Barriers in the management of cancerrelated pain and strategies to overcome them: findings of a qualitative research involving physicians and nurses in Italy

Introduction and aims. There are many barriers and obstacles that even today lead to an inadequate treatment of cancer-related pain. The aim is to describe the experiences of a group of Italian physicians and nurses as far as the nature of these barriers is concerned and the possible tools to be used to overcome them. Material and method. We run 5 focus groups with 42 healthcare professionals (11 physicians, 31 nurses) working in 5 hospitals in Italy. The findings of the focus groups were analysed according to the “Content Analysis” method. Results. Five main items emerged: the importance of communication, the need for education regarding pain therapy, the ethnic/cultural/religious differences, the mutual trust and support within the working group, the daily challenges. Conclusion. In harmony with the most recent literature, physicians and nurses voice above all their need for an education more directly aimed at overcoming the prevailing barriers rooted in ignorance, prejudice and fears

Long-Term Effect of Physical Exercise on the Risk for Hospitalization and Death in Dialysis Patients. A Post-Trial Long-Term Observational Study

Background and objectives In the EXerCise Introduction to Enhance Performance in Dialysis (EXCITE) trial, a simple, personalized 6-month walking exercise program at home during the day off of dialysis improved the functional status and the risk for hospitalization in patients with kidney failure. In this post-trial observational study, we tested whether the same intervention was associated with a lower long-term risk of death or hospitalization (combined end point) during a follow-up extended up to 36 months. Design, setting, participants, & measurements In total, 227 patients (exercise, n5104; control, n5123) completed the 6-month trial and entered the post-trial observational study. Data were analyzed by unadjusted and adjusted Cox regression analyses and Bayesian analysis. Results In the long-term observation (up to 36 months), 134 events were recorded (eight deaths not preceded by hospitalization and 126 hospitalizations, which were followed by death in 38 cases). The long-term risk for hospitalization or death was 29% lower (hazard ratio, 0.71; 95% confidence interval, 0.50 to 1.00), and in an analysis stratified by adherence to the walking exercise program during the 6-month trial, the subgroup with high adherence (.60% of prescribed sessions) had a 45% lower risk as compared with the control group (hazard ratio, 0.55; 95% confidence interval, 0.35 to 0.87). A Bayesian analysis showed that the posterior probability of a hazard ratio of 0.71 (95% confidence interval, 0.50 to 1.00) for the risk of the composite outcome observed in the post-trial observational study was 93% under the conservative prior and 97% under the optimistic prior. Sensitivity analyses restricted to the risk of hospitalization only or censoring patients at the time of transplantation fully confirmed these findings. Conclusions A simple, personalized, home-based, low-intensity exercise program was associated with a lower risk of hospitalization

Environmental sustainability fruit quality and production in mycorrhizal tomato plants without P fertilizing

The influence of root colonization by arbuscular mycorrhizal (AM) fungus Funelliformis mosseae, on fruit quality, production and environmental sustainability were evaluated in field-tomato plants grown exposed to P-limited soil 5 µg g -1 soil (basal-soil) with nitrate fertilization (50 µg g -1 soil), after greenhouse germination and fungus colonization. After 60 days sowing (DAS), when the percentage of mycorrhizal root length (% RLC) raised at about 50%, the plants were transplanted in open field. During the experiment, the mycorrhization has affected a lot of physiological aspects like vegetative and reproductive growth, improving them and ended the fruiting with a major fruit production that was 50% higher than not mycorrhizal (NM) plants. The ripening process of the fruits was also followed by testing sugars content and ß-Amylase activity in fruits of NM and mycorrhizal (M) plants fruits. At 140 DAS, in the harvesting fruits stage, fruits of M plants showed significantly higher mineral nutrient sugars and organic nitrogen compounds as amino acids and protein, compared to fruits from NM plants. In particular, GLU-GLN-ASP and ASN raised about 35% more than fruits from NM plants, improving nutritional aspect and flavor of the product. THR-ILEU-LEU-VAL and LYS, essential amino acids in man nutrition, increased around 25% more than fruits from NM plants, too. In this contest, lycopene, total carotenoids, ascorbic acid and glutathione (GS) and reduced form (GSH) were also tested in ripe fruits. The overall results suggest that tomato roots colonization by mycorrhizal fungus Funelliformis mosseae affects host plant nutritional status, modifying reproductive behavior, fruits production and nutritional quality

Obesity and Breast Cancer: Interaction or Interference with the Response to Therapy?

Background: Aromatase inhibitors (AI) are widely used for treating hormone-sensitive breast cancer (BC). Obesity, however, due to aromatase-mediated androgen conversion into estradiol in the peripheral adipose tissue, might impair AI inhibitory capacity. We aimed at identifying a cut-off of body mass index (BMI) with significant prognostic impact, in a cohort of stage I-II BC patients on systemic adjuvant therapy with AI. Methods: we retrospectively evaluated routinely collected baseline parameters. The optimal BMI cut-off affecting disease-free survival (DFS) in AI-treated BC patients was identified through maximally selected rank statistics; non-linear association between BMI and DFS in the AI cohort was assessed by hazard-ratio-smoothed curve analysis using BMI as continuous variable. The impact of the BMI cut-off on survival outcomes was estimated through Kaplan-Meier plots, with log-rank test and hazard ratio estimation comparing patient subgroups. Results: A total of 319 BC patients under adjuvant endocrine therapy and/or adjuvant chemotherapy were included. Curve-fitting analysis showed that for a BMI cut-off >29 in AI-treated BC patients (n = 172), DFS was increasingly deteriorating and that the impact of BMI on 2-year DFS identified a cut-off specific only for the cohort of postmenopausal BC patients under adjuvant therapy with AI. Conclusion: in radically resected hormone-sensitive BC patients undergoing neoadjuvant or adjuvant chemotherapy and treated with AI, obesity represents a risk factor for recurrence, with a significantly reduced 2-year DFS

Sensors for the monitoring of analytes in the sweat

In the last decade, can be found an exceptional growth in research activity relating to the development of wearable devices, capable of continuously monitoring the health conditions of the wearer by analyzing body fluids such as blood, urine, saliva, tears and sweat. Among the body fluids available, sweat is a biofluid of particular interest, as it allows a non-invasive, continuous and comfortable collection. Human sweat contains useful information on the health of an individual and therefore is an excellent biofluid for the detection of specific analytes. The most abundant ions in the sweat are Na+ and Cl- (10 - 100 mM), and their monitoring is useful in patients with cystic fibrosis. Other constituents are Ca2+, K+, ascorbic acid, glucose (0.1-10 µM) related to osteoporosis, hypoaldosteronism, scurvy and diabetes disease. The sweat pH is in the range 3 to 8 [1] [2] and indicates the level of metabolism and homeostasis of the body. Wearable sensor needs to be flexible, compact and easily applicable. It must also offer a stable response, with high sensitivity and selectivity towards specific analytes [3]. Over the years, many wearable sensors for sweat monitoring have been developed, combining different form factors, substrates and sensing mechanism. In this work, electrochemical sensors based on polyaniline (PANi), which is pH sensitive, were studied. First, the best conditions of electrochemical deposition of PANi were studied [4], using as flexible substrate polyethylene terephthalate coated with indium-tin oxide (ITO-PET). In order to improve the sensor performance electrodes were also modified by electrochemical deposition of reduced graphene oxide (rGO). All samples were characterized by XRD, SEM and EDS analysis in order to study morphology and evaluate the crystalline phases of the deposited PANi. The electrodes were tested as pH sensors using different buffer solutions, from 2 to 8, by Open Circuit Potential (OCP) technique. The ITO-PET/rGO/PANi electrodes show good behavior in terms of sensitivity (62.3 mV/pH), very close to Nernstian response of 59 mV/pH and reproducibility of 3.8%. Flexibility and mechanical stability tests were carried out on the sensor to evaluate both the wearability and mechanical resistance. In addition, interference tests, in the presence of competing ions such as Na+, Cl-, K+, NH4+, aimed to verify the selectivity were also performed

Design of a control architecture for an underwater remotely operated vehicle (ROV) used for search and rescue operations

summary:A control system architecture design for an underwater ROV, primarily Class I - Pure Observation underwater ROV is presented in this paper. A non-linear plant model was designed using SolidWorks 3D modeling tool and is imported to MATLAB as a 3D model. The non-linear modeled plant is linearized using the MATLAB linear analysis toolbox to have a linear approximate model of the system. The authors designed controllers for the linear plant model of underwater ROV. PID controllers are utilized as a controller of the modeled plant. The PID tuning tools by MATLAB are utilized to tune the controller of the plant model of underwater ROV. The researchers test the control design of underwater ROV using MATLAB Simulink by analyzing the response of the system and troubleshoot the control design to achieve the objective parameters for the control design of underwater ROV