Identifying Cancer-Related Cognitive Impairment Using the FACT-Cog Perceived Cognitive Impairment.

Cancer-related cognitive impairment (CRCI) is a concerning problem for many cancer survivors. Evaluating patients for CRCI has been a challenge, in part because of a lack of standardized practices. Self-report instruments are often used to assess CRCI, but there are no validated cutpoints. We present the results of receiver operating characteristic curve analysis identifying cutpoints of the Functional Assessment of Cancer Therapy-Cognition perceived cognitive impairment (PCI) in female breast cancer survivors for identifying CRCI cases. We defined presence of CRCI based on elevated complaints on the Patient's Assessment of Own Functioning Inventory compared with healthy control scores. Our results indicate that scores less than 54 in PCI scores using 18 items and scores less than 60 in PCI scores using 20 items exhibited good ability to discriminate CRCI cases from noncases (area under the receiver operating characteristic curve was 0.84 [95% CI = 0.73 to 0.94]). These preliminary results represent an important contribution toward standardizing practices across CRCI studies

Interview with Patricia Petersen

In this interview with Julia Stringfellow, Patricia Petersen, Milwaukee-Downer College class of 1957, discusses her time as a student.https://lux.lawrence.edu/oralhistories/1012/thumbnail.jp

Evaluating the Way Forward in Online Student Engagement.

Several factors make up the successful instructional experience in online higher education classes. With the advanced offerings in online learning, educational institutions are compelled to innovate all aspects of their online classes (U.S. Department of Education, 2016). The innovation can lead to a higher caliber learning environment. This paper advances a simple model for Instructors to follow, an Instructional Online Model (IOM), with the intent of improving student engagement, knowledge retention, leading to increased business profit. Instructors who model the discussed techniques may find increased student’s satisfaction with their courses, leading to the students pursuing further online education. Technological advancement and student maturity are themes identified during this research. These trends are topics for further research

Association of Recent Fatherhood With Antidepressant Treatment Initiation Among Men in the United Kingdom

IMPORTANCE: There is some evidence that men may be at higher risk of depression directly following the birth of their child and that approximately 1 in 10 men will experience depression in the year after birth, but less is known about men's antidepressant treatment during this time. Likewise, few direct comparisons have been made with antidepressant treatment in men who have not recently become fathers. OBJECTIVES: To determine whether recently having a child was associated with increased odds of antidepressant treatment in men. DESIGN, SETTING, AND PARTICIPANTS: This cohort study used UK primary care electronic health records from the IQVIA Medical Research Database. Participants included men aged 15 to 55 years who had had a child in the previous year, from January 2007 to December 2016, and compared with up to 5 men who did not have a child in the same calendar year. Data were analyzed from January 2022 to March 2023. EXPOSURE: A record of having a child in the previous year was identified through linked primary care records using a family identification number. MAIN OUTCOMES AND MEASURES: The main outcome was antidepressant initiation in the year after childbirth or in the year after this index date for men who did not have a child. Random-effects Poisson regression was used to determine associations of cohort, age group, social deprivation, history of antidepressant treatment, and calendar year with having an antidepressant prescription in the year after index date using prevalence risk rates (PPRs). RESULTS: Analysis included 90 736 men who had had a child in the previous year and 453 632 men in the comparison cohort. Most men in the study (463 879 men [85.2%]) were aged between 25 and 44 years, and there were more men living in the least deprived areas (130 277 men [23.9%]) than the most deprived areas (72 268 men [13.3%]). Overall, 4439 men (4.9%) had at least 1 antidepressant prescription in the year after they had a child, compared with 26 646 men (5.9%) who did not have a child in the same year. However, after adjustment there was no difference in antidepressant treatment between groups (adjusted PRR [aPRR], 1.01; 95% CI, 0.98-1.04). In fathers, those who had recently received antidepressant treatment were much more likely to receive antidepressant treatment after childbirth compared with fathers with no history of antidepressant treatment (aPRR, 32.31; 95% CI, 30.37-34.38). Fathers living in the most deprived areas were 18% more likely to have an antidepressant prescription compared with fathers living in the least deprived areas (aPRR, 1.18; 95% CI, 1.07-1.30). CONCLUSIONS AND RELEVANCE: These findings suggest that recently having a child was not associated with an increase in antidepressant treatment among men, but previous antidepressant treatment in fathers was strongly associated with treatment after childbirth. Further research is needed to determine whether antidepressant treatment or experiencing depression can be a barrier to fatherhood and whether fatherhood is a barrier to receiving antidepressant treatment

Childhood maltreatment, psychological resources, and depressive symptoms in women with breast cancer.

Childhood maltreatment is associated with elevated risk for depression across the human lifespan. Identifying the pathways through which childhood maltreatment relates to depressive symptoms may elucidate intervention targets that have the potential to reduce the lifelong negative health sequelae of maltreatment exposure. In this cross-sectional study, 271 women with early-stage breast cancer were assessed after their diagnosis but before the start of adjuvant treatment (chemotherapy, radiation, endocrine therapy). Participants completed measures of childhood maltreatment exposure, psychological resources (optimism, mastery, self-esteem, mindfulness), and depressive symptoms. Using multiple mediation analyses, we examined which psychological resources uniquely mediated the relationship between childhood maltreatment and depressive symptoms. Exposure to maltreatment during childhood was robustly associated with lower psychological resources and elevated depressive symptoms. Further, lower optimism and mindfulness mediated the association between childhood maltreatment and elevated depressive symptoms. These results support existing theory that childhood maltreatment is associated with lower psychological resources, which partially explains elevated depressive symptoms in a sample of women facing breast cancer diagnosis and treatment. These findings warrant replication in populations facing other major life events and highlight the need for additional studies examining childhood maltreatment as a moderator of treatment outcomes

Current Challenges in Travelers' Malaria

Travel health providers are often confronted with complex scenarios when advising travelers on malaria prevention. Current challenges in prevention include malaria risk assessment, where a detailed itinerary and knowledge of malaria epidemiology are needed. Up-to-date information on the correct use, limitations, and drug interactions of current priority chemoprophylaxis agents (atovaquone/proguanil, mefloquine, doxycycline) is key. Another challenge is to identify and reach travelers who are most at risk of malaria, such as the traveler visiting friends and relatives. Posttravel, delays in presentation, diagnosis, and inappropriate treatment of malaria are key risk factors leading to death. Treatment of malaria is an emergency requiring expert in-patient management and referral to a center with adequate expertise. Artemisinin combination therapies are the drugs of choice for uncomplicated malaria. Complicated malaria is treated preferably with intravenous artesunate, and the supply and quality of this life-saving antimalarial in some settings can pose one of the most urgent challenges in travelers' malari

Bidirectional manipulation of gene expression in adipocytes using CRISPRa and siRNA

Objective: Functional investigation of novel gene/protein targets associated with adipocyte differentiation or function heavily relies on efficient and accessible tools to manipulate gene expression in adipocytes in vitro. Recent advances in gene-editing technologies such as CRISPR-Cas9 have not only eased gene editing but also greatly facilitated modulation of gene expression without altering the genome. Here, we aimed to develop and validate a competent in vitro adipocyte model of controllable functionality as well as multiplexed gene manipulation in adipocytes, using the CRISPRa “SAM” system and siRNAs to simultaneously overexpress and silence selected genes in the same cell populations. Methods: We introduced a stable expression of dCas9-VP64 and MS2-P65, the core components of the CRIPSRa SAM system, in mesenchymal C3H/10T1/2 cells through viral delivery and used guide RNAs targeting Pparγ2, Prdm16, Zfp423, or Ucp1 to control the expression of key genes involved in adipocyte differentiation and function. We additionally co-transfected mature adipocytes with sgRNA plasmids and siRNA to simultaneously up-regulate and silence selected genes. Quantitative gene expression, oxygen consumption, fluorescence-activated cell sorting and immunocytochemistry served as validation proxies in pre- or mature adipocytes. Results: CRISPRa SAM-mediated up-regulation of a key adipogenic gene, Pparγ2, was successfully achieved using selected sgRNAs targeting the Pparγ2 promoter region (i.e. up to 104 fold); this induction was long lasting and sufficient to promote adipogenesis. Furthermore, co-activation of Pparγ2 with either Prdm16 or Zfp423 transcripts drove distinct thermogenic gene expression patterns associated with increased or decreased oxygen consumption, respectively, mimicking typical characteristics of brite/beige or white cell lineages. Lastly, we demonstrated that up-regulation of endogenous genes in mature adipocytes was also easily and efficiently achieved using CRISPRa SAM, here exemplified by targeted Ucp1 overexpression (up to 4 × 103 fold), and that it was compatible with concomitant gene silencing using siRNA, allowing for bidirectional manipulation of gene expression in the same cell populations. Conclusions: We demonstrate that the CRISPRa SAM system can be easily adopted and used to efficiently manipulate gene expression in pre- and mature adipocytes in vitro. Moreover, we describe a novel methodological approach combining the activation of endogenous genes and siRNA-mediated gene silencing, thus providing a powerful tool to functionally decipher genetic factors controlling adipogenesis and adipocyte functions

Biomarkers of aging associated with past treatments in breast cancer survivors.

Radiation and chemotherapy are effective treatments for cancer, but are also toxic to healthy cells. Little is known about whether prior exposure to these treatments is related to markers of cellular aging years later in breast cancer survivors. We examined whether past exposure to chemotherapy and/or radiation treatment was associated with DNA damage, telomerase activity, and telomere length 3-6 years after completion of primary treatments in breast cancer survivors (stage 0-IIIA breast cancer at diagnosis). We also examined the relationship of these cellular aging markers with plasma levels of Interleukin (IL)-6, soluble TNF-receptor-II (sTNF-RII), and C-reactive protein (CRP). Ninety-four women (36.4-69.5 years; 80% white) were evaluated. Analyses adjusting for age, race, BMI, and years from last treatment found that women who had prior exposure to chemotherapy and/or radiation compared to women who had previously received surgery alone were more likely to have higher levels of DNA damage (P = .02) and lower telomerase activity (P = .02), but did not have differences in telomere length. More DNA damage and lower telomerase were each associated with higher levels of sTNF-RII (P's < .05). We found that exposure to chemotherapy and/or radiation 3-6 years prior was associated with markers of cellular aging, including higher DNA damage and lower telomerase activity, in post-treatment breast cancer survivors. Furthermore, these measures were associated with elevated inflammatory activation, as indexed by sTNF-RII. Given that these differences were observed many years after the treatment, the findings suggest a long lasting effect of chemotherapy and/or radiation exposure

Intensive Outpatient Acceptance and Commitment Therapy with Exposure and Response Prevention for Adolescents

Intensive treatments for youth obsessive-compulsive disorder (OCD) are important and underresearched. This study used three adolescent cases to assess the preliminary efficacy of an intensive treatment combining acceptance and commitment therapy (ACT) with exposure and response prevention (ERP) for OCD. Participants received intensive treatment for 15 hours per week for three weeks. Assessments were collected at pre-treatment, weekly during treatment, and at posttreatment. All participants ended treatment in the mild range of OCD severity with 32-60% reductions in symptoms. Participants also reported notable improvements in psychological flexibility and ended treatment in the non-clinical range of depression, anxiety, and stress. These results indicate promise and preliminary support for the use of ACT+ERP in intensive settings for adolescents with OCD. This paper focuses on the clinical application of these techniques