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1.

Objective

The aim of this study was to elucidate the clinicopathological significance and prognostic role of loss of claudin-1 in colorectal cancer (CRC).

Methods

The correlations between claudin-1 expression and clinicopathological characteristics, including survival rates, were assessed using immunohistochemistry on 260 archival, paraffin-embedded CRC tissues. In addition, the correlations between cludin-1 and nuclear factor-kappa B (NF-κB), epithelial-mesenchymal transition markers and tumor-infiltrating lymphocytes were investigated.

Results

Claudin-1 expression was markedly lost in 42.7% of the 260 CRCs analyzed. Loss of claudin-1 expression significantly correlated with larger tumor size, vascular invasion, higher pT stage, and high metastatic lymph node ratio. In addition, loss of claudin-1 expression significantly correlated with NF-κB activation (P?<?0.001), high SNAI (P?<?0.001), and low E-cadherin (P?<?0.001) expressions. Patients with high immunoscores showed significantly lower rates of claudin-1 expression loss (P?=?0.020). In detail, loss of claudin-1 expression were frequently found in CRCs low CD3- and CD8-positive lymphocytes. There were significant correlations between claudin-1 expression loss and poor overall and recurrence-free survivals (P?<?0.001 and P?<?0.001, respectively).

Conclusion

Taken together, our results suggest that the loss of claudin-1 expression significantly correlates with aggressive tumor behaviors, high SNAI expression, lower immunoscore, and poor prognoses.  相似文献   

2.

Background

MFG-E8(Milk fat globule-EGF factor 8), a secreted glycoprotein, plays an exceptional role in various diseases. MFG-E8 overexpression is found in a variety of cancers. However, it remains unclear whether MFG-E8 overexpression is associated with the clinicopathological characteristics and prognosis of human breast cancer.

Materials and methods

In this study, we detected the expression and localization of MFG-E8 protein in breast cancer and cancer-adjacent tissues using immunohistochemical staining, Western blot analysis and immunofluorescence. We analyzed the association between MFG-E8 expression and clinical characteristics and outcomes of breast cancer patients with different HR and HER2 statuses.

Results

Our results confirmed that MFG-E8 expression increased significantly in breast cancer compared with cancer-adjacent tissues by immunohistochemical staining (P?<? 0.001). Similarly, the Western blot results further confirmed the increased expression of MFG-E8 in breast cancer compared with cancer-adjacent tissues (P?=? 0.001). Immunofluorescence staining showed that MFG-E8 was mainly localized in the cytoplasm and membrane of tumor cells, consistent with the immunohistochemical staining results. The high expression levels of MFG-E8 showed a greater association with lymph node metastasis, TNM stage and histological grade (P < 0.001). Moreover, high MFG-E8 expression was related to a shortened overall survival (OS) (P?<? 0.001) and disease-free survival (DFS) (P?<? 0.001). Bioinformatics analysis with a Kaplan-Meier plotter also demonstrated a strong association of MFG-E8 mRNA overexpression with a short OS and DFS compared with low MFG-E8 expression (P?=? 0.040, P?=? 0.005).

Conclusions

Our findings indicate that MFG-E8 may be a potential marker for poor prognosis and survival in breast cancer.  相似文献   

3.

Background

TONSL has been suggested to function as an oncogene in lung, esophageal and cervical cancer. This study was aimed to identify the expression of TONSL and its role in hepatocellular carcinoma (HCC).

Methods

By data mining in the Cancer Genome Atlas (TCGA) and Human Protein Atlas (HPA) databases, the expression profile of TONSL, its clinical significance, the potential mechanisms of its dysregulation and its underlying biological function in HCC were investigated.

Results

TONSL was significantly upregulated in HCC tissues relative to normal liver tissues (P?<?0.05). High TONSL expression was significantly correlated with advanced TNM stage, poorly differentiated tumors, vascular invasion, elevated serum alpha-fetoprotein expression and a worse prognosis (all P?<?0.05). Multivariate analysis further confirmed that TONSL overexpression was an independent risk factor for poor overall survival (OS) and recurrence-free survival (RFS) in HCC (all P?<?0.05). Additionally, 16% of HCC cases (n?=?370) had TONSL DNA amplification. The total methylation level of TONSL was moderately and negatively correlated with its mRNA expression (P?<?0.05). TONSL was predictively targeted by miR-133b, which was downregulated in HCC and negatively related to TONSL mRNA expression (all P?<?0.05). Kaplan-Meier analyses demonstrated that low miR-133b expression was significantly associated with poor OS and RFS (all P?<?0.05). Moreover, gene set enrichment analysis revealed that cases with TONSL overexpression were enriched in cell cycle regulation pathways (all P?<?0.05).

Conclusions

TONSL holds promise for serving as a prognostic biomarker for HCC. DNA amplification, hypomethylation and miR-133b downregulation could be the mechanisms associated with TONSL upregulation in HCC. TONSL might function as an oncogene via cell cycle regulation pathways in HCC.  相似文献   

4.

Objective

To develop a patient-centered informed consent and assessment tool written at a 6th grade-level that is multimodal, affordable, transportable, and readily modifiable for protocol updates.

Methods

This quality improvement initiative was performed in two phases on an actively-recruiting study at a pediatric diabetes clinic. In phase I, 38 volunteers underwent the standard-paper consent process, a comprehension assessment and provided feedback. Using feedback and the structure of the Plan-Do-Study-Act cycle a multimodal consent and assessment were developed. In phase II, volunteers were randomized to the standard (n?=?25) or the multimodal consent (n?=?25) and all completed the same comprehension assessment via touch-screen tablet. Primary outcomes were comparison of the individual and total comprehension assessment scores.

Results

Total comprehension scores were higher in the multimodal versus the standard consent group (p?<? 0.001) and on the elements of benefits (p?<? 0.001), risks (p?<? 0.001), volunteerism (p?<? 0.012), results (p?<? 0.001), confidentiality (p?<? 0.004) and privacy (p < 0.001).

Conclusion

A multimodal consent and assessment presented sequentially on a touch-screen tablet were patient-centered enhancements to standard consent.

Practice implications

Multimodal standardization of delivery with improved readability may strengthen the informed consent process.  相似文献   

5.

Objective

Recently, a low frequency of de novo T790M mutations existing in tumor tissues before TKIs therapy has been reported. However, the origin of T790M and its impact on clinical outcomes is still being debated. This study aimed to use highly sensitive methods to detect T790M before and after TKIs therapy and investigated the correlation of T790M with clinical prognosis.

Patients and methods

Matched tumor samples before and after treatment were collected from 61 lung adenocarcinoma (LAC) patients in Beijing Chest Hospital between June 2014 to October 2017. Presence of the T790M mutation was simultaneously detected using amplification refractory mutation system-PCR (ARMS-PCR) assay and droplet digital PCR (ddPCR) assay.

Results

Of the 61 enrolled patients, 46 were candidates for and received TKIs treatment based on their EGFR mutation status. When these samples were assayed, ddPCR identified significantly more T790M mutations than ARMS-PCR (before TKIs treatment: 19.6% (9/46) vs. 2.2% (1/46), P?=?0.040; after TKIs treatment: 78.3% (36/46) vs. 50% (23/46), P?<?0.001, respectively). Patients with first-line TKIs treatment harboring de novo T790M mutations showed a shorter PFS compared to those without de novo T790M mutations (median, 7.0 months vs. 11.7 months, p?=?0.013). In multivariate analyses, de novo T790M mutation was an independent predictor of PFS in EGFR-mutant patients who received TKIs treatment (p?=?0.031, HR 0.310, 95% CI: 0.107-0.900).

Conclusion

The ddPCR assay is an ultra-sensitive method to detect a minor amount of de novo T790M mutations in tumor samples. The de novo T790M mutation is a relatively unfavorable prognosis factor for patients receiving first-line TKIs treatment.  相似文献   

6.
7.

Background

The purpose of this study was to characterise the histopathological changes in the infrapatellar fat pad (IPFP) in the early stage of patellofemoral osteoarthritis (PFOA).

Methods

Sixty-four New Zealand white rabbits were randomly divided into experimental (n?=?24), sham (n?=?16), and control groups (n?=?24). In the experimental group, denoted as the patellar ligament uneven shortening group (US group), the patellar ligament (PL) was folded eight millimetres and sutured. After eight weeks, all animals were euthanised, and magnetic resonance imaging (MRI) evaluation, wet IPFP weight measurement, and histopathological and immunohistochemistry analysis were performed to analyse the histopathological changes in the IPFPs.

Results

The maximum cross-sectional area (CSA) of the IPFPs in the sagittal position of MRI in the control group, sham group, and US group were 45.50?±?7.19?mm2, 45.88?±?6.60?mm2 (vs. control group, P?=?0.907), and 53.83?±?8.24?mm2 (vs. control group, P?=?0.015; vs. sham group, P?=?0.035), respectively. The MRI intensity of the IPFPs in the control group, sham group, and US group were 115.53?±?28.85, 108.53?±?26.73 (vs. control group, P?=?0.589), and 154.52?±?18.48 (vs. control group, P?=?0.002; vs. sham group, P?=?0.002), respectively. The wet weight of the IPFPs in the control group, sham group, and US group were 0.32?±?0.05?g, 0.32?±?0.04?g (vs. control group, P?=?0.895), and 0.38?±?0.06?g (vs. control group, P?=?0.017; vs. sham group, P?=?0.033), respectively. The Osteoarthritis Research Society International (OARSI) scores of the IPFPs in the US group were 6.00?±?1.91, which was higher than the scores of 2.50?±?2.02 (P?<?0.001) in the control group and of 2.75?±?1.67 (P?=?0.001) in the sham group.

Conclusions

The histopathological changes of the IPFPs as determined via MRI and microscopic structure appeared to occur much earlier than cartilage damage in PFOA. Furthermore, detecting and treating the IPFP changes may offer aid in the diagnosis and treatment of PFOA.  相似文献   

8.
9.

Background

Studies have shown that 30–50% of non-small cell lung cancer (NSCLC) patients develop brain metastasis (BM). Since BM shortens overall survival and decreases the quality of life, early detection and treatment of BM are vital. While data are available for clinical risk factors of NSCLC with BM, histopathological factors are not well understood. Therefore, we evaluated the histopathological related factors which will help early detection and selection of effective treatment options.

Materials and methods

A total of 117 surgical lung specimens diagnosed as NSCLC with BM were included as a study group. We included 237 cases without BM as a control group. One pathologist reviewed H&E slides and analyzed the histopathologic factors of all cases.

Results

In pulmonary adenocarcinoma, vascular invasion, N stage, micropapillary pattern and necrosis were significantly associated with BM in multivariate analysis (vascular invasion, p?=?0.009; micropapillary pattern, p?=?0.024; others, p?<?0.001). Tumor with extensive necrosis had higher hazard ratio and shorter time to BM (p?<?0.001).

Conclusion

Our findings suggest that necrosis is a new predictive factor of BM in pulmonary adenocarcinoma. Short term follow-up is needed especially when extensive necrosis is present.  相似文献   

10.

Objectives

To evaluate the performance of a new mathematical model γ-glutamyl transpeptidase to cholinesterase and platelet ratio (GCPR) versus γ-glutamyl transpeptidase to platelet ratio (GPR) in predicting significant fibrosis and cirrhosis of chronic hepatitis B.

Methods

A complete cohort of 2343 patients was divided into early and late cohort depending on the time of liver biopsy. With reference to the Scheuer standard, liver pathologic stage 2 or higher and stage 4 or higher were defined as significant fibrosis and cirrhosis, respectively. Receiver operating characteristic (ROC) curve was used to evaluate the performance of investigated models.

Results

In the early cohort, the areas under ROC curves (AUROCs) of GCPR in predicting significant fibrosis of hepatitis B e antigen (HBeAg)-positive and HBeAg-negative patients (0.782 and 0.775) were both significantly greater than those of GPR (0.748 and 0.747) (Z = 8.198 and Z = 6.023, both p <0.0001); the AUROCs of GCPR in predicting cirrhosis of HBeAg-positive and HBeAg-negative patients (0.842 and 0.861) were both significantly greater than those of GPR (0.802 and 0.823) (Z = 6.686 and Z = 6.116, both p <0.0001). In early, late and complete cohorts, using a single cutoff of GCPR > 0.080, the specificities of GCPR in predicting significant fibrosis of HBeAg-positive patients were 83.3%, 88.2% and 85.0% and of HBeAg-negative patients were 87.6%, 87.4% and 87.6%, respectively; and the sensitivities of GCPR in predicting cirrhosis of HBeAg-positive patients were 81.9%, 88.7% and 84.2% and of HBeAg-negative patients were 83.1%, 82.1% and 82.7%, respectively.

Conclusions

GCPR has higher performance than GPR in predicting significant fibrosis and cirrhosis of chronic hepatitis B.  相似文献   

11.

Background

GPR110 is a member of the adhesion G protein-coupled receptor family, which has been identified as an oncogene in various cancers, including hepatocellular carcinoma, lung cancer, prostatic cancer and glioma. Whereas the expression and the clinical relevance of GPR110 in gastric cancer has not been investigated. The research purpose of this study was to explore the expression pattern of GPR110 and evaluate its clinical-pathological and prognostic value in gastric cancer.

Methods

In this study, the expression of GPR110 was detected in 117 paired gastric cancer tissues and adjacent non-tumorous tissues by using qRT-PCR and immunohistochemical assays. Univariate Kaplan-Meier and multivariate Cox analysis were used to determine the prognostic value of GPR110 in GC.

Results

We demonstrated that the mRNA and protein levels of GPR110 in GC tissues were overexpressed than the adjacent non-tumorous tissues. Furthermore, elevated GPR110 protein expression was correlated with decreased overall and recurrence-free survival (P?=?0.001 and P?=?0.000, respectively). Univariate and multivariate analysis indicated that GPR110 protein level may serve as an independent prognostic indicator for determining prognosis of GC patients.

Conclusions

Our study revealed that high expression of GPR110 predicts the poor prognosis of GC patients, and GPTR110 may function as a potential biomarker for the diagnosis of GC.  相似文献   

12.

Objective

To assess women’s attitudes and preferences related to recent changes in cervical cancer screening guidelines.

Methods

We distributed 380 surveys in three University based and Community clinics. Study participants anonymously completed surveys, which included questions related to demographics, cervical cancer, screening practices, risk perception and attitudes towards changing practices.

Results

315 women agreed to participate (83%). 60% (185/310) of participants had some college education or higher and 12% (36/305) worked in the medical field. On average, participants answered 4.1 (SD?=?1.3) of the 8 knowledge questions correctly. Knowledge scores significantly increased with education level (Kruskal-Wallis test p-value?<?0.001). The majority (72%, n?=?228) reported that they should be screened annually, and that screening should be initiated with the onset of sexual activity (63%, n?=?197). Participants that were more knowledgeable of current screening practices were more comfortable extending screening intervals (Kruskal-Wallis test p?<?0.001).

Conclusion

Even among a relatively highly educated population of women, participants had limited knowledge of cervical cancer and current screening guidelines. Many participants reported discomfort with less frequent screening intervals.

Practice implications

This study supports the need for improvement in cervical cancer prevention education especially with regards to the new screening guidelines.  相似文献   

13.

Background

CARGEL (Smith & Nephew Inc.), a chitosan-based polymer scaffolding biomaterial, has been used since 2012 for treating articular cartilage lesions. Limited data are available on patient outcomes following CARGEL treatment. This study aimed to describe short-term clinical and radiographic outcomes in a cohort of patients treated with CARGEL and microfracture surgery for articular cartilage defects in the knee.

Methods

A retrospective cohort study was conducted of consecutive patients with articular cartilage defects who had undergone microfracture surgery with CARGEL, or in patellar lesions microfracture and CARGEL plus Chondro-Gide (at SportsClinic Zurich). Study outcomes included reoperations, infections, allergic reactions, pain, swelling, range of motion, and tissue quality and quantity. Ethics approval was obtained from the local ethics committee on 05/09/2017 (Basec. Nr: 2017-01441).

Results

A total of 91 participants, with 93 treated lesions, consenting to chart review were included. No participants required reoperation due to complications on the index lesion. Fifteen participants had second-look surgery on the index knee for other reasons, allowing for visual confirmation of cartilage repair. No study participants experienced a post-surgical infection or suffered an allergic reaction. No significant changes in range of motion or T2 values were observed from pre-treatment to post-treatment follow-up. However, significant decreases were found in pain (P?<?0.001) and swelling (P?<?0.001), along with significant increases in MOCART II scores (P?<?0.001). Similar results were found in a subgroup of patients with patellar lesions.

Conclusions

Patients treated with CARGEL experienced few postoperative complications and reported promising reductions in pain and swelling after treatment.

Level of evidence

IV  相似文献   

14.

Introduction

Syndecan-1 is heparan sulfate proteoglycans (HSPGs) that is used as coreceptors for signaling of growth factors. The comprehensive effect of syndecan-1 is to augment receptor stimulation at little ligand concentrations.

The goal of this research

is to study syndecan-1 expression in breast carcinoma and its value in predicting the prognosis in comparison to other clinicopathological parameters.

Material &methods

immunohistochemistry study for syndecan-1 is done on 103 cases of invasive breast carcinoma. Its expression is assessed and correlated to other clinicopathological parameters and prognosis.

Results

overexpression was significantly related to high histologic grade (p?=?0.001), large tumor size (p?=?0.043), HER2-positive status (p?=?0.001), and ER&PR-negative status (p?=?0.001). It was also have a negative impact on the overall survival (p=0.012) and disease free survival (p?=?0.009). Syndecan-1 expression showed weak positive correlation with Her 2 expression (Correlation Coefficient (co): 0.332, p?=?0.001).

Conclusion

syndecan-1 is a good predictor of poor overall survival and recurrence/ metastasis free survival. It is associated with aggressive phenotype as HER2 enriched and Triple negative rather than luminal subtypes of breast carcinoma. So it can be added to the hormonal receptors and HER 2 assay in the routine management of invasive breast cancer after confirmation on a more larger study.  相似文献   

15.

Objective

This study evaluates the effectiveness of technology versus in-person, group-initiated diabetes prevention to enhance comprehension of learning objectives between patients with differing health literacy (HL).

Methods

Evidence-based content through either a DVD (n?=?217) or in-person, group class (n?=?225) to initiate the intervention. A teach-back call was used to assess comprehension of, and reinforce, learning objectives. Chi-squared was used to determine differences between conditions (DVD vs Class) and HL levels (High n?=?361 vs. Low n?=?81) and regression analyses were used to examine relationships.

Results

DVD participants performed significantly better across teach back questions (15.4?±?2.5 v. 14.8?±?2.6, p?<?0.01), demonstrated comprehension in fewer teach-back rounds (1.9?±?0.7 v. 2.1?±?0.7, p?<?0.01), and answered more questions correctly on the first try (4.2?±?1.6 v. 3.4?±?1.8, p?<?0.01). Models for HL levels and modality by HL level were statistically significant (p?<?0.01) favoring the DVD.

Conclusion

Initiating a diabetes prevention program with the use of a DVD appears to be a superior option to in-person, class sessions. Teach-back and teach-to-goal strategies enables participants of both high and low health literacy levels to receive and confirm mastery of diabetes prevention objectives.

Practice Implications

A teach-back call may improve information uptake increasing the likelihood of health behavior uptake.  相似文献   

16.

Objective

To evaluate the long-term safety and effectiveness of tocilizumab (TCZ) for the treatment of rheumatoid arthritis (RA) in a real-world clinical setting in Taiwan.

Method

All refractory RA patients who initiated intravenous TCZ between August 2012 and March 2015 were enrolled. Data on patient characteristics, drug safety and effectiveness were collected.

Results

A total of 114 RA patients were recruited. Despite the majority of them (93%) had previous biologic failure, 43.75% of the patients were able to reach ACR50 after one year. Serious adverse events commonly found were bacterial pneumonia (4.24/100 patient-years) followed by cellulitis (2.12/100 patient-years). Twenty-three patients had old or latent TB infections, 11 patients had chronic hepatitis B. During the 3 years follow-up, none of them had reactivation of TB, or hepatitis B with concomitant use of isoniazid prophylaxis or pre-emptive antiviral treatment.

Conclusion

In this 3-year real-world study on RA patients of Taiwan, we found a good long-term effectiveness and similar safety profiles for the TCZ treatment. With prophylactic strategy for latent TB and pre-emptive antiviral treatment for HBV carriers, the risk of reactivation of latent TB and HBV may be reassured.  相似文献   

17.

Background

An association between Tako-Tsubo cardiomyopathy (TTC) and underlying malignancies has been observed, suggesting that TTC might be the consequence of paraneoplastic phenomena. This study investigates the presence of autoantibodies against cardiomyocytes as well as adrenergic (β1, β2) and muscarinic (M2) receptors in patients with TTC.

Methods and results

Serum from 20 TTC patients and 20 controls with ischemic heart disease was obtained. Indirect immunofluorescence testing for intracellular autoantibodies against cardiomyocytes showed a homogenous distribution, as in both groups 9 of 20 sera displayed a characteristic binding pattern of antibodies including vascular walls and intracellular structures. Flow cytometry analysis revealed no difference between TTC and controls in the binding of autoantibodies to the surface antigens of cardiomyocyte HL-1 cells (p?=?0.569, t-test). Flow cytometry analysis of nontransfected wild type cells (p?=?0.633, t-test), M2 receptor-transfected cells (p?=?0.687, t-test), β1 receptor-transfected cells (p?=?0.444, t-test) and β2 receptor-transfected cells (p?=?0.632, t-test) showed similar results for control and TTC sera. Likewise, the binding pattern of TTC patients with a history of neoplasia compared to those without or to controls did not differ significantly (p?>?0.05, u-test).

Conclusion

Findings suggest that the presumed paraneoplastic etiology of TTC cannot be attributed to the formation of these antibodies.  相似文献   

18.

Aims

We explored the effect of remote ischaemic conditioning (RIC) on endothelial function and on circulating mediators.

Methods and results

In 20 healthy male volunteers (mean age 31?±?10 years), flow-mediated dilation (FMD) was measured before and after 20?min of arm ischaemia, followed by reperfusion. Remote ischaemic conditioning (RIC) was performed by applying 3 cycles of 5?min of ischaemia of the leg at the onset of index arm ischaemia. Each volunteer underwent the IR-induced vascular injury protocol with and without RIC in a crossover study design.In the control group, IR significantly reduced FMD (5.9?±?2.9% before IR vs. 2.2?±?3.7% after IR; p?<?0.001). This effect was significantly attenuated by performing RIC (FMD of 5.5?±?3.1% before IR vs. 4.0?±?3.4% % after IR; p for interaction?=?0.01). Serum levels of SOD and ADMA increased significantly whereas MCP-1 and VEGF levels decreased significantly.Only changes in SOD levels were significantly related to the degree of RIC induced protection (r²?=?0.34; p?=?0.018).

Conclusion

RIC has protective effects against endothelial IR injury. Our biomarker study suggests that anti-oxidative stress mediators, such as SOD, seem to be more involved in the pathogenesis of RIC-induced protection in humans than angiogenesis factors or chemo-attractant cytokines.  相似文献   

19.

Objectives

The aim of this study was to investigate the link between perceived dimensions of patient centred care and the satisfaction of adolescents and young adults within the UK, USA, Australian, Italian, and Chinese healthcare systems.

Methods

One thousand and thirty-four participants (212 from China,206 from Australia,208 from UK, 202 from USA, and 206 from Italy) answered a self-report questionnaire assessing the perceived dimensions of patient centred care. Factor analysis (PFA) was conducted on the data to identify relevant dimensions. One-way ANOVAs were run to identify differences between country samples related to perceived dimensions of patient centredness, and a multi-level multiple regression model was computed to assess the link between satisfaction and dimensions of patient centred care.

Results

Countries’ mean scores on ‘Satisfaction with Care’ (PF1) and on ‘Psychosocial Context’ (PF2) were statistically significant by inspecting the ANOVAs (p?<?.05). Satisfaction with care was predicted by PF2 and clinical utilization.

Conclusion

An online survey collected meaningful data on perceptions of healthcare received by respondents from five countries. This initial international study highlights important associations worthy of closer investigation.

Practice implications

Healthcare providers should assess comprehensively the psychosocial context of young patients during consultations.  相似文献   

20.

Objective

Information overload can negatively impact positive health behaviors such as cancer screening. The 8-item Cancer Information Overload (CIO) scale appears to be the only validated measure of health-related information overload. The present study assesses the validity of the CIO scale when modified for use in patients with atrial fibrillation (AF) residing in Australia.

Methods

We conducted a secondary analysis of data from a study of adult Australian patients with AF (N?=?386) in which a modified version of the CIO scale was used. In the present study, we examined the construct (convergent and divergent) validity and performed an exploratory factor analysis for the modified scale.

Results

All items on the modified-CIO scale appear to load onto a single factor. As predicted, higher education levels (rs=-.24, p?<?.001) and higher oral anticoagulant knowledge (rs=-.17, p?=?.001) were significantly associated with lower modified-CIO scores; no other demographic characteristics were significantly associated with CIO scores.

Conclusion

When adapted to the AF context, the modified-CIO scale appears to be a valid measure of information overload.

Practice Implications

A valid scale is required to measure information overload accurately. Knowledge of the interplay between information overload and various health behaviors help focus future efforts to support patient empowerment.  相似文献   

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