Gendered Analysis of Cyberbullying Victimization and Its Associations with Suicidality: Findings from the 2019 Youth Risk Behavior Survey

Cyberbullying victimization (CV), a widespread experience in adolescence, is associated with increased depression and suicidality. However, few studies have taken a gender approach when investigating the association between CV and suicidality, despite research that indicates disparate experiences by gender for both CV and mental health. We conducted a secondary data analysis of the 2019 Youth Risk Behavior Survey (N = 10,309; 50.1% girls), a cross-sectional survey drawn from a representative sample of US high school students. We found that CV remained significantly associated with suicidality after controlling for emotional and behavioral risk factors, for both boys and girls. CV increased the odds of suicidality directly and indirectly by increasing risk for depression, for both boys and girls. Boys contending with both CV and sexual violence were particularly vulnerable to suicidality, and binge drinking was positively associated with CV for girls but negatively associated with CV for boys. Findings confirmed that CV is a pervasive issue among U.S. adolescents. A gendered approach is necessary in order to understand and address the effects of CV

Gendered Analysis of Cyberbullying Victimization and Its Associations with Suicidality: Findings from the 2019 Youth Risk Behavior Survey

Cyberbullying victimization (CV), a widespread experience in adolescence, is associated with increased depression and suicidality. However, few studies have taken a gender approach when investigating the association between CV and suicidality, despite research that indicates disparate experiences by gender for both CV and mental health. We conducted a secondary data analysis of the 2019 Youth Risk Behavior Survey (N = 10,309; 50.1% girls), a cross-sectional survey drawn from a representative sample of US high school students. We found that CV remained significantly associated with suicidality after controlling for emotional and behavioral risk factors, for both boys and girls. CV increased the odds of suicidality directly and indirectly by increasing risk for depression, for both boys and girls. Boys contending with both CV and sexual violence were particularly vulnerable to suicidality, and binge drinking was positively associated with CV for girls but negatively associated with CV for boys. Findings confirmed that CV is a pervasive issue among U.S. adolescents. A gendered approach is necessary in order to understand and address the effects of CV

Cancer related mortality in multiple sclerosis. A population based cohort study

Background: Cancer is a major cause of death, but how cancer influences mortality risk in Multiple Sclerosis (MS) is unclear. Objectives: Determine all-cause mortality and mortality following a cancer diagnosis among MS patients compared with matched population controls. Methods: Norwegian MS patients born 1930 - 1979 (n= 6950) followed-up 1953 – 2016, were matched with 37 922 controls. We compared incident cancer diagnosis from the Cancer Registry of Norway, date of death from the Cause of Death Registry, education from the National Education Database, by multivariate Cox proportional hazard regression. Results: Hazard ratio (HR) and 95% confidence interval (CI) for all-cause mortality among MS patients was 4.97 (4.64 – 5.33), and 2.61 (2.29 – 2.98) for mortality following a cancer diagnosis. Mortality in MS was highest following urinary- (2.53: 1.55 – 4.14), colorectal- (2.14: 1.47 – 3.11), hematological- (1.76: 1.08 – 2.88), ovarian - 2.30 (1.73-3.06) and breast cancer diagnosis (2.61: 1.85 – 3.68), compared to controls. High education was inversely associated with mortality among MS patients. Conclusions: All-cause mortality was five- fold and mortality following a cancer diagnosis was two- fold increased among MS patients. Mortality following specific cancers raises the possibility of diagnostic neglect.publishedVersio

Incidence of cancer in multiple sclerosis before and after the treatment era– a registry- based cohort study

Background: Whether disease-modifying therapies (DMTs) influence cancer in multiple sclerosis (MS) is uncertain. Objectives: Assess incidence of cancer diagnosis among Norwegian MS patients compared to the general population in 1953 to 1995 and 1996 to 2017-reflecting era before and after introduction of DMTs. Methods: We performed a nationwide cohort study comprising 6949 MS patients and 37,922 controls, matched on age, sex and county. The cohort was linked to Norwegian Cancer Registry, Cause of Death Registry and National Educational database. We used Poisson regression to calculate incidence rate ratio (IRR) of cancer. Results: During 1953–1995 MS patients had similar cancer frequency compared to controls (IRR: 1.11 (95% Confidence Intervals (CI): 0.90–1.37)), although MS patients had increased frequency of cancer in endocrine glands (IRR: 2.51 (1.27–4.93). During 1996–2017 we identified significant increased frequency of cancer among MS patients compared to controls (IRR: 1.38 (95% CI: 1.28–1.52): in brain (IRR: 1.97 (1.41–2.78)), meninges (IRR: 2.44 (1.54–3.77)), respiratory organs (IRR: 1.96 (1.49–2.63)). The excess cancer diagnosis was most frequent among MS patients ≥ 60 years of age (HR 1.30 (1.15–1.47)). Conclusion: Incidence of cancer among MS patients compared to controls was higher in 1996 to 2017, corresponding in time to the introduction of DMT for MS. This was observed more frequently among MS patients older than 60 years of age

Incidence of cancer in multiple sclerosis before and after the treatment era– a registry- based cohort study

Background Whether disease-modifying therapies (DMTs) influence cancer in multiple sclerosis (MS) is uncertain. Objectives Assess incidence of cancer diagnosis among Norwegian MS patients compared to the general population in 1953 to 1995 and 1996 to 2017-reflecting era before and after introduction of DMTs. Methods We performed a nationwide cohort study comprising 6949 MS patients and 37,922 controls, matched on age, sex and county. The cohort was linked to Norwegian Cancer Registry, Cause of Death Registry and National Educational database. We used Poisson regression to calculate incidence rate ratio (IRR) of cancer. Results During 1953–1995 MS patients had similar cancer frequency compared to controls (IRR: 1.11 (95% Confidence Intervals (CI): 0.90–1.37)), although MS patients had increased frequency of cancer in endocrine glands (IRR: 2.51 (1.27–4.93). During 1996–2017 we identified significant increased frequency of cancer among MS patients compared to controls (IRR: 1.38 (95% CI: 1.28–1.52): in brain (IRR: 1.97 (1.41–2.78)), meninges (IRR: 2.44 (1.54–3.77)), respiratory organs (IRR: 1.96 (1.49–2.63)). The excess cancer diagnosis was most frequent among MS patients ≥ 60 years of age (HR 1.30 (1.15–1.47)). Conclusion Incidence of cancer among MS patients compared to controls was higher in 1996 to 2017, corresponding in time to the introduction of DMT for MS. This was observed more frequently among MS patients older than 60 years of age

Risk of cancer among multiple sclerosis patients, siblings, and population controls: A prospective cohort study

Background: Risk of cancer in multiple sclerosis (MS) patients compared to their siblings is unknown. Objective: The objective was to prospectively investigate the risk of cancer among MS patients compared to siblings without MS and to population controls. Methods: We retrieved data on MS patients born between 1930 and 1979 from the Norwegian Multiple Sclerosis Registry and population studies and on cancer diagnosis from the Cancer Registry of Norway. We used adjusted Cox proportional hazard regression to estimate cancer risk among 6883 MS patients, 8918 siblings without MS, and 37,919 population controls. Results: During 65 years of follow-up, cancer risk among MS patients was higher than that among population controls (hazard ratio (HR) = 1.14, 95% confidence interval (CI): 1.05–1.23) in respiratory organs (HR = 1.66, 95% CI: 1.26–2.19), urinary organs (HR = 1.51, 95% CI: 1.12–2.04), and the central nervous system (HR = 1.52, 95% CI: 1.11–2. 09). Siblings had higher risk of hematological cancers compared with MS patients (HR = 1.82, 95% CI: 1.21–2.73) and population controls (HR = 1.72, 95% CI: 1.36–2.18). Conclusion: MS patients were associated with increased risk of cancer compared to population controls. Siblings had increased risk of hematological cancer. This indicates that MS and hematological cancer could share a common etiology

How do medical students respond to emotional cues and concerns expressed by simulated patients during OSCE consultations? - A multilevel study

Objectives: How medical students handle negative emotions expressed by simulated patients during Objective Structured Clinical Examinations (OSCE) has not been fully investigated. We aim to explore (i) whether medical students respond differently to different types of patients’ emotional cues; and (2) possible effects of patients’ progressive disclosure of emotional cues on students’ responses. Methods: Forty OSCE consultations were video recorded and coded for patients’ expressions of emotional distress and students’ responses using a validated behavioural coding scheme (the Verona Coding Definitions of Emotional Sequence). Logistic multilevel regression was adopted to model the probability of the occurrence of student reduce space response behaviour as a function of the number of patients’ expressions of emotional cues. Results: We found that medical students offered responses that differed to emotional cue types expressed by simulated patients. Students appeared to provide space to emotional cues when expressed in vague and unspecific words and reduce space to cues emphasizing physiological or cognitive correlates. We also found that medical students were less likely to explore patients’ emotional distress nearer the end of the consultation and when the duration of a patient speech turn got larger. Cumulative frequency of patients’ emotional cues also predicted students’ reduce space behaviour. Practical Implications: Understanding how medical students manage negative emotions has significant implications for training programme development focusing on emotion recognition skills and patient-centred communication approach. In addition, the statistical approaches adopted by this study will encourage researchers in healthcare communication to search for appropriate analytical techniques to test theoretical propositions.Publisher PDFPeer reviewe

Level of education and multiple sclerosis risk over a 50-year period: Registry-based sibling study

Background: The conflicting results from studies on socioeconomic status (SES) and multiple sclerosis (MS) risk might be due to a change in the distribution of environmental exposures over time or to methodological limitations in previous research. Objective: To examine the association between SES and MS risk during 50 years. Methods: We included patients registered in Norwegian MS registries and prevalence studies born between 1930 and 1979, and identified their siblings and parents using the Norwegian Population Registry. Information on education was retrieved from the National Education Registry, categorized into four levels (primary, secondary, undergraduate and graduate) and compared in patients and siblings using conditional logistic regression. Results: A total of 4494 MS patients and 9193 of their siblings were included in the analyses. Level of education was inversely associated with MS risk (p trend < 0.001) with an odds ratio (OR) of 0.73 (95% confidence interval (CI): 0.59–0.90) when comparing the highest and lowest levels. The effect estimates did not vary markedly between participants born before or after the median year of birth (1958), but we observed a significant effect modification by parental education (p = 0.047). Conclusion: Level of education was inversely associated with MS risk, and the estimates were similar in the earliest and latest birth cohorts

GAP43-dependent mitochondria transfer from astrocytes enhances glioblastoma tumorigenicity

The transfer of intact mitochondria between heterogeneous cell types has been confirmed in various settings, including cancer. However, the functional implications of mitochondria transfer on tumor biology are poorly understood. Here we show that mitochondria transfer is a prevalent phenomenon in glioblastoma (GBM), the most frequent and malignant primary brain tumor. We identified horizontal mitochondria transfer from astrocytes as a mechanism that enhances tumorigenesis in GBM. This transfer is dependent on network-forming intercellular connections between GBM cells and astrocytes, which are facilitated by growth-associated protein 43 (GAP43), a protein involved in neuron axon regeneration and astrocyte reactivity. The acquisition of astrocyte mitochondria drives an increase in mitochondrial respiration and upregulation of metabolic pathways linked to proliferation and tumorigenicity. Functionally, uptake of astrocyte mitochondria promotes cell cycle progression to proliferative G2/M phases and enhances self-renewal and tumorigenicity of GBM. Collectively, our findings reveal a host-tumor interaction that drives proliferation and self-renewal of cancer cells, providing opportunities for therapeutic development