Objectives: Depression is a critical public health concern among older Americans. However, little is known about how older adults social engagement activities, health protocol maintenance, and social interaction (both physically and virtually) potentially contribute to their feelings of depression. Methods: Data were collected from the Covid-19 supplement to the National Health and Aging Trend Study (NHATS) and core longitudinal follow-up study. A total of 3,181 Medicare-eligible older adults between June and December 2020 were examined how self-reported depression is related to social engagement activities, health protocols, social interaction with friends and family (F&F), and doctors using multiple logistic regression. Results: This study reveals that the lack of social engagement activities, such as birthday parties and long-term care visits significantly contributes to older adults depression (OR: 1.34, 90% CI: 1.07-1.68, p=0.012, and OR: 1.28, 90% CI: 1.01-1.65, p=0.053 respectively). Subsequently, health protocols compliance with washing hands and wearing masks in public places were more likely 2.36 times and 3.44 times higher symptoms of depression for the older adults than those who were not maintaining those protocols (OR: 2.36, 90% CI: 1.24-4.57, p=0.009, OR: 3.44, 90% CI: 1.97-6.17, p<0.001 respectively). Furthermore, the lack of virtual social interaction via phone and text message with F&F is significantly related to depression whereas email or video call are not significantly related to depression for older adults. During Covid-19 pandemic, in-person visits with doctors significantly reduced patients depression on the other hand email communication significantly increased. However other virtual interactions with doctors did not significantly associate with patients depression. Conclusion: The lack of social engagement, maintaining health protocols, and lacking virtual interactions over the phone significantly increase depression symptoms for older adults during the Covid-19 pandemic. Therefore, it would be beneficial to take initiative to engage older adults in a variety of social activities to make them feel more connected to their community. The older population should be contacted by phone during the Covid-19 pandemic with encouraging messages and informed of the importance of maintaining health protocols.

ObjectivesSeveral studies have revealed contradictory findings on survival by exposing cancer treatments with disparities of sociodemographic and tumor histologic factors. However, this study aimed to evaluate the effect of cancer treatments on mortality among patients with soft tissue cardiac sarcomas (CS) in the United States. We also estimated the overall survival probability through a competing risk nomogram for this notorious disease.MethodsThe data was taken from the US National Cancer Institute’s Surveillance Epidemiology, and End Results (SEER) -18 dataset, version 2020. Between the years 2000 and 2018. The study cohort included patients diagnosed with soft tissue cancer, including cardiac sarcoma. We computed the cumulative incidence function (CIF) and sub-distributional hazard by the Fine and Gray model for evaluating the risk of mortality. In addition, using a competing-risk nomogram we forecasted the overall survival probability for patients with soft tissue CS. Calibrations and Brier scores were used to validate and compare the prediction to ensure predictive accuracy.ResultsA total of 416 completed cases were selected for evaluation in this study. There was 66.5% mortality from soft tissue CS in the patients during this study period, while there was only 16.3% death from other diseases. For patients with soft tissue CS, the five-year cumulative incidence of cause-specific mortality was 74%, while only 18% was caused by other diseases. Non-whites, older age groups, and more advanced cancer stages all contributed to a higher cause-specific cumulative incidence, but sex was not a significant predictor of soft tissue CS deaths. Patients who underwent surgical intervention [sdHR: 0.55, 95%CI:0.28-0.98] and chemotherapy [sdHR: 0.29, 95%CI:0.02-0.36] on prime site had a significant decrease in CS death compared with no intervention, whereas primary systemic therapy and radiation intervention were not significantly decreased patients mortality. The patients who received surgery on the prime site survived 2, and 5 years above 70%, and 60%, respectively, whereas those who did not receive surgery on the prime site survived only 10%. Nomograms for assessing the hazard of mortality for patients with soft tissue cancers were well calibrated and had a good discriminatory ability.ConclusionDespite the small sample size, this study provided a reliable model-based prediction of the effect of cancer treatment on rare malignancies. The use of surgery and chemotherapy significantly reduced patient cause-specific mortality; however, the use of primary systemic treatment and radiation did not significantly reduce patient mortality among patients with soft tissue CS.Clinical PerspectiveWhat is New?Patients with soft tissue Cardiac Sarcoma (CS) are more likely to die if they are older, at a distant stage, and have not received treatment.Among patients with CS, there is no significant association between race, gender, radiotherapy, or primary systemic therapy with mortalityThere is a greater reduction in mortality rate associated with chemotherapy and surgical intervention at the primary site than without these interventions.What are the Clinical Implications?A competing risk nomogram suggests that soft tissue CS is associated with a lower probability of cause-specific survival than other causes of mortality.The survival rate for patients who underwent surgery on prime sites was 70%, 55%, after two, and five years, whereas the survival rate for patients who did not undergo surgery was only 10%.A cause specific nomogram revealed that radiation intervention increases survivability compared to not receiving radiation intervention, and that age, sex, treatment, and cancer stages affected survival.

Introduction: This study aimed to assess the effects of cancer treatment on sarcoma types and to predict overall survival probabilities using nomograms. Methods. This study uses the SEER-18 database, Version 2020, sponsored by the National Cancer Institute (NCI). The study cohort included participants diagnosed between 2000 and 2018 with soft tissue cancers including the heart. A multivariable Cox proportional hazards model was applied to predict mortality rate, and nomograms were used to predict overall survival probability. Results. The median survival time for 24,849 study participants was 48 months (IQR: 19-102) with Spindle Cell Sarcoma (ScS) having a shorter median survival time compared with Liposarcoma (LiS). A significant number of STS patients had surgery, where surgery on ScS improved survival by 75% (HR: 0.25, 95%CI: 0.19-0.32, p<0.001) and those who received radiation had a 26% improvement (HR: 0.74, 95%CI: 0.61-0.89, p=0.001). Furthermore, chemotherapy on GcS resulted in a 40% reduction in mortality for patients compared to those who did not receive chemotherapy (HR 0.60, 95%CI:0.45-0.80, p<0.001). Based on nomogram, after two, five, and ten years, a patient who received surgery on their primary sites would have a survival rate of approximately 90 percent. In contrast, a patient who did not receive surgery on their primary sites would only live for 20 percent or less. Patients with MyS have a 90% chance of surviving for 5 and 10 years after surgery, but only 22% and 10% without surgery. Conclusions: Based on the results of this study, surgical and radiation intervention on sarcomas was associated with improved survival in patients with STS, while chemotherapy and primary systemic therapy had contradictory effects.

Objective: Studies have concluded that treatments for patients with anal cancer vary based on their age, sex, and race. We examined gender-specific differences in mortality and overall survival for patients with squamous cell carcinoma (SCC) of the anal canal (AC), based on differences in treatment, stage and demographic factors. Method: SEERs retrospective cohort dataset was used to review all patients diagnosed with SCC of the AC between 2000 and 2018. We analyzed survival by sub-distributed Cox models and estimated overall survival probabilities through nomograms based on cancer treatments, tumor characteristics, and demographic data Results: In the study, 24,892 patients with SCC in the AC had a median survival time of 43 months (IQR: 16-97). However, males (median 38.0 months, IQR: 13.0-92.0) had significantly shorter median survival times than females (median 46.0 months, IQR: 17-100). There were 12% of patients in metastatic stages, with females (70.3%) receiving more treatments than males (29.7%). The survival rate of patients with SCC of the AC who underwent radiation treatment was significantly higher (HR 0.72, 95% CI: 0.65-0.80, p<0.001). Moreover, compared to those without surgery on the primary site, those undergoing surgery on the primary site had a 49% lower mortality rate (HR 0.51; 95% CI: 0.45 to 0.56, p0.001). According to the study, the overall survival probability at 5 and 10 years for patients who received chemotherapy on primary sites was about 90%, compared to only 40% and 22% for those who did not receive chemotherapy. Surgical intervention yielded similar results, but radiation therapy did not significantly improve survival rates. Conclusion: Compared with men, women with SCC of the AC have a higher survival rate, and younger patients tend to live longer. The factors negatively affecting survival were increasing age, non-whites, divorced / separated / widowed, and advanced stages of cancer. A significant increase in survival was seen after surgery and chemotherapy for SCC, while radiation had little effect on survival.