Patient-reported outcome measures obtained via E-Health tools ease the assessment burden and encourage patient participation in cancer care (PaCC Study).

Patient-reported outcome measures obtained via E-Health tools ease the assessment burden and encourage patient participation in cancer care (PaCC Study) BACKGROUND: E-health based patient-reported outcome measures (PROMs) have the potential to automate early identification of both nutrition status and distress status in cancer patients while facilitating treatment and encouraging patient participation. This cross-sectional study assessed the acceptability, accuracy, and clinical utility of PROMs collected via E-Health tools among patients undergoing treatment for stomach, colorectal, and pancreatic tumors. RESULTS: Eight-nine percent mostly, or completely, agreed that PROMs via tablets should be integrated in routine clinical care. Men were significantly more likely to require help completing the questionnaires than women (inv.OR= 0.51, 95% CI=(0.27, 0.95), p = 0.035). The level of help needed increased by 3% with each 1-year increase in age (inv. OR=1.03, 95% CI=(1.01, 1.06), p = 0.013). On average, a patient tended to declare weight which was 0.84 kg inferior to their true weight (Bland and Altman 95 % CI=(-3.9, 5.6); SD: 2.41) and a height which was 0.95 cm superior to their true height (Bland and Altman 95 % CI=(-5, 3.1); SD 2.08). Patient-reported nutrition status was significantly associated with the professionally generated assessment (95% CI=(2.27, 4.15), p < 0.001). As nutrition status declined, the distress score increased (95%CI=(0.88, 1.68), p < 0.001). Of the patients, 48.8% who were both distressed and malnourished requested supportive care to address their problems. CONCLUSION: Patient-reported assessments utilizing E-health tools are an accurate and efficient method to encourage patient participation in cancer care while simultaneously ensuring that regular assessment of psycho-social and nutritional aspects of care are efficiently integrated in the daily clinical routine.

Direct effects on scenarios and types of path analyses in corn hybrids.

The objective of this study was to estimate the direct effects of explanatory variables on the grain yield of corn in the combinations formed by three types of hybrids x two harvests x nine scenarios of explanatory variables x two types of path analyses. Eleven explanatory variables were measured in 361, 373, and 416 single-, triple-, and double-cross hybrid plants from the 2008/2009 harvest, respectively, and in 1777, 1693, and 1720 single-, triple-, and double-cross hybrid plants from the 2009/2010 harvest, respectively: plant height at harvest (PH), ear insertion height (EIH), ear weight (EW), number of grain rows per ear (NR), ear length (EL), ear diameter (ED), cob weight (CW), cob diameter (CD), 100-grain mass (HGM), number of grains per ear (NGE), grain length (GL) and, the main variable, grain yield (YIELD). Before conducting the traditional and ridge path analyses, 0, 1, 2, 3, 4, 5, 6, 7, and 8 explanatory variables were excluded from scenarios 1, 2, 3, 4, 5, 6, 7, 8, and 9, respectively. Next, the direct effects of explanatory variables on YIELD were estimated for each hybrid, harvest, scenario, and type of path analysis. The variables EW, NGE, and HGM had stronger direct effects on YIELD in the first three scenarios and the variables EL and ED had stronger direct effects on YIELD in the other scenarios regardless of hybrid or harvest. The use of the ninth scenario of path analysis is recommended regardless of hybrid and harvest given the ease of explanatory variable measurement (EIH, EL, and ED), the low degree of multicollinearity and the good prediction of the path analysis (R2 ≥ 0.78).

Sample size for estimation of direct effects in path analysis of corn.

The objective of this study was to assess the sample size required for estimating the direct effects of explanatory variables on the grain yield of corn in the combinations formed by three types of hybrids x two harvests x nine scenarios of explanatory variables x two types of path analyses x four levels of accuracy. A total of 6340 plants were evaluated (361, 373, and 416 plants from single-, triple-, and double-cross hybrids in the 2008/2009 harvest, respectively, and 1777, 1693, and 1720 plants from single-, triple-, and double-cross hybrids in the 2009/2010 harvest, respectively). Eleven explanatory variables were measured in each plant: plant height, ear insertion height, ear weight, number of grain rows per ear, ear length and diameter, cob weight and diameter, 100-grain mass, number of grains per ear, grain length and, the main variable, grain yield. Thus, nine scenarios were planned (scenarios 1, 2, 3, 4, 5, 6, 7, 8, and 9 with 0, 1, 2, 3, 4, 5, 6, 7, and 8 explanatory variables excluded, respectively) and two types of path analyses conducted (traditional and ridge path analyses). The sample size required for estimating the direct effect of each explanatory variable on grain yield was assessed using resampling with replacement at four accuracy levels [95% confidence interval ranges (95%CI) of 0.15, 0.25, 0.35, and 0.45]. The use of the ninth scenario of path analysis is recommended regardless of hybrid and harvest given the smaller sample size required compared to the previous scenarios. To estimate direct effects with the maximum 95%CI of 0.25, 10 to 530 plants are required depending on the type of hybrid, harvest, scenario, type of path analyses, and explanatory variables. To estimate the direct effects in the ninth scenario with a maximum 95%CI of 0.25, 120 plants suffice regardless of the type of hybrid, harvest, or type of path analyses.

Deep peels: what the nurse does.

This article is intended to prepare the dermatology nurse to competently and confidently assist in the deep chemical peel and to manage the care of the patient effectively before, during, and after the procedure.

Long term studies of pancreas transplantation in experimental diabetes mellitus.

Alloxan diabetes was induced in inbred rats that then were divided into four groups consisting of unoperated diabetic controls, sham-operated diabetic controls, rats given pancreaticoduodenal isografts, and rats given duct-ligated pancreas isografts. The animals were studied for from 18 months (controls) to two years (transplants) and the following important results were obtained: 1) In striking contrast to the diabetic controls, pancreas transplants of both types produced immediate and permanent relief of hyperglycemia, immediate and lasting elevation of serum insulin levels, a normal weight and growth curve, and good health for two years. Removal of the graft was followed by recurrence of severe diabetes. 2) Pancreas transplants of both types prevented the widespread and severe renal, ophthalmic and neural lesions of diabetes that were found in the diabetic controls. 3) The duct-ligated pancreas graft and pancreaticoduodenal transplant were equally effective in controlling diabetes. Ligation of the pancreatic duct was not followed by significant morphologic or clinical evidence of pancreatitis or by loss of endocrine function. 4) Portal venous drainage of the pancreas transplant was unnecessary for good endocrine function.