Goal
Men diagnosed with prostate cancer experience high decision-related distress concurrent with cancer-related distress. Psycho-education, problem solving and decision support were integrated in a ...novel telephone-delivered supportive care intervention targeting men at diagnosis and assessed for feasibility.
Materials and Methods
An exploratory single-group pre–post-test design tracked session frequency, duration and content. Standardised measures assessed decisional conflict, cancer-related distress and decision involvement. Brief screening measures for psychological and decision-related distress were incorporated into the intervention protocol. Twenty men (77% response) newly diagnosed with localised prostate cancer received the intervention.
Results
Men who were undecided about treatment at study entry required more pre-treatment intervention calls (
p
< 0.013). Pre-treatment support calls were longer (
M
= 40.2 min) and more complex by comparison to post-treatment calls (
M
= 30.9 min;
p
< 0.002). Brief screening for decision-related distress correlated with concurrent (
p
< 0.008) and prospective (
p
< 0.046) decisional conflict. Decisional conflict and intrusion decreased at post-test (
p
< 0.001;
p
< 0.005). Men reported a high level of satisfaction with the support received with benefits identified including anonymity and accessibility.
Conclusions
In this setting, a tele-based supportive care and decision support intervention for men newly diagnosed with prostate cancer was feasible. The use of brief screening measures as within-intervention clinical tools appears promising.
Early postnatal overnutrition in humans is associated with long-term negative outcomes including obesity, increased risk of type-II diabetes, and cardiovascular disease. Hypothalamic neurons from ...rodents exposed to early postnatal overnutrition show altered expression of satiety signals and receptors, and exhibit altered responses to many satiety signals, suggesting a hypothalamic link between early overnutrition and development of these sequelae. Importantly, several hypothalamic nuclei receive information regarding circulating hormones (such as insulin, leptin and ghrelin) from the subfornical organ (SFO), a forebrain sensory circumventricular organ which lacks a blood brain barrier. Previous transcriptomic studies indicate that challenges to energy balance and hydration status stimulate changes in gene expression within the SFO, including genes encoding ion channels and receptors. In order to determine if early postnatal overnutrition also causes changes in SFO gene expression which may be associated with homeostatic dysregulation, we performed whole transcriptome sequencing on SFO tissue from rats raised in small (4 pups), or control (large, 12 pups) litters. Illumina RNA sequencing was performed on SFO tissue from rats raised from small and large litters, and read sequences were aligned to the Rat Rnor_6.0 genome. Control data were further compared to previously published microarray data set for validation. We found statistically significant (p<0.05) changes in expression of 12 transcripts, three of which have likely roles in neuronal excitability, neurite outgrowth and differentiation, and food intake (Manf, Slc24a4, Cracr2b). Additionally, gene ontology analysis identified a trend among significantly altered transcripts in roles for oxidative stress response. We conclude that the SFO transcriptome is subtly altered by early postnatal overnutrition, and recommend further investigation of the effect of early postnatal overnutrition on SFO physiology and morphology.
The spine is routinely subjected to repetitive complex loading consisting of axial compression, torsion, flexion and extension. Mechanical loading is one of the important causes of spinal diseases, ...including disc herniation and disc degeneration. It is known that static and dynamic compression can lead to progressive disc degeneration, but little is known about the mechanobiology of the disc subjected to combined dynamic compression and torsion. Therefore, the purpose of this study was to compare the mechanobiology of the intervertebral disc when subjected to combined dynamic compression and axial torsion or pure dynamic compression or axial torsion using organ culture. We applied four different loading modalities 1. control: no loading (NL), 2. cyclic compression (CC), 3. cyclic torsion (CT), and 4. combined cyclic compression and torsion (CCT) on bovine caudal disc explants using our custom made dynamic loading bioreactor for disc organ culture. Loads were applied for 8 h/day and continued for 14 days, all at a physiological magnitude and frequency. Our results provided strong evidence that complex loading induced a stronger degree of disc degeneration compared to one degree of freedom loading. In the CCT group, less than 10% nucleus pulposus (NP) cells survived the 14 days of loading, while cell viabilities were maintained above 70% in the NP of all the other three groups and in the annulus fibrosus (AF) of all the groups. Gene expression analysis revealed a strong up-regulation in matrix genes and matrix remodeling genes in the AF of the CCT group. Cell apoptotic activity and glycosaminoglycan content were also quantified but there were no statistically significant differences found. Cell morphology in the NP of the CCT was changed, as shown by histological evaluation. Our results stress the importance of complex loading on the initiation and progression of disc degeneration.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background
Patient and Family Advisory Councils (PFACs) are an emerging mechanism to integrate patient and family voices into healthcare. One such PFAC is the Patient Advisory Council (PAC) of the ...ImproveCareNow (ICN) network, a learning health system dedicated to advancing the care of individuals with pediatric inflammatory bowel disease (IBD). Using quality improvement techniques and co‐production, the PAC has made great strides in developing novel patient‐led resources.
Methods
This paper, written by patients and providers from ICN, reviews current ICN data on PAC‐generated resources, including creation processes and download statistics.
Results
Looking at different iterations of PAC infrastructure, this paper highlights specific leadership approaches used to increase patient involvement and improve resource creation. Emerging data suggests that the larger ICN learning health system has had limited interactions with these resources.
Conclusion
ICN provides a novel approach for meaningful integration of patient partners into learning health systems. This paper points to the incredible value of PFAC expertise in the resource creation process. Future work should seek to support PFAC development across other diseases and address the challenges of integrating patient‐led resources into clinical care.
We present rest-frame optical emission-line flux ratio measurements for five \(z>5\) galaxies observed by the JWST Near-Infared Spectrograph (NIRSpec) in the SMACS 0723 Early Release Observations. We ...add several quality-control and post-processing steps to the NIRSpec pipeline reduction products in order to ensure reliable relative flux calibration of emission lines that are closely separated in wavelength, despite the uncertain \textit{absolute} spectrophotometry of the current version of the reductions. Compared to \(z\sim3\) galaxies in the literature, the \(z>5\) galaxies have similar OIII\(\lambda\)5008/H\(\beta\) ratios, similar OIII\(\lambda\)4364/H\(\gamma\) ratios, and higher (\(\sim\)0.5 dex) NeIII\(\lambda\)3870/OII\(\lambda\)3728 ratios. We compare the observations to MAPPINGS V photoionization models and find that the measured NeIII\(\lambda\)3870/OII\(\lambda\)3728, OIII\(\lambda\)4364/H\(\gamma\), and OIII\(\lambda\)5008/H\(\beta\) emission-line ratios are consistent with an interstellar medium that has very high ionization (\(\log(Q) \simeq 8-9\), units of cm~s\(^{-1}\)), low metallicity (\(Z/Z_\odot \lesssim 0.2\)), and very high pressure (\(\log(P/k) \simeq 8-9\), units of cm\(^{-3}\)). The combination of OIII\(\lambda\)4364/H\(\gamma\) and OIII\(\lambda\)(4960+5008)/H\(\beta\) line ratios indicate very high electron temperatures of \(4.1<\log(T_e/{\rm K})<4.4\), further implying metallicities of \(Z/Z_\odot \lesssim 0.2\) with the application of low-redshift calibrations for ``\(T_e\)-based'' metallicities. These observations represent a tantalizing new view of the physical conditions of the interstellar medium in galaxies at cosmic dawn.
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