IMPORTANCEDuring hospitalization for hematopoietic stem cell transplantation (HCT), patients receive high-dose chemotherapy before transplantation and experience significant physical and psychological symptoms and poor quality of life (QOL).OBJECTIVE To assess the effect of inpatient palliative care on patient-and caregiver-reported outcomes during hospitalization for HCT and 3 months after transplantation.DESIGN, SETTING, AND PARTICIPANTS Nonblinded randomized clinical trial among 160 adults with hematologic malignancies undergoing autologous/allogeneic HCT and their caregivers (n = 94). The study was conducted from August 2014 to January 2016 in a Boston hospital; follow-up was completed in May 2016.INTERVENTIONS Patients assigned to the intervention (n=81) were seen by palliative care clinicians at least twice a week during HCT hospitalization; the palliative intervention was focused on management of physical and psychological symptoms. Patients assigned to standard transplant care (n=79) could be seen by palliative care clinicians on request.MAIN OUTCOMES AND MEASURES Primary: change in patient QOL from baseline to week 2; secondary: patient-assessed mood, fatigue, and symptom burden scores at baseline, 2 weeks, and 3 months after HCT and caregiver-assessed QOL and mood at baseline and 2 weeks after HCT. RESULTS Among 160 patients (mean age, 60 [SD, 13.3] years; 91 women [56.9%]; median hospital stay, 21 days) and 94 caregivers, 157 (98.1%) and 89 (94.7%), respectively, completed 2-week followup, and 149 patients (93.1%) completed 3-month follow-up. Intervention patients reported a smaller decrease in QOL from baseline to week 2 vs controls. Intervention patients had less increase in depression,loweranxiety,nodifferenceinfatigue,andlessincreaseinsymptomburden.At3months, intervention patients had higher QOL and less depression but no significant differences in anxiety, fatigue, or symptom burden. From baseline to week 2 after HCT, caregivers of intervention patients vs controls reported no significant differences in QOL or anxiety but had a smaller increase in depression (mean, 0.25 vs 1.80; mean difference, 1.55; 95% CI, 0.14-2.96; P = .03). Patient Outcomes Mean Score at Week 2 Mean Difference Between Groups (95% CI) P Value Standard Care Palliative Care Quality of life (change from baseline) −21.54 −14.72 −6.82 (−13.48 to −0.16) .045 Fatigue −13.65 −10.30 −3.34 (−7.25 to 0.56) .09 Symptom burden 23.14 17.35 5.80 (0.49 to 11.10) .03 Depression 3.92 2.43 1.49 (0.20 to 2.78) .02 Anxiety 1.12 −0.80 1.92 (0.83 to 3.01) <.001CONCLUSIONS AND RELEVANCE Among adults at a single institution undergoing HCT for hematologic malignancy, the use of inpatient palliative care compared with standard transplant care resulted in a smaller decrease in QOL 2 weeks after transplantation. Further research is needed for replication and to assess longer-term outcomes and cost implications.
Three orders of magnitude is the range over which the grain size (see figure) can be tuned in solution‐processed organic semiconductor thin films for TFTs. Fluorinated triethylsilyl anthradithiophene (FTES‐ADT) is added in fractional amounts to seed crystallization of TES‐ADT. Correlation between device mobility and grain size in the active layer is described by a composite mobility model that assumes charge‐carrier traps are located at grain boundaries.
A hybrid approach to solar cells is demonstrated in which a silicon p-n junction, used in conventional silicon-based photovoltaics, is replaced by a room-temperature fabricated silicon/organic heterojunction. The unique advantage of silicon/organic heterojunction is that it exploits the cost advantage of organic semiconductors and the performance advantages of silicon to enable potentially low-cost, efficient solar cells.
The short-circuit current density of inverted organic solar cells comprising a solution-processed titania electron transport layer increases with continuous illumination in air and saturates after 10 min. On extended exposure (>2 days), the open-circuit voltage of the devices increases also. The improvement in device characteristics over short time scales is attributed to the filling of shallow electron traps in titania. With an increase in photoconductivity of titania, the short-circuit current increases accordingly. The increase in open-circuit voltage on extended exposure to air is attributed to an increase in the electrostatic field across the diodes when polythiophene is doped by oxygen.
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