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1.
J Exp Biol ; 2024 Sep 05.
Article in English | MEDLINE | ID: mdl-39234635

ABSTRACT

Insect guts house a complex community of microbes that affect host physiology, performance, and behavior. Gut microbiome research has largely focused on bacteria-host symbioses and paid less attention to other taxa, such as yeasts. We found that axenic Drosophila melanogaster (reared free of microbes) develops from egg to adult more slowly (c. 13 days) than those with a natural microbiota (c. 11.5 days). Here we show that live yeasts are present and reproducing in the guts of flies and that the fast development time can be restored by inoculating larvae with a single yeast species (either Saccharomyces cerevisiae or Lachancea kluyveri). Nutritional supplements (either heat-killed yeasts, or a mix of essential vitamins and amino acids) slightly speed the development of axenic flies (to c. 12.5 days), but not to the same extent as live yeasts. During the first two instars, this acceleration appears to result from additional macronutrient availability, but during the third instar, when most growth occurs, live yeasts increase feeding rate, implying an effect mediated by the gut-brain axis. Thus, the fly-yeast interaction extends beyond yeasts-as-food to yeasts as beneficial interactive symbionts.

2.
J Environ Qual ; 2024 Sep 10.
Article in English | MEDLINE | ID: mdl-39256968

ABSTRACT

The Soil and Water Management Research Unit of the USDA-Agricultural Research Service is located in St. Paul, MN, and conducts long-term research at the University of Minnesota Research and Outreach Center located at Rosemount, MN. As part of USDA's Long-Term Agroecosystem Research (LTAR) network, the croplands common experiment (CCE) at this location is focused on integration of a kura clover (Trifolium ambiguum M. Bieb.) living mulch (KCLM) system into the prevailing 2-year rotation of corn (Zea mays L.) and soybean (Glycine max L.) that is typical of the midwestern Corn Belt. The LTAR-CCE conducted at Rosemount, MN, aims to compare the long-term environmental and agronomic performance of KCLM while identifying challenges and developing management strategies for this alternative practice. The use of a living mulch for this region is advantageous because, once established, it does not require additional time for fall field operations typically associated with winter cover crops. Results from LTAR-CCE studies at this site show that KCLM results in a substantial increase in soil field-saturated hydraulic conductivity and decreases in leaching of nitrate-nitrogen (NO3 --N). Disadvantages of the KCLM system include potential for increased emissions of nitrous oxide (N2O) and reduced crop yields, particularly during drought. Also, the optimal approach for crop row establishment in the spring remains uncertain. Ongoing LTAR-CCE research with KCLM aims to better understand and quantify both benefits and risks across conditions of interannual weather variability and changing climate to develop guidance for suitable adoption and management of this alternative practice.

3.
BMJ Case Rep ; 17(8)2024 Aug 22.
Article in English | MEDLINE | ID: mdl-39179262

ABSTRACT

Arteriovenous malformations (AVMs) in mesenteric vessels are exceptionally rare. These congenital vascular anomalies lead to direct vascular flow between the highly pressured arterial system and the low-pressure venous system. We describe the case of a patient with prior left colectomy for splenic flexure colonic adenocarcinoma presenting with persistent abdominal pain after developing multiple mesenteric thromboses. CT and colonoscopy showed left hemicolon congestion, anastomotic stenosis and mucosal oedema. Mesenteric angiogram revealed AVMs in the right colic and left colic arteries. Embolisation of the left colic AVM led to symptom resolution without recurrence at interval follow-up.


Subject(s)
Arteriovenous Malformations , Humans , Arteriovenous Malformations/complications , Arteriovenous Malformations/diagnostic imaging , Thrombosis/diagnostic imaging , Thrombosis/etiology , Male , Colonic Neoplasms/complications , Colonic Neoplasms/surgery , Embolization, Therapeutic , Colectomy , Adenocarcinoma/complications , Colonic Diseases/etiology , Colonic Diseases/diagnostic imaging , Colonic Diseases/surgery , Abdominal Pain/etiology , Colon/blood supply , Tomography, X-Ray Computed , Colonoscopy , Mesenteric Vascular Occlusion/diagnostic imaging , Mesenteric Vascular Occlusion/etiology
4.
J Natl Cancer Inst ; 2024 Aug 06.
Article in English | MEDLINE | ID: mdl-39107910

ABSTRACT

BACKGROUND: Physical activity can improve cognition; however, little is known regarding the relationships between longitudinal objectively-measured physical activity, cognition, and inflammation in older breast cancer survivors. METHODS: Older (≥60 yrs) breast cancer survivors (n = 216) and frequency-matched non-cancer controls (n = 216) were assessed at baseline (pre-systemic therapy for survivors) and annually for up to five years. Assessments included hip-worn ActiGraphs worn for seven days, neuropsychological tests, the Functional Assessment of Cancer Therapy-Cognitive Function Perceived Cognitive Impairment (FACT-Cog PCI) subscale, and circulating levels of C-reactive protein (CRP) and interleukin-6 (IL-6). Data were analyzed using linear mixed-effect, random-effect contemporaneous fluctuation, and multi-level mediation models, considering covariates; p < .05 (two-sided) was considered significant. RESULTS: Survivors had fewer minutes of moderate-to-vigorous physical activity (MVPA) than controls at 36-, 48-, and 60-month time points (p < .03). Fewer survivors met Aerobic Physical Activity Guidelines at 36 months than controls (17.7% vs 33.0%, p = .030). When Guidelines were met (vs not), FACT-Cog PCI scores were 2.1 ± 1.0 (p = .034) points higher. Higher MVPA and meeting Aerobic Guidelines were not related to objective neuropsychological performance. MVPA was inversely associated with CRP and IL-6 (p < .001), but inflammation did not mediate physical activity effects on perceived cognition. CONCLUSIONS: Older breast cancer survivors were less physically active than older non-cancer controls, especially farther from baseline. Meeting Aerobic Guidelines was associated with better perceived cognition in survivors. Survivorship care should consider physical activity monitoring and referral to rehabilitation and supervised exercise programs to promote physical activity and improve recovery in older survivors.

5.
Cancer ; 2024 Aug 04.
Article in English | MEDLINE | ID: mdl-39097814

ABSTRACT

BACKGROUND: Social isolation and social connectedness are health determinants and aspects of social well-being with strong associations with psychological distress. This study evaluated relationships among social isolation, social connectedness, and psychological distress (i.e., depression, anxiety) over 1 year in young adult (YA) cancer survivors 18-39 years old. METHODS: Participants were YAs in a large cohort study that completed questionnaires every 2 months for 1 year. Social isolation, aspects of social connectedness (i.e., companionship, emotional support, instrumental support, and informational support), depression, and anxiety were assessed with Patient-Reported Outcomes Measurement Information System short form measures. Mixed-effect models were used to evaluate changes over time. Confirmatory factor analysis and multilevel structural equation modeling were used to define social connectedness as a latent construct and determine whether relationships between social isolation and psychological distress were mediated by social connectedness. RESULTS: Participants (N = 304) were mean (M) = 33.5 years old (SD = 4.7) and M = 4.5 years (SD = 3.5) post-initial cancer diagnosis. Most participants were female (67.4%) and non-Hispanic White (68.4%). Average scores for social well-being and psychological distress were within normative ranges and did not change (p values >.05). However, large proportions of participants reported at least mild social isolation (27%-30%), depressive symptoms (36%-37%), and symptoms of anxiety (49%-51%) at each time point. Across participants, more social isolation was related to less social connectedness (p values <.001), more depressive symptoms (p < .001), and more symptoms of anxiety (p < .001). Social connectedness mediated the relationship between social isolation and depression (p = .004), but not anxiety (p > .05). CONCLUSIONS: Social isolation and connectedness could be intervention targets for reducing depression among YA cancer survivors.

6.
Environ Microbiol Rep ; 16(4): e13319, 2024 Aug.
Article in English | MEDLINE | ID: mdl-39096033

ABSTRACT

Freshwater samples (n = 199) were obtained from 41 sites with contrasting land-uses (avian, low impact, dairy, urban, sheep and beef, and mixed sheep, beef and dairy) and the E. coli phylotype of 3980 isolates (20 per water sample enrichment) was determined. Eight phylotypes were identified with B1 (48.04%), B2 (14.87%) and A (14.79%) the most abundant. Escherichia marmotae (n = 22), and Escherichia ruysiae (n = 1), were rare (0.68%) suggesting that these environmental strains are unlikely to confound water quality assessments. Phylotypes A and B1 were overrepresented in dairy and urban sites (p < 0.0001), whilst B2 were overrepresented in low impact sites (p < 0.0001). Pathogens ((Salmonella, Campylobacter, Cryptosporidium or Giardia) and the presence of diarrhoeagenic E. coli-associated genes (stx and eae) were detected in 89.9% (179/199) samples, including 80.5% (33/41) of samples with putative non-recent faecal inputs. Quantitative PCR to detect microbial source tracking targets from human, ruminant and avian contamination were concordant with land-use type and E. coli phylotype abundance. This study demonstrated that a potential recreational health risk remains where pathogens occurred in water samples with low E. coli concentration, potential non-recent faecal sources, low impact sites and where human, ruminant and avian faecal sources were absent.


Subject(s)
Escherichia coli , Fresh Water , Public Health , Water Quality , New Zealand , Escherichia coli/genetics , Escherichia coli/isolation & purification , Escherichia coli/classification , Fresh Water/microbiology , Animals , Humans , Water Microbiology , Phylogeny , Feces/microbiology , Cryptosporidium/genetics , Cryptosporidium/isolation & purification , Cryptosporidium/classification , Giardia/genetics , Giardia/isolation & purification , Giardia/classification
8.
Cancer Med ; 13(14): e7464, 2024 Jul.
Article in English | MEDLINE | ID: mdl-39021272

ABSTRACT

BACKGROUND: Merkel cell carcinoma is a rare skin cancer associated with poor survival. Based on a previous Phase II trial of adults with advanced Merkel cell carcinoma by Kim and colleagues (2022), there is now a strong rationale for combination therapy (i.e., nivolumab and ipilimumab) to become a treatment option for patients with advanced Merkel cell carcinoma. The goal of this paper was to report on the secondary outcome of quality of life (QOL) among patients on this trial. METHODS: Patients receiving combined nivolumab and ipilimumab, with or without stereotactic body radiation therapy (SBRT), completed the European Organisation for Research and Treatment of Cancer (EORTC) QLQ-C30 prior to starting treatment and every 2 weeks thereafter. Changes in QOL during treatment and post-treatment were evaluated using piecewise random-effects mixed models. Exploratory analyses compared changes in QOL between study arms. The original trial was registered with ClinicalTrials.gov (NCT03071406). RESULTS: Study participants (n = 50) reported no changes in overall QOL (ps > 0.05), but emotional functioning improved during treatment (p = 0.01). Cognitive and social functioning worsened post-treatment (ps < 0.01). In general, patients treated with combination therapy only (n = 25) reported no change in QOL over time, whereas patients also treated with SBRT (n = 25) consistently demonstrated worsening QOL post-treatment. CONCLUSION: QOL is generally preserved in patients treated with combination therapy, but the addition of SBRT may worsen QOL. Combined with clinical efficacy data published previously, results support the use of combination therapy with nivolumab and ipilimumab as a treatment option for patients with advanced Merkel cell carcinoma.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Carcinoma, Merkel Cell , Ipilimumab , Nivolumab , Quality of Life , Radiosurgery , Skin Neoplasms , Humans , Ipilimumab/administration & dosage , Ipilimumab/adverse effects , Ipilimumab/therapeutic use , Nivolumab/therapeutic use , Nivolumab/adverse effects , Nivolumab/administration & dosage , Carcinoma, Merkel Cell/therapy , Carcinoma, Merkel Cell/pathology , Male , Female , Aged , Skin Neoplasms/therapy , Skin Neoplasms/pathology , Skin Neoplasms/drug therapy , Radiosurgery/adverse effects , Radiosurgery/methods , Middle Aged , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Antineoplastic Combined Chemotherapy Protocols/adverse effects , Aged, 80 and over , Patient Reported Outcome Measures
9.
Muscle Nerve ; 2024 Jun 28.
Article in English | MEDLINE | ID: mdl-38943290

ABSTRACT

INTRODUCTION/AIMS: Type 1 myotonic dystrophy (DM1) is a neuromuscular disorder of multiple organ systems with important electrophysiologic (EP) manifestations, leading to a cumulative incidence of sudden death of 6.6%. Due to genetic anticipation, there is a pediatric subset of this patient population. However, most EP research on DM1 patients has been in adults, making cardiac care for pediatric patients difficult and directed by adult guidelines which often leads to cardiovascular implantable electronic device (CIED) implants. We sought to investigate the prevalence of CIEDs in the pediatric DM1 population. METHODS: The Vizient® Clinical Data Base was queried from October 2019 to October 2023 for admissions with and without ICD-10 code for myotonic dystrophy (G71.11), with and without codes for presence of a pacemaker or ICD (Z95.0, Z95.810). Patients who were identified were stratified by age: Pediatric (0-21 years) and Adult (22-50 years). RESULTS: Prevalence of CIED in pediatric DM1 was 2.1% and in adult DM1 was 15.8%. When comparing to pediatric and adult patients with CIED and without DM1, the odds ratio for CIED in pediatric DM1 was 48.8, compared to 23.3 for CIED in adult DM1. DISCUSSION: There are pediatric DM1 patients who have received CIED despite a lack of data to inform this decision-making. Further research will be important to ensure appropriate use of CIED in this population and to develop appropriate guidelines to direct management.

10.
FEBS J ; 2024 Jun 23.
Article in English | MEDLINE | ID: mdl-38922780

ABSTRACT

Disorders of Gut-Brain Interaction (DGBI) are widely prevalent and commonly encountered in gastroenterology practice. While several peripheral and central mechanisms have been implicated in the pathogenesis of DGBI, a recent body of work suggests an important role for the gut microbiome. In this review, we highlight how gut microbiota and their metabolites affect physiologic changes underlying symptoms in DGBI, with a particular focus on their mechanistic influence on GI transit, visceral sensitivity, intestinal barrier function and secretion, and CNS processing. This review emphasizes the complexity of local and distant effects of microbial metabolites on physiological function, influenced by factors such as metabolite concentration, duration of metabolite exposure, receptor location, host genetics, and underlying disease state. Large-scale in vitro work has elucidated interactions between host receptors and the microbial metabolome but there is a need for future research to integrate such preclinical findings with clinical studies. The development of novel, targeted therapeutic strategies for DGBI hinges on a deeper understanding of these metabolite-host interactions, offering exciting possibilities for the future of treatment of DGBI.

11.
J Natl Cancer Inst ; 116(9): 1495-1507, 2024 Sep 01.
Article in English | MEDLINE | ID: mdl-38788675

ABSTRACT

PURPOSE: We evaluated whether plasma Alzheimer disease (AD)-related biomarkers were associated with cancer-related cognitive decline among older breast cancer survivors. METHODS: We included survivors aged 60-90 years with primary stage 0-III breast cancers (n = 236) and frequency-matched noncancer control paricipant (n = 154) who passed a cognitive screen and had banked plasma specimens. Participants were assessed at baseline (presystemic therapy) and annually for up to 60 months. Cognition was measured using tests of attention, processing speed, and executive function and learning and memory; perceived cognition was measured by the Functional Assessment of Cancer Therapy-Cognitive Function v3 Perceived Cognitive Impairments. Baseline plasma neurofilament light, glial fibrillary acidic protein, ß-amyloid 42 and 40 and phosphorylated tau 181 were assayed using single molecule arrays. Mixed models tested associations between cognition and baseline AD biomarkers, time, group (survivor vs control participant), and their 2- and 3-way interactions, controlling for age, race, Wide Range 4 Achievement Test Word Reading score, comorbidity, and body mass index; 2-sided P values of .05 were considered statistically significant. RESULTS: There were no group differences in baseline AD-related biomarkers except survivors had higher baseline neurofilament light levels than control participants (P = .013). Survivors had lower adjusted longitudinal attention, processing speed, and executive function than control participants starting from baseline and continuing over time (P ≤ .002). However, baseline AD-related biomarker levels were not independently associated with adjusted cognition over time, except control participants had lower attention, processing speed, and executive function scores with higher glial fibrillary acidic protein levels (P = .008). CONCLUSION: The results do not support a relationship between baseline AD-related biomarkers and cancer-related cognitive decline. Further investigation is warranted to confirm the findings, test effects of longitudinal changes in AD-related biomarkers, and examine other mechanisms and factors affecting cognition presystemic therapy.


Subject(s)
Alzheimer Disease , Biomarkers , Breast Neoplasms , Cognitive Dysfunction , Humans , Female , Aged , Alzheimer Disease/blood , Alzheimer Disease/psychology , Breast Neoplasms/psychology , Breast Neoplasms/blood , Breast Neoplasms/complications , Middle Aged , Cognitive Dysfunction/etiology , Cognitive Dysfunction/blood , Cognitive Dysfunction/diagnosis , Aged, 80 and over , Biomarkers/blood , Cancer Survivors/psychology , Neurofilament Proteins/blood , Amyloid beta-Peptides/blood , tau Proteins/blood , Neuropsychological Tests , Glial Fibrillary Acidic Protein/blood , Case-Control Studies
12.
J Exp Biol ; 227(10)2024 May 15.
Article in English | MEDLINE | ID: mdl-38779934

ABSTRACT

Efficient water balance is key to insect success. However, the hygric environment is changing with climate change; although there are compelling models of thermal vulnerability, water balance is often neglected in predictions. Insects survive desiccating conditions by reducing water loss, increasing their total amount of water (and replenishing it) and increasing their tolerance of dehydration. The physiology underlying these traits is reasonably well understood, as are the sources of variation and phenotypic plasticity. However, water balance and thermal tolerance intersect at high temperatures, such that mortality is sometimes determined by dehydration, rather than heat (especially during long exposures in dry conditions). Furthermore, water balance and thermal tolerance sometimes interact to determine survival. In this Commentary, we propose identifying a threshold where the cause of mortality shifts between dehydration and temperature, and that it should be possible to predict this threshold from trait measurements (and perhaps eventually a priori from physiological or -omic markers).


Subject(s)
Climate Change , Insecta , Animals , Insecta/physiology , Dehydration , Water/metabolism , Water-Electrolyte Balance/physiology , Thermotolerance
13.
Clin Exp Dermatol ; 2024 May 20.
Article in English | MEDLINE | ID: mdl-38767179

ABSTRACT

The Ehlers-Danlos Syndromes (EDS) are a heterogenous group of heritable connective tissue disorders, characterised by joint hypermobility, skin hyperextensibility and generalised tissue fragility. In all types of EDS skin wound healing is impaired to a variable degree. Additional support through wound management plans may help to improve these outcomes, however, there is paucity of evidence regarding clinical management of skin fragility and wounds in EDS. This paper aims to review current evidence and provide recommendations for management of skin wounds in EDS types. Preventative measures to avoid skin injury are strongly recommended, including avoidance of high impact sport and use of appropriate protection such as shin guards. Bruising is common and some types of EDS are associated with haematoma formation with management including compression bandages and consideration of pharmacological therapy. Skin fragility and tears should be managed with a focus on protection of remaining tissue, avoidance of wound tension and low adherence dressings to avoid further injury. This paper provides clear recommendations to address skin management for this group of patients. It highlights the lack of good quality published data to support treatment decisions.

14.
Gastroenterol Clin North Am ; 53(2): 299-308, 2024 06.
Article in English | MEDLINE | ID: mdl-38719380

ABSTRACT

As we all acknowledge benefits of ostomies, they can come with significant morbidity, quality of life issues, and major complications, especially during reversal procedures. In recent years, we have started to observe that similar graft and patient survival can be achieved without ostomies in certain cases. This observation and practice adopted in a few large-volume transplant centers opened a new discussion about the necessity of ostomies in intestinal transplantation. There is still more time and randomized studies will be needed to better understand and analyze the risk/benefits of "No-ostomy" approach in intestinal transplantation.


Subject(s)
Intestines , Humans , Intestines/transplantation , Surgical Stomas , Graft Survival , Postoperative Complications/etiology , Quality of Life , Enterostomy
16.
Health Psychol ; 43(9): 650-662, 2024 Sep.
Article in English | MEDLINE | ID: mdl-38815096

ABSTRACT

OBJECTIVE: Despite the popularity of mindfulness in research and interventions, information is missing about how and why mindfulness may benefit employee sleep health. Drawing from emotion regulation theory, we evaluate affective rumination, negative affect, and positive affect as potential mechanisms. We also explore differential effects of trait and state attentional mindfulness on both subjective (e.g., quality and sufficiency) and actigraphy-measured aspects (e.g., duration and wake after sleep onset) of sleep health. METHOD: Ecological momentary assessment and sleep actigraphy data were collected across two independent samples of health care workers (N1 = 60, N2 = 84). Ecological momentary assessment was also used to collect daily information on state mindfulness, affect, and rumination. RESULTS: Our results support rumination and, to a less consistent extent, negative affect as mediators of the association between mindfulness and sleep health but not positive affect. Trait and state mindfulness demonstrate comparable benefits for employee sleep health, but these benefits largely emerge for subjective sleep dimensions than actigraphy-measured. CONCLUSIONS: These findings support emotion regulation as a sound theoretical framework for sleep and mindfulness research and may support more informed workplace mindfulness interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).


Subject(s)
Actigraphy , Ecological Momentary Assessment , Emotional Regulation , Mindfulness , Humans , Male , Female , Adult , Emotional Regulation/physiology , Middle Aged , Sleep/physiology , Health Personnel/psychology , Affect/physiology , Rumination, Cognitive/physiology
17.
Pediatr Cardiol ; 2024 May 09.
Article in English | MEDLINE | ID: mdl-38724762

ABSTRACT

Patients with Fontan physiology have reduced exercise performance compared to their peers as well as a higher incidence of bundle branch block (BBB). This study aims to investigate the association between BBB and exercise performance in the Fontan population through a retrospective review of the Pediatric Heart Network Fontan study public use dataset. "Low Performers" were defined as ≤ 25th percentile (for Fontan patients) for each exercise parameter at anaerobic threshold (AT) for gender and age and "Normal Performers" were all other patients. A total of 303 patients with Fontan physiology who underwent exercise testing reached AT and had complete data for BBB. BBB occurred more frequently in Low Performers for VO2 [OR (95% CI): 2.6 (1.4, 4.8)] and Work [OR (95% CI): 2.7 (1.4, 5.1)], suggesting that BBB in the Fontan population is associated with reduced exercise performance. This data adds to the existing clinical evidence of the adverse effects of conduction abnormalities on single ventricle cardiac output and adds support for consideration of cardiac resynchronization and multi-site ventricular pacing in this patient population.

18.
Nat Commun ; 15(1): 3621, 2024 Apr 29.
Article in English | MEDLINE | ID: mdl-38684708

ABSTRACT

Circulating proteins can reveal key pathways to cancer and identify therapeutic targets for cancer prevention. We investigate 2,074 circulating proteins and risk of nine common cancers (bladder, breast, endometrium, head and neck, lung, ovary, pancreas, kidney, and malignant non-melanoma) using cis protein Mendelian randomisation and colocalization. We conduct additional analyses to identify adverse side-effects of altering risk proteins and map cancer risk proteins to drug targets. Here we find 40 proteins associated with common cancers, such as PLAUR and risk of breast cancer [odds ratio per standard deviation increment: 2.27, 1.88-2.74], and with high-mortality cancers, such as CTRB1 and pancreatic cancer [0.79, 0.73-0.85]. We also identify potential adverse effects of protein-altering interventions to reduce cancer risk, such as hypertension. Additionally, we report 18 proteins associated with cancer risk that map to existing drugs and 15 that are not currently under clinical investigation. In sum, we identify protein-cancer links that improve our understanding of cancer aetiology. We also demonstrate that the wider consequence of any protein-altering intervention on well-being and morbidity is required to interpret any utility of proteins as potential future targets for therapeutic prevention.


Subject(s)
Neoplasms , Humans , Neoplasms/genetics , Female , Risk Factors , Mendelian Randomization Analysis , Biomarkers, Tumor/genetics , Biomarkers, Tumor/metabolism , Biomarkers, Tumor/blood , Male , Blood Proteins/metabolism
19.
Support Care Cancer ; 32(5): 298, 2024 Apr 19.
Article in English | MEDLINE | ID: mdl-38639810

ABSTRACT

PURPOSE: Colorectal cancer (CRC) incidence and mortality are increasing among young adults (YAs) aged 18-39. This study compared quality of life (QOL) between YA and older adult CRC survivors in the ColoCare Study. METHODS: Participants were grouped by age (years) as follows: 18-39 (YA), 40-49, 50-64, and 65 + . Functional QOL (physical, social, role, emotional, cognitive) and global QOL were assessed with the EORTC-QLQ-C30 at enrollment, 3, 6, and 12 months. Average scores were compared between groups over time using longitudinal mixed-effect modeling. Proportions with clinically meaningful QOL impairment were calculated using age-relevant thresholds and compared between groups over time using logistic regression with mixed effects. RESULTS: Participants (N = 1590) were n = 81 YAs, n = 196 aged 40-49, n = 627 aged 50-64, and n = 686 aged 65 + . Average physical function was better among YAs than participants aged 50-64 (p = 0.010) and 65 + (p < 0.001), and average social function was worse among YAs than aged 65 + (p = 0.046). Relative to YAs, all age groups were less likely to report clinically meaningful social dysfunction (aged 40-49 OR = 0.13, 95%CI = 0.06-0.29; aged 50-64 OR = 0.10, 95%CI = 0.05-0.21; aged 65 + OR = 0.07, 95%CI = 0.04-0.15) and role dysfunction (aged 40-49 OR = 0.36, 95%CI = 0.18-0.75; aged 50-64 OR = 0.41, 95%CI = 0.22-0.78; aged 65 + OR = 0.32, 95%CI = 0.17-0.61). Participants aged 40-49 were also less likely to report physical dysfunction (OR = 0.42, 95%CI = 0.19-0.93). CONCLUSION: YA CRC survivors reported better physical and worse social function compared to older CRC survivors, and YA CRC survivors were more likely to report clinically meaningful social, role, and physical disfunction. Future work should further investigate QOL using age-relevant benchmarks to inform best practices for CRC survivorship care. TRIAL REGISTRATION: NCT02328677, registered December 2014.


Subject(s)
Cancer Survivors , Colorectal Neoplasms , Aged , Humans , Young Adult , Cancer Survivors/psychology , Colorectal Neoplasms/therapy , Colorectal Neoplasms/psychology , Emotions , Quality of Life/psychology , Survivors/psychology , Adolescent , Adult , Middle Aged
20.
JNCI Cancer Spectr ; 8(2)2024 Feb 29.
Article in English | MEDLINE | ID: mdl-38556480

ABSTRACT

PURPOSE: Cancer survivors commonly report cognitive declines after cancer therapy. Due to the complex etiology of cancer-related cognitive decline (CRCD), predicting who will be at risk of CRCD remains a clinical challenge. We developed a model to predict breast cancer survivors who would experience CRCD after systematic treatment. METHODS: We used the Thinking and Living with Cancer study, a large ongoing multisite prospective study of older breast cancer survivors with complete assessments pre-systemic therapy, 12 months and 24 months after initiation of systemic therapy. Cognition was measured using neuropsychological testing of attention, processing speed, and executive function (APE). CRCD was defined as a 0.25 SD (of observed changes from baseline to 12 months in matched controls) decline or greater in APE score from baseline to 12 months (transient) or persistent as a decline 0.25 SD or greater sustained to 24 months. We used machine learning approaches to predict CRCD using baseline demographics, tumor characteristics and treatment, genotypes, comorbidity, and self-reported physical, psychosocial, and cognitive function. RESULTS: Thirty-two percent of survivors had transient cognitive decline, and 41% of these women experienced persistent decline. Prediction of CRCD was good: yielding an area under the curve of 0.75 and 0.79 for transient and persistent decline, respectively. Variables most informative in predicting CRCD included apolipoprotein E4 positivity, tumor HER2 positivity, obesity, cardiovascular comorbidities, more prescription medications, and higher baseline APE score. CONCLUSIONS: Our proof-of-concept tool demonstrates our prediction models are potentially useful to predict risk of CRCD. Future research is needed to validate this approach for predicting CRCD in routine practice settings.


Subject(s)
Breast Neoplasms , Cancer Survivors , Cognitive Dysfunction , Hominidae , Humans , Female , Animals , Aged , Cancer Survivors/psychology , Breast Neoplasms/complications , Breast Neoplasms/psychology , Prospective Studies , Cognitive Dysfunction/diagnosis , Cognitive Dysfunction/epidemiology , Cognitive Dysfunction/etiology
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