The interaction of oxytocin and nicotine addiction on psychosocial stress: an fMRI study.

The anxiolytic effect of oxytocin (OXT) on psychosocial stress has been well documented, but the effectiveness under the interference of other factors still requires in-depth research. Previous studies have shown that nicotine addiction interacts with OXT on psychosocial stress on the behavioral level. However, the underlying neural mechanism of interaction between OXT and nicotine addiction on psychosocial stress has not been examined, and we conducted two experiments to reveal it. Firstly, after intranasal administration of randomized OXT or placebo (saline), a group of healthy participants (n = 27) and a group of smokers (n = 26) completed the Montreal Imaging Stress Task (MIST) in an MRI scanner. Secondly, a group of smokers (n = 22) was recruited to complete a transcranial direct current stimulation (tDCS) experiment, in which anodal tDCS was applied on subjects' anterior right superior temporal gyrus (rSTG). In both experiment, subjective stress ratings, salivary cortisol samples and the amount of daily cigarette consumption were obtained from each participant. Analysis of variance were applied on both behavioral and neural data to examine the effects of OXT and nicotine addiction, and correlation analysis were used to examine relationships between neural and behavioral data. In first fMRI experiment, analysis of variance (ANOVA) revealed an interaction of OXT and nicotine addiction on subjective stress. In smokers, OXT failed to suppress the elevation of subjective stress and craving ratings after psychosocial stress. A voxel-wise ANOVA of fMRI data identified an interaction between OXT and nicotine addiction in anterior rSTG, and its functional connectivity with right middle frontal gyrus. Correlations between this functional connectivity and subjective psychosocial stress were also found abnormal in smokers. In second tDCS experiment, we found that under tDCS, OXT successfully suppressed the elevation of subjective stress and craving ratings after stress. In summary, we found that nicotine addiction blocked OXT's anxiolytic on psychosocial stress, which was related to abnormalities in anterior rSTG. By applying anodal tDCS on anterior rSTG, OXT's anxiolytic effect was restored in smokers. These findings will support further development on oxytocin's intervention of psychosocial stress in nicotine addiction, and provides essential information for indicating OXT's effectiveness.

Treatment patterns and clinical outcomes in patients with metastatic triple-negative breast cancer: a large-scale data analysis using the Japanese claims database.

PURPOSE: This study evaluated treatment patterns and clinical outcomes among patients with metastatic triple-negative breast cancer (mTNBC) in real-world clinical settings in Japan. METHODS: The treatment patterns, time to next treatment or death (TTNTD), time to treatment discontinuation, adverse events of interest, and medical costs of treating patients with mTNBC in first-, second-, and third-line settings were investigated using data of patients meeting the inclusion criteria between January 2017 and March 2022 in a Japanese medical claims database. The treatment regimens for mTNBC were defined according to the Japanese Breast Cancer Society Clinical Practice Guidelines. RESULTS: In this study, 2236 patients with mTNBC (median age 66.0 years; 99.8% female) were included in the first-line cohort. Of these, 46.6% and 20.8% were included in the second- and third-line cohorts, respectively. The two most frequently used treatments were capecitabine (19.1%) and S-1 (tegafur-gimeracil-oteracil) (14.5%) in the first-line cohort, eribulin (18.3%) and bevacizumab/paclitaxel (14.4%) in the second-line cohort, and eribulin (19.4%) and bevacizumab/paclitaxel (17.5%) in the third-line cohort. The TTNTD shortened as the line of therapy progressed (median 8.0, 6.5, and 5.2 months for the first-, second-, and third-line treatments, respectively). Nausea/vomiting and neutropenia/leukopenia occurred in 62.8% and 18.3% of all patients, respectively. The medical total costs per day were 6.7, 10.2, and 12.9 thousand yen during the first-/second-/third-line treatments, respectively. CONCLUSION: This study provides insight into current treatment patterns for mTNBC in Japan. The cost-benefit balance worsens with later-line treatment and a high unmet need for mTNBC drug treatment remains.

Real-world treatment patterns and clinical outcomes of Japanese patients with non-muscle invasive bladder cancer receiving intravesical bacillus Calmette-Guérin treatment.

OBJECTIVES: To investigate current patterns and outcomes of intravesical bacillus Calmette-Guérin treatment in Japanese patients with bladder cancer, including the proportion of patients completing induction therapy, and time to subsequent treatments. METHODS: This retrospective cohort study utilized administrative claims data from the Medical Data Vision Co., Ltd. database to identify patients with a diagnosis of bladder cancer who had received ≥1 prescription of intravesical bacillus Calmette-Guérin between April 2008 and September 2015, and had ≥1 database record dated ≥12 weeks after the initial bacillus Calmette-Guérin dose. Patients were followed until September 2018, the last date of available data, or in-hospital death. Patients receiving six doses of bacillus Calmette-Guérin at intervals of <21 days were considered to have completed induction according to guidelines. Time from initial bacillus Calmette-Guérin dose to subsequent bladder cancer treatment after the end of treatment was defined as the recurrence-free duration. RESULTS: Of 6140 patients identified (median age 73.0 years; 83.4% males), 4588 (74.7%) completed induction and 1552 (25.3%) did not. Median recurrence-free duration was 64.4, 77.7, and 31.6 months in the overall, complete-induction and incomplete-induction cohorts, respectively. Corresponding 3-year recurrence-free rate was 56.3%, 59.0%, and 48.2% in these groups. The rate of cystectomy was approximately 6% at 5 years in all cohorts. CONCLUSIONS: Approximately 75% of Japanese patients who undergo intravesical bacillus Calmette-Guérin treatment receive a guideline-compliant induction regimen, but outcomes were not satisfactory, highlighting the need for more effective treatments for non-muscle invasive bladder cancer.

Factors affecting mammography screening behaviour among rural Vietnamese women.

OBJECTIVES: To identify factors associated with mammography screening behaviour and its predictors among rural Vietnamese women. METHOD: A predictive correlational study involving 120 women aged ≥ 40 years was conducted in the suburbs of Hanoi, Vietnam, in July 2018 by using Breast Cancer Awareness Measurement and the Champion Health Beliefs Model Scale. Mammography screening behaviour was assessed by asking participants about their previous mammography experience. RESULTS: Only 16.7% of participants had undergone mammography screening. High education levels, high monthly family income, having family members or friends with breast cancer, and receiving physicians' recommendations increased the likelihood of participants screening for breast cancer. Mean scores on perceived susceptibility and perceived barriers differed significantly between participants who had and those who had not undergone screening (t = 4.31; p < .001; t = -5.05; p < .001, respectively). Perceived susceptibility and perceived barriers significantly increased the predictive power of the hierarchical logistic model (critical value = 6.16; [df = 2]; p = .046). Perceived barriers were the most significant predictors of screening behaviour (odds ratio 0.84; 95% CI, 0.71-0.99; p = .039). CONCLUSION: Efforts are necessary to increase mammography awareness in the community and promote screening rates in Vietnam.

Isolation and functional characterization of four microbial type terpene synthases from ferns.

Typical plant terpene synthases (TPSs) are responsible for the production of terpenes, a major class of plant secondary metabolites. However, various nonseed plants also harbor genes encoding microbial terpene synthase-like (MTPSL) enzymes. Here, a scan of 31 ferns transcriptomes revealed 40 sequences putatively encoding MTPSLs. Two groups of sequences were recognized based on the key conserved motifs. Four representative genes were isolated from each of the four species Adiantum capillus-veneris, Cyclosorus parasiticus, Drynaria bonii and Microlepia platyphylla. Following their heterologous expression in E. coli, the recombinant proteins were tested for monoterpene synthase and sesquiterpene synthase activity. These enzymatic products were typical monoterpenes and sesquiterpenes that have been previous shown to be generated by classical plant TPSs when provided with GPP and FPP as substrates. Subcellular localization experiments in the leaf epidermis of Nicotiana benthamiana and onion (Allium cepa) inner epidermal cells indicated that AcMTPSL1 and DbMTPSL were deposited in both the cytoplasm and nucleus, whereas CpMTPSL1 and MpMTPSL were localized in the cytoplasm, chloroplasts and nucleus. AcMTPSL1 was up-regulated in plants exposed to methyl jasmonate treatment, suggesting a role for this gene in host defense. This study provides more information about the catalytic function of MTPSLs in nonseed plants and for the first time, the subcellular localization of MTPSLs was experimentally characterized.

Association between subjective symptoms and obesity and postoperative recurrence in differentiated thyroid cancer: a matched-pair analysis.

Several patients with thyroid cancer experience symptom distress after diagnosis and surgery. Data on the association between symptomatology and disease recurrence are limited. A retrospective review of a prospectively maintained database was performed, and 57 patients who had recurrence after operation of differentiated thyroid cancer were identified. Controlling for age, sex, surgery, and tumour stage, 114 patients without recurrent disease were selected by case-control matching. Subjective symptoms at follow-up visits were extracted from medical records and classified into three symptom clusters: pharyngolaryngeal, psychoneurological, and gastrointestinal. Compared to the control group, patients with recurrence had higher symptom totals in the pharyngolaryngeal (P < 0.001) and psychoneurological clusters (P = 0.005). Symptom score >3 yielded a sensitivity of 61.4% and a specificity of 80.7% to predict recurrence. Multivariate Cox regression analysis revealed that high symptom score (hazard ratio [HR] = 4.184), family history of thyroid cancer (HR = 2.463), and obesity (HR = 1.981) were independently associated with disease recurrence. Taken together, the likelihood of postoperative recurrence seemed to increase with high self-perceived symptom burden, family history, and obesity in patients with thyroid cancer. The results could be applied to the recurrence surveillance and symptomatic management of thyroid cancer post-operation.

Effects of exercise interventions on social and cognitive functioning of men with prostate cancer: a meta-analysis.

PURPOSE: Exercise is beneficial for prostate cancer patients' physical functioning; however, effects on social and cognitive functioning are inconsistent. This meta-analysis of exercise interventions for prostate cancer patients had two aims: the primary aim was to evaluate the effects of exercise interventions on social functioning; the secondary aim was to consider additional outcomes of cognitive functioning as well as adverse events. METHODS: Electronic databases (Embase, MEDLINE, PubMed, PsycINFO, and the Chinese database Airti Library) were searched for relevant papers (1987-2019), which included hand searching. After careful inspection, 10 relevant randomized controlled trials were analyzed using Comprehensive Meta-Analysis software; pooled means determined social and cognitive functioning. RESULTS: Meta-analysis of summary scores (fixed-effects model) showed an overall beneficial effect of exercise on social functioning (Hedges' g = 0.35, 95% CI [0.193, 0.515], p < 0.001) and cognitive functioning (Hedges' g = 0.35, 95% CI [0.123, 0.575], p < 0.01) in men with prostate cancer when compared to controls. Intervention durations of 12-16 and 24-48 weeks that provided supervised aerobic exercise combined with resistance exercise sessions had a small to medium effect on social functioning compared to controls. One exercise group experienced one serious, but non-fatal, adverse event due to a higher exercise intensity (50-75% VO2max). DISCUSSION AND RECOMMENDATIONS: To the best of our knowledge, this is the first meta-analysis to examine the effects of exercise interventions on cognitive functioning among prostate cancer patients. We suggest further research be conducted to confirm these findings.

The clinical and economic burden of cytomegalovirus management post allogeneic hematopoietic stem cell transplantation in Japan - a retrospective database study.

Introduction: Reactivation of cytomegalovirus (CMV) infection is a major threat and it causes significant morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT). There remains, however, a paucity of evidence regarding the economic burden of current CMV management in Japan. The aim of this study is to characterize the healthcare resource utilization (HCRU) and cost incurred for CMV management post allo-HSCT, using a Japanese hospital claims database.Methods: Patients who underwent allo-HSCT between April 2010 and March 2018 were identified and followed up for 180 days.Results: In total, 916 patients were included for analysis and categorized into CMV (-) group and CMV (+) group based on the presence of a CMV episode within 100 days post allo-HSCT. A CMV episode was defined as evidence of receiving at least one dose of the following anti-CMV drugs, ganciclovir, foscarnet, or valganciclovir. The mean (± standard deviation [SD]) total length of stay was 93.6 (± 43.7) days in the CMV (+) group, which was significantly longer than 55.9 (±40.6) days in the CMV (-) group, and this trend was more pronounced in patients with multiple CMV episodes. The mean (±SD) total medical cost within 180 days post allo-HSCT was US$122,328 (±56,977) in the CMV (+) group, while the mean total medical cost was US$75,344 (±43,821) in the CMV (-) group. Moreover, transfusion and antimicrobial use was observed as the major medication cost component, which is suggestive of the indirect effect of CMV episodes.Conclusion: This study demonstrated that CMV episodes post allo-HSCT were associated with increased HCRU and cost.

Medication Adherence/Persistence and Demographics of Japanese Dyslipidemia Patients on Statin-Ezetimibe as a Separate Pill Combination Lipid-Lowering Therapy　- An Observational Pharmacy Claims Database Study.

BACKGROUND: This study aimed to identify potential predictors of medication adherence and persistence with statin-ezetimibe combinational lipid-lowering therapy (LLT) as a separate pill combination in a real-world setting in Japan.Methods and Results:Patients newly switched to statin-ezetimibe combinational LLT from statin monotherapy were identified within a Japanese national pharmacy claims database during January 2015 to April 2018. Adherence and persistence were measured by the proportion of days covered (PDC), time to treatment discontinuation and persistence rate at 1 year. A stepwise multivariate logistic regression model and Cox proportional hazards regression model were used to explore potential predictors associated with adherence and persistence, respectively. Among 6,921 patients, 71.9% were adherent (PDC ≥80%), and 83.6% were persistent at 1 year after initiation. Patients aged ≤54 years and ≥75 years were prone to be more non-adherent. Secondary prevention was associated with better adherence and longer persistence. Concomitant use of medications for depression/anxiety was associated with shorter persistence, whereas use of antihypertensive drugs was associated with better adherence and persistence. CONCLUSIONS: Age, concomitant use of certain classes of medications (or the existence of these diseases) and secondary prevention were associated with adherence and persistence of statin-ezetimibe combinational LLT. Given that dyslipidemia is a chronic disease requiring life-long control, active interventions are required for patients with poor adherence and persistence.

Experiential learning of HIV self-test among student nurses: A qualitative study.

BACKGROUND: There is increasing demand for HIV self-tests, and nurses play an important role in counselling and assisting in the testing process. Traditional lecture-based nursing education has not typically focused on self-testing procedures, and there is little understanding of clients' experiences of self-testing. OBJECTIVES: To understand the experiential learning (EL) of student nurses during the process of self-testing for HIV. DESIGN: This study used a qualitative design. SETTINGS: A college in northern Taiwan. PARTICIPANTS: We recruited a purposive sample of 30 nursing students. METHODS: The OraQuick self-test was used as the self-testing tool in this study. After participants used the OraQuick self-test, they underwent a semi-structured interview during the post-test counselling period. All interview data were subjected to line-by-line content analysis. RESULTS: We extracted nine themes of nursing students' experiences during experiential learning of HIV self-test. In the pre-test stage, they recalled possible risk behaviors for HIV infection, decided to complete the self-test alone or asked for significant others to accompany them, and endured emotional fluctuations immediately prior to the test. When waiting for the test results, they felt isolated from the outside world. Some participants also began questioning the accuracy and safety of the test, and either viewed the results immediately or later on. In the post-test stage, some participants reported being uncertain about the results. Participants reported a greater understanding of the personal impact of testing and revealed their needs for support. Some identified a sense of loss and linked this to the rapid and direct delivery of test results. CONCLUSIONS: Our results can be used to guide HIV-related education courses and prevention programs. Experiential learning has the potential to improve HIV pre and post-test counselling, as nurses develop both clinical knowledge and personal insight of the testing process.

Low-Theta Electroencephalography Coherence Predicts Cigarette Craving in Nicotine Addiction.

Addicts are often vulnerable to drug use in the presence of drug cues, which elicit significant drug cue reactivity. Mounting neuroimaging evidence suggests an association between functional magnetic resonance imaging connectivity networks and smoking cue reactivity; however, there is still little understanding of the electroencephalography (EEG) coherence basis of smoking cue reactivity. We therefore designed two independent experiments wherein nicotine-dependent smokers performed a smoking cue reactivity task during EEG recording. Experiment I showed that a low-theta EEG coherence network occurring 400-600 ms after onset during long-range (mainly between frontal and parieto-occipital) scalp regions, which was involved in smoking cue reactivity. Moreover, the average coherence of this network was significantly correlated with participants' level of cigarette craving. In experiment II, we tested an independent group of smokers and demonstrated that the low-theta coherence network significantly predicted changes in individuals' cigarette craving. Thus, the low-theta EEG coherence in smokers' brains might be a biomarker of smoking cue reactivity and can predict addiction behavior.

Isolation and functional characterization of two Caffeoyl Coenzyme A 3-O-methyltransferases from the fern species Polypodiodes amoena.

Caffeoyl Coenzyme A 3-O-methyltransferases (CCoAOMTs) catalyze the transfer of a methyl group from S-adenosylmethionine (SAM) to a hydroxyl moiety. CCoAOMTs are important for the synthesis of lignin, which provides much of the rigidity required by tracheophytes to enable the long distance transport of water. So far, no CCoAOMTs has been characterized from the ancient tracheophytes ferns. Here, two genes, each encoding a CCoAOMT (and hence denoted PaCCoAOMT1 and PaCCoAOMT2), were isolated from the fern species Polypodiodes amoena. Sequence comparisons confirmed that the product of each gene resembled enzymes known to be associated with lignin synthesis in higher plants. When either of the genes was heterologously expressed in E. coli, the resulting recombinant protein was able to methylate caffeoyl CoA, along with a number of phenylpropanoids, flavones and flavonols containing two vicinal hydroxyl groups. Their in vitro conversion rate when presented with either caffeoyl CoA or certain flavonoids as substrate was comparable with that of the Medicago sativa MsCCoAOMT. Their constitutive expression in Arabidopsis thaliana boosted the plants' lignin content, but did not affect that of methylated flavonols, indicating that both PaCCoAOMTs contributed to lignin synthesis and that neither was able to methylate flavonols in planta. The transient expression of a PaCCoAOMT-GFP fusion gene in tobacco demonstrated that in planta, PaCCoAOMTs are likely directed to the cytoplasm.

The effect evaluation of advanced penlight.

Pupil diameter measurement is crucial for physical assessment and disease monitoring in a health and nursing care situation. A general penlights (GPLs) is frequently used and allow for an approximate and indirect measurement of the pupil diameter. Health caregivers or nurses generally have less confidence in the value of the pupil diameter measured using the GPL. The Advanced Penlight (APL) is a new device designed for accurate measurement of the pupil diameter. The purpose of the presented research was to compare the accuracies and operational times of the pupil diameter measurements by means of the GPL and APL. One-group post-test and single-blind study designed was used in this study. The innovation of the APL is the addition of a perspective measurement ruler (PMR) attached to one side of the penlight that allows precise measurement of the pupil diameter before and after pupillary contraction. The PMR can be rotated by any angle for adaptation to the measurement conditions. After standard pupil diameter measurements by a refractometer (RM) were performed on a subjects, ninety study participants measured the pupil diameters of the same subject separately by the GPL and APL. A self-administered questionnaire was used to assess the opinions of the participants after using the GPL compare to the APL. The mean age of the participants was 20.01 (SD = 0.47) years and 83% of them were female senior nursing students. There were no statistically significant differences between the average values of pupil diameters measured by the APL and the RM. Compared to the GPL, the pupil diameter measured by APL was much similar to the RM measurement. The average operational time was 8.72 seconds shorter (t = -3.81, p = 0.001) for the APL measurement compared to the GPL measurement. The average scores of convenience and confidence on pupil diameter measurements of questionnaire were higher for the APL compared to the GPL. The APL can increase the accuracy and save operating time of pupil diameter measurement and thereby promote the quality of health assessment and nursing care practice.

A systematic review of the effectiveness of problem-solving approaches towards symptom management in cancer care.

AIMS: To investigate the evidence of problem-solving approach interventions on symptom management in cancer care. BACKGROUND: Symptom-related problems are a common challenge in cancer care. The problem-solving approach is one strategy of cognitive behavioural therapy used to help patients with cancer self-manage their symptoms. However, no systematic review has investigated the effectiveness of this approach. DESIGN: Systematic review. METHOD: A systematic search for intervention studies using randomised controlled designs, controlled clinical trial and quasi-experimental studies designs was conducted using the following electronic databases: EBSCO host, CINAHL (1991-2008), Medline (1975-2009), Electronic Periodical Services (Chinese) and Electronic Theses and Dissertations System (Taiwan). RESULTS: Seven studies published in English between 1975-2009 were included in this systematic review. All studies were randomly assigned and almost all studies demonstrated the positive effects of a problem-solving approach in reducing symptomatic problems in the target participants. Varying protocols and qualities of methodological design (14% good, 43% fair and 43% poor) were found in this review. CONCLUSIONS: This systematic review highlighted the potential of a problem-solving approach in the management of symptom problems in patients with cancer. However, more rigourous studies are needed and a better evaluation of the most effective problem-solving approach protocols is required. RELEVANCE TO CLINICAL PRACTICE: Cancer care nurses should explore the use of problem-solving approach interventions in their practice as the evidence base suggests the value of this approach--but caution is needed in regard to the precise structure of the problem-solving approach protocol.