Introduction
Resilience has been associated with psychological adaptation to many threatening life events, but previous studies have rarely analysed the integrated relationships among demographic and ...disease characteristics and various health outcomes in Taiwan. This study examined the associations among demographic factors, disease characteristics, resilience, coping styles and adverse health outcomes, including anxiety and depressive symptoms and sleep disorders.
Methods
A descriptive, cross‐sectional study design was used. Data from a convenience sample of 175 patients with breast cancer aged 20 years or older were collected using a self‐reported questionnaire. A structural equation modelling approach was applied to examine the relationships among the variables.
Results
The results showed that greater resilience was related to fewer depressive symptoms, lower anxiety levels and better sleep quality. All three coping styles, including active coping, minimising the situation and avoidance coping, were negatively correlated with depressive symptoms, but only active coping was significantly correlated with sleep quality. Resilience had a direct effect on depressive symptoms, anxiety and sleep disorders. Furthermore, a mediating effect of resilience was observed on the relationship between marital satisfaction and depressive symptoms.
Conclusion
Resilience can strengthen breast cancer‐related adaptation. Additionally, breast cancer survivors who used mainly the active and minimising coping styles tended to experience fewer depressive symptoms.
Liver metastasis has been found to affect outcome in prostate cancer and colorectal cancer, but its role in lung cancer is unclear. The current study aimed to evaluate the impact of de novo liver ...metastasis (DLM) on stage IV non-small cell lung cancer (NSCLC) outcomes and to examine whether tyrosine kinase inhibitors (TKI) reverse poor prognosis in patients with DLM and epidermal growth factor receptor (EGFR)-mutant NSCLC. Among 1392 newly diagnosed NSCLC patients, 490 patients with stage IV disease treated between November 2010 and March 2014 at Kaohsiung Chang Gung Memorial Hospital were included. Patients were divided into two groups according to DLM status. There were 75 patients in the DLM group and 415 patients in the non-DLM group. The DLM group included more patients with bone metastasis, fewer patients with a lymphocyte-to-monocyte ratio (LMR) > 3.1, and fewer patients with pleural metastasis. In the DLM group, Eastern Cooperative Oncology Group performance status 3-4 and LMR ≦3.1 were associated with poor outcome. In patients without DLM, overall survival (OS) was longer in patients with EGFR-mutant NSCLC than in those without (20.2 vs. 7.3 months, p < 0.001). Among DLM patients, OS was similar between the EGFR-mutant and wild-type EGFR tumor subgroups (11.9 vs. 7.7 months, p = 0.155). We found that DLM was a significant poor prognostic factor in the EGFR-mutant patients treated with EGFR-TKIs, whereas DLM did not affect the prognosis of EGFR-wild-type patients.
Cancer is a complex heterogeneous disease to which singular modes of treatment mostly fail to produce a desired therapeutic efficacy. Targeting different cellular pathways using combinational ...therapies has been gaining popularity in cancer treatment, with the added benefit of reducing dosage and side effects.
A gold nanoparticle-mediated drug delivery nanoplatform was developed for co-delivery of doxorubicin and polo-like kinase 1 (PLK1) siRNA. Gold nanoparticles were coated with polyethyleneimine to facilitate assembly of PLK1 on the surface. Doxorubicin was loaded on nanoparticles through a pH-sensitive linker with a thiol group at one terminal end for controlled release.
The therapeutic efficiency of this co-delivery system was evaluated in 2D and 3D cultured systems. The reduced IC
value clearly demonstrated the synergistic effect of combined drug and gene delivery over their individual delivery in a cancer treatment model.
This study may provide an adaptable, facile platform to investigate drug-siRNA combinations for cancer inhibition.
The hemodialysis regimen is an inevitable and mandatory treatment for patients with end-stage renal disease (ESRD). During the dialysis journey, patients may experience maladaptation in terms of ...sleep disturbances, depressive symptoms, and reduced health-related quality of life (HRQOL). Psychosocial resources such as social support may have beneficial influences on health outcomes, but studies have rarely analyzed the integrated relationships among risk factors which include pain, sleep disturbances, duration since diagnosis and various health outcomes in Taiwan. This study aimed to bridge this gap by investigating the relationships among related risk factors, social support, sleep disturbances, depressive symptoms, and HRQOL, which is composed of physical quality of life (PQOL) and mental quality of life (MQOL), in ESRD patients.
A correlational design was used, and 178 patients aged 20 years or older were recruited via convenience sample. The relationships among the risk factors, the mediators, depressive symptoms, PQOL, and MQOL were analyzed using structural equation modeling.
The findings showed that more than 70% of the participants reported poor sleep quality, and 32% reported depressive symptoms. When participants had greater pain and more sleep disorders, they were more likely to be depressed. When participants had more appraisal support; they had better PQOL and fewer depressive symptoms. Overall, the structural equation model explained 31.8% of the variance in self-reported depressive symptoms, 29.4% of the variance in PQOL, and 5.7% of the variance in MQOL. Moreover, appraisal support enhanced PQOL and reduced depressive symptoms by exerting its two mediating effects on sleep disturbances.
Our findings indicate that patients with ESRD who have more social support have better PQOL and MQOL and fewer depressive symptoms than those with less social support.
Nutritional status affects the survival of patients with sepsis. This retrospective study analyzed the impact of body mass index (BMI) and modified nutrition risk in critically ill (mNUTRIC) scores ...on survival of these patients. Data of 1291 patients with sepsis admitted to the intensive care unit (ICU) were extracted. The outcomes were mortality, duration of stay, ICU stay, and survival curve for 90-day mortality. Logistic regression analysis was performed to examine the risk factors for mortality. Cytokine and biomarker levels were analyzed in 165 patients. The 90-day survival of underweight patients with low mNUTRIC scores was significantly better than that of normal-weight patients with low mNUTRIC scores (70.8% vs. 58.3%, respectively; p = 0.048). Regression model analysis revealed that underweight patients with low mNUTRIC scores had a lower risk of mortality (odds ratio = 0.557; p = 0.082). Moreover, normal-weight patients with low mNUTRIC scores had the lowest human leukocyte antigen DR (HLA-DR) level on days 1 (underweight vs. normal weight vs. overweight: 94.3 vs. 82.1 vs. 94.3, respectively; p = 0.007) and 3 (91.8 vs. 91.0 vs. 93.2, respectively; p = 0.047). Thus, being underweight may not always be harmful if patients have optimal clinical nutritional status. Additionally, HLA-DR levels were the lowest in patients with low survival.
Abstract
Coccidioidomycosis is a human fungal disease cause by inhalation of aerosol spores produced by Coccidioides posadasii or Coccidioides immitis. This disease is a common cause of ...community-acquired pneumonia in the endemic areas of the Southwestern United States. It also can present as a life-threatening disease as the fungal cells disseminate to skin, bone, and central nervous system. The outcome of coccidioidomycosis is largely determined by the nature of host immune response to the infection. Escalation of symptomatic infections and increased cost of long-term antifungal treatment warrant a concerted effort to better understand the innate and adaptive immune responses and the genetics associated with coccidioidomycosis susceptibility. This knowledge can be harnessed for development of a human vaccine against Coccidioides and advance clinic management of this disease. This review discusses recently reported studies on innate and adaptive immunity to Coccidioides infection, Mendelian susceptibility to disseminated disease and progress toward a human vaccine against this formidable disease.
Immune dysfunction is seen both in sepsis patients and in those with malnutrition. This study aimed to determine whether insufficient nutrition and immune dysfunction have a synergistic effect on ...mortality in critically ill septic patients. We conducted a prospective observational study from adult sepsis patients admitted to intensive care units (ICUs) between August 2013 and June 2016. Baseline characteristics including age, gender, body mass index, NUTRIC, Acute Physiology and Chronic Health Evaluation (APACHE) II and Sequential Organ Failure Assessment (SOFA) scores were recorded. Immune dysfunction, defined by human leukocyte antigen DR (HLA-DR) expression, was tested at days 1, 3, and 7 of ICU admission. The study included 151 patients with sepsis who were admitted to the ICU. The 28-day survivors had higher day 7 caloric intakes (89% vs 73%,
= 0.042) and higher day 1-HLA-DR expression (88.4 vs. 79.1,
= 0.045). The cut-off points of day 7 caloric intake and day 1-HLA-DR determined by operating characteristic curves were 65.1% and 87.2%, respectively. Immune dysfunction was defined as patients with day 1-HLA-DR < 87.2%. Insufficient nutrition had no influence on survival outcomes in patients with immune dysfunction. However, patients with insufficient nutrition had poor prognosis when they were immune competent. Insufficient nutrition and immune dysfunction did not have a synergistic effect on mortality in critically ill septic patients.
The Coronavirus Disease 2019 (COVID-19) pandemic provided an unprecedented natural experiment, that allowed us to investigate the impacts of different restrictive measures on personal exposure to ...specific volatile organic compounds (VOCs) and aldehydes and resulting health risks in the city. Ambient concentrations of the criteria air pollutants were also evaluated. Passive sampling for VOCs and aldehydes was conducted for graduate students and ambient air in Taipei, Taiwan, during the Level 3 warning (strict control measures) and Level 2 alert (loosened control measures) of the COVID-19 pandemic in 2021–2022. Information on the daily activities of participants and on-road vehicle counts nearby the stationary sampling site during the sampling campaigns were recorded. Generalized estimating equations (GEE) with adjusted meteorological and seasonal variables were used to estimate the effects of control measures on average personal exposures to the selected air pollutants. Our results showed that ambient CO and NO2 concentrations in relation to on-road transportation emissions were significantly reduced, which led to an increase in ambient O3 concentrations. Exposure to specific VOCs (benzene, methyl tert-butyl ether (MTBE), xylene, ethylbenzene, and 1,3-butadiene) associated with automobile emissions were remarkably decreased by ~40–80 % during the Level 3 warning, resulting in 42 % and 50 % reductions of total incremental lifetime cancer risk (ILCR) and hazard index (HI), respectively, compared with the Level 2 alert. In contrast, the exposure concentration and calculated health risks in the selected population for formaldehyde increased by ~25 % on average during the Level 3 warning. Our study improves knowledge of the influence of a series of anti-COVID-19 measures on personal exposure to specific VOCs and aldehydes and its mitigations.
Display omitted
•Benzene and 1,3-butadiene exposure decreased during stricter control measures.•Exposure to formaldehyde was increased due to stricter restriction measures.•The abatement of transportation can reduce personal exposure to specific VOCs.•A significant reduction (42 %) in cancer risks for VOC exposure was observed.•Traffic flow reductions confirm the decrease in traffic-related VOCs.
Body mass index (BMI) influences the prognosis of patients with non-small cell lung cancer (NSCLC), including both early-stage and late-stage NSCLC patients that are undergoing chemotherapies. ...However, earlier research on the relationship between BMI and survival in patients taking epidermal growth factor receptor (EGFR)-tyrosine kinase inhibitors (TKIs) yielded contradictory results. These publications either had a limited number of patients or were getting TKIs in various lines of therapy, which might explain why the outcomes were contradictory. As a result, we undertook retrospective study to examine the effect of BMI on survival outcomes in patients with advanced EGFR mutant NSCLC receiving first-line EGFR-TKIs. We also compared the findings to those with wild-type EGFR. Between November 2010 and March 2014, 513 patients with advanced NSCLC were enrolled in the study. According to the adjusted BMI cut-off point for Asia, 35 out of 513 (6.8%) patients were underweight (BMI < 18.5 kg/m
), whereas 197 (38.4%) were overweight (BMI > 24 kg/m
). Overweight patients with wild-type EGFR exhibited longer progression-free survival (4.6 vs. 2.1 months,
= 0.003) and overall survival (OS) (8.9 vs. 4.3 months,
= 0.003) than underweight patients. Overweight patients with EGFR mutations had a longer OS than normal-weight patients (23.0 vs. 20.2 months,
= 0.025). Bodyweight reduction was related to a shorter OS in both the mutant EGFR patients (17.1 vs. 30.5 months,
< 0.001) and the wild-type EGFR patients (7.8 vs. 18.7 months,
< 0.001). In conclusion, advanced stages NSCLC patients with a lower BMI and early weight loss had a worse outcome that was independent of EGFR mutation status.
Abstract The fabricated metal product industries were identified as producers of variable and heterogeneous pollution. Workers in these manufacturing facilities are exposed to multiple pollutants ...present at variable concentrations. Specific known adverse health effects include bladder cancer associated with metalworking fluid exposure and lung cancer associated with electroplating processes. To reduce the incidence of these adverse effects, the main challenge is to identify the most hazardous pollutants within this complex exposure environment and evaluate the corresponding health potentials. In this study, exposure indices were formulated to assess multiple metal exposures with the ultimate goal of providing relevant information for exposure reduction and control measures. Fifteen plants, including metal mold manufacturing, metal casting, and surface treatment plants, were investigated in terms of total concentration, summation of corresponding ratio to threshold limit value (STLV r ), hazard index (HI), and incremental cancer risk. The results revealed that emissions of aluminum, iron, and manganese were primarily found in the metal mold manufacturing/casting plants, while emissions of chromium, nickel, and zinc were found in surface treatment plants. STLV r and HI were more useful than the total concentration for identifying hazardous metals, which were chromium and nickel, and could specify the facilities that were in need of control measures. As for cancer risk, the metal mold manufacturing/casting plants had lower risk than the surface treatment plants, and the contributing metals for these two plant types were cobalt and chromium, respectively. This study established a useful procedure to evaluate health hazards and cancer risk. The resulting information is useful for prioritizing mitigation control of multiple metal exposures.
PDF
