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Purpose: Patient-reported outcomes are considered the gold standard for documenting treatment-related toxicities and cancer-related symptoms in the management of oncology patients. Poor concordance between patients and health care professionals (HCPs) on patients’ symptoms has been documented. The purpose of this study is to examine the association between social desirability, a response style, and symptom reporting in a colorectal cancer clinic. Methods: Patients being treated for colorectal cancer completed a social desirability measure and a symptom measure before their appointment in the oncology clinic. The HCP who saw the patient completed a symptom measure for the patient after the clinic visit. Results: One hundred sixty-nine patients consented to participate in the study. The majority of the patients had stage 4 disease. There was a statistically significant positive correlation between social desirability and overall reported symptom burden. There was a statistically significant negative correlation between social desirability and concordance between the patient and the HCP on the patient’s symptoms. Social desirability scores were stable over the course of 1 year. Conclusion: Sensitivity to social desirability effects seems to play an important role in patient self-report of symptoms. As social desirability is a stable quality, patients sensitive to it may be persistently at risk for undertreatment of symptoms due to limited symptom reporting. [ABSTRACT FROM AUTHOR]

Density functional theory is used to study the effect of asymmetric in-plane strain on various BiInO3 phases. Structural relaxation is carried out to simulate the growth of coherently strained epitaxial films on (001) oriented orthorhombic perovskite substrates. The results are in particular analyzed with respect to commercially available substrates in order to assess the stabilization of new and fundamentally interesting BiInO3 phases. We find that a pyroxene-like Pcca phase is energetically more favorable than the bulk-like Pna21 structure on standard cubic substrate materials, such as SrTiO3. However, the presence of imaginary phonon modes suggests that this phase is dynamically instable. The bulk-like structure instead is stable over a wide range of lattice in-plane strain, but coherent growth requires substrates with unusually large lattice parameters. We suggest the use of lanthanate substrates in order to produce high-quality thin films of the bulk phase. [ABSTRACT FROM AUTHOR]

Introduction: Opioid overdose rescue situations are time-critical, high-stress scenarios that frequently require nonmedical first responders or bystanders to intervene and administer naloxone to avoid opioid-induced fatalities. Training nonmedical personnel to respond during such mentally constraining situations presents the human factors challenge of how best to design a safe and effective lay delivery system. This paper comparatively evaluates the ease of use of two nasal naloxone administration products: NARCAN® Nasal Spray and a naloxone prefilled syringe with nasal atomizer (PFS-NA). Methods: We evaluated the use requirements and usability of NARCAN® Nasal Spray versus a naloxone PFS-NA using a systems-oriented method. First, we determined the use requirements of different user groups. Next, we focused on constructing a human factors task analysis of both products. Finally, we conducted a comparative risk assessment of the tasks that were different between the two products. Results: Inexperienced users, such as nonmedical first responders and bystanders, are at the highest risk of incorrectly administering naloxone, particularly in high-stress emergency opioid overdose situations. The device Preparation and Medication Delivery tasks most differentiate the use of NARCAN® Nasal Spray and a PFS-NA. The level of task complexity and number of steps within those tasks is substantially greater for a PFS-NA than for the NARCAN® Nasal Spray. Conclusions: NARCAN® Nasal Spray requires fewer steps and is easier to administer than a naloxone PFS-NA. Thus, using NARCAN® Nasal Spray should increase the likelihood that nonmedical personnel correctly deliver naloxone in time-critical, high-stress opioid overdose rescue situations. Funding: ADAPT Pharma, Inc. [ABSTRACT FROM AUTHOR]

The development of oxide dispersion strengthened ferrous alloys has shown that microstructures designed for excellent irradiation resistance and thermal stability ideally contain stable nanoscale precipitates and dislocation sinks. Based upon this understanding, the microstructures of conventionally manufactured ferritic and ferritic-martensitic steels can be designed to include controlled volume fractions of fine, stable precipitates and dislocation sinks via specific alloying and processing paths. The concepts proposed here are categorized as advanced high-Cr ferritic-martensitic (AHCr-FM) and novel tailored precipitate ferritic (TPF) steels, which have the potential to improve the in-reactor performance of conventionally manufactured alloys. AHCr-FM steels have modified alloy content relative to current reactor materials (such as alloy NF616/P92) to maximize desirable precipitates and control phase stability. TPF steels are designed to incorporate nickel aluminides, in addition to microalloy carbides, in a ferritic matrix to produce fine precipitate arrays with good thermal stability. Both alloying concepts may also benefit from thermomechanical processing to establish dislocation sinks and modify phase transformation behaviors. Alloying and processing paths toward designed microstructures are discussed for both AHCr-FM and TPF material classes. [ABSTRACT FROM AUTHOR]