Direct Effect Research Articles

How do management decisions impact butterfly assemblages in smallholding oil palm plantations in Peninsular Malaysia?

Abstract In the world's leading palm oil‐producing countries (Indonesia and Malaysia), smallholders make up about 40 per cent of total oil palm plantation area. Management in smallholdings can be highly variable, ranging from intensive monoculture to polyculture systems, especially in the earlier years of cultivation when open canopies allow a variety of understorey crop types to be grown alongside oil palm. Currently, many plantations in the region are mature and due to be replanted, which is likely to have substantial impacts on the ecosystems within them, but studies investigating the impacts of alternative post‐replanting management strategies in smallholder plantations are lacking. We investigated the impacts of replanting and choice of crop management following replanting (growing oil palm as a monoculture or polyculture) on habitat structure and complexity, and on the abundance, richness and composition of butterfly assemblages in smallholding oil palm plantations in Banting, Selangor, Malaysia. We also assessed the direct effects of habitat structure and complexity on butterfly assemblages. Butterflies are likely to be a valuable indicator group for monitoring the impacts of management practices on biodiversity as butterfly species also show a range of sensitivities to habitat disturbance, with some being vulnerable to change, but others being common in plantations. They are also a functionally important group that pollinate wild plants, are prey for larger species and are common in tropical systems. Across 27 plantations, we recorded 1227 butterflies from 5 families, 46 genera and 56 species. Habitat structure and complexity differed between management decisions (mature monoculture, immature monoculture, immature polyculture), although many environmental parameters overlapped. We found no significant differences in species richness, density and assemblage composition of butterflies between management decisions. However, changes in local environmental conditions, such as an increase in the coverage of understorey vegetation, increased the abundance of butterflies. Synthesis and applications. Our findings suggest that replanting oil palm and choice of mono or polyculture have relatively few effects on butterflies, but management for specific features in plantations could benefit butterfly assemblages.

Toward an Integrated Model of Healthy Food Purchase via the Impact of Online Nutrition Information Seeking

Healthy eating is critical to consumers’ overall health. The purpose of this study was to examine body mass index (BMI), obesity knowledge, and self-efficacy, along with online nutrition information seeking (ONIS), as antecedents to healthy food purchase (HFP) in a moderated mediation model. An online survey was conducted using Amazon Mechanical Turk to recruit 897 participants, with 484 women and 380 men. A moderated mediation analysis was then used to explore the mediating effect of ONIS, and the moderating effects of obesity knowledge and self-efficacy. Results found the impact of ONIS on HFP was significantly generated by obesity knowledge but not by BMI. Both ONIS and self-efficacy yielded individual and interactive effects on HFP, and ONIS did not only generate a direct effect on HFP but also interacted with self-efficacy for HFP. Practically, it was suggested that online health information should be strategically crafted to promote healthy eating behavior, given that consumers in various health conditions were activated to purchase heathier foods via ONIS. Through the ONIS’s mediation of the relationship between obesity knowledge and HFP, consumers with poor obesity knowledge would be cultivated well to further develop their better eating habits.

Paranormal belief, psychopathological symptoms, and well-being: Latent profile analysis and longitudinal assessment of relationships.

Within non-clinical samples the relationship between paranormal belief (PB) and well-being varies as a function of level of psychopathology. Accordingly, believers are best conceptualised as a heterogeneous set of sub-groups. The usefulness of previous findings has been restricted by conceptual methodological limitations. Specifically, overreliance on cross-sectional design, the assumption that believers constitute a homogeneous group, and consideration of direct effects. Acknowledging these limitations, the present study investigated whether profile membership derived from PB and psychopathology (schizotypy and manic-depressive experience) predicted well-being (i.e., stress, somatic complaints, life satisfaction and meaning in life) across time. Concurrently, analysis assessed the mediating effect of theoretically important variables (transliminality, happiness orientation, fearful and skeptical attitude). A sample of 1736 (Mage = 52, range = 18 to 88; 883 females, 845 males, eight non-binary) completed self-report measures indexing study constructs across time points. Latent profile analysis at baseline, identified three sub-groups varying in level of PB and psychopathology at baseline: Profile 1, moderate PB and high psychopathology; Profile 2, moderate PB and psychopathology; and Profile 3, moderate PB and low psychopathology. Path analysis demonstrated that Profile 1 (the highest psychopathology scoring profile) predicted higher negative and lower positive well-being over time in comparison with the other profiles. Moreover, Transliminality and Fearful Attitude positively mediated this relationship, whereas Skeptical Attitude produced negative mediation. These outcomes supported the presence of a sophisticated process underpinning the PB and well-being relationship. Overall, PB in the absence of psychopathology had no significant influence on well-being.

Joint effects of air pollution and neighborhood socioeconomic status on cognitive decline - Mediation by depression, high cholesterol levels, and high blood pressure

Air pollution and neighborhood socioeconomic status (N-SES) are associated with adverse cardiovascular health and neuropsychiatric functioning in older adults. This study examines the degree to which the joint effects of air pollution and N-SES on the cognitive decline are mediated by high cholesterol levels, high blood pressure (HBP), and depression. In the Emory Healthy Aging Study, 14,390 participants aged 50+ years from Metro Atlanta, GA, were assessed for subjective cognitive decline using the cognitive function instrument (CFI). Information on the prior diagnosis of high cholesterol, HBP, and depression was collected through the Health History Questionnaire. Participants' census tracts were assigned 3-year average concentrations of 12 air pollutants and 16 N-SES characteristics. We used the unsupervised clustering algorithm Self-Organizing Maps (SOM) to create 6 exposure clusters based on the joint distribution of air pollution and N-SES in each census tract. Linear regression analysis was used to estimate the effects of the SOM cluster indicator on CFI, adjusting for age, race/ethnicity, education, and neighborhood residential stability. The proportion of the association mediated by high cholesterol levels, HBP, and depression was calculated by comparing the total and direct effects of SOM clusters on CFI. Depression mediated up to 87 % of the association between SOM clusters and CFI. For example, participants living in the high N-SES and high air pollution cluster had CFI scores 0.05 (95 %-CI:0.01,0.09) points higher on average compared to those from the high N-SES and low air pollution cluster; after adjusting for depression, this association was attenuated to 0.01 (95 %-CI:-0.04,0.05). HBP mediated up to 8 % of the association between SOM clusters and CFI and high cholesterol up to 5 %. Air pollution and N-SES associated cognitive decline was partially mediated by depression. Only a small portion (<10 %) of the association was mediated by HBP and high cholesterol.

Disentangling influences of driving forces on intra-annual variability in sediment discharge in karst watersheds

The intra-annual variability in sediment discharge was considerably influenced by the climate variability and vegetation dynamics. Because of the coupled or relationships between climatic and vegetation variables, it is still challenging to decouple the direct and indirect effects of climate variability and vegetation dynamics on hydrological and sediment transport processes. The purpose of this study is to decouple influences of individual driving force on intra-annual distribution of sediment discharge during 2003–2017 using the partial least squares structural equation model (PLS-SEM) method in four typical karst watersheds of Southwest China. The coefficient of variation (Cv), Completely regulation coefficient (Cr), Lorenz asymmetry coefficient and Gini coefficient were used to represent the intra-annual sediment discharge variability. Results showed that the monthly sediment discharge (190 % < Cv < 353 %) exhibited greater variability than its potential affecting factors (18 % < Cv < 101 %). From the PLS-SEM analysis, the water discharge, climate, and vegetation together explain 57 %–75 %, 64 %–79 %, and 53 %–80 % of the total variance in Cv, Cr, and Gini coefficient, respectively. Specifically, water discharge exerts the largest influence on sediment discharge variability (0.65 ≤ direct effect ≤0.97, P < 0.05), while vegetation dynamic mainly indirectly affects sediment discharge variability (−0.88 ≤ indirect effect ≤ −0.01) through influencing water discharge. The climate factors also principally indirectly affect the sediment discharge variability (−0.47 ≤ indirect effect ≤0.19) by affecting water discharge and vegetation. The PLS-SEM can effectively reveal the driving force and influencing mechanism of intra-annual sediment discharge changes, and provide an important reference for regional soil and water resources management in karst watersheds. Future studies can decouple the influences of the extreme climate, unique lithology, discontinuous soil, heterogeneous landscape, and special geomorphology on spatial variability in sediment discharge across different karst watersheds.

The State-of-the-Art Mechanisms and Antitumor Effects of Somatostatin in Colorectal Cancer: A Review.

Somatostatin, a somatotropin release inhibiting factor (SST, SRIF), is a widely distributed multifunctional cyclic peptide and acts through a transmembrane G protein-coupled receptor (SST1-SST5). Over the past decades, research has begun to reveal the molecular mechanisms underlying the anticancer activity of this hormonal peptide. Among gastrointestinal tract (GIT) tumors, direct and indirect antitumor effects of SST have been documented best in gastroenteropancreatic neuroendocrine tumors (GEP-NETs) and less well in non-endocrine cancers, including sporadic colorectal cancer (CRC). In the latter, the signaling pathways involved in the antitumor function of SST are primarily MAPK/ERK/AKT and Wnt/β-catenin. Direct (involving the MAPK pathway) and indirect (VEGF production) antiangiogenic effects of SST in CRC have also been described. The anti-inflammatory role of SST in CRC is emphasized, but detailed molecular mechanisms are still being explored. The role of SST in tumor genome/tumor microenvironment (TME)/host's gut microbiome interactions is only partially known. The results of SST analogues (SSAs)' treatment of sporadic CRC in monotherapy in vivo are not spectacular. The current review aims to present the state-of-the-art mechanisms and antitumor activity of endogenous SST and its synthetic analogues in CRC, with particular emphasis on sporadic CRC.

Direct, indirect and mediation effects of consumer ethnocentrism on the willingness to pay premium price for locally produced honey

The study investigated the factors influencing the preference for locally produced honey in Ghana and the direct and indirect effects of consumer ethnocentrism on the willingness to pay premium price. The study results indicated that consumer ethnocentrism, trust, and purchase from the local or farmers’ market positively influenced the preference for locally produced honey; meanwhile, monthly consumption and packaging negatively influenced the preference for locally produced honey. Evidence from the structural equation model suggested that consumer ethnocentrism had a direct and positive effect on consumers’ willingness to pay for locally produced honey at premium price. Also, monthly consumption negatively mediates the consumer ethnocentrism and readiness to pay for locally produced honey at premium price. Further, education had a direct and negative effect on consumers’ willingness to pay for locally produced honey at premium price, but education through consumer ethnocentrism had no significant effect.

Impact of Saharan dust outbreaks on short‐range weather forecast errors in Europe

AbstractMineral dust, the most abundant atmospheric aerosol by mass, interacts with radiation directly and alters cloud properties indirectly. Many operational numerical weather prediction models account for aerosol direct effects by using climatological mean concentrations and neglect indirect effects. This simplification may lead to shortcomings in model forecasts during outbreaks of Saharan dust towards Europe, when climatological mean dust concentrations deviate strongly from actual concentrations. This study investigates errors in model analyses and short‐range forecasts during such events. We investigate a pronounced dust event in March 2021 using the pre‐operational ICOsahedral Nonhydrostatic weather and climate model with Aerosols and Reactive Trace gases (ICON‐ART) with prognostic calculation of dust and the operational European Centre for Medium‐Range Weather Forecasts (ECMWF) Integrated Forecasting System (IFS) model, which deploys a dust climatology. We compare model analysis and forecast with measurements from satellite and in situ instruments. We find that inclusion of prognostic aerosol and direct radiative effects from dust improves forecasts of surface radiation during clear‐sky conditions. However, dust‐induced cirrus clouds are strongly underestimated, highlighting the importance of representing indirect effects adequately. These findings are corroborated by systematic quantification of forecast errors against satellite measurements. For this we construct an event catalogue with 49 dust days over Central Europe between January 2018 and March 2022. We classify model cells by simulated and observed cloudiness and simulated dustiness in the total atmospheric column. We find significant overestimations of brightness temperature for cases with dust compared with cases without dust. For surface shortwave radiation, we find median overestimations of 6.2% during cloudy conditions with dust optical depth greater than 0.1, however these are not significant compared with cloudy conditions without dust. Our findings show that the pre‐operational ICON‐ART and the operational IFS model still do not reproduce cloudiness adequately during events with Saharan dust over Central Europe. Missing implementations of prognostic dust, particularly of indirect effects on cloud formation, lead to significant underestimations of cloudiness and potentially overestimations of surface radiation.

Direct and Indirect Contributions of Three Aspects of Morphological Knowledge to Second Language Reading Comprehension

Growing attention has been devoted to the contribution of morphological knowledge to reading comprehension. Because of the complex nature of morphological knowledge, more fine-grained approaches are sought on this topic by exploring multiple aspects of morphological knowledge and multiple pathways through which each aspect contributes to reading comprehension. This study measured three aspects of affix knowledge (form, meaning, and use) and vocabulary breadth and examined how each aspect contributes to EFL (English as a foreign language) reading comprehension by modeling direct and indirect effects with vocabulary as a mediator. The participants were 211 Japanese university students. All variables were measured using standardized tests. Direct effects of meaning, use, and vocabulary and indirect effects of meaning and use via vocabulary were significant. However, form displayed no significant effect. The lack of significant effects for form may be due to the design of this study, which did not include word reading (a variable that may mediate form’s effect). In sum, although the form aspect did not show any effect, semantic and syntactic aspects demonstrated direct and indirect contributions. Overall, this study endorsed the criticality of a more fine-grained approach, shedding light on what and how morphological knowledge supports L2 reading comprehension.

Impact of the COVID-19-pandemic and perception of self-efficacy on the mental health of out-of-hospital emergency healthcare professionals by modality of care.

To analyse the influence of the COVID-19 pandemic and the perception of self-efficacy on the health professionals of the Spanish out-of-hospital emergency services. Observational, cross-sectional and descriptive with a survey methodology of 1710 participants from Spain (1 February-30 April, 2021). The mental health of healthcare workers was assesed in terms of stress, anxiety and depression, as well as their self-efficacy. Linear and logistic regression models were fitted to predict these variables. A moderation analysis was conducted to determine the effect of self-efficacy on mental health. The means of the sample for stress, anxiety, depression and self-efficacy were 20.60, 15.74, 13.07 and 70.87, respectively. In the regression models, being a woman was the most significant factor for severe mental health impairment. Female gender was also a relevant factor for self-efficacy. Self-efficacy had a direct effect on the mental health for working in patient care. Healthcare workers showed moderate stress, severe anxiety, mild depression and good self-efficacy. Direct patient care was associated with more stress and severe anxiety. Age, female gender, job changes and job adjustment were associated with levels of stress, anxiety and depression. Self-efficacy is a determining factor of mental health in the direct care modality. The mental health of healthcare workers has been of great importance in the aftermath of the pandemic, but out-of-hospital emergency workers have been neglected in research. The levels of stress, anxiety and depression during the pandemic justify the creation of prevention and early diagnosis programmes, as they are essential in a health disaster. Surprisingly, their high level of perceived self-efficacy directly impact on the mental health of patient helthcare workers, so improving it will reduce the psychological risk. We have followed the STROBE guidelines. It has been partially funded by the Asistencia Sanitanitaria Interprovincial de Seguros - ASISA Foundation (Spain). PATIENT OR PUBLIC CONTRIBUTION: 'No patient or public involvement'.

Assessment of Genetic Variability and Character Associations in Sunflower (Helianthus annuus L.) Yield Related Traits

Aims: To investigate yield and yield related characteristics for variability and association studies in fifty-two powdery mildew differentials of sunflower.&#x0D; Study Design: Augmented block design.&#x0D; Place and Duration of Study: Main agricultural Research station, University of Agricultural Science, Raichur, Karnataka between November 2022 and February 2023.&#x0D; Methodology: Study included 52 powdery mildew differentials of sunflower studied factors such as genetic variability, heritability, and genetic advance in characters such as head diameter, seed filling percent, test weight, number of seeds per head, volume weight, oil content and seed yield. Correlation and path analysis was also done.&#x0D; Results: Findings revealed significant differences among the traits, especially in seed yield per plant, head diameter, seed filling percent, test weight, and number of seeds per head which conclude that there is variability present in the studied character and there is scope for crop improvement. Correlation coefficients showed positive connections between seed yield per plant and traits like head diameter, test weight, seed filling percentage, and number of seeds per head. However, volume weight had a negative correlation. Path coefficient analysis helped us understand the direct and indirect impacts of these traits on seed yield per plant. Head diameter, seed filling percentage, test weight, and number of seeds per head had positive direct effects on seed yield per plant. In contrast, volume weight had a negative direct effect.&#x0D; Conclusion: The study contributes to the understanding of the genetic architecture of sunflower traits related to yield and provides a foundation for developing targeted breeding strategies. These insights can guide sunflower breeding programs in selecting traits for improved yield.

The Role of Entrepreneurship in Changing the Employment Rate in the European Union

AbstractThe aim of this research is to examine the role of entrepreneurship in changing the employment rate in the European Union (EU). With the aim of understanding the relationship between entrepreneurship and employment dynamics, this research investigates the impact of entrepreneurial activities on job creation, job opportunities, and overall employment trends across EU member states. By analyzing a comprehensive dataset encompassing various economic indicators and entrepreneurial metrics, including business startups, self-employment rates, and entrepreneurial ecosystem factors, this study provides insights into the mechanisms through which entrepreneurship influences employment in the EU. The analysis considers both the direct and indirect effects of entrepreneurship on employment, exploring how entrepreneurial ventures contribute to job creation, stimulate economic growth, and shape labor market dynamics. The findings of this study reveal that entrepreneurship plays a crucial role in changing the employment rate in the EU. Entrepreneurial activities, such as new business startups and self-employment, contribute significantly to job creation, particularly in sectors characterized by innovation, technology, and services. Furthermore, entrepreneurship fosters a dynamic and flexible labor market, promoting job opportunities and reducing unemployment rates. The study also highlights the importance of supportive policies, access to financing, and a favorable regulatory environment in facilitating entrepreneurship and its positive impact on employment. Understanding the role of entrepreneurship in changing the employment rate has implications for policymakers, practitioners, and stakeholders involved in fostering economic growth and labor market development in the EU. The findings emphasize the need to encourage and support entrepreneurial initiatives, provide resources and support mechanisms for startups, and create an enabling environment that nurtures entrepreneurship and innovation. By leveraging the potential of entrepreneurship, the EU can stimulate employment growth, enhance competitiveness, and achieve sustainable economic prosperity.

Does tourism experience matter in cultural tourism destinations? Predicting future tourist behavior

Cultural tourism, as a niche market in the service-intensive tourism industry, has distinctive characteristics, experiences, and different individual consequences. The primary objective of this study is to explore the underlying substantial dimension of cultural tourism experiences in predicting tourists’ behaviors to stimulate electronic word-of-mouth (e-WoM) and shaping the cultural destination image. A quantitative approach was conducted with PLS-SEM to analyze data for tourists visiting the culture tourism village at Gorontalo, in Indonesia. The bootstrapping procedure is used to test the mediation effect, with direct and indirect effects analyzed. The results indicate that among the various components of the cultural tourism experience, relaxation and learning about the local culture are particularly significant in generating tourist e-wom behavior. The study also acknowledges the crucial role of e-WoM in cultural tourism as a mediator among relaxation, learn local culture, and destination image. Ultimately, these findings emphasize the importance of cultural tourism in showcasing experiences that provide relaxation and new knowledge originating from destinations. This research contributes to an enhanced understanding of the diverse impact of the cultural tourism experience dimension and its consequences for tourist behavior.

High-mobility group box 1 and its related receptors: potential therapeutic targets for contrast-induced acute kidney injury.

Percutaneous coronary intervention (PCI) is a crucial diagnostic and therapeutic approach for coronary heart disease. Contrast agents' exposure during PCI is associated with a risk of contrast-induced acute kidney injury (CI-AKI). CI-AKI is characterized by a sudden decline in renal function occurring as a result of exposure to intravascular contrast agents, which is associated with an increased risk of poor prognosis. The pathophysiological mechanisms underlying CI-AKI involve renal medullary hypoxia, direct cytotoxic effects, endoplasmic reticulum stress, inflammation, oxidative stress, and apoptosis. To date, there is no effective therapy for CI-AKI. High-mobility group box 1 (HMGB1), as a damage-associated molecular pattern molecule, is released extracellularly by damaged cells or activated immune cells and binds to related receptors, including toll-like receptors and receptor for advanced glycation end product. In renal injury, HMGB1 is expressed in renal tubular epithelial cells, macrophages, endothelial cells, and glomerular cells, involved in the pathogenesis of various kidney diseases by activating its receptors. Therefore, this review provides a theoretical basis for HMGB1 as a therapeutic intervention target for CI-AKI.

Exploring genetic diversity and trait associations with foliar blast disease among parental lines in pearl millet [Pennisetum glaucum (L.) R Br

Thirty-seven pearl millet genotypes were evaluated for morphometric traits and disease incidence and severity during summer and kharif, 2022. Pooled ANOVA revealed significant variation were present in all genotypes across different season. Association studies identified high positive correlations between grain yield and traits such as single earhead weight, single ear head threshed weight, and test weight, with direct and indirect effects on grain yield through key characters. E2 (kharif – 2022) showed favourable conducive weather parameters for disease infection throughout the growing season compared to E1. The higher PCV relative to GCV for disease incidence underscores the environmental influence in disease resistance programs. Negative correlations between disease metrics and yield traits highlight blast disease’s detrimental effect on grain yield. Disease severity indirectly suggests environmental factors may enhance its impact. Disease incidence exhibited a direct negative impact on yield, supported by negative genotypic correlations. The line, PT 6679, exhibit both high yield and highly resistant to blast. Restorer lines (PT 6029, PT 6067, PT 6300, PT 6707, PT 7068) and B lines (ICMB 01666, ICMB 02777) showed promising yield attributes with high to moderate disease resistant for future breeding programs. In D2 analysis, five clusters revealed distinct genetic diversity with Clusters II and V indicating strong hybrid vigor, while Clusters IV (PT 6946, ICMB 06111) and V (ICMB 93111, ICMB 95444) excelled in disease resistance. Clusters I (PT 6029, PT 7068) and II (GMR 58) exhibited superior grain yield, particularly Cluster I, had potential restorer lines for future breeding. Clear differentiation between B and R lines underscored genetic distinctions in trait expression, validating the use of morphological data for assessing genetic diversity.

Acculturation Preferences in the Asturian Educational Context: A Study on the Direct and Interactive Effects of Gender and Stereotypes at School

AbstractAs a consequence of globalisation, a large number of studies have been carried out on the attitudes and preferences of acculturation of immigrants and host societies, with the aim of observing the different changes that occur in this intercultural contact. These studies have been carried out in places with a large migratory flow; however, it was considered convenient to carry out the same type of studies in regions with less migratory flow, which is why this investigation focuses on a place with a lower migratory flow, such as the Principality of Asturias. Thus, the main objective of this work is to observe whether gender contributes to the creation of different attitudes and whether this is moderating the intensity with which stereotypes participate in the formation of the acculturation preferences of native students in compulsory secondary education. The analysis of acculturation attitudes was carried out on the dimensions of “adopting” and “maintaining” separately, in order to study how these dimensions are affected by each of the variables (gender/stereotype) in different domains. The exploratory results obtained through quantitative analysis reveal that stereotypes affect the dimensions differently in each of the domains. It is also found that gender affects both dimensions, and finally, it is claimed that gender can moderate the intensity with which stereotypes are involved in the creation of acculturation attitudes in almost all domains. These results are discussed in comparison with those found in other studies with different social and cultural groups.

Childhood maltreatment is longitudinally associated with cardiometabolic biomarkers through marital quality: Do health locus of control and eating habits matter?

Childhood maltreatment is longitudinally associated with cardiometabolic biomarkers through marital quality: Do health locus of control and eating habits matter?

Mobile phone addiction and academic burnout: the mediating role of technology conflict and the protective role of mindfulness.

With the rapid development of Internet technology, more and more college students are facing the threat of mobile phone addiction. However, the relationship and underlying mechanism between mobile phone addiction and academic burnout haven't been explored in depth. This study proves the mediating role of technology conflict and the moderating role of mindfulness in the relation between mobile phone addiction and academic burnout. 752 college students were recruited to complete the questionnaire of mobile phone addiction, technology conflict, mindfulness and academic burnout. Results showed that mobile phone addiction was significantly and positively associated with academic burnout, and this relationship could be mediated by technology conflict. Besides, the direct effect of mobile phone addiction on academic burnout and the indirect effect of technology conflict in this link were moderated by mindfulness. Both these two effects are stronger for college students with lower level of mindfulness. Our findings enrich our understanding of how and when mobile phone addiction was related to academic burnout. Educational professionals and parents should take timely measure to the academic burnout of college students suffering from mobile phone addiction, particularly for those with lower level of mindfulness.

(134) Early Impact of Androgen Deprivation Therapy on Endothelial Function and Metabolic Parameters in Prostate Cancer Patients: A Prospective Study

Abstract Introduction Androgen deprivation therapy (ADT) is considered one of the mainstays in the treatment of prostate cancer. ADT slows cancer progression, alleviates cancer-related symptoms, and is associated with survival gains. Despite these proven benefits, this treatment is related to several side effects, such as increased cardiovascular risk, changes in body composition and various metabolic changes. Although the well-established association between circulating testosterone level and endothelial integrity, the direct effects of ADT on endothelial function remain controversial. Objective This study aimed to investigate the impact of ADT on endothelial function, through the analysis of vascular parameters of the brachial artery and measurement of serum inflammatory markers. It was also our aim to evaluate the early impact of ADT on body composition and metabolic parameters. Methods We prospectively evaluated men with moderate to high-risk prostate cancer treated with ADT from January to December 2022 at our institution. Smokers and those who quit smoking less than five years ago, decompensated diabetics (glycated hemoglobin &amp;gt; 9%) and those who had already had a cardiovascular event were excluded. High-resolution B-mode ultrasound was used to assess vascular diameter and endothelium-dependent flow-mediated vasodilation (FMD) of the brachial artery. Our metabolic and inflammatory profile included measurement of serum total cholesterol and fractions, triglycerides, fasting glucose, glycated hemoglobin, basal insulin, C-reactive protein and assessment of body fat distribution through bioelectrical impedance. Subjects were evaluated at baseline and 3 months after starting ADT with goserelin acetate 10.80 mg. Results A total of 32 men were included. The mean age was 69 years and the prevalence of diabetes was 31.25%. FMD demonstrated a worsening trend after ADT, which did not reach statistical significance after 3 months (mean 3.39 ± 6.83 vs 1.16 ± 7.65; p = 0.14) (figure 1). Baseline brachial artery diameter also showed a tendency to worsen with ADT compared to baseline (0.44 ± 0.06 vs 0.42 ± 0.06; p = 0.06). With regard to the metabolic profile, ADT significantly increased insulin resistance: fasting glucose (mean 104.10 ± 18.96 vs 110.60 ± 25.29; p = 0.01), fasting insulin levels (mean 13.05 ± 8.76 vs 16.82 ± 11.36; p = 0.003), glycated hemoglobin (mean 5.89% ± 0.46 vs 6.15% ± 0.67; p = 0.008) and homeostatic model assessment insulin resistance (mean 3.47 ± 2.55 vs 5.05 ± 4.50; p = 0.005) increased significantly after 3 months. Triglycerides concentrations (mean 142.30 ± 69.66 vs 165.50 ± 93.04; p = 0.03) were higher after 3 months of ADT. Abdominal circumference (mean 98.66 ± 10.16 vs 99.76 ± 9.39; p = 0.02) and body mass index (mean 27.46 ± 4.06 vs 27.76 ± 3.89; p = 0.02) also increased after ADT. Conclusions Although not statistically significant, the present study demonstrated a trend towards a decrease in brachial artery FMD. We also observed an important and surprisingly early worsening of the metabolic profile with ADT, especially increased insulin resistance and dyslipidemia, which represent well-established risk factors for cardiovascular events. Disclosure No.

Investigating the Effects of Transdiagnostic Processes on Anxiety and Depression Symptoms in Autistic Young People: the Mediating Role of Emotion Dysregulation.

Internalising symptoms are elevated in autism compared to the general population. Few studies have investigated emotional dysregulation (ED) as a potential mediator between specific transdiagnostic processes and anxiety and depression symptoms in autistic youth. In a sample of 94 autistic young people aged 5-18years referred to a specialist clinic for an autism evaluation, we tested the effects of ED as a mediator between cognitive inflexibility (CI), intolerance of uncertainty (IU) and alexithymia with anxiety and depression symptoms, using structural equation modelling. Effect sizes were compared to a non-autistic comparison group (n = 84). CI and alexithymia did not significantly predict depression symptoms in autistic young people, directly nor via ED. Relationships between CI/alexithymia and depression were fully mediated by ED in the non-autistic sample. There was a direct effect of CI on anxiety in the non-autistic group but not in those with a diagnosis. IU predicted depression symptoms in the autism group; and ED mediated this relationship only in those who did not receive a diagnosis. IU directly predicted anxiety in both groups and this relationship did not occur via ED. The finding of a direct pathway from IU to anxiety and depression in autistic youth is consistent with the literature. The finding that CI did not predict anxiety or depression in those with autism is novel, as was the finding that ED mediated relationships between alexithymia and anxiety/depression symptoms in both samples. The findings may have important implications for the delivery of psychological interventions for autistic youth.