Utilizing Digital Health to Collect Electronic Patient-Reported Outcomes in Prostate Cancer: Single-Arm Pilot Trial

Background: Measuring patient-reported outcomes (PROs) requires an individual’s perspective on their symptoms, functional status, and quality of life. Digital health enables remote electronic PRO (ePRO) assessments as a clinical decision support tool to facilitate meaningful provider interactions and personalized treatment. Objective: This study explored the feasibility and acceptability of collecting ePROs using validated health-related quality of life (HRQoL) questionnaires for prostate cancer. Methods: Using Apple ResearchKit software, the Strength Through Insight app was created with content from validated HRQoL tools 26-item Expanded Prostate Cancer Index Composite (EPIC) or EPIC for Clinical Practice and 8-item Functional Assessment of Cancer Therapy Advanced Prostate Symptom Index. In a single-arm pilot study with patients receiving prostate cancer treatment at Thomas Jefferson University Hospital and affiliates, participants were recruited, and instructed to download Strength Through Insight and complete ePROs once a week over 12 weeks. A mixed methods approach, including qualitative pre- and poststudy interviews, was used to evaluate the feasibility and acceptability of Strength Through Insight for the collection and care management of cancer treatment. Results: Thirty patients consented to the study; 1 patient failed to complete any of the questionnaires and was left out of the analysis of the intervention. Moreover, 86% (25/29) reached satisfactory questionnaire completion (defined as completion of 60% of weekly questions over 12 weeks). The lower bound of the exact one-sided 95% CI was 71%, exceeding the 70% feasibility threshold. Most participants self-identified with having a high digital literacy level (defined as the ability to use, understand, evaluate, and analyze information from multiple formats from a variety of digital sources), and only a few participants identified with having a low digital literacy level (defined as only having the ability to gather information on the Web). Interviews were thematically analyzed to reveal the following: (1) value of emotional support and wellness in cancer treatment, (2) rise of social patient advocacy in online patient communities and networks, (3) patient concerns over privacy, and (4) desire for personalized engagement tools. Conclusions: Strength Through Insight was demonstrated as a feasible and acceptable method of data collection for ePROs. A high compliance rate confirmed the app as a reliable tool for patients with localized and advanced prostate cancer. Nearly all participants reported that using the smartphone app is easier than or equivalent to the traditional paper-and-pen approach, providing evidence of acceptability and support for the use of remote PRO monitoring. This study expands on current research involving the value of digital health, as a social and behavioral science, augmented with technology, can begin to contribute to population health management, as it shapes psychographic segmentation by demographic, socioeconomic, health condition, or behavioral factors to group patients by their distinct personalities and motivations, which influence their choices

Drug Interaction Study Of Apixaban With Cyclosporine Or Tacrolimus: Results From A Phase 1, Randomized, Open-Label, Crossover Study In Healthy Volunteers

BACKGROUND Solid organ transplant recipients commonly require anticoagulation. Apixaban (APX) is principally metabolized by CYP3A4, undergoes direct intestinal excretion, and is a substrate to P-glycoprotein (P-gp) and Breast Cancer Resistance Protein (BCRP) transporters. We examined the potential drug interaction between cyclosporine (CsA) and tacrolimus (Tac) [combined inhibitors of CYP3A4, P-gp and, BCRP] with APX.https://jdc.jefferson.edu/petposters/1005/thumbnail.jp

Pemphigoid Gestationis: A Rare Dermatosis of Pregnancy

INTRODUCTION Pemphigoid gestationis is a rare dermatosis of pregnancy that often goes unrecognized or misdiagnosed. It can lead to adverse fetal outcomes including preterm delivery, low fetal birth weight, and even neonatal pemphigoid gestationis1. As such, proper diagnosis and management is critical in reducing fetal risk

Patient Safety Case Review: Inpatient Use of Recreational Opiates

Background of Case Patient with active substance use (reported snorting 8-10 bags of fentanyl/day) not initially interested in MOUD admitted to TJUH for severe sepsis due to empyema Placed on hydromorphone PCA with scheduled oxycodone for pain control and withdrawal, found to have diverted prescribed opiates and used recreational fentanyl while inpatient Project Aim Perform root cause analysis of safety event Develop solutions to prevent similar instances in future given growing opiate epidemic in Philadelphi

Evaluation of Sleep Outcomes After Traumatic Brain Injury in Children Using Questionnaires and Actigraphy

Traumatic brain injuries are the result of a sudden external blunt force to the brain and can result in long-term complications or death. In pediatrics, it is the leading cause of acute and chronic sleep wake disturbances, as well as cognitive deficits, which can lead to a reduction in the quality of life. These impairments can later result in lowered performance in work and school settings or decreased psychosocial function. Although there is sufficient evidence that traumatic brain injuries contribute to is that it is unknown whether or not sleep wake disturbances contribute to an increase in the mentioned cognitive impairments. Currently, there is also a lack of therapies that are well researched to help patients who are suffering from sleep wake disturbances from traumatic brain injuries. There is a need for more research on whether or not sleep wake disturbances is a possible factor in cognitive function with pediatrics who had TBIs. Therefore, there needs to be further research and study on determining the association between sleep wake disturbances and cognitive function with questionnaire and objective measurements, as well as implementing randomized controlled trials of melatonin and sleep interventions

A generic domain pruning technique for GDL-based DCOP algorithms in cooperative multi-agent systems

Generalized Distributive Law (GDL) based message passing algorithms, such as Max-Sum and Bounded Max-Sum, are often used to solve distributed constraint optimization problems in cooperative multi-agent systems (MAS). However, scalability becomes a challenge when these algorithms have to deal with constraint functions with high arity or variables with a large domain size. In either case, the ensuing exponential growth of search space can make such algorithms computationally infeasible in practice. To address this issue, we develop a generic domain pruning technique that enables these algorithms to be effectively applied to larger and more complex problems. We theoretically prove that the pruned search space obtained by our approach does not affect the outcome of the algorithms. Moreover, our empirical evaluation illustrates a significant reduction of the search space, ranging from 33% to 81%, without affecting the solution quality of the algorithms, compared to the state-of-the-art

The Inter-linkage among FDI, Export and Economic Growth in Vietnam: A Causality Analysis

The aim of this paper is to investigate the linkage among export, foreign direct investment and economic growth in Vietnam. By using Granger causality method based on VECM model to analyze data over the period 1990-2015, this study estimates the causal relationship among FDI, export and Vietnamese economic growth in short run and long run. The unit root test and Johansen test are also applied to verify the stationary of variables and co-integration among three time-series. The findings indicate that both FDI and export Granger cause Vietnamese economic growth and have positive effects on Vietnamese economic growth in long run. Besides, the short-run influences of FDI on Vietnamese economic growth and export are also demonstrated in this research. Keywords: Export; FDI; Granger Causality; VECM model; Vietnamese Economic Growt