The number of cancer survivors is growing steadily and increasingly, clinical trials are being designed to include long-term follow-up to assess not only survival, but also late effects and ...health-related quality of life (HRQOL). Therefore it is is essential to develop patient-reported outcome measures (PROMs) that capture the full range of issues relevant to disease-free cancer survivors. The objectives of this project are: 1) to develop a European Organisation for Research and Treatment of Cancer (EORTC) questionnaire that captures the full range of physical, mental and social HRQOL issues relevant to disease-free cancer survivors; and 2) to determine at which minimal time since completion of treatment the questionnaire should be used.
We reviewed 134 publications on cancer survivorship and interviewed 117 disease-free cancer survivors with 11 different types of cancer across 14 countries in Europe to generate an exhaustive, provisional list of HRQOL issues relevant to cancer survivors. The resulting issue list, the EORTC core questionnaire (QLQ-C30), and site-specific questionnaire modules were completed by a second group of 458 survivors.
We identified 116 generic survivorship issues. These issues covered body image, cognitive functioning, health behaviors, negative and positive outlook, health distress, mental health, fatigue, sleep problems, physical functioning, pain, several physical symptoms, social functioning, and sexual problems. Patients rated most of the acute symptoms of cancer and its treatment (e.g. nausea) as no longer relevant approximately one year after completion of treatment.
Compared to existing cancer survivorship questionnaires, our findings underscore the relevance of assessing issues related to chronic physical side effects of treatment such as neuropathy and joint pain. We will further develop a core survivorship questionnaire and three site-specific modules for disease-free adult cancer survivors who are at least one year post-treatment.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Nitroxide radicals are characterized by a long-lived open-shell electronic ground state and are strongly sensitive to the chemical environment, thus representing ideal spin probes and spin labels for ...paramagnetic biomolecules and materials. However, the interpretation of spectroscopic parameters in structural and dynamic terms requires the aid of accurate quantum chemical computations. In this paper we validate a computational model rooted into double-hybrid functionals and second order vibrational perturbation theory. Then, we provide reference quantum chemical results for the structures, vibrational frequencies and other spectroscopic features of a large panel of nitroxides of current biological and/or technological interest.
Na1/2Bi1/2TiO3‐based materials have been earmarked for one of the first large‐volume applications of lead‐free piezoceramics in high‐power ultrasonics. Zn2+‐doping is demonstrated as a viable route ...to enhance the thermal depolarization temperature and electromechanically harden (1‐y)Na1/2Bi1/2TiO3‐yBaTiO3 (NBT100yBT) with a maximum achievable operating temperature of 150 °C and mechanical quality factor of 627 for 1 mole % Zn2+‐doped NBT6BT. Although quenching from sintering temperatures has been recently touted to enhance TF‐R, with quenching the doped compositions featuring an additional increase in TF‐R by 17 °C, it exhibits negligible effect on the electromechanical properties. The effect is rationalized considering the missing influence on conductivity and therefore, negligible changes in the defect chemistry upon quenching. High‐resolution diffraction indicates that Zn2+‐doped samples favor the tetragonal phase with enhanced lattice distortion, further corroborated by 23Na Nuclear Magnetic Resonance investigations.
Zn2+‐doping (0.5 and 1 mole %) is demonstrated to enhance the thermal depolarization temperature (Td) and electromechanically harden (1‐y)Na1/2Bi1/2TiO3‐yBaTiO3 (NBT100yBT). Quenching (Q1100) the doped compositions feature an additional increase in Td by ~15‐20 °C. The results are rationalized based on the stabilization of ferroelectric order, evidenced from the enhanced tetragonality and rhombohedral (R) distortion, changing phase fraction (using high resolution diffraction) and decrease in the cubic phase fraction (using NMR) upon Zn2+‐doping.
Health related quality of life (HRQoL) is an important recognized health outcome for cancer treatments, but also disease course with slower recovery and increased morbidity. These issues are of ...implication in melanoma, which maintains a risk of disease progression for many years after diagnosis. This study aimed to explore and weigh factors in the perception of the quality of life and possible relationships with demographic-clinical characteristics in people with melanoma
a machine learning approach. In this observational study, patients with melanoma, without metastatic disease, were recruited from January 2020 to December 2021 with a follow-up of at least one year. Demographic variables and clinics were collected, and the 12-Item Short-Form Health Survey (SF-12) was adopted as the physical and mental aspects of the Health-Related Quality of Life (HRQoL) measure. All the variables were processed in a random forest model to weigh at each node of each tree of this machine learning regression model, their actual weight in SF-12 score. We included 203 melanoma patients, mean aged 59.25 ± 15.1 years: 56 (27%) affecting the upper limbs and 147 (73%) affecting the trunk. The model of 142 patients with no missing value, generating 92 trees (MSE = 0.45, R2 of 0.78), reported that the lesion site was the most influencing variable on HRQoL based on the decrease in Gini impurity in variable weighing at each node intersection in forest generation. In this scenario, we built two distinct models for lesion sites and demonstrated that the variable that most influenced the quality of life in upper limb melanoma was lymphedema, while BMI was in the trunk. Given these results, random forest regressions could play a crucial role in the clinical and rehabilitation approach. The machine-learning model for detecting the HRQoL predictor in melanoma patients indicates that the experienced lymphedema and BMI may influence the HRQoL perception. This study suggests that the prevention and treatment of lymphedema and bodyweight reduction might improve the quality of life in melanoma.
Background Preterm newborn nutrition affects postnatal skeletal growth and bone mineralization, but studies have not yet fully concluded the relationship between nutrition and osteopenia. This study ...was intended to investigate the impact of nutritional factors on osteopenia in preterm newborns. Methods This is a case-control study with babies born with gestational age less than or equai to 32 weeks in a high-risk maternity hospital, between 2018 and 2019. The population consisted of 115 newborns, being 46 cases (40%) and 69 controls (60%). Disease outcome was based on serum alkaline phosphatase levels > 900UL/l and hypophosphatemia < 4 mg/dl. Gestational data at birth and clinical and nutritional follow-up data during 8 weeks postnatally were assessed. Variables were assessed using regressive logistic models. Findings Preterm infants who were fed pasteurized fresh human milk with acidity greater than or equal to 4 ºDornic are 5.36 times more likely to develop osteopenia (p = 0.035). Higher calcium intake, compared to controls, also increased the probability of disease occurrence OR 1.05 (CI 1.006-1.1); p = 0.025, while the presence of a partner OR 0.10 (CI 0.02-0.59); p = 0.038 and the shortest time using sedatives OR 0.89 (CI 0.83-0.98); p = 0.010 were protective factors associated with osteopenia. Extremely low birth weight OR 5.49 (CI 1.20-25.1); p = 0.028, sepsis OR 5.71 (CI 1.35-24.2); p = 0.018 and invasive ventilatory support OR 1.09 (CI 1.03-1.18); p = 0.007 were risk factors. Conclusions Acidity and high calcium intake are the main nutritional factors associated with osteopenia of prematurity. Further studies on the use of human milk with lower acidity, recommendation and nutritional supplementation of calcium should be accomplished to guide prevention strategies in newborns at risk for osteopenia during hospital stay. Keywords: Infant, Premature, Bone diseases, Metabolic, Nutritional support
Introduction Chronic Graft versus Host Disease (cGvHD) is a long term immunological multi-organ syndrome that may occur after Allogenic Hemopoietic Stem Cell Transplantation (Allo-HSCT). ...Musculoskeletal issues have been considered a rare complication in cGvHD but recently these issues have been better documented and the role of rehabilitation is emerging to improve functioning in daily life, social participation and quality of life in these patients. Musculoskeletal clinical pictures of cGvHD Musculoskeletal clinical pictures of cGvHD include diagnostic signs and symptoms (fasciitis and joint stiffness/contractures), distinctive signs and symptoms (myositis and polymyositis), and other signs and symptoms as well as complications common to various types of oncological diseases. The Role of Rehabilitation Rehabilitation aims to optimize functioning and autonomy in daily activities, as well as in social life including work and school, which are major determinants for a satisfactory quality of life. In Italy a document called Rehabilitation National Plan was developed in 2011 by Italian Government and a Committee of health specialists as well as stakeholders. It defined the Italian Guidelines for Rehabilitation and proposed a unique tool for physiatrists, rehabilitation health professionals, patients and caregivers named the Individual Rehabilitation Project (IRP). For each patient the IRP described the rehabilitation programs and interventions (Therapeutic Exercise, Orthotics and aids, Occupational Therapy, Complementary and Alternative Medicine, Physical Activity) and the various involved health professionals (physiotherapist, occupational therapist, orthopedic technician, psychologist, rehabilitation nurse). Conclusions In cGvHD, Rehabilitation represents a critical step in achieving long- term health outcomes. Clinical evidence supports the relevance of referring patients to rehabilitation services as well as individualized rehabilitation interventions in dedicated facilities.
Background Prostate cancer (PCa) is the second most common cancer in men worldwide. The standard non-surgical approach for localized PCa is radiotherapy (RT), but one of the limitations of high-dose ...RT is the potential increase in gastrointestinal and genitourinary toxicities. We present the protocol of the Microstyle study, a multicentre randomized two-arm crossover clinical trial. The primary outcome will be assessed at the end of 6-month intervention, by measuring the change in adherence to a healthy lifestyle score. The hypothesis is that modifying lifestyle we change microbiome and improve quality of life and decrease side effects of RT. Methods Study participants will be recruited among men undergoing RT in two Italian centers (Milan and Naples). We foresee to randomize 300 patients in two intervention arms: Intervention Group (IG) and Control Group (CG). Participants allocated to the IG will meet a dietitian and a physiotherapist before RT to receive personalized diet and exercise recommendations, according to their health status, to improve overall lifestyle and reduce side effects (bowel and/or urinary problems). Dietitian and physiotherapist will work together to set individualized goals to reduce or eliminate side effects and pain according to their health status. All participants (IG) will be given a pedometer device (steps counter) in order to monitor and to spur participants to increase physical activity and reduce sedentary behavior. Participants included in the CG will receive baseline general advice and materials available for patients undergoing RT. According to the cross-over design, the CG will cross to the intervention approach after 6-month, to actively enhance compliance towards suggested lifestyle recommendations for all patients. Discussion This trial is innovative in its design because we propose a lifestyle intervention during RT, that includes both dietary and physical activity counselling, as well as monitoring changes in microbiome and serum biomarkers. The promotion of healthy behaviour will be initiated before initiation of standard care, to achieve long lasting effects, controlling side effects, coping with feelings of anxiety and depression and improve efficacy of RT. Trial registration ClincalTrial.gov registration number: NCT05155618. Retrospectively registered on December 13, 2021. The first patient was enrolled on October 22, 2021. Keywords: Prostate cancer, Randomized controlled trial, Diet, Physical activity, Counseling, Quality of life, Body composition, Microbiome, Serum biomarkers, Radiotherapy
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Green computing is a growing trend in computing, pursuing the goal of helping software developers to be more aware and produce energy-efficient software. This is especially relevant for ...battery-powered mobile applications, where a minimal energy consumption is desired to both mitigate the greenhouse effect and extend the battery lifetime. In this paper, we analyze the energy consumption and execution time of cryptographic primitives in Android devices. Our ultimate goal is to help Android application developers, especially those who are not experts in security, to choose the most energy-efficient cryptographic algorithms considering different security providers and security transformations. Information to make a tradeoff between energy and time consumption is also provided, being especially useful when the differences in energy consumption of different alternatives are not so significant. We have conducted our experiments with an energy profiling tool based on the PowerTutor application, which has been adapted to automate the energy profiling. Our results show that this type of power consumption studies is necessary, because selecting the most energy-efficient configuration depends on many factors, and some of the choices are not obvious to developers.
Among the possible pathologies in buildings, one of the main occurrences in humid climates is the appearance of mold. The mold growth on envelope inside surfaces is not exclusively due to failure on ...building execution and waterproofing. Factors such as, the air relative humidity, inside air temperature, and surface condensation, are aspects that could cause the mold emergence. In this context, the present research was carried out in order to understand the influence of the use of thermal insulation and the solar orientation of the walls in the mold growth in naturally ventilated residences. This study is developed in the humid temperate climate (Köppen Cfa) of Florianópolis, Brazil, located in South America. For this, simulations in the EnergyPlus software, version 8.8, were performed. The residence was simulated by varying the use of thermal insulation in external walls: thermal insulation on the internal side of the wall, insulation on the outer side of the wall and wall without insulation. Two solar orientations were adopted, being north and south. Based on the results found, it was observed how the constructive parameters affect the periods of occurrence of ideal conditions for formation and growth of the mold. It was found that when the rooms were facing north, fewer occurrences of long periods satisfying the conditions for the appearance of the mold occurred. It was also observed that the non-use of thermal insulation reduced these occurrences when the performance among construction systems was compared. This effect also occurred due to the increase in air changes in this model.
•The use of thermal insulation affects the favorable conditions of mold growth.•The seasons of the year showed as a crucial factor for mold development.•The occurrence of satisfaction conditions to mold happened often for long periods.•The intensity factor become the results more intelligible.
Resource sharing and mass storage in server farms provided by cloud platforms save huge amounts of energy. However, optimizing energy consumption at the server room is not enough, being desirable to ...perform energy optimization of cloud services at the application level. In cloud computing a tailored configuration of services is deployed for each client (tenant), requiring different energy consumption optimizations. Indeed, energy consumption of cloud services depends on several factors determined by the context and usage of the applications. So, to evolve a cloud application to new requirements of energy efficiency implies to perform custom-made adaptations for each tenant. Thus, managing the evolution of a multi-tenant application with hundreds of tenants and thousands of different valid architectural configurations can become intractable if performed manually. This paper proposes a product line architecture approach that: (1) uses cardinality-based variability models to model each tenant as a clonable feature, and (2) automatizes the process of evolving the multi-tenant application architecture when the energy requirements change. The implemented process is efficient for a high number of tenants in a reasonable time.
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