In the US, breast cancer mortality is lower among Asian American females diagnosed with breast cancer compared with other racial and ethnic groups, although reasons for this difference are not well understood. To examine contributions of clinical, lifestyle, and sociodemographic factors to mortality differences among females identifying as Asian races and ethnicities compared with non-Latina White females and whether associations vary by nativity. This cohort study analyzed time-to-event survival data from Asian and White females with breast cancer from 4 epidemiologic studies. Cohorts were recruited from California and Hawaii, with information from questionnaires and cancer registries. Participants were females with first primary invasive breast cancer diagnosed from 1992 to 2019 who self-identified as Asian and females who self-identified as White as a comparison group. Analyses were conducted from February 2024 to February 2026. Self-reported race and ethnicity, nativity, clinical factors (eg, stage and tumor grade), marital status, educational level, reproductive factors, insurance status, lifestyle factors (eg, smoking and alcohol use), diabetes, and neighborhood socioeconomic indicators. The outcomes of interest were all-cause and breast cancer-specific mortality. Cox proportional hazards models were used to estimate hazard ratios (HRs) comparing each Asian group with White females, and changes in these estimates with adjustment for various prognostic factors. A total of 8994 females (mean [SD] age at diagnosis, 59 [13] years), including 3973 Asian females and 5021 White females, were analyzed. There were 2637 total deaths and 1140 deaths attributed to breast cancer (mean follow-up time 12.6 years; range, 1 month to 28 years). Most Asian groups had a higher proportion diagnosed before age 50 years compared with White females: from 34% among Filipinas to 73% among another Asian group vs 15% among White females. Nearly all Asian ethnic groups had lower proportions (45%-67%) of localized stage disease relative to White females (69%). Relative to White females, risk of all-cause mortality in fully adjusted models was lower for Chinese females (HR, 0.77; 95% CI, 0.62-0.96), Filipina females (HR, 0.81; 95% CI, 0.67-0.99), Japanese females (HR, 0.71; 95% CI, 0.54-0.93), and Asian females identifying as multiple races or ethnicities, not Native Hawaiian or Pacific Islander (HR, 0.67; 95% CI, 0.51-0.89). Lower adjusted risk of all-cause mortality was observed for Chinese (HR, 0.73; 95% CI, 0.57-0.94) and Filipina (HR, 0.79; 95% CI, 0.63-0.94) females born outside the US and Japanese females (HR, 0.63; 95% CI, 0.45-0.90) and Asian females with multiple races or ethnicities, not Native Hawaiian or Pacific Islander (HR, 0.59; 95% CI, 0.39-0.88) born in the US compared with White females. In this pooled cohort study of females with breast cancer, several Asian groups had lower risk of all-cause mortality, even after accounting for clinical, sociodemographic, reproductive, lifestyle, and neighborhood factors. Identification of the specific resiliency factors will provide insights into mechanisms that may improve survival after breast cancer.

This study aimed to examine the associations between lifestyle factors and concentrations of cadmium (Cd) and nickel (Ni) in seminal fluid (SF) of potential sperm donors, and to determine whether these metals are related to donor qualification status. Between 2015 and 2021, 206 healthy men aged 18–40 were screened as potential sperm donors at reproductive centres in Moravia, Czech Republic. Respondents completed a lifestyle questionnaire covering diet, sedentary behaviour, physical activity, sleep, substance usage, and psychological well-being. Initial semen analysis determined their qualification as donors. Seminal Cd and Ni levels were measured by high-resolution continuum source electrothermal atomic absorption spectrometry (HR-CS ETAAS). Non-parametric methods were used for statistical evaluation. Elevated Cd concentrations were significantly associated with smoking (P = 0.008), fish (P = 0.024) and confectionery consumption, uninterrupted sedentary time (P = 0.017), lower psychological well-being (P = 0.024), and sleep duration. Higher fruit (P = 0.040) and vegetable (P = 0.015) intake resulted in increased seminal Ni concentrations, but without direct association to qualification status. Increased Cd levels were also associated with a bigger size of the settlement (P = 0.012). Notably, Cd levels were significantly increased among non-qualified donors (P = 0.002), while no such pattern was observed for Ni. No direct significant differences in lifestyle factors were shown between qualified and non-qualified donors. These findings highlight associations between lifestyle factors and seminal Cd levels in potential sperm donors, providing new insights into the role of trace elements in male reproductive health.

Systemic C-reactive protein and vitamin D are not associated with development of chronic musculoskeletal pain over a 2-7 year follow-up period.

Inflammation-related biomarkers have been implicated in a wide range of cancer-related symptoms and patient-reported outcomes (PROs), including fatigue, pain, and depression. To interpret biomarker data among cancer patients, normative reference values from healthy populations are essential. This cross-sectional study aimed to provide sex- and age-stratified reference data distributions for 12 inflammation-related serum biomarkers in a representative sample of Dutch adults without a history of cancer. Adults from the LISS panel were selected to match cancer cohorts from the PROFILES registry in age and sex. Participants completed questionnaires and optionally provided blood samples using harmonized protocols aligned with the PROFILES registry. Serum levels of IL-1α, IL-1β, IL-6, IL-8, IL-10, IL-17A, IL-22, CRP, TGF-α, IFN-γ, IL-1RA, and soluble TNF receptors I and II (sTNFRI/II) were quantified using the Meso Scale Discovery (MSD) platform. Cytokine levels were stratified by demographics, lifestyle factors, and self-reported health conditions. ANOVAs were used to compare groups. In total 720 panel members filled out the questionnaires, of which 265 (mean age = 59.0, 47.9% male) provided additional serum blood samples. Biomarker levels varied by sex, age, BMI, smoking status, and number of health conditions. Notably, higher levels of IL-1RA and sTNFRI/II were observed in individuals with obesity or diabetes. Individuals with osteoarthritis exhibited elevated IL-6 and IL-1β levels. This study offers a robust reference dataset for key inflammatory biomarkers, stratified by relevant demographics, lifestyle factors, and self-reported health conditions. These data facilitate interpretation of biomarker-PRO relationships in cancer survivors and support comparative research across chronic disease populations.

This study examined the association between work intervals and depressive symptoms among daytime workers, and whether lifestyle behaviors might help explain this association. A cross-sectional analysis was conducted on 8007 daytime workers who participated in a questionnaire survey of the Japan Epidemiology Collaboration on Occupational Health Study. Work intervals-both including and excluding commuting time-were calculated based on the participants' self-reported work departure and arrival times. Depressive symptoms were assessed using the 11-item Center for Epidemiological Studies Depression Scale. Multilevel robust Poisson regression models were used to estimate the prevalence ratio (PR) and 95% confidence interval (CI) for depressive symptoms across work interval categories. Five lifestyle factors (sleep duration, breakfast consumption, dietary balance, dinner timing, and leisure-time physical activity) were examined in a mediation analysis to assess the extent to which they account for the observed association. The adjusted PRs (95% CIs) for depressive symptoms were 1.41 (1.12-1.77), 1.23 (1.12-1.35), 1.03 (0.96-1.11), 1.00 (reference), and 1.08 (1.04-1.12) for those with work intervals of <11.0, 11.0-12.9, 13.0-13.9, 14.0-14.9, and ≥15.0h, respectively. A substantial proportion of the association between shorter work intervals and depressive symptoms was explained by the lifestyle factors examined: 57.9% for <11.0h and 38.9% for 11.0-12.9h. Similar results were obtained when the commuting time was subtracted from the work interval. Shorter work intervals were associated with depressive symptoms, and this association may be partly related to health-related lifestyle factors.

BackgroundAlzheimer's disease (AD) involves interactions among genetic, environmental, and lifestyle factors, yet the contribution of environmental exposures to cognitive decline and biomarker changes remains unclear. Detoxification genes such as EPHX1 may influence susceptibility to environmental neurotoxicants.ObjectiveTo evaluate associations between environmental risk, cognitive outcomes, and AD biomarkers, and to examine potential contributions of detoxification genes.MethodsWe analyzed 5101 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI) across four study phases. Environmental exposure was summarized using a composite Environmental Risk Score (ERS) derived from Rural-Urban Continuum Codes, Rural-Urban Commuting Area codes, Risk-Screening Environmental Indicators, and occupational exposure. Cognitive outcomes included Mini-Mental State Examination, Clinical Dementia Rating, Montreal Cognitive Assessment, Neuropsychological Test Battery, Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and Executive Dysfunction Cognitive Assessment. Biomarkers included PET amyloid/tau, MRI hippocampal volume, and cerebrospinal fluid amyloid-β, tau, and neurofilament light chain. Multivariable regression models adjusted for sociodemographic factors and APOE ε4 carrier status.ResultsERS was significantly associated with CDR (β = -1.13E-07; 95% CI -1.98E-07, -2.75E-08; p = 0.00956) but not with other cognitive measures. EPHX1 showed a significant main effect on ADAS-Cog (β = 0.479; 95% CI 0.0305, 0.927; p = 0.0356). ERS × gene interaction terms were not significant. ERS was not associated with amyloid PET SUVR.ConclusionsEnvironmental risk showed limited associations with AD-related outcomes, while EPHX1 demonstrated a significant main effect on cognitive performance. Longitudinal studies are needed to clarify mechanisms linking environmental exposure and AD.

Evidence linking serum ferritin (SF) with metabolic syndrome (MetS) remains inconsistent by sex. Data from Latin American populations are lacking, and adults free of cardiometabolic disease remain understudied. We examined whether SF was independently associated with MetS (harmonized definition) in adults from Cali, Colombia. In this cross-sectional study of 245 adults (123 women) without type 2 diabetes or cardiovascular disease, SF was the exposure, and outcomes included categorical MetS, a continuous MetS z-score, individual MetS components, and total and LDL cholesterol (LDL-C). Sex-stratified logistic and linear regressions were performed, unadjusted and progressively adjusted for age, lifestyle factors, C-reactive protein, and BMI. MetS prevalence was 24.6% in men and 12.2% in women; overweight/obesity prevalence was 64.1% (men 68.9%, women 59.3%). In men, each 1-SD increase in SF was associated with a higher MetS z-score across models (β [95% CI] 0.82 [0.39–1.26]; p < 0.001), whereas the association with categorical MetS was attenuated after adjustment for C-reactive protein and BMI. In women, SF was not independently associated with MetS. By components, higher SF related to higher fasting glucose and triglycerides in men, and to lower HDL-C in both sexes. SF was associated with LDL-C only in women. In men, SF increased with the number of MetS components, including one or two versus none (p = 0.043). In conclusion, in this Latin American sample free of cardiometabolic disease, SF was positively associated with MetS score in men, but not in women, among whom SF was consistently linked to LDL-C.

Household environmental exposures and postpartum depression: A nationwide prospective birth cohort study.

Association of reproductive lifespan with depression in postmenopausal women from NHANES (2005-2018): A cross-sectional study.

Fatigue is a common long-term complaint in childhood cancer patients and survivors. Treatment of pediatric bone sarcomas is intensive and can lead to physical, functional and psychosocial challenges; however, little is known about fatigue in this group. This study aimed to gain insight into fatigue and related demographic, medical, psychosocial, and lifestyle factors in pediatric bone sarcoma patients and survivors. Patients treated for pediatric bone sarcoma, ≥ 2years post-diagnosis and after completion of treatment with no evidence of disease, completed PedsQL™ Multidimensional Fatigue Scale and PROMIS® fatigue measures. Prevalence and mean scores were compared with Dutch normative data using binomial tests, one-sample t-tests, and ANOVA. Linear regression analyses examined associations of fatigue with demographic and medical factors, psychological difficulties (measured with emotion thermometers), pain (measured with a numeric rating scale), and physical activity (using an accelerometer). In total, 139 patients participated. In children (N = 44), 51.6% (95% CI 34.0-69.2) reported moderate to severe fatigue, significantly higher than the weighted norm (29.8%), while adults (N = 95) (11.5%, 95% CI 4.4-18.6) did not differ from the weighted norm (12.1%). Children scored worse than the norm on all fatigue measures (Cohen's d range = 0.58 to 1.10); adults did not significantly differ. Longer time since end of treatment was associated with less cognitive fatigue. More psychological difficulties and pain were associated with more fatigue, while higher levels of physical activity were associated with less fatigue. Children after pediatric bone sarcoma experience more fatigue than the norm. More psychological difficulties, more pain, and less physical activity are associated with more fatigue. Medical factors are limited to time since end of treatment, where a longer time is associated with less cognitive fatigue. Screening for fatigue and associated factors during treatment and follow-up may help identify and support patients at risk.

The CHRONO trial: Protocol for a randomized controlled trial of early time-restricted eating in patients with breast or rectal cancer.

Delineating key determinants of health-related quality of life (HrQoL) in patients with disorders of the gut-brain-interaction (DGBI) remains challenging due to complex interplay of socioeconomic, psychological, and clinical factors. This exploratory comparative study aimed to identify factors and latent patient-profiles associated with generic and condition-specific HrQoL across different DGBI. Data from 4 clinical patient-cohorts were analyzed, including patients with functional dyspepsia ([FD]; n = 73), fecal incontinence ([FI]; n = 72), and irritable bowel syndrome ([IBS]; n = 419; 2 cohorts). Participants completed questionnaires on gastrointestinal (GI) symptoms, psychological factors, generic HrQoL (EQ-5D-5L), and condition-specific HrQoL. Finite mixture modeling identified latent clusters, and multivariate regression assessed factors associated with HrQoL outcomes. In patients with IBS and FD, higher depression scores and GI symptom severity were significantly associated with lower generic and condition-specific HrQoL (P < .001). In both FI and IBS cohorts, higher anxiety scores were associated with reduced HrQoL. Finite mixture modeling identified distinct latent clusters-2 in FD and FI cohorts, and 3 in IBS cohort-primarily defined by psychological comorbidity. Latent clusters with higher anxiety and depression scores showed markedly lower HrQoL outcomes. In contrast, socioeconomic and lifestyle factors appeared less relevant. There were no significant associations between GI symptom severity and HrQoL in FI. Psychological comorbidity appears the most salient factor associated with HrQoL, which was uniformly seen across different DGBI, whereas GI symptom severity was only associated with HrQoL in patients with FD and patients with IBS, but not in patients with FI. Although causality between psychological factors and HrQoL cannot be ascertained, our findings underscore the importance of holistic DGBI management that extends beyond symptom control to encompass the full spectrum of patient experience.

Obesity is a chronic, biologically defended disease, yet its clinical management continues to be shaped by behavioural paradigms that no longer reflect contemporary science, especially outside specialist services. While lifestyle factors such as dietary patterns, physical inactivity, sleep disruption and other environmental influences contribute to obesity development, they do not fully explain or reverse the neuroendocrine mechanisms that defend elevated adiposity. Although calorie restriction can produce short-term metabolic improvements, including improved insulin resistance, it does not modify the underlying neuroendocrine drivers of adipocyte mass regulation; consequently, exclusive reliance on calorie-restriction-centred models may delay the introduction of mechanism-based treatments and allow obesity-related complications to recur or progress over time. In contrast, modern pharmacotherapies act directly on the regulatory systems governing adipocyte mass and thus affect appetite, energy homeostasis and metabolic adaptation, producing durable improvements across cardiometabolic, hepatic, respiratory and musculoskeletal domains. Safety profiles for obesity medications are well characterised, and for appropriately selected patients the benefit-risk balance is favourable. Prevention efforts remain essential, but no population-level strategy has yet demonstrated sustained impact on obesity prevalence. Conceptual analogies help clarify these distinctions: carrying additional weight, like a heavy backpack, does not in itself constitute a disease and treating established pathology cannot depend on upstream environmental reform, just as anaphylaxis cannot be managed by regulating peanut exposure alone. A therapeutic framework grounded in biological mechanisms rather than behavioural assumptions is now both possible and necessary to close long-standing gaps in obesity care.

Environmental and lifestyle factors affecting nickel concentrations in human colostrum: A cross-sectional study in Poznań, Poland.

Patterns of contraceptive side-effect variation: Assessing medical and lifestyle factors associated with side-effects among those using hormonal contraception in the United Kingdom.

Temporal Knowledge Discovery in Drug-Resistant Tuberculosis: A Decade-Long Machine Learning Analysis From Egyptian Clinical Data.

Dietary patterns have changed significantly over time, with ultra-processed foods now comprising a large proportion of daily energy intake in many countries. Ultra-processed foods (UPFs) contain numerous additives and may also increase exposure to processing- and packaging-related contaminants that could influence immune function. This review summarizes why UPFs have drawn growing attention and evaluates their potential relevance to autoimmune inflammation, with a focus on rheumatoid arthritis (RA) and related disorders. Population studies suggest that higher UPF intake is associated with an increased risk of RA after adjustment for obesity and lifestyle factors. Experimental and translational studies suggest that components common in UPF-rich diets (e.g., emulsifiers, thickeners, synthetic colorants, added sugars, excess sodium, and some nonnutritive sweeteners), as well as microplastic exposures, may disrupt gut barrier integrity, remodel the microbiome, and promote low-grade inflammation. These mechanisms overlap with pathways implicated in RA and systemic inflammation, including dysregulation of Treg/Th17 balance, loss of mucosal tolerance, endotoxemia, and innate immune activation. Overall, evidence supports biologically plausible mechanisms and epidemiologic associations linking UPF-rich dietary patterns to immune dysregulation relevant to rheumatic disease, but direct RA-specific interventional and mechanistic clinical data remain limited. Dietary exposures may represent modifiable risks; however, stronger longitudinal studies with validated RA phenotyping and pragmatic dietary interventions are needed before firm clinical recommendations can be made.

Body composition phenotypes, and specific adiposity and lean mass indicators, and their lifestyle determinants among adult childhood cancer survivors - The iBoneFIT adult study.

Association of walking and osteoporosis risk among 432,493 UK participants: A prospective cohort study.

In the field of male health, disorders of the reproductive and urological systems present significant challenges. The global increase in male infertility, primarily attributed to environmental and lifestyle factors, along with the high incidence of urological cancers, not only places a significant socio-economic burden but also emphasizes the urgent need for in-depth research. Epigenetic modifications, especially N6-methyladenosine (m6A) methylation, are of great importance in these conditions. m6A, which is regulated by specific "writer", "eraser", and "reader" proteins, has an impact on various RNA-related processes. This review summarizes the regulatory functions of m6A in male reproductive health and urological cancers. In male reproduction, it explores how m6A affects somatic cell functions, steroidogenesis, and the blood-testis barrier. It also delves into its role in diabetic erectile dysfunction and benign prostatic hyperplasia. In urological cancers, the review examines m6A's influence on metabolic reprogramming, programmed cell death, and tumor immunity. Furthermore, this review discusses the potential of targeting m6A as a therapeutic approach for these conditions. By integrating recent research findings, it offers new perspectives on the role of m6A in male reproductive and urological disorders, laying a foundation for future research.