Cohort Of Young Adults Research Articles

Searching Reproducible Brain Features using NeuroMark: Templates for Different Age Populations and Imaging Modalities

A primary challenge to the data-driven analysis is the balance between poor generalizability of population-based research and characterizing more subject-, study- and population-specific variability. We previously introduced a fully automated spatially constrained independent component analysis (ICA) framework called NeuroMark and its functional MRI (fMRI) template. NeuroMark has been successfully applied in numerous studies, identifying brain markers reproducible across datasets and disorders. The first NeuroMark template was constructed based on young adult cohorts. We recently expanded on this initiative by creating a standardized normative multi-spatial-scale functional template using over 100,000 subjects, aiming to improve generalizability and comparability across studies involving diverse cohorts. While a unified template across the lifespan is desirable, a comprehensive investigation of the similarities and differences between components from different age populations might help systematically transform our understanding of the human brain by revealing the most well-replicated and variable network features throughout the lifespan. In this work, we introduced two significant expansions of NeuroMark templates first by generating replicable fMRI templates for infants, adolescents, and aging cohorts, and second by incorporating structural MRI (sMRI) and diffusion MRI (dMRI) modalities. Specifically, we built spatiotemporal fMRI templates based on 6,000 resting-state scans from four datasets. This is the first attempt to create robust ICA templates covering dynamic brain development across the lifespan. For the sMRI and dMRI data, we used two large publicly available datasets including more than 30,000 scans to build reliable templates. We employed a spatial similarity analysis to identify replicable templates and investigate the degree to which unique and similar patterns are reflective in different age populations. Our results suggest remarkably high similarity of the resulting adapted components, even across extreme age differences. With the new templates, the NeuroMark framework allows us to perform age-specific adaptations and to capture features adaptable to each modality, therefore facilitating biomarker identification across brain disorders. In sum, the present work demonstrates the generalizability of NeuroMark templates and suggests the potential of new templates to boost accuracy in mental health research and advance our understanding of lifespan and cross-modal alterations.

Cardiometabolic profiles and proteomics associated with obesity phenotypes in a longitudinal cohort of young adults

To assess cardiometabolic profiles and proteomics to identify biomarkers associated with the metabolically healthy and unhealthy obesity. Young adults (N = 156) enrolled were classified as not having obesity, metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUHO) based on NCEP ATP-III criteria. Plasma proteomics at study entry were measured using Olink Cardiometabolic Explore panel. Linear regression was used to assess associations between proteomics and obesity groups as well as cardiometabolic traits of glucose, insulin, and lipid profiles at baseline and follow-up visits. Enriched biological pathways were further identified based on the significant proteomic features. Among the baseline 95 (61%) and 61 (39%) participants classified as not having obesity and having obesity (8 MHO and 53 MUHO), respectively. Eighty of the participants were followed-up with an average 4.6 years. Forty-one proteins were associated with obesity (FDR < 0.05), 29 of which had strong associations with insulin-related traits and lipid profiles (FDR < 0.05). Inflammation, immunomodulation, extracellular matrix remodeling and endoplasmic reticulum lumen functions were enriched by 40 proteins. In this study population, obesity and MHO were associated with insulin resistance and dysregulated lipid profiles. The underlying mechanism included elevated inflammation and deteriorated extracellular matrix remodeling function.

Primary and Secondary Intracerebral Hemorrhage in Pregnant and Nonpregnant Young Adults by SMASH-UP Criteria.

Intracerebral hemorrhage (ICH) is a major cause of maternal morbidity, but its pathophysiology is poorly characterized. We investigated characteristics of pregnancy-associated ICH (P-ICH), compared with ICH in similar aged nonpregnant adults of both sexes. We performed a retrospective analysis of 134 adults aged 18 to 44 years admitted to our center with nontraumatic ICH from January 1, 2012, to December 31, 2021. We compared ICH characteristics among 3 groups: those with P-ICH (pregnant or within 12 months of end of pregnancy); nonpregnant women; and men. We categorized ICH pathogenesis according to a modified scheme, SMASH-UP (structural, medications, amyloid angiopathy, systemic, hypertension, undetermined, posterior reversible encephalopathy syndrome/reversible cerebral vasoconstriction syndrome), and calculated odds ratios and 95% CIs for primary (spontaneous small-vessel) ICH versus secondary ICH (structural lesions or coagulopathy related), using nonpregnant women as the reference. We also compared specific ICH pathogenesis by SMASH-UP criteria and functional outcomes between groups. Of 134 young adults with nontraumatic ICH, 25 (19%) had P-ICH, of which 60% occurred postpartum. Those with P-ICH had higher odds of primary ICH compared with nonpregnant women (adjusted odds ratio, 4.5 [95% CI, 1.4-14.7]). The odds of primary ICH did not differ between men and nonpregnant women. SMASH-UP pathogenesis for ICH differed significantly between groups (P<0.001). While the in-hospital mortality rate was lowest in the P-ICH group (4%) compared with nonpregnant women (13%) and men (24%), 1 in 4 patients with P-ICH were bedbound and dependent at the time of discharge. In our cohort of young adults with ICH, 1 in 5 was pregnancy related. P-ICH differed in pathogenesis compared with non-pregnancy-related ICH in young adults, suggesting unique pathophysiology.

Threats to social safety and neuro-inflammatory mechanisms underlying sexual orientation disparities in depression symptom severity: A prospective cohort study of young adults

Sexual minority individuals have a markedly elevated risk of depression compared to heterosexuals. We examined early threats to social safety and chronically elevated inflammation as mechanisms contributing to this disparity in depression symptoms, and compared the relative strength of the co-occurrence between chronic inflammation and depression symptoms for sexual minorities versus heterosexuals. To do so, we analyzed data from a prospective cohort of sexual minority and heterosexual young adults (n = 595), recruited from a nationally representative sample, that included assessments of early threats to social safety in the form of adverse childhood interpersonal events, three biomarkers of inflammation (i.e., CRP, IL-6, TNF-α) measured at two time points, and depression symptoms over four years. In pre-registered analyses, we found that sexual minorities experienced more adverse childhood interpersonal events, were more likely to display chronically elevated inflammation, and reported more severe depression symptoms than heterosexuals. Adverse childhood interpersonal events and chronically elevated inflammation explained approximately 23 % of the total effect of the association between sexual orientation and depression symptom severity. Further, there was an increased coupling of chronically elevated inflammation and depression symptoms among sexual minorities compared to heterosexuals. These results provide novel longitudinal, population-based evidence for the role of chronically elevated inflammation in linking threats to social safety during childhood with depression symptom severity in young adulthood, consistent with the primary tenets of the social signal transduction theory of depression. Our study extends this theory to the population level by finding that members of a stigmatized population (i.e., sexual minorities) experience a greater risk of depression because of their greater exposure to adverse childhood interpersonal events and the subsequent link to chronic inflammation, highlighting potential biopsychosocial intervention targets.

Executive function and maladaptive coping in a young adult cohort of individuals with congenital heart disease

BackgroundYoung adults with congenital heart disease (CHD) are more likely to exhibit executive dysfunction and maladaptive coping yet are less likely to get diagnosed than the general population for psychiatric disorders. The etiology of psychiatric diagnosis is inconclusive amongst CHD populations, and more research is needed to evaluate risk factors contributing to psychiatric disorders, including executive function, coping mechanisms, anxiety, depression, fatigue and sleep disorders, parental style/involvement, and sense of coherence. ObjectivesThe study proposed to demonstrate the presence of risk for psychiatric diagnoses amongst young adults with CHD and evaluate factors contributing to mental health and executive dysfunction comorbidities. MethodsWe used a mixed methods study of quantitative scales and a guided interview on a cohort of 11 young adults (18–24) with CHD who are considered in the American Heart Association high-risk group for developmental disorders or disabilities. We assessed for risk of anxiety and depression, maladaptive and disengagement coping, executive dysfunction, and other factors associated with mental health using the Reponses to Stress (RSQ), Patient Reported Outcomes Measurement Information System (PROMIS), and the Amsterdam Executive Function Inventory (AEFI) scales. Qualitative interviews focused on experiences living with CHD, social and family support, and executive functioning skills. ResultsOur mean participant age was 20 years, and 36 % had some college education. PROMIS scoring showed increased risk for poor physical function (mean r = 31.8), anxiety (mean r = 64.9), depression (mean r = 66.8), and pain interference (mean r = 66.6). AEFI results also showed poor executive functioning skills, particularly in Self-Control/Self-Monitoring (mean 18.1) and Planning and Initiative (mean 5.3). 27 % of participants had medical record documentation of depression. Interviews showed participants overinflated sense of coherence and poor executive functioning, leading to two main themes: 1) perceptions of their disability, including denial of their CHD diagnosis and disengagement with mental health needs, and 2) challenges in transition care. ConclusionsOur study indicates a need for larger scale interventions for psychological young adults with CHD as part of the transition process to adult care.

Vitamin D deficiency and atopic dermatitis severity in a Bangladeshi population living in East London: A cross‐sectional study

AbstractBackgroundAtopic eczema is a common, chronic, inflammatory skin condition with considerable heterogeneity. South Asian people living in the UK frequently have low serum vitamin D3 (25(OH)D3), and those with atopic disease can present with severe eczema. The association between vitamin D deficiency and eczema severity, and the role of vitamin D supplementation in atopic eczema is inconsistent, and under‐researched in people with Asian ancestry.ObjectivesThis cross‐sectional study investigates the association between serum 25(OH)D3 and eczema severity in a cohort of South Asian children and young adults living in London.MethodsEligible participants were Bangladeshi children and young adults aged 0–30 years with eczema, living in London and participating in the Tower Hamlets Eczema Assessment study. Data was collected via parent/patient self‐reporting, clinical history and examination, and hospital databases. 25(OH)D3 levels were documented retrospectively, if available, from hospital databases. Eczema severity was classified by Eczema Area and Severity Index (EASI) score less than or greater than 10 (clear‐mild vs. moderate‐severe). Multivariate logistic regression was used to adjust for confounding factors.Results681 participants were included in analyses. 25(OH)D3 results were available for 49.6% (338/681), 84.3% of which had deficient or insufficient lowest 25(OH)D3. Lowest 25(OH)D3 was inversely correlated with EASI score (Spearman's rank R2 = −0.24, p &lt; 0.001). 26.1% (178/681) had EASI &gt;10 and a lower median lowest and nearest 25(OH)D3. After adjustment for confounding EASI &gt; 10 was significantly associated with a lowest 25(OH)D3 &lt; 25 (OR 3.21, 95%CI 1.35, 8.60), use of mild‐moderate potency topical steroid on the face and neck (OR 3.11, 95%CI 1.86, 5.31), calcineurin inhibitor on the face and neck (OR 2.79, 95% CI 1.26, 6.10) and potent – very potent topical steroid on the face and neck (OR2.23, 95%CI 1.02, 4.77) and body (OR 2.11, 95%CI 1.18, 3.87).DiscussionVitamin D plays a role in modulation of proteins required for skin barrier function and regulation of the innate immune system, suggesting 25(OH)D3 deficiency contributes to skin inflammation. This study demonstrates a relationship between 25(OH)D3 deficiency and worse eczema severity in a cohort of South Asian children and young adults.

No Room to Fall: Criminal Justice Contact and Neighborhood Disadvantage

Abstract Neighborhoods across the United States are shaped by the criminal justice system and socioeconomic inequality. This article examines whether multiple forms of criminal justice contact affect neighborhood attainment for a cohort of young adults coming of age in the era of mass incarceration. Using the National Longitudinal Survey of Youth, 1997 cohort, and census data, I analyze neighborhood conditions before and after contact with the criminal justice system. Conviction is a critical experience in the life course. Having a household member incarcerated is associated with moving to a worse neighborhood only for White young adults. I contextualize these findings in the literature on the cumulative disadvantages faced by the justice-involved population and the complexities of identifying causal effects for this population. For many, incarceration represents a late stage of criminal justice contact, at which point there is no room to fall. Disentangling the web of disadvantage that follows criminal justice contact is crucial as the effects of the era of mass incarceration continue to accumulate. Locational attainment contextualized within the life course must be central to understanding how the legal system creates and reproduces disadvantage.

Disposable E-Cigarette Use and Subsequent Use Patterns in Adolescents and Young Adults.

Disposable electronic cigarettes (e-cigarettes) are widely used by adolescents and young adults (AYAs). Whether using disposable devices is associated with future e-cigarette use patterns is unknown but important for informing e-cigarette regulation. Prospective longitudinal study combining data from adolescent (14-17 years) and young adult (21-24 years) cohorts from Southern California surveyed at baseline and approximately 8-month follow-up during 2021 to 2022. The analyses included AYAs who used e-cigarettes in the past 30 days at baseline and had exposure and outcome data (N = 403; adolescent n = 124, young adult n = 279). In the pooled sample of AYAs who used e-cigarettes at baseline (57.2% cis-gender female, 56.2% Hispanic), 278 (69.0%) reported past 30-day disposable e-cigarette use, and 125 (31.0%) used only nondisposable e-cigarettes. Baseline use of disposable (versus only nondisposable) devices was associated with higher odds of continued e-cigarette use (adjusted odds ratio = 1.92; 95% confidence interval = 1.09-3.42) and a greater number of times used e-cigarettes per day at follow-up (adjusted incidence rate ratio = 1.29; 95% confidence interval = 1.02-1.63). In supplemental analyses, disposable e-cigarette use was associated with greater odds of no changes (versus reductions) in e-cigarette use frequency and puffs per episode from baseline to follow-up but was not associated with increases in use frequency and intensity. No differences in e-cigarette use outcomes were found between those with poly-device (disposable and nondisposable) versus only disposable device use. Use of disposable e-cigarette devices among AYAs may be associated with higher risks for persistent e-cigarette use patterns, which should be considered in tobacco product regulation designed to protect AYAs.

Education systems as life course policies? The example of subnational educational regimes and young adults’ family transitions

Abstract This study investigates the role of subnational educational opportunities for three typical transitions in young adulthood: 1) leaving the parental home, 2) starting to cohabit and 3) becoming a parent. Educational opportunities shape young adults’ life courses as they facilitate the accumulation of human capital, labour market entry and financial independence. Education systems and opportunities are part of transition regimes shaped by the specific cultural, economic and policy characteristics of a (subnational) context, and are thus likely to affect moving out and family formation. Drawing on the example of Switzerland with its large cantonal variation in educational opportunities, we use longitudinal data from the TREE panel study to follow a cohort of young adults born in the mid-1980s from ages 16 to 29. Event history models show that larger shares of young people in vocational education at a cantonal level are associated with earlier moving out and parenthood, but later partnership formation. The influence of vocational opportunities is moderated by the presence of a university in the canton.

Relationship between long-acting reversible contraception and acne in a cohort of adolescents and young adults.

The use of progestin-only long-acting reversible contraception (LARC) may be a risk factor for acne. Few studies have focused primarily on the effects of hormonal LARC on the development or exacerbation of acne in adolescents and young adults. We sought to understand the incidence and management of acne following hormonal LARC insertion in this adolescent/young adult population. A secondary data analysis was conducted of prospectively collected quality improvement (QI) data from the Adolescent Medicine LARC Collaborative. Subjects were evaluated by clinicians in adolescent medicine clinics at participating study sites, and acne severity was documented using a standardized recording instrument and scale. Descriptive statistics were reported as frequencies and percentages for categorical variables or mean and standard deviation (SD) for continuous variables. We compared demographic and clinical characteristics by those who had worsening acne, accounting for site inter-correlation using Cochran-Mantel-Haenszel chi-square tests for categorical variables and linear generalized estimating equation (GEE) regression for continuous variables. Of 1319 subjects who completed LARC insertion, 28.5% (376/1319) experienced worsening acne following use of progestin-only LARC. Acne was a contributing factor to LARC removal in only 3% (40/1319), and the sole reason for removal in 0.4% (5/1319) of all subjects. As this was a secondary analysis of prospectively collected QI data, limitations of this study include incomplete or inaccurate documentation of acne severity. Moreover, LARC insertions without follow-up/removal visits or with only follow-up/removal within 8 weeks of insertion were excluded from our study, which may also bias results. Adolescents and young adults seeking progestin-only LARC should be counseled about the potential for developing acne or experiencing a worsening of existing acne during LARC use. However, acne was not a common reason for LARC discontinuation.

Pediatric Medullary Thyroid Carcinoma: Clinical Presentations and Long-Term Outcomes in 144 Patients Over 6 Decades.

Sporadic medullary thyroid carcinoma (sMTC) rarely occurs in childhood and no studies have specifically focused on this entity. To describe the clinical presentations and long-term outcomes of a large cohort of children and young adults with sMTC compared with hereditary MTC (hMTC). Retrospective study of 144 patients diagnosed with MTC between 1961 and 2019 at an age ≤ 21 years and evaluated at a tertiary referral center. In contrast to hMTC (n = 124/144, 86%), patients with sMTC (n = 20/144, 14%) are older (P < .0001), have larger tumors (P < .0001), a higher initial stage grouping (P = .001) and have more structural disease (P = .0045) and distant metastases (DM) (P = .00084) at last follow-up, but are not more likely to die from MTC (P = .42). Among 77 patients diagnosed clinically, not by family history (20/20 sMTC and 57/124 hMTC), there was no difference in the initial stage (P = .27), presence of DM at diagnosis (P = 1.0), disease status at last follow-up (P = .13), overall survival (P = .57), or disease-specific survival (P = .87). Of the 12 sMTC tumors that underwent somatic testing, 11 (91%) had an identifiable alteration: 10 RET gene alterations and 1 ALK fusion. sMTC is primarily a RET-driven disease that represents 14% of childhood-onset MTC in this cohort. Pediatric sMTC patients are older, present with clinical disease at a more advanced TNM classification, and have more persistent disease at last follow-up compared with hMTC, but these differences disappear when comparing those presenting clinically. Somatic molecular testing should be considered in sMTC patients who would benefit from systemic therapy.

Effect of reverberation and informational masking on speech perception by adolescents and young adults with cochlear implants

Children with severe to profound hearing loss fitted with cochlear implants (CIs) can develop speech with degraded auditory inputs. Little is known about how speech perception by CI users who developed speech through electrical hearing is affected by realistic reverberation—a source of additional degradation in acoustic inputs to the CI speech processor. Moreover, how these young CI users handle competing maskers with high informational masking, such as two-talker babble, in speech-in-noise perception is not well characterized. Both reverberation and competing maskers are relevant factors in everyday classroom listening scenarios. In this work, we studied a cohort of adolescents and young adults with early fitting of CIs. Speech reception thresholds (SRTs) were measured in five types of maskers: speech-shaped noise (SSN), SSN modulated by a speech envelope, two-talker babble in English and in French, and time-reversed two-talker English babble. SRTs from each masker type were repeated in an anechoic condition and two reverberation conditions mimicking a classroom meeting classroom acoustics standard versus a lecture hall. When compared with a group of age-matched normal-hearing listeners, young CI users showed steeper increase of masked SRTs by increasing reverberation but comparable release from informational masking. [Work supported by the Hearing Health Foundation.]

A cross-sectional study observing the association of psychosocial stress and dietary intake with gut microbiota genera and alpha diversity among a young adult cohort of black and white women in Birmingham, Alabama

BackgroundThe relationships between psychosocial stress and diet with gut microbiota composition and diversity deserve ongoing investigation. The primary aim of this study was to examine the associations of psychosocial stress measures and dietary variables with gut microbiota genera abundance and alpha diversity among young adult, black and white females. The secondary aim was to explore mediators of psychosocial stress and gut microbiota diversity and abundance.MethodsData on 60 females who self-identified as African American (AA; n = 29) or European American (EA; n = 31) aged 21–45 years were included. Cortisol was measured in hair and saliva, and 16S analysis of stool samples were conducted. Discrimination experiences (recent and lifetime), perceived stress, and depression were evaluated based on validated instruments. Spearman correlations were performed to evaluate the influence of psychosocial stressors, cortisol measures, and dietary variables on gut microbiota genus abundance and alpha diversity measured by amplicon sequence variant (ASV) count. Mediation analyses assessed the role of select dietary variables and cortisol measures on the associations between psychosocial stress, Alistipes and Blautia abundance, and ASV count.ResultsAA females were found to have significantly lower ASV count and Blautia abundance. Results for the spearman correlations assessing the influence of psychosocial stress and dietary variables on gut microbiota abundance and ASV count were varied. Finally, diet nor cortisol was found to partially or fully mediate the associations between subjective stress measures, ASV count, and Alistipes and Blautia abundance.ConclusionIn this cross-sectional study, AA females had lower alpha diversity and Blautia abundance compared to EA females. Some psychosocial stressors and dietary variables were found to be correlated with ASV count and few gut microbiota genera. Larger scale studies are needed to explore the relationships among psychosocial stress, diet and the gut microbiome.

Chronic inflammation is associated with worsening working memory performance: Preliminary evidence from a diverse, longitudinal cohort of adolescents and young adults

Many depressed individuals experience cognitive difficulties that persist when depression is in remission. Inflammation is hypothesized to play a role in cognitive dysfunction in depression; however, many aspects of this relationship are not well characterized. The current study examined whether inflammation is associated with specific cognitive deficits in individuals with a history of depression and with progressively worsening working memory over time. Adolescents who participated in a prospective, longitudinal study of adolescent-onset depression were recruited to complete a follow-up cognitive assessment. The sample was comprised of 82 participants (52.4% female; 37.8% white; 42.7% low socioeconomic status) who were aged 22.61 years (SD = 1.50) at the time of the follow-up cognitive assessment. Prior to the follow-up cognitive assessment, they had completed an average of 6.24 (SD = 1.80) prior annual assessments over 6.24 years (SD = 2.08) as part of the parent longitudinal study in which C-reactive protein (CRP), depressive symptoms, and working memory were assessed repeatedly. First, using linear regression, we tested whether individuals exhibiting inflammation (CRP ≥3 mg/L) at multiple timepoints and a history of likely depression (Children’s Depression Inventory ≥19) exhibited differentially worse executive functioning, episodic memory, or psychomotor speed. Second, using hierarchical linear modeling, we tested whether the combination of inflammation and likely past depression was associated with poorer working memory over time. Chronic inflammation was associated with worsening working memory over time, but no significant associations were observed in cross-sectional analyses. These preliminary data indicate that chronic inflammation may lead to progressive decline in working memory over time.

Mental Health Status by Race, Ethnicity and Socioeconomic Status among Young Adults in Texas during COVID-19.

Differences in symptoms of depression and anxiety by race/ethnicity and socioeconomic status (SES) among a diverse cohort of young adults during the COVID-19 pandemic (Spring 2020-Fall 2021) have not been examined. We analyzed four waves of biannual, panel data from n = 2629 emerging adults (16-25years old) from the Texas Adolescent Tobacco and Marketing Surveillance study (TATAMS). We conducted a series of mixed effects ordinal logistic regression models to compare the independent and joint effects of race/ethnicity and SES on symptoms of (a) depression and (b) anxiety, adjusting for sex, cohort, and time. Symptoms of depression (aOR range: 1.54 - 2.19; 95% CI: 1.02 - 3.08) and anxiety (aOR range: 1.64 - 2.19; 95% CI: 1.22 - 2.79) were elevated among low SES young adults, across all racial/ethnic groups. Across SES groups, symptoms of depression were lower among non-Hispanic Blacks compared to non-Hispanic Whites (aOR range: 0.33 - 0.41; 95% CI: 0.18 - 0.62) and Hispanics /Latinos (aOR range: 0.33 - 0.38; 95% CI: 0.20 - 0.57); similarly, symptoms of anxiety were lower among non-Hispanic Blacks compared to non-Hispanic Whites (aOR range: 0.44; 95% CI: 25 - 0.77) and Hispanics/Latinos (aOR range: 0.47 - 0.56; 95% CI: 0.29 - 0.83). No significant interaction (joint effect) was observed between SES and race/ethnicity during this period. Low SES was persistently related to poor mental health. Lower odds of symptoms of anxiety and depression among non-Hispanic Black young adults may reflect the 'mental health paradox'. Overall, mental health policies should prioritize lower SES young adults regardless of race and ethnicity.

Clinical Features and Long-Term Outcomes of a Pan-Canadian Cohort of Adolescents and Young Adults with Myeloproliferative Neoplasms: A Canadian MPN Group Study.

Myeloproliferative neoplasms (MPNs) are a group of chronic hematologic malignancies that lead to morbidity and early mortality due to thrombotic complications and progression to acute leukemia. Clinical and mutational risk factors have been demonstrated to predict outcomes in patients with MPNs and are used commonly to guide therapeutic decisions, including allogenic stem cell transplant, in myelofibrosis. Adolescents and young adults (AYA, age ≤45 years) comprise less than 10% of all MPN patients and have unique clinical and therapeutic considerations. The prevalence and clinical impact of somatic mutations implicated in myeloid disease has not been extensively examined in this population. We conducted a retrospective review of patients evaluated at eight Canadian centers for MPN patients diagnosed at ≤45 years of age. In total, 609 patients were included in the study, with median overall survival of 36.8 years. Diagnosis of prefibrotic or overt PMF is associated with the lowest OS and highest risk of AP/BP transformation. Thrombotic complications (24%), including splanchnic circulation thrombosis (9%), were frequent in the cohort. Mutations in addition to those in JAK2/MPL/CALR are uncommon in the initial disease phase in our AYA population (12%); but our data indicate they may be predictive of transformation to post-ET/PV myelofibrosis.

When National Origins Equal Socio-economic Background: The Effect of the Ethno-class Parental Background on the Education of Children Coming of Age in Switzerland

The educational outcomes of the descendants of migrants are important indicators of migrants’ incorporation into host societies and an indicator of intergenerational social im/mobility. This paper examines this relationship using data from a survey that follows a cohort of young adults, born between 1988 and 1997, who grew up in Switzerland. It looks at the relationship between the educational output of respondents and their parental migratory background, with the theoretical consideration that the family’s social capital is a starting point in the descendants’ trajectories. The paper is based on secondary data and exploratory cross-sectional quantitative analyses. The results highlight first a correspondence between migrant parents’ national origins and their socio-economic status—in other words, an ‘ethno-class’. Second, they show differences in educational outcomes between migrants’ descendants and native Swiss as well as between the migrants’ descendants themselves—which indicates a segmented incorporation process for both the first and the second generation, in confirmation of previous research. Third, results show that parental background and language region of residence are statistically significant in determining the level of education achieved by the migrants’ descendants, especially those with a low socio-economic status. Their social mobility is ‘limited’, and they remain mostly in vocational education. The paper concludes that the Swiss school system still fails to include the most unprivileged and that a glass ceiling remains for them.

Abstract WMP77: In-Hospital Mortality Sex Differences in Young Adults With Intracerebral Hemorrhage

Introduction: Intracerebral hemorrhage (ICH) accounts for 10-20% of strokes and is associated with severe disability and high mortality. While males are reported to have worse outcomes in older patients with ICH, data are limited regarding sex differences in mortality risk after ICH for younger patients. Methods: We conducted a cross-sectional study of 134 adults aged 18-44 admitted to our academic medical center with ICH from 01/01/2012-12/31/2021, using data from an internal stroke registry and the Intracerebral Hemorrhage Outcomes Project (ICHOP). All vascular and non-vascular causes were included other than trauma. We used logistic regression models to calculate odds ratios (OR) and 95% confidence intervals (CI) for the association between sex and in-hospital mortality, adjusting for comorbidities and presence of multicompartmental hemorrhage (including intraventricular extension). Results: Characteristics of the study sample are summarized in the Table. Males had higher proportion of chronic hypertension and subcortical ICH location. Adjusting for hypertension, ICH location, multicompartmental extension, and use of antiplatelet medication, males had higher odds of death (OR 4.0, 95% CI 1.1-15.4) than females. Functional outcomes at discharge are shown in the Figure. Conclusion: In our cohort of young adults with ICH, males had 4-fold higher odds of in-hospital death than females. Future research should investigate the social and biological mechanisms that may underlie sex differences in mortality for young adults with ICH, including differences in ICH etiology, and potentially differential withdrawal of life sustaining treatment.

Abstract WP225: Changes in Hemoglobin Levels During Vascular Events in Moyamoya Arteriopathy

Background: Anemia is a well-established risk factor for stroke in many populations. Recent data suggest that in patients with moyamoya arteriopathy (MMA), decrease in hemoglobin is associated with perioperative stroke. Evaluating the role of anemia in stroke pathogenesis outside of the perioperative period in MMA could aid in risk stratification and stroke prevention. Hypothesis: We hypothesized that patients with MMA have lower hemoglobin levels in the setting of vascular events compared to their pre-event baseline. Methods: In this retrospective self-controlled case series, we abstracted demographic and clinical data from patients &lt; 40 years old with MMA cared for in our institution’s pediatric or young adult stroke clinics between 2003 and 2023. Laboratory data for each vascular event (stroke or TIA) were collected. The most recent laboratory data preceding events were also collected (baseline). Perioperative events (those occurring ≤7 days after revascularization) were excluded. Pre- and post-revascularization events were analyzed together and separately. Paired T-tests were used to compare baseline and vascular event hemoglobin values. Results: Eighty-nine (89) participants met inclusion criteria. There were 32 vascular events with corresponding baseline data available. There was no significant difference in hemoglobin between event and baseline values (11.2 v 11.3 g/dL, p = 0.87). However, among only pre-surgical events (n=20), hemoglobin was lower during events compared to baseline (10.4 v 11.5 g/dL, p=0.03). For events that occurred &gt;7 days post-revascularization (n=12), hemoglobin was higher during events compared with baseline (12.6 v 10.9 g/dL, p=0.008). Conclusions: In our cohort of children and young adults with MMA, hemoglobin was lower than baseline during presurgical vascular events and higher than baseline during post-revascularization vascular events. Though further exploration with multivariate models is necessary, these preliminary data suggest that while anemia and dehydration may both increase the risk of stroke in MMA, the relative contributions of these stroke risk factors differ based on surgical status.

Abstract TP41: Racial Differences in Cumulative Blood Pressure Exposure and Hippocampal Subvolumes

Introduction: We previously showed that a higher cumulative systolic blood pressure (cSBP) burden from young adulthood to midlife was associated with lower hippocampal volumes in Black but not White individuals independent of other vascular risk factors (VRF). And this difference was particularly evident in those with highest cSBP. In this study, we further explored these relationships by examining the impact of cSBP exposure on different hippocampal subvolumes. Methods: Thirty-four participants (18 black, 16 white) in the highest quartile of cSBP and longitudinal VRF exposure over 30 years with available brain MRI at the year 30 visit of the Coronary Artery Risk Development in Young Adults (CARDIA) cohort were used for this analysis. We measured the hippocampal subvolumes (CA1, CA2/3, and CA4) standardized as a percentage of total intracranial volume. T1 MRI images were processed using FreeSurfer (7.3.2) recon-all and the hippocampal sub-regions were segmented based on the computational atlas available in FreeSurfer. Results: Among the three regions, cSBP was only associated with CA1 subvolume in Black but not White participants. Racial differences were most evident in the CA1 hippocampal subvolume (p=0.099) and this difference remained even when other VRF were accounted for. Conclusion: Blacks with higher cSBP exposure over young adulthood to midlife, have smaller hippocampal CA1 subvolumes, which parallels the disparities in cSBP we previously reported. Our findings further highlight the anatomic vulnerability of the CA1 region to cSBP exposure and underscore the importance of early blood pressure control, particularly in minority populations where early screening for VRF may be limited.