Patient understanding of pharmacogenomic test results in clinical care

OBJECTIVE

Previous research has not objectively assessed patients' comprehension of their pharmacogenomic test results. In this study we assessed understanding of patients who had undergone cytochrome P450 2C19 (CYP2C19) pharmacogenomic testing.

METHODS

31 semi-structured interviews with patients who underwent CYP2C19 testing after cardiac catheterization and had been sent a brochure, letter, and wallet card explaining their results. Answers to Likert and binary questions were summarized with descriptive statistics. Qualitative data were analyzed using a grounded theory approach, with particular focus on categorization.

RESULTS

No participants knew the name of the gene tested or their metabolizer status. Seven participants (23%) knew whether the testing identified any medications that would have lower effectiveness or increased adverse effects for them at standard doses ("Adequate Understanding"). Four participants (13%) read their results from the letter or wallet card they received but had no independent understanding ("Reliant on Written Materials"). Ten participants remembered receiving the written materials (32%).

CONCLUSION

A majority of participants who had undergone CYP2C19 PGx testing did not understand their results at even a minimal level and would be unable to communicate them to future providers.

PRACTICE IMPLICATIONS

Further research is necessary to improve patient understanding of PGx testing and their results, potentially through improving patient-provider communication.

Review of Domain Wall Dynamics Engineering in Magnetic Microwires

The influence of magnetic anisotropy, post-processing conditions, and defects on the domain wall (DW) dynamics of amorphous and nanocrystalline Fe-, Ni-, and Co-rich microwires with spontaneous and annealing-induced magnetic bistability has been thoroughly analyzed, with an emphasis placed on the influence of magnetoelastic, induced and magnetocrystalline anisotropies. Minimizing magnetoelastic anisotropy, either by the selection of a chemical composition with a low magnetostriction coefficient or by heat treatment, is an appropriate route for DW dynamics optimization in magnetic microwires. Stress-annealing allows further improvement of DW velocity and hence is a promising method for optimization of DW dynamics in magnetic microwires. The origin of current-driven DW propagation in annealing-induced magnetic bistability is attributed to magnetostatic interaction of outer domain shell with transverse magnetization orientation and inner axially magnetized core. The beneficial influence of the stress-annealing on DW dynamics has been explained considering that it allows increasing of the volume of outer domain shell with transverse magnetization orientation at the expense of decreasing the radius of inner axially magnetized core. Such transverse magnetic anisotropy can similarly affect the DW dynamics as the applied transverse magnetic field and hence is beneficial for DW dynamics optimization. Stress-annealing allows designing the magnetic anisotropy distribution more favorable for the DW dynamics improvement. Results on DW dynamics in various families of nanocrystalline microwires are provided. The role of saturation magnetization on DW mobility improvement is discussed. The DW shape, its correlation with the magnetic anisotropy constant and the microwire diameter, as well as manipulation of the DW shape by induced magnetic anisotropy are discussed. The engineering of DW propagation through local stress-annealing and DW collision is demonstrated.

Microwire-Based Sensor Array for Measuring Wheel Loads of Vehicles

In this paper, a magnetic microwire-based sensor array embedded under the pavement is proposed as a weighing system at customs ports of entry. This sensor is made of a cementitious material suitable for embedding within the core of concrete structures prior to curing. The objective of this research is to verify the feasibility of stress monitoring for concrete materials using an array of cement-based stress/strain sensors that have been developed using the magnetic sensing property of an embedded microwire in a cement-based composite. Test results for microwire-based sensors and gauge sensors are compared. The strain sensitivity and their linearity are investigated through experimental testing under compressive loadings. Sensors made of these materials can be designed to satisfy specific needs and reduce costs in the production of sensor aggregates with improved coupling performance, thus avoiding any disturbance to the stress state.

Long-term effect of nutrition on the metabolic status and reproductive potential of Merino rams under grazing conditions

To evaluate the impact of feeding rams for 14 weeks with legumes and supplement on their clinical, behavioural and endocrine responses, 32 Merino rams, 17 months old, were allocated to four groups (n = 8). The 2 × 2 factorial arrangement evaluated the pasture type (IP, improved pasture; NP, native pasture) and the effect of feeding (+S) or not (–S) feeding a supplement. Every 2 weeks liveweight, scrotal circumference and serving capacity were evaluated and blood samples taken to measure the concentrations of metabolites and metabolic hormones. Grazing behaviour was evaluated every 4 weeks. Rams grazing IP (61.8 ± 0.7 kg) were heavier than those grazing NP (59.6 ± 0.7 kg; P < 0.05), and +S rams (61.8 ± 0.7 kg) heavier than –S rams (59.3 ± 0.6 kg; P < 0.05). Compared with rams from the IP+S, IP–S and NP+S, rams grazing NP–S lost weight (P < 0.001) during the experiment. The scrotal circumference was larger in IP+S (30 ± 0.4 cm), IP–S (30 ± 0.4 cm) and NP+S (31 ± 04 cm) than in NP–S (29 ± 0.4 cm; P < 0.001). Only in rams from the group NP+S was a significant increase in scrotal circumference observed during the trial (P < 0.05). The supplement tended to maintain the mating potential elevated towards the end of the experiment (+S: 74.3 ± 5.4 and –S: 61.7 ± 6.3 ewes/ram; P = 0.07). Supplemented rams were less frequently seen grazing (47 ± 3%) than non-supplemented rams (57 ± 4%; P = 0.09). Rams grazing IP ruminated more frequently (13 ± 2%) than those grazing NP (9 ± 2%; P < 0.001). Events such as lying down, playing, self-grooming and drinking water were more frequent in supplemented (36 ± 2%) than non-supplemented rams (30 ± 2%; P = 0.09). The supplement increased the concentrations of insulin and glucose and decreased the concentrations of non-esterified fatty acids, albumin and urea (P < 0.05). IP increased the concentrations of insulin-like growth factor-I, protein, albumin and urea and tended to increase the concentrations of insulin. We conclude that feeding Merino rams a high plane of nutrition reduced the frequency of grazing events and stimulated a long-term improvement of the metabolic status, evidenced by an increase in liveweight and scrotal circumference, with relevant implications for their mating potential.

Thermal annealing dependence of high-frequency magnetoimpedance in amorphous and nanocrystalline FeSiBCuNb ribbons

The magnetoimpedance (MI) effect in Fe73.5Si13.5B9Nb3Cu1 melt-spun amorphous ribbons has been studied in the frequency range (1-500 MHz). Isothermal heating treatments in a furnace have been employed to nanocrystallize the ribbons (1 h at 565 degrees C in a vacuum of 10(-3) mbar), while other samples were annealed at lower temperatures (400 and 475 degrees C during 1 h), in order to evaluate the influence of the annealing temperature on the MI effect. The high-frequency impedance was measured using a technique based on the reflection coefficient measurements of a specific transmission line by using a network analyzer. Frequency dependence of the MI ratio, DeltaZ/Z, and both resistive, DeltaR/R, and reactive, DeltaX/X, components of magnetoimpedance were measured in the amorphous and annealed states, at different temperatures. A maximum value of the MI ratio of about 50% at a driving frequency of 18 MHz is obtained in the nanocrystalline (annealed at 565 degrees C) ribbon. Maxima for DeltaR/R of about 81% at 85 MHz and DeltaX/X around 140% at 5 MHz were also achieved. It is revealed that the microstructural evolution in the nanocrystalline sample leads to a magnetic softening, an optimum domain structure and a permeability which is sensitive to frequency and applied magnetic field, generating a large MI response.

[Mesenteric fibromatosis as the cause of a single abdominal mass]

We present a mesenteric desmoid tumor in a man without associated diseases. Characteristics of this tumor are reviewed and the need to perform total exeresis of the mass for diagnosis is emphasized. Although surgery is the treatment of choice, alternative treatments are recommended when surgery cannot be performed, has been incomplete, or in cases of repeated recurrence.