We examined posttraumatic growth (PTG) in men treated for prostate cancer and their partners 1 year after surgery. Levels of PTG in prostate cancer survivors and their partners were similar and modest. For survivors, higher levels of presurgery negative affect, and coping by using positive reframing and emotional support were associated with higher levels of PTG 1 year following surgery. For partners, PTG 1 year after the patient's surgery was higher in partners who were partnered to employed patients, were less educated, endorsed higher cancer-specific avoidance symptoms of stress at presurgery, and used positive reframing coping. Quality of life was largely unrelated to PTG in survivors or partners. Findings suggest that psychological disruption associated with the cancer experience and coping are related to PTG in prostate cancer survivors and their partners.

Our findings suggest that lung cancer survivors have many unmet needs. Patients who report higher physical distress and intrusive stress symptoms, or lower satisfaction with their health care, may experience the highest level of supportive care need and intervention.

Modified oligodeoxynucleotides complementary to RNA of human immunodeficiency virus 1 (HIV-1) were tested for their ability to inhibit virally induced syncytium formation and expression of viral p24 protein. The Fig. 1. All the modified oligonucleotides were found to be resistant to nucleases such as snake venom or spleen phosphodiesterases. amounts of material for toxicity studies were made by a manual solid-support method on an Omnifit assembly (13). Unmodified oligomers were made and purified by methods described previously (2). Phosphorothioates and phosphoramidates were synthesized by a modification of the Hphosphonate procedure (14,15). To generate phosphorothioate linkages, oxidation following the final coupling and detritylation was replaced by treatment with 0.1 M sulfur in carbon disulfide/triethylamine (9:1, vol/vol) at room temperature for up to 2 hr, depending on chain length (16). For the phosphoramidates, this step was replaced by treatment with a 10% solution of the appropriate amine in carbon tetrachloride for up to 1.5 hr, depending on chain length (16).After deblocking in concentrated ammonium hydroxide (550C for 51/2 hr or room temperature for >2 days), products were purified on 2-mm-thick preparative layer plates (Merck silica gel 60) in propanol/water/concentrated ammonium hydroxide (55:35:10, vol/vol). Phosphorothioates were further purified on DEAE-cellulose and C18 silica (details will be published elsewhere). Phosphoramidates from preparative layer plates were passed through Sephadex G-25 in aqueous 30% (vol/vol) ethanol and then through C18 silica and dialyzed. In all cases, small amounts of oligomers attached to the solid support were taken before the final treatment with sulfur or amine and were oxidized with 2% iodine in pyridine/water (98:2, vol/vol) (15) to phosphodiesters. These were used for determination of base composition by enzymatic degradation to nucleosides followed by HPLC. The phosphorothioates were also characterized by polyacrylamide gel electrophoresis, where they had similar mobility to the corresponding diesters.Phosphoramidates were further characterized by hydrolysis with formic acid to the phosphodiesters (16) for comparison with authentic samples on HPLC and degradation to nucleosides for determination of nucleoside composition and integrity by HPLC. A useful indicator of oligonucleotide purity and integrity is the melting curve of its duplex with a complementary DNA Abbreviations: HIV, human immunodeficiency virus; AIDS, acquired immunodeficiency syndrome. 7079The publication costs of this article were defrayed in part by page charge payment. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. §1734 solely to indicate this fact.

IMPORTANCE Atrial fibrillation (AF) is a major cause of preventable strokes. Screening asymptomatic individuals for AF may increase anticoagulant use for stroke prevention. OBJECTIVE To evaluate 2 home-based AF screening interventions. DESIGN, SETTING, AND PARTICIPANTS This multicenter randomized clinical trial recruited individuals from primary care practices aged 75 years or older with hypertension and without known AF. From April 5, 2015, to March 26, 2019, 856 participants were enrolled from 48 practices. INTERVENTIONSThe control group received standard care (routine clinical follow-up plus a pulse check and heart auscultation at baseline and 6 months). The screening group received a 2-week continuous electrocardiographic (cECG) patch monitor to wear at baseline and at 3 months, in addition to standard care. The screening group also received automated home blood pressure (BP) machines with oscillometric AF screening capability to use twice-daily during the cECG monitoring periods. MAIN OUTCOMES AND MEASURESWith intention-to-screen analysis, the primary outcome was AF detected by cECG monitoring or clinically within 6 months. Secondary outcomes included anticoagulant use, device adherence, and AF detection by BP monitors. RESULTSOf the 856 participants, 487 were women (56.9%); mean (SD) age was 80.0 (4.0) years. Median cECG wear time was 27.4 of 28 days (interquartile range [IQR], 18.4-28.0 days). In the primary analysis, AF was detected in 23 of 434 participants (5.3%) in the screening group vs 2 of 422 (0.5%) in the control group (relative risk, 11.2; 95% CI, 2.7-47.1; P = .001; absolute difference, 4.8%; 95% CI, 2.6%-7.0%; P < .001; number needed to screen, 21). Of those with cECG-detected AF, median total time spent in AF was 6.3 hours (IQR, 4.2-14.0 hours; range 1.3 hours-28 days), and median duration of the longest AF episode was 5.7 hours (IQR, 2.9-12.9 hours). Anticoagulation was initiated in 15 of 20 patients (75.0%) with cECG-detected AF. By 6 months, anticoagulant therapy had been prescribed for 18 of 434 participants (4.1%) in the screening group vs 4 of 422 (0.9%) in the control group (relative risk, 4.4; 95% CI, 1.5-12.8; P = .007; absolute difference, 3.2%; 95% CI, 1.1%-5.3%; P = .003). Twice-daily AF screening using the home BP monitor had a sensitivity of 35.0% (95% CI, 15.4%-59.2%), specificity of 81.0% (95% CI, 76.7%-84.8%), positive predictive value of 8.9% (95% CI, 4.9%-15.5%), and negative predictive value of 95.9% (95% CI, 94.5%-97.0%). Adverse skin reactions requiring premature discontinuation of cECG monitoring occurred in 5 of 434 participants (1.2%). CONCLUSIONS AND RELEVANCEIn this randomized clinical trial, among older community-dwelling individuals with hypertension, AF screening with a wearable cECG monitor was well tolerated, increased AF detection 10-fold, and prompted initiation of anticoagulant therapy in most cases. Compared with continuous ECG, intermittent oscillometric screening with a BP monitor was an inferior strategy for detecting paroxysmal AF. Large trials with hard...