Association between information provision and decisional conflict in cancer patients

BACKGROUND

In this study, we aimed to identify demographic and clinical variables that correlate with perceived information provision among cancer patients and determine the association of information provision with decisional conflict (DC).

PATIENTS AND METHODS

We enrolled a total of 625 patients with cancer from two Korean hospitals in 2012. We used the European Organization for Research and Treatment of Cancer (EORTC) quality-of-life questionnaire (QLQ-INFO26) to assess patients' perception of the information received from their doctors and the Decisional Conflict Scale (DCS) to assess DC. To identify predictive sociodemographic and clinical variables for adequate information provision, backward selective logistic regression analyses were conducted. In addition, adjusted multivariate logistic regression analyses were carried out to identify clinically meaningful differences of perceived level of information subscales associated with high DC.

RESULTS

More than half of patients with cancer showed insufficient satisfaction with medical information about disease (56%), treatment (73%), other services (83%), and global score (80%). In multiple logistic regression analyses, lower income and education, female, unmarried status, type of cancer with good prognosis, and early stage of treatment process were associated with patients' perception of inadequate information provision. In addition, Information about the medical tests with high DCS values clarity [adjusted odds ratio (aOR), 0.54; 95% confidence interval (CI) 0.30-0.97] and support (aOR, 0.53; 95% CI 0.33-0.85) showed negative significance. For inadequate information perception about treatments and other services, all 5 DCS scales (uncertainty, informed, values clarity, support, and effective decision) were negatively related. Global score of inadequate information provision also showed negative association with high DCS effective decision (aOR, 0.43; 95% CI 0.26-0.71) and DCS uncertainty (aOR, 0.46; 95% CI 0.27-0.77).

CONCLUSION

This study found that inadequate levels of perceived information correlated with several demographic and clinical characteristics. In addition, sufficient perceived information levels may be related to low levels of DC.

A genetic variation in microRNA target site of KRT81 gene is associated with survival in early-stage non-small-cell lung cancer

BACKGROUND

MicroRNAs (miRNAs) have a key role in carcinogenesis through negative regulation of their target genes. Therefore, genetic variations in miRNAs or their target sites may affect miRNA-mRNA interactions, thereby result in altered expression of target genes. This study was conducted to investigate the associations between single-nucleotide polymorphisms (SNP) located in the miRNA target sites (poly-miRTSs) and survival of patients with early-stage non-small-cell lung cancer (NSCLC).

METHODS

Using public SNP database and miRNA target sites prediction program, 354 poly-miRTSs were selected for genotyping. Among these, 154 SNPs applicable to Sequenom's MassARRAY platform were investigated in 357 patients. A replication study was carried out on an independent patient population (n = 479). Renilla luciferase assay and reverse transcription-polymerase chain reaction were conducted to examine functional relevance of potentially functional poly-miRTSs.

RESULTS

Of the 154 SNPs analyzed in a discovery set, 14 SNPs were significantly associated with survival outcomes. Among these, KRT81 rs3660G>C was found to be associated with survival outcomes in the validation cohort. In the combined analysis, patients with the rs3660 GC + CC genotype had a significantly better overall survival compared with those with GG genotype [adjusted hazard ratio (aHR) for OS, 0.65; 95% confidence interval (CI) 0.50-0.85; P = 0.001]. An increased expression of the reporter gene for the C allele of rs3660 compared with the G allele was observed by luciferase assay. Consistently, the C allele was associated with higher relative expression level of KRT81 in tumor tissues.

CONCLUSION

The rs3660G>C affects KRT81 expression and thus influences survival in early-stage NSCLC. The analysis of the rs3660G>C polymorphism may be useful to identify patients at high risk of a poor disease outcome.

Osteoporosis therapy: a novel insight from natural homeostatic system in the skeleton

The skeleton normally responds to mechanical environment to maintain the resulting elastic deformation (strain) of bone, while increased bone strength by an osteoporosis drug results in decreased bone strain. Thus, it can be hypothesized that the effect of osteoporosis therapy is limited by natural homeostatic system in the skeleton. This logic is consistent with the fact that there exists a powerful effect that returns bone mass to its pre-treatment level after the withdrawal of treatment with osteoporosis agents. The present hypothesis provides a new significant insight into the mechanisms by which osteoporosis drugs improve bone fragility. Here we briefly discuss the effects of teriparatide, romosozumab, and odanacatib on bones in animals and humans.

A novel Microchannel Electrode Array: towards bioelectronic medical interfacing of small peripheral nerves

Bioelectronic medicine is an emerging field that relies on electrical signals to modulate complex neuronal circuits, particularly in the peripheral nervous system, as an alternative to drug-enabled therapeutics. Small autonomic nerves are one of the targets in this field, however, interfacing peripheral nerves smaller than 300 μm remains a challenge. Here we report the development of a Microchannel Electrode Array (DCEA) capable of interfacing nerve fascicles as small as 50-300μm. The current μCEA records and stimulates from 28 channels and is designed for easy implantation and removal, bearing promise to enable neural interfacing in BM.

Characteristic corrosion resistance of nanocrystalline TiN films prepared by high density plasma reactive magnetron sputtering

Nanocytalline TiN films were deposited on non-alkali glass and Al substrates by reactive DC magnetron sputtering (DCMS) with an electromagnetic field system (EMF). The microstructure and corrosion resistance of the TiN-coated Al substrates were estimated by X-ray diffraction (XRD), scanning electron microscopy (SEM) and electrochemical methods. All the TiN films shows that they have a (111) preferred orientation at room temperature. TiN films deposited on Al substrate using only DCMS 400 W showed a sheet resistance of 3.22 x 10-1 omega/symbol see texts (resistivity, 3.22 x 10-5 omegacm). On the other hand, a relatively low sheet resistance of 1.91 x 10-1 omega/symbol see text (1.91 x 10-5 omegacm) was obtained for the dense nanocrystalline TiN film deposited on Al substrate using DCMS 375 W+ EMF 25 W, indicating that the introduction of an EMF system enhanced the electrical properties of the TiN film. TiN films deposited on Al substrate at 400 degreesC had a (200) preferred orientation with the lowest sheet resistance of 1.28x10-1 omega/symbol see texts (1.28 x 10-5 omegacm) which was attributed to reduced nano size defects and an improvement of the crystallinity. Potentiostatic and Potentiodynamic tests with a TiN-coated Al showed good corrosion resistance (l/corr, = 2.03 microA/cm2, Ecorr = -348 mV) compared to the uncoated Al substrate (/corr = 4.45 microA/cm2, Ecorr = -650 mV). Furthermore, EMF system showed that corrosion resistance of the TiN film also was enhanced compared to DCMS only. For the TiN film deposited on Al substrate at 400 degreesC, corrosion current and potential was 0.63 micro/cm2 and -1.5 mV, respectively. This improved corrosion resistance of the TiN film could be attributed to the densification of the film caused by enhancement of nitrification with increasing high reactive nitrogen radicals.

Partial posterior hyaloidectomy for macular disorders

PURPOSE

To evaluate the effect of partial posterior hyaloidectomy (PPH) in preventing iatrogenic retinal breaks related to the induction of a posterior vitreous detachment (IPVD).

METHODS

Fifty-nine patients who necessitated IPVD for an epiretinal membrane or macular hole were included in this prospective, interventional case series. Extensive removal of vitreous gel, close to the retina, was conducted before IPVD under 23 G (gauge)-vitrectomy system. The PPH involved the limited extent of IPVD and limited removal of the outermost vitreous cortex to an area slightly beyond the margin of the temporal major vascular arcade. The incidence of retinal breaks related to the surgery was compared with 57 eyes that had undergone conventional 23-G total vitrectomy accompanied by extensive IPVD using χ(2)-test.

RESULTS

Patients were followed-up for a mean of 14.3 months (6-30 months) after the surgery. The incidence of peripheral retinal breaks after the PPH was 3.4% (2/59 eyes), which was significantly lower than that in the eyes that underwent conventional 23 G vitrectomy (15.8%, 9/57 eyes, P=0.023) for the same disorders that required an IPVD. No patient complained of postoperative floaters, postoperatively.

CONCLUSIONS

PPH would be an efficient procedure to prevent iatrogenic peripheral retinal breaks related to an IPVD.