The Effect of Temperament on the Association Between Pre-treatment Anxiety and Chemotherapy-Related Symptoms in Patients With Breast Cancer

Objective Pre-treatment anxiety (PA) before chemotherapy increases complaints of chemotherapy-related symptoms (CRS). The results on the association have been inconsistent, and the effect of temperament remains unclear. We aimed to determine whether PA is a risk factor for CRS and the effect of differing temperaments on CRS. Methods This prospective study comprised 176 breast cancer patients awaiting adjuvant chemotherapy post-surgery. We assessed CRS, PA, and temperament using the MD Anderson Symptom Inventory (MDASI), the Hospital Anxiety and Depression Scale, and the short form of the Temperament and Character Inventory-Revised, respectively. The MDASI was re-administered three weeks after the first chemo-cycle. Results PA showed weak positive correlation with several CRS after the first cycle; no CRS was significantly associated with PA when pre-treatment depressive symptoms and baseline CRS were adjusted in multiple regression analysis. Moderation model analysis indicat-ed that the PA effect on several CRS, including pain, insomnia, anorexia, dry mouth, and vomiting, was moderated by harm avoidance (HA) but not by other temperament dimensions. In particular, PA was positively associated with CRS in patients with low HA. Conclusion The results in patients with low HA indicate that more attention to PA in patients with confident and optimistic temperaments is necessary

LENS-GRM Applicability Analysis and Evaluation

Recently, there have been many abnormal natural phenomena caused by climate change. Anthropogenic factors associated with insufficient water resource management can be another cause. Among natural causes, rainfall intensity and volume often induce flooding. Therefore, accurate rainfall estimation and prediction can prevent and mitigate damage caused by these hazards. Sadly, uncertainties often hinder accurate rainfall forecasting. This study investigates the uncertainty of the Korean rainfall ensemble prediction data and runoff analysis model in order to enhance reliability and improve prediction. The objectives of this study include: (i) evaluating the spatial characteristics and applicability of limited area ensemble prediction system (LENS) data; (ii) understanding uncertainty using parameter correction and generalized likelihood uncertainty estimation (GLUE) and grid-based rainfall-runoff model (GRM); (iii) evaluating models before and after LENS-GRM correction. In this study, data from the Wicheon Basin was used. The informal likelihood (R2, NSE, PBIAS) and formal likelihood (log-normal) were used to evaluate model applicability. The results confirmed that uncertainty of the behavioral model exists using the likelihood threshold when applying the runoff model to rainfall forecasting data. Accordingly, this method is expected to enable more reliable flood prediction by reducing the uncertainties of the rainfall ensemble data and the runoff model when selecting the behavioral model for the user’s uncertainty analysis. It also provides a basis for flood prediction studies that apply rainfall and geographical characteristics for rainfall-runoff uncertainty analysis

Development of Deep Learning Models to Improve the Accuracy of Water Levels Time Series Prediction through Multivariate Hydrological Data

Since predicting rapidly fluctuating water levels is very important in water resource engineering, Long Short-Term Memory (LSTM) and Gated Recurrent Unit (GRU) were used to evaluate water-level-prediction accuracy at Hangang Bridge Station in Han River, South Korea, where seasonal fluctuations were large and rapidly changing water levels were observed. The hydrological data input to each model were collected from the Water Resources Management Information System (WAMIS) at the Hangang Bridge Station, and the meteorological data were provided by the Seoul Observatory of the Meteorological Administration. For high-accuracy high-water-level prediction, the correlation between water level and collected hydrological and meteorological data was analyzed and input into the models to determine the priority of the data to be trained. Multivariate input data were created by combining daily flow rate (DFR), daily vapor pressure (DVP), daily dew-point temperature (DDPT), and 1-hour-max precipitation (1HP) data, which are highly correlated with the water level. It was possible to predict improved high water levels through the training of multivariate input data of LSTM and GRU. In the prediction of water-level data with rapid temporal fluctuations in the Hangang Bridge Station, the accuracy of GRU’s predicted water-level data was much better in most multivariate training than that of LSTM. When multivariate training data with a large correlation with the water level were used by the GRU, the prediction results with higher accuracy (R2=0.7480–0.8318; NSE=0.7524–0.7965; MRPE=0.0807–0.0895) were obtained than those of water-level prediction results by univariate training

Psychiatric symptoms mediate the effect of resilience on health-related quality of life in patients with breast cancer: Longitudinal examination

Objective Patients with breast cancer receiving neoadjuvant chemotherapy are at increased risk of poor health-related quality of life (HRQOL). This study examined clinical caseness on depression and anxiety mediate the relationship between resilience and HRQOL in patients with breast cancer. Methods A total of 193 patients with breast cancer undergoing neoadjuvant chemotherapy completed questionnaires including the Connor-Davidson Resilience Scale, Hospital Anxiety and Depression Scale (HADS), and Functional Assessment of Cancer Therapy-Breast before the first session (T0), before the start of the last session (T1), and 6 months after the end (T2) of chemotherapy. Mediation analyses using a bootstrapping method was performed. Results The indirect effect (IE) through T1 depression was significant (IE through depression = 0.043, 95% confidence interval [CI] [0.002-0.090]), while IE through T1 anxiety was not significant (IE through anxiety = 0.037, 95% CI [-0.010-0.097]) in the association between T0 resilience and T2 HRQOL. Conclusions Clinical caseness on HADS depression subscale during chemotherapy was a mediating factor of the relationship between resilience before chemotherapy and HRQOL after chemotherapy in patients with breast cancer receiving neoadjuvant chemotherapy. Depression during chemotherapy in patients with breast cancer may be a target symptom of screening and intervention to maintain the HRQOL after chemotherapy. Also, patients with low resilience are more likely to develop depression during chemotherapy, and clinicians should carefully monitor whether depression occurs in these patients with low resilience

The longitudinal effects of chronotype on chemotherapy-induced nausea and vomiting in patients with breast cancer receiving neoadjuvant chemotherapy

Objective: The object of this longitudinal cohort study was to investigate whether chronotype affects the incidence of chemotherapy-induced nausea and vomiting (CINV) among patients with breast cancer. Methods: The study included a total of 203 breast cancer patients who received neoadjuvant chemotherapy using a regimen of doxorubicin and cyclophosphamide with high emetogenicity. Patients received four cycles of chemotherapy in approximately three months. Patients completed questionnaires including the Munich Chronotype Questionnaire (MCTQ) before the first chemotherapy and the Multinational Association of Supportive Care in Cancer Antiemesis Tool (MAT) after each of the four chemotherapy sessions. To confirm the effect of chronotype on CINV during the four cycles, we performed statistical analyses using a generalized estimating equation (GEE). Results: CINV occurred in 108 (53.2%), 112 (55.2%), 102 (50.3%), and 62 (30.5%) patients during four cycles of treatment. In the GEE approach, late and early chronotypes (vs. intermediate chronotype) were associated with an increased risk of CINV (late chronotype: odds ratio [OR], 2.06; 95% confidence interval [CI], 1.41-2.99; p < 0.001, early chronotype: OR, 1.84; CI, 1.25-2.73; p = 0.002), which remained significant even after adjusting for age, BMI, antiemetic treatment, history of nausea and vomiting, anxiety, and sleep quality. Conclusion: Chronotype affected CINV across the four cycles of neoadjuvant chemotherapy in patients with breast cancer, suggesting the need to consider chronotype in predicting and managing CINV

The effect of perceived social support on chemotherapy-related symptoms in patients with breast cancer: A prospective observational study

Objective: Few studies have examined the effect of perceived social support (PSS) on chemotherapy-related symptoms (CRS). This study examined the effect of PSS on CRS in 184 patients with breast cancer. Methods: Participants were consecutively enrolled from a tertiary general hospital in Seoul, South Korea. CRS were assessed eight times, from before the first neoadjuvant chemotherapy to six months after the end of neoadjuvant chemotherapy, with the MD Anderson Symptom Inventory. PSS was evaluated once, before the first neoadjuvant chemotherapy session, using the Multidimensional Scale of Perceived Social Support (MSPSS). Two groups were formed based on MSPSS scores: the low PSS group (n = 62) and the moderate-to-high PSS group (n = 122). Linear mixed model analyses were used to compare the change in CRS severity between the two groups during chemotherapy. Results: Results indicated a significant group-by-time (low PSS or moderate-to-high PSS; 8 periods of chemotherapy) interaction for pain (p=.005), nausea (p=.033), insomnia (p<.001), distress (p=.003), dyspnea (p=.014), memory loss (p=.021), vomiting (p=.016), and numbness (p=.008) in which the moderate-to-high PSS group showed significantly lower levels of increase in those symptoms during chemotherapy. Moreover, the effect of PSS on CRS differed depending on the sources of PSS. Conclusion: Patients with moderate-to-high PSS experience less severe CRS compared with patients with low PSS during chemotherapy. The current findings indicate the potential benefits of providing social support in the management of CRS

Prevalence and comorbidities of adult adhd in male military conscripts in korea: Results of an epidemiological survey of mental health in korean military service

We assessed the prevalence/comorbidities of attention deficit hyperactivity disorder (ADHD) in Korean servicemen using the Epidemiological Survey of Mental Health in Military Service in Korea. A total of 3,441 participants were assessed for adult ADHD, depression, social anxiety, generalized anxiety, somatization, insomnia, suicidality, cigarette dependence, and alcohol dependence using a self-report scale. Participants were also asked to rank their perception of their career prospects, health status, and quality of life on a Likert scale. Participants were classified as ADHD according to the WHO A-ADHD self-report scale. Firth multiple logistic regression and Cochran-Armitage trend tests were used to identify the risks of comorbidities and trends of self-perception between the two groups. ADHD (prevalence: 2.8%) was significantly associated with social anxiety (OR, 40.52; 95% CI 25.14-65.74), generalized anxiety (OR, 28.21; 95% CI 17.37-45.69), depression (OR, 16.36; 95% CI 10.50-25.52), somatization (OR, 14.47; 95% CI 9.21-22.76), suicidality (OR, 11.03; 95% CI 6.67-17.86), and insomnia (OR, 5.92; 95% CI 3.68-9.35). Servicemen with ADHD had negative perceptions (p <0.001) of their career prospects, health status, and quality of life compared to servicemen without ADHD. It is essential to revise the enlistment criteria for individuals with ADHD or to develop management programs for servicemen with ADHD