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BMC Complementary Medicine and Therapies May 2024Elderly cancer patients often experience cognitive difficulties that can affect their quality of life and autonomy. However, they are rarely included in clinical trials,...
BACKGROUND
Elderly cancer patients often experience cognitive difficulties that can affect their quality of life and autonomy. However, they are rarely included in clinical trials, and only one study has explored the feasibility of cognitive training in this population. While digital cognitive training has been successful in improving cognition in younger patients, its feasibility in elderly patients requires evaluation.
OBJECTIVES
This feasibility study primarily focused on evaluating patients' ability to use digital cognitive stimulation (usability). Secondary objectives were to evaluate acceptability, adherence, and satisfaction with regard to digital cognitive stimulation in elderly breast cancer patients.
METHODS
Elderly breast cancer patients at least 70 years old who were receiving cancer treatment (chemotherapy, targeted therapy, and/or radiotherapy) were recruited. Cognitive complaints were evaluated at baseline using the Functional Assessment of Cancer Therapy-Cognitive Function scale (FACT-Cog). Participants were invited to attend three 20-minute sessions of digital cognitive stimulation using HappyNeuron PRESCO software App on tablets, with the first session being supervised by a neuropsychologist and the two others being performed independently either at home or at the cancer center. We hypothesized that participants would spend 10 of the 20 min of the given time with the tablet completing exercises (training time). Thus, the usability of digital cognitive stimulation was defined as completing at least three exercises during the training time (10 min) of one of the two training sessions in autonomy. The proportion of patients who agreed to participate (acceptability) and completion of planned sessions (adherence) were also estimated. Satisfaction was evaluated post-intervention through a self-report questionnaire.
RESULTS
240 patients were initially screened, 60% (n = 145) were eligible and 38% agreed to participate in the study. Included patients (n = 55) had a mean age of 73 ± 3 years, 96% an ECOG score of 0-1 and were undergoing radiotherapy (64%), and/or chemotherapy (47%) and/or targeted therapy (36%) for stage I-II breast cancer (79%). Most patients reported significant cognitive complaints (82%) and 55% had previous experience with digital tools (n = 30). The usability rate was 92%, with 46 out of 50 evaluable participants completing at least three exercises during the training time. The adherence rate was 88%, with 43/50 participants completing all planned sessions. Participants were largely satisfied with the cognitive intervention format (87%). They preferred to complete sessions at the cancer center under the supervision of the neuropsychologist than alone at home (90%).
CONCLUSIONS
The high level of usability, adherence and satisfaction in this study shows for the first time the feasibility of digital cognitive stimulation in cancer patients older than 70 years. However, the intervention should be proposed only to patients reporting cognitive complaints and should be structured and supervised to improve acceptability and adherence.
TRIAL REGISTRATION
ClinicalTrials identifier: NCT04261153, registered on 07/02/2020.
Topics: Humans; Breast Neoplasms; Female; Feasibility Studies; Aged; Aged, 80 and over; Patient Satisfaction; Cognitive Behavioral Therapy; Mobile Applications; Quality of Life
PubMed: 38822324
DOI: 10.1186/s12906-024-04507-0 -
Bulletin Du Cancer May 2024Supporting children of affected parents by cancer is challenging whether for patients, families and healthcare teams. Several care methods have been developed to support...
Supporting children of affected parents by cancer is challenging whether for patients, families and healthcare teams. Several care methods have been developed to support these children (e.g. individual psychological support, support group). However, professionals may feel uncomfortable with their own theoretical and practical limits. Thus, pair working physician/psychologist can make sense in order to melt the different expertise and to provide advices, open discussion and remediation in the family behaviors and feelings. The aim is to help parents communicate with their children about the disease in order to respond appropriately to the child's needs and questions. Our study is observational, around five clinical situations. We deal with parental psychological function, family communication, marital function, and parent-child relationship… Most of the time, children of cancer patients live a stressful experience with major psycho-emotional impact. Inappropriate coping mechanism can be subjected to misperception and lack of interaction with their parents. The question often expressed is the balance between telling the truth and protecting children. However, studies have reported positive effects of interventions around children needs. Thus, the doctor-psychologist pair allows for adaptability of responses to family functioning, children and parents, and thus ensures holistic support for the patient with cancer.
PubMed: 38821774
DOI: 10.1016/j.bulcan.2024.04.013 -
American Journal of Hematology May 2024
Molecular landscape of mature B-cell lymphoproliferative disorders with BCL3-translocation: A Groupe Francophone de Cytogénétique Hématologique (GFCH)/French Innovative Leukemia Organization (FILO) study.
PubMed: 38817040
DOI: 10.1002/ajh.27384 -
Scientific Reports May 2024Knowledge of remaining battery charge is fundamental to electric vehicle deployment. Accurate measurements of state-of-charge (SOC) cannot be obtained directly and...
Knowledge of remaining battery charge is fundamental to electric vehicle deployment. Accurate measurements of state-of-charge (SOC) cannot be obtained directly and estimation methods must be used instead. This requires both a good model of a battery and a well-designed state estimator. Here, hysteretic reduced-order battery models and adaptive extended Kalman filter estimators are shown to be highly effective, accurate predictors of SOC. A battery model parameterisation framework is proposed, which enhances standardised methods to capture hysteresis effects. The hysteretic model is parameterised for three independent NMC811 lithium-ion cells and is shown to reduce voltage RMS error by 50% across 18 h automotive drive-cycles. Parameterised models are used alongside an extended Kalman filter, which demonstrates the value of adaptive filter parameterisation schemes. When used alongside an extended Kalman filter, adaptive covariance matrices yield highly accurate SOC estimates, reducing SOC estimation error by 85%, compared to the industry standard battery model.
PubMed: 38816427
DOI: 10.1038/s41598-024-61596-0 -
La Revue Du Praticien Apr 2024CONTRIBUTIONS OF MOLECULAR BIOLOGY TO THE MANAGEMENT OF COLORECTAL CANCER. Colorectal cancer (CRC) is a major public health problem affecting almost 43.000 people a year...
CONTRIBUTIONS OF MOLECULAR BIOLOGY TO THE MANAGEMENT OF COLORECTAL CANCER. Colorectal cancer (CRC) is a major public health problem affecting almost 43.000 people a year and causing 17.000 deaths. Advances in molecular biology have made it possible to identify some of the mechanisms involved in colorectal carcinogenesis and tumor proliferation. Some molecular alterations are now routinely investigated to adapt follow-up and therapeutic decisions in both localized and metastatic CRC.
Topics: Humans; Colorectal Neoplasms; Molecular Biology
PubMed: 38814021
DOI: No ID Found -
Journal of Controlled Release :... May 2024Nanoparticles have a great potential to significantly improve the delivery of therapeutics to the brain and may also be equipped with properties to investigate brain... (Review)
Review
Nanoparticles have a great potential to significantly improve the delivery of therapeutics to the brain and may also be equipped with properties to investigate brain function. The brain, being a highly complex organ shielded by selective barriers, requires its own specialized detection system. However, a significant hurdle to achieve these goals is still the identification of individual nanoparticles within the brain with sufficient cellular, subcellular, and temporal resolution. This review aims to provide a comprehensive summary of the current knowledge on detection systems for tracking nanoparticles across the blood-brain barrier and within the brain. We discuss commonly employed in vivo and ex vivo nanoparticle identification and quantification methods, as well as various imaging modalities able to detect nanoparticles in the brain. Advantages and weaknesses of these modalities as well as the biological factors that must be considered when interpreting results obtained through nanotechnologies are summarized. Finally, we critically evaluate the prevailing limitations of existing technologies and explore potential solutions.
PubMed: 38810705
DOI: 10.1016/j.jconrel.2024.05.044 -
Nature Communications May 2024Solid-state lithium-based batteries offer higher energy density than their Li-ion counterparts. Yet they are limited in terms of negative electrode discharge performance...
Solid-state lithium-based batteries offer higher energy density than their Li-ion counterparts. Yet they are limited in terms of negative electrode discharge performance and require high stack pressure during operation. To circumvent these issues, we propose the use of lithium-rich magnesium alloys as suitable negative electrodes in combination with LiPSCl solid-state electrolyte. We synthesise and characterise lithium-rich magnesium alloys, quantifying the changes in mechanical properties, transport, and surface chemistry that impact electrochemical performance. Increases in hardness, stiffness, adhesion, and resistance to creep are quantified by nanoindentation as a function of magnesium content. A decrease in diffusivity is quantified with Li pulsed field gradient nuclear magnetic resonance, and only a small increase in interfacial impedance due to the presence of magnesium is identified by electrochemical impedance spectroscopy which is correlated with x-ray photoelectron spectroscopy. The addition of magnesium aids contact retention on discharge, but this must be balanced against a decrease in lithium diffusivity. We demonstrate via electrochemical testing of symmetric cells at 2.5 MPa and 30C that 1% magnesium content in the alloy increases the stripping capacity compared to both pure lithium and higher magnesium content alloys by balancing these effects.
PubMed: 38802332
DOI: 10.1038/s41467-024-48071-0 -
Clinical Neurology and Neurosurgery May 2024VEXAS (Vacuoles, E1 Enzyme, X-linked, autoinflammatory, Somatic) syndrome is a recently described severe adult-onset autoinflammatory disorder mediated by X-linked gene...
INTRODUCTION
VEXAS (Vacuoles, E1 Enzyme, X-linked, autoinflammatory, Somatic) syndrome is a recently described severe adult-onset autoinflammatory disorder mediated by X-linked gene UBA1 somatic mutations, responsible of recurrent fever, skin involvement, chondritis, macrocytic anemia and inflammatory syndrome. Neurological manifestations are rarely described, and predominantly involve peripheral nervous system (PNS) impairment.
RESULTS
We report the first central nervous system (CNS) vasculitis in VEXAS syndrome, characterized by headache, cognitive dysfunction and focal signs (cerebellar ataxia). Magnetic resonance imaging (MRI) revealed multifocal white-matter lesions corresponding to recent ischemic strokes, combined with cortical hemorrhagic lesions and gadolinium enhancement of the distal wall vessels. Treatment with methylprednisone, ruxolitinib and tocilizumab led to clinical improvement and a decrease of the inflammatory syndrome. The patient died few months after due to infectious complications.
CONCLUSION
CNS vasculitis, occurring as a manifestation of the systemic auto-inflammatory state of VEXAS syndrome, might be a rare but severe complication. We suggest that it be added to the list of inflammatory vasculopathies. More prospective studies are needed to optimize the treatment.
PubMed: 38801808
DOI: 10.1016/j.clineuro.2024.108351 -
EJNMMI Research May 2024Besides International Prognostic Index (IPI) score, baseline prognostic factors of post-transplant lymphoproliferative disorders (PTLD) are poorly identified due to the...
BACKGROUND
Besides International Prognostic Index (IPI) score, baseline prognostic factors of post-transplant lymphoproliferative disorders (PTLD) are poorly identified due to the rarity of the disease. New indexes derived from healthy organ uptake in baseline 18F-FDG PET/CT have been studied in immunocompetent lymphoma patients. The aim of this study is to evaluate the performances of the cerebellum-to-liver uptake ratio (denoted as CLIP) as a prognostic factor for PFS and OS. This retrospective multicenter study is based on patients with PTLD included in the K-VIROGREF cohort. The previously published threshold of 3.24 was used for CLIP in these analyses.
RESULTS
A total of 97 patients was included with a majority of monomorphic diffuse large B-cell lymphoma subtype (78.3%). Both IPI score (≥ 3) and CLIP (< 3.24) were significant risk factors of PFS with corresponding hazard ratios of 2.0 (1.0-4.0) and 2.4 (1.3-4.5) respectively. For OS, CLIP was not significant and resulted in a hazard ratio of 2.6 (p = 0.059). Neither IPI score or Total Metabolic Tumor Volume reached significance for OS.
CONCLUSION
CLIP is a promising predictor of PFS and perhaps OS in PTLD. Further prospective studies are needed to confirm these results.
PubMed: 38801646
DOI: 10.1186/s13550-024-01111-8 -
Revue Medicale de Liege May 2024The promotion of diversity, equity and inclusion (DEI) is increasingly sought after in healthcare, which is why we wanted to draw up a picture of DEI in radiation... (Review)
Review
INTRODUCTION
The promotion of diversity, equity and inclusion (DEI) is increasingly sought after in healthcare, which is why we wanted to draw up a picture of DEI in radiation oncology and give some ideas on how to contribute to its dissemination.
METHOD
This article proposes a non-exhaustive review of the international literature on DEI in radiation oncology, both among health professionals and patients. In addition, this review identifies some implicit cognitive biases and proposes strategies to address them.
RESULTS
Most of the proposed publications identify a lack of DEI among radiation oncology staff and document inequities in access to high-quality radiotherapy affecting patients belonging to minority groups.
CONCLUSION
Significant disparities exist between genders and ethnic groups within the radiotherapy teams, and in the radiotherapy treatment of patients. Nevertheless, DEI is gaining importance, and a range of initiatives and instruments are being developed to address these disparities.
Topics: Humans; Radiation Oncology; Cultural Diversity; Healthcare Disparities; Social Inclusion; Minority Groups
PubMed: 38778657
DOI: No ID Found