INFLUENCE OF PIRACETAM ON ERYTHROPOIESIS IN RATS

The effects of piracetam (2 x 200 mg/kg b. w.) injected intraperitoneally for three days on erythropoiesis and some functional characteristics of erythrocytes were studied in Wistar rats. A significant increase of reticulocytes in relative (by 122,03 %, p < 0,01) and in absolute counts (by 109,29 %, p < 0,01), an increase of 59Fе incorporation in newly-formed erythrocytes (by 13,80 %) and a significant rise of erythroblasts as followed: total counts (by 59,39 %, p < 0,01), proerythroblasts (by 52,87 %, p < 0,05), and orthochromatic erythroblasts (by 54,25 %, p< 0,01) were observed in the piracetamtreated rats. It was accepted that piracetam stimulated erythroid proliferation and differentiation. Erythroid deformability enhanced by 14,69 % (p < 0,01) but spontaneous haemolysis of erythrocytes reduced by 16,95 % (p < 0,025). Thus it could be suggested that piracetam, along with its stimulatory effect on erythropoiesis, improves some of the most important functional characteristics of erythrocytes such as deformability and oxidative resistance

The Interplay between Light Quality and Biostimulant Application Affects the Antioxidant Capacity and Photosynthetic Traits of Soybean (Glycine max L. Merrill).

This paper evaluates the combined effect of biostimulant and light quality on bioactive compound production and seedling growth of soybean (Glycine max L. Merrill) plants. Germinated seeds pre-treated with different concentrations (0.01%, 0.05%, 0.5%) of an amino acid-based biostimu-lant were grown for 4 days at the dark (D), white fluorescent light (FL), full-spectrum LED (FS), and red-blue (RB) light. Potential changes in the antioxidant content of sprouts were evaluated. Part of the sprouts was left to grow at FL, FS, and RB light regimes for 24 days to assess modifications in plants’ anatomical and physiological traits during the early developmental plant stage. The seed pre-treatment with all biostimulant concentrations significantly increased sprout antioxidant compounds, sugar, and protein content compared to the control (seeds treated with H2 O). The positive effect on bioactive compounds was improved under FS and RB compared to D and FL light regimes. At the seedling stage, 0.05% was the only concentration of biostimulant effective in increasing the specific leaf area (SLA) and photosynthetic efficiency. Compared to FL, the growth under FS and RB light regimes significantly enhanced the beneficial effect of 0.05% on SLA and photosynthesis. This concentration led to leaf thickness increase and shoot/root ratio reduction. Our findings demonstrated that seed pre-treatment with proper biostimulant concentration in combination with specific light regimes during plant development may represent a useful means to modify the bioactive compound amount and leaf structural and photosynthetic traits

Manipulation of light quality is an effective tool to regulate photosynthetic capacity and fruit antioxidant properties of Solanum lycopersicum L. cv. ‘Microtom’ in a controlled environment

Light quality plays an essential role in setting plant structural and functional traits, including antioxidant compounds. This paper aimed to assess how manipulating the light spectrum during growth may regulate the photosynthetic activity and fruit bioactive compound synthesis in Solanum lycopersicum L. cv. ‘Microtom’ to improve plant physiological performance and fruit nutritional value. Plants were cultivated under three light quality regimes: red-green-blue LEDs (RGB), red-blue LEDs (RB) and white fluorescent lamps (FL), from sowing to fruit ripening. Leaf functional traits, photosynthetic efficiency, Rubisco and D1 protein expression, and antioxidant production in fruits were analyzed. Compared to FL, RGB and RB regimes reduced height and increased leaf number and specific leaf area, enhancing plant dwarf growth. The RGB regime improved photosynthesis and stomatal conductance despite lower biomass, favoring Rubisco synthesis and carboxylation rate than RB and FL regimes. The RB light produced plants with fewer flowers and fruits with a lower ascorbic acid amount but the highest polyphenol content, antioxidant capacity and SOD and CAT activities. Our data indicate that the high percentage of the green wavelength in the RGB regime promoted photosynthesis and reduced plant reproductive capacity compared to FL and RB. Conversely, the RB regime was the best in favoring the production of health-promoting compounds in tomato berries

Training clinicians in how to use patient-reported outcome measures in routine clinical practice

Introduction: Patient-reported outcome measures (PROs) were originally developed for comparing groups of people in clinical trials and population studies, and the results were used to support treatment recommendations or inform health policy, but there was not direct benefit for the participants providing PROs data. However, as the experience in using those measures increased, it became obvious the clinical value in using individual patient PROs profiles in daily practice to identify/monitor symptoms, evaluate treatment outcomes and support shared decision-making. A key issue limiting successful implementation is clinicians’ lack of knowledge on how to effectively utilize PROs data in their clinical encounters. Methods: Using a change management theoretical framework, this paper describes the development and implementation of three programs for training clinicians to effectively use PRO data in routine practice. The training programs are in three diverse clinical areas (adult oncology, lung transplant and paediatrics), in three countries with different healthcare systems, thus providing a rare opportunity to pull out common approaches whilst recognizing specific settings. For each program, we describe the clinical and organizational setting, the program planning and development, the content of the training session with supporting material, subsequent monitoring of PROs use and evidence of adoption. The common successful components and practical steps are identified, leading to discussion and future recommendations. Results: The results of the three training programs are described as the implementation. In the oncology program, PRO data have been developed and are currently evaluated; in the lung transplant program, PRO data are used in daily practice and the integration with electronic patient records is under development; and in the paediatric program, PRO data are fully implemented with around 7,600 consultations since the start of the implementation. Conclusion: Adult learning programs teaching clinicians how to use and act on PROs in clinical practice are a key steps in supporting patient engagement and participation in shared decision-making. Researchers and clinicians from different clinical areas should collaborate to share ideas, develop guidelines and promote good practice in patient-centred care

Long-term health-related quality of life in meningioma survivors: a mixed-methods systematic review

Background Meningiomas account for ~25% of all primary brain tumours. These tumours have a relatively favourable prognosis with ~92% of meningioma patients surviving > 5 years after diagnosis. Yet, patients can report high disease burden and survivorship issues even years after treatment, affecting health-related quality of life (HRQOL). We aimed to systematically review the literature and synthesise evidence on HRQOL in meningioma patients across long-term survival, defined as >2 years post diagnosis. Methods Systematic literature searches were carried out using Medline, EMBASE, CINAHL, PsycINFO, and Web of Science Core Collection. Any published, peer reviewed article with primary quantitative, qualitative, or mixed methods data covering the physical, mental, and/or social aspects of HRQOL of meningioma survivors were included. Narrative synthesis method was used to interpret findings. Results Searches returned 2253 unique publications, of which 21 were included. Of these, N=15 involved quantitative methodology, N=4 mixed methods and N=2 were qualitative reports. Patient sample survival ranged from 2.75–13 years. HRQOL impairment was seen across all domains. Physical issues included persevering symptoms (e.g. headaches, fatigue, vision problems); mental issues comprised emotional burden (e.g., high prevalence of depressive symptoms and anxiety) and cognitive complaints; social issues included role limitations, social isolation, and affected work productivity. Due to study heterogeneity, the impact of treatment on long-term HRQOL remains unclear. Conclusions Findings from this review highlight the areas of HRQOL that can be impacted in long-term survivorship for patients with meningioma. These findings could help raise awareness among clinicians and patients, facilitating support provision

Assessing the quality and communicative aspects of patient decision aids for early-stage breast cancer treatment: a systematic review

Purpose: Decision aids (DAs) support patients in shared decision-making by providing balanced evidence-based treatment information and eliciting patients’ preferences. The purpose of this systematic review was to assess the quality and communicative aspects of DAs for women diagnosed with early-stage breast cancer. Methods: Twenty-one currently available patient DAs were identified through both published literature (MEDLINE, Embase, CINAHL, CENTRAL, and PsycINFO) and online sources. The DAs were reviewed for their quality by using the International Patient Decision Aid Standards (IPDAS) checklist, and subsequently assessed to what extent they paid attention to various communicative aspects, including (i) information presentation, (ii) personalization, (iii) interaction, (iv) information control, (v) accessibility, (vi) suitability, and (vii) source of information. Results: The quality of the DAs varied substantially, with many failing to comply with all components of the IPDAS criteria (mean IPDAS score = 64%, range 31–92%). Five aids (24%) did not include any probability information, 10 (48%) presented multimodal descriptions of outcome probabilities (combining words, numbers, and visual aids), and only 2 (10%) provided personalized treatment outcomes based on patients and tumor characteristics. About half (12; 57%) used interaction methods for eliciting patients’ preferences, 16 (76%) were too lengthy, and 5 (24%) were not fully accessible. Conclusions: In addition to the limited adherence to the IPDAS checklist, our findings suggest that communicative aspects receive even less attention. Future patient DA developments for breast cancer treatment should include communicative aspects that could influence the uptake of DAs in daily clinical practice

An audit of acute oncology services: patient experiences of admission procedures and staff utilisation of a new telephone triage system.

OBJECTIVES: In 2010, St. James Institute of Oncology (Leeds, UK) created a new acute oncology service (AOS) consisting of a new admissions unit with a nurse-led telephone triage (TT) system. This audit cycle (March 2011 and June 2013) evaluated patient experiences of the reconfigured AOS and staff use of the TT system. METHODS: Patient views were elicited via a questionnaire and semi-structured interviews. The TT forms were analysed descriptively evaluating completion and data quality, reported symptoms and their severity and advice given (including admission rates). RESULTS: Patients (n = 40) reported high satisfaction with the new AOS. However, 56 % of patients delayed 2 days or more before contacting the unit. In 2011, 26 % of all the admitted patients were triaged via the TT system; 133 TT forms were completed. In June 2013, 49 % of the admitted patients were triaged; 264 forms were completed. The most commonly reported symptoms on the TT forms were pain, pyrexia/rigors/infection, diarrhoea, vomiting and dyspnoea. Half of the patients using the TT system were admitted (52 % in 2011, 49 % in 2013). CONCLUSIONS: Our audit provided evidence of successful implementation of the TT system with the number of TT forms doubling from 2011 to 2013. The new AOS was endorsed by patients, with the majority satisfied with the care they received

Systematic Review of Patient-Reported Outcome Measures in Locally Recurrent Rectal Cancer

Background The availability of high-quality patient-reported outcome (PRO) data is crucial to guiding shared decision-making in the context of locally recurrent rectal cancer (LRRC), where potential treatment benefits must be balanced against the impact of both the disease and treatment on PROs, such as quality of life. This review aimed to identify the patient-reported outcome measures (PROMs) currently being reported in LRRC and to appraise the methodological quality of studies using these measures. Methods PubMed, Embase and CINAHL databases were searched, including studies published up until 14th September 2022. Studies in adults with LRRC reporting PROMS as a primary or secondary outcome measure were included. Data were extracted concerning the methodological quality of the reporting of PROMs using criteria informed by the CONSORT-PRO checklist and the psychometric properties of the PROMs identified using the COSMIN Risk of Bias checklist. Results Thirty-five studies including 1914 patients with LRRC were identified. None of the studies included in the review met all eleven criteria for the quality of reporting of PROMs. Seventeen PROMs and two clinician-reported outcome measures were identified, none of which have been validated for use in patients with LRRC. Conclusions None of the PROMs which are currently being used to report PROs in LRRC have been validated for use in this cohort of patients. Future studies in this disease area should focus on utilising PROMs that have undergone a robust development process including patients with LRRC, to produce data which is high quality, accurate and relevant