Precision oncology has changed the landscape of cancer care. The paradigm shift to genomics-informed care has led to rapid succession of novel targeted drug approvals. Though well-established in ...certain disease states, the use of biomarker-driven targeted treatment for ovarian cancer is relatively new. This project sought to assess knowledge, confidence, and current practice of nurses caring for patients with ovarian cancer regarding the topics of biomarker testing and related terminology, indication for and use of poly (ADP-ribose) polymerase (PARP) inhibitors, and management of patients receiving PARP inhibitors. Analysis of this information enables identification of priority issues, knowledge gaps, and needs of oncology nurses in practice. A mixed methods approach was utilized for data collection. An online survey of 100 oncology nurses was comprised of open text, multiple-choice, and five-point Likert scale questions. Additionally, a focus group with 20 oncology nurses used case-based discussion and open-ended prompts. Questions focused on knowledge and familiarity with biomarkers and PARP inhibitors, roles and responsibilities related to biomarker testing and PARP inhibitor side effect management, and challenges encountered in practice related to these topics. Results suggest lower levels of familiarity and confidence among nurses when explaining the rationale for somatic biomarkers used when prescribing PARP inhibitor therapy, such as homologous recombination repair deficiency. Nurses reported feeling less knowledgeable about specific aspects of PARP inhibitors such as mechanism of action, indication for use, and differences among approved agents. Real-world challenges perceived as significant barriers to gaining new knowledge included nursing burnout, staffing shortages, and work-life balance. Nurses noted confidence in anticipating and managing physical side effects from PARP inhibitors but endorsed challenges and lacking communication skills in addressing patients' psychological and emotional needs. Supplementary education for practicing nurses has not kept pace with the evolution of precision oncology in ovarian cancer care. As new biomarkers are identified and targeted treatments are developed, so too must timely, succinct, nursing-focused education to establish competency in foundational genomic knowledge. Information must be concentrated and simplified to meet the time-constraints of practicing nurses. An understanding of the complex concepts of precision oncology is required for nurses to translate this information to patients using effective, empathetic communication skills. Closing this knowledge gap is critically important to ensure oncology nurses are prepared for the increased velocity of oncology care transformation.
OBJECTIVES: To assess oncology nurses' awareness of biomarker testing and targeted therapy for ovarian cancer. SAMPLE & SETTING: 100 oncology nurses completed an online survey in June 2022. METHODS & ...VARIABLES: A cross-sectional survey was used to examine nurses' understandingof ovarian cancer testing and treatments, assess barriers, and identify opportunities for further education. RESULTS: Almostall respondents believed biomarker testing and targeted therapy were very/extremely important in diagnosing and supporting treatment of patients with ovarian cancer. Nurses were very/extremely familiar with cancerantigen 125 and germline testing, but fewer reported the same familiarity with somatic testing. Most nurses were familiar with targeted therapy for ovarian cancer, but only about half were very/extremely familiar with poly(ADP-ribose) polymerase (PARP) inhibitors. Less than half felt highly knowledgeable about PARP inhibitors. IMPLICATIONS FOR NURSING: It is important that oncology nurses understand biomarker testing and targeted therapy. There is an opportunity to provide resources to nurses to help them become more comfortable with PARP inhibitors in particular. KEYWORDS oncology nursing; ovarian neoplasms; biomarkers; PARP inhibitors
OBJECTIVES: To assess oncology nurses' awareness of biomarker testing and targeted therapy for ovarian cancer. SAMPLE & SETTING: 100 oncology nurses completed an online survey in June 2022. METHODS & ...VARIABLES: A cross-sectional survey was used to examine nurses' understanding of ovarian cancer testing and treatments, assess barriers, and identify opportunities for further education. RESULTS: Almost all respondents believed biomarker testing and targeted therapy were very/extremely important in diagnosing and supporting treatment of patients with ovarian cancer. Nurses were very/ extremely familiar with cancer antigen 125 and germline testing, but fewer reported the same familiarity with somatic testing. Most nurses were familiar with targeted therapy for ovarian cancer, but only about half were very/extremely familiar with poly(ADP-ribose) polymerase (PARP) inhibitors. Less than half felt highly knowledgeable about PARP inhibitors. IMPLICATIONS FOR NURSING: It is important that oncology nurses understand biomarker testing and targeted therapy. There is an opportunity to provide resources to nurses to help them become more comfortable with PARP inhibitors in particular.
MicroRNAs (miRNAs) are released from cells in association with proteins or microvesicles. We previously reported that malignant transformation changes the assortment of released miRNAs by affecting ...whether a particular miRNA species is released or retained by the cell. How this selectivity occurs is unclear. Here we report that selectively exported miRNAs, whose release is increased in malignant cells, are packaged in structures that are different from those that carry neutrally released miRNAs (n-miRNAs), whose release is not affected by malignancy. By separating breast cancer cell microvesicles, we find that selectively released miRNAs associate with exosomes and nucleosomes. However, n-miRNAs of breast cancer cells associate with unconventional exosomes, which are larger than conventional exosomes and enriched in CD44, a protein relevant to breast cancer metastasis. Based on their large size, we call these vesicles L-exosomes. Contrary to the distribution of miRNAs among different microvesicles of breast cancer cells, normal cells release all measured miRNAs in a single type of vesicle. Our results suggest that malignant transformation alters the pathways through which specific miRNAs are exported from cells. These changes in the particles and their miRNA cargo could be used to detect the presence of malignant cells in the body.
Objective: We aim to explore whether the surgical tumor free margin is important for overall survival (OS) and local control in patients who undergo neoadjuvant radiation (RT) for vulvar cancer. ...Methods: A retrospective review from 2004 to 2021 of patients who underwent RT followed by surgical resection was performed. Patients were categorized into groups based on margin status (no residual disease, >8 mm, close margins defined as 1 to 7 mm, or positive). Local control and OS were analyzed using the Kaplan-Meier with log rank test. Multivariate analysis was performed with cox hazards model. Results: Eighty-three patients were included. A complete pathologic response (pCR) was found in 56% (n=46) of patients. The median follow-up time was 35 months (range: 4 to 216). The median OS for the entire cohort was 46 months (95% CI: 32.3-59.7). Having a pCR improved both OS and disease-free survival (DFS) compared with residual disease by 81 and 91 months, respectively ( P <0.001). In the 2 patients with a margin >8 mm, there was no statistical difference in survival between those with close margins (46 vs. 25 mo, P =0.485). Factors that significantly impacted both OS and DFS were depth of invasion (DOI) and LVSI. On multivariate analysis of those with residual disease, there was no difference in OS or DFS by margin status but having a DOI >9 mm showed decreased OS (HR: 3.654; 95% CI: 1.317-10.135). Conclusions: In this cohort, response to RT, not margin status drives survival and recurrence. Given residual disease, the optimal margin is not clear, as there were only 2 patients with >8 mm margins. A close or positive margin had no impact on OS or local recurrence. A DOI >9 mm significantly impacts both OS and local recurrence even when accounting for other factors.
Use of lime to mitigate acid mine drainage is, in general, accompanied by precipitation of iron (Fe) and aluminium (Al) (hydr)oxides which may increase the removal of trace elements from water. This ...work aimed to evaluate the precipitation of Fe/Al (hydr)oxides to remove rare earth elements (REE) from contaminated water and the stability of precipitates. Two sets of 60-day syntheses were carried out using different Fe/Al/REE molar ratios, for europium (Eu) and holmium (Ho). The pH was periodically adjusted to 9.0, and the stability of the resulting precipitates was evaluated by water-soluble and BCR extractable phases, namely (1) acid soluble, extracted by 0.11 mol L
−1
acetic acid; (2) reducible, extracted with 0.5 mol L
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hydroxylamine hydrochloride; and (3) oxidisable, extracted with 8.8 mol L
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hydrogen peroxide efficiencies of the water treatments for both Eu and Ho that were higher than 99.9% irrespective to the Fe/Al/REE molar ratios. Water-soluble phases of Eu and Ho were lower than 0.01% of the total contents in the precipitates. Recoveries from precipitates by Bureau Communautaire de Référence (BCR) sequential extractions increased with increasing concentrations of Eu and Ho. Acetic acid extracted higher amounts of REE, but Eu recovery was superior to Ho. Lepidocrocite was formed as Eu concentration increased which decreased its stability in the precipitates.
Research indicates that student learning of science, student attitudes toward science, and their motivation to learn science and pursue science-related careers is related to classroom instruction. ...This study examined anatomy and physiology (A&P) classes in a south Texas high school where 97 percent of students are Hispanic bilingual learners. Classes were assigned to control or treatment groups, with the treatment group receiving instruction designed to help students develop a deeper understanding of anatomy vocabulary related to brain structures by making connections to these words in everyday life as well as to their understanding of Spanish. Main effects between group and test scores were significant, with the control group reporting higher test scores than the treatment group. We attribute this finding to a bleed-over of the treatment group instructional design to the control group. In addition, significant differences in mean and median scores were observed with respect to intrinsic motivation and self-efficacy. The statistically significant increases in learning for both groups suggests the activity-, problem-, and project-based (APB) curriculum has the potential to be an effective type of instruction, especially for bilingual learners.
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