An insight into the risk factors of brain tumors and their therapeutic interventions

4,5-Dimethoxycanthin-6-one Inhibits Glioblastoma Stem Cell and Tumor Growth by Inhibiting TSPAN1 Interaction with TM4SF1

Glioblastoma stem cells (GSCs) have been implicated in the self-renewal and treatment resistance of glioblastoma (GBM). Our previous study found that 4,5-dimethoxycanthin-6-one has the potential to inhibit GBM cell proliferation. This current study aims to elucidate the molecular mechanism underlying the effects of 4,5-dimethoxycanthin-6-one in GBM development. The effect of 4,5-dimethoxycanthin-6-one on GSC formation and differentiation was explored in human GBM cell lines U251 and U87. Subsequently, 4,5-dimethoxycanthin-6-one binding to tetraspanin 1 (TSPAN1) / transmembrane 4 L six family member 1 (TM4SF1) was analyzed by molecular simulation docking. Co-immunoprecipitation (Co-IP) and immunofluorescence (IF) were used to assess the interactions between TSPAN1 and TM4SF1 in GSCs. Cell proliferation was detected by cell counting kit-8 (CCK-8) and colony formation assay. To evaluate cell migration, invasion and apoptosis, we employed wound healing assay, transwell and flow cytometry, respectively. Furthermore, subcutaneous xenograft tumor models in nude mice were constructed to evaluate the impact of 4,5-dimethoxycanthin-6-one on GSCs in vivo by examining tumor growth and histological characteristics. 4,5-Dimethoxycanthin-6-one inhibited GSC formation and promoted stem cell differentiation in a concentration-dependent manner. Molecular docking models of 4,5-dimethoxycanthin-6-one with TM4SF1 and TSPAN1 were constructed. Then, the interaction between TSPAN1 and TM4SF1 in GSC was clarified. Moreover, 4,5-dimethoxycanthin-6-one significantly inhibited the expressions of TM4SF1 and TSPAN1 in vitro and in vivo. Overexpression of TSPAN1 partially reversed the inhibitory effects of 4,5-dimethoxycanthin-6-one on GSC formation, proliferation, migration and invasion. 4,5-Dimethoxycanthin-6-one inhibited GBM progression by inhibiting TSPAN1/TM4SF1 axis. 4,5-Dimethoxycanthin-6-one might be a novel and effective drug for the treatment of GBM.

Status quo and influencing factors of readiness for hospital discharge in patients with brain tumours after surgery

Objective

This study aimed to investigate the status quo of readiness for hospital discharge in patients with brain tumours after surgery and to analyse its influencing factors.

Method

A total of 300 patients with brain tumours who were admitted to the neurosurgery ward of our hospital between September 2020 and December 2022 were selected as the study participants using the convenient sampling method. The readiness for hospital discharge in patients with brain tumours after surgery was investigated using a general information questionnaire, the Readiness for Hospital Discharge Scale (RHDS), the Quality of Discharge Teaching Scale (QDTS), the University of Washington Quality of Life Questionnaire (UW-QOL), and the Social Support Rating Scale (SSRS), and its influencing factors were analysed.

Results

The total RHDS score of patients with brain tumours was (155.02 ± 14.67), which was at a medium level. There was a positive correlation between readiness for hospital discharge in patients with brain tumours after surgery and the UW-QOL score (r = 0.459, p = 0.001), SSRS score (r = 0.322, p = 0.000), and QDTS score (r = 0.407, p = 0.001). The influencing factors of readiness for hospital discharge in patients with brain tumours included the content actually obtained by patients (health guidance) before discharge (p = 0.001), discharge teaching skills (p = 0.001), age (p = 0.006), swallowing status (p = 0.021), education level (p = 0.016), and objective support (p = 0.022).

Conclusion

The readiness for hospital discharge in patients with brain tumours is at a medium level. Medical staff should give inpatients more targeted knowledge and implement personalised health education according to the patient's age, education level, swallowing status, and objective support to improve the patient's readiness for hospital discharge.

Financing of Neurosurgical Care for Brain Tumors in Low- and Middle-Income Countries : A Scoping Review of Barriers and Strategies

BACKGROUND

Making neurosurgical care accessible to a larger portion of the population in low- and middle-income countries (LMICs) is integral due to the high mortality and morbidity associated with brain tumors. However, the high cost of care often makes it financially out of reach for many individuals. Therefore, this review aims to identify barriers to neurosurgical care of brain tumors in terms of financing in LMICs.

METHODS

Without restriction to language, a search of the literature was undertaken in a number of databases, including PubMed, Scopus, Google Scholar, and CINAHL, in order to find the most pertinent research involving financing of brain tumors in LMICs. The last day of the search was October 20, 2022. Following screening and data extraction, significant themes were found and categorized using thematic analysis.

RESULTS

A total of 28 studies were analyzed in this review. The review highlighted some of the barriers to providing surgical care of brain tumors in LMICs. In the cited studies, surgical expenses (41%), neuroimaging costs (30%), and care-related expenses (33%) were the primary concerns. Addressing these challenges involves cross-border collaboration (23%), transparent financing systems (46%), awake craniotomy (15%), cost-effective/reusable intra-operative supplies (8%), and optimizing resources in healthcare systems (8%).

CONCLUSIONS

This study explored barriers and challenges to financing neurosurgical care of brain tumors in LMICs. Government support and transparency in healthcare financing should be prioritized to ensure that all individuals have access to surgical care of brain tumors.

Associations between dietary antioxidant vitamins and risk of glioma: an updated systematic review and meta-analysis of observational studies

Background

Epidemiological studies investigating the potential associations between antioxidant vitamins intake and risk of glioma have yielded inconsistent results. To address this, we carried out a systematic review and updated meta-analysis to explore the relationship between dietary antioxidant vitamins intake and risk of glioma.

Methods

We comprehensively searched electronic databases including PubMed, Web of Science, Embase, Scopus, China National Knowledge Infrastructure (CNKI) and Wan fang Data from their inception to March 2024. We employed fixed-effects or random-effects models to estimate the pooled relative risks (RRs) and 95% confidence intervals (CIs) for the associations between dietary antioxidant vitamins intake and risk of glioma. Publication bias was assessed through the visual inspection of the funnel plots and quantified by the Begg's and Egger's tests. Heterogeneity across studies was assessed using the Cochran's Q test and I-square (I2). Additionally, subgroup and sensitivity analyses were performed to explore potential sources of heterogeneity and evaluate the robustness of the results.

Results

Overall, a total of 15 articles involving 3,608 glioma cases and 771,930 participants were included in the final analysis. The pooled analyses revealed that the highest intake of vitamin C significantly reduced the risk of glioma (RR = 0.78; 95%CI: 0.63-0.96; P = 0.022), compared to the lowest intake. However, no significant associations were observed between vitamin A and vitamin E intake and the risk of glioma (P>0.05). Subgroup analyses revealed the inverse association between vitamin C intake and risk of glioma in the population-based case-control studies (RR = 0.82; 95%CI: 0.68-1.00, P = 0.049) and study quality <7(RR = 0.52, 95%CI: 0.29-0.92, P = 0.025).

Conclusion

Our findings show that higher intake of vitamin C is strongly associated with a reduced risk of glioma, although a dose-response relationship was not evident. Future large-scale prospective studies are warranted to confirm these findings.

Development of Predicting Nomograms for Diffuse Astrocytoma and Anaplastic Astrocytoma: A Study Based on the Surveillance, Epidemiology, and End Results Database

BACKGROUND

Astrocytoma is a type of adult-type diffuse gliomas that includes diffuse astrocytoma (DA) and anaplastic astrocytoma (AA). However, comprehensive investigations into the risk assessment and prognosis of DA and AA using population-based studies remain noticeably scarce.

METHODS

In this study, we developed 2 predictive nomograms to evaluate the susceptibility and prognosis associated with DA and AA. The study cohort comprised 3837 individuals diagnosed with DA or AA between 2010 and 2019 selected from the Surveillance, Epidemiology, and End Results (SEER) database. Independent predictors were identified and used to construct the nomograms for overall death and cancer-specific death rates. The performance of the models was assessed using C-index, calibration curves, and receiver operating characteristic curve, and the clinical applicability was evaluated using decision curve analysis.

RESULTS

The receiver operating characteristic curves in this study show excellent clinical applicability and predictive power. Notably, the area under the curves of the training and verification queues was higher than 0.80, thereby cementing the models' precision. Additionally, the calibration plots demonstrate that the anticipated mortality rates strikingly match the measured values. This alignment of figures is sustained in the validation cohort. Furthermore, the decision curve analysis corroborates the models' translational potential, reinforcing their relevance within real-world clinical settings.

CONCLUSIONS

The presented nomograms have not only exhibited good predictive performance but also showcased pragmatic clinical utility in prognosticating patient outcomes. Significantly, this will undoubtedly serve as a valuable asset for oncologists, facilitating informed treatment decisions and meticulous follow-up planning.

Immunological processes of enhancers and suppressors of long non-coding RNAs associated with brain tumors and inflammation

Immunological processes, such as inflammation, can both cause tumor suppression and cancer progression. Moreover, deregulated levels of long non-coding RNA (lncRNA) expression in the brain may cause inflammation and lead to the growth of tumors. Like other biological processes, the immune system's role in cancer is complicated, varies, and can help or hurt the cancer's maintenance. According to research, inflammation and brain cancer are correlated via several signaling pathways. A variety of lncRNAs have recently been revealed to influence cancer by modulating inflammatory pathways. As a result, lncRNAs have the potential to influence carcinogenesis, tumor formation, or tumor suppression via an increase or decrease in inflammation functions. Although the study and targeting of lncRNAs have made great progress in the treatment of cancer, there are definitely limitations and challenges. Using new technologies like nanocarriers and cell-penetrating peptides (CPPs) to target treatments without hurting healthy body tissues has shown to be very effective. In this review article, we have collected significantly related lncRNAs and their inhibitory or stimulating roles in inflammation and brain cancer for the first time. However, there are limitations, such as side effects and damage to normal tissues. With the advancement of new targeting technologies, these lncRNAs may be candidates for the specific targeting therapy of brain cancers by limiting inflammation or stimulating the immune system against them in the future.

Principles in the Management of Glioblastoma

Glioblastoma, the most aggressive and common malignant primary brain tumour, is characterized by infiltrative growth, abundant vascularization, and aggressive clinical evolution. Patients with glioblastoma often face poor prognoses, with a median survival of approximately 15 months. Technological progress and the subsequent improvement in understanding the pathophysiology of these tumours have not translated into significant achievements in therapies or survival outcomes for patients. Progress in molecular profiling has yielded new omics data for a more refined classification of glioblastoma. Several typical genetic and epigenetic alterations in glioblastoma include mutations in genes regulating receptor tyrosine kinase (RTK)/rat sarcoma (RAS)/phosphoinositide 3-kinase (PI3K), p53, and retinoblastoma protein (RB) signalling, as well as mutation of isocitrate dehydrogenase (IDH), methylation of O6-methylguanine-DNA methyltransferase (MGMT), amplification of epidermal growth factor receptor vIII, and codeletion of 1p/19q. Certain microRNAs, such as miR-10b and miR-21, have also been identified as prognostic biomarkers. Effective treatment options for glioblastoma are limited. Surgery, radiotherapy, and alkylating agent chemotherapy remain the primary pillars of treatment. Only promoter methylation of the gene MGMT predicts the benefit from alkylating chemotherapy with temozolomide and it guides the choice of first-line treatment in elderly patients. Several targeted strategies based on tumour-intrinsic dominant signalling pathways and antigenic tumour profiles are under investigation in clinical trials. This review explores the potential genetic and epigenetic biomarkers that could be deployed as analytical tools in the diagnosis and prognostication of glioblastoma. Recent clinical advancements in treating glioblastoma are also discussed, along with the potential of liquid biopsies to advance personalized medicine in the field of glioblastoma, highlighting the challenges and promises for the future.

Risk factor analysis and nomogram establishment and verification of brain astrocytoma patients based on SEER database

Astrocytoma is a common brain tumor that can occur in any part of the central nervous system. This tumor is extremely harmful to patients, and there are no clear studies on the risk factors for astrocytoma of the brain. This study was conducted based on the SEER database to determine the risk factors affecting the survival of patients with astrocytoma of the brain. Patients diagnosed with brain astrocytoma in the SEER database from 2004 to 2015 were screened by inclusion exclusion criteria. Final screened brain astrocytoma patients were classified into low grade and high grade according to WHO classification. The risk factors affecting the survival of patients with low-grade and high-grade brain astrocytoma were analyzed by univariate Kaplan-Meier curves and log-rank tests, individually. Secondly, the data were randomly divided into training set and validation set according to the ratio of 7:3, and the training set data were analyzed by univariate and multivariate Cox regression, and the risk factors affecting the survival of patients were screened and nomogram was established to predict the survival rates of patients at 3 years and 5 years. The area under the ROC curve (AUC value), C-index, and Calibration curve are used to evaluate the sensitivity and calibration of the model. Univariate Kaplan-Meier survival curve and log-rank test showed that the risk factors affecting the prognosis of patients with low-grade astrocytoma included Age, Primary site, Tumor histological type, Grade, Tumor size, Extension, Surgery, Radiation, Chemotherapy and Tumor number; risk factors affecting the prognosis of patients with high-grade astrocytoma include Age, Primary site, Tumor histological type, Tumor size, Extension, Laterality, Surgery, Radiation, Chemotherapy and Tumor number. Through Cox regression, independent risk factors of patients with two grades were screened separately, and nomograms of risk factors for low-grade and high-grade astrocytoma were successfully established to predict the survival rate of patients at 3 and 5 years. The AUC values of low-grade astrocytoma training set patients were 0.829 and 0.801, and the C-index was 0.818 (95% CI 0.779, 0.857). The AUC values of patients in the validation set were 0.902, 0.829, and the C-index was 0.774 (95% CI 0.758, 0.790), respectively. The AUC values of high-grade astrocytoma training set patients were 0.814 and 0.806, the C-index was 0.774 (95% CI 0.758, 0.790), the AUC values of patients in the validation set were 0.802 and 0.823, and the C-index was 0.766 (95% CI 0.752, 0.780), respectively, and the calibration curves of the two levels of training set and validation set were well fitted. This study used data from the SEER database to identify risk factors affecting the survival prognosis of patients with brain astrocytoma, which can provide some guidance for clinicians.

Long Non-Coding RNA LINC00052 Targets miR-548p/Notch2/Pyk2 to Modulate Tumor Budding and Metastasis of Human Breast Cancer

Abnormal expression of long non-coding RNAs (lncRNAs) is involved in many pathological processes of cancers. However, the role of lncRNA LINC00052 in breast cancer progression is still unclear. Here, LINC00052 expression was detected by in situ hybridization and quantitative real-time PCR assays. Cell Counting Kit-8, wound healing, and transwell assays were used to investigate changes in the proliferation, migration, and invasion of breast cancer cells. MiR-548p was found associated with LINC00052 or Notch2 by RNA pull-down, dual-luciferase reporter, and qRT-PCR assays. The effect of LINC00052 on lung metastasis was explored through in vivo experiments. High LINC00052 expression was observed in breast cancer tissues and cells. LINC00052 silencing inhibited the proliferation, migration, and invasion of MCF7 cells, and LINC00052 overexpression produced the opposite results. MiR-548p, a target gene of LINC00052, partially rescued the effects of LINC00052 on proliferation, migration, and invasion of MCF7. Notch2 was the target of miR-548p and LINC00052 could promote Notch2 expression. Moreover, the phosphorylation of proline-rich tyrosine kinase 2 (Pyk2), a downstream factor of Notch2, was increased by LINC00052, and a Pyk2 mutant could inhibit the cell migration and invasion induced by LINC00052 overexpression in MDA-MB-468 cells, which was similar to the function of the miR-548p mimic. We further demonstrated that LINC00052 exacerbated the metastases of breast cancer cells in vivo. Our research demonstrated that LINC00052 is highly expressed in breast cancer and promotes breast cancer proliferation, migration, and invasion via the miR-548p/Notch2/Pyk2 axis. LINC00052 could serve as a potential therapeutic target for breast cancer.

Brain DNA damaging effects of volatile anesthetics and 1 and 2 Gy gamma irradiation in vivo: Preliminary results

Although both can cause DNA damage, the combined impact of volatile anesthetics halothane/sevoflurane/isoflurane and radiotherapeutic exposure on sensitive brain cells in vivo has not been previously analyzed. Healthy Swiss albino male mice (240 in total, 48 groups) were exposed to either halothane/sevoflurane/isoflurane therapeutic doses alone (2 h); 1 or 2 gray of gamma radiation alone; or combined exposure. Frontal lobe brain samples from five animals were taken immediately and 2, 6, and 24 h after exposure. DNA damage and cellular repair index were analyzed using the alkaline comet assay and the tail intensity parameter. Elevated tail intensity levels for sevoflurane/halothane were the highest at 6 h and returned to baseline within 24 h for sevoflurane, but not for halothane, while isoflurane treatment caused lower tail intensity than control values. Combined exposure demonstrated a slightly halothane/sevoflurane protective and isoflurane protective effect, which was stronger for 2 than for 1 gray. Cellular repair indices and tail intensity histograms indicated different modes of action in DNA damage creation. Isoflurane/sevoflurane/halothane preconditioning demonstrated protective effects in sensitive brain cells in vivo. Owing to the constant increases in the combined use of radiotherapy and volatile anesthetics, further studies should explore the mechanisms behind these effects, including longer and multiple exposure treatments and in vivo brain tumor models.

Healthy dietary patterns, foods, and risk of glioma: A systematic review and meta-analysis of observational studies

Background

Accumulating epidemiological evidence has shown the favorable associations between healthy dietary patterns and risk of glioma, although the results remain inconclusive.

Objective

We therefore carried out a systematic review and meta-analysis to summarize the evidence from previous published studies, and to clarify the effects of healthy dietary patterns, typical healthy foods on glioma.

Methods

PubMed, Web of Science, CNKI, and Wan fang data were searched from inception up to September 2022 for eligible studies. Two authors independently performed the literature search, study selection, data extraction, and quality assessment. Heterogeneity across studies was estimated using the Cochran's Q test and I ² statistic. According to heterogeneity, the fixed-effects model or random-effects model was selected to obtain the relative risk (RR) of the merger. Subgroup analysis, sensitivity analysis and publication bias were also used for our analysis.

Results

Twenty-four articles that met the selection criteria, involving 7,278 glioma cases and 2,143,528 participants, were included in our analysis. There was a reduced risk of glioma in the highest compared with the lowest categories of healthy dietary patterns (RR = 0.58; 95% CI: 0.44-0.77; P < 0.0001). Moreover, compared with the lowest intakes, the highest intakes of vegetables (RR = 0.84; 95% CI: 0.73-0.96; P = 0.012) and fruits (RR = 0.85; 95% CI: 0.72-1.00; P = 0.045) significantly reduce the risk of glioma. However, the intakes of fresh fish, nuts, whole grains, and dairy products showed no statistically significant associations with the risk of glioma (P > 0.05).

Conclusion

Findings from this systematic review and meta-analysis indicate that higher intakes of healthy dietary patterns, vegetables, and fruits are significantly associated with the lower risk of glioma. Further studies, particularly with prospective design, are required to confirm our findings.

Classification of Brain Tumor from Magnetic Resonance Imaging Using Vision Transformers Ensembling

The automated classification of brain tumors plays an important role in supporting radiologists in decision making. Recently, vision transformer (ViT)-based deep neural network architectures have gained attention in the computer vision research domain owing to the tremendous success of transformer models in natural language processing. Hence, in this study, the ability of an ensemble of standard ViT models for the diagnosis of brain tumors from T1-weighted (T1w) magnetic resonance imaging (MRI) is investigated. Pretrained and finetuned ViT models (B/16, B/32, L/16, and L/32) on ImageNet were adopted for the classification task. A brain tumor dataset from figshare, consisting of 3064 T1w contrast-enhanced (CE) MRI slices with meningiomas, gliomas, and pituitary tumors, was used for the cross-validation and testing of the ensemble ViT model's ability to perform a three-class classification task. The best individual model was L/32, with an overall test accuracy of 98.2% at 384 × 384 resolution. The ensemble of all four ViT models demonstrated an overall testing accuracy of 98.7% at the same resolution, outperforming individual model's ability at both resolutions and their ensembling at 224 × 224 resolution. In conclusion, an ensemble of ViT models could be deployed for the computer-aided diagnosis of brain tumors based on T1w CE MRI, leading to radiologist relief.

Exosomal miRNA-21 from Toxoplasma gondii-infected microglial cells induces the growth of U87 glioma cells by inhibiting tumor suppressor genes

Toxoplasma gondii is an intracellular protozoan parasite that can modulate the microenvironment of infected hosts and is known to be associated with the incidence of brain tumor growth. In this study, we suggested that the exosomal microRNA-21 derived from Toxoplasma infection would contribute to the growth of brain tumors. Exosomes of BV2 microglial cells infected with Toxoplasma were characterized and confirmed internalization to U87 glioma cells. Exosomal miRNA expression profiles were analyzed using microRNA array and miR-21A-5p associated with Toxoplasma and tumor sorted. We also examined the mRNA level of tumor-associated genes in U87 glioma cells by changing the level of miR-21 within exosomes and the effects of exosomes on the proliferation of human U87 glioma cells. Expression of miRNA-21 was increased and anti-tumorigenic genes (FoxO1, PTEN, and PDCD4) were decreased in exosomes within T. gondii-infected U87 glioma cells. Toxoplasma-infected BV2-derived exosomes induced proliferation of U87 glioma cells. The exosomes induced the growth of U87 cells in a mouse tumor model. We suggest that the increased exosomal miR-21 from Toxoplasma-infected BV2 microglial cells may play an important role as a cell growth promotor of U87 glioma cells through a down-regulation of anti-tumorigenic genes.

Association Between Dietary Nitrite intake and Glioma Risk: A Systematic Review and Dose-Response Meta-Analysis of Observational Studies

Background

Nitrite and nitrate intake through food and water may be an important risk factor for many cancers, including glioma. However, the association of nitrite and nitrate with glioma is unclear.

Objective

This review aimed to quantitatively assess the effects of nitrite and nitrate on glioma by meta-analysis.

Methods

A literature search was conducted for available articles published in English using the databases of Embase, Web of Science, PubMed, Medline, and the Cochrane Library up to 24 March 2022. According to heterogeneity, the fixed-effects or random-effects model was selected to obtain the merger’s relative risk (RR). Based on the methods described by Greenland and Longnecker, we explored the dose-response relationship between nitrite/nitrate and the risk of glioma. Subgroup analysis, sensitivity analysis, and publication bias tests were also used.

Results

This study reviewed 17 articles, including 812,107 participants and 4,574 cases. For glioma in adults, compared with the lowest intakes, the highest intakes of nitrite significantly increased the risk of glioma (RR=1.26, 95% confidence interval (95%CI):1.09-1.47). For brain tumors in children, compared with the lowest intakes, the highest intakes of nitrate significantly increased the risk of brain tumors (RR=1.27, 95%CI:1.06-1.52). The results of subgroup and sensitivity analyses remained unchanged. In the dose-response relationship, per 1 mg/day increase in nitrite intake increased the risk of glioma by 14% (RR=1.14, 95%CI:1.01-1.27).

Conclusions

Our analysis suggests that nitrite increases the risk of glioma in adults, while nitrate increases the risk of brain tumors in children. Therefore, the effects of nitrite and nitrate on glioma cannot be ignored.

Systematic Review Registration

https://www.crd.york.ac.uk/prospero/, identifier CRD42022320295.

Prevalence of depression and associated factors among adult cancer patients receiving chemotherapy during the era of COVID-19 in Ethiopia. Hospital-based cross-sectional study

Background

Depression is a major public health problem among cancer patients undergoing chemotherapy. It compromises patient outcomes, resulting in higher rates of mortality. Currently, there are little data on the prevalence of depression in Sub-Sharan countries. Therefore, the current study was done to assess the prevalence of depression among adult cancer patients and its associated factors in Ethiopia.

Method

An institutional based cross-sectional study was conducted among 420 adult cancer patients from 1^st March to April 30, 2021. Systematic random sampling technique was used to recruit participants. Depression was assessed using the Patient Health Questionnaire-9. The collected data were coded and entered into Epi-data version 4.2 and exported to SPSS version 25 for analysis. Bivariate binary logistic regression was performed to select factors that will be included in multivariate analysis, and variables with a p-value < 0.05 were included in multivariate analysis. In multivariate analysis, odds ratios and their 95% confidence intervals were computed and variables with p-value < 0.05 were considered to declare a significant association.

Results

In this study, the prevalence of depression was 33.1% (95% CI = 0.2858, 0.3761). Minimal symptoms of depression, minor depression, moderate depression, moderate severe depression, and severe depression were found to be 272 (64.8%), 9 (2.1%), 104 (24.8%), 28 (6.7%), and 7 (1.7%), respectively. Those cancer patients who had unemployed status, sacked from jobs, and had stage IV cancer were most likely to develop depression, whereas patients who completed primary education, colon, prostate and cervical cancer were less likely to have depression.

Conclusion

Depression is found to be a major public health concern for adult cancer patients in Ethiopia. To reduce the occurrence of depression among cancer patients, special attention is needed.

Therapeutic potentials of genistein: New insights and perspectives

Genistein, a polyphenolic isoflavone compound found abundantly in soy or soy-based products, is widely consumed in the Asian population. Genistein has poor bioavailability, to overcome this problem many advanced nano-drug delivery carrier systems are designed to enhance its water solubility and stability. However, further research is required to develop more efficient bioavailability improvement strategies. Genistein is a phytoestrogen which has been associated with reducing the risk of cancer, cardiovascular disorders, and diabetes mellitus. This plant-based bioactive compound possesses numerous biological activities such as anti-oxidant, anti-inflammatory, anti-obesity, anti-cancer, cardioprotective, and anti-diabetic activities to treat various disease states. Genistein has been used as an active therapeutic agent in many medications. Moreover, several clinical trials are in the ongoing stage to develop more efficient treatment therapies, especially for cancer treatment. This article highlights the protective and therapeutic benefits of genistein in the treatment of different ailments, and more specifically elaborates on the anti-cancer potential of genistein regarding various types of cancers. PRACTICAL APPLICATIONS: Genistein possesses versatile biological activities, including anti-diabetic, anti-inflammatory, anti-oxidant, anti-obesity, and anti-angiogenic. The most studied activity is anti-cancer. Currently, a number of pre-clinical and clinical trials are being carried out on anti-neoplastic and cytotoxic activities of genistein to develop novel therapeutic agents with excellent anti-cancer potential for the treatment of various kinds of cancer. Moreover, many bioavailability enhancement strategies have been developed to improve the bioavailability of genistein. Genistein shows significant hypoglycemic effects alone or in combination with other anti-diabetic agents. Genistein in combination with other chemotherapeutic agents is used for the treatment of prostate, bone, colorectal, glioma, breast, and bladder cancer.