Cancer-related cognitive impairment in older adults with acute myeloid leukemia treated with hypomethylating agents and venetoclax chemotherapy: a longitudinal descriptive study.

PURPOSE: To explore cancer-related cognitive impairment (CRCI) in older adults with acute myeloid leukemia (AML) receiving venetoclax in combination with hypomethylating agents or low-dose cytarabine chemotherapy. METHODS: This study is a longitudinal, qualitative descriptive study. Participants were recruited using purposive sampling. Semi-structured interviews were conducted among 11 older adults with AML at cycle 2, cycle 4, and cycle 7 of chemotherapy. An early end-of-study interview was conducted for those who changed treatment plans during the study follow-up. RESULTS: A total of 22 transcripts were included for thematic analysis. Four themes emerged: (1) CRCI experiences, (2) impact of CRCI, (3) CRCI coping strategies, and (4) perceived CRCI-related factors. Older adults with AML experienced challenges in memory, language, and attention both intermittently and daily. These cognitive changes impacted their emotion, daily activities, social connection, and their caregivers' responsibilities. Hence, these older adults with AML developed problem-solving and emotional coping strategies to cope with CRCI. Older adults with AML also identified demographic, physiology/clinical, psychological, and other factors that might contribute to CRCI. CONCLUSION: This study offers important insight for clinicians to understand how older adults with AML experience CRCI and how it impacts their daily routines. It indicates that clinicians should ask patients about their experience with cognitive changes at each encounter to provide support or coping strategies as needed to prevent CRCI from further hindering their quality of life.

Care partners experience of an oral health intervention for individuals with mild cognitive impairment and mild dementia using behavior change technique: A qualitative study.

Oral health declines in older adults with cognitive impairment. We aimed to improve oral hygiene outcomes for individuals with mild cognitive impairment (MCI) or mild dementia (MD) by fostering behavior changes among carepartners assisting them. We used qualitative data of verbatim transcripts of coaching sessions with carepartners (n = 17 dyads:10 dyads for MCI, 7 dyads for MD). Directed and emergent coding were used to understand behavior change techniques (BCTs). BCTs were compared with carepartners of participants with MCI and MD. Most frequently used BCTs in both groups: prompts and cues, instruction on how to perform the behavior, review behavioral goal, and problem solving. Different BCTs emerged in study: social support-unspecified of the MCI group and credible source for MD group. Findings clarified active intervention components, common BCTs used by carepartners, and different BCT approaches for both participants. Findings help to elucidate the mechanisms of changes in individuals' behaviors in these interventions.

A Scoping Review of Biological Pathways of Integrative Interventions Used to Manage Chemotherapy-Induced Nausea and Vomiting in Children With Cancer.

BACKGROUND: As with pharmacological management approaches, characteristics of complementary and alternative medicine (CAM) interventions for managing chemotherapy-induced nausea and vomiting (CINV) in children with cancer should be considered when developing and testing these interventions and reporting the outcomes. OBJECTIVES: This systematic scoping review aimed to identify gaps and weaknesses in CAM and integrative interventions studies to prevent and manage CINV in children being treated for cancer, according to the CINV biological pathways. METHODS: This systematic scoping review was conducted under the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews guideline. Included studies were published in English before May 2020 and examined the effects of integrative interventions on CINV in children being treated for cancer. Two authors performed computerized searches and manual reviews; these authors also extracted data about study characteristics, intervention characteristics, and CINV outcomes from the studies included in the review. RESULTS: Twenty-six studies of 29 CAM interventions met eligibility criteria. Most of these studies used randomized controlled trial designs and measured CINV outcomes at least once prior to and then after the intervention. Some studies did not explicate the interval between exposure to the intervention and outcome measurements. The CAM interventions studied included 15 cognitive-behavioral interventions, 8 acupoint stimulation interventions, 5 herb/supplementation interventions, and 1 educational intervention. One study tested two CAMs and clarified the underlying biological pathways, whereas 25 studies (27 CAMs) did not illustrate pathways; the pathways were deduced from information provided in the articles. DISCUSSION: Considering the biological pathways underlying CINV while developing integrative interventions, including the CAM component, could improve intervention efficacy. Measurement of biomarkers of activity in these pathways would provide a means to test whether changes in underlying pathways mediate change in CINV. Better reporting of intervention details and study processes is needed to support replication of CAM interventions and inform translation into clinical practice.

Examining the Causal Impact of Prenatal Home Visiting on Birth Outcomes: A Propensity Score Analysis.

OBJECTIVES: In Ohio, African American babies die at 2.5-3 times the rate of White babies. Preterm birth and low birth weight are the leading causes of infant mortality. Home visiting is an evidence-based strategy for serving low-income pregnant women; however, there are relatively few rigorous studies examining its effect on birth outcomes. METHODS: This study uses a propensity score technique to estimate the causal effect of participation in home visiting on prematurity and low birth weight among a low-income, predominantly African American sample (N = 26,814). RESULTS: We found that participation in home visiting significantly reduced the odds of experiencing both adverse birth events, with a larger program effect for the low birth weight outcome. CONCLUSIONS FOR PRACTICE: Results suggest that selective prevention strategies must be accompanied by universal attempts to improve the health and life circumstances of low income and minority women.

Behavioral and Physiological Pain Responses in Brain-Injured Patients Who Are Unable to Communicate in the Intensive Care Unit.

BACKGROUND: Assessing pain of critically ill patients with brain injuries who are unable to communicate is a challenge. Current behavioral scales are limited in accurate pain assessments for this population. AIMS: This study sought to investigate the behavioral and physiological responses induced by routine painful procedures in patients with brain injuries who are unable to communicate. METHODS: Using a repeated-measure within-subject observational study design, 12 participants admitted to an intensive care unit were observed before, during, and 15 minutes after a nonnociceptive (noninvasive blood pressure measurement) procedure and three nociceptive (suctioning, turning, and trapezius pinch) procedures. During each assessment, patients' behavioral and physiological responses were observed using video cameras and bedside monitors. RESULTS: In the overall behavioral responses to the nociceptive procedures, clenched teeth with tense jaw, frowning, orbit tightening, closing of eyes, eye movement, fixation-staring, flushing, flexion withdrawal of arm, flexion withdrawal of leg, muscle rigidity, twitching, and coughing were more frequently observed during procedures than before and after procedures (p < .01). Regarding physiological responses, significant increases in systolic blood pressure, diastolic blood pressure, mean arterial pressure, heart rate, and respiratory rate were identified across assessments (p < .001). CONCLUSIONS: The findings can be used as a basis for pain assessment and the development of pain assessment tools for brain-injured patients who are unable to communicate. However, since physiological responses may be influenced by various factors besides pain, physiological changes may be used as a sign of the need for pain assessment rather than being used alone as a basis for pain assessment.

The association between residential mobility and adolescents' health: The mediating role of neighborhood social cohesion.

This study examined the relationship between residential mobility, neighborhood social cohesion, and health status in US adolescents. Using data from the 2017 National Child Health Survey, our study showed that high residential mobility is negatively related to adolescents' health. Furthermore, we found that the association between residential mobility and adolescents' health status was mediated by neighborhood social cohesion. These findings suggest that neighborhood social cohesion can be an important mechanism through which residential mobility affects adolescents' health status.

Dual System Youth and their Pathways: A Comparison of Incidence, Characteristics and System Experiences using Linked Administrative Data.

Insight into the characteristics and system experiences for youth who touch both the child welfare and juvenile justice systems has increased over the last decade. These youth are typically studied as one population and referred to as "crossover youth." While this literature contributes valuable insight into who crossover youth are, studies are virtually silent on distinguishing characteristics and experiences across different pathways leading to dual system contact. This study reviews what is currently known about dual system youth generally (i.e., youth who have contact with both the juvenile justice and child welfare systems) and introduces a framework for consistently defining dual system youth and their pathways. The utility of the framework is then explored using linked administrative data for cohorts of youth aged 10 to 18 years old with a first petition to delinquency court in three sites: Cook County, Illinois between 2010 and 2014 (N = 14,170); Cuyahoga County, Ohio between 2010 and 2014 (N = 11,441); and New York City between 2013 and 2014 (N = 1272). The findings show a high prevalence of dual system contact overall, ranging from 44.8 to 70.3%, as well as wide variation in the ways in which youth touched both systems. Specifically, non-concurrent system contact is more prevalent than concurrent system contact in all sites, and individual characteristics and system experiences vary within and across these different pathway groups. Based on study findings, implications for future research on dual system youth and for developing collaborative practices and policies across the systems are discussed.

Central administration of GLP-1 and GIP decreases feeding in mice.

Glucagon-like peptide-1 amide (GLP-1) and gastric inhibitory polypeptide (GIP) are incretin hormones regulating energy metabolism. GLP-1 and GIP combination is suggested as a promising therapeutic strategy for treatment of obesity and diabetes. However, the neuronal mechanisms are not yet investigated. In the present study, we investigated the role of central GLP-1 and GIP in regulation of body weight homeostasis. The effect of GLP-1 with GIP on food intake, body weight, locomotor activity were determined following intracerebroventricular (ICV) administration of GLP-1 and/or GIP in mice. ICV administration of low dose GLP-1 (0.3 nmol) and GIP (1 and 3 nmol) did not change food intake. However, ICV administration of higher doses GLP-1 (1 and 3 nmol) and GIP (6 nmol) significantly decreased food intake and body weight. To investigate the synergic effect of ICV GLP-1 and GIP, subeffective dose GLP-1 (0.3 nmol) and subeffective dose GIP (1 nmol) were chosen for further co-administration study. ICV co-administration of GLP-1 and GIP significantly decreased food intake, body weight and drinking. ICV co-administration of GLP-1 and GIP significantly increased neuronal activation and pro-opiomelanocortin (POMC) expression in hypothalamic arcuate nucleus. The neuronal activation and POMC expression were observed in two distinct neuronal populations. These results provide neuronal mechanisms supporting the development of GLP-1 and GIP combination therapeutics for treatment of obesity and diabetes.

Metformin intervention in obese non-diabetic patients with breast cancer: phase II randomized, double-blind, placebo-controlled trial.

Previous observational studies have suggested that metformin in diabetes patients may reduce breast cancer risk more than the reductions from other anti-diabetes medications. This randomized, double-blind, placebo-controlled trial was performed to evaluate the efficacy of metformin for controlling physical and metabolic profiles related to prognosis and adverse events in non-diabetic breast cancer patients. Female breast cancer patients (N = 105), at least 6 months post-mastectomy, with obesity (≥25 kg/m(2)) and/or pre-diabetes (fasting blood sugar levels ≥100 mg/dL), were randomly assigned to three groups (placebo, metformin 500 mg, and metformin 1000 mg) stratified by tamoxifen use. A linear mixed model for repeated measurements among three groups and ANOVA for profile differences during 6 months of treatment were used for the intention-to-treat analysis. The metformin 1000 mg group had a significantly greater decline in glucose and HbA1c levels between treatment weeks 0 and 6 month (p = 0.008 and 0.009, respectively), and the declines increased with an increase in body mass index (BMI) level (p interaction with BMI = 0.007 and 0.067, respectively). A marginally significant different effect from the metformin 1000 mg treatment was detected for glucose and HbA1c levels (p interaction = 0.084 and 0.063, respectively) in the intention-to-treat analysis. Metformin 1000 mg treatment had a favorable effect on controlling glucose and HbA1C levels in obese non-diabetic breast cancer patients, indicating prognostic importance. Further trials are needed to elucidate the risk-benefit ratio of long-term use of metformin.

Examining the relationships between resources and online health information seeking among patients with chronic diseases and healthy people.

The Internet is increasingly used as an important source of health and medical-related information for people with chronic diseases. It is recognized that online health information seeking (OHIS) is influenced by individuals' multi-dimensional factors, such as demographics, socio-economic factors, perceptions of the Internet, and health conditions. This study applies the conservation of resource theory to examine relationships between various multi-dimensional factors, daily challenges, and OHIS depending on individuals' health conditions. The data used in this study was taken from the U.S. Health Tracking Survey (2012). In this study, Internet users aged 18 and older were classified into patients (N = 518) and healthy people (N = 677) based on their health status related to chronic diseases. Multiple regression analysis was used to examine the relationships between multi-dimensional factors (resources), self-rated health, and OHIS. Patients' various resources (e.g., age, income, education, having a smartphone, and health tracking) significantly predicted their self-rated health and OHIS; in addition, self-rated health significantly mediated the relationships between focal resources and OHIS. However, the mediating effects of self-rated health were not found in healthy people.

Synthesis and characterization of ethosomal contrast agents containing iodine for computed tomography (CT) imaging applications.

As a first step in the development of novel liver-specific contrast agents using ethosomes for computed tomography (CT) imaging applications, we entrapped iodine within ethosomes, which are phospholipid vesicular carriers containing relatively high alcohol concentrations, synthesized using several types of alcohol, such as methanol, ethanol, and propanol. The iodine containing ethosomes that were prepared using methanol showed the smallest vesicle size (392 nm) and the highest CT density (1107 HU). The incorporation of cholesterol into the ethosomal contrast agents improved the stability of the ethosomes but made the vesicle size large. The ethosomal contrast agents were taken up well by macrophage cells and showed no cellular toxicity. The results demonstrated that ethosomes containing iodine, as prepared in this study, have potential as contrast agents for applications in CT imaging.

Herbal Medicines for the Improvement of Immune Function in Patients With Non-Small Cell Lung Cancer: A Systematic Review and Meta-Analysis.

Background: Lung cancer has the highest mortality rate of all cancers worldwide. Conserving the immune system and reducing the adverse events associated with cancer treatment have become increasingly important. Our study aimed to investigate the immunological effects of herbal medicine (HM) alone, independent of conventional cancer therapies, in patients with non-small cell lung cancer (NSCLC). Methods: We searched 8 databases for articles published until March 2023. Bias risk was assessed using RevMan 5.4. Meta-analyses of CD4+ and CD8+ levels reported in the included RCTs were also performed. Results: A total of 610 patients from 5 RCTs were included in the analysis. Immune markers in the peripheral blood of patients treated with HM alone were compared with those in the control group. As a result of meta-analyses, CD4+ (three studies; mean difference(MD) = 5.21, 95 confidence interval (CI) [3.26, 7.27], I2 = 61%, n = 428) and CD4+/CD8+ (two studies; MD = 0.22, 95% CI [0.18, 0.26], I2 = 0%, n = 278) significantly increased in the treatment group, while CD8+ levels (three studies; MD = -3.04, 95% CI [-5.80, -0.29], I2 = 74%, n = 428) decreased in HM groups compared to comparison groups. In a single trial, IL-1, IL-6, tumor necrosis factor (TNF)-a levels and the number of Tregs in the treatment group significantly decreased, while Th17 levels and the Th17/Treg ratios increased. Conclusion: This study provides a comprehensive and systematic review of the immunological effects of HM in patients with NSCLC. Future studies should explore how the immunological effects of HM correlate with clinical outcomes, such as tumor response and survival rates.PROSPERO registration: CRD42023459.

A cross-cultural examination of temporal orientation through everyday language on social media.

Past research has shown that culture can form and shape our temporal orientation-the relative emphasis on the past, present, or future. However, there are mixed findings on how temporal orientations vary between North American and East Asian cultures due to the limitations of survey methodology and sampling. In this study, we applied an inductive approach and leveraged big data and natural language processing between two popular social media platforms-Twitter and Weibo-to assess the similarities and differences in temporal orientation in the United States of America and China, respectively. We first established predictive models from annotation data and used them to classify a larger set of English Twitter sentences (NTW = 1,549,136) and a larger set of Chinese Weibo sentences (NWB = 95,181) into four temporal catetories-past, future, atemporal present, and temporal present. Results show that there is no significant difference between Twitter and Weibo on past or future orientations; the large temporal orientation difference between North Americans and Chinese derives from their different prevailing focus on atemporal (e.g., facts, ideas) present (Twitter) or temporal present (e.g., the "here" and "now") (Weibo). Our findings contribute to the debate on cultural differences in temporal orientations with new perspectives following a new methodological approach. The study's implications call for a reevaluation of how temporal orientation is measured in cross-cultural studies, emphasizing the use of large-scale language data and acknowledging the atemporal present category. Understanding temporal orientations can guide effective cross-cultural communication strategies to tailor approaches for different audience based on temporal orientations, enhancing intercultural understanding and engagement.

Language-based EMA assessments help understand problematic alcohol consumption.

BACKGROUND: Unhealthy alcohol consumption is a severe public health problem. But low to moderate alcohol consumption is associated with high subjective well-being, possibly because alcohol is commonly consumed socially together with friends, who often are important for subjective well-being. Disentangling the health and social complexities of alcohol behavior has been difficult using traditional rating scales with cross-section designs. We aim to better understand these complexities by examining individuals' everyday affective subjective well-being language, in addition to rating scales, and via both between- and within-person designs across multiple weeks. METHOD: We used daily language and ecological momentary assessment on 908 US restaurant workers (12692 days) over two-week intervals. Participants were asked up to three times a day to "describe your current feelings", rate their emotions, and report their alcohol behavior in the past 24 hours, including if they were drinking alone or with others. RESULTS: Both between and within individuals, language-based subjective well-being predicted alcohol behavior more accurately than corresponding rating scales. Individuals self-reported being happier on days when drinking more, with language characteristic of these days predominantly describing socializing with friends. Between individuals (over several weeks), subjective well-being correlated much more negatively with drinking alone (r = -.29) than it did with total drinking (r = -.10). Aligned with this, people who drank more alone generally described their feelings as sad, stressed and anxious and drinking alone days related to nervous and annoyed language as well as a lower reported subjective well-being. CONCLUSIONS: Individuals' daily subjective well-being, as measured via language, in part, explained the social aspects of alcohol drinking. Further, being alone explained this relationship, such that drinking alone was associated with lower subjective well-being.

Self-Powered Electrical Bandage Based on Body-Coupled Energy Harvesting.

Self-powered electrical bandages (SEBs), integrated with wearable energy harvesters, can provide an effective and autonomous electrical stimulation (ES) solution for rapid and scarless wound healing. A continuously operating, wireless, and applicable-to-comprehensive-wound ES device is essential for the quick restoration of wounds and convenience. This work illustrates a SEB powered by body-coupled energy harvesting. The SEB continuously treats the wound with 60-Hz sinusoidal electrical potential gained from the coupling of the human body and ambient electrical waves. It is demonstrated that enough level of electrical potential can be applied to the wound, further enhanced by strong capacitive coupling arising from the use of high-permittivity poly(vinylidene fluoride-trifluoroethylene):CaCu3Ti4O12 (P(VDF-TrFE):CCTO) nanocomposite. The potential clinical efficacy of the SEB is illustrated by preclinical analysis of human fibroblasts and mouse wound model, thus confirming the successful expedition of wound recovery. This work suggests a new class of wearable devices to provide ES events and its potential for extension to other conventional wound care materials and device technology.

Emission characteristics of particulate matter and volatile organic compounds in cow dung combustion.

Biomass fuel is used for cooking and heating, especially in developing countries. Combustion of biomass fuel can generate high levels of indoor air pollutants, including particulate matter (PM) and volatile organic compounds (VOCs). This study characterized PM and VOC emissions from cow dung combustion in a controlled experiment. Dung from grass-fed cows was dried and combusted using a dual-cone calorimeter. Heat fluxes of 10, 25, and 50 kW/m(2) were applied. The concentrations of PM and VOCs were determined using a dust spectrometer and gas chromatography/mass spectrometry, respectively. PM and VOC emission factors were much higher for the lower heat flux, implying a fire ignition stage. When the heat flux was 50 kW/m(2), the CO2 emission factor was highest and the PM and VOC emission factors were lowest. Particle concentrations were highest in the 0.23-0.3 µm size range at heat fluxes of 25 and 50 kW/m(2). Various toxic VOCs, including acetone, methyl ethyl ketone, benzene, and toluene, were detected at high concentrations. Although PM and VOC emission factors at 50 kW/m(2) were lower, they were high enough to cause extremely high indoor air pollution. The characteristics of PM and VOC emissions from cow dung combustion indicated potential health effects of indoor air pollution in developing countries.

An Integrative Survey on Mental Health Conversational Agents to Bridge Computer Science and Medical Perspectives.

Mental health conversational agents (a.k.a. chatbots) are widely studied for their potential to offer accessible support to those experiencing mental health challenges. Previous surveys on the topic primarily consider papers published in either computer science or medicine, leading to a divide in understanding and hindering the sharing of beneficial knowledge between both domains. To bridge this gap, we conduct a comprehensive literature review using the PRISMA framework, reviewing 534 papers published in both computer science and medicine. Our systematic review reveals 136 key papers on building mental health-related conversational agents with diverse characteristics of modeling and experimental design techniques. We find that computer science papers focus on LLM techniques and evaluating response quality using automated metrics with little attention to the application while medical papers use rule-based conversational agents and outcome metrics to measure the health outcomes of participants. Based on our findings on transparency, ethics, and cultural heterogeneity in this review, we provide a few recommendations to help bridge the disciplinary divide and enable the cross-disciplinary development of mental health conversational agents.

Making the case for lead safe housing: Downstream effects of lead exposure on outcomes for children and youth.

Lead based paint is a predominate source of lead exposure in children, which has a documented negative effect on their health and development. Despite public health efforts, the housing stock in disinvested neighborhoods in many cities continues to present significant risk of childhood lead exposure. In this article, we describe how a multi-agency integrated data system was used to document the impact of lead exposure on indicators of child and youth development as recorded in educational and human service systems. By tracking administrative data for two cohorts of Cleveland, Ohio children from birth to early adulthood and using rigorous matching methods to reduce confounders when comparing those with and without elevated blood lead levels, we document negative effects on developmental, behavioral and socio-economic outcomes due to early childhood lead exposure. The magnitude of disparities between individuals who had elevated blood lead levels (≥5 µg/dL) in early childhood, compared to their matched counterparts, is in the ranges of 20-40%. The analysis is framed by clarifying the context, assumptions and limitations associated with the use of administrative data. This type of information has been useful in illuminating the burden of lead exposure for children, families and youth serving agencies and engaging public officials, landlords and residents in initiatives to bring housing up to lead safe standards.

Using integrated data to examine the effects of summer youth employment program completion on educational and criminal justice system outcomes: Evidence from Cuyahoga County, Ohio.

The current study builds the evidence base on the effects of Summer Youth Employment Programs (SYEP) both geographically and methodologically by linking SYEP participant records to a comprehensive integrated longitudinal database to better understand programmatic impacts on youth who completed participation in an SYEP in Cleveland, Ohio. The study matches SYEP participants and unselected applicants on various observed covariates using the Child Household Integrated Longitudinal Data (CHILD) System and relies upon propensity score matching techniques to estimate program completion impacts on educational and criminal justice system involvement outcomes. SYEP completion is associated with a lower prevalence of juvenile offense filings and incarceration events, better school attendance, and improved graduation rates 1-2 years following program participation.

Fabrication of transparent cellulose nanofibril composite film with smooth surface and ultraviolet blocking ability using hydrophilic lignin.

Ecofriendly multifunctional films with only biomass-based components have gathered significant interest from researchers as next-generation materials. Following this trend, a TEMPO-oxidized cellulose nanofibril (TOCNF) film containing hydrophilic lignin (CL) was fabricated. To produce the lignin, peracetic acid oxidation was carried out, leading to the introduction of carboxyl groups into the lignin structure. By adding hydrophilic lignin, various characteristics (e.g., surface smoothness, UV protection, antimicrobial activity, and barrier properties) of the TOCNF film were enhanced. In particular, the shrinkage of CNF was successfully prevented by the addition of CL, which is attributed to the lower surface roughness (Ra) from 18.93 nm to 4.99 nm. As a result, the smooth surface of the TOCNF/CL film was shown compared to neat TOCNF film and TOCNF/Kraft lignin composite film. In addition, the TOCNF/CL film showed a superior UV blocking ability of 99.9 % with high transparency of 78.4 %, which is higher than that of CNF-lignin composite films in other research. Also, water vapor transmission rate was reduced after adding CL to TOCNF film. Consequently, the developed TOCNF/CL film can be potentially utilized in various applications, such as food packaging.