Racial differences in user experiences and perceived value of electronic symptom monitoring in a cohort of black and white bladder and prostate cancer patients

Purpose: Electronic patient-reported outcomes (ePROs) are increasingly being used for symptom monitoring during routine cancer care, but have rarely been evaluated in diverse patient populations. We assessed ePRO user experiences and perceived value among Black and White cancer patients. Methods: We recruited 30 Black and 49 White bladder and prostate cancer patients from a single institution. Participants reported symptoms using either a web-based or automated telephone interface over 3 months and completed satisfaction surveys and qualitative interviews focused on user experiences and value. Using a narrative mixed methods approach, we evaluated overall and race-specific differences in ePRO user experiences and perceived value. Results: Most participants selected the web-based system, but Blacks were more likely to use the automated telephone-based system than Whites. In satisfaction surveys, Whites more commonly reported ease in understanding and reporting symptoms compared with Blacks. Blacks more often reported that the ePRO system was helpful in facilitating symptom-related discussions with clinicians. During interviews, Blacks described how the ePRO helped them recognize symptoms, while Whites found value in better understanding and tracking symptoms longitudinally. Blacks also expressed preferences for paper-based ePRO options due to perceived ease in better understanding of symptom items. Conclusion: Electronic patient-reported outcomes are perceived as valuable for variable reasons by Black and White cancer populations, with greater perceived value for communicating with clinicians reported among Blacks. To optimize equitable uptake of ePROs, oncology practices should offer several ePRO options (e.g., web-based, phone-based), as well as paper-based options, and consider the e-health literacy needs of patients during implementation

Microstructure and Porosity of Laser Welds in Cast Ti-6Al-4V with Addition of Boron

Addition of small amounts of boron to cast Ti-6Al-4V alloy has shown to render a finer microstructure and improved mechanical properties. For such an improved alloy to be widely applicable for large aerospace structural components, successful welding of such castings is essential. In the present work, the microstructure and porosity of laser welds in a standard grade cast Ti-6Al-4V alloy as well as two modified alloy versions with different boron concentrations have been investigated. Prior-β grain reconstruction revealed the prior-β grain structure in the weld zones. In fusion zones of the welds, boron was found to refine the grain size significantly and rendered narrow elongated grains. TiB particles in the prior-β grain boundaries in the cast base material restricted grain growth in the heat-affected zone. The TiB particles that existed in the as cast alloys decreased in size in the fusion zones of welds. The hardness in the weld zones was higher than in the base material and boron did not have a significant effect on hardness of the weld zones. The fusion zones were smaller in the boron-modified alloys as compared with Ti-6Al-4V without boron. Computed tomography X-ray investigations of the laser welds showed that pores in the FZ of the boron modified alloys were confined to the lower part of the welds, suggesting that boron addition influences melt pool flow