Tag: nevin manimala

Am J Public Health. 2024 Mar;114(S3):S239-S241. doi: 10.2105/AJPH.2024.307635.

NO ABSTRACT

PMID:38537167 | DOI:10.2105/AJPH.2024.307635

J Clin Oncol. 2024 Mar 27:JCO2301500. doi: 10.1200/JCO.23.01500. Online ahead of print.

ABSTRACT

PURPOSE: To compare giredestrant and physician’s choice of endocrine monotherapy (PCET) for estrogen receptor-positive, HER2-negative, advanced breast cancer (BC) in the phase II acelERA BC study (ClinicalTrials.gov identifier: NCT04576455).

METHODS: Post-/pre-/perimenopausal women, or men, age 18 years or older with measurable disease/evaluable bone lesions, whose disease progressed after 1-2 lines of systemic therapy (≤1 targeted, ≤1 chemotherapy regimen, prior fulvestrant allowed) were randomly assigned 1:1 to giredestrant (30 mg oral once daily) or fulvestrant/aromatase inhibitor per local guidelines (+luteinizing hormone-releasing hormone agonist in pre-/perimenopausal women, and men) until disease progression/unacceptable toxicity. Stratification was by visceral versus nonvisceral disease, prior cyclin-dependent kinase 4/6 inhibitor, and prior fulvestrant. The primary end point was investigator-assessed progression-free survival (INV-PFS).

RESULTS: At clinical cutoff (February 18, 2022; median follow-up: 7.9 months; N = 303), the INV-PFS hazard ratio (HR) was 0.81 (95% CI, 0.60 to 1.10; P = .1757). In the prespecified secondary end point analysis of INV-PFS by ESR1 mutation (m) status in circulating tumor DNA-evaluable patients (n = 232), the HR in patients with a detectable ESR1m (n = 90) was 0.60 (95% CI, 0.35 to 1.03) versus 0.88 (95% CI, 0.54 to 1.42) in patients with no ESR1m detected (n = 142). Related grade 3-4 adverse events (AEs), serious AEs, and discontinuations due to AEs were balanced across arms.

CONCLUSION: Although the acelERA BC study did not reach statistical significance for its primary INV-PFS end point, there was a consistent treatment effect with giredestrant across most key subgroups and a trend toward favorable benefit among patients with ESR1-mutated tumors. Giredestrant was well tolerated, with a safety profile comparable to PCET and consistent with known endocrine therapy risks. Overall, these data support the continued investigation of giredestrant in other studies.

PMID:38537155 | DOI:10.1200/JCO.23.01500

Soc Cogn Affect Neurosci. 2024 Feb 28;19(1):nsae019. doi: 10.1093/scan/nsae019.

ABSTRACT

The cerebellum causally supports social processing by generating internal models of social events based on statistical learning of behavioral regularities. However, whether the cerebellum is only involved in forming or also in using internal models for the prediction of forthcoming actions is still unclear. We used cerebellar transcranial Direct Current Stimulation (ctDCS) to modulate the performance of healthy adults in using previously learned expectations in an action prediction task. In a first learning phase of this task, participants were exposed to different levels of associations between specific actions and contextual elements, to induce the formation of either strongly or moderately informative expectations. In a following testing phase, which assessed the use of these expectations for predicting ambiguous (i.e. temporally occluded) actions, we delivered ctDCS. Results showed that anodic, compared to sham, ctDCS boosted the prediction of actions embedded in moderately, but not strongly, informative contexts. Since ctDCS was delivered during the testing phase, that is after expectations were established, our findings suggest that the cerebellum is causally involved in using internal models (and not just in generating them). This encourages the exploration of the clinical effects of ctDCS to compensate poor use of predictive internal models for social perception.

PMID:38537123 | DOI:10.1093/scan/nsae019

J Psychosoc Nurs Ment Health Serv. 2024 Apr 1:1-8. doi: 10.3928/02793695-20240322-02. Online ahead of print.

ABSTRACT

PURPOSE: To analyze the relationship between self-efficacy in protecting against substance use and loneliness in adolescents.

METHOD: This descriptive, cross-sectional study comprised 400 adolescents. A Sociodemographic Data Form, Self-Efficacy for Adolescents Protecting Against Substance Abuse Scale (SEAPSAS), and Short-Form UCLA Loneliness Scale (ULS-8) were used for data collection. Regression analysis and Pearson correlation analysis, as well as descriptive statistics, were used in data analysis.

RESULTS: Mean ULS-8 total score was 17.94 (SD = 5.07) and mean SEAPSAS total score was 68.78 (SD = 17.59). A weak significant negative relationship was found between mean ULS-8 total score and mean SEAPSAS subdimensions and total score. As a result of regression analysis, it was determined that ULS-8 total score negatively affected mean SEAPSAS total score by 24.9% (R² = 0.249; B = -1.713; p < 0.001).

CONCLUSION: Loneliness in adolescents, which was observed to negatively impact self-efficacy in protecting against substance use, should be addressed by psychiatric nurses through prevention activities and support programs and services, such as early detection and intervention. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

PMID:38537106 | DOI:10.3928/02793695-20240322-02

AIDS. 2024 Mar 27. doi: 10.1097/QAD.0000000000003894. Online ahead of print.

ABSTRACT

OBJECTIVE: With aging, people living with HIV (PLWH) have diminishing postural stability that increases liability for falls. Factors and neuromechanisms contributing to instability are incompletely known. Brain white matter abnormalities seen as hyperintense (WMH) signals have been considered to underlie instability in normal aging and PLWH. We questioned whether sway-WMH relations endured after accounting for potentially relevant demographic, physiological, and HIV-related variables.

DESIGN: Mixed cross-sectional/longitudinal data acquired over 15 years in 141 PLWH and 102 age-range matched controls, 25-80 years old.

METHODS: Multimodal structural MRI data were quantified for 7 total and regional WMH volumes. Static posturography acquired with a force platform measured sway path length separately with eyes closed and eyes open. Statistical analyses used multiple regression with mixed modeling to test contributions from non-MRI and non-path data on sway path-WMH relations.

RESULTS: In simple correlations, longer sway paths were associated with larger WMH volumes in PWLH and controls. When demographic, physiological, and HIV-related variables were entered into multiple regressions, the sway-WMH relations under both vision conditions in the controls were attenuated when accounting for age and 2-point pedal discrimination. Although the sway-WMH relations in PLWH were influenced by age, 2-point pedal discrimination, and years with HIV infection, the sway-WMH relations endured for 5 of the 7 regions in the eyes-open condition.

CONCLUSIONS: The constellation of age-related increasing instability while standing, degradation of brain white matter integrity, and peripheral pedal neuropathy is indicative of advancing fraility and liability for falls as people age with HIV infection.

PMID:38537080 | DOI:10.1097/QAD.0000000000003894

Int J Surg. 2024 Apr 3. doi: 10.1097/JS9.0000000000001404. Online ahead of print.

ABSTRACT

BACKGROUND: Gastrectomy for gastric cancer is associated with postoperative changes in cardiovascular risk factors, however, the impact of gastrectomy on cardiovascular events remains unclear. We assessed the incidence of cardiovascular events between patients undergoing gastrectomy or endoscopic resection for gastric cancer, and the general population.

MATERIALS AND METHODS: This retrospective nationwide cohort study included patients with gastric cancer undergoing gastrectomy(n=37,698), endoscopic resection(n=2,773), and matched control population(n=161,887) between 2004 and 2013. We included patients without a history of cancer other than gastric cancer, myocardial infarction, or ischemic stroke. The primary outcome was the incidence of major adverse cardiovascular events (MACE) such as acute myocardial infarction, revascularization, or acute ischemic stroke, in patients with gastric cancer.

RESULTS: Among patients who underwent gastrectomy for gastric cancer, 2.9% (4.69 per 1000 person-years) developed novel MACE within the seven-year follow-up period. The gastrectomy group demonstrated a significantly decreased risk for MACE than the control population (hazard ratio[HR], 0.65; 95% confidence interval[CI], 0.61-0.69; P<0.001). Among the patients undergoing endoscopic resection for gastric cancer, 5.4% (8.21 per 1000 person-years) developed novel MACE within the seven-year follow-up period. The risk for MACE in the endoscopic resection group was not significantly different from the control population.

CONCLUSION: Patients with gastric cancer who have undergone gastrectomy exhibit a reduced risk of cardiovascular diseases in comparison to the general population. In contrast, the risk for cardiovascular diseases in patients with gastric cancer who underwent endoscopic resection did not demonstrate a significant difference in cardiovascular risk in comparison to the general population.

PMID:38537066 | DOI:10.1097/JS9.0000000000001404

Blood Adv. 2024 Mar 27:bloodadvances.2023012080. doi: 10.1182/bloodadvances.2023012080. Online ahead of print.

ABSTRACT

Patients with chronic lymphocytic leukemia (CLL) who develop Richter transformation (RT) have a poor prognosis when treated with chemoimmunotherapy regimens used for de novo diffuse large B-cell lymphoma. Venetoclax, a BCL2 inhibitor, has single agent efficacy in patients with RT and is potentially synergistic with chemoimmunotherapy. In this multicenter, retrospective study, we evaluated 62 patients with RT who received venetoclax-based treatment outside of a clinical trial, in combination with a Bruton tyrosine kinase inhibitor (BTKi; n=28), R-CHOP (n=13), or intensive chemoimmunotherapy other than R-CHOP (n=21). The best overall and complete response rates were 36%/25%, 54%/46%, and 52%/38%, respectively. The median progression-free and overall survival estimates for the same treatment groups were 4.9/14.3 months, 14.9 months/not reached, and 3.3/9 months, respectively. CLL with del(17p) was associated with a lower complete response rate in the total cohort (odds ratio [OR] 0.15; 95% confidence interval [CI] 0.04-0.6; p=0.01) and venetoclax-naïve subgroup (OR 0.13; 95%CI 0.02-0.66; p=0.01). TP53 mutated CLL was associated with a lower complete response rate (OR 0.15; 95%CI 0.03-0.74; p=0.02) and shorter progression-free survival (hazard ratio 3.1; 95%CI 1.21-7.95; p=0.02) only in venetoclax-naïve subgroup. No other clinical or baseline characteristics, including prior venetoclax treatment for CLL, showed statistically significant association with outcomes. Grade 3-4 neutropenia and thrombocytopenia events were most frequent with intensive chemoimmunotherapy + venetoclax; grade 3-4 infection rates were similar across treatment groups. In this difficult-to-treat RT patient population, venetoclax-based combination regimens achieved high response rates, with durable remission and survival observed in a subset of patients.

PMID:38537065 | DOI:10.1182/bloodadvances.2023012080

Mil Psychol. 2021 Nov 22;34(2):197-210. doi: 10.1080/08995605.2021.1984741. eCollection 2022.

ABSTRACT

As a component of the US Army’s Comprehensive Soldier and Family Fitness program (CSF2), the Global Assessment Tool (GAT) represents a multidimensional constellation of measures designed to assess characteristics related to resilience. Using a foundation of validated measures from prior research, the GAT has been the vehicle for self-assessment to provide Soldiers, their families, and Army Civilians snapshots of their psychosocial wellness. Despite the long history of the measurement instrument (first implemented in 2009) and widespread use (mandatory for all active-duty Soldiers annually), the longitudinal capabilities of the GAT has received little attention. Here, we examine the longitudinal stability of the GAT across an approximate five-year time frame and multiple statistical approaches that demonstrate measurement stability at both the aggregate population level (people on average) and the individual level. We find evidence that the majority of the measures within the GAT are relatively stable over time both at the population level and individual level. This evidence contributes to knowledge of how best to improve the GAT for future use with the pay-off for the Army being a self-assessment tool that is more effective and efficient.

PMID:38536386 | PMC:PMC10161959 | DOI:10.1080/08995605.2021.1984741

Mil Psychol. 2022 Mar 1;34(5):551-569. doi: 10.1080/08995605.2021.2022067. eCollection 2022.

ABSTRACT

Data are often available only for recruits, a range-restricted sample. This creates the potential for mistaken inferences and poor decisions. This is because inferences and decisions are about the population, not the sample. Despite these problems, researchers must try to determine statistical values as if the sample was not range-restricted. Although range restriction correction methods have been available for over a century, often they are not applied or are applied incorrectly. Technical psychometric discussions of range restriction have not improved researcher practice. As an alternative, realistic scenarios are presented to illustrate and explain the consequences of (1) failing to correct correlations, (2) using the wrong correction formula, (3) correcting when information about previous selection variables is unavailable, (4) using an inappropriate unrestricted sample, (5) incorrectly computing the confidence interval for corrected correlations, and (6) interpretation of results. Although there are situations under which correction has little effect, correction still provides better estimates of relations among variables. It also improves theoretical understanding and interpretation of real-world results.

PMID:38536384 | PMC:PMC10069334 | DOI:10.1080/08995605.2021.2022067

Mil Psychol. 2020 Jun 4;32(4):300-312. doi: 10.1080/08995605.2020.1754123. eCollection 2020.

ABSTRACT

This systematic review examines studies published between 2003, the initial invasion of Iraq, and 2018 related to the long-term treatment outcomes for Veterans of Iraq and Afghanistan suffering from combat-related posttraumatic stress disorder (PTSD). More specifically this review attempts to estimate the rate at which Veterans experience the return of symptoms after completing treatment. The review was conducted by the authors in accordance with the Cochrane Handbook for Systematic Reviews of Interventions. The literature search identified eight eligible studies, which met the predefined inclusion criteria. Of the included studies a majority were deemed to be at a high risk of attrition bias. In addition, few studies comprehensively reported relevant relapse or recurrence related outcome statistics. The implications of the available evidence base on long-term treatment outcomes are discussed. Recommendations for future studies on relapse and recurrence of PTSD symptoms among Veterans of Iraq and Afghanistan are also presented.

PMID:38536379 | PMC:PMC10013559 | DOI:10.1080/08995605.2020.1754123