The NCCN Guidelines for Cancer-Associated Venous Thromboembolic Disease outline strategies for treatment and prevention of venous thromboembolism (VTE) in adult patients with a diagnosis of cancer or for whom cancer is clinically suspected. VTE is a common complication in patients with cancer, which places them at greater risk for morbidity and mortality. Therefore, risk-appropriate prophylaxis is an essential component for the optimal care of inpatients and outpatients with cancer. Critical to meeting this goal is ensuring that patients get the most effective medication in the correct dose. Body weight has a significant impact on blood volume and drug clearance. Because obesity is a common health problem in industrialized societies, cancer care providers are increasingly likely to treat obese patients in their practice. Obesity is a risk factor common to VTE and many cancers, and may also impact the anticoagulant dose needed for safe and effective prophylaxis. These NCCN Guidelines Insights summarize the data supporting new dosing recommendations for VTE prophylaxis in obese patients with cancer.

The role of tight junctions in the binding and cytoxicity of Pseudomonas aeruginosato apical or basolateral membranes of lung airway epithelial cells was tested with fluorescence microscopy on living cells. Binding of noncytotoxic P. aeruginosa strain O1 was assessed with P. aeruginosa that expressed green fluorescent protein. Binding of cytotoxic P. aeruginosa strain 6206 was assessed with FITC-labeled P. aeruginosa; cytotoxicity was determined from nuclear uptake of the impermeant dye propidium iodide. The role of direct contact of P. aeruginosa to epithelial cells was tested with filters with small (0.45-μm) or large (2.0-μm) pores. High transepithelial resistance ( R t) Calu-3 and cultured bovine tracheal monolayers ( R t > 1,000 Ω ⋅ cm2) bound P. aeruginosa very infrequently (<1 P. aeruginosa/100 cells) at the apical membrane, but P. aeruginosabound frequently to cells near “free edges” at holes, wounds, islands, and perimeters; cytotoxicity required direct interaction with basolateral membranes. Wounded high R t epithelia showed increased P. aeruginosa binding and cytotoxicity at the free edges because basolateral membranes were accessible to P. aeruginosa, and dead and living cells near the wound bound P. aeruginosa similarly. Compared with high R t epithelia, low R t CFT1 ( R t = 100–200 Ω ⋅ cm2) and EGTA-treated Calu-3 monolayers were 25 times more susceptible to P. aeruginosa binding throughout the monolayer. Cytotoxicity to CFT1 cells (throughout the confluent monolayer, not only at the free edge) occurred after a shorter delay (0.25 vs. 2.0 h) and then five times faster than to Calu-3 cells, indicating that the time course of P. aeruginosa cytotoxicity may be limited by the rate of gaining access through tight junctions and that this occurred faster in low R t than in high R t airway epithelia. Cytotoxicity appeared to occur in a sequential process that led first to a loss of fura 2 and a later uptake of propidium iodide. P. aeruginosa bound three times more frequently to regions between cells (tight junctions?) than to cell membranes of low R t CFT1 cells.

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Reciprocal relations between autonomous motivation from self-determination theory and social cognition constructs from the theory of planned behavior: A cross-lagged panel design in sport injury prevention.

The purpose of this three‐study paper was to develop and validate the Perceived Social Influence in Sport Scale‐2 (PSISS‐2) that aimed to resolve the limitations of PSISS‐1 in assessing the relative social influence of significant others in youth sport. In Study 1, a pool of 60 items generated from revisiting a qualitative dataset about significant others of young athletes were examined by two expert panel reviews in terms of content validity, clarity, coverage, and age‐appropriateness, leading to the development of 16 items of the PSISS‐2. In Study 2, multi‐group exploratory structural equation model for PSISS‐2 was conducted among 904 young athletes, and the results supported a model comprising positive influence (ie, conditional and unconditional positive influence combined), punishment (ie, conditional negative influence), and dysfunction (ie, unconditional negative influence) as three factors. The goodness of fit of the three‐factor model was acceptable and invariant across the coach‐, father‐, mother‐, and teammates‐versions of PSISS‐2. In support of the criterion validity of PSISS‐2, the three factors explained substantial variance of young athletes’ perceived competence, effort, enjoyment, and trait anxiety in sport. Study 3 examined the relationship between PSISS‐2 factors, psychological need support, and controlling behaviors in a subsample of 452 young athletes, and the findings supported the concurrent validity and discriminant validity of the scale. In conclusion, the data are supportive of PSISS‐2. The three factors of the scale (ie, positive influence, punishment, and dysfunction) may form a new framework for understanding and comparing the relative role of significant others in youth sport.

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