Predicting Effective Adaptation to Breast Cancer to Help Women BOUNCE Back : Protocol for a Multicenter Clinical Pilot Study

Publisher Copyright: © 2022 Greta Pettini.Background: Despite the continued progress of medicine, dealing with breast cancer is becoming a major socioeconomic challenge, particularly due to its increasing incidence. The ability to better manage and adapt to the entire care process depends not only on the type of cancer but also on the patient's sociodemographic and psychological characteristics as well as on the social environment in which a person lives and interacts. Therefore, it is important to understand which factors may contribute to successful adaptation to breast cancer. To our knowledge, no studies have been performed on the combination effect of multiple psychological, biological, and functional variables in predicting the patient's ability to bounce back from a stressful life event,such as a breast cancer diagnosis. Here we describe the study protocol of a multicenter clinical study entitled "Predicting Effective Adaptation to Breast Cancer to Help Women to BOUNCE Back"or, in short, BOUNCE. Objective: The aim of the study is to build a quantitative mathematical model of factors associated with the capacity for optimal adjustment to cancer and to study resilience through the cancer continuum in a population of patients with breast cancer. Methods: A total of 660 women with breast cancer will be recruited from five European cancer centers in Italy, Finland, Israel, and Portugal. Biomedical and psychosocial variables will be collected using the Noona Healthcare platform. Psychosocial, sociodemographic, lifestyle, and clinical variables will be measured every 3 months, starting from presurgery assessment (ie, baseline) to 18 months after surgery. Temporal data mining, time-series prediction, sequence classification methods, clustering time-series data, and temporal association rules will be used to develop the predictive model. Results: The recruitment process stared in January 2019 and ended in November 2021. Preliminary results have been published in a scientific journal and are available for consultation on the BOUNCE project website. Data analysis and dissemination of the study results will be performed in 2022. Conclusions: This study will develop a predictive model that is able to describe individual resilience and identify different resilience trajectories along the care process. The results will allow the implementation of tailored interventions according to patients' needs, supported by eHealth technologies.Peer reviewe

The effect of bone marrow microenvironment on the functional properties of the therapeutic bone marrow-derived cells in patients with acute myocardial infarction

<p>Abstract</p> <p>Background</p> <p>Treatment of acute myocardial infarction with stem cell transplantation has achieved beneficial effects in many clinical trials. The bone marrow microenvironment of ST-elevation myocardial infarction (STEMI) patients has never been studied even though myocardial infarction is known to cause an imbalance in the acid-base status of these patients. The aim of this study was to assess if the blood gas levels in the bone marrow of STEMI patients affect the characteristics of the bone marrow cells (BMCs) and, furthermore, do they influence the change in cardiac function after autologous BMC transplantation. The arterial, venous and bone marrow blood gas concentrations were also compared.</p> <p>Methods</p> <p>Blood gas analysis of the bone marrow aspirate and peripheral blood was performed for 27 STEMI patients receiving autologous stem cell therapy after percutaneous coronary intervention. Cells from the bone marrow aspirate were further cultured and the bone marrow mesenchymal stem cell (MSC) proliferation rate was determined by MTT assay and the MSC osteogenic differentiation capacity by alkaline phosphatase (ALP) activity assay. All the patients underwent a 2D-echocardiography at baseline and 4 months after STEMI.</p> <p>Results</p> <p>As expected, the levels of pO₂, pCO₂, base excess and HCO₃were similar in venous blood and bone marrow. Surprisingly, bone marrow showed significantly lower pH and Na⁺and elevated K⁺levels compared to arterial and venous blood. There was a positive correlation between the bone marrow pCO₂and HCO₃levels and MSC osteogenic differentiation capacity. In contrast, bone marrow pCO₂and HCO₃levels displayed a negative correlation with the proliferation rate of MSCs. Patients with the HCO₃level below the median value exhibited a more marked change in LVEF after BMC treatment than patients with HCO₃level above the median (11.13 ± 8.07% vs. 2.67 ± 11.89%, P = 0.014).</p> <p>Conclusions</p> <p>Low bone marrow pCO₂and HCO₃levels may represent the optimal environment for BMCs in terms of their efficacy in autologous stem cell therapy in STEMI patients.</p

Planetary well-being

Tensions between the well-being of present humans, future humans, and nonhuman nature manifest in social protests and political and academic debates over the future of Earth. The increasing consumption of natural resources no longer increases, let alone equalises, human well-being, but has led to the current ecological crisis and harms both human and nonhuman well-being. While the crisis has been acknowledged, the existing conceptual frameworks are in some respects ill-equipped to address the crisis in a way that would link the resolving of the crisis with the pivotal aim of promoting equal well-being. The shortcomings of the existing concepts in this respect relate to anthropocentric normative orientation, methodological individualism that disregards process dynamics and precludes integrating the considerations of human and nonhuman well-being, and the lack of multiscalar considerations of well-being. This work derives and proposes the concept of planetary well-being to address the aforementioned conceptual issues, to recognise the moral considerability of both human and nonhuman well-being, and to promote transdisciplinary, cross-cultural discourse for addressing the crisis and for promoting societal and cultural transformation. Conceptually, planetary well-being shifts focus on well-being from individuals to processes, Earth system and ecosystem processes, that underlie all well-being. Planetary well-being is a state where the integrity of Earth system and ecosystem processes remains unimpaired to a degree that species and populations can persist to the future and organisms have the opportunity to achieve well-being. After grounding and introducing planetary well-being, this work shortly discusses how the concept can be operationalised and reflects upon its potential as a bridging concept between different worldviews.</p

Effect of remdesivir post hospitalization for COVID-19 infection from the randomized SOLIDARITY Finland trial

We report the first long-term follow-up of a randomized trial (NCT04978259) addressing the effects of remdesivir on recovery (primary outcome) and other patient-important outcomes one year after hospitalization resulting from COVID-19. Of the 208 patients recruited from 11 Finnish hospitals, 198 survived, of whom 181 (92%) completed follow-up. At one year, self-reported recovery occurred in 85% in remdesivir and 86% in standard of care (SoC) (RR 0.94, 95% CI 0.47-1.90). We infer no convincing difference between remdesivir and SoC in quality of life or symptom outcomes (p > 0.05). Of the 21 potential long-COVID symptoms, patients reported moderate/major bother from fatigue (26%), joint pain (22%), and problems with memory (19%) and attention/concentration (18%). In conclusion, after a one-year follow-up of hospitalized patients, one in six reported they had not recovered well from COVID-19. Our results provide no convincing evidence of remdesivir benefit, but wide confidence intervals included possible benefit and harm.Peer reviewe

Predicting Effective Adaptation to Breast Cancer to Help Women BOUNCE Back : Protocol for a Multicenter Clinical Pilot Study

Publisher Copyright: © 2022 Greta Pettini.Background: Despite the continued progress of medicine, dealing with breast cancer is becoming a major socioeconomic challenge, particularly due to its increasing incidence. The ability to better manage and adapt to the entire care process depends not only on the type of cancer but also on the patient's sociodemographic and psychological characteristics as well as on the social environment in which a person lives and interacts. Therefore, it is important to understand which factors may contribute to successful adaptation to breast cancer. To our knowledge, no studies have been performed on the combination effect of multiple psychological, biological, and functional variables in predicting the patient's ability to bounce back from a stressful life event,such as a breast cancer diagnosis. Here we describe the study protocol of a multicenter clinical study entitled "Predicting Effective Adaptation to Breast Cancer to Help Women to BOUNCE Back"or, in short, BOUNCE. Objective: The aim of the study is to build a quantitative mathematical model of factors associated with the capacity for optimal adjustment to cancer and to study resilience through the cancer continuum in a population of patients with breast cancer. Methods: A total of 660 women with breast cancer will be recruited from five European cancer centers in Italy, Finland, Israel, and Portugal. Biomedical and psychosocial variables will be collected using the Noona Healthcare platform. Psychosocial, sociodemographic, lifestyle, and clinical variables will be measured every 3 months, starting from presurgery assessment (ie, baseline) to 18 months after surgery. Temporal data mining, time-series prediction, sequence classification methods, clustering time-series data, and temporal association rules will be used to develop the predictive model. Results: The recruitment process stared in January 2019 and ended in November 2021. Preliminary results have been published in a scientific journal and are available for consultation on the BOUNCE project website. Data analysis and dissemination of the study results will be performed in 2022. Conclusions: This study will develop a predictive model that is able to describe individual resilience and identify different resilience trajectories along the care process. The results will allow the implementation of tailored interventions according to patients' needs, supported by eHealth technologies.Peer reviewe

Planetary well-being

Tensions between the well-being of present humans, future humans, and nonhuman nature manifest in social protests and political and academic debates over the future of Earth. The increasing consumption of natural resources no longer increases, let alone equalises, human well-being, but has led to the current ecological crisis and harms both human and nonhuman well-being. While the crisis has been acknowledged, the existing conceptual frameworks are in some respects ill-equipped to address the crisis in a way that would link the resolving of the crisis with the pivotal aim of promoting equal well-being. The shortcomings of the existing concepts in this respect relate to anthropocentric normative orientation, methodological individualism that disregards process dynamics and precludes integrating the considerations of human and nonhuman well-being, and the lack of multiscalar considerations of well-being. This work derives and proposes the concept of planetary well-being to address the aforementioned conceptual issues, to recognise the moral considerability of both human and nonhuman well-being, and to promote transdisciplinary, cross-cultural discourse for addressing the crisis and for promoting societal and cultural transformation. Conceptually, planetary well-being shifts focus on well-being from individuals to processes, Earth system and ecosystem processes, that underlie all well-being. Planetary well-being is a state where the integrity of Earth system and ecosystem processes remains unimpaired to a degree that species and populations can persist to the future and organisms have the opportunity to achieve well-being. After grounding and introducing planetary well-being, this work shortly discusses how the concept can be operationalised and reflects upon its potential as a bridging concept between different worldviews.peerReviewe

Planetary well-being

Tensions between the well-being of present humans, future humans, and nonhuman nature manifest in social protests and political and academic debates over the future of Earth. The increasing consumption of natural resources no longer increases, let alone equalizes, human well-being, but has led to the current ecological crisis and harms both human and nonhuman well-being. While the crisis has been acknowledged, the existing conceptual frameworks are in some respects ill-equipped to address the crisis in a way that would link the resolving of the crisis with the pivotal aim of promoting equal well-being. The shortcomings of the existing concepts in this respect relate to anthropocentric normative orientation, methodological individualism that disregards process dynamics and precludes integrating the considerations of human and nonhuman well-being, and the lack of multiscalar considerations of well-being. This work derives and proposes the concept of planetary well-being to address the aforementioned conceptual issues, to recognize the moral considerability of both human and nonhuman well-being, and to promote transdisciplinary, cross-cultural discourse for addressing the crisis and for promoting societal and cultural transformation. Conceptually, planetary well-being shifts focus on well-being from individuals to processes, Earth system and ecosystem processes, that underlie all well-being. Planetary well-being is a state where the integrity of Earth system and ecosystem processes remains unimpaired to a degree that species and populations can persist to the future and organisms have the opportunity to achieve well-being. After grounding and introducing planetary well-being, this work shortly discusses how the concept can be operationalized and reflects upon its potential as a bridging concept between different worldviews.peerReviewe