Preliminary Evidence Research Articles

Local therapies for oligometastatic hormone-sensitive prostate cancer

Oligometastatic, hormone-sensitive prostate cancer (omHSPC) is increasingly diagnosed due to the implementation of molecular imaging. OmHSPC is mostly defined as amaximum of four bone metastases without visceral metastases on conventional imaging. This study highlights the existing evidence regarding local treatment of omHSPC, taking into account molecular imaging and modern therapies. Narrative review article based on expert consensus and national/international guideline recommendations, supported by anonsystematic literature search in PubMed (MEDLINE). The authors consider the cited studies as the most significant works in this regard and these were selected to illustrate developments and fundamental concepts, without claiming completeness. Initially, the STAMPEDE study prospectively demonstrated an oncologic benefit of radiotherapy (RT) to the prostate in addition to androgen deprivation therapy for omHSPC. At 3years, overall survival (OS) was 81% with RT versus 73% without RT (hazard ratio [HR] 0.68; 95% confidence interval [CI] 0.52-0.90; p = 0.007). However, this benefit was not observed in polymetastatic HSPC (HR 1.07; 95% CI 0.90-1.28; p = 0.4). In astudy by Dai etal., local therapy for omHSPC was performed surgically in 85% of cases, also demonstrating an OS advantage (HR 0.44; 95% CI 0.24-0.81; p = 0.008). OmHSPC should be treated using adjunctive RT. Preliminary prospective evidence shows comparable efficacy with prostatectomy. Modern systemic combination therapies challenge the role of local therapy.

Host-specific co-evolution likely driven by diet in Buchnera aphidicola

BackgroundRussian wheat aphid (Diuraphis noxia Kurd.) is a severe pest to wheat, and even though resistance varieties are available to curb this pest, they are becoming obsolete with the development of new virulent aphid populations. Unlike many other aphids, D noxia only harbours a single endosymbiont, Buchnera aphidicola. Considering the importance of Buchnera, this study aimed to elucidate commonalities and dissimilarities between various hosts, to better understand its distinctiveness within its symbiotic relationship with D. noxia. To do so, the genome of the D. noxia’s Buchnera was assembled and compared to those of other aphid species that feed on diverse host species.ResultsThe overall importance of several features such as gene length and percentage GC content was found to be critical for the maintenance of Buchnera genes when compared to their closest free-living relative, Escherichia coli. Buchnera protein coding genes were found to have percentage GC contents that tended towards a mean of ~ 26% which had strong correlation to their identity to their E. coli homologs. Several SNPs were identified between different aphid populations and multiple isolates of Buchnera were confirmed in single aphids.ConclusionsEstablishing the strong correlation of percentage GC content of protein coding genes and gene identity will allow for identifying which genes will be lost in the continually shrinking Buchnera genome. This is also the first report of a parthenogenically reproducing aphid that hosts multiple Buchnera strains in a single aphid, raising questions regarding the benefits of maintaining multiple strains. We also found preliminary evidence for post-transcriptional regulation of Buchnera genes in the form of polyadenylation.

Eating behavior during pregnancy mediates the association between depression and diet quality--a new strategy for intervention in pregnancy.

Depression can result in changes in eating behavior and decrease the quality of eating. It has been shown that maternal depression during pregnancy can result in malnutrition, which can have adverse effects on the pregnancy and the offspring. There is currently no clear association between depression and diet. Five hundred and forty-nine pregnant women recruited from Danyang Maternal and Child Health Hospital in Jiangsu Province participated in this study and were administered the Intuitive Eating Scale-2 (IES-2), Edinburgh Post-natal Depression Scale (EPDS), Pregnancy Stress Scale (PPS), Self-rating Anxiety Scale (SAS), and Dietary Guidelines Adherence Index for Pregnant Women during Pregnancy (CDGCI-PW). The nutritional software collected dietary records for three consecutive days in mid-pregnancy to calculate dietary intake and nutrients that support energy production. The mediation analyses were conducted using SPSS 24.0 macro PROCESS. The relationship between depressive symptoms during pregnancy and diet quality was moderated primarily by two aspects of eating behavior, "Reliance on Hunger and Satiety Cues" (RHS) and "Body-Food Choice Congruence" (BFC). Depressive symptoms (EPDS scores) showed a negative correlation with RHS, BFC, and RHS, and BFC showed a positive correlation with diet quality, yielding a significant specific indirect effect. The multiple mediation model explained 14.7% of the variance in the diet quality. This study highlights the important role of eating behaviors during pregnancy in the relationship between depressive symptoms (EPDS scores) and diet quality, and provides preliminary evidence for feasible ways pregnant women with depressive symptoms can improve diet quality, promote maternal and child health, and reduce depression.

Metabolomic biomarkers for (R, S)-ketamine and (S)-ketamine in treatment-resistant depression and healthy controls: A systematic review.

Ketamine is increasingly used for treatment-resistant depression (TRD) while its mechanism of action is still being investigated. In this systematic review, we appraise the current evidence of metabolomic biomarkers for racemic ketamine and esketamine in patients with TRD and healthy controls (HCs). A comprehensive search of several databases (Ovid MEDLINE®, Embase, and Epub Ahead of Print) was performed from each database's inception to June 29, 2022, in any language, was conducted. We included studies wherein the metabolomic biomarkers for racemic ketamine or esketamine were investigated in TRD or HCs. Our main outcomes were to examine changes in metabolites among patients treated with ketamine/esketamine and explore the association with response to ketamine/esketamine. A total of 1859 abstracts were screened of which 11 were included for full-text review. Of these, a total of five articles were included (N = 147), including three RCTs (n = 129) and two open-label trials (n = 18). All studies used racemic ketamine; one study additionally used esketamine. The included studies evaluated patients with treatment-resistant bipolar depression (n = 22), unipolar depression (n = 91), and HCs (n = 34). The included studies reported alteration in several metabolites including acylcarnitines, lipids, kynurenine (KYN), and arginine with ketamine in TRD. Studies suggest the involvement of energy metabolism, KYN, and arginine pathways. In HCs, acetylcarnitine decreased post-infusion, whereas inconsistent findings were observed after the ketamine infusion in TRD patients. This systematic review provides preliminary evidence that ketamine may cause changes in several important pathways involved in energy metabolism and inflammation. Larger and more rigorous studies are needed.

Parental Expressed Emotion and Behavioural Outcomes in Autistic Children and Adolescents: A Systematic Review.

Growing interest in the links between parent-child relationships and child behavioural presentations in families of autistic children has led to an increased use of the Five Minute Speech Sample (FMSS) measure of parental expressed emotion (EE) in autism research. This review focuses on studies exploring the relationships between parental EE and behavioural outcomes in autistic children. Electronic searches of six databases and grey literature wielded eight studies that met eligibility criteria. Study designs were a mixture of cross-sectional and longitudinal and quality of studies was variable. Parental criticism was largely positively related to, and showed some predictive value for, child behaviour problems. Warmth was mostly negatively related to, and showed some predictive value for, child behaviour problems. Preliminary evidence from one study showed paternal warmth to be significantly related to child behaviours, whilst child behaviours were also significantly related to paternal warmth, suggesting a bidirectional relationship. Analysis of additional EE components produced variable results, however parental stress and depressive symptoms were consistently related to child behaviour, and preliminary evidence suggests a possible role of maternal education level and family cohesion. Outcomes were variable across FMSS coding systems and greater consistency in their application is needed in future research. The current findings suggest that parental EE has an important relationship with child behaviour and future intervention efforts may benefit from aiming to reduced EE in order to improve child outcomes.

Bta-miR-301a targets ACVR1 to influence cleavage time and blastocyst formation rate of early embryos in cattle.

Accumulating evidence indicates that paternally-derived miRNAs play a crucial role in the development of early embryos and are regarded as the key factor in the successful development of somatic cell cloned embryos. In our previous study, bta-miR-301a was found to be highly expressed in bovine sperm, and was delivered into oocytes during fertilization. In this study, bioinformatics, dual luciferase reporter assays, rescue experiments and gain- and loss-of-function experiments indicated that ACVR1 is the target gene of bta-miR-301a in early bovine embryos. By microinjecting bta-miR-301a mimic into embryos of parthenogenetic or somatic cell nuclear transfer, we observed that bta-miR-301a prolonged the first cleavage time of the embryos and increased the blastocyst formation rate. Thus, this study provides preliminary evidence that bta-miR-301a influences remodeling of the microfilament skeleton, prolongs the first cleavage time, and improves the developmental competence of embryos by negatively regulating ACVR1 translation.

Preliminary exploratory research on the application value of oral and intestinal meta-genomics in predicting subjects' occupations-A case study of the distinction between students and migrant workers.

In the field of forensic science, accurately determining occupation of an individual can greatly assist in resolving cases such as criminal investigations or disaster victim identifications. However, estimating occupation can be challenging due to the intricate relationship between occupation and various factors, including gender, age, living environment, health status, medication use, and lifestyle habits such as alcohol consumption and smoking. All of these factors can impact the composition of oral or gut microbial community of an individual. In this study, we collected saliva and feces samples from individuals representing different occupational sectors, specifically students and manual laborers. We then performed metagenomic sequencing on the DNA extracted from these samples to obtain data that could be analyzed for taxonomic and functional annotations in five different databases. The correlation between occupation with microbial information was assisted from the perspective of α and β diversity, showing that individuals belonging to the two occupations hold significantly different oral and gut microbial communities, and that this correlation is basically not affected by gender, drinking, and smoking in our datasets. Finally, random forest (RF) models were built with recursive feature elimination (RFE) processes. Models with 100% accuracy in both training and testing sets were constructed based on three species in saliva samples or on a single pathway annotated by the KEGG database in fecal samples, namely, "ko04145" or Phagosome. Although this study may have limited representativeness due to its small sample size, it provides preliminary evidence of the potential of using microbiome information for occupational inference.

Body shaming and internalized weight bias as potential precursors of eating disorders in adolescents.

Body shaming (BS) is a growing phenomenon within the school context, especially among adolescents. Recently, it has been described as an unrepeated act in which a person expresses unsolicited, mostly negative comments about an individual's body. The targeted person perceives these comments as negative, offensive or body shame-inducing. Empirical evidence also suggests that body weight is the most common reason that youths are teased and bullied. Indeed, weight stigma, described as bias or discriminatory behaviors, attitudes, feelings, and thinking about individuals, because of their weight, can lead to weight-based discrimination and victimization. Preliminary evidence suggests that BS and weight stigma have negative effects on psychological health both in the short and long term. In the delicate stage of adolescence development and pubertal maturation, BS experiences can be highly prevalent and it can lead to adverse outcomes such as eating disorders (ED). However, prevalence data in the Italian context are still lacking. The study aims to estimate weight-related BS perceived by different sources (i.e., peers and family members) and their associations with public and internalized weight bias, body mass index (BMI), body dissatisfaction, and ED symptoms. A sample of 919 high school students (Mage = 15.97, SD = 1.58; 57.1% boys) completed a battery of self-report questionnaires assessing these variables. One in four students reported experiences of weight-related BS by peers or family members. A total of 37% reported having at least one BS experience in a lifetime. Higher scores of ED symptoms, body dissatisfaction, and weight bias were reported by adolescents who experienced BS, especially females. Among overweight participants, results showed that internalized weight bias partially mediated the relationship between BS by family members and ED symptoms and fully mediated the relationship between BS by peers and ED symptoms, after controlling for age, sex and BMI. These findings, despite their cross-sectional nature, add an important contribution to the creation of quantitative empirical evidence on the phenomenon of BS. Its role in explaining eating disorders, both alone and with the mediation of internalized weight stigma has been first proved and needs to be confirmed by longitudinal results.

Effect of action observation training on the oral phase of swallowing in children with cerebral palsy: a pilot randomized controlled trial

Swallowing disorder is prevalent in children with cerebral palsy (CP), and previous studies have shown that motor-based programs benefit children with CP by facilitating motor learning. We hypothesized that action observation training (AOT) could enhance motor learning and improve the oral phase of swallowing in children. In this two-group parallel double-blind randomized controlled trial, the intervention group received AOT and sensorimotor therapy, while the control group received a sham and sensorimotor therapy. The function of the oral phase of swallowing, as the primary outcome, was measured pre-intervention, post-intervention, and at one month of follow-up. Secondary outcomes included reported symptoms of feeding problems and the impact of the child’s swallowing disorder on the main caregiver, which were measured pre-intervention and post-intervention. The result of the Mann-Whitney U test showed a significant difference between the two groups in the function of the oral phase of swallowing after the intervention. Additionally, the intervention had a large effect size. However, no significant difference was found in the parent-reported scores of the feeding/swallowing impact survey and symptoms of feeding problems between the two groups. In conclusion, this pilot study provides preliminary evidence of the clinical efficacy of AOT as a safe neurorehabilitation method to improve the oral phase of swallowing in children with CP. However more studies are needed in the future.

Comparing embedded performance validity indicators within the WAIS-IV Letter-Number sequencing subtest to Reliable Digit Span among adults referred for evaluation of attention-deficit/hyperactivity disorder

Objectives: This study investigated the Wechsler Adult Intelligence Scale-Fourth Edition Letter-Number Sequencing (LNS) subtest as an embedded performance validity indicator among adults undergoing an attention-deficit/hyperactivity disorder (ADHD) evaluation, and its potential incremental value over Reliable Digit Span (RDS). Method: This cross-sectional study comprised 543 adults who underwent neuropsychological evaluation for ADHD. Patients were divided into valid (n = 480) and invalid (n = 63) groups based on multiple criterion performance validity tests. Results: LNS total raw scores, age-corrected scaled scores, and age- and education-corrected T-scores demonstrated excellent classification accuracy (area under the curve of .84, .83, and .82, respectively). The optimal cutoff for LNS raw score (≤16), age-corrected scaled score (≤7), and age- and education-corrected T-score (≤36) yielded .51 sensitivity and .94 specificity. Slightly lower sensitivity (.40) and higher specificity (.98) was associated with a more conservative T-score cutoff of ≤33. Multivariate models incorporating both LNS and RDS improved classification accuracy (area under the curve of .86), and LNS scores explained a significant but modest proportion of variance in validity status above and beyond RDS. Chaining LNS T-score of ≤33 with RDS cutoff of ≤7 increased sensitivity to .69 while maintaining ≥.90 specificity. Conclusions: Findings provide preliminary evidence for the criterion and construct validity of LNS as an embedded validity indicator in ADHD evaluations. Practitioners are encouraged to use LNS T-score cutoff of ≤33 or ≤36 to assess the validity of obtained test data. Employing either of these LNS cutoffs with RDS may enhance the detection of invalid performance.

The role of the six factors model of athletic mental energy in mediating athletes’ well-being in competitive sports

In the realm of high-performance sports, athletes often prioritize success at the expense of their well-being. Consequently, sports psychology researchers are now focusing on creating psychological profiles for athletes that can forecast their performance while safeguarding their overall well-being. A recent development in this field is the concept of athletic mental energy (AME), which has been associated with both sporting success and positive emotions. Therefore, the aim of this study was to explore if AME in athletes can mediate this directly observed relationship between performance and psychological well-being. For stronger predictive validity these relationships were examined across two studies with each involving distinct sets of participants engaged in various sports disciplines, including football, cricket, basketball, archery, and more. The self-report measures of sports performance, athletic mental energy (AME), and psychological well-being (PWB) were administered post-competition on the local, regional, state, national, international, and professional level athletes of age 18 and above. Our study found that both, the affective and cognitive components of AME mediated the athletes’ performance and psychological well–being relationship. Interestingly, the study found no significant gender differences in AME and PWB scores. While family structures didn’t yield significant variations in AME scores, there were some descriptive distinctions in PWB scores across different family structures. Our research offers preliminary evidence suggesting that AME can play a pivotal role in preserving athletes’ psychological well-being following competitive events.

Digital Health Psychosocial Intervention in Adult Patients With Cancer and Their Families: Systematic Review and Meta-Analysis.

Patients with cancer and their families often experience significant distress and deterioration in their quality of life. Psychosocial interventions were used to address patients' and families' psychosocial needs. Digital technology is increasingly being used to deliver psychosocial interventions to patients with cancer and their families. A systematic review and meta-analysis were conducted to review the characteristics and effectiveness of digital health interventions on psychosocial outcomes in adult patients with cancer and their family members. Databases (PubMed, Cochrane Library, Web of Science, Embase, CINAHL, PsycINFO, ProQuest Dissertations and Theses Global, and ClinicalTrials.gov) were searched for randomized controlled trials (RCTs) or quasi-experimental studies that tested the effects of a digital intervention on psychosocial outcomes. The Joanna Briggs Institute's critical appraisal checklists for RCTs and quasi-experimental studies were used to assess quality. Standardized mean differences (ie, Hedges g) were calculated to compare intervention effectiveness. Subgroup analysis was planned to examine the effect of delivery mode, duration of the intervention, type of control, and dosage on outcomes using a random-effects modeling approach. A total of 65 studies involving 10,361 patients (mean 159, SD 166; range 9-803 patients per study) and 1045 caregivers or partners (mean 16, SD 54; range 9-244 caregivers or partners per study) were included in the systematic review. Of these, 32 studies were included in a meta-analysis of the effects of digital health interventions on quality of life, anxiety, depression, distress, and self-efficacy. Overall, the RCT studies' general quality was mixed (applicable scores: mean 0.61, SD 0.12; range 0.38-0.91). Quasi-experimental studies were generally of moderate to high quality (applicable scores: mean 0.75, SD 0.08; range 0.63-0.89). Psychoeducation and cognitive-behavioral strategies were commonly used. More than half (n=38, 59%) did not identify a conceptual or theoretical framework. Most interventions were delivered through the internet (n=40, 62%). The median number of intervention sessions was 6 (range 1-56). The frequency of the intervention was highly variable, with self-paced (n=26, 40%) being the most common. The median duration was 8 weeks. The meta-analysis results showed that digital psychosocial interventions were effective in improving patients' quality of life with a small effect size (Hedges g=0.05, 95% CI -0.01 to 0.10; I2=42.7%; P=.01). The interventions effectively reduced anxiety and depression symptoms in patients, as shown by moderate effect sizes on Hospital Anxiety and Depression Scale total scores (Hedges g=-0.72, 95% CI -1.89 to 0.46; I2=97.6%; P<.001). This study demonstrated the effectiveness of digital health interventions on quality of life, anxiety, and depression in patients. Future research with a clear description of the methodology to enhance the ability to perform meta-analysis is needed. Moreover, this study provides preliminary evidence to support the integration of existing digital health psychosocial interventions in clinical practice. PROSPERO CRD42020189698; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=189698.

Offering an auto-play feature likely increases total gambling activity at online slot-machines: preliminary evidence from an interrupted time series experiment at a real-life online casino.

Auto-play is a ubiquitous feature in online casino gambling and virtual slot machines especially, allowing gamblers to initiate spin sequences of pre-set length and value. While theoretical accounts diverge on the hypothesized causal effect on gambling behavior of using the auto-play feature, observational findings show that this feature is used to a higher degree by problem and/or high-intensity gamblers, suggesting that banning this feature may constitute a global responsible gambling measure. Direct, experimental research on causal effects of offering auto-play at online casinos is however lacking. Here, we report the findings of an interrupted time series experiment, conducted at a real-life online casino in Sweden, in which the auto-play feature was made available during a pre-set duration on 40 online slot machines, with 40 matched slots serving as control. Aggregated time series on daily betted amount, spins and net losses were analyzed using a structural Bayesian framework that compared observed developments during the peri-intervention period to modeled counterfactual estimates. Results suggest that offering an auto-play feature on online casinos likely increases total gambling activity in terms of betted amount (approx.+ 7-9%) and (perhaps) number of spins (approx. +3%) but has no effect on net losses. Limitations of studying auto-play effects on a population-level, as well as the complexities of banning this feature within a complex ecosystem of non-perfect channelization to licensed providers, are discussed, including suggestions for future research.

Future thinking in PTSD: Preliminary evidence for altered event construction

Using a future event fluency task, the current study sought to examine future event construction in PTSD and to identify clinical profiles associated with altered event construction. Thirty-eight trauma exposed war-zone veterans with (n=25) and without (n=13) PTSD generated within one minute as many positive and negative future events as possible in the near and distant future. The PTSD group generated fewer specific, but not generic, events than the no-PTSD group, a difference that was amplified for positive events as a result of comorbid depression. Clinical correlates of event construction varied as a function of event valence.

Emotion-focused therapy for youth: clinical outcomes of a single-site, randomized waitlist-controlled trial

ABSTRACT Although there is considerable evidence to support Emotion Focused Therapy (EFT) in the adult population, it has not been empirically studied in youth. EFT does not rely on an individual’s adherence to manualized strategies or between-session homework tasks, focusing instead on within-session processes. These processes activate and transform core emotions that are often linked to experiences with primary caregivers, family members, and other significant relationships. This novel study reports on an adaptation of EFT for youth. Building upon the evidence base for EFT with adults, we examined the impact of an 8-session EFT-Y intervention on clinical disorders in youth (n = 43). Using a single-site randomized waitlist-controlled design, outcomes from a treatment group (n = 22) were compared to a waitlist control group (n = 21), similar in age and presenting problems. In comparison to youth in the waitlist control group, the treatment group reported a significant decrease in their emotion dysregulation and depression scores at the end of treatment. Youth in the treatment group also demonstrated a decrease in their emotion difficulties, conduct problems, and overall difficulties, with baseline scores controlled for. These findings provide preliminary evidence that EFT-Y is an efficacious therapeutic approach for common child and adolescent psychopathology.

Abstract B033: Mapping subclonal epigenetic evolution in colorectal cancer by spatial analysis of DNA hypermethylation

Abstract Aberrant patterns of DNA methylation (DNAme) have long been noted in colorectal cancer (CRC). Early studies found overall hypomethylation of the cancer genome, while subsequent work revealed focal hypermethylation at specific loci, especially CpG-rich promoters. Loci occupied by polycomb repressive complex 2 in stem cells are remarkably enriched in cancer-specific hypermethylation events. These Polycomb Target Genes (PTGs) include important transcriptional regulators of lineage specification and differentiation, suggesting that hypermethylation-mediated silencing of PTGs could play an active role in CRC initiation or progression. Despite these findings, we have limited knowledge of when, where, and how this hypermethylation arises. Preliminary evidence from bulk tumor samples in the Cancer Genome Atlas suggests that many of these PTG hypermethylation events may be almost completely clonal. Additionally, we have noted rare, densely methylated reads covering PTGs in cancer-adjacent, histologically normal tissue. These observations suggest that PTG hypermethylation may be a very early event in carcinogenesis and may play a permissive or even active role in that process. To better understand the timing and evolution of PTG hypermethylation events in CRC, we have developed a protocol that allows us to extract dozens of small (20µL), spatially annotated mini-bulk samples from live tumors. These mini-bulks may be frozen or dissociated to viable single-cell suspensions. Remaining tumor tissue is preserved in the form of spatially annotated FFPE blocks, which can be used for analyses such as high-plex immunofluorescence or spatial transcriptomics. Using this process, we have collected over 500 spatially annotated samples from 6 CRC cases, including 196 micro-bulk samples profiled using the Infinium MethylationEPIC array. Additionally, we have profiled DNAme in 147 single cells using a dramatically improved single-cell whole-genome bisulfite sequencing protocol developed in our lab. Analysis of EPIC array data reveals wide variation in DNAme heterogeneity between tumors. While in some tumors, the vast majority of DNA hypermethylation events are clonal, other tumors reveal significant intra-tumor heterogeneity, including two or more prominent DNAme subclones as well as a substantial number of ‘private’ hypermethylation events that occur in only one sample. Mapping DNAme information back onto our spatial data reveals that in at least one case, DNAme clones are spatially partitioned and are associated with distinct histology. Ongoing work includes inference of phylogenetic trees from DNA hypermethylation events using non-reversible models of methylation accumulation, allowing us to measure the relative timing of hypermethylation events, as well as integration of array, whole-genome, and single-cell methylation data to more completely characterize DNAme subclones, characterize cellular DNAme heterogeneity at variably methylated sites, and shed further light on the evolution of cancer-related DNA hypermethylation. Citation Format: Nathan J. Spix, Hsiao-yun Milliron, Manpreet Kalkat, Emily Eugster, David W. Chesla, David Sokol, Emily Jung, Paula Nolte, Kelly K. Krzyzanowski, Toshinori Hinoue, Hui Shen, Peter W. Laird. Mapping subclonal epigenetic evolution in colorectal cancer by spatial analysis of DNA hypermethylation [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Translating Cancer Evolution and Data Science: The Next Frontier; 2023 Dec 3-6; Boston, Massachusetts. Philadelphia (PA): AACR; Cancer Res 2024;84(3 Suppl_2):Abstract nr B033.

Personalised preinterventional risk stratification of mortality, length of stay and hospitalisation costs in transcatheter aortic valve implantation using a machine learning algorithm: a pilot trial

IntroductionRisk stratification based on Euroscore II (ESII) is used in some centres to assist decisions to perform transcatheter aortic valve implant (TAVI) procedures. ESII is a generic, non-TAVI-specific metric, and...

Psychometric evaluation of the Symptom-Checklist-K-9 among U.S. working-age adults with psychiatric disabilities.

The Symptom Checklist 90-Revised (SCL-90-R; Derogatis, 1992) is a widely used self-report measure of psychiatric symptoms (Prinz et al., 2013), but it is longer than many screening measures used in certain settings. Recently, a nine-item form of the SCL-90-R, the Symptom-Checklist-K-9 (SCL-K-9), has been gaining traction despite the limited research examining its psychometric properties in the United States. The purpose of this study is to conduct a psychometric evaluation of the SCL-K-9 scores in U.S. working-age adults with psychiatric disabilities. Six hundred and thirty participants with self-reported psychiatric disabilities completed the SCL-K-9 and other psychosocial self-report measures. Confirmatory factor analysis (CFA) was conducted to evaluate the SCL-K-9 scores' dimensionality. Coefficient omega was used to assess the scores' internal consistency. Convergent and discriminant validity were assessed by examining the strength and direction of correlation coefficients between the SCL-K-9 and other psychosocial measures. Measurement invariance across sex, age, and primary diagnostic groups was also examined. CFA revealed a one-factor solution with satisfactory reliability (coefficient omega = .828). Convergent validity was supported by the relatively high correlation coefficients between the SCL-K-9 with neuroticism, self-stigma, and psychiatric disability acceptance, and discriminant validity by relatively low correlation coefficients with perceived social stigma and hope. Full measurement invariance for sex and partial invariance for diagnostic groups was supported. Overall, this study provides preliminary reliability and validity evidence for the SCL-K-9 scores among U.S. working-age adults with psychiatric disabilities. Further investigation is warranted to support its use for research and treatment progress monitoring in recovery-oriented care. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The feasibility of an educational and monitoring smartphone application for patients with advanced renal cell carcinoma undergoing combination immunotherapy.

413 Background: Renal Cell Carcinoma (RCC) is a global public health burden with over 400,000 new cases and over 175,000 deaths annually. Immune checkpoint inhibitors (ICI) in combination with vascular endothelial growth factor tyrosine kinase inhibitors (VEGF-TKI) has become an integral part of the management of patients with advanced RCC which requires adaptation of healthcare systems to provide information and optimize the management of drug-related adverse events. This study aims to improve the education on therapy-related symptoms and the quality of life of patients with RCC treated with these drugs. Methods: We created a smartphone application (mHealth) that combines educational data, patient-reported outcomes, and peer-to-peer interactions. We aim to assess the feasibility of expansion of this pilot study. We prospectively enrolled stage IV RCC patients (n=20) undergoing treatment with combination ICI and VEGF-TKI. Therapy-related symptom education, knowledge PRO questionnaires, and peer-to-peer support were provided at baseline and at different time points throughout this study duration (Table 1). Time-course data of PROs were visualized using line plots and then compared with paired t-tests. The study's primary endpoint was to assess acceptability and feasibility of mHealth, defined as acceptable if 50% of patients offered participation agree to be enrolled and feasible if 50% of enrolled patients complete the intervention with 70% of these completing at least 50% of survey instruments. Results: Eighty percent of patients were male, 80% were white, 75% had at least some college education, 70% were married, and the mean age of the cohort was 66 years.A total of 22 patients were approached for the study with an acceptance rate of 90%. Sixty percent of patients completed every questionnaire and knowledge assessment at every timepoint of the intervention and 75% of those completed at least 50% of instruments. PROs data showed no significant difference compared to baseline in global health status, functional scales, and symptom scales across the 24 weeks. We noticed an improvement in the patients' knowledge assessment on symptom management after completion of the mHealth knowledge component. Conclusions: Our pilot study was considered acceptable and feasible, showing preliminary evidence of improvement in patient knowledge with mHealth. Our future direction will be to assess, in a larger randomized study, the efficacy of mHealth in improving the quality of life of patients with advanced RCC treated with ICI and VEGF-TKI. Clinical trial information: NCT05579847 . [Table: see text]

Public Stigma and Continuum Beliefs Across Personality Disorder Severity Levels.

Stigmatizing attitudes toward persons with personality disorders are common. Preliminary evidence suggests that continuum beliefs (the view that presented symptoms lie on a continuum with normality) are associated with reduced personality disorder stigma. This study aimed to evaluate whether this association holds across the entire spectrum of personality disorder severity and whether greater personality disorder severity is linked to higher stigma. A general population sample (N = 848) completed questions about a vignette depicting mild, moderate, or severe personality disorder severity. Higher continuum beliefs were associated with a lower desire for social distance from persons with mild, moderate, or severe personality disorder. In addition, continuum beliefs were higher, and the desired social distance was lower toward a person with mild than a person with moderate or severe personality disorder. Thus, fostering continuum beliefs might aid in combating personality disorder stigma, including toward severely affected persons who experience strong stigmatization.