Search Results (193)

Background: Chronic hemodialysis (HD) patients face symptoms that significantly impact their quality of life and health outcomes. Longitudinal research on the dynamics of symptom severity and the integration of individual patient characteristics into cluster analyses is limited, hindering understanding of cluster evolution over time. Objective: The objective of this study was to characterize and compare symptom clusters across body systems based on frequency and severity at three time points in chronic HD patients. Methods: This prospective longitudinal study collected self-reported data on 23 symptoms using validated measures from 69 chronic HD patients (age range: 24–87 years) at three time points over a year. Symptoms were rated on a 0–10 scale. Symptom progression and clustering were analyzed using heat maps and principal component analysis. Results: Among 69 HD patients, a substantial symptom burden was identified at baseline, with fatigue, overall perceived health, worry or distress, and sleep disturbance reported as the most severe (mean scores > 4.0 on a 0–10 scale). Hierarchical clustering yielded a five-cluster solution; however, longitudinal analysis revealed poor structural stability in patient symptom profiles over 12 months (ARI < 0.70), indicating significant symptomatic reorganization. Gastrointestinal cluster showed a statistically significant reduction in severity over time (β = −0.914, p = 0.003); fatigue and overall perceived health remained a high burden. Subgroup analyses demonstrated that patients using central venous catheters reported significantly higher severity in pain, fatigue, and nausea compared to patients with arteriovenous fistulas, while Diabetes mellitus was uniquely associated with increased dyspnea (p < 0.001). Conclusions: Chronic HD patients experience a dynamic and multidimensional symptom burden, with significant variations in severity, progression, and clustering of symptoms over time. The observed temporal instability of symptom clusters and the heterogeneity of individual trajectories emphasize the importance of routine, longitudinal symptom assessment and flexible, patient-centered management strategies by nephrology nurse specialists, which may support value-based healthcare approaches. Full article

Brain metastases are the third most common metastatic site in melanoma patients, with 40% of melanoma patients developing melanoma brain metastasis (MBM). Symptomology of MBM ranges from headaches, neurological deficits, cognitive changes, and seizures, resulting from MBM embedding in areas of highest blood flow following the breakdown of the blood–brain barrier (BBB) via genetic, cytokine, and molecular processes. The BBB is highly restrictive, making MBM difficult to treat. Challenges in MBM treatment are evident in adverse therapeutic effects, such as neurocognitive decline with whole-brain radiation therapy (WBRT), increased risk of radiation necrosis with stereotactic radiosurgery (SRS), and reduced penetration into the brain, which can lead to drug resistance with prolonged use of MAPK inhibitors. This review investigates current and novel treatments against MBM, including radiotherapy, chemotherapy, targeted therapies such as BRAF/MAPK inhibitors, and immunotherapy. Full article

Social capital has been well established to have beneficial effects on a variety of behavioral, developmental, and health outcomes across the life course. In particular, social capital has been proven to be a protective factor benefiting health, particularly among young people. However, we know little about whether or how social capital might provide a protective effect against a very specific mental health challenge of young and mid-adult life: experiencing postpartum depression. Using linear regression models and restricted-use data from the National Study of Adolescent to Adult Health (five waves conducted beginning in 1995 when respondents were in grades 7–12 and following them into adulthood) on women who gave birth during early adulthood, and controlling for a variety of demographic factors (such as race, parental and partner social capital, SES), we aim to understand potential associations between social capital derived from families and romantic partners and postpartum depression symptomology. Our findings suggest the need for approaches that help pregnant women build and maintain key social connections and resources with fathers and partners. Full article

Background/Objectives: Mood disorders like depression, anxiety, and stress have increased steadily among adults, with growing interest in non-pharmaceutical treatments to improve symptomology. Epigallocatechin-3-gallate (EGCG) and curcumin are polyphenols with evidence to support their positive impacts on mood disorder symptomology and potential mood-associated biomarkers like brain-derived neurotrophic factor (BDNF). This study examined the effects of combined EGCG and curcumin supplementation on mood disturbance symptomology and serum brain-derived neurotrophic factor in adults. Methods: An 8-week randomized double-blinded placebo-controlled trial was conducted in adults (n = 64, 18–50 years old). Participants were randomized to a supplement group (n = 32; 350 mg EGCG and 1330 mg curcumin daily) or a matched placebo group (n = 32). Mood disturbance (DASS-21, GAD-7), sleep disturbance (GSAQ), and physical activity (IPAQ) were assessed at baseline, Week 4, and Week 8. Anthropometric measures, 24 h diet recalls, and fasted blood samples for serum BDNF were collected at baseline and Week 8. A multivariate ANOVA evaluated primary outcomes (DASS-21 composite score and BDNF), followed by repeated measures ANOVA for secondary outcomes (p < 0.05). Results: Significant improvements were observed across all participants for mood (DASS-21 composite and subscales, GAD-7, p < 0.001 for all), sleep (p < 0.001), and physical activity (p < 0.01), with no significant difference between supplement and placebo groups. Mean serum BDNF increased in both groups, but neither were statistically significant with no group-by-time interactions. Sugar intake (g/kg body weight) was positively correlated with mood symptoms at Week 8 in the supplement group. Baseline fruit and vegetable intake was associated with mood symptom severity at select time points; however, dietary changes during the intervention were not significantly related to changes in mood outcomes. Conclusions: Combined EGCG and curcumin supplementation did not show additional benefits beyond placebo for mood disturbance or serum BDNF over eight weeks. Observed improvements across both groups suggest that behavioral or lifestyle factors may play a larger role in short-term mood improvements than supplementation alone. Full article

The COVID-19 pandemic increased Intimate Partner Violence (IPV) internationally and disrupted health services. The pandemic also exacerbated risk factors linked to IPV, such as deteriorating mental health. As access to health care became restricted, IPV survivors faced barriers to help-seeking. No study has examined the factors related to IPV help-seeking intent during the pandemic, which might differ from actual behavior. The aim is to examine the impact of number of COVID-19 cases and health on IPV help-seeking and disclosure intent. A cross-sectional survey in the USA in April 2020 assessed health status, IPV (victimization and perpetration), help-seeking and disclosure intent. Linear models were used (N = 1346). Upper income positively correlated with help-seeking and disclosure intent. In terms of number of COVID-19 cases and PTSD symptomology with help-seeking intent, changes in daily life correlated positively with disclosure intent, but experience of violence correlated negatively. There were significant demographic differences. Inconsistency in the reporting of violence across scales was a notable issue. The findings on mental health support the existing literature. Healthcare providers in all settings should prioritize IPV screening. Access to care should be maximized through continued improvement/expansion of online services and policy changes that remove barriers (such as lapse in insurance coverage or financial burden). Full article

Background: Obese Latino adolescents are at increased risk for stress and depressive symptomology, but interventions to target both physiological and mental health outcomes are scarce. This pilot randomized controlled trial assessed feasibility and preliminary efficacy for a home-based strength training (HBST) intervention on stress-related and mental health outcomes in obese Latino adolescent males. Methods: Fifty-two adolescents were randomized to HBST (n = 26) or control conditions (n = 26). Participants randomized to HBST completed a 16-week progressive resistance training intervention performed twice per week at home on non-consecutive days. Primary and secondary outcomes were assessed at baseline and immediately post-intervention and included measures of upper- and lower-body strength (1RM), body mass index (BMI), BMI percentile, BMI Z-score, salivary cortisol, depressive symptoms (CES-D), and perceived stress (PSS-14). Results are presented using completer-only analyses (n = 25) and mixed-design ANOVA models. An ANCOVA sensitivity analysis was conducted for depressive symptoms due to baseline imbalance, including baseline CES-D as a covariate in the model. Results: Recruitment goals were met, but retention was lower than expected (48% overall; HBST = 31%, control = 54%). Analyses revealed a significant Time × Group interaction for salivary cortisol (F(1, 20) = 5.70, p = 0.027, ηp² = 0.222), such that cortisol decreased over time in HBST participants and increased in control participants. While all strength and anthropometric outcomes improved descriptively from baseline to follow-up in the intervention condition, no significant interactions were present between groups. Depressive symptoms also decreased descriptively in HBST participants, but this effect was no longer significant after adjusting for baseline CES-D using ANCOVA (F(1, 19) = 0.002, p = 0.968). There were no significant findings for perceived stress. Conclusions: Differential effects were observed on salivary cortisol, suggesting HBST may be feasible in obese Latino adolescents. However, results should be interpreted with caution given baseline imbalance, small sample size, high attrition, and limitations with measuring cortisol at one time point without adjustment for time of day or key psychosocial and physiological confounders. All psychological and anthropometric outcomes were exploratory and non-significant after adjustment. A larger, multisite trial using baseline-adjusted analytic procedures, repeated physiological sampling, objective measures of adherence, and extended follow-up is needed to determine whether HBST produces meaningful effects that are sustained over time. Full article

Non-motor symptoms (NMSs) are highly prevalent in Parkinson’s Disease (PD) and contribute significantly to disease severity, progression, and diminished quality of life. NMSs are rooted in both physiological and psychological domains and include emotional dysfunction, autonomic dysregulation, cognitive impairment, pain exacerbation, and neural deficits. While pharmacological approaches are often employed for the alleviation of non-motor symptomology, modest efficacy and adverse side effects may limit their practical utility for individuals with PD, leaving the need for the identification of complementary approaches. Music interventions have emerged as potential adjunctive therapeutic approaches that may positively modulate NMSs in both physiological and psychological domains. Physiologically, music interventions have been shown to alter autonomic activity and pain/sensory perceptions and mediate neurotransmitter release related to arousal, physical effort, and stress. Psychologically, music interventions, both passive and active, have been shown to modulate emotional regulation, motivation, attention, and cognitive performance. Emerging evidence utilizing neuroimaging and behavioral techniques further supports this and suggests music-induced benefits even in the presence of advancing neurodegeneration. Overall, findings from this narrative review suggest music may serve as a potential non-invasive adjunctive therapeutic tool to counteract PD-induced NMSs by adaptively modulating physiological and psychological processes. This narrative review aims to gather current evidence on the physiological and psychological mechanisms underlying the benefits of music and proposes potential therapeutic translation for NMSs in PD. Furthermore, current difficulties, gaps in knowledge, and needs for future research are discussed with the goal of informing directions for clinical translation. Full article

Background/Objectives: Research on the relationship between digital media use in adolescence and mental health outcomes in young adulthood remains unclear. This study aims to (1) assess how trajectories of digital media use from adolescence to young adulthood predict mental health outcomes and (2) identify factors in adolescence that contribute to digital media use trajectories. Methods: Participants (M_age = 15.53 years; 56.86% female; 66.89% White) from the National Longitudinal Study of Adolescent and Adult Health database provided digital media use data across Waves I–IV. At Wave I, participants self-reported parental support, family connectedness, face-to-face interactions with peers, and self-esteem. At Wave IV, participants self-reported anxiety and depression diagnoses, depressive symptomology, suicidal ideation and attempts, and short-term and working memory. General linear and logistic regression models assessed the relationships. Results: Four trajectory groups emerged: Group 1 “increase” (9.97%), Group 2 “low” (73.36%), Group 3 “decrease” (13.94%), and Group 4 “high” (2.73%). Individuals in Group 4 experienced decreased short-term memory compared to individuals in Group 2. The odds of a suicide attempt in the past 12 months were significantly higher for individuals in Groups 3 and 4 compared to Group 2. Conclusions: Patterns of digital media use from adolescence to young adulthood may contribute to suicide attempts and short-term memory in young adulthood, highlighting the need for interventions to reduce screen time. Non-significant findings highlight the need for additional research aimed at clarifying these relationships and identifying factors in early adolescence that may contribute to digital media use trajectories. Full article

Background: Peanut is susceptible to iron (Fe) deficiency, particularly in calcareous soils. However, comparative studies on the adaptive mechanisms of different peanut cultivars to Fe deficiency remain limited. This study aimed to investigate the physiological and molecular responses of two distinct peanut cultivars to Fe deprivation and to identify the key traits contributing to differential Fe efficiency. Methods: Two peanut cultivars, LH11 and YZ9102, were cultivated under Fe-sufficient and Fe-deficient conditions, using both hydroponic and pot-based soil culture systems. Multiple parameters were assessed, including visual symptomology, biomass, tissue Fe concentration, active Fe in leaves, chlorophyll (Chl) content (SPAD value), net photosynthetic rate (Pn), Chl fluorescence (Fv/Fm), rhizosphere pH, root ferric chelate reductase (FCR) activity, and the relative expression of two Fe-acquisition-related genes (AhIRT1 and AhFRO1) via qRT-PCR. Results: Cultivar YZ9102 exhibited more severe Fe deficiency chlorosis symptoms, which also appeared earlier than in LH11, under both cultivation systems. Under Fe deficiency, YZ9102 showed significantly lower Chl content, Pn, and Fv/Fm compared to LH11. In contrast, LH11 demonstrated a greater capacity for rhizosphere acidification and maintained significantly higher root FCR activity under Fe-limited conditions. Gene expression analysis revealed that Fe deficiency induced the up-regulation of AhIRT1 and AhFRO1 in the roots of LH11, while their transcript levels were suppressed or unchanged in YZ9102. Conclusions: The peanut cultivar LH11 possesses superior tolerance to Fe deficiency compared to YZ9102. This enhanced tolerance is attributed to a synergistic combination of traits: the maintenance of photosynthetic performance, efficient rhizosphere acidification, heightened root Fe³⁺ reduction capacity, and the positive transcriptional regulation of key Fe uptake genes. These findings provide crucial insights for the selection and breeding of Fe-efficient peanut varieties for cultivation in Fe-deficient environments. Full article

Background: Adenomyosis is a benign uterine disorder defined by the invagination of ectopic endometrial-like tissue into the myometrium, causing heavy menstrual bleeding and pain. While its pathogenesis remains unclear, shared-symptomology with endometriosis suggests a common mechanism. Adenomyosis is often diagnosed after age 40 due to its complex presentation and the need for histopathological confirmation, underscoring the need for non-invasive markers. Methods: Ten unrelated women with histopathological diagnosis of adenomyosis were recruited. All recruits completed the WERF-EPHect questionnaire and were additionally questioned about any comorbidities. Genomic DNA isolated from peripheral blood was subjected to whole exome sequencing (WES) on Illumina NovaSeq 6000 and was analyzed using the Pairend NGS Cloud platform. Variants were filtered for MAF < 1% and were prioritized based on functional relevance and impact determined by in silico prediction tools. Variant selection adhered to stringent quality metrics to identify candidate variants associated with adenomyosis. Results: WES analysis did not reveal any variant common to the cohort. A total of eight pathogenic and two likely pathogenic novel variants were identified. Moreover, novel variants of p.(Val331Ile) in EFHB and p.(Phe14Val) in MEIS1 were the most frequently shared genetic variants in the cohort. Conclusions: Our findings suggest novel candidate genes for adenomyosis that warrant validation and functional investigation in larger, independent cohorts. Full article

Background/Objectives: Approximately 20% of familial ALS (fALS) cases are linked to mutations in Cu/Zn superoxide dismutase (SOD1). Through a gain function, SOD1 misfolding exerts a toxic effect on motor neurons, leading to their degradation and ALS symptomology in both fALS cases and sporadic ALS (sALS) cases with no known genetic cause. To further our understanding of SOD1-ALS etiology, identifying motor neuron-specific SOD1 post-translational modifications (PTMs) and studying their structural influence is necessary. To this end, we have conducted a study on the influence of the deamidation of Asn53, a PTM proximal to key stabilizing motifs in SOD1, which has scarcely been addressed in the literature to date. Methods: Deamidation to N53 was identified by tandem mass spectrometry of SOD1 immunoprecipitated from motor neuron (MN) cultures derived from wild-type (WT) human induced pluripotent stem cells (iPSCs). WT SOD1 and N53D SOD1, a mutant mimicking the deamidation, were expressed in Escherichia coli and purified for in vitro analyses. Differences between species were measured by experiments probing metal cofactors, relative monomer populations, and aggregation propensity. Furthermore, molecular dynamics experiments were conducted to model and determine the influence of the PTM on SOD1 structure. Results: In contrast to WT, N53D SOD1 showed non-native incorporation of metal cofactors, coordinating more Zn²⁺ cofactors than total Zn-binding sites, and more readily adopted monomeric forms, unfolded, and aggregated with heating, possibly while releasing coordinated metals. Conclusions: Deamidation to N53 in SOD1 encourages the adoption of non-native conformers, and its detection in WT MN cultures suggests relevance to sALS pathophysiology. Full article

Background: Sport-related concussion is common in rugby union, yet female players remain underrepresented in research. This study examined seasonal changes in cerebral oxygenation, cardiac function, and concussion symptomology in adult female rugby players, and explored acute physiological responses following a single documented concussion. Methods: A total of 29 adult females (19 amateur rugby, 10 control) completed pre-, mid-, and end-season assessments. Measures included functional near-infrared spectroscopy (fNIRS) of the pre-frontal cortex, seismocardiography (SCG)-derived cardiac timing indices, and Sport Concussion Assessment Tool 6 (SCAT6). Group and time effects were analysed using general linear models and statistical parametric mapping. Typical error (TE) and its 90% confidence intervals (90% CI) were used to determine meaningful changes post-concussion. Results: Rugby players reported more SCAT6 symptoms (number: p = 0.006, η²_p = 0.23; severity: p = 0.020, η²_p = 0.17). They also had shorter systolic time (p = 0.002, η²_p = 0.19) and higher twist force values (p = 0.014, η²_p= 0.21) than controls. fNIRS revealed higher right-hemisphere oxyhaemoglobin (ΔO₂Hb) responses for both tasks (ps < 0.001, η²_p = 0.77 and η²_p = 0.80) and lower activation in specific prefrontal channels. No seasonal changes occurred in global oxygenation or frequency band activity. In the exploratory single-concussion case, symptomology, SCG twist force, ΔO₂Hb, and cardiac band power exceeded TE and its 90% CI at 5 days post-injury. Conclusions: The multimodal approach detected stable group-level physiology alongside localised cortical and cardiac differences, and acute changes following concussion. While these results highlight the potential of combined fNIRS and SCG measures to capture physiological disturbances, the small sample size and single-concussion case necessitate cautious interpretation. Further validation in larger, longitudinal cohorts is required before any biomarker utility can be inferred. Full article

Background/Objectives: Current estimates suggest that 6% of COVID-19 survivors develop a post-viral sequela known as Long COVID. Among those at risk for this sequela, pregnant individuals are a vulnerable patient population, but they are understudied as to the nature of their symptomology and potential adverse outcomes. Methods: This retrospective study evaluated a cohort of 150 pregnant individuals with a history of acute SARS-CoV-2 infection during pregnancy, observing for Long COVID symptoms and assessing for adverse outcomes. Of this cohort, 64% identified as Black and/or Latina, which provides a more diverse representation compared to previously published studies. Results: Within this cohort, 26.7% of individuals experienced at least one symptom of Long COVID; subcohorts, which were categorized based on presence or absence of Long COVID symptomology, presented with varying phenotypes. Pain, mental health dysfunction or psychological problems, and fatigue were the predominant symptoms documented for patients who averaged two Long COVID symptoms after at least 30 days following a COVID-19 diagnosis. Different adverse outcomes were higher in frequency among subcohorts, highlighting a need for continued study to explore the nuances of the impact of COVID-19 on this unique and vulnerable population. The most notable trends between subcohorts related to treatment patterns for acute COVID-19, vaccine status, and cesarean delivery rates. Conclusions: By providing a description of the documented health experience for a predominantly non-White cohort of individuals who were diagnosed with an acute SARS-CoV-2 during pregnancy, our study contributes to a foundation upon which future studies can build. Full article

Background: Electroencephalographic (EEG) neurofeedback training is gaining traction as a non-pharmacological treatment option for Parkinson’s disease (PD). This paper reports the first pre-registered, integrated systematic review and meta-analysis of studies examining the effects of EEG neurofeedback on cortical activity and motor function in people with PD. Method: We searched Cochrane Databases, PubMed, Embase, Scopus, Web of Science, PsycInfo, grey literature repositories, and trial registers for EEG neurofeedback studies in people with PD. We included randomized controlled trials, single-group experiments, and case studies. We assessed risk of bias using the Cochrane Risk of Bias 2 and Risk of Bias in Non-Randomized Studies tools, and we used the Grading of Recommendations, Assessment, Development and Evaluations tool to assess certainty in the evidence and resultant interpretations. Random-effects meta-analyses were performed. Results: A total of 11 studies (143 participants; Hoehn and Yahr I–IV) met the criteria for inclusion. A first meta-analysis revealed that EEG activity is modified in the prescribed way by neurofeedback interventions. The effect size is large (SMD = 1.30, 95% CI = 0.50–2.10, p = 0.001). Certainty in the estimate is high. Despite successful cortical modulation, a subsequent meta-analysis revealed inconclusive effects of EEG neurofeedback on motor symptomology. The effect size is small (SMD = 0.10, 95% CI = −1.03–1.23, p = 0.86). Certainty in the estimates is low. Narrative evidence revealed that interventions are well-received and may yield specific benefits not detected by general symptomology reports. Conclusion: EEG neurofeedback successfully modulates cortical activity in people with PD, but downstream impacts on motor function remain unclear. The neuromodulatory potential of EEG neurofeedback in people with PD is encouraging. Additional well-powered and high-quality research into the effects of EEG neurofeedback in PD is warranted. Full article

Parkinson’s disease is a progressive neurological disorder reliant on medication regime adherence to alleviate symptomology. When hospitalised, people with Parkinson’s disease have specific medication management needs which are consistently unmet. This study aims to develop, implement and evaluate solutions for improving the medication management of inpatients with Parkinson’s disease. A healthcare redesign approach was utilised, focusing on the final three phases: solutions design, implementation and evaluation. Five solutions were derived: formalise routine patient identification, provide improved staff education, develop and install automated prescriber alerts, review and amend ward PD medication stock, and develop systematic prompts for PD medications. The findings suggest that our solutions sustainably improved systems and processes that contribute to quality and safe medication management for Parkinson’s patients. Correct identification of Parkinson’s patients within an acute care hospital leads to correct prescription of medications, timeliness of medication administration and timely pharmacy review. The length of stay was not positively impacted. Full article