Patient navigation across the cancer care continuum: An overview of systematic reviews and emerging literature

Patient navigation is a strategy for overcoming barriers to reduce disparities and to improve access and outcomes. The aim of this umbrella review was to identify, critically appraise, synthesize, and present the best available evidence to inform policy and planning regarding patient navigation across the cancer continuum. Systematic reviews examining navigation in cancer care were identified in the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Embase, Cumulative Index of Nursing and Allied Health (CINAHL), Epistemonikos, and Prospective Register of Systematic Reviews (PROSPERO) databases and in the gray literature from January 1, 2012, to April 19, 2022. Data were screened, extracted, and appraised independently by two authors. The JBI Critical Appraisal Checklist for Systematic Review and Research Syntheses was used for quality appraisal. Emerging literature up to May 25, 2022, was also explored to capture primary research published beyond the coverage of included systematic reviews. Of the 2062 unique records identified, 61 systematic reviews were included. Fifty-four reviews were quantitative or mixed-methods reviews, reporting on the effectiveness of cancer patient navigation, including 12 reviews reporting costs or cost-effectiveness outcomes. Seven qualitative reviews explored navigation needs, barriers, and experiences. In addition, 53 primary studies published since 2021 were included. Patient navigation is effective in improving participation in cancer screening and reducing the time from screening to diagnosis and from diagnosis to treatment initiation. Emerging evidence suggests that patient navigation improves quality of life and patient satisfaction with care in the survivorship phase and reduces hospital readmission in the active treatment and survivorship care phases. Palliative care data were extremely limited. Economic evaluations from the United States suggest the potential cost-effectiveness of navigation in screening programs.     

Key Informants’ Perspectives on Childhood Obesity in Vietnam: A Qualitative Study

Maternal and Child Health Journal - Vietnam’s post-war globalization, economic development, and urbanization have contributed to a nutrition transition from traditional diets to...     

SARS-CoV-2 Spike Protein Disrupts Blood–Brain Barrier Integrity via RhoA Activation

The SARS-CoV-2 spike protein has been shown to disrupt blood–brain barrier (BBB) function, but its pathogenic mechanism of action is unknown. Whether angiotensin converting enzyme 2 (ACE2), the viral binding site for SARS-CoV-2, contributes to the spike protein-induced barrier disruption also remains unclear. Here, a 3D-BBB microfluidic model was used to interrogate mechanisms by which the spike protein may facilitate barrier dysfunction. The spike protein upregulated the expression of ACE2 in response to laminar shear stress. Moreover, interrogating the role of ACE2 showed that knock-down affected endothelial barrier properties. These results identify a possible role of ACE2 in barrier homeostasis. Analysis of RhoA, a key molecule in regulating endothelial cytoskeleton and tight junction complex dynamics, reveals that the spike protein triggers RhoA activation. Inhibition of RhoA with C3 transferase rescues its effect on tight junction disassembly. Overall, these results indicate a possible means by which the engagement of SARS-CoV-2 with ACE2 facilitates disruption of the BBB via RhoA activation. Understanding how SARS-CoV-2 dysregulates the BBB may lead to strategies to prevent the neurological deficits seen in COVID-19 patients.

Graphic Abstract

     

Factors associated with publication of plenary presentations at the Society of Gynecologic Oncologists annual meeting

ObjectiveTo determine the rate and factors associated with publication of plenary abstract presentations from the Society of Gynecologic Oncologists annual meeting.MethodsPlenary presentations were reviewed from 2000 to 2005. A PubMed search was performed to identify subsequent peer-reviewed publication of these presentations. Chi-squared test and logistic regression were used for statistical analyses.ResultsOf 378 main, focused or express plenary presentations, 173 (45.8%) involved multiple and 205 (54.2%) single institutions. The types of study include: chart review (29.4%), cohort study (28.0%), translational (23.5%), and randomized clinical trial (6.9%). 309 (81.7%) of presentations were subsequently published. The median time from presentation to publication was 14 months (range: 1–85). Studies from multiple vs. single institutions were more likely to be published (87.9% vs. 76.6%; p = 0.005). In addition, randomized controlled trials were more likely to be published compared with chart review, cohort, and translation research (92.3% vs. 83.8%, 77.4%, and 74.2%; p < 0.01). On multivariate analysis, multi-institutional studies (OR = 2.28, 95% CI = 1.28–4.04; p = 0.005) and type of study (OR = 1.64, 95% CI = 1.19–2.26; p = 0.002) were independent factors associated with publication. In addition, multi-institutional studies had longer times from presentation to publication compared with their counterparts.ConclusionsA high percentage of plenary presentations at the Society of Gynecologic Oncologists annual meeting resulted in subsequent publication. Multi-institutional studies and randomized clinical trials were more likely to be published.     

Understanding the tribological impacts of alkali element on lubrication of binary borate melt

Melt lubricants have been regarded as an effective class to deliver lubrication on moving mechanical contacts at extreme temperatures. Among the elementary constituents, alkali elements play a critical role in governing the physical–chemical characteristics of the lubricant despite the obscurity regarding their intrinsic roles on the rubbing interfaces. The present study attempts to unfold the effects of sodium on the tribological responses of mating steel pair under borate melt lubrication. It has been found that the involvement of Na inspires a total reversal in lubricating potentials of the lone B₂O₃ melt manifested by remarkable friction reduction, wear inhibition and prolonged load-bearing capacity. These exceptional performances are attributed to the accretion of nanothin Na layers on the contact interfaces. The interfacial occurrences are interpreted from a physico-chemistry perspective while the influences of surface microstructure are also discussed in detail. Multiple characterizations are employed to thoroughly examine the sliding interfaces in multi-dimensions including Scanning Electron Microscopy (SEM), Scanning Transmission Electron Microscopy (STEM) and Atomic Force Microscopy (AFM). In addition, chemical fingerprints of relevant elements are determined by Energy Dispersive Spectroscopy (EDS) and Electron Loss Energy Spectroscopy (EELS).

The involvement of sodium induces dramatic transformation in lubrication potentials of boron oxide melt.