Cross-sectional Analysis Research Articles

The impact of ethnicity and its definition on diabetes prevalence: A national Australian whole-of-population study

AimsWe assessed the extent to which using large geographic regions to group ethnicities (ancestries or countries-of-birth) masked intra-regional variation in diabetes risk. MethodsWe performed a cross-sectional analysis of the 2021 Australian National Census, which included self-reported health data. Ethnicity-specific diabetes prevalence was age/sex-standardised to a reference population of all census respondents 20 years and above. ResultsThere were 17.5 million adults included in this study. Within four geographical regions, there wastwo-four-fold intra-regional variation in diabetes risk. Diabetes prevalence among people reporting a single East Asianancestry ranged from less than the Australian prevalence (Japanese 4.2%, Thai 6.1%) to twice the Australian prevalence (Filipino 12.6%). Among peoplereporting a single South/Central Asianancestry, diabetes prevalence ranged from 7.3% (Armenian) to 18.4% (Bangladeshi). Among people reporting a single Middle Eastern/North African ancestry, diabetes prevalence values rangedfrom 5.4% (Jewish) to 12.3% (Iraqi). In Oceania, the diabetes prevalence in people of Australian Aboriginal, Fijian, Maori, Samoan and Tongan ancestry was greater than the Australian prevalence(17.5%, 12.3%, 10.0%, 16.3% and 17.4%, respectively versus 6.3%). ConclusionsThere wastwo-four-fold variation in diabetes prevalence between populations within four geographical regions. Aggregating ethnicity into large geographic regional groups may incorrectly estimate diabetes risk.

Variational trend in disease characteristics of hepatitis B-related primary liver cancer populations in the past five years: a retrospective single-center cross-sectional study

Objective: To study the variational trend in disease characteristics of patients with hepatitis B-related primary liver cancer (HBV-HCC) in the past five years. Method: A single-center retrospective cross-sectional analysis was performed to compare patients diagnosed with HBV-HCC from January 2012 to December 2016 (control group) and from January 2017 to December 2021 (observation group). The data of the study variables were extracted from the electronic medical record system of the hospital information system of the Second Hospital of Lanzhou University. The 1:2 propensity score matching was used to adjust potential confounding factors such as gender and age. Multivariate logistic regression analysis was used to study the factors affecting changes in disease characteristics of the HBV-HCC population in the observation group. GraphPad Prism 8.0 software was used to draw forest plots to intuitively display the effect size of the study variables in the logistic regression analysis.The t-test was used to compare normally distributed data between groups. The χ2 test was used for inter-group comparison. Results: A total of 1 717 eligible cases were collected, including 510 in the control group and 1 207 in the observation group. Compared with the control group, the number of newly diagnosed cases in the observation group increased by 2.36 times, and males were still the main onset population (83.3% vs. 82.7%). The median age of onset increased (51.9 vs. 53.5 years, P<0.001). 79.4% of HBV-HCC patients had not received antiviral therapy, and the proportion of HBeAg-negative patients increased (56.4%). The factors affecting HBV-HCC patients included family history of HBV (OR=1.626, 95%CI: 1.181-2.238), family history of hepatocellular carcinoma (OR=1.388, 95%CI: 1.013-1.901), hypoviremia (OR=1.322, 95%CI: 1.046-1.671), abnormal alanine aminotransferase (OR=1.545, 95%CI: 1.231-1.940), liver fibrosis (OR=1.478, 95%CI: 1.153-1.894), liver cirrhosis (OR=1.431, 95%CI: 1.128-1.815), and metabolic-related fatty liver disease (OR=1.438, 95%CI: 1.116-1.815) after propensity score matching adjustment. The factors affecting HBeAg-positive patients were decreased (OR=0.390, 95%CI: 0.389-0.617); however, the number of early HBV-HCC diagnoses was increased (12.7% vs. 19.3%, P=0.001). Conclusion: The characteristics of patient disease and occurrence of HBV-HCC are changing over the past five years. The risk of developing hepatocellular carcinoma in middle- to older male patients with chronic hepatitis B is increasing with familial history of HBV and hepatocellular carcinoma, HBeAg negativity, hypoviremia, abnormal alanine aminotransferase, liver fibrosis, cirrhosis, and metabolic-related fatty liver disease.

The Intermediate Barrier Performance of Electroless Co-W-B / Ni-P Stacked Deposits Between Cu and Solder Joint

Nickel (Ni) is one of the most common surface finishing materials for solder joint and wire bonding because it can behave as the diffusion barrier for Copper (Cu) and bring excellent reliability. Electroless Ni plating has many advantages such as high productivity, good thickness uniformity, and the deposition ability for isolated patterns of printed circuit boards without supplying electrolytic power. Electroless Ni plating is widely used as the jointing material for Tin (Sn) or Sn alloy solder in printed circuit boards, lead frames, and so on. The amorphous deposits of electroless Nickel-Phosphorus (Ni-P) generate the intermetallic compounds (IMC) with solder after the reflow and the remaining Ni behaves as the barrier between Cu and solder. In this time, the P amount of Ni-P deposits generally have the impact to the growth of IMC. Electroless Ni-P with high P (high P Ni) such as 10-12 wt% has been selected to achieve both corrosion resistance and solder joint reliability. Because the growth of Sn-Ni IMC between high P Ni is faster than deposits with lower P, the target thickness of high P Ni has been set to approximately 10 µm to sustain the Ni-P layer as the barrier layer between Cu and solder during reflow. However, if the Ni-Sn IMC is repeatedly formed and dissolved by the diffusion after solder jointing, the Ni-P layer reduces and finally disappears. As a result, an additional barrier layer is desirable for higher reliability. In this study, we investigated adding electroless Cobalt-Tungsten-Boron (Co-W-B) as a new intermediate barrier between Cu and solder jointing. We evaluated the bonding strength and IMC analysis after mounting Sn-Cu-Ni-P type solder on Cu/Co-W-B/Ni-P by using different reflow profiles. Results showed that Co-W-B 0.1-0.2 µm/Ni-P 1-2 µm stacked deposits had excellent bonding strength even though the Ni-P thickness is thinner such as 1 µm. After mounting solder, a P-rich layer was generated on the Co-W-B layer in cross-sectional Transmission Electron Microscope (TEM) observation. Scanning Transmission Electron Microscope (STEM) –Energy Dispersive X-ray Spectroscopy (EDS, STEMEDS) analysis showed the P-rich layer and Co-W-B layer prevented diffusion between solder and Cu. Furthermore, even if after the thermal loading of high temperature, the bonding strength was excellent. Additionally, the cross-section analysis of STEM-EDS revealed that a thin layer composed of Ni, Co and P was formed between Co-W-B and the P-rich layer. This thin layer also might behave as the barrier for solder. In conclusion, Co-W-B / Ni-P stacked deposits exhibited excellent reliability as the additional intermediate barrier layer between Cu and solder.

Using a Cross-Sectional Analysis of Age-Related Variations in Anthropometric Indices and their Association with Cardiometabolic Health in Adult Men

Background. Age-related changes in anthropometric indices and their association with cardiometabolic health markers are crucial for understanding health risks in adult men. Objectives. The study aimed to assess age-related variations in anthropometric indices and their correlation with health markers, highlighting potential cardiometabolic health risks in adult men. Materials and methods. A total of 200 men, aged 26 to 50 years, from Delhi-National Capital Region (NCR), India, were sampled using a multistage random sampling technique and divided into 5 age groups, each including 40 individuals. This study examined variations in body measurements such as the hip circumference (HC), waist circumference (WC), body mass index (BMI), and neck circumference (NC) across different age groups, as well as their relationship to health markers like HbA1c and lipid profile. Anthropometric measurements were taken in a standardized environment, and blood samples were taken under fasting conditions for lipid profile and HbA1c measurement. With SPSS software, descriptive statistics, a one-way ANOVA, and the Pearson correlation coefficients were used to analyze the data. Results. Significant age-related differences were found in NC and WC, with NC increasing from 39.61 ± 2.53 cm to 41.20 ± 2.63 cm and WC rising from 89.68 ± 12.08 cm to 98.80 ± 9.90 cm, indicating a trend toward central obesity. BMI and HC showed no considerable variation across age groups. A one-way ANOVA revealed significant differences in NC (F = 3.586, p = 0.008) and WC (F = 6.020, p = 0.005). Pearson’s correlations indicated that NC, BMI, and WC were positively correlated with triglycerides, LDL, and VLDL levels (p &lt; 0.05), while no notable correlations were observed for HbA1c. Conclusions. The study underscores the existence of significant age-related increases in NC and WC, suggesting heightened risks of abdominal obesity and cardiometabolic health issues in older men. Monitoring these anthropometric indices is vital for the early detection of health risks in adult males.

Sustainable practice in gastroenterology: travel-related CO2 emissions for gastroenterology clinic appointments in Canada

Abstract Background Telemedicine is increasingly common in gastroenterology and may represent an opportunity for improving sustainability in medical care. The purpose of this study was to determine the carbon emissions related to travel for in-person gastroenterology clinic appointments. Methods We conducted a cross-sectional analysis evaluating carbon emissions associated with travel to gastroenterology appointments over a 2-week period. We determined the average number of appointments per day and used patient’s postal codes to estimate travel distances. We estimated carbon emissions based on these travel distances and completed sensitivity analyses to model methods for emissions reductions. Results We assessed 975 clinic appointments, of which 71 were excluded (eg, insufficient data, non-physician appointments), leaving 904 included appointments of which 75% were follow-up (678) and the remainder were new consultations (226). Sixteen different gastroenterologists had an average of 22.7 patients per clinic. The mean return distance travelled per appointment was 57.3 km which translates to 14.9 kg CO2 per patient visit. An average day at our clinic was equal to burning 146.6 L of gasoline or the annual carbon capture of 15.5 trees. By changing follow-up appointments or those with a travel distance over 100 km to telehealth, emissions were reduced by 77%. Conclusions We demonstrate that a relatively modest change in the number of in-person visits can save thousands of litres of gasoline emissions annually from each practicing clinician. While we cannot avoid emissions related to travel for procedure-based appointments, the use of telemedicine is one potential strategy to reduce healthcare-related emissions.

Associations among healthy lifestyle characteristics, neuroinflammation, and cerebrospinal fluid core biomarkers of Alzheimer's disease in cognitively intact adults: The CABLE study.

The occurrence of Alzheimer's disease (AD) can be partially prevented through healthy lifestyles, but the mechanisms associated with AD pathology are unclear. To explore associations among healthy lifestyle characteristics (HLCs), cerebrospinal fluid (CSF) soluble TREM2 (sTREM2), and AD biomarkers. From the Chinese Alzheimer's Biomarker and LifestylE (CABLE) study, 924 cognitively normal participants were enrolled in this cross-sectional analysis. We defined the following 11 HLCs: appropriate frequencies of coffee and tea consumption, sufficient frequencies of fish and fruit intake, non-social isolation, adequate sleep, regular physical activity, no depression, never smoking, non-hazardous drinking, and well-maintained blood pressure. We categorized participants according to the number of HLCs reported by participants into favorable, intermediate, and unfavorable lifestyle groups. Multiple linear regression was used to investigate the relationship among HLCs, CSF sTREM2, and AD biomarkers. Mediation effects were tested using a causal mediation analysis having 10,000 bootstrap iterations. Included subjects were with a mean age of 61.8 ± 10.2 years, of which 41.8% were female. Sufficient fish intake (β = -0.164, p = 0.017) and well-maintained blood pressure (β = -0.232, p = 0.006) were significantly correlated with lower CSF sTREM2 levels. A larger number of HLCs were associated with lower CSF T-tau (p = 0.001), P-tau (p = 0.012), and sTREM2 (p = 0.040) levels. CSF sTREM2 partially mediated the association between the number of HLCs and CSF tau pathology (mediating proportion T-tau: 22.4%; P-tau: 25.0%). HLCs might impact the pathological processes of AD by regulating neuroinflammation.

Serum Leucine-Rich Alpha-2 Glycoprotein 1 Levels in Patients with Lipodystrophy Syndromes.

Serum concentrations of leucine-rich alpha-2 glycoprotein 1 (LRG1) are elevated in several cardio-metabolic and inflammatory diseases. LRG1 also plays an important role in the development of hepatic steatosis and insulin resistance. In lipodystrophies (LDs), severe cardio-metabolic complications can be observed. The dysregulation of several adipokines plays a significant role in the clinical manifestation of this syndrome. To date, there have been no studies of LRG1 levels in non-HIV-LD patients. We performed a cross-sectional analysis of LRG1 serum levels in 60 patients with non-HIV-associated LD and in 60 age-, sex-, and BMI-matched healthy controls. Furthermore, we investigated the gene expression of Lrg1 in a mouse model of generalised LD. No significant difference was found in the median concentration of LRG1 serum levels between LD patients (18.2 ng/L; interquartile range 8.3 ng/L) and healthy controls (17.8 ng/L; interquartile range 11.0 ng/L). LRG1 serum concentrations correlated positively with CRP serum levels (p < 0.001). Lrg1 mRNA expression was downregulated in the adipose tissue, whereas in the liver, no difference in Lrg1 expression between LD and wild-type mice was detected. In summary, circulating levels of LRG1 are associated with low-grade inflammation but cannot distinguish between patients with LD and controls.

Association of Fibroblast Growth Factor 23 and Cardiac Mechanics in the Cardiovascular Health Study.

Elevated levels of fibroblast growth factor 23 (FGF23) are associated with left ventricular hypertrophy and heart failure (HF) in individuals with and without kidney disease. Prior studies investigated the association of FGF23 and structural cardiac changes using conventional echocardiography, which is limited in its ability to detect early cardiac dysfunction. We investigated the relationship between FGF23 levels and cardiac dynamics using two-dimensional speckle tracking echocardiography (2D-STE), a novel imaging modality. This was a cross-sectional analysis of data from the Cardiovascular Health Study, an ongoing prospective, population-based cohort study. The study population included 506 participants from CHS with available c-terminal (cFGF23) and intact FGF23 (iFGF23) measurements from 1996-1997 and 2D-STE images from 1994-1995. Forty two percent of the study population had CKD, defined as an eGFR < 60 ml/min/1.73m2, and the mean eGFR was 63 ml/min/1.73m2. The primary exposures were cFGF23 and iFGF23. The primary outcomes were six 2D-STE parameters performed at the 1994-1995 study visit. Linear regression models were used to examine the independent associations of FGF23 with six cardiac 2D-STE indices adjusting for demographics, cardiovascular risk factors, markers of kidney disease severity, and inflammation. cFGF23 levels were moderately correlated with iFGF23 levels in the CHS population. In fully adjusted models, cFGF23 was associated with left atrial dysfunction, but no other cardiac imaging parameter (β estimate -2.47; 95% Confidence Interval -4.68, -0.25; Table 2). iFGF23 was not associated with any of the six 2D-STE indices. Limitations include small sample size and noncurrent FGF23 measurements and 2D-STE imaging. In a limited sample of individuals enrolled in the CHS with c- and i-FGF23 measurements, we did not find consistent associations between FGF23 levels and 2D-STE parameters. Further investigations in a larger population with concurrent 2D-STE are needed to better understand the associations of FGF23 with early changes in cardiac mechanics.

Characteristics and quality of life of people living with comorbid disorders in substance use recovery residences.

Opioid use disorder (OUD) is associated with significant morbidity and mortality; however, research on physical and mental health comorbidities and health-related quality of life (HRQoL) among people taking medication for OUD (MOUD) and living in recovery residences is sparse. We investigated the prevalence of comorbidities and examined which EQ-5D-5L HRQoL dimensions are most affected by these comorbidities. Data were collected from 358 residents living in 14 Texas-based recovery residences from April 2021 to June 2023. The EQ-5D-5L descriptive system comprises five dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression). Each dimension has five levels of perceived problems, dichotomized into "No problems" (level 1) and "Any problems" (levels 2-5) for analyses. Cross-sectional analyses of residents' characteristics, comorbidities (categorized as mental health disorders or association with major body systems), and EQ-5D-5L dimensions were conducted using Chi-squared or Student t-tests. Multivariable logistic regression models were used to estimate the odds ratios (ORs) and 95% confidence intervals (CIs). The mean [SD] age of residents was 36.0 [8.9]. Most residents were non-Hispanic White (68.7%), male (59.7%), unemployed (66.3%), and engaged in polysubstance use (75.4%). The most frequently reported comorbidities were mental health (26.5%), respiratory (26.3%), neurological (19.3%), cardiovascular (18.2%), and musculoskeletal (17.0%) disorders. The most reported HRQoL problems were anxiety/depression (75.8%) and pain/discomfort (53.2%). In the unadjusted regression models, all comorbidities, except mental health (negative association) and digestive (no association) disorders, were positively associated with HRQoL problems. The usual activities dimension was the most affected by comorbidities, followed by mobility and pain/discomfort. Increasing age was positively associated with cardiovascular disorders (aOR = 1.06; 95% CI = 1.03-1.10), musculoskeletal disorders (aOR = 1.03; 95% CI = 1.00-1.06), mobility problems (aOR = 1.05; 95% CI = 1.01-1.09), and pain/discomfort problems (aOR = 1.02; 95% CI = 1.00-1.05). Illicit drug use was positively associated with mobility problems (aOR = 3.36; 95% CI = 1.20-9.45). Neurological (aOR = 2.71; 95% CI = 1.38-5.33) and musculoskeletal (aOR = 2.57; 95% CI = 1.25-5.29) disorders were positively associated with pain/discomfort problems. MOUD duration was negatively associated with mental health disorders (aOR = 0.14; 95% CI = 0.08-0.22) but not HRQoL. Comorbidities significantly predict HRQoL among individuals with OUD. Our findings highlight the need for an integrated care model to treat OUD and comorbidities to sustain recovery and improve health and HRQoL.

The relationships between sleep and adiposity amongst multi-ethnic Asian populations: a cross-sectional analysis of the Health for Life in Singapore (HELIOS) study.

Short sleep duration and poor sleep quality have been associated with obesity. Asian populations report shorter sleep duration compared to other groups. We therefore aimed to explore the relationships between sleep duration, sleep quality, dozing, daytime napping, snoring, insomnia and adiposity in a multi-ethnic Asian population, and investigate the potential contribution of disturbed sleep to the risk of obesity amongst Asian populations. We studied 8876 participants of the HELIOS study, a multi-ethnic population-based cohort comprising Chinese, Malay, and Indian Asian men and women living in Singapore. Sleep traits and psychological symptoms were assessed using validated tools which included the Pittsburg Sleep Quality Index, Generalised Anxiety Disorder-7, and Patient Health Questionnaire-9. We employed multivariable regression models to examine the associations between sleep and adiposity, while also conducting sub-group and sensitivity analyses to strengthen the reliability of our results. The 8876 participants were 69.3% Chinese, 12.5% Malays, and 18.2% Indians, with mean age: 51.7 ± 11.8 years (standard deviation). Malays had the shortest sleep duration, while Chinese had the best sleep quality. Short sleep duration, poor sleep quality, and snoring were associated with higher BMI and waist circumference, independent of age, sex, ethnicity, and various confounding factors (education, household income, current smoking, regular alcohol drinking status, presence of diabetes and hypertension, and markers for anxiety and depression; P < 0.005). The estimated population attributable fraction for short sleep and snoring as contributors to obesity were 6.6% (95% CI: 2.5-10.6%) and 18.6% (95% CI: 17.0-20.2%), respectively. Sleep duration, sleep quality, and snoring are associated with adiposity in a multi-ethnic Asian population of Chinese, Malays, and Indians. Our findings suggest that a substantial portion of obesity in Asian populations could be averted through public health interventions aimed at improving sleep duration and quality.

Why Do Optimal Targets for Itch and Skin Clearance Matter in Atopic Dermatitis Treatment? Insights from TARGET-DERM AD Registry

Introduction/Background: Atopic dermatitis (AD) patients undergoing treatment may only experience partial improvement in itch and skin lesions, often leading to suboptimal outcomes. The Aiming High in Eczema/Atopic Dermatitis (AHEAD) treat-to-target recommendations emphasize the importance of achieving optimal treatment targets, such as complete or near-complete itch relief and skin clearance. However, there is limited evidence on the impact of achieving these higher efficacy targets on patient-reported outcomes and quality of life in AD. Objectives: To evaluate the independent and combined effects of achieving optimal treatment targets for itch and skin clearance on patient-reported outcomes (PROs) in AD, based on the AHEAD treat-to-target recommendations. Method: A cross-sectional analysis was conducted on adult participants in TARGET-DERM AD, a longitudinal study with over 4,000 participants across 52 U.S. and Canadian clinical-practice sites (2019-2024). Itch severity was measured using the PROMIS Itch-Severity question (NRS-Itch, 0–10 scale), with scores of 0/1 indicating no or minimal itch. Skin severity was assessed using the validated Investigator Global Assessment (vIGA-AD), where 0/1 represents clear or almost clear skin. Associations between itch and skin severity with optimal patient outcomes including POEM 0–2 (clear/almost-clear disease), DLQI 0/1 (minimal/no impact on quality of life), NRS-Sleep 0/1, and NRS-Pain 0/1 were evaluated. Logistic regression models examined the main and interaction effects of itch and skin severity. Results: Among 1,920 patients (58.6% female; 54.5% Non-Hispanic White; 93.8% US; mean age 45 years), optimal DLQI, POEM, NRS-Sleep, and NRS-Pain occurred most frequently among those achieving the optimal treatment targets for itch (WI-NRS 0/1; 52.1%, 53.7%, 57.3%, and 83.1%, respectively) and skin clearance (vIGA-AD 0/1; 44.7%, 44.3%, 44.7%, and 74.3%, respectively). Compared to partial improvement, the adjusted odds ratios (aOR) of optimal PROs were greatest for participants with complete or near-complete resolution of both itch and skin lesions (DLQI 0/1: 20.0; POEM 0-2: 41.7; Sleep-NRS: 16.1; Pain-NRS: 6.0). Conclusions: Achieving optimal treatment targets for both itch and skin lesions markedly enhances patient-reported outcomes in AD. The results of this real-world study support treat-to-optimal targets to assess therapeutic effectiveness and optimize patient outcomes.

Nutritional status, hemoglobin, and albumin levels in predicting platinum resistance in ovarian cancer at Dr. Saiful Anwar Hospital, Malang, Indonesia

HIGHLIGHTS Nutrition status, hemoglobin, and albumin levels are not predictors for platinum resistance. Hemoglobin and albumin levels increased in both platinum-sensitive or platinum-resistant. ABSTRACT Objective: This study aimed to determine whether nutritional status, hemoglobin, and albumin levels could serve as reliable predictors for predicting platinum resistance in patients with ovarian cancer. Materials and Methods: Conducted as a cross-sectional analysis, this study included 80 ovarian cancer patients who had completed six cycles of platinum-based chemotherapy. Patients were divided into two categories: those with platinum-resistant cancer and those with platinum-sensitive cancer, based on recurrence status following chemotherapy. Nutritional status was assessed through body mass index (BMI), and both hemoglobin and albumin levels were measured pre- and post-chemotherapy to investigate potential differences between the groups. Results: The analysis revealed no significant difference in BMI between the platinum-sensitive and platinum-resistant groups (p = 0.743), suggesting that nutritional status, as measured by BMI, did not correlate with platinum resistance. Hemoglobin levels were similarly non-significant before (p = 0.072) and after chemotherapy (p = 0.055), indicating no clear association between hemoglobin levels and platinum response. However, hemoglobin levels showed significant increases post-chemotherapy in both the platinum-sensitive (p = 0.002) and platinum-resistant (p = 0.025) groups, though without affecting resistance outcomes. Pre-chemotherapy albumin levels did not significantly differ between the two groups (p = 0.218); but a significant post-chemotherapy difference was observed (p = 0.027), with both groups experiencing substantial increases from pre- to post-chemotherapy (p = 0.000). Conclusion: The findings suggest that BMI, hemoglobin, and albumin levels are not reliable predictors of platinum resistance in ovarian cancer patients. Although both hemoglobin and albumin increased significantly after chemotherapy, these changes did not correspond with platinum resistance status.

Associations of physical activity and sedentary time with health-related quality of life in patients with localized renal cell cancer: a cross-sectional analysis within the ReLife study

PurposeThis study examined the associations of device-measured moderate-to-vigorous physical activity (MVPA) and sedentary time as well as self-reported MVPA with health-related quality of life (HRQoL) in patients with localized renal cell cancer (RCC) in the recovery phase after surgery.MethodsAt 3 months post-surgery, 341 patients with stage I-III RCC participating in the ReLife study wore an ActivPAL3 device to determine MVPA and sedentary time. The SQUASH questionnaire was used for assessing self-reported MVPA, and the EORTC QLQ-C30 for assessing HRQoL (range 0–100). Multivariable linear regression models were used to examine the cross-sectional associations of MVPA and sedentary time with HRQoL.ResultsThe highest (≥ 6.7 h/week) versus lowest (≤ 2.7 h/week) quartile of MVPA was associated with a better global health status (β, 10.2; 95% CI, 5.1, 15.3), summary score (β, 4.6; 95% CI, 1.1, 8.1), physical (β, 7.7; 95% CI, 3.8, 11.6), role (β, 12.4; 95% CI, 4.7, 20.2), and social functioning (β, 7.3; 95% CI, 0.2, 14.4), and lower fatigue (β, − 11.2; 95% CI, − 18.1, − 4.2). Results for self-reported MVPA were in the same direction but weaker. The lowest (≤ 8.8 h/day) versus highest (≥ 11.5 h/day) quartile of sedentary time was associated with better physical functioning (β, 4.6; 95% CI, 0.8, 8.5).ConclusionsIn patients with localized RCC, higher MVPA 3 months post-surgery was associated with better HRQoL outcomes including less fatigue whereas lower sedentary time was only associated with better physical functioning. This information can contribute to the development of physical activity guidelines and interventions to improve HRQoL.

Survivorship care plans and adherence to breast and cervical cancer screening guidelines among cancer survivors in a national sample

PurposeThe impact of the components of survivorship care plans on adherence to cancer screening guidelines among cancer survivors is limited. We examined the association of receipt of treatment summaries, follow-up instructions, and type of doctor providing survivorship care with adherence to breast cancer screening (BCS) and cervical cancer screening (CCS) guidelines in female cancer survivors.MethodsA cross-sectional analysis using Behavioral Risk Factor Surveillance System (BRFSS) data from 2014, 2016 and 2018 was conducted. BCS and CCS-eligible women were aged 40–74 and 30–64, respectively. BCS adherence was defined as a mammogram within 2 years and CCS adherence as a pap smear within 3 years or HPV test within 5 years. Univariate analysis with chi-square and multivariable logistic regression are reported.Results5,001 BCS and 3,014 CCS-eligible survivors were identified. In the BCS group, recipients of treatment summaries and follow-up instructions were significantly more adherent with BCS (84.1% vs. 77.4%; 83.4% vs. 74%, respectively, p < 0.001). In the CCS group, recipients of follow-up instructions were significantly more adherent with CCS (78.1% vs. 67.7%, p < 0.001). In both groups, there was no significant difference in BCS or CCS based on type of physician providing care (p = 0.087). On multivariate analysis, receipt of follow-up instructions was the only factor significantly associated with BCS (OR:2.81; 95%CI:1.76–4.49) and CCS (OR:3.14; 95%CI:1.88–5.23).ConclusionsFollow-up instructions, as part of survivorship care plans, have the strongest association with BCS and CCS among female cancer survivors. Additional research should focus on improving the distribution of survivorship care plans, particularly follow-up instructions, as a method to increase BCS and CCS among cancer survivors.

Formation mechanism of iron-catechol complexes in the colored periostracum of Corbicula spp.

The shell color of Corbicula clams, which are globally distributed, is roughly divided into yellowish and blackish depending on the environmental conditions of the sediment. The formation of an iron-L-3,4-dihydroxyphenylalanine (DOPA) complex in a thin organic layer, called the periostracum, on a calcareous layer causes the blackening of the clamshell. However, the iron-DOPA complex formation mechanism is unclear. To reveal how the iron is transported from the aquatic environment to the periostracum, cross-sectional analyses of the shell were conducted using an electron probe microanalyzer (EPMA) and Raman spectroscopy to investigate the distribution and structure of iron in the shell. Iron was only present in the periostracum, excluding deposition, and all iron was in the form of an iron-DOPA complex. Attenuated total reflection infrared spectroscopy and oxygen K-edge X-ray absorption fine structure spectroscopy revealed that the molecular structure of the native periostracum is independent of shell color. These results indicate that dissolved iron-organic complexes diffuse from the aqueous environment to the periostracum, forming iron-DOPA complex through ligand exchange. Because the iron-DOPA complex color depends on the pH, the shell color can serve as a historical indicator of the shell's growth environment.

Association of Body Roundness Index and A Body Shape Index with Obstructive Sleep Apnea: insights from NHANES 2015-2018 data.

This study examines the relationship between several anthropometric indices-Body Roundness Index (BRI), A Body Shape Index (ABSI), Waist-to-Weight Index (WWI), Waist Circumference (WC), and Body Mass Index (BMI)-and the prevalence of Obstructive Sleep Apnea (OSA) using data from the National Health and Nutrition Examination Survey (NHANES) spanning 2015 to 2018. A retrospective cross-sectional analysis of 7,004 adult participants was conducted using NHANES 2015-2018 data. Multivariable-adjusted logistic regression models were employed to assess the association between BRI, ABSI, and OSA. Non-linear relationships were explored via smooth curve fitting and threshold effect analysis using a two-part linear regression model. Subgroup analyses identified sensitive populations, and the discriminatory power of the indices in screening OSA was assessed using Receiver Operating Characteristic (ROC) curves. The analysis revealed a significant positive association between BRI and OSA, with a threshold effect observed at a BRI of 4.3. Below this threshold, OSA risk increased with higher BRI; however, no significant association was found above this threshold. Similarly, ABSI demonstrated a threshold effect at 8.2, with OSA risk positively associated to the left and negatively associated to the right. Subgroup analyses indicated stronger associations in younger and non-diabetic populations. ROC analysis identified BRI as a promising predictive tool for OSA, with an AUC of 0.64 (95% CI: 0.62-0.65). BRI demonstrates significant potential as a predictive index for OSA incidence, warranting further large-scale prospective studies to validate these findings.

Generic vs. Disease-Specific Patient Reported Outcome (PRO) Instruments for Assessing HRQoL Burden Among Patients Diagnosed with Alopecia Areata: Evidence from TARGET-DERM AA

Introduction Alopecia areata (AA) is a chronic, autoimmune disease characterized by patchy hair loss. Compared to other disease areas, recent work has signaled a potential shortcoming, that generic quality of life (QOL) questionnaires are not sufficiently sensitive to the impact of AA disease severity. This cross-sectional analysis investigates the Short-Form 36, the dermatology life quality index (DLQI), and the Alopecia Areata Patient Priority Outcomes (AAPPO) for similar shortcomings. Methods Patients of all ages enrolled from December 2021 to June 2024 in TARGET-DERM AA (data collection on-going) in the United States and Canada were grouped by Severity of Alopecia Tool (SALT) score (1-20, 21-49, or 50-100). At enrollment, patients completed the AAPPO and DLQI questionnaire as well as the RAND MOS Short-Form 36. The SF-36 has 8 subdomain scores (vitality, physical function, bodily pain, general health, physical role function, emotional role function, social role function, mental health) along with the physical component summaries (PCS), mental component summaries (MCS), and the SF-6D utility index score. The Kruskal-Wallis test compared differences in mean scores across SALT subgroups defined by severity. Results Of the 141 AA patients, 61.7% were female; 95.0% adults, and 67.4% Non-Hispanic White. When comparing the SALT 1-20 and the &gt;50 subgroups, significant differences in SF-36 derived mean scores were only observed in the PCS and the physical function score (p&lt;0.05). None of the other scores (MCS, SF-6D, or other SF-36 subdomains) showed any differences. Mean DLQI scores were similar across subgroups (p&gt;.05) Notably, the hair loss and activity limitation domains of the AAPPO demonstrated significant differences between the patient subgroups (p&lt;.0001 and p&lt;.05, respectively) Discussion In this real-world cohort, generic QoL instruments, namely the SF-36 and DLQI, did not capture differences in the underlying health-related QoL burden of AA patients with different AA severity. Such differences were clear when HRQoL was measured for AA patients with mild hair loss AAPPO.

The Relationship between Wellbeing and Academic Achievement: A Comprehensive Cross-Sectional Analysis of System Wide Data From 2016-2019

The Relationship between Wellbeing and Academic Achievement: A Comprehensive Cross-Sectional Analysis of System Wide Data From 2016-2019

Quality of life and coping in HIV patients, in Ho Chi Minh City

This study investigates the impact of demographic factors, coping strategies, and quality of life among HIV-positive individuals on antiretroviral therapy (ART) in Ho Chi Minh City, Vietnam. A cross-sectional analysis of 181 participants used the WHO-HIV-BREF to assess quality of life across physical, psychological, social, and environmental domains. Results show that lower socioeconomic status is linked to poorer quality of life in all domains, while older age and advanced HIV stages impact physical and environmental domains, respectively. Positive coping strategies, such as acceptance and reframing, correlate with improved quality of life, whereas humor and self-blame relate to negative outcomes. Gender differences in coping, notably men’s greater use of substance-based strategies, were also observed. Findings emphasize the need for integrated medical and social interventions to support adaptive coping and enhance well-being. Further research is advised to refine intervention strategies for this population.

Characterizing Physiologic Swallowing Impairment Profiles: A Large-Scale Exploratory Study of Head and Neck Cancer, Stroke, Chronic Obstructive Pulmonary Disease, Dementia, and Parkinson's Disease.

The purpose of the present study was to use a large swallowing database to explore and compare the swallow-physiology impairment profiles of five dysphagia-associated diagnoses: chronic obstructive pulmonary disease (COPD), dementia, head and neck cancer (HNC), Parkinson's disease (PD), and stroke. A total of 8,190 patients across five diagnoses were extracted from a de-identified swallowing database, that is, the Modified Barium Swallow Impairment Profile Swallowing Data Registry, for the present exploratory cross-sectional analysis. To identify the impairment profiles of the five diagnoses, we fit 18 partial proportional odds models, one for each of the 17 Modified Barium Swallow Impairment Profile components and the Penetration-Aspiration Scale, with impairment score as the dependent variable and diagnoses, age, sex, and race as the independent variables with interactions between age and diagnoses and between PD and dementia (in effect creating a PD with dementia [PDwDem] group). For components with > 5% missingness, we applied inverse probability weighting to correct for bias. PD and COPD did not significantly differ on 13 of the 18 outcome variables (all ps > .02). Dementia, stroke, and PDwDem all showed worse impairments than COPD or PD on five of six oral components (all ps < .007). HNC had worse impairment than all diagnoses except PDwDem for nine of 10 pharyngeal components (all ps < .006). Stroke and HNC had worse penetration/aspiration than all other diagnoses (all ps < .003). The present results show that there are both common and differing impairment profiles among these five diagnoses. These commonalities and differences in profiles provide a basis for the generation of hypotheses about the nature and severity of dysphagia in these populations. These results are also likely highly generalizable given the size and representativeness of the data set. https://doi.org/10.23641/asha.27478245.