and Clayton and Kuhn equations having 2 parameters and Henderson and Oswin equations were modified to describe the temperature dependence of isotherm data. Oswin equation was useful to predict the equilibrium moisture content values for use in determining the effective moisture diffusion coefficient during subsequent air drying process.

Dynamics of structural relaxation in bioactive 45S5 glass.

Kinetics of physical aging in archetypic 45S5 bioactive silicate glass composition with different types of phase separation are studied in situ below the glass transition temperature (T g). The qualitative nature of aging is found to be almost independent of the structural differences on the micrometer scale. A well-expressed step-like behavior in the enthalpy recovery kinetics is observed for aging temperatures T a ∼ 0.90T g and T a ∼ 0.85T g, which, however, disappears when the aging occurs at T a ∼ 0.95T g. The overall kinetics are described by a stretched-exponential function with stretching exponent close to 3/7 at T a ∼ 0.95T g, and 1/3 when the aging temperature drops to ∼0.90T g and below. The values correlate well with the predictions of Phillips' diffusion-to-traps and percolating fractals models. Appearance of step-like behavior at larger departure from T g is attributed to the hierarchical scheme of approaching equilibrium based on an alignment-shrinkage mechanism of physical aging proposed earlier for chalcogenide glasses.

Hybrid Modelling of Transarterial Chemoembolisation Therapies (TACE) for Hepatocellular Carcinoma (HCC).

We extend an agent-based multiscale model of vascular tumour growth and angiogenesis to describe transarterial chemoembolisation (TACE) therapies. The model accounts for tumour and normal cells that are both nested in a vascular system that changes its structure according to tumour-related growth factors. Oxygen promotes nutrients to the tissue and determines cell proliferation or death rates. Within the extended model TACE is included as a two-step process: First, the purely mechanical influence of the embolisation therapy is modelled by a local occlusion of the tumour vasculature. There we distinguish between partial and complete responders, where parts of the vascular system are occluded for the first and the whole tumour vasculature is destroyed for the latter. In the second part of the model, drug eluding beads (DEBs) carrying the chemotherapeutic drug doxorubicin are located at destroyed vascular locations, releasing the drug over a certain time-window. Simulation results are parameterised to qualitatively reproduce clinical observations. Patients that undergo a TACE-treatment are categorised in partial and complete responders one day after the treatment. Another 90 days later reoccurance or complete response are detected by volume perfusion computer tomography (VPCT). Our simulations reveal that directly after a TACE- treatment an unstable tumour state can be observed, where regrowth and total tumour death have the same likeliness. It is argued that this short time-window is favorable for another therapeutical intervention with a less radical therapy. This procedure can shift the outcome to more effectiveness. Simulation results with an oxygen therapy within the unstable time-window demonstrate a potentially positive manipulated outcome. Finally, we conclude that our TACE model can motivate new therapeutical strategies and help clinicians analyse the intertwined relations and cross-links in tumours.

Chromosomal aberrations induced in barley by LSD.

Seeds of hulled barley (Hordeum vulgare) were germinated and then treated with LSD. Preparations of squashed root tips stained with Feulgen revealed extensive chromosomal aberrations, most of which were chromosome breaks. Nearly half of the breaks occurred in the region of the primary constriction.

Development of nano-macroporous soda-lime phosphofluorosilicate bioactive glass and glass-ceramics.

We have extended the usefulness of bioactive glass-ceramics for the repair and reconstruction of hard tissues by introducing F ions that are known to be beneficial, especially in dentistry. Nano-macro multimodal porosity in soda-lime phosphofluorosilicate bulk samples was introduced by the recently developed melt-quench-heat-etch method. The choice of starting glass composition is based on 48SiO2-2.7P2O5-xCaF2-yCaO-zNa2O where x = 0, 1, 4, 8, 10, 12, and (y + z) = 49.3-x (mol%). The effect of thermal and chemical treatment on the microstructure of samples is characterized by SEM, XRD and EDX. We find the formation of many crystalline phases, but mainly sodium calcium silicate, calcium phosphate, fluorapatite and calcium silicate. The bioactivity of soda-lime phosphofluorosilicate glass-ceramics is assessed by monitoring the formation of hydroxyl apatite (HA) layer: fluorapatite phase accelerates the rate of HA layer formation; the initial composition and multi-modal porosity are other key parameters that impact the formation of HA. The present porous glass-ceramics should be superior candidates for use in dental bone regeneration.

An amphipathic trans-acting phosphorothioate RNA element delivers an uncharged phosphorodiamidate morpholino sequence in mdx mouse myotubes.

An efficient method for the delivery of uncharged polyA-tailed phosphorodiamidate morpholino sequences (PMO) in mammalian cells consists of employing a synthetic 8-mer amphipathic trans-acting poly-2'-O-methyluridylic thiophosphate triester element (2'-OMeUtaPS) as a transfection reagent. Unlike the dTtaPS DNA-based element, this RNA element is potent at delivering polyA-tailed PMO sequences to HeLa pLuc 705 cells or to myotube muscle cells. However, much like dTtaPS, the 2'-OMeUtaPS-mediated internalization of PMO sequences occurs through an energy-dependent mechanism; macropinocytosis appears to be the predominant endocytic pathway used for cellular uptake. The transfected PMO sequences induce alternate splicing of either the pre-mRNA encoding luciferase in HeLa pLuc 705 cells or the excision of exon 23 from the pre-mRNA encoding dystrophin in myotube muscle cells of the mdx mouse model of muscular dystrophy with an efficiency comparable to that of commercial cationic lipid reagents but without detrimental cytotoxicity.