Early Adulthood Research Articles

Parent strategies to help emerging adults manage stress are associated with their mental health: A dyadic coping perspective.

Emerging adults (EAs) are at high risk for mental health challenges and frequently reach out to their parents for support. Yet little is known about how parents help emerging adults manage and cope with daily stressors and which strategies help and which hinder EA mental health. In this cross-sectional pilot study of students at a 2- and 4-year college (ages 18-25, N = 680, mean age = 19.0), we extend models of dyadic coping from intimate relationships to the parent-emerging adult relationship and test whether six specific parent strategies to help emerging adults manage stress are associated with EA mental health. Emerging adults with parents who provided problem and emotion-focused supportive dyadic coping, delegated dyadic coping, and common/joint dyadic coping reported fewer symptoms of anxiety and depression, as well as higher levels of psychological well-being. In contrast, college-attending emerging adults who reported higher levels of parent-provided negative dyadic coping reported higher levels of depressive and anxiety symptoms and lower psychological well-being. Parent-emerging adult dyadic coping is a fruitful area for future research and intervention development.

Cerebrovascular disorders and Fabry disease

Fabry disease (FD) is an X-linked lysosomal storage disorder caused by pathogenic variants in the GLA gene encoding for alpha-galactosidase A. Renal, cardiac, and cerebrovascular involvement are the leading complications in early adulthood and are associated with severe morbidity and mortality. Cerebrovascular manifestations in FD manifest as ischemic stroke and transient ischemic attack and less frequently as hemorrhagic strokes. Many patients may develop their stroke not only before other major complications but also before the diagnosis of FD is made. This review will describe the frequency and characteristics of cerebrovascular disease in FD, the complex pathophysiological mechanisms, the neuroimaging findings, the value of screening studies in young patients with stroke, and the controversies regarding the beneficial effect of ERT for the prevention of cerebrovascular disease in FD.

Formulation and Evaluation of Microspheres Drug Delivery for Multiple Sclerosis Disease Condition

AMultiple sclerosis (MS) is chronic inflammatory disease that affecting the central nervous system (CNS) which leads to the degeneration of oligodendrocytes, neurons, and myelin over time. Being the foremost reason of neurological disability multiple sclerosis has affected about 2.5 million humans around the world. MS is mainly seen in early adulthood and adults in their middle age. Disease modifying agents are being used in treatment of relapsing multiple sclerosis. Medications that reduce the severity of the disease are frequently utilized as standard therapies. The immune system is the primary focus of modern MS treatments. However, researchers are putting more effort into designing novel CNS-focused treatments. Therefore, under the current scenario, an alternative route for drug delivery is required, one that provides a speedy onset of action and then maintains the drug release over an extended period. The desired prolong-acting intramuscular injecting stable fingolimod HCl microspheres to treat MS were formulated using solvent evaporation technique. Further, based on the number of factors to be optimized, formulation was prepared using solvent evaporation. Additionally, the formulated fingolimod microspheres were characterized for the size distribution of particle, particle surface morphology, and lyophilization of formulated microspheres. Post lyophilization, the formulated microspheres evaluation was done for efficiency of entrapment, drug release in-vitro, and stability parameters. Furthermore, in-vivo studies were performed on suitable animal models for the optimized formulation.

Examining prevalence and predictors of food insecurity for transition-age youth transitioning out of foster care

ABSTRACT Transition-age youth with foster care involvement (TAY) face significant risks for food insecurity and other hardships in early adulthood. Using representative survey data of youth transitioning out of foster care in California, we examine the prevalence and predictors of food insecurity. We find that about 30% of study participants were food insecure at ages 19, 21, and 23. We also identify multiple risk and protective factors associated with being food insecure, such as TAY’s sexual identity and receipt of public benefits. The results of our study offer life-stage-specific recommendations for policy and practice to address food insecurity among TAY.

Long-term impacts of a cash plus program on marriage, fertility, and education after six years in pastoralist Kenya: A cluster randomized trial

BackgroundPreventing early marriage by increasing girls education has shown promise. We assessed the effects of a two-year cash plus program on marriage and fertility in a pastoralist setting in Northeastern Kenya, six years after it began. MethodsA prospective 80-cluster randomized trial followed 2,147 girls 11–14 years old starting in 2015, re-interviewing 94.2% in 2021. Interventions included community dialogues (violence prevention), a conditional cash transfer (education), health and life skills training (health), and financial literacy (wealth creation). Villages were randomized to one of four study arms: (1) violence prevention only (V-only); (2) + education (VE); (3) + health (VEH); or (4) + wealth creation (VEHW). We used analysis of covariance to estimate intent-to-treat impacts of each study arm with an education component, as well as a pooled (weighted average) study arm combining VE, VEH and VEHW, in reference to V-only, four years after the intervention ended when girls were 17–20 years old. FindingsBase specification estimates show reductions in the primary outcomes, though none statistically significant in the full sample. Estimates with extended controls are larger and the pooled study arm had significantly lower marriage and pregnancy. There are considerably larger statistically significant effects for the baseline out-ofschool subsample. Pooled estimates indicate 18.2 percentage point lower marriage compared to V-only and 15.1 percentage point lower pregnancy. For the same group pooled estimates indicate a 27.9 percentage point increase in current enrollment (compared to 7.1% in V-only) and a 1.8 grades increase (compared to 1.2 in V-only). ConclusionThis study shows the potential for interventions in early adolescence with an education component to delay marriage and fertility into late adolescence and early adulthood in a marginalized and socially conservative setting with low education and high rates of child marriage.

Adolescent nicotine exposure induces long-term, sex-specific disturbances in mood and anxiety-related behavioral, neuronal and molecular phenotypes in the mesocorticolimbic system.

The majority of lifetime smokers begin using nicotine during adolescence, a critical period of brain development wherein neural circuits critical for mood, affect and cognition are vulnerable to drug-related insults. Specifically, brain regions such as the medial prefrontal cortex (mPFC), the ventral tegmental area (VTA), nucleus accumbens (NAc) and hippocampus, are implicated in both nicotine dependence and pathological phenotypes linked to mood and anxiety disorders. Clinical studies report that females experience higher rates of mood/anxiety disorders and are more resistant to smoking cessation therapies, suggesting potential sex-specific responses to nicotine exposure and later-life neuropsychiatric risk. However, the potential neural and molecular mechanisms underlying such sex differences are not clear. In the present study, we compared the impacts of adolescent nicotine exposure in male vs. female rat cohorts. We performed a combination of behavioral, electrophysiological and targeted protein expression analyses along with matrix assisted laser deionization imaging (MALDI) immediately post-adolescent exposure and later in early adulthood. We report that adolescent nicotine exposure induced long-lasting anxiety/depressive-like behaviors, disrupted neuronal activity patterns in the mPFC-VTA network and molecular alterations in various neural regions linked to affect, anxiety and cognition. Remarkably, these phenotypes were only observed in males and/or were expressed in the opposite direction in females. These findings identify a series of novel, sex-selective biomarkers for adolescent nicotine-induced neuropsychiatric risk, persisting into adulthood.

Maggots cannot live on meat meal alone: production parameters for mass rearing of the ovoviviparous blowfly, Calliphora dubia (Diptera: Calliphoridae).

This study determined a cost-effective larval diet for rearing Calliphora dubia Macquart for use as a potential managed pollinator in Australia. This fly has potential as a pollination species to support honey bees (Apis mellifera). Larvae of C. dubia were reared mostly in meat meals with varying amounts of either whole egg powder, whole eggs (+ shell), bran flakes, skimmed milk powder, brewer's yeast, or poultry oil. This was done from an economic and production perspective to support commercial rearing. Several laboratory-based studies determined the growth and output from various ingredient combinations. Larvae fed 90% meat meal and 10% whole egg powder developed rapidly through to pupation with a high pupation rate, adult size, and percent adult emergence. Given the high cost and difficulty in sourcing whole egg powder, media comprising mostly meat meals with the addition of bran flakes and whole eggs also supported rapid larval development, pupation rate, and adult emergence. The ideal amount of media/larvae was 0.5g/larvae to support high pupation rates and adult emergence. Adult eclosion occurred over 4-5 days, even when larvae were laid and fed within 1h on ample media. Commercial mass rearing would then require daily cohorts of larvae to ensure peak adult fly emergence over 1-2 days for release into a crop. Mass-rearing C. dubia should use meat meal as the base ingredient with bran flakes and whole eggs added and fed at 0.5g of media/larvae. Based on the current media ingredient costs, rearing 1-m adult C. dubia would cost just over $500 (US$342).

Abstract 3429: Using metabolomics to identify biomarkers mediating the associations of adiposity in childhood and early adulthood with mammographic breast density in premenopausal women

Abstract Introduction: Mammographic breast density (MBD), a strong predictor of breast cancer risk, is highly influenced by body mass index (BMI) in childhood and early adulthood, but the mechanisms elucidating this relationship are undetermined. To our knowledge, no study has explored the mediating role of biomarkers on the relationship between early-life adiposity and MBD. The goal of this study is to discover metabolites that mediate the relationship between BMI at ages 10 and 18 with MBD in premenopausal women. Methods: This study includes premenopausal women who had their screening mammogram at Washington University in St. Louis, MO, and provided a fasting blood sample. Metabolon performed untargeted metabolomic profiling, detecting 1,074 metabolites. Metabolites missing >300 observations were excluded, leaving 828 metabolites; the other missing values were imputed using the nearest neighbor method. To mitigate batch effect, we normalized the metabolite peak area data using ComBat. Volumetric percent density (VPD) was calculated in 700 women using Volpara software. BMI at age 10 was estimated using the Stunkard pictogram, and BMI at age 18 was calculated from self-reported weight at 18 and height at study initiation. To assess the mediating role of the 828 metabolites, we performed high dimensional mediation analysis using the hima R package adjusting for potential confounders. Missing values in the covariates and BMI measures included in the mediation analysis were imputed using multivariate imputation by chain equations. Associations were considered significant if FDR p-value <0.1. Results: Four metabolites (glutamate, beta-cryptoxanthin, phytanate, and cortolone glucuronide (1)) mediated the relationship between BMI at age 10 and VPD; and 2 metabolites (glutamate, beta-cryptoxanthin) mediated the relationship between BMI at age 18 and VPD. Glutamate and beta-cryptoxanthin significantly mediated the relationship between both BMI measures and VPD, but glutamate was the strongest mediator across both time points. Glutamate mediated 6.7% (FDR p-value=0.06) and 9.3% (FDR p-value=0.008) of the total effect between BMI at age 10 and 18, respectively, on VPD. Beta-cryptoxanthin mediated 4.1% (FDR p-value=0.06) and 6.3% (FDR p-value=0.04), of the total effect between BMI at age 10 and 18, respectively, on VPD. Additionally, phytanate mediated 2.6% (FDR p-value=0.06) and cortolone glucuronide (1) mediated 2.0% (FDR p-value=0.07) of the total effect between BMI at age 10 and VPD. Conclusion: Amino acid, lipid, cofactor/vitamin, and xenobiotic metabolites mediated the associations of BMI in early-life and VPD in premenopausal women. This innovative study offers insight into the biological mechanisms underlying the link between early-life adiposity and MBD, which can support future research into breast cancer prevention. Citation Format: Kayla R. Getz, Myung Sik Jeon, Lili Liu, Lei Liu, Chongliang Luo, Jingqin Luo, Adetunji T. Toriola. Using metabolomics to identify biomarkers mediating the associations of adiposity in childhood and early adulthood with mammographic breast density in premenopausal women [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2024; Part 1 (Regular Abstracts); 2024 Apr 5-10; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2024;84(6_Suppl):Abstract nr 3429.

Supportive Communication Between Emerging Adults With Cancer and Nurses During Diagnosis and Cancer Treatment: An Exploratory Qualitative Study Using Interviews.

Having a cancer diagnosis during early adulthood can be a significant challenge for an individual. Nurses' supportive communication plays a vital role during the diagnosis and treatment period to lessen psychological distress and promote coping. This exploratory study aimed to examine (1) the experiences of emerging adults with cancer (EAs) aged between 18 and 25 years in communicating with nurses during diagnosis and treatment and (2) nurses' experiences of providing supportive communication with this patient group. Semistructured interviews were conducted with EAs and nurses with experience caring for this patient group. Thematic analysis was conducted, guided by interpretive hermeneutic perspectives. Eight EA participants and 7 nurse participants participated in interviews. Five themes emerged: (1) having casual conversations with nurses helped EAs cope during cancer treatment and (2) helped EAs fulfill the need for social connectedness, (3) nurses as a different form of peer-like support, (4) nurses used themselves as a therapeutic tool to foster trust and emotional safety of EAs, and (5) nurses needed to maintain professional boundaries while being compassionate. This study highlighted a rather underdocumented aspect of supportive communication: meeting psychosocial needs through casual, day-to-day conversations. Having casual conversations with nurses appeared to help EAs' psychological coping during cancer treatment. These casual conversations, which on the surface seemed clinically insignificant, fulfilled their psychosocial needs. Considering the valuable interpersonal engagement that led to emotional benefits for EAs, communication training for cancer nurses needs to build their capacity to maintain both relational and emotional boundaries.

Chemical Exposure of Synthetic Pyrethroid on Deltamethrin Under the Selection Pressure over the Generations: A Reproductive Potential Study of Anopheles stephensi.

Biochemical synthetic pyrethroids, deltamethrin are presently used insecticides for the control of mosquito vector-borne diseases in worldwide. Mosquito re-emergence with diseases becoming a serious problem due to development of insecticide resistance. The comprehensive knowledge on the underlying mechanisms of resistance against deltamethrin is required for implementation of an efficient vector control programme. The assessment of the biological fitness of a mosquito strain exposed to insecticide pressure is extremely vital because it provides information on the development of resistance. In the present study, the adult stage of malaria vector, Anopheles stephensi, was designated for the study of deltamethrin resistance (F40 generations). The non-blood-fed, laboratory-reared females to sub-lethal doses of deltamethrin (0.004%, 0.005%, 0.007%, or 0.01%) exposed to every generation for up to F40. The adult mosquito susceptibility was performed by WHO standard method for evaluation. After 24h, mortality was recorded in both treated and control groups. Therefore, the biological fitness characteristics such as feeding, fecundity, hatchability, egg retention, immature duration, adult emergence, and adult life span were studied to assess the exposed deltamethrin under selection pressure as compared to the unexposed (control) population. The laboratory selection of An. stephensi exposed deltamethrin over the generations were diminished its biological fitness. Information on biological fitness including reproductive potential of mosquito strain under selection pressure against deltamethrin is incredibly necessary because it would facilitate in resistance management. Baseline information gives in this experiment will guide for future studies on the susceptibilities of wild malaria mosquito populations in India.

SALINITY EFFECTS ON THE DISTRIBUTION OF AEDES AEGYPTI AND AEDES ALBOPICTUS IN ST. JOHNS COUNTY, FLORIDA

The distribution of Aedes aegypti in St. Johns County (SJC), Florida is suggested to be coastal along the inter-coastal waterway. Anastasia Mosquito Control District (AMCD) conducted a study to investigate the effects of salinity on the distribution of container- inhabiting Aedes in SJC. Mean weekly abundances of Aedes aegypti and Aedes albopictus at 7 different distances along the coastal-inland gradient, ranging from the SJC coast to the St. Johns River, were monitored for 10 weeks. Bi-weekly salinity measurements of potential Aedes breeding containers were obtained at each distance. A laboratory test was conducted by allowing preferential oviposition at different salinity levels and adult emergence was monitored. Both container salinity and Ae. aegypti abundance were significantly higher up to 5.0 km from the coast compared to the other distances. Ae. aegypti abundance was positively and negatively associated with the container salinity and distance from the coast respectively. Ae. albopictus abundance was significantly different (lower) only at the distance at which the highest salinity was recorded. The association of abundance (positive) was significant only with the distance from the coast. The adult emergence rate of Ae. aegypti in the laboratory was higher at higher salinity levels up to 5 ppt while there was no significant difference in Ae. albopictus emergence rate at different salinities. The study demonstrated a possible salinity effect on the distribution of Ae. aegypti but not Ae. albopictus in SJC, FL. The results warrant further studies on salinity effects with other confounding environmental factors that would contribute to the distribution of the two species in the county.

Protection of cowpea seeds and toxicity against cowpea weevils by the essential oils from Lippia alba (verbenaceae) and Schinus terebinthifolius (anacardiaceae)

Alternative methods have been widely studied to mitigate problems arising from the use of pesticides in agriculture. Among them is the use of essential oils to control stored grain pests. In this context, the aim of this study was to evaluate the effect of fumigation of cowpeas with 12 essential oils having different chemical profiles, derived from the germplasm collection of Schinus terebinthifolius and Lippia alba at Rio de Janeiro Federal Rural University. These oils were applied at various concentrations (0.1–1.0 mg/mL of air) against cowpea weevils (Callosobruchus maculatus). The chemotypes evaluated included citral, citral/limonene, carvone/limonene, and linalool from the essential oils of L. alba, as well as α-pinene, sabinene, α-phellandrene/α-pinene, β-pinene/α-pinene, δ-carene/α-pinene, limonene, α-phellandrene/sabinene, and myrcene from the essential oils of S. terebinthifolius. Various aspects of the insects' reproductive cycle were evaluated, including mortality, egg laying, emergence of new adults, emergence rate, and larval hatching, along with grain mass loss. The results indicated life cycle inhibition of all evaluated oils, with the essential oil from the UFRRJ ECB028 (linalool CT) genotype having the lowest LC50 (0.10 mg/mL of air), completely halting the insects’ life cycle and totally preventing seed mass loss. Overall, the results pointed to certain genotypes as promising for the development of technologies aimed at seed protection.

The course of borderline personality disorder from adolescence to early adulthood: A 5-year follow-up study

BackgroundStudies of the medium- to long-term clinical and functional course for treatment-seeking adolescents with borderline personality disorder (BPD) are lacking. This study aims to outline the psychopathological and functional status of participants, five years after being diagnosed with BPD during adolescence. MethodsParticipants were originally enrolled in a randomized clinical trial that compared mentalization-based group treatment with treatment as usual for adolescents with BPD. Semi-structured interview assessments at five-year follow-up included the Schedules for Clinical Assessment in Neuropsychiatry and the Structured Clinical Interview for DSM-5 Personality Disorders. Attention deficit hyperactivity disorder (ADHD), alcohol, substance and tobacco use, posttraumatic stress disorder (PTSD), complex PTSD, and general functioning were assessed using self-report instruments. Results97 of the original sample of 111 participants (87%) participated. They were aged 19–23 years. The most prevalent disorders were ADHD (59%), any personality disorder (47%) of which half continued to meet criteria for BPD (24%), anxiety disorders (37%), depressive disorders (32%), PTSD or complex PTSD (20%), schizophrenia (16%), and eating disorders (13%). Only 16% did not meet criteria for any mental disorder. Approximately half of the sample were in psychological and/or psychopharmacological treatment at the time of follow-up. Their general functioning remained impaired, with 36% not engaged in education, employment or training (NEET), which is nearly four times the rate of NEET in the same age group in the general population. ConclusionsAlthough stability of the categorical BPD diagnosis is modest, adolescents meeting diagnostic criteria for BPD show a broad range of poor outcomes at five-year follow-up. BPD appears to be a marker of general maladjustment during adolescence and a harbinger of severe problems during the transition to young adulthood. Early intervention programs for adolescents diagnosed with BPD should focus upon a broad range of functional and psychopathological outcomes, especially social and vocational support, rather than the narrow BPD diagnosis.

Management of the Blueberry Gall Midge in Florida’s Southern Highbush Blueberries

The blueberry gall midge (BGM) is one of the most important pests of southern highbush blueberries in Florida. Monitoring for BGM using clear sticky traps or bucket traps should begin as early as November. Chemical control should be applied right before bud break and then ten days after bud break, or when at least two BGM are found on traps. Other management practices include the use of younger mulch, using potentially resistant cultivars, and chemical control such as Movento with Induce and Apta in rotation to avoid resistance development. Applications should also be timed with larval and adult emergence for optimal insecticide efficacy.

Characterizing developing executive functions in the first 1000 days in South Africa and Malawi: The Khula Study

The term ‘executive functions’ (EFs) refers to a set of skills that support flexible control over thought and action. Classic EFs (working memory, inhibitory control, and cognitive flexibility) do not show measurable stable function until after the third year of life and continue to develop into early adulthood. However, even at the earliest ages, these EFs are shown to have value for predicting school readiness and academic achievement. They continue to have predictive value for success, mental health, and general well-being across the lifespan including in ageing populations. As such, understanding the developing brain and cognitive developmental dynamics that set the stage for the development of EFs, in the first three years of life, is crucial for developing programming that supports healthy EFs development. The goal of this manuscript is to describe the goals, hypotheses, participant populations, and methodology of the Khula Study. Khula is a multi-modal multi-site longitudinal birth cohort study designed to characterise emerging EFs in the first 1000 days of life in global majority settings. Most research to date has been conducted in highincome countries rather than low- and middle-income countries that comprise most of the world’s child population. We assert that understanding and supporting EF development has global importance, but this must be done with the understanding that EFs are skills that develop within the context of adaptation to one’s environment. As such, the Khula Study aims to understand which EF influences are common across cultures but also which are culture specific. We will address these questions by incorporating data from South Africa and Malawi to understand influences on EF development and outcomes for children living in these contexts. We enrolled 394 mothers (84% antenatally) from Gugulethu in Cape Town, South Africa and 507 mothers (42% antenatally) from Blantyre, Malawi.

“I want purpose in my life”: A qualitative exploration of how homeless youth envision their futures

Preparing for the future is a major developmental task during adolescence and early adulthood. However, youth experiencing homelessness face additional challenges relating to economic instability, housing insecurity, and a lack of social support. Semi-structured interviews were conducted with 38 youth, from Ottawa and Toronto, who were experiencing homelessness and participating in a randomized controlled trial of Housing First for Youth (HF4Y). This qualitative study explores youths’ visions for the future, including their goals, aspirations, plans, and barriers to achieving them. Overall, findings demonstrated that youth had positive visions of the future and strove to reach developmentally appropriate goals and responsibilities. Compared to youth receiving HF4Y, the future expectations of those receiving treatment as usual (TAU) were characterized by uncertainty and lacked clear direction. Additionally, they emphasized self-reliance and autonomy, while HF4Y prioritized forming relationships and reconnection. Findings highlight the importance of stable housing intervention, and social, community, and financial support in planning for the future and transitioning out of homelessness. Implications for intervention, directions for future research, and limitations are provided.

Cadmium Exposure Impairs Development, Detoxification Mechanisms and Gene Expression of Glyphodes pyloalis Walker (Lepidoptera: Pyralidae)

Cadmium (Cd) is the most serious heavy metal pollutant in the agricultural soil of China and can transfer and accumulate through the food chain and affect the growth, development and physiological processes of phytophagous insect. Glyphodes pyloalis Walker (G. pyloalis) is one of the most important pests of mulberry, and there are few studies on the adverse effects of heavy metals on insects, especially mulberry pests. To understand the toxicology of Cd exposure on G. pyloalis, we investigated the effects of three different concentrations of Cd (0, 3.89 and 51.69 mg/kg, labeled as control check (CK), low dose (LD) and high dose (HD)) on the development and detoxification mechanism of G. pyloalis and explored the molecular mechanism of Cd on G. pyloalis larvae using RNA-seq technology. Transcriptome analysis showed that compared with the CK, a total of 63 differentially expressed genes (DEGs) were identified in LD exposure, including 24 upregulated and 39 downregulated candidates. In CK versus HD groups, 395 upregulated DEGs and 436 downregulated DEGs were identified and the expression patterns of 12 genes related to detoxification and metabolism were verified using qPCR. These DEGs were relevant to multiple specific peroxisome and drug metabolism-cytochrome P450 pathways. Gene annotation and quantitative real-time PCR revealed that a high concentration of Cd significantly stimulated the expression of metabolic detoxification enzyme genes. The results revealed that Cd exposure changed the pupal weight, adult emergence rate and the activities of AKP, ACP and GST in G. pyloalis and induced notable adverse effects at the molecular level on detoxification and metabolism such as concentration and time differences. In addition, we silenced CYP12A2 by RNA interference. Bioassays showed that after silencing CYP12A2, the survival rate of G. pyloalis under Cd exposure was lower than that of the control group.

Inter hospital external validation of interpretable machine learning based triage score for the emergency department using common data model

Emergency departments (ED) are complex, triage is a main task in the ED to prioritize patient with limited medical resources who need them most. Machine learning (ML) based ED triage tool, Score for Emergency Risk Prediction (SERP), was previously developed using an interpretable ML framework with single center. We aimed to develop SERP with 3 Korean multicenter cohorts based on common data model (CDM) without data sharing and compare performance with inter-hospital validation design. This retrospective cohort study included all adult emergency visit patients of 3 hospitals in Korea from 2016 to 2017. We adopted CDM for the standardized multicenter research. The outcome of interest was 2-day mortality after the patients’ ED visit. We developed each hospital SERP using interpretable ML framework and validated inter-hospital wisely. We accessed the performance of each hospital’s score based on some metrics considering data imbalance strategy. The study population for each hospital included 87,670, 83,363 and 54,423 ED visits from 2016 to 2017. The 2-day mortality rate were 0.51%, 0.56% and 0.65%. Validation results showed accurate for inter hospital validation which has at least AUROC of 0.899 (0.858–0.940). We developed multicenter based Interpretable ML model using CDM for 2-day mortality prediction and executed Inter-hospital external validation which showed enough high accuracy.

Gender Difference in the Relationship between Extrapulmonary Factors and Reduced Lung Function in Early Adulthood.

(1) Background: Reduced lung function in early adulthood is associated with future risks to health outcomes that have not been fully explored by gender. We investigated gender-specific relationships between lung function and extrapulmonary variables, assessing their potential as screening markers for respiratory dysfunction in young adults. (2) Methods: The participants were 151 medical students. Clinical data, handgrip strength (HS); body composition parameters such as skeletal muscle mass index (SMI), whole-body phase angle (WBPhA), and bone mineral content (BMC); and pulmonary function variables, vital capacity (VC), forced VC (FVC), and forced expiratory volume in one second (FEV1), were measured. (3) Results: FEV1 was significantly correlated with BMI, SMI, WBPhA, BMC, and both left and right HS (p < 0.0001, respectively) across all participants. According to gender, FEV1 had the strongest positive association with left HS in males (p < 0.0001) and BMC in females (p < 0.0001). The area under the curve for detecting the bottom quartile of FEV1 was 0.705 (cut-off 41.0 kg, sensitivity 91%) for left HS in males and 0.742 (cut-off 2.11 kg, sensitivity 81%) for BMC in females. (4) Conclusions: Gender-specific relationships between intrapulmonary and extrapulmonary factors such as left HS and BMC could be useful for screening suspected respiratory dysfunction in early adulthood.

Abstract P191: Changes in Ultra-Processed Food Intake During the Transition to Adulthood Are Associated With Blood Pressure in Early Adulthood Among a Filipino Birth Cohort

Ultra-processed food (UPF) intake in adulthood is positively associated with risk of high blood pressure (BP), but little is known about the implications of UPF intake in adolescence on later BP. The objective of this study was to estimate the association between the change in UPF intake during the transition from adolescence to adulthood and BP in early adulthood. We hypothesized a positive association. Data were from the 2002, 2005, 2009, and 2018 waves of the Cebu Longitudinal Health and Nutrition Survey, a birth cohort established in 1983 in metropolitan Cebu, Philippines. Participants in the analysis sample were approximately 18 (n=2,012), 21 (n=1,853), 25 (n=1,680), and 35 (n=1,305) years old at the time of the surveys. Foods and beverages from two 24-hour recalls collected at ages 18 and 21 were classified according to NOVA. UPF intake was estimated as the percentage of daily kilocalories (kcals) from UPFs. The outcomes, systolic and diastolic BP (SBP and DBP) at ages 21, 25, and 35, were estimated as the average of three measures collected each wave. The exposure was change in UPF intake from age 18 to 21, modeled as a three-level categorical variable: 1) “decreasing” if the absolute change was &lt;-2.5% of daily kcals, 2) “no change” if the absolute change was ≥-2.5% and ≤2.5%, and 3) “increasing” if the absolute change was &gt;2.5%. We used multivariable linear regression models to estimate associations of SBP and DBP at ages 21, 25, and 35 with the change in UPF intake from age 18 to 21, adjusting for physical activity, smoking status, household wealth, urbanicity, UPF intake, and BP at age 18. We stratified all analyses by sex. Mean UPF intake at ages 18 and 21, respectively, was 15% and 16% of daily kcals among females and 11% and 10% among males. Mean SBP rose from 99 mmHg at age 18 to 110 mmHg at age 35 among females and from 106 to 121 mmHg among males. Compared to females with no change in UPF intake from age 18 to 21, females with decreasing UPF intake had, on average, SBP that was 2.9 mmHg lower (95% CI: -5.1, -0.7) at age 25 and DBP that was 2.6 mmHg lower (95% CI: -4.4, -0.6) at age 21 and 2.5 mmHg lower (95% CI: -4.4, -0.6) at age 25. There were no differences at age 35. For males, compared to those with no change in UPF intake from age 18 to 21, those with decreasing UPF intake had SBP and DBP that were, on average, 3.4 mmHg lower (95% CI: -6.4, -0.3) and 2.8 mmHg lower (95% CI: -5.3, -0.2) at age 35, though there were no differences earlier in adulthood. We did not observe differences in BP comparing participants with increasing UPF intake versus no change, except among females at age 25, when, contrary to our hypothesis, SBP and DBP were lower among females with increasing intake. In conclusion, we observed lower BP in early adulthood among participants with decreasing UPF intake during the transition to adulthood. Efforts to prevent hypertension in low- and middle-income countries should aim to reduce UPF intake during this transitional period.