Nevin Manimala

Support Care Cancer. 2025 Jul 21;33(8):708. doi: 10.1007/s00520-025-09717-x.

ABSTRACT

OBJECTIVE: To explore the determinants of loneliness among patients undergoing peripheral blood stem cell transplantation (PBSCT) and to identify factors that influence their loneliness levels, with the aim of developing targeted nursing strategies and interventions.

METHODS: A total of 300 PBSCT patients were recruited through convenience sampling. Data were collected using a general information questionnaire, the UCLA Loneliness Scale (UCLA), the Functional Assessment of Cancer Therapy-General (FACT-G), and the Perceived Social Support Scale (PSSS). Statistical analyses were performed to assess loneliness levels and identify associated factors.

RESULTS: The average UCLA loneliness score among patients was 52.97 ± 12.35, indicating moderate to high levels of loneliness. Pearson correlation analysis revealed a significant negative relationship between loneliness and perceived social support as well as other measured dimensions (all P < 0.01). Multiple linear regression analysis identified marital status, employment status, presence of comorbidities, and perceived social support as significant predictors of loneliness (R² = 0.300, adjusted R² = 0.238, F = 17.874, P < 0.001), with social support and health status being the strongest contributors.

CONCLUSION: Loneliness in PBSCT patients is influenced by various factors, with social support and health status playing critical roles. To mitigate loneliness and enhance patients’ quality of life, healthcare teams should prioritize strengthening social support networks and addressing health-related challenges. Regular psychological assessments and timely interventions are essential for reducing loneliness and facilitating recovery in transplant patients.

PMID:40690046 | DOI:10.1007/s00520-025-09717-x

Cancer Med. 2025 Jul;14(14):e71053. doi: 10.1002/cam4.71053.

ABSTRACT

INTRODUCTION: Objective was to describe the association between baseline characteristics and the number of Symptom Screening in Pediatrics Tool (SSPedi) assessments completed over an 8-week period.

METHODS: This was a sub-analysis of a cluster randomized controlled trial among 10 sites that were randomized to the intervention group. Participants were English- or Spanish-speaking pediatric patients 8-18 years of age newly diagnosed with cancer. Participants were prompted to complete SSPedi three times weekly for 8 weeks. The outcome was the number of SSPedi assessments completed during the 8-week period. Factors associated with the number of assessments were determined using mixed effects Poisson regression.

RESULTS: At the 10 intervention sites, 216 patients were included in the analysis. Among these participants, 129 (59.7%) were male, 112 (51.9%) were white, and 83 (38.4%) were Hispanic. The number of SSPedi assessments was significantly higher for participants 11-14 years (rate ratio (RR) 1.13, 95% confidence interval (CI) 1.02-1.25) and 15-18 years (RR 1.15, 95% CI 1.04-1.27) compared to 8-10 years. Participants completed more SSPedi assessments if they were Asian compared to white (RR 1.27, 95% CI 1.10-1.46), non-Hispanic compared to Hispanic (RR 1.15, 95% CI 1.04-1.28) and from families with a household income ≥$60,000 (RR 1.12, 95% CI 1.03-1.21). Participants completed fewer SSPedi assessments if they had solid tumors compared to leukemia (RR 0.91, 95% CI 0.84-0.99).

CONCLUSION: Adherence to three-times weekly SSPedi varied by age, race, ethnicity, cancer diagnosis, and family income. This information may facilitate interventions to support routine symptom screening in clinical practice.

TRIAL REGISTRATION: NCT04614662.

PMID:40686265 | DOI:10.1002/cam4.71053

Cancer Med. 2025 Jul;14(14):e71052. doi: 10.1002/cam4.71052.

ABSTRACT

PURPOSE: We aimed to analyse trends in incidence, mortality and 5-year relative survival of malignant and benign/borderline brain and central nervous system (CNS) tumours between 1980 and 2021 in the Canton of Zurich, Switzerland, stratified by sex, age group, behaviour and histological subtypes.

METHODS: We used incidence data from the Cancer Registry of Zurich, Zug, Schaffhausen and Schwyz, including primary benign/borderline and malignant tumours diagnosed between 1980 and 2021 in the Canton of Zurich in patients aged ≥ 15 years (N = 10,226). Mortality data were provided by the Swiss Federal Statistical Office (N = 3514). We calculated age-standardised incidence and mortality rates per 100,000 person-years and used Joinpoint to analyse trends.

RESULTS: The age-standardised incidence rate of malignant tumours was stable over time (around 7.7-8.2 per 100,000 person-years in men and 4.6-5.2 in women), while the rate of benign/borderline tumours increased from 3.8 in 1980-1990 to 10.8 in 2011-2021 in men and from 5.7 to 19.1 in women. The age-standardised mortality rate remained stable over time for malignant tumours (around 5.5-6.1 in men and 3.5-4.0 in women) but significantly decreased for benign/borderline tumours (from 1.0 to 0.5 in men and from 1.2 to 0.5 in women). Age-standardised 5-year relative survival increased from around 80% in 1980-1989 up to > 90% in 2011-2017 for benign/borderline tumours and from < 20% to around 30% for malignant tumours. There was a small survival advantage in women compared to men.

CONCLUSIONS: We observed an increase in incidence and a decrease in mortality rates for benign/borderline tumours, while both rates remained stable for malignant tumours. Five-year relative survival improved over time. The increasing incidence rates in benign/borderline tumours may be due to improved diagnostic techniques and an increasing use of CT scans, as reported in other countries. The increase in relative survival may reflect earlier detection and better treatment options.

PMID:40686230 | DOI:10.1002/cam4.71052

J Alzheimers Dis. 2025 Jul 21:13872877251360241. doi: 10.1177/13872877251360241. Online ahead of print.

ABSTRACT

BackgroundRecent meta-analyses indicate that the relationship between grip strength (GS) and cognition is more complex than that was previously assumed. Multiple studies have established a significant correlation between body composition and GS.ObjectiveTo assess longitudinal relationships between absolute and relative GS trajectories and cognitive function.MethodsThe China Health and Retirement Longitudinal Study (CHARLS) data with 2549 participants were analyzed using the Group-Based Trajectory Model (GBTM) to ascertain GS trajectories over time. Absolute GS was defined as the raw force, while relative GS was defined as grip strength adjusted by body weight. Directed Acyclic Graphs (DAGs) were used to identify confounding variables, which were subsequently adjusted for in generalized estimating equation (GEE) models that assessed associations between these trajectories and changes in cognitive function over time.ResultsWe observed that relative GS exhibited three distinct trajectories: The three relative GS trajectories were labeled as Low-decline (n = 823, 32.29%), Medium-decline (n = 1292, 50.69%), and High-decline (n = 434, 17.03%). Absolute GS showed similar downward trends. GEE revealed a uniform five-year decline in cognitive function across all GS trajectory groups (all p_time < 0.001). The overall interaction between the timing and patterns of changes in both absolute and relative GS and cognitive function was statistically significant (p < 0.001).ConclusionsIn middle-aged and older adults, lower grip strength trajectories align with accelerated cognitive decline, while higher grip strength is associated with slower cognitive deterioration. Monitoring grip strength may serve as a practical marker for cognitive health in aging populations.

PMID:40686228 | DOI:10.1177/13872877251360241

Int J Inj Contr Saf Promot. 2025 Jul 21:1-8. doi: 10.1080/17457300.2025.2533198. Online ahead of print.

ABSTRACT

Falls are considered one of the important causes of injuries and fatalities among children and adolescents. Students are continuously exposed to the risks of falls, in the school environment. Therefore, a thorough examination of student behaviours and the environmental conditions of schools is of significant importance for preventing fall-related injuries in students. This study aims to investigate the influential factors for preventing fall-related injuries among primary school students using the PRECEDE model. This cross-sectional study has been done among 428 primary school students from grades one to six in schools of Hamadan city, located in western Iran. The students were selected randomly through a multi-stage cluster sampling method and data collection has been done between December 2023 and February 2024. The data collection tool was a researcher-made questionnaire based on the PRECEDE model. The questionnaire was included three sections including demographic questions, questions related to the constructs of the PRECEDE model (preventive behaviour constructs; predisposing factors including knowledge and attitude; reinforcing factors; enabling factors; and environmental factors), and questions concerning the history of fall-related injuries at school. The data collection has been done through interviews with the students. Data were analyzed using SPSS24 software after collection. The results of this study revealed that out of 428 students, 131(30.6%) experienced falls, with ages ranging from 7 to 12 years and an average age of 9.5 ± 1.70 years. Among these, 54 (41.2%) were females and 77 (58.7%) were males. The findings indicate that males experienced more falls than females, and females exhibited better preventive behaviours than males (p = 0.002). Most falls occurred in the schoolyard (37.4%) and during recess time (40.5%). The most common types of injuries were abrasions (28.2%) and head injuries (24.4%). Additionally, the findings showed that parents’ education level was significantly associated with preventive fall behaviours among students. Hence, the students with parents who had higher education levels (mothers’ education with (p = 0.02) and fathers’ education with (p = 0.03) demonstrated better preventive behaviours and were less at risk of falls. Among the constructs of the PRECEDE model, the predisposing factors of knowledge (p = 0.04) and attitude (p = 0.001), enabling factors (p = 0.02), and environmental factors (p = 0.03) had a significant relationship with fall-preventive behaviours. According to the statistical results, the attitude construct was the predictor of students’ fall- preventive behaviours. The study results indicated that fall-related injuries in the studied group are high. Additionally, the PRECEDE model can help identify factors associated with fall prevention among students. Given the significant role of behaviour and the school environment in fall prevention in this study, implementing appropriate interventions to enhance students’ attitudes and knowledge and creating a safe school environment can be very beneficial and effective in improving fall-preventive behaviours.

PMID:40686208 | DOI:10.1080/17457300.2025.2533198

Emerg Med Australas. 2025 Aug;37(4):e70100. doi: 10.1111/1742-6723.70100.

ABSTRACT

OBJECTIVE: The study aimed to evaluate the prevalence and impact of low-value diagnostic tests at a regional, major-referral, mixed Emergency Department (ED).

METHODS: A single-site, cross-sectional study was conducted at Townsville University Hospital in April 2022. Adult patients (aged 18 years and above) who underwent one of 10 specified diagnostic tests were included. The tests encompassed coagulation studies, urine cultures, blood cultures, cranial computed tomography (CT) in syncope, cranial CT in minor head injury, cervical spine CT in neck trauma, ankle X-ray in acute ankle trauma, duplex lower extremity ultrasound in suspected deep vein thrombosis, CT pulmonary angiography in suspected pulmonary embolism, and CT kidney ureter bladder in renal colic. Tests were classified as low-value based on Choosing Wisely recommendations, with their value determined by a research assistant using clinical documentation, prior to the availability of test results. Emergency clinicians were blinded to the study conduct.

RESULTS: Of all diagnostic tests performed, 48.2% (276/572) were deemed low-value, including 50.6% of laboratory tests (246/486) and 24.4% of imaging tests (21/86). The median ED length of stay was 6.1 h (IQR 3.9-8.5). Low-value imaging tests contributed to 152 lost bed-hours per 100 tests.

CONCLUSION: A substantial proportion of diagnostic tests were low-value, exacerbating access block and reducing the availability of ED beds, thereby delaying timely emergency care. The implementation of evidence-based, effective strategies is imperative to mitigate patient harm associated with low-value diagnostic tests.

PMID:40686189 | DOI:10.1111/1742-6723.70100

Zhongguo Zhong Yao Za Zhi. 2025 Jun;50(11):3001-3012. doi: 10.19540/j.cnki.cjcmm.20250313.302.

ABSTRACT

To explore the variation laws of volatile oil during the extraction process of Artemisiae Argyi Folium and its impact on the quality of the medicinal solution, as well as to achieve precise control of the extraction process, this study employed headspace solid phase microextraction gas chromatography-mass spectrometry(HS-SPME-GC-MS) in combination with multiple light scattering techniques to conduct a comprehensive analysis, identification, and characterization of the changes in volatile components and the physical properties of the medicinal solution during the extraction process. A total of 82 volatile compounds were identified using the HS-SPME-GC-MS technique, including 21 alcohols, 15 alkenes, 14 ketones, 9 acids, 6 aldehydes, 5 phenols, 3 esters, and 9 other types of compounds. At different extraction time points(15, 30, 45, and 60 min), 71, 72, 64, and 44 compounds were identified in the medicinal solution, respectively. It was observed that the content of volatile components gradually decreased with the extension of extraction time. Through multivariate statistical analysis, four compounds with significant differences during different extraction time intervals were identified, namely 1,8-cineole, terpinen-4-ol, 3-octanone, and camphor. RESULTS:: from multiple light scattering techniques indicated that at 15 minutes of extraction, the transmittance of the medicinal solution was the lowest(25%), the particle size was the largest(0.325-0.350 nm), and the stability index(turbiscan stability index, TSI) was the highest(0-2.5). With the extension of extraction time, the light transmittance of the medicinal solution improved, stability was enhanced, and the particle size decreased. These laws of physicochemical property changes provide important basis for the control of Artemisiae Argyi Folium extraction process. In addition, the changes in the bioactivity of Artemisiae Argyi Folium extracts during the extraction process were investigated through mouse writhing tests and antimicrobial assays. The results indicated that the analgesic and antimicrobial effects of the medicinal solution were strongest at the 15-minute extracting point. In summary, the findings of this study demonstrate that the content of volatile oil in Artemisiae Argyi Folium extracts gradually decreases with the extension of extraction time, and the variation in volatile oil content directly influences the physicochemical properties and pharmacological efficacy of the medicinal solution. This discovery provides important scientific reference for the optimization of Artemisiae Argyi Folium extraction processes and the development and application of process analytical technologies.

PMID:40686168 | DOI:10.19540/j.cnki.cjcmm.20250313.302

Zhongguo Zhong Yao Za Zhi. 2025 May;50(10):2865-2874. doi: 10.19540/j.cnki.cjcmm.20250212.502.

ABSTRACT

Based on latent structure model and association rule analysis, this study investigates the prescription patterns used by professor YANG Zhong-qi in treating hypertension with traditional Chinese medicine(TCM) and infers the associated TCM syndromes, providing a reference for clinical syndrome differentiation and treatment. The observation window spanned from January 8, 2013, to June 26, 2024, during which qualified herbal decoction prescriptions meeting efficacy criteria were extracted from the outpatient medical record system of the First Affiliated Hospital of Guangzhou University of Chinese Medicine and compiled into a standardized database. Statistical analysis of high-frequency herbs included frequency counts and herbal property-channel tropism analysis. Latent structure modeling and association rule analysis were performed using R 4.3.2 and Lantern 5.0 software to identify core herbal combinations and infer TCM syndrome patterns. A total of 2 436 TCM prescriptions were included in the study, involving 263 drugs with a cumulative frequency of 29 783. High-frequency herbs comprised Uncariae Ramulus cum Uncis, Poria, Glycyrrhizae Radix et Rhizoma, Puerariae Lobatae Radix, and Alismatis Rhizoma, predominantly categorized as deficiency-tonifying, heat-clearing, and blood-activating and stasis-resolving herbs. Latent structure analysis identified 18 latent variables, 74 latent classes, 5 comprehensive clustering models, and 15 core herbal combinations, suggesting that the core syndrome clusters include liver Yang hyperactivity pattern, Yin deficiency with Yang hyperactivity pattern, phlegm-stasis intermingling pattern, and liver-kidney insufficiency pattern. Association rule analysis revealed 22 robust association rules. RESULTS:: indicate that hypertension manifests as a deficiency-rooted excess manifestation, significantly associated with functional dysregulation of the liver, lung, spleen-stomach, heart, and kidney. Key pathogenic mechanisms involve liver Yang hyperactivity, phlegm-stasis interaction, and liver-kidney insufficiency. Therapeutic strategies should prioritize liver-calming, spleen-fortifying, and deficiency-tonifying principles, supplemented by dynamic regulation of Qi-blood and Yin-Yang balance according to syndrome evolution, alongside pathogen-eliminating methods such as phlegm-resolving and stasis-dispelling. Synergistic interventions like mind-tranquilizing therapies should be tailored to individual conditions.

PMID:40686154 | DOI:10.19540/j.cnki.cjcmm.20250212.502

Zhongguo Zhong Yao Za Zhi. 2025 May;50(10):2740-2749. doi: 10.19540/j.cnki.cjcmm.20250114.401.

ABSTRACT

This study aims to explore the mechanism through which Yishen Jiangtang Decoction(YSJTD) regulates endoplasmic reticulum stress(ERS)-mediated NOD-like receptor thermal protein domain associated protein 3(NLRP3) inflammasome to improve diabetic nephropathy(DN) in db/db mice. Thirty db/db mice were randomly divided into the model group, YSJTD group, ERS inhibitor 4-phenylbutyric acid(4-PBA) group, with 10 mice in each group. Additionally, 10 db/m mice were selected as the control group. The YSJTD group was orally administered YSJTD at a dose of 0.01 mL·g~(-1), the 4-PBA group was orally administered 4-PBA at a dose of 0.5 mg·g~(-1), and the control and model groups were given an equal volume of carboxylmethyl cellulose sodium. The treatments were administered once daily for 8 weeks. Food intake, water consumption, and body weight were recorded every 2 weeks. After the intervention, fasting blood glucose(FBG), glycosylated hemoglobin(HbA1c), urine microalbumin(U-mALB), 24-hour urine volume, serum creatinine(Scr), and blood urea nitrogen(BUN) were measured. Inflammatory markers interleukin-1β(IL-1β) and interleukin-18(IL-18) were detected using the enzyme-linked immunosorbent assay(ELISA). Renal pathology was assessed through hematoxylin-eosin(HE), periodic acid-Schiff(PAS), and Masson staining, and transmission electron microscopy(TEM). Western blot was used to detect the expression levels of glucose-regulated protein 78(GRP78), C/EBP homologous protein(CHOP), NLRP3, apoptosis-associated speck-like protein containing CARD(ASC), cysteinyl aspartate-specific proteinase(caspase-1), and gasdermin D(GSDMD) in kidney tissues. The results showed that compared to the control group, the model group exhibited poor general condition, increased weight and food and water intake, and significantly higher levels of FBG, HbA1c, U-mALB, kidney index, 24-hour urine volume, IL-1β, and IL-18. Compared to the model group, the YSJTD and 4-PBA groups showed improved general condition, increased body weight, decreased food intake, and lower levels of FBG, U-mALB, kidney index, 24-hour urine volume, and IL-1β. Specifically, the YSJTD group showed a significant reduction in IL-18 levels compared to the model group, while the 4-PBA group exhibited decreased water intake and HbA1c levels compared to the model group. Although there was a decreasing trend in water intake and HbA1c in the YSJTD group, the differences were not statistically significant. No significant differences were observed in BUN, Scr, and kidney weight among the groups. Renal pathology revealed that the model group exhibited more severe renal damage compared to the control group. Kidney sections from the model group showed diffuse mesangial proliferation in the glomeruli, tubular edema, tubular dilation, significant inflammatory cell infiltration in the interstitium, and increased glycogen staining and blue collagen deposition in the basement membrane. In contrast, the YSJTD and 4-PBA groups showed varying degrees of improvement in renal damage, glycogen staining, and collagen deposition, with the YSJTD group showing more significant improvements. TEM analysis indicated that the model group had extensive cytoplasmic edema, homogeneous thickening of the basement membrane, fewer foot processes, and widening of fused foot processes. In the YSJTD and 4-PBA groups, cytoplasmic swelling of renal tissues was reduced, the basement membrane remained intact and uniform, and foot process fusion improved.Western blot results indicated that compared to the control group, the model group showed upregulation of GRP78, CHOP, GSDMD, NLRP3, ASC, and caspase-1 expression. In contrast, both the YSJTD and 4-PBA groups showed downregulation of these markers compared to the model group. These findings suggest that YSJTD exerts a protective effect against DN by alleviating NLRP3 inflammasome activation through the inhibition of ERS, thereby improving the inflammatory response in db/db DN mice.

PMID:40686143 | DOI:10.19540/j.cnki.cjcmm.20250114.401

Zhongguo Zhong Yao Za Zhi. 2025 May;50(10):2684-2694. doi: 10.19540/j.cnki.cjcmm.20250207.301.

ABSTRACT

To elucidate the mechanism by which steaming affects the quality of Curcuma kwangsiensis root tubers, methods such as LSCM, RVA, dual-wavelength spectrophotometry, LF-NMR, and LC-MS were employed to qualitatively and quantitatively detect changes in starch gelatinization characteristics, water distribution, and material composition of C. kwangsiensis root tubers under different steaming durations. Based on multivariate statistical analysis, the correlation between differences in gelatinization parameters, water distribution, and terpenoid material composition was investigated. The results indicate that steaming affects both starch gelatinization and water distribution in C. kwangsiensis. During the steaming process, transformations occur between amylose and amylopectin, as well as between semi-bound water and free water. After 60 min of steaming, starch gelatinization and water distribution reached an equilibrium state. The content of amylopectin, the amylose-to-amylopectin ratio, and parameters such as gelatinization temperature, viscosity, breakdown value, and setback value were significantly correlated(P≤0.05). Additionally, the amylose-to-amylopectin ratio was significantly correlated with total free water and total water content(P≤0.05). Steaming induced differences in the material composition of C. kwangsiensis root tubers. Clustering of primary metabolites in the OPLS-DA model was distinct, while secondary metabolites were classified into 9 clusters using the K-means clustering algorithm. Differential terpenoid metabolites such as(-)-α-curcumene were significantly correlated with zerumbone, retinal, and all-trans-retinoic acid(P&lt;0.05). Curcumenol was significantly correlated with isoalantolactone and ursolic acid(P&lt;0.05), while all-trans-retinoic acid was significantly correlated with both zerumbone and retinal(P&lt;0.05). Alpha-tocotrienol exhibited a significant correlation with retinal and all-trans-retinoic acid(P&lt;0.05). Amylose was extremely significantly correlated with(-)-α-curcumene, curcumenol, zerumbone, retinal, all-trans-retinoic acid, and α-tocotrienol(P&lt;0.05). Amylopectin was significantly correlated with zerumbone(P&lt;0.05) and extremely significantly correlated with(-)-α-curcumene, curcumenol, zerumbone, retinal, all-trans-retinoic acid, and 9-cis-retinoic acid(P&lt;0.01). The results provide scientific evidence for elucidating the mechanism of quality formation of steamed C. kwangsiensis root tubers as a medicinal material.

PMID:40686137 | DOI:10.19540/j.cnki.cjcmm.20250207.301