Integrating Complementary Medicine Into the Care of Childhood Cancer Survivors: A Brief Report on the Preliminary Framework and Implementation of an Educational Program

BackgroundExisting educational programs typically include limited information on traditional, complementary, and integrative medicine (TCIM) for survivors of childhood cancer.ObjectivesThis brief report presents the preliminary results of an educational program that aims to promote the safe and effective use of Chinese medicine (CM) among survivors in Hong Kong.MethodsSurvivors of childhood cancer, their caregivers, and oncology practitioners were invited to participate in a program that consists of two didactic seminars and a written educational booklet that disseminated information on the use of CM. A structured questionnaire was used to evaluate participants' receptivity toward and perceived relevance of the program. The Reach, Effectiveness, Adoption, Implementation, and Maintenance (RE-AIM) framework was used to discuss the impact of the intervention.ResultsReach: A total of 174 participants attended the seminars, and the seminar recording received over 380 views on social media platforms since April 2021. The hardcopy of the educational booklet was distributed to 43 recipients. The web-version of the booklet was sent to 67 participants and downloaded 143 times. Efficacy: The majority found that the content of the seminar useful (mean score = 5.04/6 points), especially the CM exercise (mean score = 4.88/6 points) and dietary advice (mean score = 4.99/6 points). Intention to adopt: The survivors (or their caregivers) reported that they would adopt advice on food therapies (83.3%) and traditional Chinese health exercises (55.6%) during survivorship.ConclusionThe preliminary data on patient preferences will be applied to further develop educational materials and to establish a TCIM referral network within the cancer survivor community

Neurodegeneration of the retina in mouse models of Alzheimer’s disease: what can we learn from the retina?

Alzheimer’s disease (AD) is an age-related progressive neurodegenerative disease commonly found among elderly. In addition to cognitive and behavioral deficits, vision abnormalities are prevalent in AD patients. Recent studies investigating retinal changes in AD double-transgenic mice have shown altered processing of amyloid precursor protein and accumulation of β-amyloid peptides in neurons of retinal ganglion cell layer (RGCL) and inner nuclear layer (INL). Apoptotic cells were also detected in the RGCL. Thus, the pathophysiological changes of retinas in AD patients are possibly resembled by AD transgenic models. The retina is a simple model of the brain in the sense that some pathological changes and therapeutic strategies from the retina may be observed or applicable to the brain. Furthermore, it is also possible to advance our understanding of pathological mechanisms in other retinal degenerative diseases. Therefore, studying AD-related retinal degeneration is a promising way for the investigation on (1) AD pathologies and therapies that would eventually benefit the brain and (2) cellular mechanisms in other retinal degenerations such as glaucoma and age-related macular degeneration. This review will highlight the efforts on retinal degenerative research using AD transgenic mouse models

A novel current-mode sensing scheme for magnetic tunnel junction MRAM

In this paper, we present two integrated circuits for sensing data nondestructively from one-transistor one-magnetic tunnel junction (1T-1MTJ) magnetoresistive random access memory (MRAM). The first one is a low-power sensing circuit for MTJs with a magnetoresistance (MR) ratio larger than 10\%, and the second one is a high-sensitivity switched-current sensing circuit for MTJs with an MR ratio as low as 5\%. The circuits are designed using 0.60- and 0.18-mum CMOS processes, and their performance is verified using HSPICE. Compared with existing sensing circuits at a power supply of 3.0 V, their read access time is 1.46-3.33 times faster and power consumption is 2.67-3.85 times smaller

A binary-search switched-current sensing scheme for 4-state MRAM

A current-mode binary-search sensing scheme for a 4-state one-transistor one-magnetic tunnel junction (1T1MTJ) magneto-resistive random access memory (MRAM) is proposed. By using the switched-current technique, it is able to read data non-destructively with a magneto-resistive (MR) ratio of as low as 5%. The circuit is designed using a 0.18μm CMOS process and the performance is verified by HSPICE. Compared to the parallel sensing approach, the proposed sensing scheme consumes less power and chip area and requires fewer comparison steps. Compared to the serial sensing approach, it allows a shorter read access time while requiring the same number of comparisons

A switched-current sensing architecture for a four-state per cell magnetic tunnel junction MRAM

A current-mode binary-search sensing scheme for a four-state per cell one-transistor one-magnetic tunnel junction magneto-resistive (MR) random access memory is proposed. By using the switched-current technique, it is able to read data non-destructively with a MR ratio as low as 5\%. The sensing circuit is designed using a 0.18-mum CMOS process and the performance is verified by HSPICE simulation. At a supply voltage of 1.8 V, the data can be accessed in 17.5 ns with a power consumption of 475.9 muW. Compared to the parallel sensing approach, the proposed sensing scheme consumes less power and chip area, and requires fewer comparison steps. Compared to the conventional serial sensing approach, it allows a shorter read access time while performing the same number of comparisons

High-sensitivity switched-current sensing circuit for magnetic tunnel junction MRAM

A high-sensitivity switched-current sensing circuit for reading data non-destructively from 1T-1MTJ magneto-resistive random access memory (MRAM) is presented. Compared to the existing sensing circuits at a power supply of 3.0V, simulation results showed that the read access time and the power consumption are about 3 times faster and smaller

Staging of nasopharyngeal carcinoma - The past, the present and the future

This article reviews the evolution of the International Union Against Cancer/American Joint Committee on Cancer staging system for nasopharyngeal carcinoma. With the increasing availability of newer imaging methods, more sophisticated radiotherapy techniques and rapidly evolving molecular assays, we also examine newer clinical features that might have impact on staging. A new version of the staging system taking into account of some of these factors is also proposed. © 2013 Elsevier Ltd. All rights reserved.Link_to_subscribed_fulltex

EGFR mutation-guided use of afatinib, erlotinib and gefitinib for advanced non-small-cell lung cancer in Hong Kong - A cost-effectiveness analysis.

IntroductionTyrosine kinase inhibitors (TKIs) therapy targets at epidermal growth factor receptor (EGFR) gene mutations in non-small-cell lung cancer (NSCLC). We aimed to compare the EGFR mutation-guided target therapy versus empirical chemotherapy for first-line treatment of advanced NSCLC in the public healthcare setting of Hong Kong.MethodsA Markov model was designed to simulate outcomes of a hypothetical cohort of advanced (stage IIIB/IV) NSCLC adult patients with un-tested EGFR-sensitizing mutation status. Four treatment strategies were evaluated: Empirical first-line chemotherapy with cisplatin-pemetrexed (empirical chemotherapy group), and EGFR mutation-guided use of a TKI (afatinib, erlotinib, and gefitinib). Model outcome measures were direct medical cost, progression-free survival, overall survival, and quality-adjusted life-years (QALYs). Incremental cost per QALY gained (ICER) was estimated. Sensitivity analyses were performed to examine robustness of model results.ResultsEmpirical chemotherapy and EGFR mutation-guided gefitinib gained lower QALYs at higher costs than the erlotinib group. Comparing with EGFR mutation-guided erlotinib, the afatinib strategy gained additional QALYs with ICER (540,633 USD/QALY). In 10,000 Monte Carlo simulations for probabilistic sensitivity analysis, EGFR mutation-guided afatinib, erlotinib, gefitinib and empirical chemotherapy were preferred strategy in 0%, 98%, 0% and 2% of time at willingness-to-pay (WTP) 47,812 USD/QALY (1x gross domestic product (GDP) per capita), and in 30%, 68%, 2% and 0% of time at WTP 143,436 USD/QALY (3x GDP per capita), respectively.ConclusionsEGFR mutation-guided erlotinib appears to be the cost-effective strategy from the perspective of Hong Kong public healthcare provider over a broad range of WTP