Fear of cancer recurrence and change in hair cortisol concentrations in partners of breast cancer survivors.

PURPOSE: Partners of breast cancer (BC) survivors report high rates of psychological distress including fear of cancer recurrence (FCR). Research suggests that partners may have poorer physical health outcomes than the general population, but little research has examined the physiological biomarkers by which distress may impact partner health outcomes. The current study examined the associations between FCR and changes in hair cortisol among BC partners. METHODS: Male partners (N = 73) of early-stage BC survivors provided hair samples during two visits, one after completion of survivors' adjuvant treatment (T1) and again 6 months later (T2). Two subscales from the Fear of Cancer Recurrence Inventory and one subscale from the Concerns about Recurrence Scale comprised a latent FCR factor at T1. A latent change score model was used to examine change in cortisol as a function of FCR. RESULTS: Partners were on average 59.65 years of age (SD = 10.53) and non-Hispanic White (83%). Latent FCR at T1 was positively associated (b = 0.08, SE = 0.03, p = .004, standardized ß = .45) with change in latent hair cortisol from T1 to T2. CONCLUSIONS: Results indicated that greater FCR was associated with increases in hair cortisol in the months following adjuvant treatment. This is one of the first studies to examine the physiological correlates of FCR that may impact health outcomes in BC partners. IMPLICATIONS FOR CANCER SURVIVORS: Findings highlight the need for further research into the relationship between FCR and its physiological consequences. Interventions to address partner FCR are needed and may aid in improving downstream physical health outcomes.

Romantic relationships and type 2 diabetes: The role of invisible social control.

OBJECTIVE: This study aimed to determine whether invisible social control provided by a romantic partner is associated with improved objective glucose outcomes for patients with Type 2 diabetes. Social control reflects a partner's attempt to modify or influence a patient's health behaviors. We hypothesized that the best outcome for all continuous glucose monitoring measures would be captured by an interaction condition reflecting invisible social control. METHOD: Patients with Type 2 diabetes and their partners (N = 63 couples) completed an 8-day daily diary period between 2016 and 2017. Self-report measures of social control receipt and provision were obtained each evening from patients and partners and patients wore a continuous glucose monitor throughout the diary period. Outcomes of daily glucose mean, standard deviation, time in range, and coefficient of variation were computed and two-way interactions between social control receipt and social control provision were probed and plotted. RESULTS: The two-way interaction significantly predicted daily glucose mean, standard deviation, and time in range, such that when patients reported no social control receipt, but partners reported social control provision, patients showed improvements in objective glucose measures. We found no significant effect for coefficient of variation. CONCLUSIONS: This study was the first to use an invisible social control framework to examine the daily dyadic associations between partner social control provision, patient social control receipt, and four objectively measured continuous glucose monitoring outcomes. Findings suggest that the visibility of social control provided by a romantic partner may be predictive of glycemic control in patients with Type 2 diabetes. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Determinants of experience & satisfaction in telehealth psychiatry during the COVID-19 pandemic for patients & providers.

Introduction: The objective of this study was to characterize the experiences and overall satisfaction of patients and providers with the March 2020 transition to telehealth in a psychiatric setting (telepsychiatry). The study also investigated how socio-demographic and clinical characteristics impact an individual's experiences and satisfaction with telepsychiatry. Methods: Responses were collected from 604 patients and 154 providers engaged in clinical care at one of three participating Johns Hopkins Medicine outpatient psychiatric clinics between January 2020-March 2021. Survey data were collected by self-report via Qualtrics or telephone follow-up. Results: Respondents were predominately female and White. Over 70% of patients and providers were generally satisfied with telepsychiatry. However, providers were more likely to favor in-person care over telepsychiatry for post-pandemic care 48% to 17% respectively, while 35% rated both modalities equivalently. Patients were more evenly divided with 45% preferring telepsychiatry compared to 42% for in-person care, and only 13% rating them equivalently. Among providers, technical difficulties were significantly associated with both less satisfaction and lower preference for telepsychiatry [odds ratio for satisfaction (ORS) = 0.12; odds ratio for preference (ORP) = 0.13]. For patients, factors significantly associated with both lower satisfaction and lower preference for telepsychiatry included technical difficulties (ORS = 0.20; ORP = 0.41), unstable access to the internet (ORS = 0.46; ORP = 0.50), worsening depression (ORS = 0.38; ORP = 0.36), and worsening anxiety (ORS = 0.41; ORP = 0.40). Factors associated with greater satisfaction and higher preference for telepsychiatry among patients included higher education (ORS = 2.13; ORP = 1.96) and a decrease in technical difficulties over time (ORS = 2.86; ORP = 2.35). Discussion: Patients and providers were satisfied with telepsychiatry. However, there were greater differences between them in preferences for continuing to use telepsychiatry post-pandemic. These findings highlight factors that influence patient and provider preferences and should be addressed to optimize the use of telepsychiatry in the future.

Daily partner responsiveness and everyday sleep outcomes in breast cancer survivors and their partners.

PURPOSE: Breast cancer (BC) survivors and their intimate partners face several adverse consequences from the cancer experience, including sleep disturbance, which is a common side effect of BC and its treatment. Sleep has been conceptualized and examined as an individual phenomenon despite most adults sharing a bed/room with a partner. Limited research has examined the associations between daily relationship processes and sleep in couples coping with cancer. Using an intensive longitudinal design, the present study examined the daily, within-person links between attempted and perceived partner responsiveness and subjective sleep. METHODS: Immediately following adjuvant treatment, 72 early-stage BC survivors and their intimate partners (144 paired individuals) reported on daily attempted and perceived partner responsiveness each evening and subjective sleep each morning for 21 consecutive days. RESULTS: Survivor and partner reports of partner responsiveness were associated with their own subjective sleep, such that greater attempted and perceived partner responsiveness were associated with improvements in one's own subjective sleep. Effects of one participant's partner responsiveness on their partner's sleep were not observed. CONCLUSIONS: Findings suggest that among couples coping with early-stage BC, increased partner responsiveness is associated with subsequent improvements in subjective sleep. IMPLICATIONS FOR CANCER SURVIVORS: Sleep disturbance is a serious concern for BC survivors and their intimate partners. Future research should assess intimacy processes as a potential method to improve BC survivor and partner sleep.

National Network of Depression Centers' Recommendations on Harmonizing Clinical Documentation of Electroconvulsive Therapy.

ABSTRACT: Electroconvulsive therapy (ECT) is a highly therapeutic and cost-effective treatment for severe and/or treatment-resistant major depression. However, because of the varied clinical practices, there is a great deal of heterogeneity in how ECT is delivered and documented. This represents both an opportunity to study how differences in implementation influence clinical outcomes and a challenge for carrying out coordinated quality improvement and research efforts across multiple ECT centers. The National Network of Depression Centers, a consortium of 26+ US academic medical centers of excellence providing care for patients with mood disorders, formed a task group with the goals of promoting best clinical practices for the delivery of ECT and to facilitate large-scale, multisite quality improvement and research to advance more effective and safe use of this treatment modality. The National Network of Depression Centers Task Group on ECT set out to define best practices for harmonizing the clinical documentation of ECT across treatment centers to promote clinical interoperability and facilitate a nationwide collaboration that would enable multisite quality improvement and longitudinal research in real-world settings. This article reports on the work of this effort. It focuses on the use of ECT for major depressive disorder, which accounts for the majority of ECT referrals in most countries. However, most of the recommendations on clinical documentation proposed herein will be applicable to the use of ECT for any of its indications.

Long-term physical health outcomes of obsessive-compulsive personality disorder traits.

BACKGROUND: Obsessive-compulsive personality disorder (OCPD) is characterized by pervasive and persistent traits including preoccupation with orderliness, perfectionism, and control. Relatively little is known about the potential relationship between OCPD traits and physical health. METHODS: We investigated the association between OCPD traits and several self-reported medical conditions in 249 individuals followed prospectively from 1981 until 2004/2005 as part of the Epidemiological Catchment Area. RESULTS: The OCPD trait score was inversely related to hypertension in males, in models unadjusted (OR = 0.66; 95% CI, 0.45-0.90) and adjusted (OR = 0.70; 95% CI, 0.47-0.95) for sociodemographic variables. Perfectionism was inversely related to hypertension in the unadjusted models for men (OR = 0.34; 95% CI, 0.12-0.89). Indecisiveness was positively associated with heart conditions in adjusted models for women (OR = 3.46; 95% CI, 1.11-10.52). CONCLUSION: OCPD traits are associated with cardiovascular health in both sexes. Further studies are needed to understand the specificity of these relationships, as well as to determine the underlying mechanism.

Correction: A novel epigenetic modulating agent sensitizes pancreatic cells to a chemotherapy agent.

[This corrects the article DOI: 10.1371/journal.pone.0199130.].

A novel epigenetic modulating agent sensitizes pancreatic cells to a chemotherapy agent.

Pancreatic ductal adenocarcinoma (PDAC) is expected to be the second leading cause of cancer mortality by 2030. PDAC remains resistant to the majority of systemic chemotherapies. In this paper, we explore if epigenetic sensitization can improve chemotherapy response in PDAC. Multiple PDAC cell lines were tested with serial concentrations of the epigenetic modulators 5-azacitidine (Aza) and guadecitabine (SGI-110). Guadecitabine was effective at inhibiting the expression of DNA Methyltransferase 1 (DNMT1) and in decreasing cell viability at nanomolar concentrations. We also report that guadecitabine has increased efficacy following a delay period or as we reference, a 'rest period'. Sensitization with guadecitabine improved response to the chemotherapeutic agent-Irinotecan- as measured by decreased cell viability and accompanied by an increase in caspase activity. Additional studies are needed to understand the mechanism of action.

Efficiency and Specificity of Targeted Integration Mediated by the Adeno-Associated Virus Serotype 2 Rep 78 Protein.

The adeno-associated virus serotype 2 (AAV2) Rep 78 protein, a strand-specific endonuclease (nickase) promotes site-specific integration of transgene sequences bearing homology arms corresponding to the AAVS1 safe harbor locus. To investigate the efficiency and specificity of this approach, plasmid-based donor vectors were tested in concert with nuclease encoding vectors, including an engineered version of the AAV2 Rep 78 protein, an AAVS1-specific zinc finger nuclease (ZFN), and the CRISPR-Cas9 components in HEK 293 cells. The Rep 78 and ZFN-based approaches were also compared in HEK 293 cells and in human induced pluripotent stem cells using integrase deficient lentiviral vectors. The targeting efficiencies involving the Rep 78 protein were similar to those involving the AAVS1-specific ZFN, while the targeting specificity for the Rep 78 protein was lower compared to that of the ZFN. It is anticipated that the Rep 78 nickase-based targeting approach may ultimately contribute to the reduction of risks associated with other genome editing approaches involving DNA double-strand breaks.

Treatment with epigenetic agents profoundly inhibits tumor growth in leiomyosarcoma.

Leiomyosarcomas are rare mesenchymal neoplasms characterized by a smooth muscle differentiation pattern. Due to the extremely poor prognosis in patients, the development of novel chemotherapeutic regimens remains critically important. In this study, multiple leiomyosarcoma cell lines, SK-UT1, SK-LMS1, and MES-SA were treated with varying doses of the DNA Methyltransferase Inhibitors (DNMTi) 5-azacitidine (Aza), 5-aza-2-deoxycytidine (DAC), and guadecitabine (SGI-110). The effect of these epigenetic modulators was measured using both in-vitro and in-vivo models. Of the three epigenetic modulators, Guadecitabine was the most effective at decreasing cell survival in LMS cell lines. SK-UT1 was found to be the more sensitive to all three epigenetic modulators, while SK-LMS1 and MES-SA were more resistant. The contrast in sensitivity seen was also represented by the increase in apoptosis in Aza and guadecitabine. In parallel with Aza, guadecitabine was observed to also arrest the cell cycle. Treatment with guadecitabine led to a decrease in growth across the spectrum of sensitivity in LMS cell lines, both in a delayed in vitro and in vivo model; in parallel experiments, apoptotic pathways were activated in sensitive and less sensitive lines. Additional studies are required to explore potential therapeutic applications and mechanisms for leiomyosarcoma treatment.