viewcare35
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BACKGROUND Invasive fungal disease is a major cause of morbidity and mortality in children with cancer and high-risk febrile neutropenia (HRFN). Repeated serum galactomannan (sGM) measurements have been described as an effective tool to guide therapy in adults under suspicion of Invasive Aspergillosis. However, the utility of this approach has not been reported in pediatric population. OBJECTIVES To evaluate the usefulness of sGM measurements in initiating and modifying antifungal therapy (AFT) in children with cancer and persistent HRFN. PATIENTS/METHODS Nested case-control study in children with cancer and persistent HRFN episodes, between July 2013 and January 2019. Patients were classified as cases and controls depending on if they received AFT or not, respectively. Through odds-ratio analysis, we assessed the role of sGM positivity in the AFT initiation decision. Then, we analyzed the group of patients that initiated AFT, and compared those who had AFT modifications and those who didn't, analyzing different sGM kinetics thresholds. RESULTS 191 episodes from children with persistent HRFN were enrolled, of which 107 received AFT and 84 did not. The median age was 7 years (IQR 4-12), 52% were male and 89% had a hematologic malignancy as underlying disease. Positive sGM was not associated with AFT initiation (OR 0.99, 95% CI 0.43-2.33, p = 0.99). A difference threshold in sGM Δ≥ 0.3 sGM was significantly associated with AFT modification (OR 5.07, 95% CI 1.02- 25.70, p = 0.04). CONCLUSIONS Our results suggest the utility of serial sGM sampling during AFT in children with persistent HRFN. This article is protected by copyright. All rights reserved.BACKGROUND Education plays an important role in cancer symptom management for patients and their families. With the advancement of information and communication technology, there may be additional evidence for the use of mobile apps to support patient and family education. Fumarate hydratase-IN-1 order PURPOSE The purpose of this review was to explore and synthesize scientific literature about cancer symptom management mobile apps that can be used by patients and their families. METHODS This review adopted a scoping review study framework, using electronic databases including EBSCO, PubMed, ProQuest, Science Direct, and Google Scholar using search keywords 'caregiver family', 'mobile application', 'symptom management' and 'palliative care'. Of a total of 2633 papers found, 11 papers were selected. FINDINGS Assessment tools are a major component of mobile apps in reporting and assessing symptoms to provide appropriate education. The information in mobile apps is delivered through various mediums that include modules, videos, avatars and cultural integration features. CONCLUSION Mobile apps can improve provision of palliative care in several ways, most importantly by increasing the knowledge of the patient's family to manage cancer symptoms. Nurses are expected to play an active role in finding and utilizing appropriate mobile apps to assist families in managing a patient's symptoms at home. © 2020 John Wiley & Sons Australia, Ltd.Construction of porous organic polymers (POPs) with high surface areas, well-defined nanopores and excellent stability remains extremely challenging due to unmanageable reaction process. Until now, only a few reported POPs have Brunauer-Emmett-Teller (BET) surface areas ( S BET ) exceeding 3000 m 2 g -1 . Herein, we demonstrate a molecular expansion strategy to integrate high surface areas, large nanopore sizes and outstanding stability into POPs. A series of hyper-crosslinked conjugated polymers ( HCCPs ) with exceptional porosity are successfully synthesized through this strategy. Specially, HCCP-6 and HCCP-11 exhibit the highest surface areas ( S BET > 3000 m 2 g -1 ) and excellent total pore volumes (up to 3.98 cm 3 g - 1 ) among these HCCPs . They present decent total CH 4 storage capacities of 491 and 421 mg g -1 at 80 bar and 298 K, respectively. Meanwhile, they are highly stable in hostile environments. The facile and general molecular expansion strategy would lead to an unprecedented revolution in improving synthetic routes of POPs for desired functions. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.Published decisions by federal and state appellate courts impact health care risk management in a number of ways, including overruling precedents, explaining and clarifying new laws and regulations, describing new and novel rules, describing new performance standards, and describing new civil rights. © 2020 American Society for Healthcare Risk Management of the American Hospital Association.Uniaxial magnetic anisotropy is an essential property that governs the performance of dysprosium metallocene single-molecule magnets (SMMs). Determining this property using experimental methods is necessary and important as it provides direct information vital to the understanding of the magneto-structural correlation and a valuable reference for theoretical analysis, but has been proved extremely challenging. Herein, we investigate a family of dinuclear dysprosium metallocene SMMs bridged by the methyl and halogen groups [Cp' 2 Dy( μ -X)] 2 (Cp' = cyclopentadienyltrimethylsilane anion; 1 X = CH 3 - ; 2 X = Cl - ; 3 X = Br - ; 4 X = I - ). For the first time, the magnetic easy axes of dysprosium metallocene SMMs are experimentally determined, confirming that the orientation of them are perpendicular to the equatorial plane. While the orientation of magnetic easy axis for 1 deviates from the normal direction (10.3°), due to the stronger equatorial interactions between Dy III and methyl groups. Moreover, its magnetic axes show a temperature-dependent shifting, which is caused by the competition between the exchange interactions and Zeeman interactions. The fluorescence, specific heat studies and ab initi o calculations reveal the significant influences of the bridging ligands on their low-lying exchange-based levels and consequently low-temperature magnetic properties. This work proves the role of equatorial interactions on the magnetic anisotropy and provides insights to design high-performance dysprosium metallocene SMMs. © 2020 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

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