Relationships Between Socio-behavioral Factors and the Symptoms Among Asian American Breast Cancer Survivors: A Structural Equation Modeling.

BACKGROUND: Despite increased research on breast cancer survivors, little is known about how socio-behavioral factors influence the symptoms among racial/ethnic minority breast cancer survivors, particularly Asian American breast cancer survivors (AABCS). OBJECTIVE: This study examined the relationship between multiple socio-behavioral factors in AABCS, including attitudes, perceived barriers, and social influences, and their symptom experiences, with an emphasis on the mediating effect of self-efficacy. METHODS: This secondary analysis used data collected from 195 AABCS women recruited through online and offline communities from January 2017 to June 2020. Study variables were measured using validated instruments such as the Questions on Attitudes, Self-Efficacy, Perceived Barriers, and Social Influences; the Cancer Behavior Inventory; and the Memorial Symptom Assessment Scale-Short Form. For structural equation modeling based on Bandura's self-efficacy theory, mediation analysis was performed using SPSS version 26.0 and AMOS 28. RESULTS: The overall fitness of the hypothetical model to the data is acceptable (χ2 = 51.36, P < .001; goodness-of-fit index = 0.95, adjusted goodness-of-fit index = 0.89, comparative fit index = 0.96, Tucker-Lewis index = 0.94, normed fit index = 0.94, and root-mean-square error of approximation index = 0.08). Both attitudes and social influences indirectly influenced symptom distress through self-efficacy (ß = -0.054, P = .019, and ß = -0.053, P = .017, respectively). Perceived barriers had indirect effects through self-efficacy (ß = 0.121, P = .024) and significant direct effects (ß = 0.605, P = .003) on symptom distress. CONCLUSIONS: Our findings supported that the self-efficacy for coping mediated their symptom experience among AABCS. In addition, there were significant relationships among attitudes, perceived barriers, social influences, and symptom experience. IMPLICATIONS FOR PRACTICE: Future theory-driven interventions need to consider self-efficacy and socio-behavioral factors in symptom management among AABCS.

Five Dimensions of Needs for Help: The Efficacy of a Technology-Based Intervention Among Asian American Breast Cancer Survivors.

Cancer survivors including Asian American breast cancer survivors have reported their high needs for help during their survivorship process. With the COVID-19 pandemic, the necessity of technology-based programs to address their needs for help without face-to-face interactions has been highlighted. The purpose of this randomized intervention study was to determine the efficacy of a technology-based program in reducing various types of needs for help among this specific population. This was a randomized clinical trial with repeated measures. A total of 199 participants were included in the data analysis. The recruitment settings included both online and offline communities/groups for Asian Americans. The needs for help were assessed using the Support Care Needs Survey-34 Short Form (SCNS) subscales measuring psychological, information, physical, support, and communication needs. Data analysis was conducted through an intent-to-treat approach. In the mixed effect models, psychological needs, information needs, physical needs, and communication needs decreased over time (P < .001). However, there were no significant group * time effects. Social support significantly mediated the effects of a technology-based intervention on psychological, information, and support needs at the pre-test and the post-1 month. This study supported significant decreases in the needs for help of Asian American breast cancer survivors by a technology-based intervention. Further studies are needed with other racial/ethnic groups of cancer survivors to confirm the efficacy of a technology-based intervention in reducing cancer survivors' needs for help during their survivorship process.

The Influence of Workplace Violence, Psychosocial Working Conditions on Depressive Symptoms Among Female Workers in South Korea.

Workers' depression is an important issue, with the prevalence higher in women than in men. This study aimed to identify the effects of workplace violence exposure and psychosocial working conditions on depressive symptoms in female workers in South Korea. This study included 15 605 female wageworkers who participated in the fifth Korean Working Conditions Survey. Logistic regression analyses were implemented to identify the factors that affected their depression. The female workers reported increased frequency of symptoms of depression when there was humiliating behavior from co-workers (adjusted odds ratio [aOR] = 1.999) or physical violence from clients (aOR = 1.609). In psychosocial working environments, they reported a greater frequency of depressive symptoms with high quantitative demands (aOR = 1.498), high emotional demands (aOR = 1.085), lower colleague's support (aOR = 1.566), or lack of support from supervisors at the workplace (aOR = 1.707). An emphasis should be put on preventing humiliating behaviors from co-workers as well as violence from clients in the workplace.

Sociobiome - Individual and neighborhood socioeconomic status influence the gut microbiome in a multi-ethnic population in the US.

Lower socioeconomic status (SES) is related to increased incidence and mortality due to chronic diseases in adults. Association between SES variables and gut microbiome variation has been observed in adults at the population level, suggesting that biological mechanisms may underlie the SES associations; however, there is a need for larger studies that consider individual- and neighborhood-level measures of SES in racially diverse populations. In 825 participants from a multi-ethnic cohort, we investigated how SES shapes the gut microbiome. We determined the relationship of a range of individual- and neighborhood-level SES indicators with the gut microbiome. Individual education level and occupation were self-reported by questionnaire. Geocoding was applied to link participants' addresses with neighborhood census tract socioeconomic indicators, including average income and social deprivation in the census tract. Gut microbiome was measured using 16SV4 region rRNA gene sequencing of stool samples. We compared α-diversity, ß-diversity, and taxonomic and functional pathway abundance by SES. Lower SES was significantly associated with greater α-diversity and compositional differences among groups, as measured by ß-diversity. Several taxa related to low SES were identified, especially an increasing abundance of Prevotella copri and Catenibacterium sp000437715, and decreasing abundance of Dysosmobacter welbionis in terms of their high log-fold change differences. In addition, nativity and race/ethnicity have emerged as ecosocial factors that also influence the gut microbiota. Together, these results showed that lower SES was strongly associated with compositional and taxonomic measures of the gut microbiome, and may contribute to shaping the gut microbiota.

Risk Groups by the Needs for Help: Asian American Breast Cancer Survivors.

To supply proper and sufficient information and coaching through cancer education, it is important to decide who are risk groups among a target population. A decision tree analysis could help decide the characteristics of the risk groups. This study aimed to identify the combined characteristics of Asian American breast cancer survivors that were closely linked to high needs for help during their breast cancer survivorship process. The data on the needs for help among 185 Asian American breast cancer survivors from a parent clinical trial were included in this analysis. The instruments included the Supportive Care Needs Survey-Short Form 34 (SCNS-SF34) and multiple scales to measure the factors influencing the women's needs for help. The data were analyzed using latent profile analyses and decision tree analyses. The characteristics of the group with the highest needs for help were different depending on the types of needs. For instance, the group with the highest patient care/support needs for help score had high global symptom distress scores (cut point = 2.25) and high physical symptom distress (cut point = 1.57) and did not have regular access to health care (mean = 95.00; node 10). The findings suggest several risk groups to target in future interventions for cancer education to reduce the needs for help among this specific population. Multiple factors that could influence the needs for help among Asian American breast cancer survivors need to be considered in future intervention development for cancer education.

Changes in Symptom Clusters Among Asian American Breast Cancer Survivors in Technology-Based Coaching Intervention.

BACKGROUND: Limited research studies have focused on examining the impact of technology-based interventions in changing symptom clusters among Asian American breast cancer survivors. OBJECTIVE: The aim of this study was to understand the longitudinal impact of a technology-based program on the symptom cluster experience of Asian American breast cancer survivors. METHODS: This is a secondary data analysis that used exploratory factor analysis at each time point (baseline, post-1 month, post-3 months) for the control and intervention groups (N = 199). RESULTS: The number of symptom clusters remained the same, and the same symptoms remained in similar clusters across the 2 groups. The control group experienced psychological cluster, fatigue cluster, and neck/skin cluster at baseline; psychological cluster, fatigue/dizzy cluster, and neck/skin cluster at post-1 month; and psychological cluster, fatigue/dizzy cluster, and somatic cluster at post-3 months. The intervention group experienced psychological cluster, neck cluster, and appetite/itching cluster at baseline; somatic/anticholinergic cluster, psychological/sexual cluster, and appetite cluster at post-1 month; and psychological cluster, neck cluster, and itching cluster at post-3 months. The psychological and neck clusters shared similar core symptoms of feeling nervous, dry mouth, and cough between the control and intervention groups. CONCLUSION: The different symptom cluster experiences may be due to the technology-based intervention where the intervention group receives individual/group coaching/support that may have changed symptom clusters over time. Yet, the true efficacy of the intervention on symptom clusters warrants further investigation. IMPLICATIONS FOR PRACTICE: Clinicians should understand the changes in symptom clusters as well as the presence of core symptoms and take a targeted symptom cluster approach in clinical settings.

A randomized controlled trial testing a virtual program for Asian American women breast cancer survivors.

A culturally tailored virtual program could meet the survivorship needs of Asian American women breast cancer survivors (AABC). This study aims to determine the efficacy of a culturally tailored virtual information and coaching/support program (TICAA) in improving AABC's survivorship experience. A randomized clinical trial (NCT02803593) was conducted from January 2017 to June 2020 among 199 AABC. The intervention group utilized TICAA and the American Cancer Society [ACS] website while the control group used only ACS website for 12 weeks. The outcomes were measured using the SCNS-34SF (needs; primary), the MSAS-SF (symptoms; secondary), and the FACT-B (quality of life; secondary). The data were analyzed using an intent-to-treat approach. The intervention group showed significant reductions in their needs from the baseline (T0) to post 4 weeks (T1) and to post 12 weeks (T2). Although the changes were not statistically significant, the intervention group had decreased symptoms from T0 to T2 while the control group had an increase in their symptoms. The intervention group had a significant increase in their quality of life from T0 to T2. A culturally tailored virtual program could therefore improve quality of life in AABC patients. Trial Registration: To Enhance Breast Cancer Survivorship of Asian Americans (TICAA), NCT02803593, https://clinicaltrials.gov/ct2/show/NCT02803593?titles=TICAA&draw=2&rank=1.

A Decision Tree Analysis on Symptom Experience of Asian American Breast Cancer Survivors.

BACKGROUND: Mainly due to their cultural attitudes toward symptoms and breast cancer, Asian American breast cancer survivors tend to suffer from symptoms and often delay in getting treatments, information, and support. To improve their symptom management, it would be important to determine risk groups among them. Decision tree analyses reportedly help determine risk groups by identifying the characteristics that are directly associated with target health outcomes. OBJECTIVE: Using a decision tree analysis, this study aimed at identifying the characteristics that were closely linked to the symptom experience of Asian American breast cancer survivors. METHODS: This was a part of a parent randomized controlled trial among Asian American breast cancer survivors. Only the data from 135 women at the pre-test were included. Multiple instruments were used to collect the data: the Memorial Symptom Assessment Scale-Short Form, the Cancer Behavior Inventory, the PRQ-2000, the Perceived Isolation Scale, and the Supportive Care Needs Survey-Short Form 34. The data were analyzed using latent profile analysis and decision tree analyses. RESULTS: Two most frequently found profiles included the low symptom experience profile (72.6%) and the high symptom experience profile (27.4%). The high symptom experience profile was predicted by 2 combined characteristics; (a) high psychological needs for help (over 60.00 points), and (b) low psychological needs for help (cut point = 60.00), high perceived barriers (cut point = 1.62), and high social isolation (social support) (cut point = 2.33). CONCLUSIONS: These characteristics linked to Asian American breast cancer survivors with high symptom experience need to be considered in future intervention development.

Cannabinoid receptor type 1 in the aging gut regulates the mucosal permeability via miR-191-5p.

Background: Aging is associated with a broad loss of function throughout the body, and gastrointestinal (GI) dysfunction can occur with aging. The endocannabinoid (eCB) system plays a pivotal role in various GI diseases, and alterations in the eCB system have been observed during brain and skin aging. Therefore, we investigated the putative role of the eCB system in aging-related changes in the intestine. Methods: The expression of cannabinoid receptor type 1 (CB1) was investigated in rat intestinal tissues using quantitative real-time PCR. Cellular senescence was induced by hydrogen peroxide (H2O2) and hydroxyurea (HU) in rat and human intestinal epithelial cells. Cellular permeability was evaluated by transepithelial electrical resistance (TEER) measurement. Results and Discussion: The expression of CB1 was decreased in the small intestine of aged rats compared to that of young rats. Senescent cells showed reduced TEER values and decreased expression of ZO-1, indicating increased intestinal permeability, which is tightly regulated by the CB1 signaling. In silico miRNA analysis suggested that ZO-1 was a direct target gene of miR-191-5p. Increased expression of miR-191-5p by HU was restored by CB1 agonist ACEA co-treatment. Moreover, NF-κB p65 activation was associated with CB1-related miR-191-5p signaling. In conclusion, aging-induced CB1 reduction leads to increased intestinal permeability and decreased ZO-1 expression via upregulation of miR-191-5p and NF-κB p65 activation. Taken together, these results suggest that CB1 signaling may be a useful strategy to reduce intestinal permeability in aging-related and other inflammatory conditions in the gut.

Association between type 2 diabetes mellitus and depression among Korean midlife women: a cross-sectional analysis study.

BACKGROUND: The prevalence of depression is higher among midlife women, and they have less control over their diabetes during the menopausal transition. However, there is limited evidence on the association between type 2 diabetes mellitus and depression among Korean women in their midlife. This study aimed to examine the association between type 2 diabetes mellitus and depression and explore the levels of awareness and treatment of depression among Korean midlife women with T2DM. METHODS: This is a cross-sectional analysis study conducted using data from the Korea National Health and Nutrition Examination Surveys of 2014, 2016, and 2018. Korean women aged 40-64 years who randomly participated in the surveys were included, and 4,063 midlife women were selected as study participants. The diabetes progression status of the participants was classified into diabetes, pre-diabetes, and non-diabetes. Furthermore, the Patient Health Questionnaire-9 was used for screening depression. Participants' awareness rate, treatment rate among incident cases of depression, and treatment rate among awareness cases of depression were also analyzed. For data analysis, the Rao-Scott χ2 test, multiple logistic regression, and linear regression were conducted using SAS 9.4 software program. RESULTS: The prevalence of depression significantly differed between diabetes, pre-diabetes, and non-diabetes groups. However, depression awareness, treatment/incident, and treatment/awareness rates did not differ statistically between the diabetes progression status groups. Compared to the non-diabetes group, diabetes group had a higher odds ratio of depression after adjusting for general and health-related factors. Thus, the diabetes group had significantly higher PHQ-9 scores than the non-diabetes group after adjusting for covariates. CONCLUSIONS: Women in their midlife who have type 2 diabetes mellitus tend to have higher levels of depressive symptoms and are at risk of depression. However, we found no significant differences between diabetes and non-diabetes regarding the awareness and treatment rates of depression in South Korea. We recommend that future studies focus on developing clinical practice guidelines aimed at additional screening and intervention for depression in midlife women with type 2 diabetes mellitus to ensure prompt treatment and improved outcomes.

Sociobiome - Individual and neighborhood socioeconomic status influence the gut microbiome in a multi-ethnic population in the US.

Lower socioeconomic status (SES) is related to increased incidence and mortality due to chronic diseases in adults. Association between SES variables and gut microbiome variation has been observed in adults at the population level, suggesting that biological mechanisms may underlie the SES associations; however, there is a need for larger U.S. studies that consider individual- and neighborhood-level measures of SES in racially diverse populations. In 825 participants from a multi-ethnic cohort, we investigated how SES shapes the gut microbiome. We determined the relationship of a range of several individual- and neighborhood-level SES indicators with the gut microbiome. Individual education level and occupation were self-reported by questionnaire. Geocoding was applied to link participants' addresses with neighborhood census tract socioeconomic indicators, including average income and social deprivation in the census tract. Gut microbiome was measured using 16SV4 region rRNA gene sequencing of stool samples. We compared α-diversity, ß-diversity, and taxonomic and functional pathway abundance by socioeconomic status. Lower SES was significantly associated with greater α-diversity and compositional differences among groups, as measured by ß-diversity. Several taxa related to low SES were identified, especially an increasing abundance of Genus Catenibacterium and Prevotella copri. The significant association between SES and gut microbiota remained even after considering the race/ethnicity in this racially diverse cohort. Together, these results showed that lower socioeconomic status was strongly associated with compositional and taxonomic measures of the gut microbiome, suggesting that SES may shape the gut microbiota.

Practical Issues in a Culturally Tailored Technology-Based Intervention for Asian American Colorectal Cancer Survivors.

BACKGROUND: Despite an increasing number of culturally tailored technology-based interventions for racial/ethnic minorities, little is known about practical issues in conducting a culturally tailored technology-based intervention study among racial/ethnic minority groups, especially among Asian American colorectal cancer survivors. OBJECTIVE: The aim of this study was to describe the practical issues in conducting a study using a culturally tailored technology-based intervention among Asian American colorectal cancer survivors. METHODS: In a technology-based colorectal cancer intervention study, research team members wrote memos on issues in conducting a culturally tailored technology-based intervention study among the specific population and plausible reasons for the issues. Then, a content analysis was used to analyze the research diaries and written records of the research team. RESULTS: The practical issues found in the research process included (a) unauthentic cases, (b) a low response rate, (c) high dropout rates, (d) technological literacy, (e) language issues, (f) cultural tailoring issues, and (g) time and geographical limitations. CONCLUSIONS: These practical issues need to be considered in planning and implementing culturally tailored technology-based interventions among Asian American colorectal cancer survivors. IMPLICATIONS FOR PRACTICE: Multiple implications such as detailed information sheets, flexibility in languages, open attitudes toward cultural differences and variances, and continuous training of interventionists are proposed for culturally tailored technology-based interventions among this specific population.

pH-sustaining nanostructured hydroxyapatite/alginate composite hydrogel for gastric protection and intestinal release of Lactobacillus rhamnosusGG.

The gut microbiome is closely linked to gastrointestinal health and disease status. Oral administration of known probiotic strains is now considered a promising therapeutic strategy, especially for refractory diseases such as inflammatory bowel disease. In this study, we developed a nanostructured hydroxyapatite/alginate (HAp/Alg) composite hydrogel that protects its encapsulated probiotic Lactobacillus rhamnosus GG (LGG) by neutralizing hydrogen ions that penetrate the hydrogel in a stomach without inhibiting LGG release in an intestine. Surface and transection analyses of the hydrogel revealed characteristic patterns of crystallization and composite-layer formation. TEM revealed the dispersal of the nanosized HAp crystals and encapsulated LGG in the Alg hydrogel networks. The HAp/Alg composite hydrogel maintained its internal microenvironmental pH, thereby enabling the LGG to survive for substantially longer. At intestinal pH, the encapsulated LGG was completely released upon disintegration of the composite hydrogel. In a dextran sulfate sodium-induced colitis mouse model, we then assessed the therapeutic effect of the LGG-encapsulating hydrogel. This achieved intestinal delivery of LGG with minimal loss of enzymatic function and viability, ameliorating colitis by reducing epithelial damage, submucosal edema, inflammatory cell infiltration, and the number of goblet cells. These findings reveal the HAp/Alg composite hydrogel as a promising intestinal-delivery platform for live microorganisms including probiotics and live biotherapeutic products.

Identification of high-risk symptom cluster burden group among midlife peri-menopausal and post-menopausal women with metabolic syndrome using latent class growth analysis.

BACKGROUND: Midlife peri-menopausal and post-menopausal women with metabolic syndrome experience multiple co-occurring symptoms or symptom clusters, which often result in significant symptom cluster burden. While they are a high-risk symptom burden group, there are no studies that have focused on identifying symptom cluster trajectories in midlife peri-menopausal and post-menopausal women with metabolic syndrome. OBJECTIVES: The objectives were to identify meaningful subgroups of midlife peri-menopausal and post-menopausal women with metabolic syndrome based on their distinct symptom cluster burden trajectories, and to describe the demographic, social, and clinical characteristics of different symptom cluster burden subgroups. DESIGN: This is a secondary data analysis using the longitudinal data from Study of Women's Health Across the Nation. METHODS: Multi-trajectory analysis using latent class growth analysis was conducted to join the different developmental trajectories of symptom clusters to identify meaningful subgroups and high-risk subgroup for greater symptom cluster burden over time. Then, descriptive statistics were used to explain the demographic characteristics of each symptom cluster trajectory subgroup, and bivariate analysis to examine the association between each symptom cluster trajectory subgroup and demographic characteristics. RESULTS: A total of four classes were identified: Class 1 (low symptom cluster burden), Classes 2 and 3 (moderate symptom cluster burden), and Class 4 (high symptom cluster burden). Social support was a significant predictor of high symptom cluster burden subgroup and highlights the need to provide routine assessment. CONCLUSION: An understanding and appreciation for the different symptom cluster trajectory subgroups and their dynamic nature will assist clinicians to offer targeted and routine symptom cluster assessment and management in clinical settings.

Lactobacillus plantarum Metabolites Elicit Anticancer Effects by Inhibiting Autophagy-Related Responses.

Lactobacillus plantarum (L. plantarum) is a probiotic that has emerged as novel therapeutic agents for managing various diseases, such as cancer, atopic dermatitis, inflammatory bowel disease, and infections. In this study, we investigated the potential mechanisms underlying the anticancer effect of the metabolites of L. plantarum. We cultured L. plantarum cells to obtain their metabolites, created several dilutions, and used these solutions to treat human colonic Caco-2 cells. Our results showed a 10% dilution of L. plantarum metabolites decreased cell viability and reduced the expression of autophagy-related proteins. Moreover, we found co-treatment with L. plantarum metabolites and chloroquine, a known autophagy inhibitor, had a synergistic effect on cytotoxicity and downregulation of autophagy-related protein expression. In conclusion, we showed the metabolites from the probiotic, L. plantarum, work synergistically with chloroquine in killing Caco-2 cells and downregulating the expression of autophagy-related proteins, suggesting the involvement of autophagy, rather than apoptosis, in their cytotoxic effect. Hence, this study provides new insights into new therapeutic methods via inhibiting autophagy.

Therapeutic Potential of Bioactive Components from Scutellaria baicalensis Georgi in Inflammatory Bowel Disease and Colorectal Cancer: A Review.

Scutellaria baicalensis Georgi (SBG), an herbal medicine with various biological activities, including anti-inflammatory, anticancer, antiviral, antibacterial, and antioxidant activities, is effective in treatment of colitis, hepatitis, pneumonia, respiratory infections, and allergic diseases. This herbal medicine consists of major active substances, such as baicalin, baicalein, wogonoside, and wogonin. Inflammatory bowel disease (IBD) comprises a group of inflammatory conditions of the colon and small intestine, with Crohn's disease and ulcerative colitis being the main types. IBD can lead to serious complications, such as increased risk of colorectal cancer (CRC), one of the most common cancers worldwide. Currently, there is no cure for IBD, and its incidence has been increasing over the past few decades. This review comprehensively summarizes the efficacy of SBG in IBD and CRC and may serve as a reference for future research and development of drugs for IBD and cancer treatment.

Atractylodin Ameliorates Colitis via PPARα Agonism.

Atractylodin is a major compound in the rhizome of Atractylodes lancea, an oriental herbal medicine used for the treatment of gastrointestinal diseases, including dyspepsia, nausea, and diarrhea. Recent studies have shown that atractylodin exerts anti-inflammatory effects in various inflammatory diseases. Herein, we investigated the anti-colitis effects of atractylodin and its molecular targets. We determined the non-cytotoxic concentration of atractylodin (50 µM) using a cell proliferation assay in colonic epithelial cells. We found that pretreatment with atractylodin significantly inhibits tumor necrosis factor-α-induced phosphorylation of nuclear factor-κ-light-chain-enhancer of activated B in HCT116 cells. Through docking simulation analysis, luciferase assays, and in vitro binding assays, we found that atractylodin has an affinity for peroxisome proliferator-activated receptor alpha (PPARα). Daily administration of atractylodin (40 mg/kg) increased the survival rate of mice in a dextran sodium sulfate-induced colitis mouse model. Thus, atractylodin can be a good strategy for colitis therapy through inducing PPARα-dependent pathways.

The Characteristics of Asian American Breast Cancer Survivors with Low Quality of Life: a Decision Tree Analysis.

To provide appropriate and adequate information and support for Asian American breast cancer survivors, it would be essential to identify risk groups among them to target in future cancer education interventions. In this secondary analysis, the characteristics of risk groups within Asian American breast cancer survivors who had low quality of life were identified using a decision tree analysis. For this analysis, only the pre-test data of 185 women from a parent study were selected. Multiple instruments including the Functional Assessment of Cancer Therapy Scale-Breast Cancer (FACT-B) were used in the parent study. The data were analyzed using descriptive and inferential statistics and decision tree analyses. The decision tree analyses showed six combined characteristics associated with lower quality of life scores than the total mean quality of life scores. For instance, the women with lower quality of life scores (than the total mean quality of life scores) had high perceived barriers (cut point = 1.84), low self-efficacy for coping (cut point = 81.50), and high global symptom distress (cut point = 2.27). Also, the characteristics linked to the lowest quality life scores were different depending on the dimensions of the quality of life. The characteristics associated with the quality of life of Asian American breast cancer survivors need to be considered in future education programs for this specific population.

N-Acetylserotonin is an oxidation-responsive activator of Nrf2 ameliorating colitis in rats.

N-Acetylserotonin (NAS) is an intermediate in the melatonin biosynthetic pathway. We investigated the anti-inflammatory activity of NAS by focusing on its chemical feature oxidizable to an electrophile. NAS was readily oxidized by reaction with HOCl, an oxidant produced in the inflammatory state. HOCl-reacted NAS (Oxi-NAS), but not NAS, activated the anti-inflammatory nuclear factor erythroid 2-related factor 2 (Nrf2)-heme oxygenase (HO)-1 pathway in cells. Chromatographic and mass analyses demonstrated that Oxi-NAS was the iminoquinone form of NAS and could react with N-acetylcysteine possessing a nucleophilic thiol to form a covalent adduct. Oxi-NAS bound to Kelch-like ECH-associated protein 1, resulting in Nrf2 dissociation. Moreover, rectally administered NAS increased the levels of nuclear Nrf2 and HO-1 proteins in the inflamed colon of rats. Simultaneously, NAS was converted to Oxi-NAS in the inflamed colon. Rectal NAS mitigated colonic damage and inflammation. The anticolitic effects were significantly compromised by the coadministration of an HO-1 inhibitor.

Immigration Transition and Symptom Distress Changes by a Technology-Based Intervention: Asian American Breast Cancer Survivors.

Technology-based programs using computers and mobile devices are known to be effective in providing information and support to marginalized populations including immigrants. Yet, little is still known on the factors that may influence the effectiveness of technology-based programs in improving symptom experience, including immigration transition, especially among Asian American breast cancer survivors. This study aimed to identify the characteristics related to immigration transition that significantly affected the symptom distress changes by a technology-based information and coaching/support program among Asian American breast cancer survivors. This secondary analysis was conducted with the data from 102 Asian American breast cancer survivors from a randomized clinical trial in progress. Multiple instruments were used: the questions on background characteristics and immigration transition and the Memorial Symptom Assessment Scale-Short Form. The data were analyzed using repeated-measurement analyses and decision tree analyses. The mean changes in the symptoms distress scores were as follows: -0.12 (SD, 0.47) in the Global Distress Index scores; -0.08 (SD, 0.43) in the physical symptom distress scores; and -0.15 (SD, 0.65) in the psychological symptom distress scores. The characteristics with the highest impact on the symptom distress score changes included the immigration age for Global Distress Index and physical symptom distress score and the level of acculturation for psychological symptom distress score.