Side effects of analgesia may significantly reduce quality of life in symptomatic multiple myeloma: a cross-sectional prevalence study

Background Pain is a common symptom in patients with multiple myeloma (MM). Many patients are dependent on analgesics and in particular opioids, but there is limited information on the impact of these drugs and their side effects on health-related quality of life (HRQoL). Method In a cross-sectional study, semi-structured interviews were performed in 21 patients attending the hospital with symptomatic MM on pain medications. HRQoL was measured using items 29 and 30 of the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30. Results Patients were able to recall a median of two (range 0–4) analgesics. They spontaneously identified a median of two (range 1–5) side effects attributable to their analgesic medications. Patients’ assessment of HRQoL based on the EORTC QLQ-C30 questions 29/30 was mean 48.3 (95 % CI; 38.7–57.9) out of 100. Patients’ assessment of their HRQoL in the hypothetical situation, in which they would not experience any side effects from analgesics, was significantly higher: 62.6 (53.5–71.7) (t test, p=0.001). Conclusion This study provides, for the first time, evidence that side effects of analgesics are common in symptomatic MM and may result in a statistically and clinically significant reduction of self-reported HRQoL

Convection and the Extracellular Matrix Dictate Inter- and Intra-Biofilm Quorum Sensing Communication in Environmental Systems.

The mechanisms and impact of bacterial quorum sensing (QS) for the coordination of population-level behaviors are well studied under laboratory conditions. However, it is unclear how, in otherwise open environmental systems, QS signals accumulate to sufficient concentration to induce QS phenotypes, especially when quorum quenching (QQ) organisms are also present. We explore the impact of QQ activity on QS signaling in spatially organized biofilms in scenarios that mimic open systems of natural and engineered environments. Using a functionally differentiated biofilm system, we show that the extracellular matrix, local flow, and QQ interact to modulate communication. In still aqueous environments, convection facilitates signal dispersal while the matrix absorbs and relays signals to the cells. This process facilitates inter-biofilm communication even at low extracellular signal concentrations. Within the biofilm, the matrix further regulates the transport of the competing QS and QQ molecules, leading to heterogenous QS behavior. Importantly, only extracellular QQ enzymes can effectively control QS signaling, suggesting that the intracellular QQ enzymes may not have evolved to degrade environmental QS signals for competition

The role of diet in the aetiopathogenesis of inflammatory bowel disease

Crohn’s disease and ulcerative colitis, collectively known as IBD, are chronic inflammatory disorders of the gastrointestinal tract. Although the aetiopathogenesis of IBD is largely unknown, it is widely thought that diet has a crucial role in the development and progression of IBD. Indeed, epidemiological and genetic association studies have identified a number of promising dietary and genetic risk factors for IBD. These preliminary studies have led to major interest in investigating the complex interaction between diet, host genetics, the gut microbiota and immune function in the pathogenesis of IBD. In this Review, we discuss the recent epidemiological, gene–environment interaction, microbiome and animal studies that have explored the relationship between diet and the risk of IBD. In addition, we highlight the limitations of these prior studies, in part by explaining their contradictory findings, and review future directions

Sorry, Your Order Has a Substitution : The Effects of Substitution Policy in Online Grocery Retailing

Post-purchase out-of-stock (OOS) often happens in an online store context, where products appear to be available at the time a consumer makes an order and checks out, but then become OOS when the order is to be dispatched. To mitigate negative responses from consumers, online grocery retailers often provide consumers a substitution alternative to the OOS item. This paper investigates the effects of two substitution policies where we focus on different matching strategies of the substitution with the OOS item. In policy one, we measure the effect of matching on the dominant attribute (brand vs. flavour). In policy two, we test the effect of matching with a product from the consumers’ past purchase portfolio. We investigate these two substitution policies and their interaction in two categories that differ on the level of differentiation (i.e., the degree to which distinctions are objectively measurable – vertical differentiation/VD vs. not easy to evaluate – horizontal differentiation/HD). Our dependent variable is the probability to accept the substitute. The study employs a computer-simulated purchase experiment, using two product categories: margarine (VD) and cereals (HD). 2,113 UK consumers representative of general UK shopper profile participated. Findings show that in the margarine category where brand is the dominant attribute, the same brand substitution is more likely to be accepted than the same flavour substitution. In contrast, in the cereal category where flavour is more likely to be the dominant attribute, same flavour substitution is more likely to be accepted than same brand substitution. The results also show that, in both categories, matching the substitution product with a product from consumers’ past purchase portfolio is more likely to be accepted than offering a substitute that consumers have not bought before. We also found a significant interaction between the two policy types but for cereals only. The effects of two substitution policies are mediated by perceived fairness of the substitution. The paper discusses contributions and implication for future research