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Geriatric Assessment and Management with Question Prompt List using a Web-based Application for Elderly Cancer Patients to Communicate Aging-related Concerns - Randomized Controlled Trial -

ABSTRACT: Interventions: Based on the manual, clinical psychologist, nurses, physicians, or hospital staff as the interventionist will: 1) Explain the Geriatric Assessment (GA) summary to the patient and then discuss the patient’s perception about GA impairments and need for recommended management; then prepare a feedback sheet based on information obtained from the patients, such as aging-related concerns and their interest in the recommendations, 2) Provide communication support using Question Prompt List (QPL), assist patients in organizing and communicating aging-related concerns and intentions for treatment and care to their oncologists; then prepare a feedback sheet including a list of selected questions, 3) Provide feedback on the results of 1) and 2) to their oncologist using a feedback sheet. Interventions will be conducted just prior to the first outpatient visit after randomization. Interventionists are clinical psychologists, nurses, physicians, or hospital staff who have completed training based on the manual in advance. For the 5 months after the initial intervention, interventionists will review and discuss implementation of GA-guided management monthly with the patients and their oncologists to implement management as needed. At 3 months after the initial GA+QPL, GA will be reassessed, and management will be revised if necessary, and feedback on GA+QPL will be provided to patients and oncologists in the same manner as that in the first intervention. Usual care Primary outcome(s): Number of conversations about aging-related concerns during consultation at the first outpatient visit after randomization Study Design: Parallel Randomized

DISEASE(S): Advanced Or Recurrent Esophageal Cancer, Gastric Cancer, Colorectal Cancer, Liver Cancer, Biliary Cancer, And Pancreatic Cancer

PROVIDER: 2661377 | ecrin-mdr-crc |

REPOSITORIES: ECRIN MDR

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Project description:Background: Grape is highly sensitive to gibberellin (GA), which is crucial during seed and berry development (SBD) either by itself or by interacting with other hormones, such as auxin, Abscisic acid (ABA), and Cytokinin (CK). However, no systematic analysis of GA metabolic and signal transduction (MST) pathway has been undertaken in grapevine. Results: In this study, total endogenous GA3 content significantly decreased during SBD, and a total of 48 known genes in GA metabolic (GAM; 31) and signal transduction (ST; 17) pathways were identified in this process. In the GAM pathway, out of 31 genes, VvGA20ox1-1, VvGA3ox4-1, and VvGA2ox1-1 may be the major factors interacting at the green-berry stage (GBS) accompanied with higher accumulation rate. GA biosynthesis was greater than GA inactivation at GBS, confirming the importance of seeds in GA synthesis. The visible correlation between endogenous GA3 content and gene expression profiles suggested that the transcriptional regulation of GA biosynthesis pathway genes was a key mechanism of GA accumulation at the stone-hardening stage (SHS). Interestingly, we observed a negative feedback regulation between VvGA3oxs-VvGAI1-4, VvGA2oxs-VvGAI1-4, and VvGID1B-VvGAI1-4 in maintaining the balance of GA3 content in berries. Moreover, 11 miRNAs may be involved in the modulation of GA MST pathway by mediating their target genes, such as VvGA3ox, VvGID1B, and VvGAMYB. Many genes in auxin, ABA, and CK MST pathways were further identified and found to have a special pattern in the berry, and the crosstalk between GA and these hormones may modulate the complex process during SBD through the interaction gene network of the multihormone pathway. Lastly, based on the expression characterization of multihormone MST pathway genes, a proposed model of the GA-mediated multihormone regulatory network during SBD was proposed. Conclusions: Our results provided novel insights into GA-mediated regulatory networks during SBD in grape. The complexity of GA-mediated multihormone ST in SBD was also elucidated, thereby providing valuable information for future functional characterizations of specific genes in grape.

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Geriatric Assessment and Management with Question Prompt List using a Web-based Application for Elderly Cancer Patients to Communicate Aging-related Concerns - Randomized Controlled Trial -

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