Cross-sectional Analysis Research Articles

Clinical and Imaging Markers of Cardiac Function and Brain Health: A Meta-Analysis of Community-Based Studies.

Cardiac dysfunction and heart failure are linked to cognitive impairment, but the underlying brain pathology remains undetermined. We investigated associations between cardiac function (measured by echocardiography or cardiac MRI), clinical heart failure, and structural markers on brain MRI, including volumes of gray and white matter (WM), the hippocampus, and white matter hyperintensities (WMHs). We leverage data from 7 prospective, community-based cohorts across Europe and the United States, all part of the Cross-Cohort Collaboration. The included cohorts were the Age, Gene/Environment Susceptibility-Reykjavik Study, Atherosclerosis Risk in Communities study, Austrian Stroke Prevention Study, Cardiovascular Health Study, Framingham Heart Study, Rotterdam Study, and Study of Health in Pomerania (SHIP-START and SHIP-TREND). Each cohort performed cross-sectional multivariable linear regression analyses, after which estimates were pooled through random-effects meta-analysis. Heterogeneity was assessed by the I2 index (%). Among 10,889 participants (mean age: 66.8 years, range 52.0-76.0; 56.7% women), markers of systolic dysfunction were consistently associated with smaller total brain volume (TBV) (e.g., adjusted standardized mean difference for moderate to severe dysfunction -0.19, 95% CI -0.31 to -0.07, I2 = 20%). Impaired relaxation and restrictive diastolic dysfunction were also associated with smaller TBV (e.g., for impaired relaxation -0.08, 95% CI -0.15 to -0.01, I2 = 32%) and hippocampal volume (-0.18, 95% CI -0.33 to -0.03, I2 = 0%), with similar results for the E/A-ratio. Systolic and diastolic dysfunction was not consistently associated with volume of WMHs. Among 5 cohorts with available data, 302 (3.4%) participants had clinical heart failure, which was associated with smaller brain volumes, particularly in the hippocampus (-0.13, 95% CI -0.23 to -0.02, I2 = 1%). In this large study among community-dwelling adults, subclinical cardiac dysfunction was associated with brain imaging markers of neurodegeneration. These findings encourage longitudinal investigations on the effect of maintaining cardiac function on brain health.

Neuroimaging Correlates of Traumatic Brain Injury in an Older Community-Dwelling Population: The Atherosclerosis Risk in Communities Study.

Neuroimaging correlates of remote traumatic brain injury (TBI) are not well understood. Our objective was to examine associations of TBI with brain MRI markers of degeneration and vascular disease. We performed a cross-sectional analysis using data from a subset of participants who underwent a 3T brain MRI during the fifth Atherosclerosis Risk in Communities Study visit in 2011-2013. Prior TBI and age at first TBI (<18 years, 18-65 years, >65 years) was defined using self-report and International Classification of Diseases, Ninth Edition code data. We examined the following brain MRI metrics: presence of infarcts and microhemorrhages, white matter hyperintensity (WMH) volume, and the distribution of the number of regions of interest (ROIs) below a z-score cut-point of -1.5 for volumetrics, cortical thickness, and fractional anisotropy (FA) and above +1.5 for mean diffusivity (MD). A total of 1,642 participants were included (mean age 76.8 ± 5.32 years, 61.0% female, 28.3% self-reported Black race, and 25.5% with a history of TBI [median time between first TBI and MRI: 38.2 years]). There was no evidence of differences in vascular imaging findings by overall TBI status, but individuals who sustained their first TBI at age <18 years had higher WMH volume (adjusted β = 0.22 mm3, 95% CI 0.00-0.43) and individuals who sustained their first TBI at age >65 years were more likely to have subcortical microhemorrhages (adjusted OR 1.69, 95% CI 1.03-2.75) compared with individuals without TBI. Compared with individuals without TBI, individuals with a history of TBI had a greater number of ROIs beyond the z-score cut-point for all metrics (smaller volumes, lower cortical thickness, lower FA, and higher MD). These findings were consistent among participants with first TBI sustained at age >65 years old, whereas participants with first TBI sustained at age <18 years old had a greater number of regions beyond the z-score cut-point only for FA and MD. In this community-dwelling cohort of older adults, TBI was associated with smaller brain volumes, lower cortical thickness, lower FA, and higher MD. Further work is needed in the chronic postinjury period to elucidate the mechanisms underlying the observed structural changes after TBI.

Abstract 4969: Ethnic disparities in breast and cervical cancer screening in Guam: a cross-sectional analysis (2012-2022)

Background: In Guam, breast and cervical cancer late-stage diagnoses and mortality rates exceed U.S. averages. From 2013-2017, 30.7% of breast and 28.6% of cervical cancers were diagnosed late. Micronesians had the highest late-stage breast cancer rate (59.1%); Filipinos had the highest for cervical cancer (33.3%). Breast cancer mortality was 27.3 per 100,000 in Guam vs. 20.3 in the U.S., with Micronesians at 104.6. Cervical cancer mortality was 6.7 in Guam vs. 2.3 in the U.S., with Micronesians at 22.3. Methods: A cross-sectional study analyzed 6,625 female adults from Guam using Behavioral Risk Factors Surveillance System data from 2012 to 2022. We examined current mammogram screenings for women aged 40 and older and Pap tests for women aged 21 to 65. Binary logistic regression models assessed trends and associations, adjusting for age, education, income, and survey year. Results: Overall, 64.4% of women ≥40 were current with mammograms, and 67.7% of women aged 21 to 65 had recent Pap tests. White women had the highest screening rates (70.7% for mammograms; 79.7% for Pap tests), while Micronesian had the lowest (44.2% for mammograms; 49.1% for Pap tests). Mammogram rates increased by 1.4% bi-annually, with the highest increases among Filipino (2.9%) and White (1.3%) women, but declined among Micronesians (-0.8%). Pap test rates declined slightly (-0.3%), with CHamoru women having the biggest decrease (-2.1%). Despite Micronesian women having the largest increase in Pap test rates (3.7%), their screening rates (54.1%) remained significantly below the overall rate (68%). Adjusted odds ratios showed higher mammogram screening among Asians (OR = 1.3; 95% CI: 1.1-1.6) and lower among Micronesians (OR = 0.6; 95% CI: 0.6-0.8) compared to White women. Age groups 50-59 (OR = 2.2; 95% CI: 2.0-2.6), 60-69 (OR = 2.8; 95% CI: 2.6-3.0), and 70+ (OR = 2.0; 95% CI: 1.8-2.2) had higher odds than ages 40-49. Higher education and income levels were associated with increased screening. For Pap tests, Filipinos (OR = 0.6, 95% CI: 0.6-0.7), Asians (OR = 0.7, 95% CI: 0.6-0.8), and Micronesians (OR = 0.5, 95% CI: 0.5-0.6) had lower odds compared to White women. Age group 60-69 had lower odds (OR = 0.6; 95% CI: 0.5-0.7) compared to ages 18-29. Higher education and income were also associated with increased Pap test screening. Conclusion: Despite some improvements, Guam’s cancer screening rates remain below U.S. medians. Significant ethnic disparities exist, especially among Micronesian and CHamoru populations. Targeted interventions are needed to improve screening rates and reduce late-stage cancer diagnoses among these groups. Acknowledgement: This research was funded by the National Cancer Institute: The University of Guam/University of Hawaii Cancer Center Partnership to Advance Cancer Health Equity (PIPCHE), Grant U54CA143728 (University of Guam, YCP)/Grant U54CA143727 (University of Hawaii Cancer Center). Citation Format: Aurienne Cruz, Grazyna Badowski, Grace Garces Bordallo. Ethnic disparities in breast and cervical cancer screening in Guam: a cross-sectional analysis (2012-2022) [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4969.

Neighbourhood exposure to fast-food and sit-down restaurants and estimated 24-hour urinary sodium excretion: A cross-sectional analysis of urban adults from the ORISCAV-LUX 2 study.

Increased out-of-home consumption may elevate sodium (Na) intake, but self-reported dietary assessments limit evidence. This study explored associations between neighbourhood exposure to fast-food and sit-down restaurants and estimated 24-hour urinary Na excretion. A cross-sectional analysis from the ORISCAV-LUX 2 study (2016-2017). 24-hour urinary Na was estimated from a morning spot urine sample using the INTERSALT formula. Spatial access to fast-food and sit-down restaurants was derived from GIS data around participants' addresses within 800-m and 1000-meter road-network buffers by summing up the inverse of the road-network distance between their residential address and all restaurants within the corresponding buffer size. Multi-adjusted linear models were used to assess the association between spatial access to restaurants and estimated 24-hour urinary Na excretion. Luxembourg. Urban adults age over 18 years (n=464). Fast-food and sit-down restaurants accounted for 58.5% of total food outlets. Mean 24-hour urinary Na excretion was 3564 mg/d for men and 2493 mg/d for women. Health-conscious eating habits moderated associations between spatial access to fast-food and sit-down restaurants and Na excretion. For participants who did not attach great importance to having a balanced diet, greater spatial access to restaurants, combining both density and accessibility, was associated with increased urinary Na excretion at 800 m (βhighvslow = 259, 95% CI: 47-488) and 1000 m (βhighvslow = 270, 95% CI: 21-520). Neighbourhood exposure to fast-food and sit-down restaurants influences sodium intake, especially among individuals with less health-conscious eating habits, potentially exacerbating diet-related health disparities.

The association between pulse wave velocity and cerebrospinal fluid biomarkers for Alzheimer's disease.

We examined the association between arterial stiffness using non-invasive pulse wave velocity (PWV) and cerebrospinal fluid (CSF) Alzheimer's disease (AD) biomarkers. We conducted a cross-sectional multivariate logistic regression analysis using established cut-off values for PWV and CSF biomarkers. Of the 739 participants, 69% were female, 84% were White, 12% were Black, and the mean age was 62. After adjustment for potential confounders, participants with high PWV had 94% (OR = 1.94, 95% CI 1.20-3.20) greater odds of AD biomarker positivity for tTau/Aβ42 and 108% (OR = 2.08, 95% Cl, 1.27-3.46) for pTau181/Aβ42. Our results suggest that higher arterial stiffness is associated with AD CSF biomarker positivity.

Abstract 4903: Short chain per- and polyfluoroalkyl substances associate with elevated alanine aminotransferase: cross-sectional analysis results from the STRIVE cohort

Abstract Background: Although long chain, high molecular weight per- and polyfluoroalkyl substances (PFAS) (≥8 and ≥6 carbons for carboxylic and sulfonic acids; molecular weight &amp;gt;400 g/mol) have been associated with elevated ALT, the association of short chain, low molecular weight PFAS with elevated ALT or cirrhosis, a risk factor for hepatocellular carcinoma, remains unclear. Objectives: To examine associations of short or long chain PFAS mixtures with elevated ALT or cirrhosis and baseline factors related to PFAS. Methods: We included 349 adults aged 40-75 years from the Southern Liver Health Study (STRIVE), an ongoing longitudinal observational study. At enrollment, 135 out of 196 participants had a confirmed diagnosis of cirrhosis. We used logistic regression to examine associations between individual PFAS serum levels and elevated ALT or cirrhosis, at baseline. Quantile g-computation was used to test the associations of short or long chain PFAS mixtures with the outcomes. Linear regression examined baseline factors associated with PFAS. Results: Increasing all short chain PFAS by one quartile was associated with higher odds of elevated ALT (odds ratio: 2.20 [1.32-3.67]); no association was observed with the long chain PFAS mixture. Perfluoroheptanoate, a short-chain PFAS, was associated with both elevated ALT and cirrhosis (odds ratios: 1.53 [1.01-2.33]; 1.51 [1.01-2.27], respectively) at unadjusted P. Long chain PFAS were higher in males and linked to higher reported levels of alcohol consumption. Both long and short chain PFAS were lower in bottled water users, non-water drinkers, and current smokers compared. Perfluoropentanoic acid, a short chain PFAS, was higher in females. Conclusions: In the STRIVE cohort, higher short-chain PFAS mixture concentrations were significantly associated with elevated ALT and varied by sex and lifestyle behaviors. Citation Format: Bojung Seo, Hongxu Wang, Rachel Maguire, Yukun Liu, Beatrice Smith, Kristin Haller, David Conti, Heinz-Josef Lenz, Antonio Planchart, Giorgio Roccaro, Lesley S. Miller, Andrew Muir, Susan K. Murphy, Andrew Moon, Melissa Troester, Cynthia A. Moylan, Joellen Schildkraut, Cathrine Hoyo, Jesse A. Goodrich. Short chain per- and polyfluoroalkyl substances associate with elevated alanine aminotransferase: cross-sectional analysis results from the STRIVE cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4903.

Prevalence and molecular epidemiology of the novel equine parasite Theileria haneyi in China.

Equine piroplasmosis (EP), caused by Theileria equi (T. equi) and Babesia caballi (B. caballi), is a tick-borne disease with significant economic impacts on the equine industry. Theileria haneyi (T. haneyi), a newly identified pathogen of EP, is globally distributed but has not been reported in China, where its epidemiological patterns remain undefined. To develop diagnostic techniques for T. haneyi and to assess its prevalence and risk factors in China. Assay development and cross sectional survey. A nested PCR (nPCR) nucleic acid diagnostic technique targeting the chromosome 1 single-copy (chr1sco) open reading frame (ORF) was developed. This method was applied to 1318 equine nucleic acid samples. Additionally, an iELISA serological diagnostic method was established based on the EMA11 gene. This method was utilised in a cross-sectional analysis of 2627 equine samples. Logistic regression analysis was performed to identify significant risk factors. The nPCR assay showed an 11.76% positive detection rate, while iELISA indicated a 16.41% seroprevalence. Both assays were successfully applied for the epidemiological investigation of T. haneyi. Logistic regression analysis identified host species, age, altitude, soil type, and forest and grassland coverage as the main risk factors influencing seropositivity. Phylogenetic analysis of 18S rRNA from 29 positive samples confirmed the presence of T. haneyi in China. Data on clinical signs were not collected. The logistic regression model's performance metrics were not calculated. This study provides the first evidence of T. haneyi infection in China and establishes a scientific basis for understanding its prevalence and geographical distribution.

Abstract 2264: Disparities in perceptions and uptake of genetic testing among the United States population: trends from 2011-2022

Background: Over the last decade, genetic testing has become more readily available, but it is not known whether this has translated to greater public awareness and usage over time. We aimed to evaluate patterns and temporal trends in genetic testing awareness and usage, along with their sociodemographic and cancer history correlates, in the United States (US) population. Methods: We performed a serial, cross-sectional analysis of nationally representative data from the National Cancer Institute’s Health Information National Trends Survey (HINTS). We analyzed survey responses from adults aged 18 or older from HINTS 4 Cycle 1 (2011), 4 Cycle 2 (2012), 4 Cycle 3 (2013), 4 Cycle 4 (2014), 5 Cycle 1 (2017), 5 Cycle 4 (2020), 6 (2022). Crude linear trend was evaluated using a linear regression model and multivariable logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CIs). Results: Data on 22,256 individuals (mean [SD] age, 46.7 [17.0] years; 13,208 (50.7%) female; non-Hispanic White 13,559 (65.2%)) were analyzed from 2011-2022 HINTS data. Awareness of genetic testing increased from 36.6% in 2011 to 81.7% in 2022 (p&amp;lt;0.001). Older adults, men, non-Hispanic Black individuals, non-Hispanic Asian individuals, Hispanic individuals, those with an education level less than some college, and individuals with annual household incomes less than $75,000 were significantly less likely to be aware of genetic testing. Uptake of genetic testing, however, lagged behind awareness with rates of 21.4% in 2020 and 35.6% in 2022. Uptake of genetic testing was significantly lower among non-Hispanic Asian individuals, those with household incomes under $35,000, and those without a personal history of cancer. Conclusion: Despite high levels of awareness, genetic testing uptake remains disproportionately low, with notable disparities across sociodemographic groups. Targeted educational interventions focused on genetic testing are necessary for marginalized populations and the providers caring for them. Further study is needed to understand genetic testing uptake patterns in the US. Citation Format: Ariana Naaseh, Mengyao Shi, Steven Tohmasi, Erin L. Linnenbringer, Julie A. Margenthaler, Graham A. Colditz, Yin Cao. Disparities in perceptions and uptake of genetic testing among the United States population: trends from 2011-2022 [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 2264.

Validation of an Adaptive Assessment of Executive Functions (Adaptive Cognitive Evaluation-Explorer): Longitudinal and Cross-Sectional Analyses of Cognitive Task Performance

Background Executive functions (EFs) predict positive life outcomes and educational attainment. Consequently, it is imperative that our measures of EF constructs are both reliable and valid, with advantages for research tools that offer efficiency and remote capabilities. Objective The objective of this study was to evaluate reliability and validity evidence for a mobile, adaptive measure of EFs called Adaptive Cognitive Evaluation-Explorer (ACE-X). Methods We collected data from 2 cohorts of participants: a test-retest sample (N=246, age: mean 35.75, SD 11.74 y) to assess consistency of ACE-X task performance over repeated administrations and a validation sample involving child or adolescent (5436/6052, 89.82%; age: mean 12.78, SD 1.60 years) and adult participants (484/6052, 8%; age: mean 38.11, SD 14.96 years) to examine consistency of metrics, internal structures, and invariance of ACE-X task performance. A subset of participants (132/6052, 2.18%; age: mean 37.04, SD 13.23 years) also completed a similar set of cognitive tasks using the Inquisit platform to assess the concurrent validity of ACE-X. Results Intraclass correlation coefficients revealed most ACE-X tasks were moderately to very reliable across repeated assessments (intraclass correlation coefficient=0.45-0.79; P&lt;.001). Moreover, in comparisons of internal structures of ACE-X task performance, model fit indices suggested that a network model based on partial correlations was the best fit to the data (χ228=40.13; P=.06; comparative fit index=0.99; root mean square error of approximation=0.03, 90% CI 0.00-0.05; Bayesian information criterion=5075.87; Akaike information criterion=4917.71) and that network edge weights are invariant across both younger and older adult participants. A Spinglass community detection algorithm suggested ACE-X task performance can be described by 3 communities (selected in 85% of replications): set reconfiguration, attentional control, and interference resolution. On the other hand, Pearson correlation coefficients indicated mixed results for the concurrent validity comparisons between ACE-X and Inquisit (r=–.05-.62, P&lt;.001-.76). Conclusions These findings suggest that ACE-X is a reliable and valid research tool for understanding EFs and their relations to outcome measures.

Abstract 4110: Non-classical HLA epigenetic biomarkers associated with concordant cervical and oral HPV infection

Background: Human papillomavirus (HPV) is prevalent in mucocutaneous surfaces, with the persistence of infections causing approximately 5% of human cancers. While HPV presence at one site increases the risk at others and, possibly, increases the risk of cancer(s) in other anatomical sites, this risk varies among individuals despite similar sexual behaviors. Identifying women with high-risk cervical HPV who are also at risk for high-risk oral HPV could help reduce HPV-associated cancers. This study aims to identify methylation biomarkers explaining the risk of concordant high-risk oral HPV in women with cervical high-risk HPV infections. Methods: As part of the Sexual Behavior and HPV Infections in Nigerians in Ibadan study, we conducted a cross-sectional analysis of sexually active women aged 18-45 years in Ibadan, Nigeria. Participants had interviews and clinical examinations and provided oral rinse and cervical swab samples. DNA was extracted and genotyped for HPV using the Anyplex™ II HPV28 assay. An epigenome-wide association study compared DNA methylation patterns between women with high-risk HPV types 16, 18, or 35 detected in both oral and cervical samples (concordant group) and those with high-risk HPV only in cervical samples (control group), matched by age, sexual behaviors, and lifestyle factors. Genome-wide DNA methylation profiling was performed on both sample types (total n=32) using the Infinium Methylation EPIC v2.0 BeadChip. Results: We identified 61 differentially methylated CpG sites in the concordant group, with consistent associations in both cervical and oral samples (Pearson's r = 0.91, p&amp;lt;0.001). Notably, cg11201654 in the promoter region of a non-classical human leukocyte antigen (HLA) gene, HLA-F, was one of the top significant CpGs and showed approximately two-fold hypermethylation in the concordant group in cervical (p = 0.00080) and oral samples (p = 0.00005). Similarly, cg27020253 in the promoter of another non-classical HLA gene, HLA-L, exhibited ∼1.7-fold hypermethylation in both cervical (p = 0.00039) and oral samples (p = 0.00025). These epigenetic modifications suggest that HPV may facilitate immune evasion and persistent infection by suppressing non-classical HLA genes, which are known for modulating immune responses through interactions with natural killer cells. Conclusion: Hypermethylation of non-classical HLA genes may serve as novel biomarkers for identifying women at elevated risk for persistent high-risk HPV infections and related malignancies, offering insights into HPV-mediated immune evasion mechanisms. The consistent methylation patterns across oral and cervical tissues highlight the capacity of HPV to broadly influence host gene regulation. These epigenetic biomarkers could have applications in broader contexts of immunogenetics and cancer risk prediction, potentially refining the stratification of high-risk women. Citation Format: Yinan Zheng, Imran Morhason-Bello, Yishu Qu, Jun Wang, Adeola Fowotade, Adekunle Daniel, Akinyele Adisa, Olutosin Awolude, John Ogunbiyi, Miquel Pavon, Robert Murphy, Isaac Adewole, Deborah Watson-Jones, Lifang Hou. Non-classical HLA epigenetic biomarkers associated with concordant cervical and oral HPV infection [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4110.

Pooled prevalence and factors of low birth weight among newborns in the top 20 countries with the highest infant mortality: analysis of recent demographic and health surveys

ObjectiveThis study aimed to assess the pooled prevalence and factors of low birth weight among newborns in the top 20 countries with the highest infant mortality rates.DesignWe conducted a community-based...

Abstract 4939: Social determinants disadvantage score and risk of liver cancer in the All of Us Research Program

Abstract Background: Social determinants of health (SDOH) are crucial in shaping health outcomes, yet comprehensive studies that span all key SDOH domains (economic stability, education, healthcare access and quality, neighborhood and built environment, and social and community context) to examine their associations with liver cancer risk are sparse. We developed and validated a Social Determinants Disadvantage Score (SDDS) to address this knowledge gap. Methods: We conducted a cross-sectional analysis of 117, 783 participants from the All of Us Research Program. The SDDS was systematically constructed using validated questionnaires covering five domains recognized by the World Health Organization and U.S. Department of Health and Human Services. Each domain was dichotomized into advantage (0) or disadvantage (1), with the SDDS ranging from 0 to 5. Prevalent liver cancer, especially hepatocellular carcinoma (HCC), was identified by the Electronic Health Record. We used logistic regression models to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for the associations of SDDS with HCC, adjusting for age, sex, race, ethnicity, birthplace, marital status, smoking status, and alcohol intake. Results: We identified 110 HCC cases in the participants who completed the SDOH questionnaires. Disadvantage in SDOH, as assessed by higher SDDS, was associated with a higher risk of HCC. Per unit increase in SDDS, the adjusted OR (95% CI) was 1.21 (1.02, 1.43) for HCC. The OR was 5.62 (1.95, 16.22) comparing the most disadvantaged to the most advantaged SDDS group. Strongest associations were observed for disadvantage in economic stability (OR = 2.37; 95% CI = 1.22, 4.63) and education (OR = 1.87; 95% CI = 1.08, 3.24). Conclusion: The SDDS provides a comprehensive, validated tool for assessing SDOH. Our findings highlight significant associations between social disadvantage and HCC prevalence, emphasizing the need for future longitudinal studies to inform targeted interventions. Citation Format: Xinyuan (Cindy) Zhang, Longgang Zhao, David Vlahov, Yun Chen, Tamar Taddei, Xuehong Zhang. Social determinants disadvantage score and risk of liver cancer in the All of Us Research Program [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2025; Part 1 (Regular Abstracts); 2025 Apr 25-30; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2025;85(8_Suppl_1):Abstract nr 4939.

Exploring the link between Grahanidosha, and Chronic Neck and Back Pain: A Cross-Sectional Study

Introduction: Chronic back pain is a significant public health issue, often leading to work absenteeism. Traditional treatments may not fully address the root causes, particularly the role of gut health in chronic pain. This study explores the association between grahaṇīdōṣaḥ, a digestive dysfunction concept in Ayurveda, and chronic neck and back pain. Methodology: A cross-sectional analysis was conducted at VPSV Ayurveda College Hospital involving 164 patients with chronic neck and back pain. The study used a newly validated assessment tool to identify grahaṇīdōṣaḥ, examining its prevalence and association with pain. Inclusion criteria were patients aged 20-45 with pain persisting for over three months, excluding those with traumatic, infective, or malignant causes. Results: The study revealed a significant association between grahaṇīdōṣaḥ and chronic pain. Notably, 109 out of 164 patients exhibited features of grahaṇīdōṣaḥ. Statistical analysis showed a strong correlation between digestive dysfunctions and pain sites, particularly low back pain and cervical pain with gastrointestinal symptoms like indigestion and constipation. Discussion: The findings suggest that underlying digestive issues, as conceptualized in Ayurveda, play a crucial role in chronic neck and back pain. Addressing grahaṇīdōṣaḥ could lead to more effective and holistic pain management strategies, integrating both Ayurvedic and modern medical approaches. Conclusion: This study underscores the potential association between grahaṇīdōṣaḥ and chronic pain pathologies. Further research should explore the clinical efficacy of integrating these traditional Ayurvedic concepts with conventional treatments to develop a comprehensive approach to pain management.

Polypharmacy and Mild Cognitive Impairment in Older Adults: A 3-year Study of DO-HEALTH.

Polypharmacy and Mild Cognitive Impairment in Older Adults: A 3-year Study of DO-HEALTH.

Barriers to Healthy Eating Among University Students

ABSTRACT This research explores the healthy eating habits of university students and the obstacles they face in maintaining these habits. The study was conducted as a cross-sectional analysis at a university. The findings indicate an increase in fast food, packaged products, and tea or coffee consumption, while fish consumption decreased. Major obstacles to healthy eating included heavy coursework (69.2%), limited access to healthy food in or around university cafeterias (67%), high costs (50.6%), short shelf life of healthy foods (52.1%), and inadequate kitchen equipment (50.6%). Academic demands, time constraints, access issues, costs, and kitchen equipment deficiencies were identified as significant barriers.

From genes to clinic: Genomic and cross-sectional cohort analysis of oxidative stressors and lipid metabolism in European ancestry.

From genes to clinic: Genomic and cross-sectional cohort analysis of oxidative stressors and lipid metabolism in European ancestry.

Native T1 mapping times are strongly influenced by elite athlete status.

Limited data indicates that athletes' hearts demonstrate decreased native T1, but this assertion has not been replicated in large cohorts of extreme phenotypes of elite athletes. Therefore, we investigated differences in native T1 between elite athletes and healthy non-athletic controls. Cross-sectional analysis comparing native T1 between elite athletes (≥ 16 years; ≥ 10 hours of exercise/week) and age-matched healthy non-athletic controls. All participants underwent cardiovascular magnetic resonance imaging on a 1.5 tesla MRI machine. We included 240 elite athletes (50% women; age 28 [25 - 32] years) and 80 non-athlete healthy controls (50% women; age 28 [23-39] years). Elite athletes demonstrated lower native T1 than non-athlete healthy controls (960 ±21 ms vs 983 ±26 ms, p < .001), also when stratified by sex (male athletes vs. controls 953 ms ±19 vs. 968 ms ±16, p < .001; female athletes vs. controls 968 ms ±20 vs. 999 ms ±25, p < .001). Multivariate linear regression identified elite athlete status (β = -13.34, p < .001), heart rate (β = 0.6, p < .001), average left-ventricular wall thickness (β = -8.28, p < .001) and native blood pool T1 (β = 0.09, p < .001) as independent determinants of native T1 (adjusted R2 = 51.4%, p < .001). Elite athletes have lower native T1 compared to non-athletes, both in women and men. Athlete- and sex-specific reference ranges should be applied when interpreting native T1 in athlete populations, especially in female athletes.

Interaction of Genetics and Dietary Patterns Scored by the High Healthy Eating Index in Hyperhomocysteinaemia Influencing Cardiovascular Disease Risk.

Hyperhomocysteinaemia has been associated with increased cardiovascular disease (CVD) risk, but the complex interplay between genetic determinants and modifiable lifestyle factors in modulating homocysteine (HC) levels remains incompletely understood. We aimed to investigate the aetiology of hyperhomocysteinaemia by examining the interactions between genetic predisposition, dietary patterns and other lifestyle factors and their potential associations with metabolic syndrome (MetS) and CVD risk. Cross-sectional analysis from the Korean Genome and Epidemiology Study, a hospital-based cohort conducted by the Korean Centers for Disease Control and Prevention from 2012 to 2016. Korean adults (n = 62 743, aged 40-79 years) were categorised into Low-HC (n = 53 450) and High-HC (n = 9293) groups based on a 15 μM serum homocysteine cutoff. Demographic, anthropometric and biochemical data were analysed. Genome-wide association and gene-environment interaction models explored genetic variants influencing hyperhomocysteinaemia and their interplay with lifestyle factors, including nutrient intake. Multivariable logistic regression assessed associations between hyperhomocysteinaemia and metabolic/CVD risks, adjusting for covariates. Genetic variant-environment interaction analyses identified genetic determinants and their interactions with diet/lifestyle. The High-HC group exhibited an elevated MetS risk. Hyperhomocysteinaemia was correlated with liver damage, inflammation and CVD risks. Low vitamin B12 intake (< 5.4 μg/day) showed a stronger association with hyperhomocysteinaemia than low folate intake (< 350 μg/day), with combined deficiencies exacerbating hyperhomocysteinaemia. An inverse relationship was observed between hyperhomocysteinaemia and healthy eating indices like Asian balanced and plant-based diets. Variants in MTHFR, NOX4, PLOD1, MIIP, PAX6 and CBS genes, involved in methionine/cysteine metabolism, exhibited differential expression in skeletal muscle, liver and adipose tissues. High polygenic risk scores interacted with poor diet quality, excess energy intake, a high glycemic index, smoking and heavy alcohol consumption to contribute to hyperhomocysteinaemia. In conclusion, these findings elucidate the complex interplay between genetics, diet and lifestyle in modulating homocysteine levels, providing insights for personalised nutrition strategies to mitigate CVD risk.

Regulatory Alignment of Psilocybin Clinical Trials in Major Depressive Disorder on ClinicalTrials.gov: A Cross-Sectional Analysis.

Regulatory compliance is crucial in the clinical development of psychedelic substances, including psilocybin. This study aimed to examine the alignment of clinical trial protocols for psilocybin in the treatment of major depressive disorder (MDD) and treatment-resistant depression (TRD) with established regulatory requirements.A cross-sectional investigation was conducted on ClinicalTrials.gov using the keywords: "Psilocybin" and "Psilocin" to identify interventional studies with posted trial protocols. Only protocols for MDD and TRD were included. Data extraction focused on key regulatory aspects, including safety, functional unblinding, expectancy bias, and the distribution of investigational medical products.Eleven psilocybin trial protocols were identified, with four meeting the inclusion criteria. The most commonly studied psilocybin dose was 25 mg. Two trials were double-blind. Although the analyzed protocols superficially adhered to regulatory requirements, there were gaps in addressing potential drug interactions, the acute and chronic concurrent use of antidepressants, and prohibited medications. Certain aspects, such as functional unblinding or expectancy bias, did not share all pathways. Risk mitigation strategies were primarily based on external criteria. Patients with bipolar spectrum disorders or schizoaffective disorders were excluded.This study underscores the importance of conducting clinical trials on psychedelics in strict adherence to regulatory standards. Future research should focus on improving regulatory compliance and exploring the efficacy of psychedelics in broader patient populations.

The Potential Role of Ecotoxicological Data in National Essential Medicine Lists: A Cross-Sectional Analysis

Background: Medicines affect the environment throughout their lifecycle, from production and distribution to use and disposal. They contribute to the pollution of air, water, and soil, impacting ecosystems and human health. Recognizing these risks, regulatory bodies and organizations have highlighted pharmaceutical pollution as a global concern, emphasizing the need for environmental risk assessments and sustainable practices. Methods: This study reviewed the essential medicines lists (EMLs) from 158 countries and examined the available ecotoxicological data. Medicines with high bioaccumulation, persistence, and toxicity were identified and cross-referenced with their inclusion in EMLs. Additionally, we analyzed the presence of alternative medicines with similar therapeutic effects but potentially lower environmental risks. Results: Five medicines—ciprofloxacin, ethinylestradiol, levonorgestrel, ibuprofen, and sertraline—were selected as illustrative examples due to their high environmental persistence and toxicity. All were listed in the 2023 WHO model list, with ciprofloxacin appearing in 94.3% of national EMLs. Conclusions: This study underscores the limited availability of ecotoxicological data, which hinders environmental risk assessment for medicines. EMLs could serve as a tool to enhance the awareness and data mobilization of pharmaceutical pollution. Incorporating environmental criteria into EMLs could support more sustainable medicine selection and regulatory practices.