Electrospun Spiderskin Bandage for Epidermal Protection and Recovery

Spider silk is one of nature\u27s most promising biomaterial s for a variety of applications, however, due to the inability to farm spiders, transgenic hosts are required for large-scale production. With the unique combination of strength, elasticity, and biocompatibility, spider silk has an incredible potential for use in the human body. This study was conducted to merge two major applications of spider silk for the creation of a novel bandaging product. Electrospinning technology was utilized to create a spider silk/polymer bandage matrix to be applied with an aqueous spider silk skin adhesive. In designing the bandaging matrix , the mechanical properties of the electrospun silk were evaluated against commercially-available product s and known values of human skin. The chosen formulation had physical properties more comparable human skin than commercially-available products. The aqueous adhesive was tested in conjunction with the electro spun matrix for its adhesion and found comparable to commercial products. The durability of the bandage was tested via cyclic stresses and found analogous to commercial products. The common antimicrobial chlorhexidine was incorporated into the adhesive and had a release profile lasting about 4 days. With this incorporation into the aqueous adhesive, the adhesive can be reapplied to provide additional antimicrobial protection, a necessity in the healthcare industry. The bandaging showed no signs of inhibiting mammalian cell proliferation under cytotoxicity testing. The final product, deemed SpiderSkin, presents a unique bandaging solution capable of providing a healthy environment for the regeneration of epidermal tissue, while protecting the wound from outside infection , and providing mechanical stability similar to that of human skin

Development of a Multilevel Intervention to Increase Colorectal Cancer Screening in Appalachia

Background Colorectal cancer (CRC) screening rates are lower in Appalachian regions of the United States than in non-Appalachian regions. Given the availability of various screening modalities, there is critical need for culturally relevant interventions addressing multiple socioecological levels to reduce the regional CRC burden. In this report, we describe the development and baseline findings from year 1 of “Accelerating Colorectal Cancer Screening through Implementation Science (ACCSIS) in Appalachia,” a 5-year, National Cancer Institute Cancer MoonshotSM-funded multilevel intervention (MLI) project to increase screening in Appalachian Kentucky and Ohio primary care clinics. Methods Project development was theory-driven and included the establishment of both an external Scientific Advisory Board and a Community Advisory Board to provide guidance in conducting formative activities in two Appalachian counties: one in Kentucky and one in Ohio. Activities included identifying and describing the study communities and primary care clinics, selecting appropriate evidence-based interventions (EBIs), and conducting a pilot test of MLI strategies addressing patient, provider, clinic, and community needs. Results Key informant interviews identified multiple barriers to CRC screening, including fear of screening, test results, and financial concerns (patient level); lack of time and competing priorities (provider level); lack of reminder or tracking systems and staff burden (clinic level); and cultural issues, societal norms, and transportation (community level). With this information, investigators then offered clinics a menu of EBIs and strategies to address barriers at each level. Clinics selected individually tailored MLIs, including improvement of patient education materials, provision of provider education (resulting in increased knowledge, p = .003), enhancement of electronic health record (EHR) systems and development of clinic screening protocols, and implementation of community CRC awareness events, all of which promoted stool-based screening (i.e., FIT or FIT-DNA). Variability among clinics, including differences in EHR systems, was the most salient barrier to EBI implementation, particularly in terms of tracking follow-up of positive screening results, whereas the development of clinic-wide screening protocols was found to promote fidelity to EBI components. Conclusions Lessons learned from year 1 included increased recognition of variability among the clinics and how they function, appreciation for clinic staff and provider workload, and development of strategies to utilize EHR systems. These findings necessitated a modification of study design for subsequent years. Trial registration Trial NCT04427527 is registered at https://clinicaltrials.gov and was registered on June 11, 2020

Diet and Health-related Quality of Life Among Men on Active Surveillance for Early-stage Prostate Cancer: The Men’s Eating and Living Study (Cancer and Leukemia Group 70807 [Alliance])

BackgroundHealth-related quality of life (HRQoL) among patients with localized prostate cancer (PC) on active surveillance (AS) and whether it may be improved through lifestyle-focused interventions remain underdefined.ObjectiveTo assess longitudinal changes in HRQoL in patients who received and those who did not receive a behavioral intervention that increased vegetable intake.Design, setting, and participantsA secondary analysis of participants in the Men's Eating and Living (MEAL) study (Cancer and Leukemia Group 70807 [Alliance]), a randomized trial of vegetable consumption in patients on AS, was conducted.Outcome measurements and statistical analysisPatient-reported outcomes (PROs) included the Memorial Anxiety Scale for Prostate Cancer (MAX-PC), the Expanded Prostate Cancer Index Composite 26 (EPIC-26), and the Functional Assessment of Cancer Therapy Scale-Prostate (FACT-P). Areas under the curves (AUCs) were used to summarize serial HRQoL.Results and limitationsPROs were completed in 87% (n = 387) of the intention-to-collect population. Baseline characteristics of patients completing HRQoL measures did not differ significantly from the entire study population or between groups. Baseline scores were high for all PROs and remained stable over 24 mo, with no significant differences from baseline at any time point. In adjusted analyses, there were no significant differences in summary AUC measures comparing control with intervention for the total MAX-PC score (p = 0.173); EPIC-26 domains of urinary incontinence (p = 0.210), urinary obstruction (p = 0.062), bowel health (p = 0.607), sexual health (p = 0.398), and vitality (p = 0.363); and total FACT-P scores (p = 0.471).ConclusionsAmong men with localized PC on AS enrolled in a randomized trial, HRQoL was high across multiple domains at baseline, remained high during follow-up, and did not change in response to a behavioral intervention that increased vegetable intake.Patient summaryPatients with localized prostate cancer enrolled on active surveillance experience minimal cancer-associated anxiety, suffer low levels of cancer-associated symptoms, and perceive high physical and emotional well-being