Role of patient characteristics in adherence to first-line treatment guidelines in breast, lung and prostate cancer: insights from the Nordic healthcare system.

OBJECTIVES: This study investigates the influence of socioeconomic status, health literacy, and numeracy on treatment decisions and the occurrence of adverse events in patients with breast, lung, and prostate cancer within a Nordic healthcare setting. DESIGN: A follow-up to a cross-sectional, mixed-methods, single-centre study. SETTING: A Nordic, tertiary cancer clinic. PARTICIPANTS: A total of 244 participants with breast, lung and prostate cancer were initially identified, of which 138 first-line treatment participants were eligible for this study. First-line treatment participants (n=138) surpassed the expected cases (n=108). INTERVENTIONS: Not applicable as this was an observational study. PRIMARY AND SECONDARY OUTCOME MEASURES: The study's primary endpoint was the rate of guideline adherence. The secondary endpoint involved assessing treatment toxicity in the form of adverse events. RESULTS: Guideline-adherent treatment was observed in 114 (82.6%) cases. First-line treatment selection appeared uninfluenced by participants' education, occupation, income or self-reported health literacy. A minority (3.6%) experienced difficulties following treatment instructions, primarily with oral cancer medications. CONCLUSIONS: The findings indicated lesser cancer health disparities regarding guideline adherence and treatment toxicity within the Nordic healthcare framework. A causal connection may not be established; however, the findings contribute to discourse on equitable cancer health provision.

Socioeconomic status and lifestyle patterns in the most common cancer types-community-based research.

INTRODUCTION: As the global burden of chronic cancer increases, its correlation to lifestyle, socioeconomic status (SES) and health equity becomes more important. The aim of the present study was to provide a snapshot of the socioeconomic and lifestyle patterns for different cancer types in patients at a Nordic tertiary cancer clinic. MATERIALS AND METHODS: In a descriptive observational study, questionnaires addressed highest-attained educational level, occupational level, economy, relationship status, exposures, and lifestyle habits. The questionnaire was distributed to all cancer patients attending the cancer clinic. Treating physicians added further information about the cancer disease, including primary origin, pathology report, TNM-classification and stage. RESULTS: Patients with lung cancer had the lowest SES, and patients with gastrointestinal (GI) cancer, other cancer types and prostate cancer had the second, third and fourth lowest SES, respectively. However, breast cancer patients had the highest SES. Lifestyle and exposure patterns differed among the major cancer types. Lung cancer patients reported the highest proportion of unfavourable lifestyle and exposure patterns, and patients with GI cancer, prostate cancer and other cancer types had the second, third and fourth highest proportion of unfavourable lifestyle and exposure patterns, respectively. The most favourable exposure and lifestyle patterns were observed in breast cancer patients. CONCLUSIONS: The present study indicated significant socioeconomic and lifestyle differences among cancer types at a Nordic cancer centre, with differences in lifestyle being more prominent than socioeconomic differences.

Electronic excitations of 1,4-disilyl-substituted 1,4-disilabicycloalkanes: a MS-CASPT2 study of the influence of cage size.

We present a multistate complete active space second-order perturbation theory computational study aimed to predict the low-lying electronic excitations of four compounds that can be viewed as two disilane units connected through alkane bridges in a bicyclic cage. The analysis has focused on 1,4-disilyl-1,4-disilabicyclo[2.2.1]heptane (1a), 1,4-bis(trimethylsilyl)-1,4-disilabicyclo[2.2.1]heptane (1b), 1,4-disilyl-1,4-disilabicyclo[2.1.1]hexane (2a), and 1,4-bis(trimethylsilyl)-1,4-disilabicyclo[2.1.1]hexane (2b). The aim has been to find out the nature of the lowest excitations with significant oscillator strengths and to investigate how the cage size affects the excitation energies and the strengths of the transitions. Two different substituents on the terminal silicon atoms (H and CH3) were used in order to investigate the end group effects. The calculations show that the lowest allowed excitations are of the same character as that found in disilanes but now red-shifted. As the cage size is reduced from a 1,4-disilabicyclo[2.2.1]heptane to a 1,4-disilabicyclo[2.1.1]hexane, the Si...Si through-space distance decreases from approximately 2.70 to 2.50 A and the lowest allowed transitions are red-shifted by up to 0.9 eV, indicating increased interaction between the two Si-Si bonds. The first ionization potential, which corresponds to ionization from the Si-Si sigma orbitals, is lower in 1b and 2b than in Si2Me6 by approximately 0.9 and 1.2 eV, respectively. Moreover, 1b and 2b, which have methyl substituents at the terminal Si atoms, have slightly lower excitation energies than the analogous species 1a and 2a.

Heavy group 14 1,(n+2)-dimetallabicyclo[n.n.n]alkanes and 1,(n+2)-dimetalla[n.n.n]propellanes: are they all realistic synthetic targets?

[n.n.n]Propellanes and bicyclo[n.n.n]alkanes (1

Podocyte-associated molecules in puromycin aminonucleoside nephrosis of the rat.

Molecules of central functional significance for the glomerular podocytes are rapidly emerging and have been shown to be distinctly involved in diseases with altered glomerular filtration barrier. Here we used the puromycin aminonucleoside (PA) nephrosis model in the rat to study some key proteins associated with the maintenance of the functional glomerular filtration barrier in vivo. The molecules studied included the filtration slit component nephrin, the hairpin-like membrane protein podocin, the basolateral adhesion molecules beta1 integrin and alpha-dystroglycan, and the cytoskeleton-linking intermediary beta-catenin and the actin-associated alpha-actinin-4. The results showed diminished protein levels of podocin and nephrin in the PA-treated group. beta-catenin showed distinct down-regulation at 3 days of induction, and the control level was reached at 10 days. beta1 integrin was markedly up-regulated during induction. alpha-actinin-4 was not changed at the studied time points. The results show distinct differences in the different domains of podocytes during PA-induced proteinuria.