Fear of disease progression, self-management efficacy, and family functioning in patients with breast cancer: a cross-sectional relationship study.

Introduction: Fear of disease progression (FoP) has been identified as one of the most prevalent unmet needs among breast cancer patients in recent years. The aim of this study was to examine FoP in patients with breast cancer and explore its associations with demographic and clinical characteristics, self-management efficacy, and family functioning. We also aimed to create a clinically-relevant prediction model based off of these factors (i.e., a "nomogram") to help identify patients' probability of experiencing high FoP. Methods: A cross-sectional survey of breast cancer in patients at the Affiliated Hospital of Jiangnan University was conducted from June 2023 to February 2024. The study included the Demographic and Clinical Characteristics Questionnaire, the Fear of Disease Progression Scale (FoP-Q-SF), the Chinese Self-Management Efficacy Scale for Cancer Patients (C-SUPPH), and the Family Care Index Questionnaire (APGAR). Data analysis included descriptive statistics, independent-samples t-test, one-way ANOVA, Pearson correlation analysis, and multiple regression analysis. A nomogram was constructed based on multiple regression results and the model performance was evaluated. Results: A total of 151 breast cancer patients were enrolled in the study. The mean (standard deviation) FoP score of the patients was 35.87 ± 9.24. The average score of C-SUPPH was 96.97 ± 17.29, and the average score of APGAR was 6.74 ± 2.98. Pearson correlation analysis showed that FoP was negatively correlated with self-management efficacy (r = -0.544, p < 0.01) and family functioning (r = -0.730, p < 0.01). Multiple regression analysis showed that age (B = -4.038), self-management efficacy (B = -0.085) and family functioning (B = -1.972) were significantly related to FoP, and together explained 36% of FoP variation (R 2 = 0.360, F = 20.50, p < 0.001). The nomogram of these variables showed satisfactory prediction performance [the Bootstrap Correction Consistency Index (C-index) = 0.872]. According to previous studies, a C-index of >0.70 indicates that the model is acceptable. Conclusion: We found that greater fear of cancer progression (FoP) was associated with younger age, lower self-management efficacy and poorer family functioning in breast cancer patients. Based on these variables, our exploratory prediction model should be further investigated in order to help identify breast cancer patients who may be at highest risk of experiencing high FoP.

Association between pregnancy loss and depressive symptoms in women: a population-based study.

BACKGROUND: Depression is a common mental disorder with a much higher prevalence in women than in men. Although there has been a gradual increase in research on the association between reproductive health and depression, there is still some inconsistency in the evidence of the relationship between pregnancy loss and depression. This study aimed to investigate the relationship between pregnancy loss and depressive symptoms. METHODS: We analyzed data from the 2007-2020 National Health and Nutrition Examination Survey (NHANES), which included female participants aged 20 to 80 years. Pregnancy loss was determined based on participants' self-reported number of pregnancies and pregnancy outcomes. Depressive symptoms were measured using the Patient Health Questionnaire (PHQ-9, score ≥ 10). Multivariate logistic regression, smoothed curve fitting, and generalized additive modeling were used to examine the association between pregnancy loss and depression. We also performed sensitivity analyses and subgroup analyses to verify the robustness and specificity of the findings. RESULTS: A total of 12,873 female participants were included in our study, of which 1,595 (12.39%) were categorized as depressed. Multivariate logistic regression results indicated that experiencing a pregnancy loss increased the risk of prevalence of depression in women (for 1 loss: OR = 1.31, 95% CI 1.15,1.50; for 2 or more losses: OR = 1.58, 95% CI 1.38, 1.81). When sensitivity analyses were performed, an association between pregnancy loss and depression was found in both multivariate linear regressions with PHQ-9 scores as a continuous variable and multivariate logistic regressions with a threshold of 5 PHQ-9 scores. The association between pregnancy loss and depression remained stable across subgroups. CONCLUSION: Pregnancy loss correlated with elevated PHQ-9 scores and a heightened risk of depression in adult women across the United States. Focusing on the incidence of adverse pregnancy events in the female population may help prevent or early recognize the onset of depression.

Association Between Triglyceride Glucose Index and Infertility in Reproductive-Aged Women: A Cross-Sectional Study.

Purpose: In recent years, female infertility has become a research hotspot in the field of health management, and its cause may be related to insulin resistance (IR). We used a novel and practical IR indicator, the TyG index to explore its association with infertility. Patients and Methods: We calculated the TyG index using data from adult women who participated in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018. Then, we used multivariate logistic regression, smooth curve fitting, and subgroup analysis to examine the association between the TyG index and infertility in women. Results: Logistic regression models showed a positive correlation between the TyG index and infertility, which remained significant even after adjusting for all confounders (OR=1.51,95% CI:1.14-2.00, p=0.005). This association was consistent in all subgroups (age, education level, marital status, BMI, smoking, alcohol consumption, hypertension, diabetes, pelvic inflammatory disease/PID treatment, and menstrual regularity in the past 12 months) (p>0.05 for all interactions). However, the diagnostic power of the TyG index for infertility was limited (AUC=0.56, 95% CI: 0.52-0.61). Conclusion: The TyG index is positively correlated with infertility, but its diagnostic value is limited. Further research is needed on the TyG index as an early predictor of infertility.

Association between visceral adiposity index and infertility in reproductive-aged women in the United States.

Over the years, obesity has become more commonplace and has had a substantial impact on several medical specialties, including reproductive medicine. The potential correlation between the visceral adiposity index (VAI) and infertility has yet to be determined. Women between the ages of 18 and 45 were included in this cross-sectional study, which was conducted as part of the National Health and Nutrition Examination Survey (NHANES) between 2015 and 2020. Three tertiles were used to group VAI levels. Subgroup analysis and weighted binary logistic regression were employed to investigate the independent relationship between VAI and infertility. Smooth curve fitting was used to explore nonlinear relationships. This cross-sectional study followed the criteria of the STROBE guidelines. Of the 1231 participants, 127 were infertile women aged 18-45 years. A higher VAI was associated with a higher prevalence of infertility (OR = 1.22, 95% CI:1.03-1.45), which remained consistent across all subgroups (p > 0.05 for all interactions). We demonstrated a positive nonlinear association between VAI and infertility using a smooth curve fit. A higher visceral adiposity index level is positively correlated with a higher incidence of infertility among women in the United States. Women who are infertile can be identified using the visceral obesity index, and controlling visceral obesity may help lower the chances of becoming infertile.

The prognostic value of preoperative neoindices consisting of lymphocytes, neutrophils and albumin (LANR) in operable breast cancer: a retrospective study.

Background: Preoperative inflammatory factors and nutritional status are strongly associated with the prognosis of a variety of cancers. We explored the relationship between preoperative lymphocytes, neutrophils and albumin (LANR) and progression-free survival in breast cancer patients. Methods: The clinical and follow-up data of 200 breast cancer patients were retrospectively analyzed in this study, and the value of LANR was determined as follows: LANR, lymphocytes × albumin/neutrophils. ROC curves, COX proportional risk regression analysis and subgroup analysis were used to assess the prognostic value of LANR in progression-free survival of breast cancer patients. Results: The median age of the patients was 55.5 years (range 50-62 years). The median follow-up time was 46 months (range 33-55 months). In progression-free survival, the area under the LANR curve was 0.748 and the HR (95% CI) was 0.035 (0.679-0.817). LANR was associated with age (p = 0.02), positive axillary lymph nodes (p < 0.001), TNM stage (p < 0.001) and human epidermal growth factor receptor 2(p = 0.004). The results indicated that preoperative LANR may be a reliable predictor of progression-free survival in patients with operable breast cancer. Conclusion: LANR may be an essential predictor for breast cancer patients and provides a therapeutic basis for clinicians and patients.

Prognostic significance of preoperative lymphocytes, albumin, and neutrophils (LANR) index in resectable pancreatic ductal adenocarcinoma.

PURPOSE: The index composed of preoperative lymphocytes, albumin, and neutrophils (LANR), a new composite score based on inflammatory response and nutritional status, has been reported to be associated with the prognosis of multiple types of cancer, but the role of LANR in the prognosis of resectable pancreatic ductal adenocarcinoma (PDAC) has not yet been elucidated. PATIENTS AND METHODS: The data of 142 patients with PDAC who underwent radical resection in the Affiliated Hospital of Jiangnan University from January 2015 to December 2018 were retrospectively analyzed. Receiver Operating Characteristic (ROC) curves were generated to determine the optimal cut-off values for these parameters, as well as the sensitivity and specificity of LANR in predicting survival. The Kaplan-Meier method was used to draw the survival curves. Log rank test was used for univariate analysis, and Cox proportional hazards regression model was used for multivariate analysis.  RESULTS: The optimal cut-off value of LANR was 18.145, and a low preoperative LANR was significantly correlated with the location of the tumor (p = 0.047). Multivariate analysis showed that tumor differentiation degree (HR:2.357, 95%CI:1.388-4.003,p = 0.002), lymph node metastasis (HR:1.755, 95%CI: 1.115-2.763, p = 0.015), TNM stage (HR:4.686, 95%CI: 2.958-7.425, p < 0.001), preoperative cancer antigen 19 - 9 levels (HR:1.001, 95%CI: 1.000-1.001, p < 0.001) and preoperative LANR (HR:0.221, 95%CI: 0.111-0.441, p < 0.001) were independent risk factors for a poor prognosis in patients undergoing radical resection of PDAC. CONCLUSION: This study found that preoperative LANR can be used to assess the prognosis of radical resection in patients with PDAC; those with low preoperative LANR had a worse outcome.

Relationships between body image, dyadic coping and post-traumatic growth in breast cancer patients: a cross-sectional study.

Background: The diagnosis and treatment of cancer triggers not only a negative psychological response for the patient, but also a positive psychological outcome. Positive dyadic coping, as a form of coping for mental health outcomes, can maintain or reestablish internal stability between the patient and his or her spouse, resulting in positive physical and psychological changes. However, there is a paucity of research on body image, dyadic coping, and post-traumatic growth in breast cancer patients. The purpose of this study was to explore the relationship and pathways between body image, dyadic coping, and post-traumatic growth in breast cancer patients. Methods: A cross-sectional study was conducted from November 2022 to November 2023 at a tertiary care hospital in Wuxi, Jiangsu, China. This study was conducted among 154 breast cancer patients treated at the Affiliated Hospital of Jiangnan University, all of whom completed demographic and clinical information questionnaires, Body image self-rating questionnaire for breast cancer (BISQ-BC), Dyadic Coping Inventory (DCI) and Post Traumatic Growth Inventory (PTGI). A Pearson correlation analysis was used to explore the relationship between body image, dyadic coping, and post-traumatic growth. Structural equation modeling was used to analyze the path relationships among the three and to explore the mediating role of dyadic coping. Results: The level of body image was negatively correlated with post-traumatic growth (r = -0.462, p < 0.01); and the level of body image was negatively correlated with dyadic coping (r = -0.308, p < 0.01). And dyadic coping was positively associated with post-traumatic growth (r = 0.464, p < 0.01). The structural equation modeling results supported the mediation model with the following model fit indices, chi-square to degrees of freedom ratio (χ2/df = 2.05), goodness of fit index (GFI = 0.93), comparative fit index (CFI = 0.99), canonical fit index (NFI = 0.93), incremental fit index (IFI = 0.99), non-canonical fit index (TLI = 0.99) and the root mean square of the difference in approximation error (RMSEA = 0.03). Body image and dyadic coping directly affected post-traumatic growth (ß = -0.33, p < 0.05; ß = 0.43, p < 0.05). And body image indirectly influenced post-traumatic growth through dyadic coping (ß = -0.17, p < 0.05). Conclusion: Interconnections between body image, dyadic coping, and post-traumatic growth in breast cancer patients. A preliminary validation of the mediating role of dyadic coping between body image and post-traumatic growth, body image can have an impact on dyadic coping, which in turn can have an impact on post-traumatic growth. Whereby higher levels of dyadic coping in patients may also be associated with higher levels of post-traumatic growth, whereas body image disturbance may impede levels of post-traumatic growth.

Prognostic Value of CRP-Albumin-Lymphocyte (CALLY) Index in Patients Undergoing Surgery for Breast Cancer.

Purpose: According to the 2023 global cancer data, breast cancer is the most common malignant tumor among women in the world. Its occurrence and development is influenced by inflammation, nutrition, and immune status. Therefore, this study combines C-reactive protein (CRP), albumin, and lymphocyte, which can reflect the above states, to form the CRP-albumin-lymphocyte (CALLY) index, an indicator to evaluate its relationship with overall survival (OS) and disease-free survival (DFS) in breast cancer patients. Patients and Methods: We retrospectively analyzed the clinical and follow-up data of 174 patients with breast cancer. The optimal cutoff for the preoperative CALLY index was identified by considering the area under the receiver operating characteristic curve; subsequently, the discriminatory ability of the cutoff was determined. The effect of the CALLY index on overall survival (OS) and disease-free survival (DFS) was analyzed using the Kaplan-Meier method and the Cox proportional hazards model. The CALLY index was calculated as: (Albumin × Lymphocyte)/(CRP × 104). Results: The cut-off value of the CALLY index was determined at 2.285. With a cut-off value of 2.285, patients were divided into two groups: those with CALLY <2.285 and those with CALLY ≥2.285. CALLY Index ≥ 2.285 was associated with better survival outcomes. Multivariate Cox analysis showed that TNM stage and CALLY index were prognostic factors that affected OS and DFS. Conclusion: The CALLY index is a new prognostic biomarker for breast cancer patients after surgery. This new CALLY index allows for suitable patients with a poor prognosis to receive postoperative adjuvant therapy.

Prognostic significance of index (LANR) composed of preoperative lymphocytes, albumin, and neutrophils in patients with stage IB-IIA cervical cancer.

BACKGROUND: The purpose of this study was to investigate the role of preoperative lymphocytes, albumin, neutrophils, and LANR in the prognosis of patients with stage IB-IIA cervical cancer (CC). METHODS: We made a retrospective analysis of the clinical information and related materials of 202 patients with stage IB-IIA primary cervical cancer who had undergone a radical hysterectomy in the Department of Gynecology at the Affiliated Hospital of Jiangnan University between January 2017 and December 2018. The definition of LANR was as follows: LANR, lymphocyte × albumin / neutrophil. The receiver operating characteristic curve (ROC) was generated to determine the best cut-off values for these parameters, as well as the sensitivity and specificity of LANR in predicting recurrence and survival. The Kaplan-Meier method was employed to draw survival curves in our survival analysis. Univariate analysis, multifactorial analysis, and subgroup analysis were used to evaluate the prognostic significance of LANR in overall and progression-free survival. RESULTS: The median follow-up time of the study was 55 months. In overall survival, the area under the curve for LANR was 0.704 (95% CI: 0.590-0.818, p<0.05). And in progression-free survival, the area under the curve for LANR was 0.745 (95% CI: 0.662-0.828, p<0.05). Univariate and multivariate analyses showed that the value of LANR was associated with both overall survival and progression-free survival (p< 0.05). Kaplan-Meier analysis demonstrated that OS (p< 0.001) and PFS (p< 0.001) in patients with high LANR levels were significantly higher than those with low LANR levels. CONCLUSIONS: Our findings suggested that LANR might serve as a clinically reliable and effective independent prognostic indicator in patients with stage IB-IIA cervical cancer.

Evaluation of virulence of Klebsiella pneumoniae using zebrafish behavior as a biological indicator.

INTRODUCTION: Klebsiella pneumoniae is one of the common pathogenic bacteria that can cause infections in hospitals and communities and can cause respiratory, urinary, and other multi-system infections. In recent years, the emergence of highly virulent and drug-resistant Klebsiella pneumoniae has greatly increased the difficulty of treatment for infection. Clinically, it is very important to accurately judge the virulence of isolated Klebsiella pneumoniae for treatment, but there is no better method to evaluate its virulence. METHODS: In this study, zebrafish were used as a model organism, and the swimming distance was used as a detection index to identify clinically isolated Klebsiella pneumoniae. In this study, we selected two different strains of Klebsiella pneumoniae, i.e., NTUH-K2044 and ATCC BAA-1705, with known high and low virulence, respectively, to infect zebrafish juveniles and evaluated their behavioral ability according to different bacterial concentrations and different developmental times. RESULTS: It was found that highly virulent Klebsiella pneumoniae caused a significant decrease in the behavioral ability of zebrafish larvae, while low-virulence Klebsiella pneumoniae had relatively little effect. CONCLUSIONS: These results indicate that it is entirely feasible to assess the virulence of Klebsiella pneumoniae based on behavioral ability.