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Nevin Manimala Statistics

Symptom burden and quality of life among patient and family caregiver dyads in advanced cancer

Qual Life Res. 2024 Jul 24. doi: 10.1007/s11136-024-03743-8. Online ahead of print.

ABSTRACT

PURPOSE: Symptom management among patients diagnosed with advanced cancer is a high priority in clinical care that often involves the support of a family caregiver. However, limited studies have examined parallel patient and caregiver symptom burden and associations with their own and each other’s quality of life (QOL). This study seeks to identify patient and caregiver symptom clusters and investigate associations between identified clusters and demographic, clinical, and psychosocial factors (cognitive appraisals and QOL).

METHODS: This study was a secondary analysis of self-reported baseline survey data collected from a randomized clinical trial of 484 adult advanced cancer patients and their caregivers. Latent class analysis and factor analysis were used to identify symptom clusters. Bivariate statistics tested associations between symptom clusters and demographic, clinical, and psychosocial variables.

RESULTS: The most prevalent symptom for patients was energy loss/fatigue and for caregivers, mental distress. Low, moderate, and high symptom burden subgroups were identified at the patient, caregiver, and dyad level. Age, gender, race, income, chronic conditions, cancer type, and treatment type were associated with symptom burden subgroups. Higher symptom burden was associated with more negative appraisals of the cancer and caregiving experience, and poorer QOL (physical, social, emotional, functional, and overall QOL). Dyads whose caregivers had more chronic conditions were more likely to be in the high symptom burden subgroup.

CONCLUSION: Patient and caregiver symptom burden influence their own and each other’s QOL. These findings reinforce the need to approach symptom management from a dyadic perspective.

PMID:39046614 | DOI:10.1007/s11136-024-03743-8

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Nevin Manimala Statistics

Disrupting the Path from Depression to Loneliness: Multilevel Resilience among Older Sexual Minority Men with and without HIV

AIDS Behav. 2024 Jul 24. doi: 10.1007/s10461-024-04416-w. Online ahead of print.

ABSTRACT

Existing studies examining resilience among sexual minority men (SMM) have been limited by only analyzing 1 level of resilience. We therefore investigated the impact of multiple levels of resilience on the bidirectional relationship between loneliness and depression symptoms among older SMM. Loneliness, depression symptoms, and multilevel resilience scores were collected across 3 time points (October 2016 to March 2017 [T1]; October 2017 to March 2018 [T2]; and October 2018 to March 2019 [T3]) among 1,264 SMM aged 40 years and older living with and without HIV. Longitudinal mediation models were used to test the mediating effect of the multilevel resilience factors at T2 on the bidirectional relationship between loneliness and depression symptoms, adjusting for sociodemographic covariates. The multilevel resilience factors were negatively associated with loneliness and depression symptoms at T1. The individual-level global resilience factor was associated with decreased odds of depression symptoms (odds ratio [OR] = 0.50; 95% CI, 0.32-0.78), while the interpersonal-level relationship confidence (OR = 0.43; 95% CI, 0.24-0.77) and reliability (OR = 0.36; 95% CI, 0.15-0.84) factors were associated with decreased odds of loneliness at T3. The total effect of loneliness at T1 on depressive symptoms at T3 was β = 0.20 (95% CI, 0.11-0.28) and was reduced to β = 0.08 (95% CI, -0.04 to 0.20) after the inclusion of the multilevel resilience factors. The total effect of depressive symptoms at T1 on loneliness at T3 was similar (β = 0.21; 95% CI, 0.13-0.28) with the direct effect of β = 0.01 (95% CI, -0.08 to 0.11) after the inclusion of the multilevel resilience factors. Regarding specific indirect effects, individual-level global resilience (depression symptoms at T3 only) as well as the interpersonal-level relationship reliability and confidence (loneliness at T3 model only) factors were statistically significant. Multilevel resilience factors mediated the bidirectional relationship between loneliness and depression symptoms. Mental health interventions should consider implementing resilience-informed strategies that mitigate depression symptoms and loneliness among older SMM.

PMID:39046610 | DOI:10.1007/s10461-024-04416-w

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Nevin Manimala Statistics

Effects of proanthocyanidin-functionalized hydroxyapatite nanoparticles on dentin bonding

Clin Oral Investig. 2024 Jul 24;28(8):444. doi: 10.1007/s00784-024-05836-7.

ABSTRACT

OBJECTIVES: To evaluate the effect of proanthocyanidin-functionalized hydroxyapatite nanoparticles (nHAp_PA) used as pretreatment at different concentrations on the microtensile bond strength (µTBS) and endogenous enzymatic activity (MMPs) on pH-cycled dentin after 24 h and 6 months of artificial aging.

MATERIALS AND METHODS: Fifty human sound dentin blocks were randomly assigned to 5 groups (n = 10): (i) negative control (no treatment); (ii) positive control (pH-cycling); (iii) pH-cycling + 2% nHAp_PA for 60s; (iv) pH-cycling + 6.5% nHAp_PA for 60s; (v) pH-cycling + 15% nHAp_PA for 60s. A self-etch adhesive was used for bonding procedures before resin composite build-ups. Specimens were tested with the µTBS test after 24 h and 6 months of laboratory storage. The proteolytic activity in each group was evaluated with gelatin zymography and in situ zymography. Data were statistically analyzed (p < 0.05).

RESULTS: At 24 h, the µTBS of the experimental groups were significantly higher than the controls (p ≤ 0.001), and no differences were observed between different concentrations (p > 0.05). Artificial aging significantly decreased bond strength in all groups (p ≤ 0.008); however, nHAp_PA 2% still yielded higher bonding values than controls (p ≤ 0.007). The groups pretreated with nHAp_PA exhibited lower MMP-9 and MMP-2 activities compared to the positive control group and almost the same enzymatic activity as the negative control group. In situ zymography showed that after 6 months of aging, nHAp_PA 2% and nHAp_PA 6,5% decreased enzymatic activity as well as the negative control.

CONCLUSIONS: Dentin pretreatment with nHAp_PA increased the bonding performance of a self-etch adhesive and decreased MMP-2 and MMP-9 activities after 6 months.

PMID:39046575 | DOI:10.1007/s00784-024-05836-7

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Nevin Manimala Statistics

Socioeconomic Status Plays a Moderating Role in the Association Between Multimorbidity and Health-Related Quality of Life Among Cancer Patients

Inquiry. 2024 Jan-Dec;61:469580241264187. doi: 10.1177/00469580241264187.

ABSTRACT

This study aimed to explore the moderating role of socioeconomic status (SES) in the association between multimorbidity and health-related quality of life (HRQOL) among cancer patients in Anhui China. A total of 560 cancer patients were recruited for the cross-section study. Socio-demographic and clinical characteristics were analyzed using descriptive statistics. Tobit regression analysis was employed to investigate the relationship between multimorbidity and HRQOL as well as to assess the moderating effect of SES. The research findings indicated that 76.61% of cancer patients experienced multimorbidity, with psychological multimorbidity being the most prevalent (45.54%), followed by physical-psychological multimorbidity (20.89%). Moreover, physical-psychological multimorbidity had the most substantial adverse effect on HRQOL (P < .001). The presence of multimorbidity was correlated with a significant decline in HRQOL, with a 17.5% (P < .001) decrease in HRQOL for each additional multimorbidity. Additionally, SES played a significant role in moderating the impact of multimorbidity on HRQOL in cancer patients. (Marginal effect = -0.022, P < .01). The high SES group exhibited a higher overall HRQOL than the low SES group (Marginal effect = 0.068, P < .001). And with the increase of multimorbidity, HRQOL in the higher SES showed a more pronounced downward trend, compared with the lower SES (β = -.270 vs β = -.201, P < .001). Our findings underscore the importance of preventing and managing multimorbidity in cancer patients, particularly those with low SES. Furthermore, it is essential to consider the impact of the rapid decline in HRQOL as the number of multimorbidity increases in individuals with higher SES. It is imperative to explore interdisciplinary and continuous collaborative management models.

PMID:39045764 | DOI:10.1177/00469580241264187

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Nevin Manimala Statistics

Predicting Intimate Partner Violence Perpetration Among Young Adults Experiencing Homelessness in Seven U.S. Cities Using Interpretable Machine Learning

J Interpers Violence. 2024 Jul 24:8862605241263588. doi: 10.1177/08862605241263588. Online ahead of print.

ABSTRACT

Young adults experiencing homelessness (YAEH) are at higher risk for intimate partner violence (IPV) victimization than their housed peers. This is often due to their increased vulnerability to abuse and victimization before and during homelessness, which can result in a cycle of violence in which YAEH also perpetrates IPV. Identifying and addressing factors contributing to IPV perpetration at an early stage can reduce the risk of IPV. Yet to date, research examining YAEH’s IPV perpetration is scarce and has largely employed conventional statistical approaches that are limited in modeling this complex phenomenon. To address these gaps, this study used an interpretable machine learning approach to answer the research question: What are the most salient predictors of IPV perpetration among a large sample of YAEH in seven U.S. cities? Participants (N = 1,426) on average were 21 years old (SD = 2.09) and were largely cisgender males (59%) and racially/ethnically diverse (81% were from historically excluded racial/ethnic groups; i.e., African American, Latino/a, American Indian, Asian or Pacific Islander, and mixed race/ethnicity). Over one-quarter (26%) reported IPV victimization, and 20% reported IPV perpetration while homeless. Experiencing IPV victimization while homeless was the most important factor in predicting IPV perpetration. An additional 11 predictors (e.g., faced frequent discrimination) were positively associated with IPV perpetration, whereas 8 predictors (e.g., reported higher scores of mindfulness) were negatively associated. These findings underscore the importance of developing and implementing effective interventions with YAEH that can prevent IPV, particularly those that recognize the positive association between victimization and perpetration experiences.

PMID:39045762 | DOI:10.1177/08862605241263588

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Nevin Manimala Statistics

Save the subchondral bone plate: Debridement versus bone marrow stimulation in acetabular cartilage defects over 60 months of follow-up

Knee Surg Sports Traumatol Arthrosc. 2024 Jul 24. doi: 10.1002/ksa.12375. Online ahead of print.

ABSTRACT

PURPOSE: Bone marrow stimulation is a common treatment for full-thickness cartilage defects in the hip joint. However, common procedures may result in poor fibrous repair tissue and changes to the subchondral anatomy. This study investigated the clinical outcome of a cohort of International Cartilage Repair Society (ICRS) grades 3 and 4 cartilage defects treated with bone marrow stimulation compared to those who received simple debridement/chondroplasty.

METHODS: In this retrospective registry study, 236 patients with uni-focal acetabular chondral lesions of the hip up to 400 mm² (mean 177.4 ± 113.4 mm²) and of ICRS grade ≥3 with follow-up of at least 12 months (mean 33.2 ± 15.3 months) were included. Eighty-one patients underwent bone marrow stimulation (microfracture: n = 44, abrasion: n = 37) besides treatment of the underlying pathology, 155 patients underwent defect debridement/chondroplasty. The patient-reported outcome was measured using the International Hip Outcome Tool 33 (iHOT33) score and the Visual Analogue Scale (VAS) for pain.

RESULTS: iHOT33 and VAS both improved highly statistically significantly (p < 0.001) in the debridement group after 6, 12, 24, 36 and 60 months compared to the preoperative scores, whereas iHOT33 and VAS after microfracture or abrasion did not show statistically significant changes over time. Twenty-four and sixty months postsurgery the debridement group revealed significant higher scores in the iHOT33 compared to the bone marrow stimulation groups.

CONCLUSION: Patients with chondral lesions of the hip ≤400 mm2 sustainably benefit from arthroscopic debridement under preservation of the subchondral bone plate in terms of functional outcome and pain in contrast to patients treated with bone marrow stimulation. These findings discourage the currently recommended use of microfracture in the hip joint.

LEVEL OF EVIDENCE: Level III.

PMID:39045708 | DOI:10.1002/ksa.12375

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Nevin Manimala Statistics

Downward trend in male reproductive health and fertility in Eastern Iran

Urologia. 2024 Jul 24:3915603241261144. doi: 10.1177/03915603241261144. Online ahead of print.

ABSTRACT

This study aimed to assess the ten-year trend in semen quality among couples referred to the Infertility Center in Kerman between 2008 and 2017. The study included 2952 semen samples from men 18 to 60 years old referred to the infertility center as infertile couples living in Kerman province, Iran, whether they had normal or abnormal semen analysis. A total of 2952 sperm samples were included. Statistically significant changes were observed in semen parameters. Particularly, significant changes were observed for volume (-0.08 mL/year), sperm concentration (-2.34 (mio/mL)/year), total sperm count (-13.17 (mio/ejaculate)/year), progressive motility (-2.62%/year), non-progressive motility (-0.59%/year), immotile sperm (2.49%/year), and normal morphology (-0.134%/year). In bivariate analysis, the prevalence of oligozoospermia in this study showed a statistically significant association with age (OR = 1.019; 95% CI = 1.007-1.032; p = 0.003). Likewise, there was a statistically significant association with the year (OR = 1.087; 95% CI = 1.050-1.125; p = 0.000). Semen quality parameters showed a downtrend during the last 10 years in this study, emphasizing the importance of male reproductive health monitoring and warning public health coordinators to pay more attention to this important issue.

PMID:39045677 | DOI:10.1177/03915603241261144

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Nevin Manimala Statistics

18F-FDG PET/CT for early prediction of pathological complete response in breast cancer neoadjuvant therapy: a retrospective analysis

Oncologist. 2024 Jul 23:oyae185. doi: 10.1093/oncolo/oyae185. Online ahead of print.

ABSTRACT

BACKGROUND: Neoadjuvant treatment has been developed as a systematic approach for patients with early breast cancer and has resulted in improved breast-conserving rate and survival. However, identifying treatment-sensitive patients at the early phase of therapy remains a problem, hampering disease management and raising the possibility of disease progression during treatment.

METHODS: In this retrospective analysis, we collected 2-deoxy-2-[F-18] fluoro-d-glucose (18F-FDG) positron emission tomography (PET)/computed tomography (CT) images of primary tumor sites and axillary areas and reciprocal clinical pathological data from 121 patients who underwent neoadjuvant treatment and surgery in our center. The univariate and multivariate logistic regression analyses were performed to investigate features associated with pathological complete response (pCR). An 18F-FDG PET/CT-based prediction model was trained, and the performance was evaluated by receiver operating characteristic curves (ROC).

RESULTS: The maximum standard uptake values (SUVmax) of 18F-FDG PET/CT were a powerful indicator of tumor status. The SUVmax values of axillary areas were closely related to metastatic lymph node counts (R = 0.62). Moreover, the early SUVmax reduction rates (between baseline and second cycle of neoadjuvant treatment) were statistically different between pCR and non-pCR patients. The early SUVmax reduction rates-based model showed great ability to predict pCR (AUC = 0.89), with all molecular subtypes (HR+HER2-, HR+HER2+, HR-HER2+, and HR-HER2-) considered.

CONCLUSION: Our research proved that the SUVmax reduction rate of 18F-FDG PET/CT contributed to the early prediction of pCR, providing rationales for utilizing PET/CT in NAT in the future.

PMID:39045652 | DOI:10.1093/oncolo/oyae185

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Nevin Manimala Statistics

Integration of High-Resolution LC-Q-TOF Mass Spectrometry and Multidimensional Chemical-Biological Analysis to Detect Nanomolar-Level Acetylcholinesterase Inhibitors from Different Parts of Zanthoxylum nitidum

J Agric Food Chem. 2024 Jul 24. doi: 10.1021/acs.jafc.4c00866. Online ahead of print.

ABSTRACT

Zanthoxyli radix is a popular tea among the elderly, and it is believed to have a positive effect on Alzheimer’s disease. In this study, a highly effective three-step strategy was proposed for comprehensive analysis of the active components and biological functions of Zanthoxylum nitidum (ZN), including high-resolution LC-Q-TOF mass spectrometry (HRMS), multivariate statistical analysis for heterogeneity (MSAH), and experimental and virtual screening for bioactivity analysis (EVBA). A total of 117 compounds were identified from the root, stem, and leaf of ZN through HRMS. Bioactivity assays showed that the order of acetylcholinesterase (AChE) inhibitory activity from strong to weak was root > stem > leaf. Nitidine, chelerythrine, and sanguinarine were found to be the main differential components of root, stem, and leaf by OPLS-DA. The IC50 values of the three compounds are 0.81 ± 0.02, 0.14 ± 0.01, and 0.48 ± 0.01 μM respectively, indicating that they are potent and high-quality AChE inhibitors. Molecular docking showed that pi-pi T-shaped interactions and pi-lone pairs played important roles in AChE inhibition. This study not only explains the biological function of Zanthoxyli radix in alleviating Alzheimer’s disease to some extent, but also lays the foundation for the development of stem and leaf of ZN.

PMID:39045647 | DOI:10.1021/acs.jafc.4c00866

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Nevin Manimala Statistics

Social support in recently diagnosed diabetic patients: Risk factor for depression?

J Public Health Res. 2024 Jun 24;13(2):22799036241262296. doi: 10.1177/22799036241262296. eCollection 2024 Apr.

ABSTRACT

Background: social support is important for adaptation in chronic diseases, such as diabetes and depression, because it favors recovery and adherence to treatment. Introducing its evaluation in the follow-up of diabetic patients can reduce complications derived from secondary non-adherence. Aims: to establish social support in diabetic patients and its correlation with depressive symptoms. Methods: a cross-sectional analytical study nested in a cohort of 173 recently diagnosed diabetic patients (<6 months) in Colombia over 18 years of age, treated in a cardiovascular risk program in 2022. The Chronic Illness Social Support Inventory was used. Results: Most of the participants were women (77.5%); single(83.8%), age (mean = 62.6 years (SD 12.3)); glycemia (mean = 146.4 (SD 65.5)), glycosylated hemoglobin (mean = 7.6 (SD 1.7)). Cronbach’s α coefficient for the general scale of the social support instrument was 0.9859. The mean social support was 168.5 (SD 37.4), range 38-228. The total social support score was normally distributed (Shapiro Wilk p > 0.05). The correlation between domains was statistically significant. The PHQ9 total score was significantly associated with the domains of Personal Interaction and Guide but did not significantly correlate with the overall social support score. The respondents who were at risk of developing depression were referred for treatment. Conclusions: findings suggest that perceived social support may play a significant role in the prevention and treatment of depression in diabetic patients. It is desirable that health professionals consider evaluating and enhancing social support to improve their mental health. More research is needed to gain a comprehensive understanding of this relationship.

PMID:39045604 | PMC:PMC11265234 | DOI:10.1177/22799036241262296