ABSTRACT
Introduction: Indicators that assess relationships among leukocytes may inform more and/or earlier than those measured in isolation. Method(s): Blood leukocyte differential counts collected from 101 Mayo Clinic COVID-19 patients were related to later outcomes following two approaches: (i) as unstructured data (e.g., lymphocyte percentages) and (ii) as data structures that assess intercellular interactions. Analyzing the same primary data, it was asked whether information contents differed among methods and/or when two sets of structured indicators are used. Result(s): While unstructured data did not distinguish survivors from non-survivors (Fig. 1, rectangle A), one data structure (here identified with letters expressed in italics) exhibited one perpendicular inflection that differentiated two patient groups (B). Two survivor-related observations were also distinguished from the remaining data points (B). A second data structure also revealed a single line of observations and a perpendicular data inflection (C), while more (four) patient groups were identified (D). Four validations were conducted: (i) increasing mortality levels among contiguous data subsets (0, 7.1, 16.2, or 44.4%) suggested construct validity (D);(ii) internal validity was indicated because 22 of the 45 survivors detected by the first data structure were also captured by the second one;(iii) the analysis of patients that differed in address, co-morbidities and other aspects supported external validity;and (iv) quasi non-overlapping data intervals predicted statistical validity (E, F). The structured approach also uncovered new and/ or dissimilar information: different leukocyte-related ratios explained the clusters identified in these analyses (E, F). Conclusion(s): Structured data may yield more information than methods that do not assess multicellular interactions. Possible applications include daily, longitudinal, and personalized analysis of hospital data.
ABSTRACT
Background. Black women diagnosed with breast cancer are 40 percent more likely to die than their Caucasian peers. They are often diagnosed with higher staged cancers, when treatments are more toxic and costly (Centers for Disease Control, 2018). In addition, Black women have worse stage-specific survival than white women (American Cancer Society, Cancer Facts and Figures for African Americans 2019-2021). Lack of medical knowledge and social isolation are contributing factors to health care disparities. To address these factors, in fall 2019 a member of the board of directors of Living Beyond Breast Cancer approached LBBC to design an educational program for Black patients newly diagnosed with early-stage and metastatic breast cancer. The overarching program goal was to address health care disparities for Black people. The program aimed to increase knowledge about breast cancer and about the implicit and explicit bias Black patients encounter in health care settings, and to provide tools to address it. The program also prepared patients to be informed partners in their health care and connected them to existing resources and to other Black patients for peer support. Methods. LBBC convened an advisory board of ten Black community leaders with expertise in oncology, health care disparities, social and practical support, and advocacy. Most had a personal history of breast cancer. A consultant with expertise in program development and health disparities was hired to oversee the project. The advisory board met monthly to develop content, format, outreach, and speaker recommendations. Initial plans were to deliver the program as a one-day symposium attached to LBBC's fall conference. Because of the COVID-19 pandemic, the advisory board decided to offer the program virtually using a combination of live sessions supplemented with video content. Learnings were intended to prepare participants to more effectively communicate with health care professionals and empower them with practical steps to access appropriate care. An evaluation was designed, and participants received an emailprompting them to offer feedback after each session. Results. The program was delivered from September through October 2020. Speakers were Black oncologists, social workers, researchers, and advocates. The first session was an on-demand video offering guidance to recently diagnosed Black breast cancer patients. Three live sessions were delivered weekly on the topics of identifying barriers to accessing care, early-stage breast cancer treatment, and metastatic breast cancer treatment. The last two sessions focused on self-care and advocacy, with the final session delivered at LBBC's virtual fall conference. LBBC registered 436 people from 36 states and Washington, DC, Canada, and the United Kingdom. Participants ranged from age 27 to 83 and lived in urban, suburban, and rural areas. In all, 307 registrants identified as Black, and 40 reported a breast cancer diagnosis in the last six months. Of participants who completed program evaluations, 75 percent reported an increase in knowledge of breast cancer, 77 percent reported increased understanding of treatment, 82 percent reported increased confidence to have conversations with loved ones or health care providers, and 85 percent said they learned strategies to address implicit and explicit bias. An informal assessment of open-field responses demonstrated that attendees valued the programmatic focus on their unique needs as Black breast cancer patients. Conclusions. An educational program led and designed by Black health care professionals and patients can be successfully delivered in a combination live and virtual content format to improve knowledge, communication skills, and feelings of self-efficacy for Black people with breast cancer.
ABSTRACT
A novel highly sensitive cone structured porous polydimethylsiloxane (PDMS) based pressure sensor capable of detecting very low-pressure ranges was developed for wearable respiration monitoring applications. The pressure sensor was fabricated using a master mold, a dielectric layer and fabric-based electrodes. The master mold with inverted cone structures was created using a rapid and precise three-dimensional (3D) printing technique. The dielectric layer with a porous and cone structures was prepared by annealing the mixture of PDMS, nitric acid (HNO3) and sodium bicarbonate (NaHCO3) in a master mold with inverted cone structures. The electrodes were developed by screen printing silver on fabric. A sensitivity of approximate to 530 %kPa(-1) was measured for the fabricated pressure sensor at ultra-low-pressure ranges from 0 Pa to 10 Pa. The porous-cone structures provided an excellent deformation and thus resulted in high sensitivity for detecting very low pressure ranges below 100 Pa (135 %kPa(-1)). As application demonstration, the pressure sensor was sewed inside a surgical mask and it's capability to detect different respiration rates (normal, fast, and deep breathes) was investigated. An airflow controller system and custom-built software was also developed for performing the continuous sensor data acquisition and capacitance conversions while changing the airflow rate.