Symptom Scale Research Articles

Factors affecting quality of life in women post mastectomy for breast cancer in Baheya Foundation (Egypt): ‘A retrospective cohort study’

BackgroundBreast cancer treatment has many strategies, each with its own effects on survivors’ quality of life (QoL). The current study evaluated factors influencing QoL in women who have undergone mastectomy and compared different treatments based on sociodemographic and clinical factors.MethodsA retrospective cohort study was conducted utilizing the EORTC Quality of Life breast cancer specific tool and the FACT-B and FBSI questionnaires to measure functional and symptom scales impacting QoL. The questionnaire was administered to 318 Egyptian women post-mastectomy and at 6-month follow-up. Results were reported as median and interquartile range (IQR) or frequency and percentage. Fisher’s exact and Kruskal-Wallis tests were used for statistical inferences. Generalized linear models were used to predict QoL measures (outcome) by sociodemographic and clinical variables (independent) with adjusting for potential confounders. Independent variables were selected by elastic net regression.ResultsThe Global QoL score for this cohort was 42.0 (IQR 25.0–67.0). The functional scale most affected was role (62%), with the cognition having the lowest effect. The most distressing symptoms on the symptom scale were fatigue (65%), insomnia (61%), and pain (60%). FACT-B had a median score of 79.0 (IQR 63.0–95.0). Generalized linear regression indicated that higher cognitive functioning (22.45; p < 0.050) and BCS (6.026, p < 0.010) was positively correlated with women > 60 years old. Urban women correlated with a lower SWB (-2.679, p < 0.05) and higher degree of insomnia. A BMI > 30 correlated negatively with many of the QoL domains. SM or MRM with reconstruction correlated positively with TQOL (8.109 < p < 0.050). Women who received chemotherapy had lower social functioning (-12.41, p < 0.050), BCS (-3.473, p < 0.010), greater association with diarrhoea (8.865, p < 0.010) and financial difficulties (15.23, p < 0.050). In contrast, women who received hormonal therapy had higher role functioning (17.64, p < 0.010), with less complaints of diarrhoea (-10.38, p < 0.010), nausea (-8.668, p < 0.010) and pain (-8.265, p < 0.050).ConclusionThese results indicate that sociodemographic and clinical factors affect QoL in Egyptian women post-mastectomy. The worst functioning was the role and emotional scales, and the most distressing on the symptom scale were fatigue, insomnia, and pain making an imperative case for a more multidisciplinary team approach to treatment.

Health-related quality of life and symptoms in patients with previously untreated, locally advanced or metastatic non-squamous non-small cell lung cancer treated with sintilimab or placebo plus pemetrexed and platinum (ORIENT-11): A randomized, double-blind, phase 3 trial.

In the phase 3 ORIENT-11 study, sintilimab plus pemetrexed-platinum provided statistically significant longer overall survival and progression-free survival versus placebo plus pemetrexed-platinum as first-line treatment in patients with locally advanced or metastatic non-squamous non-small cell lung cancer (NSCLC). Here, we report the patient-reported outcomes (PRO) analysis findings in ORIENT-11. PROs were measured using the European Organization for Research and Treatment of Cancer Quality of Life of Cancer Patients Questionnaire Core 30 items (EORTC QLQ-C30) and the Lung Cancer Symptom Scale (LCSS) questionnaire. PRO endpoints included evaluation of least square (LS) mean changes from baseline to week 12 (platinum-containing treatment) and week 21 (maintenance treatment), time to true deterioration (TTD), and overall improvement or stability rate for QLQ-C30 and LCSS scales. PRO scores in two groups were compared using the Mann-Whitney test. Least squares (LS) mean changes from baseline to week 12, week 21, and other time points were assessed with mixed-effect model repeated measures analysis. TTD was calculated using the Kaplan-Meier method and compared with the Cox proportional hazards model between groups. 252 (94.7%) patients in the sintilimab-combination group and 123 (93.9%) patients in the placebo-combination group had a baseline and at least one postbaseline PRO assessment. Change from baseline to week 12 or 21 favored the sintilimab-combination group on QLQ-C30 global health status/quality of life (GHS/QoL), most function and symptoms scales, and most LCSS scales. Notably, the QLQ-C30 pain score change gradually deteriorated in the placebo-combination group with increased treatment. At the same time, it improved in the sintilimab-combination group significantly from 6weeks later, with the improvement sustained in subsequent courses of treatment. Sintilimab plus chemotherapy significantly delayed the TTD in most QLQ-C30 and LCSS scales compared with placebo plus chemotherapy, and the overall improvement or stability rates were higher in the former. The addition of sintilimab to chemotherapy maintained or improved health-related quality of life and symptoms compared with chemotherapy. Along with the previous efficacy and safety results, these data support the addition of sintilimab to standard chemotherapy as first-line therapy in locally advanced or metastatic non-squamous NSCLC. NCT03607539.

Quantitative pupillometry as a potential biomarker in early concussion assessment.

There are limited objective methods when it comes to identifying and diagnosing concussion. Pupil assessment is performed routinely as a standard-of-care following traumatic brain injury (TBI). Unlike the highly subjective and limited reliability of pupil assessment using penlights and flashlights, Quantitative pupillometry (QP) is an established, valid, and reliable method of pupillary assessment. This study aims to investigate the use of QP values in concussion evaluation. This observational study analyzed data collected by the North Texas Concussion Registry (ConTex). ConTex enrolls subjects who are >5-years of age and clinically diagnosed with concussion. Subjects are excluded if they had moderate or severe traumatic brain injury, spinal cord injury with an American Spinal Injury Association score of C or worse, or if the injury occurred > 6 months from enrollment. Data included demographics, medical history, time since concussion, the Sport Concussion Assessment Tool (SCAT5©) post-concussion symptom scale (PCSS), and QP assessment using the PLR3000® (Neuroptics Inc.) hand-held pupillometer. This study identified all subjects clinically diagnosed with concussion who had completed QP assessment, totaling 162. We created tertiles to describe the lowest (0-20), middle (21-43), and the highest (44-113) symptom score groupings to examine QP data. Of 162 subjects, 88 were female (54.3%), with a mean age of 15.8 (SD=6.9) years. Most (49.4%) occurrences were sport-related injuries. The mean time since injury was 21 (SD=28.6) days. The mean SCAT5 PCSS score was 37.3 (SD=25.6). A significant difference within average and maximum constriction velocities (p=.041 and 0.034, respectively) was found between subjects seen early (<2weeks) versus late (>2weeks) after injury. Pupillometry values were statistically different across SCAT5 PCSS tertiles for anisocoria after light exposure (p=.046). This exploratory study is among the first to show that certain QP values - latency of constriction, constriction velocity, and average dilation velocity - may be useful in providing objective metrics when evaluating more symptomatic concussion.

Exploration of symptom cluster patterns and their trajectory in esophageal cancer surgery patients.

To investigate symptom burden and symptom cluster trajectories in patients undergoing surgery for esophageal cancer. A convenience sample of 210 patients who underwent thoracoscopic surgery for esophageal cancer was included from July to December 2023. The symptoms of the patients were evaluated at the following time points: preoperatively (T0), 1-3 days postoperatively (T1), 7 days postoperatively (T2), 1 month postoperatively (T3), and 3 months postoperatively (T4). This was done via the Chinese version of the MD Anderson Symptom Scale and the Supplementary Questionnaire for Perioperative Esophageal Cancer Symptoms. Exploratory factor analysis was used to identify symptom clusters, and latent class growth modeling was used to analyze the trajectories of each different symptom cluster. Exploratory factor analysis revealed the presence of four symptom clusters: mood-related symptom clusters (worst at T1, T2, and T4), gastrointestinal symptom clusters (worst at T0), fatigue-related symptom clusters (worst at T3), and surgery-related symptom clusters, with cumulative variance contribution rates of 64.34%, 62.29%, 68.23%, 70.29%, and 63.82%, respectively. The latent category growth model identified the existence of 2-3 distinct trajectories in each symptom cluster. This study identified 4 distinct symptom clusters in patients undergoing esophageal cancer surgery. The mood-related and gastrointestinal symptom clusters exhibited worsening and recurrence within 7 days post-surgery, necessitating particular attention. A subset of patients in the fatigue-related symptom cluster showed a tendency for continued exacerbation, emphasizing the need for long-term monitoring. Furthermore, symptom management strategies can be prioritized based on the severity of the symptom clusters.

Preoperative Psychological Factors, Postoperative Pain Scores, and Development of Posttraumatic Stress Disorder Symptoms After Pediatric Anterior Cruciate Ligament Reconstruction.

Acute orthopedic injuries and subsequent surgical repair can be challenging for children and adolescents and result in posttraumatic stress reactions that can be problematic after the acute perioperative period. In a cohort of patients undergoing anterior cruciate ligament reconstruction (ACLR), we investigated the incidence and explored risk factors associated with the development of posttraumatic stress disorder (PTSD) symptoms after surgery. We analyzed data from a multicenter, prospective, observational registry of pediatric patients undergoing ACLR. Patient data included demographic, psychological assessments, postoperative pain measures, and a posttraumatic stress disorder assessment (Child PTSD Symptom Scale [CPSS]) collected after the operation. An analysis of patients who provided survey data at 6 months was used to determine the incidence of posttraumatic stress reactions and to explore associated risk factors. A total of 519 patients were enrolled in a prospective observational study of outcomes after ACLR. A cohort of 226 patients (44%) provided completed data collection and CPSS follow-up surveys at 6 months. We found that 17 of the patients (7.5%) met the criteria for PTSD at 6 months which represents 3.3% of our total study population (17/519). A univariate analysis suggested that a negative (P = .017), excitable (P = .039), or inhibitory (P = .043) temperament compared to a positive temperament, high preoperative scores for anxiety (P = .001) or depression (P = .019) and high pain scores on postoperative day (POD)1 (P = .02) increased the odds of PTSD at 6 months. A multivariable model revealed that patients self-reporting symptoms consistent with clinical anxiety/depression preoperatively and patients with a max pain score ≥7 on POD1 were 29 times (P = .018) and 9.8 times (P = .018) more likely to develop PTSD at 6 months. A portion of patients undergoing ACLR are at risk for the development of symptoms consistent with PTSD. Risk factors include preoperative anxiety or depression and high postoperative pain scores. Interventions designed to address preoperative risk factors and optimization of postoperative pain may represent opportunities to improve outcomes in this patient population.

A Retrospective Analysis of Rates of Malingering in a Forensic Psychiatry Practice.

Malingering is defined as the intentional falsification or exaggeration of symptoms for secondary gain. The prevalence of malingering varies widely among different medicolegal contexts, emphasizing the need to identify additional predictive factors when considering the diagnosis. This study measured rates of malingering in a sample of 1,300 subjects from a forensic psychiatry practice located in Lexington, Kentucky. Among those who failed at least three symptom or performance validity scales, odds ratios for malingering were approximately twice as high in subjects with less than a college education (p = .011), those referred by the opposing counsel (p = .001), and those meeting criteria for a mental illness in three or more DSM-5 diagnostic categories (p = .015). Those evaluated for worker's compensation and head injury were more likely to malinger than other case types (p = .028). Men were found to malinger at a higher rate than women (p = .014), and no significant differences were observed based on race. These results indicate that education, gender, psychiatric history, case type, and referral type may be important factors to consider when assessing for malingering.

Exploring the influence of health and digital health literacy on quality of life and follow-up compliance in patients with primary non-muscle invasive bladder cancer: a prospective, single-center study

ObjectiveGiven the increasing significance of digital health literacy (DHL) and health literacy (HL) in promoting informed decision-making and healthy behaviors, this study aimed to assess the influence of self-reported HL and DHL on treatment adherence and quality of life among patients who underwent transurethral resection of bladder tumors (TUR-BT) for primary non-muscle invasive bladder cancer (NMIBC).Materials & methodsThis single-center observational study involved patients who underwent TUR-BT for NIMBC at a tertiary hospital from May 2022 to February 2024. Before the procedure, the patients’ DHL and HL were evaluated using the European Health Literacy Survey Questionnaire short version and the eHealth Literacy Scale. Six months after surgery, we surveyed patients’ QoL using the EORTC QLQ-C30. In line with recommendations from the European Association of Urology guidelines, adherence to the treatment plan was assessed along with a follow-up cystoscopy examination for each patient.ResultsMultivariate analysis revealed that poorer DHL and HL were significantly associated with older age (p < 0.001), lower educational attainment (p < 0.001), and lack of internet access (p < 0.001). Conversely, higher DHL and HL levels were positively correlated with increased treatment adherence, as measured by cystoscopy completion (p < 0.001). Additionally, logistic regression analysis demonstrated significant associations between improved DHL and HL scores and better global health status (DHL, p = 0.022; HL, p = 0.008), higher emotional status (p < 0.001 for both), and social functioning (p < 0.001 for both). Notably, there were no significant differences in the symptom scale scores between the DHL and HL groups.ConclusionTo the best of our knowledge, this is the first study to explore the specific effect of HL/DHL on QoL and adherence in this patient population. Our research suggests that there may be a link between self-reported levels of DHL/HL and treatment adherence as well as QoL among patients with NIMBC.

Does mental contamination mediate the relationship between perceived teasing experiences and body dysmorphic disorder-related symptoms?

ABSTRACT Objective This study aimed to examine the relationship between body dysmorphic disorder (BDD) symptoms and mental contamination (MC). Specifically, it explored whether appearance-related teasing episodes evoke feelings of MC and whether these feelings mediate the association between teasing and BDD symptoms and their severity in a nonclinical sample. Method Three hundred and eighty-five undergraduate students completed online measures that included the Body Dysmorphic Disorder Symptom Scale, the Perception of Appearance- and Competency Related Teasing Scale, and the Vancouver Obsessive-Compulsive Inventory-Mental Contamination Scale. Results Appearance-related teasing was significantly associated with BDD symptoms and symptom severity, and MC partially mediated this relationship. Significant correlations were found between teasing, BDD cognitions, and checking and avoidance behaviours. MC was most strongly associated with BDD cognitions, checking, and avoidance, indicating its potential role in maintaining these behaviours. Mediation analyses confirmed that MC partially explained the relationship between teasing and both BDD symptoms and severity. Conclusions Mental contamination partially mediated the relationship between appearance-related teasing and BDD symptoms in a nonclinical sample. These preliminary findings, based on correlational data, suggest that mental contamination may play a role in the development and maintenance of BDD, warranting further exploration with clinical samples.

Late-onset hypogonadism: current methods of clinical diagnosis and treatment in Japan.

Testosterone affects several organs in the body and is very important for male well-being. Aging men with late-onset hypogonadism (LOH) experience physiologic, psychiatric, and sexual symptoms related to a decline in the serum concentration of testosterone with age. However, it is well-known that the extent of the decline in testosterone concentration does not correlate with the severity of LOH-related symptoms. Therefore, it is difficult to diagnose and treat patients with LOH. In addition, the symptoms, response to testosterone replacement therapy (TRT), and medical insurance coverage differ among ethnicities and countries. The evaluation of testosterone is essential for the diagnosis and treatment of LOH. The effects of testosterone are determined not only by the serum testosterone concentration but also by the androgen receptor sensitivity. A low number of glutamine repeats is indicative of high androgenic activity, and the number shows ethnicity-related differences (fewer in African American than in Caucasian people and more in East Asian people). The diagnosis of LOH is typically made using subjective symptoms and the serum testosterone concentration. The Aging Male Symptoms scale is widely used to evaluate the symptoms. The normal range of total testosterone concentration varies around the world; therefore, clinicians should follow the guidelines of their regional academic society. The principal treatment for LOH is TRT. There are many types of TRT and other treatment strategies are also available. Thus, physicians should treat LOH according to each patient's situation, considering related disorders, such as diabetes, osteoporosis, metabolic syndrome, and depression.

Exploring the effects of aromatherapy and acupoint herbal patching on fatigue and sleep disorders in people living with HIV: a pilot randomized trial

ABSTRACT The purpose of this study was to investigate the effects of aromatherapy and acupoint herbal patching on fatigue and sleep disorders in people living with HIV (PLWH). Aromatherapy and acupoint herbal patching are ancient alternative therapies in traditional Chinese medicine. We randomly selected 90 patients from the Nanjing Public Health Medical Center in China and divided them into three groups: aromatherapy group, acupoint herbal patching group and control group. They were supposed to fill in the Pittsburgh Sleepiness Index Scale (PSQI), the Piper Fatigue Scale (PFS), and the Liver Depression and Spleen Deficiency Insomnia Symptoms Scale (LDSSIPS) before and after the intervention. The results showed that the difference between the PSQI score and fatigue score of the aromatherapy group and acupressure group before and after the intervention was statistically significant (P < 0.05), and the difference between the scores of the three groups after the intervention was statistically significant (P < 0.05). This study found that aromatherapy and acupoint herbal patching could effectively alleviate fatigue of PLWH and improve the quality of sleep, and that the therapeutic effect of the aromatherapy group was comparable with that of the acupoint herbal patching group.

Depression symptom severity and behavioral impairment in school-going adolescents in Uganda

BackgroundDuring adolescence, a critical developmental phase, cognitive, psychological, and social states interact with the environment to influence behaviors like decision-making and social interactions. Depressive symptoms are more prevalent in adolescents than in other age groups which may affect socio-emotional and behavioral development including academic achievement. Here, we determined the association between depression symptom severity and behavioral impairment among adolescents enrolled in secondary schools of Eastern and Central Uganda.MethodsThis cross-sectional study was conducted among 1,669 adolescents enrolled in secondary schools in Eastern and Central Uganda. Our outcome variable was behavioral impairment defined as self-reported behavior that interferes with an individuals’ ability to do schoolwork (school performance) or get along with others (peer interaction) (yes/no). The key independent variable was depression symptom severity assessed using the Child and Adolescent Symptom Inventory-5 (CASI-5), a behavior rating scale for symptoms of DSM-5 emotional and behavioral disorders. Modified Poisson regression models tested the independent association between depressive symptom severity and behavioral impairment. Prevalence Rate Ratios (PRR) and 95% confidence intervals (95%CI) were reported.ResultsParticipants’ mean age was 15.3 years (SD = 1.8), 58.5% were female, 86.8% witnessed domestic violence, 47.4% had behavioral impairment, and 2.8% had mild depression symptoms. School-going adolescents with mild depression symptoms had two times higher risk of behavioral impairment when compared to those with no or slight depression symptoms, after controlling for potential confounders. Other factors independently associated with higher risk for behavioral impairment were female sex (Adj. PRR 1.27, 95%CI 1.12, 1.43) compared to males, taking alcohol (Adj. PRR 1.42, 95%CI 1.25, 1.61) compared to not taking alcohol, boarding school enrollees (Adj. PRR 1.62, 95%CI 1.33, 1.98), and day school enrollees (Adj. PRR 1.46, 95%CI 1.21, 1.76) compared to mixed (day and boarding) school enrollees respectively, advanced level enrolment (Adj. PRR 1.25, 95%CI 1.05, 1.48) compared to ordinary level enrolment, and attending urban schools (Adj. PRR 1.27, 95%CI 1.11, 1.45) compared to rural secondary school attendance.ConclusionsBehavioral impairments are widespread among Ugandan secondary students. Mild depression symptoms adversely affect adolescents' academic and social lives, potentially leading to long-term consequences. Where feasible, early detection of depressive symptoms and treatment may mitigate their negative effects on student school performance ability and peer/social interaction. Future research should examine school-level factors influencing academic performance by depression status. Policymakers in education and gender sectors should prioritize mental health programs in secondary schools.

A Comparative randomised controlled trial of Homeopathy -vs- Allopathy in Acute Otitis Media and its recurrence in Children.

This study evaluates the efficacy of homeopathic treatments for Acute Otitis Media (AOM) in children, comparing outcomes to standard allopathic treatments. Building on promising pilot study results that suggested homeopathy's non-inferiority, this multicenter trial aims to validate these findings and assess their broader clinical applicability. This open-label, randomized controlled trial was conducted on children (aged 02 to 12 years), suffering from acute otitis media. Primary outcome was changes in Acute Otitis Media-Severity of Symptoms (AOM-SOS) scale and Tympanic Membrane Examination scale (TMES) over 21 days and time to improvement in pain through FPS-R (Facial Pain Scale-Revised) over 10 days. The secondary outcomes were the need for antibiotics during acute AOM and the recurrence over 12 months. Intention to treat analysis was carried out on 222 children; Homeopathy(n=116)(H-group), Allopathy(n=106) (A-group). Statistically significant reduction in AOM-SOS+TMES score in H-group compared to A-group was observed at time point day 3 (mean diff.±sd: 1.67±0.47; 95% CI: 0.75 to 2.59; p=0.001), at day 7 (mean diff.±sd: 1.22±0.56; 95% CI: 0.13 to 2.31, p=0.028) favored homeopathy. However, the median time for FPS-R score to become zero by day 10 (H= 3 days, A= 4 days) was statistically insignificant (p=0.29). None of the children in the H group required antibiotics whereas it was required in 14 children(12.4%) in A group . Homeopathic treatment helped in managing acute otitis media in children similar to that of Allopathic treatment. Homeopathy can be a safe treatment approach in managing in this condition. Further blinded studies are warranted.

Allergic Rhinitis and its Impact on Asthma (ARIA) Classes in MASK-air Users.

The Allergic Rhinitis and its Impact on Asthma (ARIA) guidelines classify rhinitis as "intermittent" or "persistent" and "mild" or "moderate-severe". To assess ARIA classes in a real-world study in terms of phenotypic differences and their association with asthma. We performed a cross-sectional real-world study based on users of the MASK-air® app who reported data for at least 3 different months. We assessed the frequency of users according to the ARIA classes and compared these classes in terms of rhinitis symptoms, use of comedication, frequency of comorbid asthma, and the association between comorbid asthma and rhinitis control. A total of 2273 users (180 796 days) were assessed. Most users had moderate-severe rhinitis (n=2003; 88.1%) and persistent rhinitis (n=1144; 50.3%). The frequency of patients with probable asthma was 35.7% (95%CI, 34.5%-37.0%) for intermittent rhinitis and 48.5% (95%CI, 47.1%-49.9%) for persistent rhinitis. The maximum values on the visual analog scale (VAS) for rhinitis symptoms and the combined symptom medication score were lower in patients with mild rhinitis than in those with moderate-severe rhinitis (irrespective of whether they had persistent or intermittent rhinitis). In most ARIA classes, VAS nose and VAS eye and rhinitis comedication were more frequent in patients with rhinitis+asthma than in those with rhinitis alone. This study suggests that the presence of asthma is more closely related to persistence of rhinitis than to severity and that the presence of comorbid asthma may be associated with poorer control of rhinitis across the different ARIA classes.

Delirium after deep brain stimulation for Parkinson's disease: a meta-analysis of incidence and risk factors.

Deep brain stimulation (DBS) is a valuable treatment for Parkinson's disease (PD), but postoperative delirium (POD) is a common complication. Understanding the risk factors for POD is crucial for optimizing patient selection and developing preventative measures. This systematic review and meta-analysis aims to identify predictors of POD in PD patients undergoing DBS surgery. We conducted a comprehensive search of four major databases for cohort studies on POD in patients undergoing DBS for PD, up to June 2024. Two reviewers independently screened studies, assessed the risk of bias using the Newcastle-Ottawa Scale, and extracted data. Meta-analysis was conducted using Review Manager, with heterogeneity assessed the I2 statistic and chi-square p value. Subgroup and sensitivity analyses were also performed to explore the consistency of findings. Eleven studies, including 1,368 patients, were analyzed to determine the incidence of POD in PD patients undergoing DBS. The incidence of POD in PD patients undergoing DBS, which was found to be 21% (95% CI: [14.6%, 27.4%]). Age, Mini-Mental State Examination (MMSE), and Non-Motor Symptom Scale (NMSS) were significant predictors, with effect sizes of (OR = 1.10, 95% CI: [1.06, 1.15], P < 0.00001), (OR = 0.85, 95% CI: [0.72, 1.00], P = 0.05), and (OR = 1.01, 95% CI: [1.00, 1.02], P = 0.04), respectively. However, gender, UPDRS-III ON score, brain atrophy, diabetes, Hamilton Anxiety Score (HAMA), operation time, disease duration, BMI, and cerebral infarction were not significant predictors. This meta-analysis suggests that age, cognitive function, and non-motor symptoms are important factors associated with POD patients undergoing DBS surgery. Further research with larger sample sizes and diverse populations is needed to confirm these findings and identify more specific predictors.

Affect lability scale (ALS-18) and ADHD: incremental validity of depression, depression/anxiety and anger in the predictions of inattention and hyperactivity/impulsivity in adults

Abstract Affect lability, or difficulties in emotional regulation, has been suggested to be a defining factor in ADHD presentations, with previous studies identifying a relationship between affect lability and ADHD. However, the relationship between different dimensions of lability and ADHD dimensions has not been explored. This study aims to examine whether the three affect lability dimensions– depression/elation (D), depression/anxiety (D/A), and anger (A)– have incremental validity in predicting ADHD symptoms of inattention (IA) and hyperactivity/impulsivity (HI). A total of 558 adults aged 18–65 (Mage = 32.75; 18.8% men) from the general community completed the ALS-18 and the Current Symptom Scale (CSS). A structural equation model (SEM) approach was used to evaluate incremental validity. For a comprehensive evaluation, three different SEM models corresponding to different orders of entry of the predictors were computed to assess the incremental validity of the three ADHD dimensions. Overall, the findings showed that both D/A and D provided comparable incremental validity in the predictions of IA and HI, whereas A did not predict IA and HI. Therefore, D/A and D are important affect lability dimensions for the prediction of ADHD. These results suggest that not all components of affect lability were equally important in explaining ADHD symptoms, indicating the need to consider specific dimensions of affect lability for a more accurate understanding and treatment outcomes. Future research should further explore these relationships, incorporating broader affect lability dimensions and larger samples to generalize findings more effectively.

Efficacy and safety of abhal (Juniperus communis L). on pain intensity, uterine artery doppler flow, and quality of life in primary dysmenorrhea: A double-blind, randomized controlled trial.

Incorporating ancient wisdom from Unani Medicine, this study delves into the therapeutic efficacy of Juniperus communis L. in primary dysmenorrhea. By seamlessly merging traditional knowledge with modern scientific evaluation, this research illuminates Juniperus communis L. (Juniper) potential. This study stands as a testament to the value of exploring ethnopharmacological insights and bridging the gap between ancient healing traditions and evidence-based medicine. To assess the efficacy and safety of Juniper berry compared to mefenamic acid in menstrual cramps and its associated symptoms, and overall quality of life in women with PD. Additionally, the study aimed to explore the impact of these interventions on uterine blood flow using Doppler evaluation. This was a double-blind, standard-controlled study conducted on 62 participants aged 18-35 years. They were randomly assigned to receive either two capsules (750mg) of Juniper berry or 250mg mefenamic acid thrice daily from day 1 to day 3 of menstruation, spanning two menstrual cycles. Primary outcomes were measured using the Visual Analogue Scale (VAS) for pain intensity and the Numerical Rating Scale (NRS) for systemic symptoms. Pelvic Doppler flow indices and responses to the SF-12 questionnaire were analyzed as secondary outcomes. After the intervention in cycle 2, both the juniper and standard groups exhibited a significant reduction in mean VAS scores from 8.1±1.3 to 2.87±1.17 and 8.1±1.13 to 3.61±1.14, respectively (p=0.012). Intergroup comparisons revealed no statistically significant differences in systemic symptoms at baseline, and cycle 2 (C2) follow-up (p>0.05). Similarly, there were no significant differences in the SF-12 questionnaire scores at baseline, C2, and C4 (p>0.05). However, intragroup comparisons for VAS, NRS, and SF-12 in both groups showed significant differences at C2 and C4 compared to the baseline (p<0.001). In the juniper group, intergroup and intragroup comparisons indicated a small effect size for the right uterine artery (Rt UtA) RI and SD at C3 compared to C1 (0.2 and 0.33). Left UtA-PI and RI also demonstrated a medium effect size (0.482 and 0.501), respectively, between C3 and C1. Juniper demonstrated significant efficacy and safety in reducing menstrual cramps, and its associated symptoms and improving health-related quality of life. Further, changes in pelvic uterine artery flow indices were also observed.

Impact of motor features on non-motor symptoms in patients with de novo Parkinson's disease: Cognition, depression, anxiety, fatigue, and dysautonomia.

Patients with Parkinson's disease (PD) present with both motor and non-motor symptoms, and understanding the interplay between these symptoms is crucial for individualized patient care. This study aims to investigate the relationship between motor features and non-motor symptoms in patients with de novo PD. A total of 105 patients were analyzed, focusing on motor subtypes or subscores and their impact on cognition, depression, anxiety, fatigue, and dysautonomia. We utilized the Unified Parkinson's Disease Rating Scale-part III (UPDRS-III) for motor assessment, and various validated scales for non-motor symptoms. Compared with tremor-dominant (TD) patients, non-TD patients showed severe scores in fatigue and dysautonomia, but no difference in other non-motor symptoms, including global cognition, depression, and anxiety. Linear regression analysis revealed that the total motor score of UPDRS-III was negatively related to global cognition (β = -0.4454, P = 0.0121). As a post-hoc analysis, partial correlation analysis showed that rigidity and bradykinesia subscores were associated with global cognition (r = -0.3527, P = 0.0004; r = -0.2206, P = 0.0299, respectively), whereas the postural instability/gait difficulty subscore was associated with depression, anxiety, fatigue, and dysautonomia (r = 0.2181, P = 0.0319; r = 0.2371, P = 0.0194; r = 0.3659, P = 0.0002; r = 0.3968, P = 0.0001, respectively) but not with global cognition. These results suggest that motor features in the early stages of PD can serve as important indicators of non-motor symptoms, potentially guiding more personalized therapeutic approaches. Geriatr Gerontol Int 2025; ••: ••-••.

Efficacy of yeast beta-glucan 1,3/1,6 supplementation on respiratory infection, fatigue, immune markers and gut health among moderate stress adults in Klang Valley of Malaysia: protocol for a randomised, double-blinded, placebo-controlled, parallel-group study

IntroductionYeast beta-glucan (YBG) are recognised for enhancing the immune system by activating macrophages, a key defence mechanism. Given the global prevalence and impact of upper respiratory tract infections (URTIs) on...

Performance on the Concussion Balance Test Is Indicative of Time to Recovery in Athletes Following Sports-Related Concussion: An Exploratory Analysis.

Sports-related concussions (SRCs) are commonly occurring injuries among athletic and recreationally active populations. SRCs can result in vestibular dysfunction that should resolve before returning to activity. It has been suggested that vestibular impairment is a factor that may influence recovery time. The objective of this study was to evaluate the effect of vestibular function on recovery following SRC. Retrospective chart review. Multidisciplinary Concussion Clinic. A total of 32 patient charts (21 males, 15.34 [1.47]y, 171.29 [8.44]cm, 68.37 [15.47]kg) from patients diagnosed with SRC presenting to a concussion clinic between August of 2016 and July 2017 with clinician-identified vestibular involvement were included. Scores on the Post-Concussion Symptom Scale, Dynamic Visual Acuity Test, Gaze Stabilization Test, Concussion Balance Test (COBALT), and other clinical data were used for analysis. Descriptive statistics were calculated for all variables. Pearson correlations were used to identify variables related to time to recovery. Variables were entered into a forward linear regression model. Moderate to good relationships were identified between days to recovery and Dynamic Visual Acuity Test lines lost in the leftward direction (1.17 [0.52]; r = .39, P = .04), COBALT-condition 8 sway velocity (1.20 [0.18]; r = .44, P = .01), and days to successful completion of the COBALT (14.72 [8.35]; r = .63, P < .001). Patients' predicted time to recover was equal to 14.61 (0.86) (days to successful COBALT). The model was significant (P < .001, R2 = .30). The single predictor of time to recover was the number of days to successful completion of the COBALT. Thus, the ability to complete the task may be more informative than the performance on the task in predicting recovery time.

Characterizing Parkinson's Disease-Associated Pain in Native Patients with Malayalam Version of the King's Parkinson's Disease Pain Scale.

Pain is an important non-motor symptom in Parkinson's disease (PD) and is often under-recognized. Pain is also a symptom frequently reported by non-PD elderly subjects. The King's Parkinson's Disease Pain Scale (KPPS) is a valid tool to characterize and quantify pain in PD and has been translated into several languages. We translated KPPS to Malayalam for native patients with PD and examined the pain characteristics in consecutive patients. Correlations with comprehensive disease-specific rating scales, including the Movement Disorder Society-Sponsored Unified Parkinson's Disease Rating Scale (MDS-UPDRS) and the Non-Motor Symptoms Scale (NMSS), were explored. A group of age- and gender-matched subjects without PD were interviewed using KPPS to examine how the pain reported by the non-PD aging population is different from that in PD. In this study, 82% of patients with PD reported at least one type of pain, compared to 31.3% of age- and gender-matched control subjects (P < 0.001). KPPS total scores (18.2 ± 14.0 vs. 1.8 ± 3.2; P < 0.001) and all the individual domain scores were significantly higher in patients. Pain scores correlated with age in control subjects (R = 0.46, P < 0.001), but not in patients; females reported more pain in both groups. Patients' pain scores were higher in the postural instability and gait difficulty subtype and showed significant correlations with MDS-UPDRS and NMSS scores. Pain is a prevalent symptom in PD and differs from the pain reported by a non-PD aging population. The Malayalam version of KPPS is a valid tool to characterize pain in native, Malayalam-speaking patients.