Disease-related Characteristics Research Articles

Illness behavior and its predictors in young and middle-aged colorectal cancer patients: A latent profile analysis.

To describe the characteristics of sick role adaptation and understand the differences in young and middle-aged colorectal cancer (CRC) patients. 225 colorectal cancer patients aged 18-59 admitting to a specialized oncology hospital in Guangzhou, China were involved from January to April 2022. Socio-demographic characteristics, disease-related characteristics, scores of Illness Behavior Questionnaire, Hospital Anxiety and Depression Scale, the Brief Illness Perception Questionnaire, Mishel Uncertainty in Illness Scale and Medical Coping Modes Questionnaire were applied to collect quantitative data. Latent profile analysis (LPA) of illness behavior, analysis of variance (ANOVA) and multiple logistic regression were performed. Three latent classes of illness behavior were identified: low maladaptive illness behavior group, moderate maladaptive illness behavior group, and high maladaptive illness behavior group. Univariate analysis revealed statistically significant differences among the three latent classes with respect to education level, anxiety and depression, illness perception, uncertainty in illness and coping modes. Multiple logistic regression analysis revealed that marital status, family history of cancer, education level, family monthly income, anxiety and depression, illness perception, uncertainty in illness and coping modes were predictors of maladaptive illness behaviors among young and middle-aged CRC patients. The results of the study raise a concern of maladaptive illness behaviors in young and middle-aged colorectal cancer patients, highlighting the need for age-appropriate psychosocial care approaches to promote adjustment of the illness behaviors followed by the diagnosis and treatment of CRC.

Self-Management Behaviours in Rheumatoid Arthritis Patients: What Role Do Health Beliefs Play?

Self-management is the intrinsically controlled ability of an active, responsible, informed and autonomous individual to live with the medical, role and emotional consequences of his chronic conditions in partnership with his social network and the healthcare providers. This study evaluated the self-management behaviours of patients with rheumatoid arthritis and assess the association between health beliefs and self-management behaviours. This cross-sectional study investigated 269 rheumatoid arthritis patients' self-management behaviours using the Self-Care Behaviours Scale with a score of 0-4 for each item and a total score of 0-100 points, and health beliefs using the Arthritis Health Belief Inventory with a score of 1-5 for each item and a total score of 0-165 points. Structural equation modelling with maximum likelihood method was used to explore the mediating effect of health beliefs. The patients' mean score for self-management behaviours was at the intermediate level (2.49 ± 0.60). Sex, marital status, per capita monthly income, payment of medical expenses, social status, disease staging, duration of morning stiffness, joint pain score, treatment, receiving health education, perceived severity, perceived benefits, cue to action and health motivation were significant predictors of the average score of self-management behaviour of the rheumatoid arthritis patients. Perceived severity, perceived benefits, cues to action and health motivation directly affected self-management behaviours; perceived severity influenced self-management behaviours through the mediating effect of cues to action; and health motivation affected self-management behaviours through the chain mediating effect of perceived benefits and cues to action. Self-management behaviour of rheumatoid arthritis patients was at a moderate level, and health beliefs can effectively explain the differences in self-management behaviour scores. Health providers should pay attention to patients with different sociodemographic characteristics and disease-related characteristics, evaluate their health belief level, and develop targeted intervention measures to further improve patients' self-management behaviour level and improve their disease prognosis.

Brown adipose tissue is associated with reduced weight loss and risk of cancer cachexia: A retrospective cohort study.

Brown adipose tissue (BAT) has been mainly investigated as a potential target against cardiometabolic disease, but it has also been linked to cancer-related outcomes. Although preclinical data support that BAT and the thermogenic adipocytes in white adipose tissue may play an adverse role in the pathogenesis of cancer cachexia, results from studies in patients have reported inconsistent results. The purpose of this study was to examine the interrelationship between presence of detectable BAT, changes in body weight, and cachexia in patients with cancer. We hypothesized that evidence of BAT at cancer diagnosis would be associated with greater weight loss and risk of cancer cachexia up to a year after cancer diagnosis. We conducted a retrospective cohort study in treatment-naïve patients with detectable BAT (BAT+, n=57) and without evidence of BAT (BAT-, n=73) on 2-deoxy-2-[18F]fluoro-d-glucose positron emission tomography-computed tomography (18F-FDG-PET-CT) imaging performed for cancer staging (2004-2020). Patients' clinical, demographic, and anthropometric characteristics were extracted from their electronic medical record for up to a year after diagnosis. The two groups were a priori matched for demographic, anthropometric, and disease-related characteristics at diagnosis, as well as for season and outdoor temperature on the day of the PET-CT scan. Cancer cachexia was defined as weight loss greater than 5% or 2% if body mass index was lower than 20kg/m2. Poisson regression models were fitted to estimate the relative risk (RR) for developing cancer cachexia over the 1-year follow-up among BAT+compared to BAT- patients. The BAT+group experienced a lower magnitude of weight loss compared with the BAT- group during the 1-year follow-up (p=0.014 for interaction between BAT status and time). The risk for cancer cachexia was 44% lower in the BAT+than the BAT- group, adjusted for age, sex, outdoor temperature on the day of the 18F-FDG-PET-CT imaging, cancer site and stage (RR: 0.56, 95% CI: 0.32 to 0.97). Contrary to our original hypothesis, evidence of BAT assessed by 18F-FDG-PET-CT imaging at cancer diagnosis was associated with greater body weight maintenance and lower risk for developing cancer cachexia up to one year after diagnosis. Larger, prospective studies and mechanistic experiments are needed to expand and identify the causal factors of our observations.

Exploring factors influencing body acceptance in women with breast cancer: A cross-sectional study.

Body acceptance in women with breast cancer is a crucial factor related to their physical, psychological health, and quality of life. However, research on the factors influencing body acceptance in this population is lacking. This study aims to identify these factors to provide insights for developing tailored interventions. We conducted a cross-sectional study with 258 participants via an online survey in September 2023. Variables measured included general and disease-related characteristics, self-esteem, resilience, social support, objectified body consciousness, and body acceptance. We analyzed the data using descriptive statistics, frequency analysis, independent t-test, one-way ANOVA, Scheffé's test, Pearson's correlation coefficient, and hierarchical regression analysis. Among participants' characteristics, we identified age, religion, menstruation status, elapsed period after diagnosis, cancer stage at diagnosis, and current treatment as factors influencing body acceptance. Additionally, higher resilience (β=0.35, p<.001), increased social support (β=0.13, p=.037), and lower objectified body consciousness (β=-0.31, p<.001) positively influenced body acceptance. Collectively, these variables accounted for 78.9% of variance in body acceptance. This study offers valuable insights into the factors affecting body acceptance in women with breast cancer. The findings highlight the need for tailored interventions that enhance resilience, foster social support, and address objectified body consciousness. Future research should validate these findings across diverse populations and refine personalized care strategies in clinical practice.

The influence of genotype on the natural history of types 1 - 3 spinal muscular atrophy.

The severity of spinal muscular atrophy (SMA) is inversely correlated with the number of survival of motor neuron 2 (SMN2) copies an individual has. This observational, retrospective analysis of natural history data included untreated individuals with a genetic diagnosis of types 1-3 SMA and stratified disease-related characteristics by SMN2 copy number. The outcomes investigated were time to: death, permanent ventilation, respiratory support, feeding support, scoliosis surgery, and achievement and loss of motor milestones. Of 134 individuals; 33 had two SMN2 copies and 101 had 3 or more copies. Survival was linked to increasing SMN2 copy number: mean age at death for individuals with two SMN2 copies was 8 months (standard deviation [SD]: 4 months) and 10 years (SD: 5 months) for individuals with three copies, and no deaths were reported in individuals with ≥4 SMN2 copies. Increasing SMN2 copy number was linked to a longer time to permanent ventilation, respiratory support, feeding support, and scoliosis, as well as loss of motor milestones. SMA disease-related endpoints showed distinct patterns between groups with differing SMN2 copy numbers. Prediction and assessment of disease progression may be stratified by SMN2 copy number, which will be important for evaluating the impact of treatment.

BDNF levels in serum and CSF are associated with clinicoradiological characteristics of aggressive disease in MS patients

BackgroundBDNF has increasingly gained attention as a key molecule controlling remyelination with a prominent role in neuroplasticity and neuroprotection. Still, it remains unclear how BDNF relates to clinicoradiological characteristics particularly at the early stage of the disease where precise prognosis for the further MS course is crucial.MethodsBDNF, NfL and GFAP concentrations in serum and CSF were assessed in 106 treatment naïve patients with MS (pwMS) as well as 73 patients with other inflammatory/non-inflammatory neurological or somatoform disorders using a single molecule array HD-1 analyser. PwMS were evaluated for highly active profiles by applying the aggressive disease course criteria proposed by ECTRIMS. Serum/CSF values were logarithmically transformed and compared across groups using one-way ANOVA, while correlations were calculated using Pearson’s correlations. ROC analysis and AUC comparisons for diagnostic performance of the three biomarkers were computed in an explorative analysis.ResultsSerum BDNF (sBDNF) concentrations were higher in treatment naïve pwMS with disease onset after the age of 40 years (p = 0.029), in pwMS with ≥2 gadolinium-enhancing lesions (p = 0.009) and with motor, cerebellar, cognitive or sphincter symptoms at onset (p = 0.036). BDNF correlated positively with NfL (r = 0.198, p = 0.014) and GFAP (r = 0.253, p = 0.002) in serum, but not in CSF. Neurological patients with an acute inflammatory relapse showed significantly higher sBDNF levels (p = 0.03) compared to somatoform controls, while patients without acute relapse did not differ from somatoform controls (p = 0.4). Better diagnostic performance was found for sBDNF than sNfL and sGFAP in differentiating between patients with vs. without 2 or more gadolinium-enhancing lesions (p < 0.05) and for sBDNF as compared to sNfL for separating patients with disease onset after vs. before age of 40 years.ConclusionIn pwMS, BDNF serum levels differ depending on disease-related characteristics, suggesting that not only inflammatory activity but also remyelination capacities may vary with disease severity. BDNF is increased when other biomarkers of neuroaxonal damage and neurodegeneration, such as NfL and GFAP, are elevated, possibly as a compensatory mechanism, and reflect possibly further pathophysiological aspects in MS beyond NfL and GFAP, probably including an apoptotic role for BDNF in neuroinflammation.

Longitudinal Treatment Patterns of Chorea in North American Patients with Huntington's Disease: Data from Enroll-HD.

Chorea is the primary manifestation of Huntington's disease. Different clinicians pursue varied approaches to chorea management, and real-world evidence describing them is needed. The objective of this study was to assess the presence and severity of chorea, chorea pharmacotherapy, and treatment practice, and patterns in a large natural-history cohort with Huntington's disease. The Enroll-HD research platform Periodic Dataset 5.0 was used to select subjects. Outcomes included demographics, disease-related baseline characteristics (Primary Analysis Set), and treatment patterns (Treatment Analysis Set). A total of 2590 manifest participants comprised the Primary Analysis Set with 1040 in the Treatment Analysis Set; 96.8% of participants had chorea. Mean Unified Huntington's Disease Rating Scale scores for Total Maximal Chorea, Total Motor Score, and Total Functional Capacity were 9.6, 39.5, and 7.8, respectively. During the observation period from June 2012 to October 2020, 906 (36.1%) participants received treatment for chorea. Among these, the most common first-line therapies were monotherapy VMAT2 inhibitors (49.9%) and antipsychotics (27.7%), while 7.8% of participants discontinued first-line therapy. Of those receiving VMAT2 inhibitors or antipsychotics as first line, 92% and 84%, respectively, remained on VMAT2 inhibitors or antipsychotics alone or in combination for the duration of the study. The most common second-line treatment was combination therapy. Only 36.1% of participants with chorea were taking a medication indicated for chorea, and, while 49.9% of treated participants received VMAT2 inhibitors first-line, approximately half were prescribed off-label alternatives. It is unclear why patients with indications for treatment were untreated or why off-label alternatives were prescribed. Future research should elaborate on these observations.

Felt stigma as a determinant of health-related quality of life among community-dwelling stroke survivors in China: A cross-sectional study.

To assess the role of felt stigma versus enacted stigma in the health-related quality of life of community--dwelling stroke survivors in China. A sample of 189 community--dwelling stroke survivors were investigated with the Stigma Scale for Chronic Illness (SSCI), 12-item Short Form-12 Health Survey (SF-12), modified Barthel index (MBI), Zung Self-Rating Depression Scale (ZSDS), and demographic and disease-related characteristics. Hierarchical multiple regression analysis was used to estimate the influence of felt stigma and enacted stigma on quality of life after controlling for depression, activities of daily living, and patient characteristics. In total, 189S survivors were included in the study. Overall stigma, felt stigma, and enacted stigma were moderately and strongly positively and significantly correlated with quality of life, depression, and activity in daily living (P<0.05). Felt stigma significantly explained 2.2% (P<0.01) of the variance in the physical component summary (PCS). Felt stigma significantly explained 8.6% (P<0.01) of the variance in the mental component summary (MCS). However, enacted stigma had no effect on PCS or MCS. Felt stigma significantly and independently contributed to the PCS and MCS quality of life of community-dwelling stroke survivors after adjustment for depression, activity of daily living and patient characteristics.

Predictors of Mortality in Venoarterial Extracorporeal Membrane Oxygenation Regardless of Early Left Ventricular Unloading: A National Experience.

The use of an intra-aortic balloon pump (IABP) has been suggested to unload the left ventricle while on venoarterial extracorporeal membrane oxygenation (VA-ECMO) for cardiogenic shock (CS), leading to possibly improved in-hospital mortality. However, the predictors of mortality on dual mechanical circulatory support have not yet been evaluated, especially in real-world clinical settings. Therefore, a case-control study was conducted to determine the rate of all-cause mortality associated with VA-ECMO use regardless of left ventricular (LV) unloading, and with early LV unloading in the setting of CS, and to identify the predictors of mortality associated with VA-ECMO, with concurrent early LV unloading. Retrospective observational case-control study. National tertiary cardiology center. All patients with CS requiring VA-ECMO cannulation during the index admission between January 06, 2016, and January 0, 2022. VA-ECMO with or without IABP MEASUREMENTS AND MAIN RESULTS: Patient- and disease-related characteristics associated with in-hospital 30-day mortality following VA-ECMO with and without IABP support were assessed using multivariate logistic regression. Results are presented as odds ratio (OR), and a p-value < 0.05 indicates statistical significance. A total of 110 patients were included. Most were male (90%) with a mean age of 53 ± 11 years. Around 67% were Asian. The majority of patients were admitted with ST-elevation myocardial infarction (87%), with 26% presenting with left main disease. In-hospital 30-day mortality occurred in 42.7% of those who received VA-ECMO support regardless of IABP use, while it was 46.9% among those receiving early LV unloading with IABP. Significant positive predictors of mortality with VA-ECMO regardless of IABP in CS were cardiopulmonary resuscitation (CPR) >20 minutes (adjusted OR 14.74, 95% confidence interval 2.02-107.41, p-value = 0.008), older age (ie, >55 years) and left main disease of more than 50% stenosis were associated with a fourfold increase in the odds of mortality while on VA-ECMO. Conversely, CPR >20 minutes (adjusted OR 12.45, 95% confidence interval 1.79-86.36, p-value = 0.011) was the only significant positive predictor of mortality with VA-ECMO and IABP. The mortality rate in CS requiring VA-ECMO, regardless of IABP use, remains high. However, only one predictor (ie, prolonged CPR) was found to increase the likelihood of 30-day mortality with early LV unloading, suggesting that concomitant IABP use might minimize the effect of mortality predictors.

Characterization of Inflammatory Bowel Disease in the Elderly According to Age of Onset.

Background/Objectives: Elderly populations are under-represented in inflammatory bowel disease (IBD) clinical trials, with limited data on phenotype, treatment patterns, outcomes, and comorbidities. The main objective of this study was to evaluate, in an elderly cohort with IBD, demographic and disease characteristics, comorbidity, polypharmacy, and treatment patterns according to the development of IBD at or before old age. Secondarily, the same analysis was performed based on the type of IBD: ulcerative colitis (UC) or Crohn's disease (CD). Materials and Methods: Observational, single-center, retrospective study including patients diagnosed with IBD and aged 65 years or older seen at the IBD office of the Regional University Hospital of Malaga between September and November 2022. Data were recorded on demographic, disease-related, and IBD treatment-related variables, comorbidities, and polypharmacy. A descriptive and analytical study was undertaken according to the age of IBD onset and type of IBD. Results: Of the patients included, 50.8% were male, 55.1% had CD, and 44.9% UC. IBD onset was before age 65 years in 69.5% and ≥65 years in 30.5%. Elderly with IBD who debuted <65 presented longer disease duration (19.67 ± 9.82 years) and required more IBD-related surgeries (37.8%); elderly with IBD who debuted ≥65 were older (77.69 ± 6.26 years), with no differences in the other variables. According to the type of IBD, elderly UC patients were older (74.55 ± 6.9 years), used more aminosalicylates (77.4%), and had higher rates of polypharmacy (90.6%). Elderly patients with CD had higher IBD activity (moderate/severe in 72.3%), used more biologic drugs (58.5%), and required more IBD-related surgeries (44.6%). Conclusions: Elderly patients who develop IBD before or after the age of 65 years are overall very similar in baseline and disease-related characteristics. Elderly with CD have higher IBD activity and require more biologic drugs and IBD-related surgeries. Elderly with UC are older and have higher rates of polypharmacy and aminosalicylate use.

Integrating carotid doppler, grey scale ultrasound, and aortic oscillometry to evaluate macroangiopathy in myositides: the MYOCARD cohort.

To evaluate the combination of novel colour Doppler ultrasound (CDUS), greyscale ultrasound (GSUS), and oscillometric indices of macroangiopathy in patients with idiopathic inflammatory myopathies (IIM). Second, to explore the associations between these imaging markers and both patient-related and disease-related characteristics, as well as traditional cardiovascular (CV) risk factors. We conducted CDUS to evaluate arterial compliance markers, specifically the resistance (RI) and pulsatility (PI) indices, both in the common (CCA) and internal carotid arteries (ICA) of patients with IIM and healthy controls. Additionally, we performed GSUS examinations to measure carotid intima-media thickness (cIMT), identify plaques, and quantify cumulative carotid calcification surface. Oscillometric assessments determined aortic stiffness using carotid-femoral pulse wave velocity (cfPWV). We recruited 82 IIM patients and 88 healthy controls. Patients showed significantly higher cIMT (padj=0.014), CCA-RI (padj=0.005), CCA-PI (padj=0.002), ICA-RI (padj=0.003), and ICA-PI (padj=0.024), compared with controls. RI and PI of CCA and ICA were higher in patients with lower lung function vital capacity, respectively (all; p< 0.05). cfPWV correlated positively with traditional CV-risk factors including age (rho = 0.546, p< 0.001), mean arterial pressure (rho = 0.331, p= 0.003), diabetes (p= 0.007), and hyperlipidemia (p= 0.032), and associated negatively with lung CO-diffusion (rho=-0.329, p= 0.031). In one of the largest CV surrogate marker studies in IIM, patients exhibited increased carotid pulsatility, resistance, and atherosclerosis compared with controls. Lower lung function parameters predicted aortic stiffness and Doppler indices, suggesting a possible link between lung involvement and increased CV risk. Angiopathy markers may reveal significant vascular abnormalities in IIM patients, enhancing CV screening and risk classification.

Beneficial Impact of Follow-Up 24-Hour Urine Testing on Adherence to Pharmacological Therapy for Kidney Stone Prevention

Purpose: Preventive pharmacological therapy (PPT) is recommended for certain patients with urinary stone disease to reduce their recurrence risk, but they frequently do not adhere. With causal inference methods, we evaluated whether follow-up urine testing could be used to improve PPT adherence. Materials and Methods: Using claims data from Optum’s deidentified Clinformatics Data Mart database (2008-2019), we identified patients with urinary stone disease who were prescribed PPT (thiazide diuretic, alkali therapy, or allopurinol) after baseline 24-hour urine testing and assessed their adherence with the proportion of days covered method. After distinguishing between patients who did and did not receive follow-up urine testing, we examined the association between follow-up testing and PPT adherence with logistic regression. We then emulated a target trial using propensity score matching, stratification, and doubly robust estimators to estimate the equivalent causal effect. Results: Among 4166 patients, 496 (11.9%) completed both baseline and follow-up testing. Follow-up testing was associated with a 9.0% increase in adherence odds after adjusting for sociodemographic, behavioral, and disease-related and treatment-related patient characteristics. Furthermore, we estimated a 7.1% increase in proportion of days covered caused by follow-up testing using causal inference methods. Subgroup analyses indicated the most significant effects are among women, those with low baseline medication adherence, and those not at high risk of stone formation. Conclusions: These data suggest that follow-up urine testing after starting PPT may have a beneficial effect on long-term medication adherence.

A multicenter study on the sex difference of dysfunctions among rehabilitation outpatients in China

Dysfunction is a common clinical symptom among rehabilitation patients; however, whether there are sex differences in dysfunctions remains unclear. Therefore, this study aimed to explore this issue by examining a large sample of the population with dysfunctional problems. A multi-stage sampling scheme was used to select the rehabilitation outpatients as study participants. A total of 3415 participants from 21 medical institutions in seven cities in China were included in the final analysis. The measurement included general characteristics (age, sex, educational level, marital status, and household income) and disease-related characteristics (dysfunctions, self-care ability, vital signs, disease status, and disease course). The logistic regression was used to analyse the sex difference in dysfunctions among rehabilitation outpatients. Among 3415 rehabilitation outpatients, the mean age of participants was 45.3 years (SD:24.9), and more than half (54.0%) were male. The male patients were more likely to have cognitive impairment (OR = 1.74; 95% CI = 1.42, 2.13), speech disorders (OR = 2.00; 95% CI = 1.62, 2.48), dysphagia (OR = 1.55; 95% CI = 1.12, 2.16), and multiple dysfunctions (OR = 2.00; 95% CI = 1.57, 2.54) than female. Female patients were more likely to have motor dysfunctions (OR = 0.63; 95% CI = 0.50, 0.78). There are sex differences in dysfunctions among rehabilitation outpatients. This sex difference may provide potential clinical value for the treatment of rehabilitation patients.

Caregiving burden, depression, and anxiety in informal caregivers of people with mental illness in China: a cross-sectional survey

BackgroundCaregiving for people with mental illness (PwMI) could be burdensome, especially for informal caregivers. However, there is a scarcity of research investigating caregiving burden among informal caregivers of PwMI in China at the national level. To fill this gap, this study examined the prevalence of caregiving burden, depression, and anxiety, as well as their associated factors, among a cross-sectional sample of informal caregivers of PwMI in China.MethodsData were collected via an online survey between June and November 2023. Caregiving burden, depression, and anxiety were measured by the Zarit Burden Interview, the Patient Health Questionnaire, and the Generalized Anxiety Disorder Scale. Information on caregivers’ sociodemographic, care recipients’ sociodemographic and disease-related, and caregiving-related characteristics was also collected. Hierarchical regression analyses were performed to identify associated factors of caregiving burden, depression, and anxiety.ResultsA total of 1,224 informal caregivers of PwMI in China were included in the final analysis. 72.1% of the participants had high caregiving burden, 53.5% had moderate to severe depression, and 43.1% had moderate to severe anxiety. Caregiving burden, depression, and anxiety were inter-correlated with each other but exhibited different profiles of associated factors. The most important factors associated with all the three outcomes were disease-related characteristics, particularly care recipients’ symptom stability, medication compliance, and insight. Informal caregivers of males with mental illness had higher levels of caregiving burden, depression, and anxiety than those of females. There was a lack of differentiation in caregiving burden, depression, and anxiety based on care recipients’ diagnosis. Formal or common-law marriage was a protective factor for caregiver depression and anxiety but not for caregiving burden.ConclusionInformal caregivers of PwMI in China experienced a high level of caregiving burden, depression, and anxiety. Urgent actions are needed to relieve caregiving burden, depression, and anxiety among informal caregivers of PwMI in China.

An evaluation of autonomic and gastrointestinal symptoms, and gastric emptying, in patients with systemic sclerosis.

Assessment of gastrointestinal and autonomic symptoms in patients with systemic sclerosis, and possible associations with gastric emptying rate. Participant and patient disease-related characteristics were collected. Gastrointestinal and autonomic symptoms were assessed by the UCLA-SCTC GIT 2.0 and COMPASS-31 questionnaires, respectively. Potentially confounding gastrointestinal medications were discontinued where possible. Gastric emptying was assessed using a non-radioactive 13C sodium acetate isotope, end-expiratory breath samples collected at baseline and then serial timepoints up to 120 min. In total, 49 participants were studied: 17 with systemic sclerosis with variable gastrointestinal involvement, and healthy matched (n = 17) and non-matched controls (n = 15), the last to control for the impact of age rather than disease on gastric emptying and autonomic function. The total mean (range) UCLA GIT 2.0 questionnaire for patients with systemic sclerosis was 0.63 (0.0-1.5) and for both healthy matched and non-matched controls was 0.04 (0.0-0.2), and was higher in patients with systemic sclerosis across all domains. The total mean (range) COMPASS-31 score for patients with systemic sclerosis patients was 32.2 (0.0-54.9) and for healthy matched- and non-matched controls: 7.45 (0.0-24.9) and 4.25 (0.0-2.1), respectively, again higher for patients with systemic sclerosis across all domains. No association was observed between patients' UCLA GIT 2.0 total score (s = -0.039, p = 0.38), total COMPASS 31 score (s = -0.108, p = 0.68), or COMPASS-31 GI domain (s = -0.051, p = 0.85) and gastric emptying rates. Gastrointestinal and autonomic symptoms are overrepresented in patients with systemic sclerosis but did not associate with gastric emptying rates.

Self-help offers for people with severe mental illness: who uses which format?

Self-help can play an important supplementary role in the treatment of people with severe mental illness; however, little is known about the utilization of the various approaches. This study describes the use of various self-help options by patients with severe mental illness and examines potential predictors. As part of the observational cross-sectional study on patients with severe mental illness (IMPPETUS, N = 397), trained staff collected sociodemographic, illness-associated and treatment-associated data between March 2019 and September 2019. Binary logistic regression was used to analyze apossible association with the use of self-help. The participants most frequently reported using self-help literature (n = 170; 45.5%) followed by self-help groups (n = 130; 33.2%), electronic mental health applications (n = 56; 15.5%) and self-management approaches (n = 54; 14.8%). Trialogue seminars (n = 36; 9.9%) were the least used by the participants. The utilization of the various approaches is influenced by sociodemographic and disease-related characteristics (age, education, marital status, migration background, age at onset of initial mental health problems, psychosocial functioning level) but not by factors associated with treatment. The potential of self-help is not being fully utilized in the sample investigated. The reported use of self-help approaches by the participants ranged between 10% and 46%. The various formats address specific target groups. More targeted information must be provided about the various options and the use of self-help in routine treatment must be actively fostered in order to increase the utilization of self-help.

Construction and validation of prognostic model for colorectal mucinous adenocarcinoma patients and identification of a new prognosis related gene FAM174B.

Mucinous adenocarcinoma (MAC) is a peculiar histological subtype of colorectal cancer (CRC) with distinct medical, disease-related, and genetic characteristics. The prognosis of MAC is generally poorer less favorable compared to non-specific adenocarcinoma (AC), but the prognostic indicator of MAC is rare. Therefore, this study aims to identify potential biomarkers and construct a prognostic model to better predict patient outcomes in MAC. We conducted differential genes expression investigation, weighted gene co-expression network analysis (WGCNA), and least absolute shrinkage and selection operator (LASSO)-Cox regression model using RNA sequencing (RNA-seq) data from The Cancer Genome Atlas (TCGA) to pinpoint hub genes. Then, the hub genes were used to construct a prognostic model for MAC. Kaplan-Meier survival, receiver operating characteristic (ROC), and Cox regression analysis were used to assess the prognostic utility of the model. The potential biological function of the hub gene was examined using gene set enrichment analysis (GSEA). Four hub genes, FAM174B, CREB3L1, SPDEF, and RAP1GAP, were identified between MAC and AC by differential genes expression analysis, WGCNA, and LASSO regression analysis. The prognostic signature model was constructed based on these four hub genes, which could divide MAC into low- and high-risk groups. The overall survival (OS) was notably lower in the high-risk group compared to the low-risk group (P=0.007). The area under the curves (AUCs) for 1-, 3-, and 5-year OS were 0.61 [95% confidence interval (CI): 0.73-0.49], 0.69 (95% CI: 0.76-0.63), and 0.77 (95% CI: 0.83-0.71), respectively. We also found that FAM174B expression was closely related to the OS of MAC (P=0.02). Further, the expression of FAM174B was positively correlated with MAC's Mucin type O-glycan biosynthesis. Finally, it was indicated that FAM174B was positively correlated with the critical molecules of mucus formation, MUC5AC (P=0.004, r=0.33), MUC5B (P<0.001, r=0.43), and MUC2 (P<0.001, r=0.39). We have developed and validated a four-gene prognostic model to predict the survival of MAC. Additionally, we found that FAM174B might correlate with mucin production in MAC.

B - 96 Relationships between Self-Reported Cognitive Dysfunction, Functional Activities, and Intraindividual Cognitive Variability in Persons with Multiple Sclerosis (Pwms)

Abstract Objective To examine the relationships between intraindividual cognitive variability (IIV) and self-reported cognitive and functional difficulties in persons with multiple sclerosis (pwMS). We hypothesized higher perceived cognitive and functional difficulties would be associated with higher IIV. Method Participants (n = 35) were pwMS from a prospective memory intervention study. During the baseline evaluation, participants completed an objective neuropsychological test battery and a self-report measure of cognitive functioning (Perceived Deficits Questionnaire; PDQ Total). Participants were asked if they had problems in eight different functional areas due to their memory, with the number of endorsed problems summed. Two measures of IIV, an intraindividual standard deviation (ISD) score and maximum discrepancy score (MDS), were created from 11 indices. The relationship between the IIV and PDQ were assessed with individual linear regressions, controlling for demographics and disease-related characteristics, while Spearman correlations examined the associations with the number of reported functional memory problems. Results The PDQ was not significantly associated with either the ISD (b = −0.03, 95% CI: −0.15, 0.10, p = 0.672) or MDS (b = −0.01, 95% CI: −0.51, 0.32, p = 0.645). The overall number of functional memory problems was correlated with both the PDQ (ρ = 0.40, p = 0.018) and ISD (ρ = −0.35, p = 0.039), but not MSD (ρ = −0.22, p = 0.201). Conclusion(s) Perceived cognitive dysfunction was not associated with IIV. However, self-reported functional problems with memory were associated with perceived cognition, as well as one metric of IIV. ISD may better reflect moment to moment fluctuations that lead to difficulties with daily functioning, as opposed to MDS which may reflect underlying variation (e.g., base rates of impairment) in cognitive performance.

Population Pharmacokinetics of Xeligekimab: An Anti-IL-17A Monoclonal Antibody, in Patients with Moderate to Severe Plaque Psoriasis.

Xeligekimab, a recombinant fully human IgG4 monoclonal antibody, has been strategically developed to target IL-17A and is presently in the developmental phase for treating moderate to severe plaque psoriasis. This study aims to investigate the pharmacokinetic profile of Xeligekimab, utilizing data derived from clinical trials specifically conducted in Chinese patients. The study conducted a population pharmacokinetic (PopPK) analysis involving 614 patients with plaque psoriasis. Examined covariates encompassed demographics, baseline laboratory tests, anti-drug antibodies (ADA), injection site, and disease-related baseline characteristics. Model evaluation utilized goodness-of-fit, prediction-corrected visual prediction check, and bootstrap methods. The clinical significance of covariates statistically associated with Xeligekimab was assessed through simulation analysis. The PopPK model of Xeligekimab demonstrated characteristics of a two-compartment model with first-order absorption and linear elimination. Inter-individual variability (IIV) was estimated for clearance and volume of distribution. For a typical plaque psoriasis patient, the estimated values for absorption rate constant (Ka), apparent clearance (CL/F), central compartment volume (Vc/F), peripheral compartment volume (Vp/F), and inter-compartmental clearance (Q/F) was 0.225 per day, 2.223 L/day, 4.02 L, 4.13 L, and 1.11 L/day, respectively. The estimated IIV for CL/F and Vc/F was 25.8% and 49.8%, respectively. The elimination half-life (t1/2) was approximately 28.5 days. CL/F was significantly influenced by factors such as body weight, age, gender, and baseline total protein. Vc/F was significantly influenced by body weight, age, gender, and baseline albumin. However, the clinical relevance of these covariate effects on exposure parameters was determined to be limited.

Demographic and Clinical Characteristics of Patients with Primary Hypothyroidism and Adequacy of Levothyroxine Replacement Therapy in Them: A Nationwide Study in Bangladesh

ABSTRACT Background: Despite the huge burden of primary hypothyroidism in Bangladesh, no nationwide study has been conducted describing the demographic and clinical characteristics of these patients; data on the adequacy of levothyroxine (L-T4) replacement are also lacking. This study aimed to fill the knowledge gap. Materials and Methods: This cross-sectional study was conducted among patients with primary hypothyroidism attending the endocrinology outpatient clinics of several hospitals throughout Bangladesh from July 2023 to December 2023. Adults with primary hypothyroidism who had been on L-T4 replacement for at least 1 year were included. Data on their demographic and disease-related characteristics were collected. Serum thyroid-stimulating hormone (TSH) was measured; TSH 0.4–4.0 μIU/mL was considered the therapeutic target for nonmalignant thyroid cases. Results: Two thousand six hundred and forty-one patients (median age 37 years, 86.4% female, and median disease duration 5 years) were included. Hashimoto’s thyroiditis was the most common (40.9%) cause of hypothyroidism; 1.9% had differentiated thyroid cancer (DTC), and the etiology was not established in many (40.2%). Only 26.8% of patients had high adherence to L-T4. Among the non-DTC cases (n = 2590), over half (53.9%) had TSH within the target range, whether the disease was uncontrolled in the remaining 46.1% (TSH was below the target range in 5.6% and above the target range in 40.5%). Among the DTC cases (n = 51), only a few (9.8%) had a TSH within the target range; TSH was below and above the range in 2% and 88.2% of these patients, respectively. In the nonmalignant hypothyroid cases, vegetarian diet, smokeless tobacco use, disease duration &gt;5 years, iron or calcium supplements consumption within 4 h of L-T4 intake, and low or medium adherence to L-T4 were associated with uncontrolled hypothyroidism. Conclusion: For nearly half of Bangladeshi patients with primary hypothyroidism, L-T4 replacement is not optimal. Physicians should address the barriers to reaching the therapeutic goal for these patients.