4 research outputs found
The Expanding Use of Continuous Glucose Monitoring in Type 2 Diabetes
No full textOver the last two decades, continuous glucose monitoring (CGM) has become a common self-monitoring strategy in type 1 diabetes (T1D). CGM, in which a minimally invasive, sensor-based device automatically measures and reports one's glucose levels up to every 5 min, improves hemoglobin A1c (HbA1c), reduces the frequency of dysglycemia, improves quality of life, and is cost-effective for people living with T1D compared to self-monitoring blood glucose (SMBG). CGM studies in type 2 diabetes (T2D) have been limited to date, especially those involving participants not requiring intensive insulin therapy
Usability and Implementation Considerations of Fitbit and App Intervention for Diverse Cancer Survivors: Mixed Methods Study
No full textAbstract
BackgroundDespite the known benefits of physical activity, cancer survivors remain insufficiently active. Prior trials have adopted digital health methods, although several have been pedometer-based and enrolled mainly female, non-Hispanic White, and more highly educated survivors of breast cancer.
ObjectiveThe objective of this study was to test a previously developed mobile health system consisting of a Fitbit activity tracker and the MyDataHelps smartphone app for feasibility in a diverse group of cancer survivors, with the goal of refining the program and setting the stage for a larger future trial.
MethodsParticipants were identified from one academic medical center’s electronic health records, referred by a clinician, or self-referred to participate in the study. Participants were screened for eligibility, enrolled, provided a Fitbit activity tracker, and instructed to download the Fitbit: Health & Wellness and MyDataHelps apps. They completed usability surveys at 1 and 3 months. Interviews were conducted at the end of the 3-month intervention with participants and cancer care clinicians to assess the acceptability of the intervention and the implementation of the intervention into clinical practice, respectively. Descriptive statistics were calculated for demographics, usability surveys, and Fitbit adherence and step counts. Rapid qualitative analysis was used to identify key findings from interview transcriptions.
ResultsOf the 100 patients screened for eligibility, 31 were enrolled in the trial (mean age 64.8, SD 11.1 years; female patients=17/31, 55%; Hispanic or Latino=7/31, 23%; non-White=11/31, 35%; less than a bachelor’s degree=14/31, 45%; and household income <US $75,000=11/31, 35%). The mean (SD) years since diagnosis was 7.1 (8.2), and the two most frequent cancer diagnoses were prostate (9/31, 29%) and breast (4/31, 13%) cancer. Participants provided positive feedback on the MyDataHelps app usability; the overall app quality received a mean score of 3.79 (SD 0.82) on a 5-point Likert scale (1=worst, 5=best). Interviews with 10 patients yielded four themes: (1) Fitbit and app setup was easy but the research team provided assistance, when needed, which was helpful, (2) motivational messages within the app were not memorable, (3) step counts and Fitbit notifications were motivating, and (4) medical professionals viewing their data were acceptable. Interviews with 5 cancer care clinicians yielded four themes: (1) some patients used wearables but rarely discussed data with clinicians; (2) activity trackers can be helpful to motivate patients and keep them accountable; (3) objective activity measures—similar to BMI, weight, and blood pressure— that they can track over time and refer to afterward were preferred; and (4) training and systematic processes to view these data as part of active workflow were desired.
ConclusionsImplementing a remotely delivered, light-intensity physical activity program was feasible and acceptable in a sample of diverse cancer survivors. Future studies should consider registry-based methods and work with clinicians to engage hard-to-reach survivor populations who have low physical activity levels and disproportionately high adverse health outcomes
Usability and Implementation Considerations of Fitbit and App Intervention for Diverse Cancer Survivors: Mixed Methods Study
No full textBackground: Despite the known benefits of physical activity, cancer survivors remain insufficiently active. Prior trials have adopted digital health methods, although several have been pedometer-based and enrolled mainly female, non-Hispanic White, and more highly educated survivors of breast cancer.
Objective: The objective of this study was to test a previously developed mobile health system consisting of a Fitbit activity tracker and the MyDataHelps smartphone app for feasibility in a diverse group of cancer survivors, with the goal of refining the program and setting the stage for a larger future trial.
Methods: Participants were identified from one academic medical center's electronic health records, referred by a clinician, or self-referred to participate in the study. Participants were screened for eligibility, enrolled, provided a Fitbit activity tracker, and instructed to download the Fitbit: Health & Wellness and MyDataHelps apps. They completed usability surveys at 1 and 3 months. Interviews were conducted at the end of the 3-month intervention with participants and cancer care clinicians to assess the acceptability of the intervention and the implementation of the intervention into clinical practice, respectively. Descriptive statistics were calculated for demographics, usability surveys, and Fitbit adherence and step counts. Rapid qualitative analysis was used to identify key findings from interview transcriptions.
Results: Of the 100 patients screened for eligibility, 31 were enrolled in the trial (mean age 64.8, SD 11.1 years; female patients=17/31, 55%; Hispanic or Latino=7/31, 23%; non-White=11/31, 35%; less than a bachelor's degree=14/31, 45%; and household income <US $75,000=11/31, 35%). The mean (SD) years since diagnosis was 7.1 (8.2), and the two most frequent cancer diagnoses were prostate (9/31, 29%) and breast (4/31, 13%) cancer. Participants provided positive feedback on the MyDataHelps app usability; the overall app quality received a mean score of 3.79 (SD 0.82) on a 5-point Likert scale (1=worst, 5=best). Interviews with 10 patients yielded four themes: (1) Fitbit and app setup was easy but the research team provided assistance, when needed, which was helpful, (2) motivational messages within the app were not memorable, (3) step counts and Fitbit notifications were motivating, and (4) medical professionals viewing their data were acceptable. Interviews with 5 cancer care clinicians yielded four themes: (1) some patients used wearables but rarely discussed data with clinicians; (2) activity trackers can be helpful to motivate patients and keep them accountable; (3) objective activity measures-similar to BMI, weight, and blood pressure- that they can track over time and refer to afterward were preferred; and (4) training and systematic processes to view these data as part of active workflow were desired.
Conclusions: Implementing a remotely delivered, light-intensity physical activity program was feasible and acceptable in a sample of diverse cancer survivors. Future studies should consider registry-based methods and work with clinicians to engage hard-to-reach survivor populations who have low physical activity levels and disproportionately high adverse health outcomes.No embarg
Uridine-sensitized screening identifies demethoxy-coenzyme Q and NUDT5 as regulators of nucleotide synthesis
No full textRapidly proliferating cells require large amounts of nucleotides, making nucleotide metabolism a widely exploited therapeutic target against cancer, autoinflammatory disorders and viral infections. However, regulation of nucleotide metabolism remains incompletely understood. Here, we reveal regulators of de novo pyrimidine synthesis. Using uridine-sensitized CRISPR-Cas9 screening, we show that coenzyme Q (CoQ) is dispensable for pyrimidine synthesis, in the presence of the demethoxy-CoQ intermediate as alternative electron acceptor. We further report that the ADP-ribose pyrophosphatase NUDT5 directly binds PPAT, the rate-limiting enzyme in purine synthesis, which inhibits its activity and preserves the phosphoribosyl pyrophosphate (PRPP) pool. In the absence of NUDT5, hyperactive purine synthesis exhausts the PRPP pool at the expense of pyrimidine synthesis, which promotes resistance to purine and pyrimidine nucleobase analogues. Of note, the interaction between NUDT5 and PPAT is disrupted by PRPP, highlighting an intricate allosteric regulation. Overall, our findings reveal a fundamental mechanism of nucleotide balance and position NUDT5 as a regulator of nucleobase analogue metabolism.
© 2025. The Author(s)
