The Main Patterns in the Trend Change of Stomach Cancer Incidence amongst Selected African Countries

Aim. The current study aimed to investigate the trend changes of stomach cancer incidence amongst African countries and identify the main patterns. Methods. The annual reports of stomach cancer incidence rate (per 100,000 people) for males and females in 53 African countries from 1990 to 2016 were maintained from the World Health Organization archive. The growth mixture model was used for fitting the models in Mplus 7.4. The estimated linear trend in each pattern was characterized by intercept (the rate at 1990) and slope (the observed biennial trend changes), and finally, each country was grouped into a cluster with the most similar pattern. Results. Three main patterns for males and two main patterns for females were determined. For males, the first cluster, containing Cape Verde, Central African Republic, and Mauritius, showed a sharp fall, while countries in the second pattern including Algeria, Côte d’Ivoire, Egypt, Gambia, Libya, Malawi, Morocco, Namibia, Nigeria, and Tunisia were categorized in a pattern with a slight decrease, and other 43 countries were in the third pattern with a moderate falling trend. For females, 19 countries including Angola, Botswana, Burundi, Cape Verde, Central African Republic, Congo Republic, Equatorial Guinea, Ethiopia, Gabon, Kenya, Mali, Mauritius, Rwanda, Sao Tome and Principe, Sudan, Swaziland, Uganda, Zambia, and Zimbabwe were categorized in the moderate-to-high falling pattern, but the other 34 countries had a gentle downward pattern. Conclusion. Although most of the observed trends of stomach cancer were falling, only a few countries had experienced a favorable decreasing trend (three countries in male incidence and nineteen countries in female incidence). Therefore, taking effective actions to accelerate the observed falling trends seems necessary.

Identification of Youthful Neurocognitive Trajectories in Adults Aging with HIV: A Latent Growth Mixture Model

Despite the neurocognitive risks of aging with HIV, initial cross-sectional data suggest a subpopulation of older people with HIV (PWH) possess youthful neurocognition (NC) characteristic of SuperAgers (SA). Here we characterize longitudinal NC trajectories of older PWH and their convergent validity with baseline SA status, per established SuperAging criteria in PWH, and baseline biopsychosocial factors. Growth mixture modeling (GMM) identified longitudinal NC classes in 184 older (age ≥ 50-years) PWH with 1–5 years of follow-up. Classes were defined using ‘peak-age’ global T-scores, which compare performance to a normative sample of 25-year-olds. 3-classes were identified: Class 1Stable Elite (n = 31 [16.8%], high baseline peak-age T-scores with flat trajectory); Class 2Quadratic Average (n = 100 [54.3%], intermediate baseline peak-age T-scores with u-shaped trajectory); Class 3Quadratic Low (n = 53 [28.8%], low baseline peak-age T-scores with u-shaped trajectory). Baseline predictors of Class 1Stable Elite included SA status, younger age, higher cognitive and physiologic reserve, and fewer subjective cognitive difficulties. This GMM analysis supports the construct validity of SuperAging in older PWH through identification of a subgroup with longitudinally-stable, youthful neurocognition and robust biopsychosocial health.

The Trajectory and Influence Factors of Breast Cancer Patients’ Main Chemotherapy-Related Symptoms: A Longitudinal Study

Introduction: Identifying the pattern of change in symptoms is critical to effective symptom management. This study aimed to determine the trajectory of Main Chemotherapy-related Symptoms (MCRS) in breast cancer patients, explore the influencing factors of potential categories of MCRS trajectory.Methods: Patient-reported Outcomes Measurement System- breast-chemotherapy was used to measure the four highest incidence MCRS (pain, fatigue, anxiety, and depression) weekly in Breast cancer patients. The Growth Mixture Model (GMM) was used to fit the potential categories of the MCRS trajectory. Logistic regression was used to explore the influencing factors of potential categories of MCRS change trajectory.Results: 239 breast cancer patients completed the study. Fatigue and depression showed an overall upward trend during the chemotherapy cycle, while pain and anxiety showed a downward trend. There are two potential categories of anxiety trajectory, three potential categories of fatigue and pain trajectory, and four potential categories of depression trajectory. Compared with the mild-fatigue group, Patients in the moderate and high fatigue groups were more likely to be less educated, have lower household income, and be treated with anthracyclines. Compared with the mild-pain group, patients in the pain-declining and fluctuating-pain groups were young, live-alone, and treated with paclitaxel. Patients in the anxiety-rising group were younger, had premenopausal menstruation with regular monthly menstruation, and had stage II disease. Patients in the depression-rising and severe depression groups were more likely to be solitary and younger.Conclusion: The potential classes of major chemotherapy-related symptom trajectories vary in breast cancer patients. As for fatigue management, great attention should be paid to patients with low education, low family income, and anthracycline chemotherapy. For pain management, close attention should be paid to younger, solitary, and paclitaxel chemotherapy patients; For anxiety management, attention should be paid to younger patients with premenopausal menstruation and regular monthly menstruation patients, and those with stage II disease. In managing depression, attention should be paid to younger and solitary patients.

LDL-cholesterol trajectories and statin treatment in Finnish type 2 diabetes patients: a growth mixture model

We aimed to identify distinct longitudinal trends of LDL-cholesterol (LDL-C) levels and investigate these trajectories’ association with statin treatment. This retrospective cohort study used electronic health records from 8592 type 2 diabetes patients in North Karelia, Finland, comprising all primary and specialised care visits 2011‒2017. We compared LDL-C trajectory groups assessing LDL-C treatment target achievement and changes in statin treatment intensity. Using a growth mixture model, we identified four LDL-C trajectory groups. The majority (85.9%) had “moderate-stable” LDL-C levels around 2.3 mmol/L. The second-largest group (7.7%) consisted of predominantly untreated patients with alarmingly “high-stable” LDL-C levels around 3.9 mmol/L. The “decreasing” group (3.8%) was characterised by large improvements in initially very high LDL-C levels, along with the highest statin treatment intensification rates, while among patients with “increasing” LDL-C (2.5%), statin treatment declined drastically. In all the trajectory groups, women had significantly higher average LDL-C levels and received less frequent any statin treatment and high-intensity treatment than men. Overall, 41.9% of patients had no statin prescribed at the end of follow-up. Efforts to control LDL-C should be increased—especially in patients with continuously elevated levels—by initiating and intensifying statin treatment earlier and re-initiating the treatment after discontinuation if possible.

Identification of Main Patterns in The Incidence of Gynecological Cancers Amongst the Provinces in Iran

Introduction: Study of cancer incidence trends can provide better insight for decision-making and considering necessary interventions. The current study was focused on investigating the main patterns in the incidence of gynecological cancers among the provinces of Iran during the last decades. Methods: We carried out an applied longitudinal study through the growth mixture model (GMM), with a concentration on the trajectory of incidence rates. Information about the rate of gynecological cancer incidence (per 100,000) in 31 provinces of Iran during the 1990-2016 period was extracted from the Data Visualization System. Taking into account the p-value of the likelihood ratio test (LRT), the number of main patterns was estimated by Mplus 7.4 software. Results: Tehran province with the incidence of 2.00 per 100,000 was in the first rank in 1990, while in 2016 the highest rate was observed in Yazd province with 9.38 cases. Five main patterns were determined based on LRT. Tehran and Yazd provinces showed the sharpest rise, while Khuzestan, Fars, Esfahan, Semnan, East Azerbaijan, Razavi Khorasan, and Mazandaran provinces belonged to the pattern with a moderate-to-highrising trend. 10 provinces including Kerman, Kurdistan, Gilan, Lorestan, Alborz, Hamedan, Kermanshah, Markazi, Ardabil, and West Azerbaijan were on the other hand categorized in the moderate-rising trend. Sistan and Baluchestan and Hormozgan provinces had a slow-rising pattern, and finally, the remaining 10 provinces had the pattern with a slow-to-moderate upward trajectory. Conclusion: Due to the considerable rising trend in most provinces in Iran, taking urgent and effective preventive actions seems necessary