Theory guided integrative systematic review of the psychosocial determinants associated with non-adherence to adjuvant hormonal therapy among breast cancer population

BACKGROUND: Suboptimal adherence to 5 years adjuvant hormonal therapy (AHT) is prevalent among people with breast cancer. Non-adherence to prescribed AHT medication is linked to increased recurrence rates, lower survival rates and wasted healthcare resources. Targeting the modifiable psychosocial factors has been heralded as a means to improve the phenomenon of suboptimal medication-taking behaviour. This thesis aims to conduct a theory-guided integrative systematic review to identify (I) psychosocial factors that are associated with treatment initiation, adherence, persistence and premature discontinuation, (II) modifiable barriers and facilitators of medication-taking behaviour and (III) intervention strategies that can be used to target the psychosocial barriers. METHOD: This integrative review follows PRISMA-P guidance and the review protocol was registered in PROSPERO (CRD42018102035). Systematic searches were conducted in 7 databases (MEDLINE, EMBASE, Web of Science Cochrane Library, CENTRAL, PsycINFO, PsycARTICLE and CINAHL). Only studies that addressed the following are eligible for inclusion: (I) examined associations between cognitive, behavioural, emotional, or social factors with non-initiation, non-adherence, non-persistence or discontinuation (II) published from 1998- 2018 papers and (III) study population that have clinically diagnosed breast cancer patient groups. Mixed Methods Appraisal Tool (version 2018) was used to access the quality of the included evidence. The Behaviour Change Wheel (BCW), made up of an inner layer of Theoretical Domains Framework (TDF), middle layer of Capabilities, Opportunities, Motivation and Behaviour (COM-B), and circled by a layer of intervention functions, was used to structure the design and analysis of the three research questions. TDF was used to frame the behavioural subgroup analysis, anchor the results, COM-B model and intervention functions were subsequently used to map the identified barriers with the intervention options and solution. RESULT: Of the 1229 papers screened, 58 articles (43 quantitative studies, 13 qualitative studies and 2 mixed method studies) were included and analyzed. TDF collated the key psychosocial factors from the included studies into 11 domains (Knowledge; Skills; Beliefs about capabilities; Beliefs about Consequences; Reinforcement; Intention and goals, Memory, attention and decision process; Environmental contexts and resources; Social Influences; Emotion; and Behavioural regulation). In conformity with the TDF result, COM- B model has identified the psychological capabilities (knowledge of side effects, memory, decision making), reflective motivation (perceptions and expectations, behavioural barriers), automatic motivation (intention, negative emotion), physical opportunity (resources) and social opportunity (clinical support) as the modifiable components. Based on the collective findings of the TDF and COM-B model, 4 intervention functions (Education, Persuasion, Training, Enablement) were matched into the relative components. CONCLUSION: This review is novel as it proposes a multilayer psychological understanding of nonadherence behaviour and provides a thorough overview of the behaviour change techniques that help to formulate future interventions. The cornerstone to improving optimal medication-taking behaviour is to educate patients on the knowledge of side effects seek to adjust the patients’ psychological adaptation and provide communication skills training among healthcare providers. These results are pertinent to healthcare providers, researchers and stakeholders who are likely to initiate interventions

Robust estimation of bacterial cell count from optical density

Optical density (OD) is widely used to estimate the density of cells in liquid culture, but cannot be compared between instruments without a standardized calibration protocol and is challenging to relate to actual cell count. We address this with an interlaboratory study comparing three simple, low-cost, and highly accessible OD calibration protocols across 244 laboratories, applied to eight strains of constitutive GFP-expressing E. coli. Based on our results, we recommend calibrating OD to estimated cell count using serial dilution of silica microspheres, which produces highly precise calibration (95.5% of residuals <1.2-fold), is easily assessed for quality control, also assesses instrument effective linear range, and can be combined with fluorescence calibration to obtain units of Molecules of Equivalent Fluorescein (MEFL) per cell, allowing direct comparison and data fusion with flow cytometry measurements: in our study, fluorescence per cell measurements showed only a 1.07-fold mean difference between plate reader and flow cytometry data

Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)1.

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field

Risk Values of Weight and Body Mass Index for Chest Wall Thickness in Patients Requiring Needle Thoracostomy Decompression

Introduction. Emergency decompression is needed in patients with tension pneumothorax, a life-threatening condition. The catheter-based needle thoracostomy was suggested using a 5 cm catheter inserted into the 2nd intercostal space (ICS) and 5th ICS according to the ninth and tenth editions of Advanced Trauma Life Support, respectively. A catheter of suitable length may not be available immediately or the muscle structure of the chest wall may be modified in pneumothorax. Furthermore, alternative sites for needle thoracostomy and reference values of chest wall thickness (CWT) should be explored and warranted. Method. CT scan data and medical data of 650 eligible patients from October 2016 to December 2016 were reviewed. CWT values at four ICSs as well as four variables, namely, age, weight, height, and body mass index (BMI) for both men and women were compared using a nonparametric method, namely, the Wilcoxon signed-rank test. The associations between CWT and the four variables were assessed using the Pearson correlation coefficient. The overall performance of BMI, weight, and height in predicting CWT > 5 cm was evaluated using the receiver-operating characteristic (ROC) curve. Finally, the prediction models were built by using the bootstrap method. Results. Four variables, namely, age, height, weight, and BMI, were compared between the men and women groups. All four variables differed significantly between the two groups, and CWTs at all ICSs, except for the 3rd ICS, differed significantly between the two groups. Among the women, the area under the ROC curve (AUROC) of BMI for predicting CWT > 5 cm at 2nd ICS was larger than the AUROC of weight and height. Among the men, the AUROC of weight for predicting CWT > 5 cm at 2nd ICS was larger than that of BMI and height. The reference value tables were provided for five proposed models for women and men, respectively. Under emergencies, the variable, BMI, or even weight itself, could be used for predicting a failure performance of the needle decompression. For women, CWT at 5th ICS was predicted over 5 cm at BMI over 25.9 kg/m2 or weight over 103.1 kg. For men, CWT at 5th ICS was predicted over 5 cm at BMI over 25.5 kg/m2 or weight over 157.4 kg. Conclusion. Needle thoracostomy is the preferred first technique for many emergency providers for decompression. Therefore, a reference table for safe needle thoracostomy decompression at four usual sites, namely, 2nd ICS, 3rd CIS, 4th ICS, and 5th ICS, was recommended, which will enable paramedics and emergency specialists to rapidly determine CWT at the appropriate ICSs during emergencies

Serum vitamin D insufficiency is correlated with quadriceps neuromuscular functions in patients with anterior cruciate ligament injury: A preliminary study

Background: This study aimed to investigate the correlations of serum vitamin D insufficiency with quadriceps neuromuscular function in patients with anterior cruciate ligament (ACL) injury. Methods: A cross-sectional study was conducted. Eighteen patients with a primary, unilateral ACL injury who had insufficient serum vitamin D concentrations (<30 ng/ml) were recruited for the study. Bilateral quadriceps neuromuscular function, including maximal strength, the speed of rapid contraction, and inhibition, were measured on an isokinetic dynamometer with the hip and the knee joint flexion at 90° and 45°, respectively. Quadriceps strength was measured by maximal voluntary isometric contractions (MVIC); the speed of rapid contraction was quantified by the rate of torque development (RTD), which was divided into the early (RTD0-50) and the late phase (RTD100-200); quadriceps inhibition was quantified by the central activation ratio (CAR). Serum vitamin D concentration was quantitatively determined by serum 25(OH)D concentration measured by the 25(OH)D ELISA kit. The Spearman rank correlation analysis was used to examine the correlation between the vitamin D concentration and bilateral quadriceps MVIC, RTD0-50, RTD100-200, and CAR, respectively. Results: The results of Spearman rank correlation analyses showed that the serum 25(OH)D concentration was significantly correlated with bilateral quadriceps MVIC (injured: r = 0.574, p = 0.013; uninjured: r = 0.650, p = 0.003) and RTD0-50 (r = 0.651, p = 0.003), and CAR (r = 0.662, p = 0.003) on the uninjured limb. However, no significant correlations were found between the serum 25(OH)D concentration and the other outcomes. Conclusions: The serum vitamin D concentration correlates with quadriceps neuromuscular function in patients with ACL injury who had vitamin D insufficiency

The effect of crystallinity on photocatalytic performance of Co3O4 water-splitting cocatalysts

Cocatalysts, when loaded onto a water splitting photocatalyst, accelerate the gas evolution reaction and improve the efficiency of the photocatalyst. In this paper, we report that the efficiency of the photocatalyst is enhanced using an amorphous cobalt oxide cocatalyst. The WO3 film, when loaded with amorphous or nanocrystalline Co3O4, shows an improvement of up to 40% in photocurrent generation and 34% in hydrogen gas evolution. The effect of cocatalyst crystallinity on performance was systematically studied, and we found that the photocurrent deteriorates with the conversion of the cocatalyst to a highly crystalline phase at an annealing temperature of 500 degrees C. The mechanism of this effect was studied in detail using electrochemical impedance spectroscopy, and the enhancement effect produced by the amorphous cocatalyst is attributed to the large density of unsaturated catalytically active sites in the amorphous material

Assessments of early patellofemoral joint osteoarthritis features after anterior cruciate ligament reconstruction: a cross-sectional study

Abstract Background Persistent anterior knee pain and subsequent patellofemoral joint (PFJ) osteoarthritis (OA) are common symptoms after anterior cruciate ligament reconstruction (ACLR). Quadriceps weakness and atrophy is also common after ACLR. This can be contributed by arthrogenic muscle inhibition and disuse, caused by joint swelling, pain, and inflammation after surgery. With quadriceps atrophy and weakness are associated with PFJ pain, this can cause further disuse exacerbating muscle atrophy. Herein, this study aims to identify early changes in musculoskeletal, functional and quality of health parameters for knee OA after 5 years of ACLR. Methods Patients treated with arthroscopically assisted single-bundle ACLR using hamstrings graft for more than 5 years were identified and recruited from our clinic registry. Those with persistent anterior knee pain were invited back for our follow-up study. For all participants, basic clinical demography and standard knee X-ray were taken. Likewise, clinical history, symptomatology, and physical examination were performed to confirm isolated PFJ pain. Outcome measures including leg quadriceps quality using ultrasound, functional performance using pressure mat and pain using self-reported questionnaires (KOOS, Kujala and IKDC) were assessed. Interobserver reproducibility was assessed by two reviewers. Results A total of 19 patients with unilateral injury who had undergone ACLR 5-years ago with persistent anterior knee pain participated in this present study. Toward the muscle quality, thinner vastus medialis and more stiffness in vastus lateralis were found in post-ACLR knees (p < 0.05). Functionally, patients with more anterior knee pain tended to shift more of their body weight towards the non-injured limb with increasing knee flexion. In accordance, rectus femoris muscle stiffness in the ACLR knee was significantly correlated with pain (p < 0.05). Conclusion In this study, it was found that patients having higher degree of anterior knee pain were associated with higher vastus medialis muscle stiffness and thinner vastus lateralis muscle thickness. Similarly, patients with more anterior knee pain tended to shift more of their body weight towards the non-injured limb leading to an abnormal PFJ loading. Taken together, this current study helped to indicate that persistent quadriceps muscle weakness is potential contributing factor to the early development of PFJ pain

A newly developed porcine training model for transurethral piecemeal and en bloc resection of bladder tumour

10.1007/s00345-018-2602-2WORLD JOURNAL OF UROLOGY3791879-188