Purpose
Prostate cancer disproportionately affects Black men. Physical activity protects long-term health and quality of life outcomes in prostate cancer survivors. This study aimed to identify ...sociocultural factors related to physical activity among Black prostate cancer survivors to inform culturally tailored intervention development.
Methods
This secondary analysis included data from 257 men who identified as Black or African American and were diagnosed with prostate cancer between 2013 and 2018. Participants completed validated self-report measures of perceived history of racial discrimination, religiosity, fatalism, sociodemographic (e.g., age, ethnicity, income) and clinical characteristics (e.g., years since diagnosis, comorbidity burden), and leisure-time physical activity. Regression analyses were conducted to examine the associations between sociocultural factors and mild, moderate, and vigorous physical activity.
Results
Participants were on average 68.7 years old (
SD
= 7.7), and most were non-Hispanic (97.3%), married (68.9%), reported an annual household income above $50,000 (57.1%), received at least some college education (74.1%), and were overweight or had obesity (78.5%). Participants reported on average 88.1 (
SD
= 208.6) min of weekly mild physical activity, and most did not meet guidelines for weekly moderate (80.5%) or vigorous (73.0%) physical activity. After adjusting for covariates, older age and greater religiosity were associated with mild physical activity (
p
s ≤ 0.05). Higher levels of fatalism were associated with lower odds of meeting guidelines for moderate physical activity (
OR
= 0.87, 95% CI = 0.77–0.99).
Conclusions
Sociocultural factors such as religiosity and fatalism may be associated with some forms of physical activity in Black prostate cancer survivors. These findings suggest that incorporating faith-based practices into health behavior interventions may be appropriate for this population.
Purpose
Patients with head and neck cancer (HNC) experience significant symptom burden from combination chemotherapy and radiation (chemoradiation) that affects acute and long-term health-related ...quality of life (HRQOL). However, psychosocial impacts of HNC symptom burden are not well understood. This study examined psychosocial consequences of treatment-related symptom burden from the perspectives of survivors of HNC and HNC healthcare providers.
Methods
This was a cross-sectional, mixed-method study conducted at an NCI-designated comprehensive cancer center. Participants (
N
= 33) were survivors of HNC who completed a full course of chemoradiation (
n
= 20) and HNC healthcare providers (
n
= 13). Participants completed electronic surveys and semi-structured interviews.
Results
Survivors were
M
= 61 years old (SD = 9) and predominantly male (75%), White (90%), non-Hispanic (100%), and diagnosed with oropharynx cancer (70%). Providers were mostly female (62%), White (46%) or Asian (31%), and non-Hispanic (85%) and included physicians, registered nurses, an advanced practice nurse practitioner, a registered dietician, and a speech-language pathologist. Three qualitative themes emerged: (1) shock, shame, and self-consciousness, (2) diminished relationship satisfaction, and (3) lack of confidence at work. A subset of survivors (20%) reported clinically low social wellbeing, and more than one-third of survivors (35%) reported clinically significant fatigue, depression, anxiety, and cognitive dysfunction.
Conclusion
Survivors of HNC and HNC providers described how treatment-related symptom burden impacts psychosocial identity processes related to body image, patient-caregiver relationships, and professional work. Results can inform the development of supportive interventions to assist survivors and caregivers with navigating the psychosocial challenges of HNC treatment and survivorship.
Purpose
The COVID-19 pandemic has drastically changed cancer care delivery strategies. Patients with locally advanced head and neck cancer (LA-HNC) may be particularly affected by the COVID-19 ...pandemic, as they often undergo treatments that require daily clinic visits (e.g., radiation therapy). The goal of this study was to characterize the lived experience of LA-HNC patients and their healthcare providers during the COVID-19 pandemic.
Methods
LA-HNC patients who completed a full course of chemotherapy and radiation therapy during the COVID19 pandemic (
N
= 20) and LA-HNC healthcare providers (
N
= 13) participated in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and analyzed for qualitative themes.
Results
The COVID-19 pandemic had a significant impact on patients’ overall quality of life and health care. Results were organized in four main themes: (1) increased psychological distress; (2) exacerbated social isolation; (3) added stress in clinic for patients and providers; and (4) delays in health care.
Conclusions
Findings highlight myriad ways LA-HNC patients and providers have been affected by the COVID-19 pandemic. Results can inform the development of supportive interventions to assist LA-HNC in managing COVID-19-related stress and unmet needs related to social isolation and in-clinic support.
Idecabtagene vicleucel (ide-cel) was the first FDA-approved chimeric antigen receptor T-cell therapy for relapsed/refractory multiple myeloma (RRMM) patients. This was the first study to evaluate ...patient-reported outcomes (PROs) among RRMM patients receiving ide-cel in standard of care (SOC). We prospectively assessed health-related quality of life (HRQOL) and symptoms from pre-infusion (baseline) through day (D)90 post-infusion. Baseline PRO associations with patient characteristics, mean PRO changes, and time to stable change were evaluated with
-tests, linear mixed-effects models, and Kaplan-Meier analyses, respectively. Within-person change scores and minimally important difference thresholds determined clinical and meaningful significance. Participants (
= 42) were a median of 66 years old (range: 43-81). At baseline, extramedullary disease was associated with worse physical well-being (
= 0.008), global pain (
< 0.001), performance status (
= 0.002), and overall symptom burden (
< 0.001). Fatigue (
< 0.001) and functional well-being (
= 0.003) worsened by D7 before returning to baseline levels. Overall HRQOL (
= 0.008) and physical well-being (
< 0.001) improved by D60. Most participants reported PRO improvement (10-57%) or maintenance (23-69%) by D90. The median time it took to stabile deterioration in functional well-being was 14 days. The median time it took to stabile improvement in physical and emotional well-being was 60 days. Overall, RRMM patients reported improvements or maintenance of HRQOL and symptom burden after SOC ide-cel.
ABSTRACT
We report on the subpulse modulation properties of 1198 pulsars using the Thousand-Pulsar-Array programme on MeerKAT. About 35 per cent of the analysed pulsars exhibit drifting subpulses ...that are more pronounced towards the death line, consistent with previous studies. We estimate that this common phenomenon is detectable in 60 per cent of the overall pulsar population if high-quality data were available for all. This large study reveals the evolution of drifting subpulses across the pulsar population in unprecedented detail. In particular, we find that the modulation period P3 follows a V-shaped evolution with respect to the characteristic age τc, such that the smallest P3 values, corresponding to the Nyquist period P3 ≃ 2, are found at τc ≃ 107.5 yr. The V-shaped evolution can be interpreted and reproduced if young pulsars possess aliased fast intrinsic P3, which monotonically increase, ultimately achieving a slow unaliased P3. Enhancement of irregularities in intrinsic subpulse modulation by aliasing in small-τc pulsars would explain their observed less well defined P3’s and weaker spectral features. Modelling these results as rotating subbeams, their circulation must slow down as the pulsar evolves. This is the opposite to that expected if circulation is driven by $\boldsymbol{E}\times \boldsymbol{B}$ drift. This can be resolved if the observed P3 periodicity is due to a beat between an $\boldsymbol{E}\times \boldsymbol{B}$ system and the pulsar period. As a by-product, we identified the correct periods and spin-down rates for 12 pulsars, for which harmonically related values were reported in the literature.
ABSTRACT
The radio polarization properties of the pulsar population are only superficially captured by the conventional picture of pulsar radio emission. We study the broadband polarization of 271 ...young radio pulsars, focusing particularly on circular polarization, using high-quality observations made with the Ultra-Wideband Low receiver on Murriyang, the Parkes radio telescope. We seek to encapsulate polarization behaviour on a population scale by defining broad categories for frequency- and phase-dependent polarization evolution, studying the co-occurrences of these categorizations and comparing them with average polarization measurements and spin-down energy ($\dot{E}$). This work shows that deviations of the linear polarization position angle from the rotating vector model are linked to the presence of circular polarization features and to frequency evolution of the polarization. Polarization fraction, circular polarization contribution, and profile complexity all evolve with $\dot{E}$ across the population, with the profiles of high-$\dot{E}$ pulsars being simple and highly linearly polarized. The relationship between polarization fraction and circular contribution is also seen to evolve such that highly polarized profiles show less variation in circular contribution with frequency than less strongly polarized profiles. This evolution is seen both across the population and across frequency for individual sources. Understanding pulsar radio polarization requires detailed study of individual sources and collective understanding of population-level trends. For the former, we provide visualizations of their phase- and frequency-resolved polarization parameters. For the latter, we have highlighted the importance of including the impact of circular polarization and of $\dot{E}$.
ABSTRACT
A number of pulsars are known to have profile evolution on time-scales of months, often correlated with spin-down rate changes. Here, we present the first result from 3 yr of monitoring ...observations from MeerKAT as part of the Thousand Pulsar Array programme. This programme obtains high-fidelity pulse profiles for ∼ 500 pulsars, which enabled the detection of subtle changes in seven sources not previously known to exhibit long-term profile evolution. A 2D Gaussian convolution is used to highlight correlated emission variability in both the pulse phase and observing epoch direction. Simulations show that for one additional source the observed profile variability is likely to originate from stochastic single-pulse shape variability (jitter). We find that it is common for long-term profile variability to be associated with changes in polarization fractions, but not with polarization position angle (PA) changes. PA changes are expected if emission height changes or precession is responsible for the profile variability. PSR J1741−3927 is the only pulsar in our sample that shows correlated PA variability, and this is associated with orthogonal polarization mode activity. For the six other pulsars limits on possible emission height changes and impact angle changes are derived. These limits are consistent with the small changes in the total intensity profile shape. None of the sources show detectable spin-down variability correlated with the emission changes, which are thought to be driven by magnetospheric current fluctuations. Therefore, the absence of correlated spin-down rate variability allows upper limits to be placed on changes in the magnetospheric charge density.
Background: Clinicians must closely monitor patients for toxicities after chimeric antigen receptor T-cell therapy (CAR-T). Patient-reported outcomes (PROs) (e.g., toxicities, quality of life) and ...activity data (e.g., steps, sleep) may complement clinicians’ observations. This study tested the feasibility and acceptability of collecting PROs and activity data from patients with hematologic malignancies during CAR-T and explored preliminary data patterns. Methods: Participants wore a Fitbit tracker and completed PROs at several timepoints through 90-days post-infusion. Feasibility was assessed with a priori benchmarks for recruitment (≥50%), retention (≥70%), PRO completion (≥70%), and days wearing the Fitbit (≥50%). Acceptability was assessed with participant satisfaction (a priori benchmark > 2 on a 0−4 scale). Results: Participants (N = 12) were M = 66 years old (SD = 7). Rates of recruitment (68%), retention (83%), PRO completion (85%), and days wearing the Fitbit (85%) indicated feasibility. Satisfaction with completing the PROs (M = 3.2, SD = 0.5) and wearing the Fitbit (M = 2.9, SD = 0.5) indicated acceptability. Preliminary data patterns suggested that participants with better treatment response (vs. progressive disease) had a higher toxicity burden. Conclusions: Longitudinal PRO and activity data collection was feasible and acceptable. Data collected on a larger scale may be used to specify risk prediction models to identify predictors of severe CAR-T-related toxicities and inform early interventions.
ABSTRACT We report here on the timing of 597 pulsars over the last four years with the MeerKAT telescope. We provide times of arrival, pulsar ephemeris files, and per-epoch measurements of the flux ...density, dispersion measure (DM), and rotation measure (RM) for each pulsar. In addition, we use a Gaussian process to model the timing residuals to measure the spin frequency derivative at each epoch. We also report the detection of 11 glitches in nine individual pulsars. We find significant DM and RM variations in 87 and 76 pulsars, respectively. We find that the DM variations scale approximately linearly with DM, which is broadly in agreement with models of the ionized interstellar medium. The observed RM variations seem largely independent of DM, which may suggest that the RM variations are dominated by variations in the interstellar magnetic field on the line of sight, rather than varying electron density. We also find that normal pulsars have around 5 times greater amplitude of DM variability compared to millisecond pulsars, and surmise that this is due to the known difference in their velocity distributions.
Purpose
This study aimed to test the feasibility and acceptability of a digital health promotion intervention for family caregivers of patients with advanced colorectal cancer and explore the ...intervention’s preliminary efficacy for mitigating the impact of caregiving on health and well-being.
Methods
We conducted a single-arm pilot feasibility trial of C-PRIME (Caregiver Protocol for Remotely Improving, Monitoring, and Extending Quality of Life), an 8-week digital health-promotion behavioral intervention involving monitoring and visualizing health-promoting behaviors (e.g., objective sleep and physical activity data) and health coaching (NCT05379933). A priori benchmarks were established for feasibility (≥ 50% recruitment and objective data collection; ≥ 75% session engagement, measure completion, and retention) and patient satisfaction (> 3 on a 1–5 scale). Preliminary efficacy was explored with pre- to post-intervention changes in quality of life (QOL), sleep quality, social engagement, and self-efficacy.
Results
Participants (
N
= 13) were M = 52 years old (SD = 14). Rates of recruitment (72%), session attendance (87%), assessment completion (87%), objective data collection (80%), and retention (100%) all indicated feasibility. All participants rated the intervention as acceptable (M = 4.7; SD = 0.8). Most participants showed improvement or maintenance of QOL (15% and 62%), sleep quality (23% and 62%), social engagement (23% and 69%), and general self-efficacy (23% and 62%).
Conclusion
The C-PRIME digital health promotion intervention demonstrated feasibility and acceptability among family caregivers of patients with advanced colorectal cancer. A fully powered randomized controlled trial is needed to test C-PRIME efficacy, mechanisms, and implementation outcomes, barriers, and facilitators in a divserse sample of family caregivers.
Trial registration
The Caregiver Protocol for Remotely Improving, Monitoring, and Extending Quality of Life (C-PRIME) study was registered on clinicaltrials.gov, NCT05379933, in May 2022.
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