PurposeTo support colorectal cancer couples cope with cancer, we developed a couple-based unmet supportive care needs intervention program guided by the Supportive Care Needs Framework and examined the feasibility, acceptability, and initial effects of the unmet supportive care needs program.MethodsThe design of a pre-and post-intervention study was conducted among Chinese colorectal cancer couples. The intervention was delivered in five sessions through in-person and telephone interventions combined. To measure program feasibility through recruitment and retention rates, and to test program acceptability through quantitative and qualitative post-intervention program assessments. The complete data (N = 20 pairs) were used to calculate effect sizes to assess the initial intervention effect.ResultsThere was evidence of the feasibility of the intervention program in terms of recruitment (66.7%) and retention (83.3%) rates. Participants' satisfaction with the program also attested to its acceptability. The intervention (Cohen’s =0.15-0.56) had a small-moderate effect size in improving unmet supportive care needs and most cancer-adapted outcomes for colorectal cancer couples, validating the initial effect of the program.ConclusionsThe unmet supportive care needs program is feasible, acceptable, and preliminarily effective in supporting Chinese colorectal cancer couples to improve unmet supportive care needs and cancer adaptability, as provided by this study.

<p>Supplementary Table1.Characteristic of antibodies used in the flow cytometry evaluation.Supplementary Table2.Primer sequence and product size for PCR amplification.Supplementary Table3.Clinical and baseline clinical characteristics of OC patients with diabetes</p>

<p>Supplementary Fig.1.Increased MDSCs levels in peripheral blood and tumor from OC patients.Supplementary Fig.2.Characterization of phenotype and immunosuppressive activity of MDSCs in OC patients.Supplementary Fig.3.Phenotypic analysis of MDSCs following metformin treatment.</p>

Hospitals are suffering from a critical challenge induced by the rapid spread of Coronavirus disease 2019 (COVID-19). Not only have patients been marginalized, but many clinicians working in the region-al hospitals have limited access to the specialist consultations and treatment guidelines they need from provincial-level hospitals to manage pneumonia cases caused by COVID-19. Telemedicine has been acknowledged as a breakthrough technology in combating epidemics. This study aims to demonstrate the implementation of Emergency Telemedicine Consultation System (ETCS) since COVID-2019 first emerged in Henan Province, beginning in late December 2019. This system was developed for coronavirus care across 126 connected hospitals, serving as the overarching authoritative source for diagnostic decision making and knowledge sharing for treatment. The information shared could rapidly expand to enable open collaborations with key stakeholders such as government authorities, research institutions and laboratories. The experience from building this system during this crisis can provide insights to guide public health institutions as they implement telemedicine to increase resilience to future epidemic outbreaks.

PURPOSE:Cancer and its treatment can affect quality of life (QOL) in cancer patient and family caregiver dyads. However, the factors influencing dyad QOL remain inconclusive. Our study was designed to (i) assess dyads' QOL, and examine the relationship between the QOL of cancer patients and that of their family caregivers, and (ii) investigate factors that may modify this relationship.METHODS:Participants comprised 641 cancer patient-family caregiver dyads. Four types of variables were collected as potential influencing factors, including cancer patient-related variables, family caregiver-related variables, family-related variables, and symptom distress-related variables.RESULTS:Generally, family caregivers reported better QOL than cancer patients did. The effect sizes of the correlation (r) between cancer patients' QOL and those of their family caregivers ranged from 0.08 to 0.27. Various variables influencing the QOL correlations between cancer patients and family caregivers were identified, including cancer patient-related variables (e.g., age, gender, marital status, understanding of the disease, cancer type and treatment); family caregiver-related variables (e.g., being the spouse or offspring of a patient, duration in their role as a family caregiver, understanding of the disease, and amount of time spent on caregiving each day); family-related variables (e.g., cancer patient enjoyed a good relationship with family pre-cancer diagnosis, family was experiencing serious or mild financial burden due to cancer treatment); and symptom stress-related variables (anxiety and depression).CONCLUSIONS:Study findings draw attention to QOL and its related factors in cancer patient-family caregiver dyads. This will benefit the development of interventions to improve dyad QOL.

Background Evolving practices in non-small cell lung cancer (NSCLC) therapy inevitably affect health care budgets, especially through the introduction of targeted therapies. This results in a rise of health economic evaluations (HEEs) in this domain. This article reviews the quality of the economic evidence of targeted therapies used in metastatic NSCLC. Methods A literature search was conducted using PubMed, Cochrane, Embase and CRD (University of York Centre for Reviews and Dissemination) databases to identify topical original articles published between 1/1/2000 and 3/31/2019. A quality of reporting assessment using the CHEERS (Consolidated Health Economic Evaluation Reporting Standards statement) checklist was converted into a quantitative score and compared with the results of a QHES (Quality of Health Economic Studies) evaluation. Components of QHES were also used to analyze the validity of primary outcomes, consideration of heterogeneity and rationality of main assumptions of models in modeling studies. Results In total, 25 HEEs were obtained and analyzed. From the CHEERS assessment, it was found that method description integrity (including setting, perspective, time horizon and discount rate), justification of data sources and a heterogeneity description were often absent or incomplete. Only five examined studies met the accepted standard of good quality. Modeled articles were examined with the QHES instrument, and a lack of illustrated structure, population variability, formula of the transitioning probability and justification for the choice of the model were the most frequently observed problems in the selected studies. After quantification, the CHEERS scores and QHES scores did not differ significantly. Conclusion Current NSCLC models generally lack consideration for demographic heterogeneity and transparency of data description, and it would be difficult to transfer or generalize from the scientific literature to real-world evidence-based decision-making. Frameworks of future models should be informed and justified based on the validity of model results and the improvement of modeling accuracy.

AbstractBackgroundAssessing the impact of vital signs (blood pressure, body temperature, heart rate, respiratory rate, and oxygen saturation) on the death of patients with new coronavirus pneumonia would provide a simple and convenient method for the monitoring of subsequent illness, and therefore, in some degree reduce treatment costs and increase the cure rate clinically.MethodsSix databases were retrieved. The software R 3.6.2 was used for meta-analysis of the included literature.Results12 studies were included, which comprise 8996 patients affected with COVID-19 infection. The meta-analysis study found that blood pressure (MAP, SBP and DBP), heart rate, respiration rate and SpO2 are the risk factors for disease progression in patients with COVID-19. Among them, the increase in MAP and the decrease in SpO2 have the greatest impact on the death of patients with COVID-19 [MAP: MD = 5.66, 95% CI (0.34, 10.98), SpO2: MD = −5.87, 95% CI (−9.17, −2.57), P = 0.0005]. However, comparing the body temperature of the death group and the survival group found that the body temperature was not statistically significant between the two groups [body temperature: MD = 0.21, 95% CI (−0.01, 0.43), P = 0.0661].ConclusionThe increase in MAP, heart rate and respiratory rate, as well as the decrease in SBP, DBP and SpO2 are all independent risk factors for death in patients with COVID-19. These factors are simple and easy to monitor, and individualized treatment can be given to patients in time, reducing the mortality rate and improving treatment efficiency.

This retrospective study was designed to explore whether neutrophil to lymphocyte ratio (NLR) is a prognostic factor in patients with coronavirus disease 2019 (COVID-19). A cohort of patients with COVID-19 admitted to the Tongren Hospital of Wuhan University from 11 January 2020 to 3 March 2020 was retrospectively analyzed. Patients with hematologic malignancy were excluded. The NLR was calculated by dividing the neutrophil count by the lymphocyte count. NLR values were measured at the time of admission. The primary outcome was all-cause in-hospital mortality. A multivariate logistic analysis was performed. A total of 1004 patients with COVID-19 were included in this study. The mortality rate was 4.0% (40 cases). The median age of nonsurvivors (68 years) was significantly older than survivors (62 years). Male sex was more predominant in nonsurvival group (27; 67.5%) than in the survival group (466; 48.3%). NLR value of nonsurvival group (median: 49.06; interquartile range [IQR]: 25.71-69.70) was higher than that of survival group (median: 4.11; IQR: 2.44-8.12; P < .001). In multivariate logistic regression analysis, after adjusting for confounding factors, NLR more than 11.75 was significantly correlated with all-cause in-hospital mortality (odds ratio = 44.351; 95% confidence interval = 4.627-425.088). These results suggest that the NLR at hospital admission is associated with in-hospital mortality among patients with COVID-19. Therefore, the NLR appears to be a significant prognostic biomarker of outcomes in critically ill patients with COVID-19. However, further investigation is needed to validate this relationship with data collected prospectively.

BackgroundBoth genetic and environmental factors contribute to the development of cancer and its mutant spectrum. Lung cancer has familial aggregation. Lung cancer caused by non-tobacco factors has unique pathological and molecular characteristics. The interaction between genetic lung cancer susceptibility and carcinogens from coal burning remains complex and understudied. MethodsWe selected 410 non-small cell lung cancer (NSCLC) patients with a family history of lung cancer (FLC) and exposure to coal combustion between 2014 and 2017. Clinicopathologic parameters were analyzed. Reverse transcription-PCR was performed to detect ALK, ROS1, RET, and NTRK1 rearrangement. ResultsAmong the 410 NSCLC patients, 192 had FLC and 204 (49.8%) were exposed to occupational or domestic coal combustion. FLC patients had the same characteristics regardless of gender and coal exposure: younger age, high female ratio, adenocarcinoma, increased metastasis, later stage at diagnosis, and higher frequency of gene fusion. Sixty-seven patients (16.3%) had gene rearrangement: 51 (12.4%) harbored EML4-ALK fusions and 16 ROS1 fusions (3.9%). The highest gene fusion rate (35.1%, 33/94) occurred in patients with both FLC and high tobacco and coal exposure. ALK fusions and total gene rearrangement were closely associated with women, never smokers, younger age, FLC, and coal exposure. ConclusionFLC and exposure to coal combustion have an important impact on the clinicopathological characteristics and gene fusion mode of NSCLC, particularly in cases of higher levels of carcinogens, and genetic susceptibility has a greater impact. Our findings may help evaluate the effect of FLC and coal exposure on the pathogenesis of lung cancer.

1Department of Neurology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China; 2Department of Orthopedics, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China; 3Department of Pharmacy, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China; 4Department of Oncology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China; 5Department of Nursing, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China; 6Department of Medical Administration, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan Province, People’s Republic of China Purpose: This study aims to explore the mediating role of sense of coherence in the relationship