Long-term Impact Research Articles

Application and Prognostic Analysis of Vacuum Sealing Drainage in the Incision Infection in Patients With Stage II-III Colorectal Cancer.

This study aims to explore the application value of vacuum sealing drainage (VSD) technology in the treatment of incision infection dehiscence after surgery in patients with stage II-III colorectal cancer and analyze its impact on prognosis. This retrospective study included patients who experienced incision infection dehiscence after surgery for colorectal cancer between February 2014 and August 2019. Clinical and pathological data, short-term outcomes, and long-term outcomes were compared between the traditional group and the VSD group. A total of 97 patients were included in this study. There was no significant difference in clinical and pathological data between the traditional group and the VSD group (P > 0.05). The VSD group had fewer dressing changes, lower pain scores during dressing changes, and better granulation tissue growth grading than the traditional group, with statistical significance (P < 0.05). The VSD group started adjuvant chemotherapy earlier and had a higher proportion of ≥4 cycles of chemotherapy. The three-year overall survival rate in the VSD group was better than the traditional group, but the difference was not statistically significant (P > 0.05). The application of VSD technology can promote granulation tissue growth, accelerate incision healing, and facilitate patients to complete subsequent adjuvant chemotherapy. However, further verification of its long-term impact on prognosis requires longer-term follow-up results.

Empowering neuro-diversity: A neuroaffirmative approach to workplace coaching

This study examines the significance of neuro-affirmative coaching strategies in empowering neurodiverse individuals within workplace environments. Through a review of existing literature, the study aims to identify both the challenges and opportunities inherent in implementing neuro-affirmative coaching interventions. Acknowledging the diverse range of neurodiverse traits, including autism, ADHD, and dyslexia, the study seeks to bridge gaps in understanding and support. The methodological approach involves a narrative review, recognizing its limitations in methodological rigor and generalizability while valuing its capacity to offer valuable insights. The major findings emphases the importance of personalised coaching strategies tailored to the unique strengths and challenges of neurodiverse individuals, promoting self-awareness, self-advocacy, and a sense of belonging in the workplace. Effective approaches such as accommodating communication preferences, providing mentorship, and fostering inclusive environments emerge from the review. However, the study also highlights challenges such as shifting organizational perspectives towards neurodiversity, addressing stigma, and reconciling medical and social models of disability. The main contributes of the study is to the knowledge discipline by emphasizing the importance of embracing neurodiversity and fostering inclusive workplaces, paving the way for future research to explore the effectiveness of specific coaching interventions and their long-term impact on individual and organizational outcomes.

Nature-engagement and wellbeing in Brazil: Understanding the dose-effect relationship for designing urban green spaces

Statement of problemIn the face of increasing urbanization, the pursuit of healthy and sustainable cities promoting a high quality of life intertwined with nature is paramount. PurposeThis research endeavors to assess the impact of variations in nature interaction styles on health, with the objective of generating evidence to inform the design of urban green spaces. MethodEthically approved by the Human Research Ethics Committee (CAAE 58149622.3.0000.0077), a survey involving 2136 respondents was conducted. Participants reported their nature engagement frequency, duration, and intensity, alongside mental health assessments using the Depression, Anxiety, and Stress Scale (DASS-21). Welch's ANOVA and Cohen’s d were employed to derive meaningful effect size. ConclusionsThis research provided empirical insights into the relationship between nature interaction and public health, thus offering evidence to inform urban green space design. Practical implicationsThe findings are expected to empower urban planners and policymakers with evidence-based strategies for creating urban green spaces conducive to physical activities, leisure events, and nature-based recreation, promoting public health through appropriately timed and frequented activities. Future directionsFurther research avenues may include longitudinal studies to assess the long-term impact of nature interaction on mental health and the implementation of evidence-based design strategies in urban green space development.

Long-term impact of nusinersen on motor and electrophysiological outcomes in adolescent and adult spinal muscular atrophy: insights from a multicenter retrospective study.

5q spinal muscular atrophy (SMA) is a progressive autosomal recessive motor neuron disease. We aimed to assess the effects of nusinersen on motor function and electrophysiological parameters in adolescent and adult patients with 5q SMA. Patients with genetically confirmed 5q SMA were eligible for inclusion, and clinical data were collected at baseline (V1), 63days (V4), 180days (V5), and 300days (V6). The efficacy of nusinersen was monitored by encompassing clinical assessments, including the Revised Upper Limb Module (RULM), Hammersmith Functional Motor Scale Expanded (HFMSE), 6-Minute Walk Test (6MWT), and percent-predicted Forced Vital Capacity in sitting position (FVC%) and Compound Muscle Action Potential (CMAP) amplitude. The patients were divided into "sitter" and "walker" subgroups according to motor function status. 54 patients were screened, divided into "sitter" (N = 22) and "walker" (N = 32), with the mean age at baseline of 27.03years (range 13-53years). The HFMSE in the walker subgroup increased significantly from baseline to V4 (mean change +2.32-point, P = 0.004), V5 (+3.09, P = 0.004) and V6 (+4.21, P = 0.005). The patients in both the sitter and walker subgroup had no significant changes in mean RULM between V1 and the following time points. Significant increases in CMAP amplitudes were observed in both upper and lower limbs after treatment. Also, patients with RULM ≥ 36 points showed significant CMAP improvements. Our analysis predicted that patients with CMAP amplitudes of trapezius ≥ 1.76mV were more likely to achieve significant motor function improvements. Nusinersen effectively improves motor function and electrophysiological data in adolescent and adult patients with SMA. This is the first report on the CMAP amplitude changes in the trapezius after treatment in patients with SMA. The CMAP values effectively compensate for the ceiling effect observed in the RULM, suggesting that CMAP could serve as an additional biomarker for evaluating treatment efficacy.

Pemanfaatan Ruang Terbuka Studio Pengembang Media Pembelajaran Sebagai Pusat Inkubasi Batik Berbasis Triplehelix Collaboration Bernilai Income Generating

The use of the open space of the learning media developer studio as a batik incubation center based on the Triple Helix Collaboration with income generating value aims to increase innovation and productivity in the batik industry through collaboration between academics, industry, and the government. This program utilizes the open space of the studio to create an ecosystem that supports the development of skills, creativity, and entrepreneurship in batik production. Various methods are used, including in-depth technical training, creative workshops to encourage innovation, and facilitation of market access to expand the range of batik products. The results of the program show a significant improvement in the technical skills and entrepreneurial capacity of the participants, which contributes to their economic growth and competitiveness. The implementation of the program focuses not only on improving individual skills, but also on strengthening networks and relationships between academia, industry, and government to create synergistic and sustainable collaborations. Through this approach, the economic value and competitiveness of the local batik industry can be significantly improved, providing a long-term positive impact on the community and the local economy.

Implementation of Online Teacher Professional Development Programs: Physical Education Teacher Perspectives

One current focus in education is the importance of developing professionalism among physical education teachers to meet the demands and challenges of physical education in the 21st century. Several challenges faced by physical education teachers in implementing online professional development programs include limited access to technology, reduced social interaction, and difficulties in assessing and providing immediate feedback. Additional challenges that require further investigation include the relevance of content and its adaptation specifically to the physical education curriculum and practical contexts. The relevance of physical education teachers' understanding of online professional development programs involves program design and improvement, professional growth and efficacy, implementation and adoption, policy, and advocacy. This study aims to explore the perspectives of physical education teachers on participating in online professional development programs. The method used is quantitative research with a descriptive quantitative design. The sampling technique employed is census sampling, involving all members of the population in the survey, thus including 245 teachers from across Indonesia who are participating in the online development program. The results show that over 80% of participants were able to receive and assimilate the material provided by instructors through a Learning Management System (LMS) during the specified duration of the online teacher development program. Indeed, more than 75% of participants were able to not be disturbed by network issues in their area. Significant differences were reported beyond these percentages, including differences in age groups, teaching experience, and geographical location. Other findings from this study reveal that more than 50% of participants were not interested in the online teacher development program. Factors causing this lack of interest include limited social interaction, digital fatigue, mistrust in effectiveness, and limitations in technology and internet access. The practical implications of these findings are to enhance interactivity, address digital fatigue, improve content relevance, and provide technological support. Future research directions on this topic include longitudinal studies to evaluate the long-term impact of online learning programs on teaching practices and learning outcomes, aiming to identify ongoing changes and improvements in teaching practices. Key Words: Implementation, Perception, Physical Education, Teacher Professional Development

Long-term impact of aerodigestive symptoms on adults with oesophageal cancer: A qualitative study

Purpose The impact of long-term aerodigestive symptoms following oesophageal cancer surgery is still not well understood. This study aimed to qualitatively understand the long-term impact of aerodigestive symptoms on quality of life in adults post-oesophagectomy. Method Participants who received curative transhiatal/transthoracic surgery for oesophageal cancer in Ireland’s National Oesophageal Cancer Centre were invited to attend semi-structured interviews. Surgery had to be completed at least 12 months prior. Reflexive thematic analysis was conducted. Result Forty participants were interviewed individually face-to-face. Four key themes were identified: (a) isolation, reflecting the reported solitude experienced by oesophageal cancer survivors when attempting to manage their ongoing aerodigestive symptoms; (b) fear, including fear of choking and fear that dysphagia symptoms may indicate recurrence of oesophageal cancer; (c) altered work capacity, caused by ongoing aerodigestive symptoms; and (d) avoidance of social situations involving food, due to the pain, discomfort, and embarrassment caused by these symptoms. Conclusion Oesophageal cancer treatment can be lifesaving, however, such medical interventions can result in distressing physiological aerodigestive symptoms throughout survivorship, which can significantly impact quality of life. Our findings indicate a need for greater community support to manage aerodigestive symptoms and reduce the impact these have on quality of life.

Parental Mental Health, Gender, and Lifestyle Effects on Post-Pandemic Child and Adolescent Psychosocial Problems: A Cross-Sectional Survey in Northern Italy.

The exacerbation of psychosocial problems among children and adolescents during the coronavirus disease 2019 (COVID-19) pandemic necessitates an assessment of the long-term mental health impact of pandemic interventions. Focusing on both pandemic-related factors and demographic variables, such as gender and daily habits, an analysis was conducted to understand how these elements continue to affect young populations in the post-pandemic era. In April 2023, a comprehensive online survey was administered to families in South Tyrol, Italy, with children aged 7-19 years, to ensure age and gender representation. The survey included parent ratings and adolescent (11-19 years) self-reports using standardized instruments to measure the symptoms of mental health problems (Strengths and Difficulties Questionnaire, SDQ), anxiety (Screen for Child Anxiety Related Emotional Disorders, SCARED), and depression (Patient Health Questionnaire-2, PHQ-2). Statistical analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs). Of the 4525 valid responses, 1831 were self-reported by adolescents. Notable gender differences in mental health outcomes were identified, along with significant demographic predictors, such as age, single parenthood, parental mental health problems, and immigrant background. Negative effects were associated with reduced family climate and increased screen time, whereas physical activity showed beneficial effects. Proxy reports overestimated adolescents' mental health problems, whereas self-reports tended to underestimate them. Persistent mental health problems and gender disparities highlight the need for a public health approach. This should include accessible support services, resilience building, targeted support for vulnerable families and gender-specific interventions.

Air pollution walk as an impact education tool for air quality sensitization: a pilot from an Indian megacity

Abstract. Air pollution has become a serious matter of concern in the global south, and a significant amount of funding has been used to create awareness of air pollution. The conventional method of sensitization relies on workshops where slide-based presentations, images, plots and graphs are shown to participants. However, sensitization about air quality using such an audio-visual format might not be sufficient to create adequate impact. Here, in this study, we propose a new sensitization technique, the pollution walk, where participants and a subject matter expert will walk through different urban micro-environments with a live air quality monitor. A pilot involving three such pollution walks with 24 participants was conducted in a South Asian megacity, and pre- and post-walk surveys were conducted. The results indicate a greater sense of understanding among the participants, and the multi-disciplinary nature of the air pollution problem has been communicated well. To understand the long-term impact, a survey after 1 year was conducted which clearly indicates high levels of awareness and behavioural changes among the participants.

Impact of post-hepatectomy biliary leaks on long-term survival in different liver tumors: A single institute experience.

A postoperative biliary leak is one of the most morbid complications occurring after a liver resection, the long-term impact of which remains unknown. Retrospective analysis of consecutive liver resections performed from 1 January 2011 to 31 December 2021. Primary endpoint of disease-free survival (DFS) was compared between patients with and without a bile leak, stratifying for tumor type. Survival curves were plotted using Kaplan-Meier estimates, and differences between them were analyzed using the log-rank test. In toto, 862 patients were analyzed, and included 306 (35.5%) hepatocellular carcinomas, 212 (24.6%) metastatic colorectal cancers, and 111 (12.9%) cholangiocarcinomas (69 intrahepatic cholangiocarcinomas, 42 hilar cholangiocarcinomas). Occurrence of a bile leak was associated with significantly poorer DFS only in patients with cholangiocarcinoma (median DFS 9.9 months vs. 24.9 months, p = 0.013), and further analysis was restricted to this cohort. A Cox regression performed for factors associated with DFS detriment in patients with cholangiocarcinoma showed that apart from node positivity (hazard ratio [HR]: 2.482, p = 0.033) and margin positivity (HR: 2.65, p = 0.021), development of a bile leak was independently associated with worsening DFS on both univariate and multiple regression analyses (HR: 1.896, p = 0.033). Post-hepatectomy biliary leaks are associated with significantly poorer DFS only in patients with cholangiocarcinoma, but not in patients with hepatocellular carcinoma or metastatic colorectal cancer. Methods to mitigate this survival detriment need to be explored.

Impact of lower-respiratory tract infections on healthcare utilization and mortality in older adults: a Swedish population-based cohort study

BackgroundLower respiratory tract infections (LRTIs) have an immediate significant impact on morbidity and mortality among older adults. However, the impact following the infectious period of LRTI remains understudied. We aimed to assess the short- to long-term impact of LRTIs on hospitalization, mortality, and healthcare utilization in older adults.MethodsData from the Swedish National Study of Aging and Care in Kungsholmen (SNAC-K) was analyzed, with data from 2001 to 2019 for mortality and 2001–2016 for healthcare utilization. LRTI-exposed participants were identified and matched with LRTI-nonexposed based on sociodemographics, lifestyle factors, and functional and clinical characteristics. Statistical models evaluated post-LRTI hospitalization risk, days of inpatient hospital admissions, healthcare visits, and mortality.Results567 LRTIs-exposed participants during the study period and were matched with 1.701 unexposed individuals. LRTI-exposed individuals exhibited increased risk of hospitalization at 1-year (HR 2.14, CI 1.74, 2.63), 3-years (HR 1.74, CI 1.46, 2.07), and 5-years (HR 1.59, CI 1.33, 1.89). They also experienced longer post-LRTI hospital stays (IRR 1.40, CI 1.18, 1.66), more healthcare visits (IRR 1.47, CI 1.26, 1.71), specialist-care visits (IRR 1.46, CI 1.24, 1.73), and hospital admissions (IRR 1.57, CI 1.34, 1.83) compared to nonexposed participants over 16-years of potential follow-up. Additionally, the 19-year risk of mortality was higher among LRTI-exposed participants (HR 1.45, CI 1.24, 1.70). Men exhibited stronger associations with these risks compared to women.ConclusionsLRTIs pose both short- and long-term risks for older adults, including increased risks of mortality, hospitalization, and healthcare visits that transpire beyond the acute infection period, although these effects diminish over time. Men exhibit higher risks across these outcomes compared to women. Given the potential preventability of LRTIs, further public health measures to mitigate infection risk are warranted.

Trends and factors influencing the mental health of college students in the post-pandemic: four consecutive cross-sectional surveys.

The long-term impact of COVID-19 on the mental health and well-being of college students, specifically trends over time after full removal of COVID-19 restrictions, has not been well-studied. Four consecutive cross-sectional surveys were conducted in December 2022 (N = 689), March 2023 (N = 456), June 2023 (N = 300), and November 2023 (N = 601) at a university in Sichuan Province, China. The proportion of students with COVID-19 panic decreased from 95.1 to 77.3% (p < 0.001). The prevalence of moderate anxiety and above decreased from 18 to 13.6% (p < 0.001), and the prevalence of moderate and above depression decreased from 33.1 to 28.1% (p < 0.001), while the prevalence of post-traumatic stress disorder (PTSD) increased from 21.5 to 29.6% (p < 0.005). Further, the proportion of suicidal thoughts increased from 7.7 to 14.8% (p < 0.001). Suicidal thoughts and self-injuries were significantly associated with COVID-19 panic, depression, anxiety, and PTSD. Students who reported being in close contact with COVID-19 patients in the past were more likely to develop PTSD. Further, COVID-19-induced panic was a risk factor for self-injury. One year after the COVID-19 pandemic, the overall mental health of college students was not optimal. Hence, we can conclude that the long-term impacts of COVID-19 on the mental health of college students may have already occurred. To mitigate this impact and prepare for the next major public health event, strengthening college students' mental health curricula and promoting healthy behaviors among college students should be a priority for universities and education authorities.

The Post-Internationalization Evolution of the Price Discovery Pattern in China’s Iron Ore Markets

Previous literature provided evidence of a negative impact of internationalization on the quality of China’s iron ore futures market within a 6-month window (i.e. June 1, 2018 to November 31, 2018), but little is known on the long-term impact. Using a longer, 4-year-7-month window from June 1, 2018 to December 30, 2022, we examine the market’s price discovery function, an important measure of market quality. We find significant structural break in China’s iron ore data series in August 2021, which largely coincide with a period of rising commodity prices to all-time high. Before the breaks, the price discovery function of China’s iron ore futures appears quite weak, with the spot market leading the futures market, which is consistent with the findings of Fan et al. During the post-break period, however, the futures market demonstrates a stronger price discovery function and takes over the leading role. The day-of-the-week effects in iron ore futures also seem to weaken post-break as well. Our GARCH model results exhibit significant bi-directional volatility spillover between the futures and spot markets.

The effectiveness and health impact of fad diets on obese patients: a literature review

Introduction and purpose Obesity is a serious health problem nowadays and it is becoming more and more common. There are plenty of causes of obesity including bad eating habits, genetic factors, and psychological factors. A lot of obese people look for a way to lose weight. Fad diets are popular dietary strategies which are promoted as a quick way to lose weight. This article highlights some popular dietary strategies including low-carbohydrate diet, low-fat diet, Paleolithic Diet and Detox Diet. The aim of this paper is to analyse their effectiveness in the process of successful weight loss and their health impact. State of knowledge According to WHO in 2022 1 in 8 people in the world were obese. Fad diets are promoted as methods to improve health and as a quick way to lose weight. However, available research suggests a rather unfavorable impact on human health in the context of long-term adherence to these diets. Limited data suggests the beneficial long-term health impact of such diets. Moreover, dieting and weight cycling caused by the repetitive process of weight loss after dieting and weight regain afterwards may also play a role in the development of obesity. Conclusion Fad diets are not recommended as a long-term way of nutrition. The main limitation of these dietary strategies is their short-term effectiveness rather than long-term. Adherence to these diets is hard for patients. Because of their strict rules and food exclusions, the risk of weight regain is high. Moreover, they do not show many positive long-term health consequences and they are not superior to conventional healthy diets. What’s more, strict obedience to fad diets for extended periods of time may be detrimental to the dieter's health.

Video based educational intervention in waiting area to improve awareness about health screening among patients visiting family medicine clinics

BackgroundMultiple educational modalities have been utilized including leaflet, face-to-face counseling and watching videos in waiting areas for engaging patients. Considering the two challenges of waiting time frustration and lack of health screening awareness, Family Physicians’ waiting area are an ideal place to bridge this gap. The objective of this study is to evaluate the effectiveness of video-based health education intervention in improving knowledge about health screening among patients and their families sitting in waiting area of Family Medicine clinics.MethodsIt was a pre and post quasi-experimental study that was conducted in family medicine clinics located at main campus and Outreach centers of a tertiary care hospital. A total of 300 participants were approached during the six month period. The intervention consisted of an educational video on health screening. The content of the video was taken from the recommended preventive care guidelines from CDC and USPSTF. The pre-and post-intervention knowledge of the participants was assessed through a semi-structured coded questionnaire by an interviewer who was trained in data collection. Data was analyzed using SPSS version 26. Pre and post intervention knowledge adequacy was determined using MacNemar’s Chi-square test.ResultsTotal 300 participants voluntarily participated into the study. Median age of the participants was 28 (IQR = 23.25–36.75) years. Majority of participants were males (56%). Following the intervention, there was significant increase in the proportion of participants (51.3% versus 68%) who had understanding of health screening check-up (p < 0.001). Following the study intervention, there was significant increase in proportion of participants who had adequate knowledge related to diabetes (p = 0.045), hypertension (p < 0.001), cholesterol (p < 0.001), cervical cancer (p < 0.001), colon cancer (p < 0.001) and hepatitis B & C (p < 0.001). No significant improvement in breast cancer related knowledge was observed (p = 0.074). Highest post-intervention increase in knowledge from baseline was observed for hypertension (13.3% versus 63.3%) followed by colon cancer (24.3% versus 59.3%), cholesterol (67 versus 96.7%), hepatitis b & C (56.7% versus 77.3%), diabetes (29.7% versus 48%), cervical cancer (1.7% versus 19%), and breast cancer (7.7% versus 18.3%).ConclusionThis study highlighted a pivotal role of an educational video intervention in clinic waiting area to improve awareness regarding health screening among patients and their families. Further interventional community based or multicenter studies are warranted to assess the long-term impact of these educational videos on knowledge and utilization of health screening among adult population.

Bullying experiences in childhood and health outcomes in adulthood.

This study examines whether the experience of being bullied at school has a long-term impact on three health outcomes in adulthood in Japan: subjective health, mental health, and activity restriction due to health conditions. We employed a random effects model and the Karlson-Holm-Breen method to decompose the total effect of being bullied at school on health inequality into a direct effect and an indirect effect working through intervening factors including education, marriage, economic well-being, and social networks. We used the Japanese Life Course Panel Surveys 2007-2020 (waves 1-14), a nationally representative panel data set that includes 2,260 male and 2,608 female respondents. The results demonstrate that for both men and women, the direct effect of being bullied at school was strong and significant. Bullying experiences in childhood had a long-term impact on health outcomes in adulthood, regardless of social background and mediating factors of education, marriage, economic well-being, and social networks. Bullying victimization increased the risk of poor subjective health, low mental health scores, and activity restriction due to health conditions. Intervening factors (especially economic well-being and friendship) mediated the association between bullying experiences and all health outcomes, but their contributions were modest. Policy measures not only to prevent bullying during childhood but also to alleviate its negative consequences in adulthood should be considered to help people who have encountered adverse childhood experiences.

Type I interferon induced during chronic viral infection favors B-cell development in the thymus.

Chronic viral infections cause thymic involution yet the potential for broader, longer-term impact on thymic composition remains unexplored. Here we show that chronic, but not acute, lymphocytic choriomeningitis virus infection promotes a unique population of immature B cells in the thymus. We show that chronic viral infection promotes signals within the thymus, including the expression of B-cell activating factor (BAFF), that favor the maturation of this population as these cells acquire expression of CD19 and immunoglobulin M. Mechanistically, type I interferon (IFN-I), predominantly IFNβ, signals to thymic hematopoietic cells, strongly delaying T-cell development at the earliest precursor stage. Furthermore, IFN-I signaling to the nonhematopoietic compartment provides a second signal essential to favor B-cell differentiation and maturation within the thymus. Importantly, chronic infection yields changes in the B-cell population for at least 50 days following infection, long after thymic atrophy has subsided. Thus, the inflammatory milieu induced by chronic viral infection has a profound, and long-lasting, effect on thymic composition leading to the generation of a novel population of thymic B cells.

Long-term COVID-19 pandemic impact on suicide Thoughts and Behaviors (STB): An interrupted time series analysis in Spain 2-year after pandemic outbreak

This study assessed the impact of the COVID-19 pandemic on suicidal thoughts and behaviors (STB) by age and gender in Cantabria, Spain, from January 2019 to March 2022, using interrupted time series analysis. Post-lockdown, STB declined in males (-42 %, p = 0.01) and females (-25 %, p = 0.58), with a gradual increase in both genders. The reduction was most pronounced in older adults (-39 %, p = 0.56), followed by middle-aged (-26 %, p = 0.36) and younger groups (-8.3 %, p = 0.25). Subsequent upward trends in STB were more pronounced in younger (p = 0.15) and older age groups (p = 0.25), likely due to prolonged isolation and economic hardship.

Investigating grey matter volumetric trajectories through the lifespan at the individual level

Adolescents exhibit remarkable heterogeneity in the structural architecture of brain development. However, due to limited large-scale longitudinal neuroimaging studies, existing research has largely focused on population averages, and the neurobiological basis underlying individual heterogeneity remains poorly understood. Here we identify, using the IMAGEN adolescent cohort followed up over 9 years (14–23 y), three groups of adolescents characterized by distinct developmental patterns of whole-brain gray matter volume (GMV). Group 1 show continuously decreasing GMV associated with higher neurocognitive performances than the other two groups during adolescence. Group 2 exhibit a slower rate of GMV decrease and lower neurocognitive performances compared with Group 1, which was associated with epigenetic differences and greater environmental burden. Group 3 show increasing GMV and lower baseline neurocognitive performances due to a genetic variation. Using the UK Biobank, we show these differences may be attenuated in mid-to-late adulthood. Our study reveals clusters of adolescent neurodevelopment based on GMV and the potential long-term impact.

Perinatal Famine Exposure and Young-Onset Cancer-Lessons from China Health and Nutrition Survey.

Background/Objectives: Perinatal exposure to malnutrition has been hypothesised to influence the development of young-onset cancer (≤50 years of age). This study aimed to determine if perinatal malnutrition in individuals exposed to the Great Famine of China increased their risk of developing young-onset cancer compared to other individuals born prior to the famine. Subjects/Methods: This cross-sectional study involved 7272 participants from the China Health and Nutrition Survey who were classified into four groups based on birth year: participants born between 1953 and 1955 (before the famine) were designated as the pre-famine group (unexposed); the remainder formed perinatal exposure groups comprised of those exposed during the famine (1959-1961), those exposed in the early post-famine period (1962-1964), and those exposed in the late post-famine period (1965-1967). Multivariable adjusted log-binomial regression models were used to calculate the RR and 95% CI of young-onset cancer (including genitourinary cancer) across four groups. Results: Perinatal exposure to early post-famine (RR 2.08; 95%CI 1.04, 4.34; p = 0.043) and the female sex (RR 15.6, 95%CI 4.54, 60.3; p < 0.001) were noted to have a significantly increased risk of young-onset cancer. In addition, the early (RR 13.8; 95%CI 2.68, 253; p = 0.012) and late post-famine (RR 12.3; 95%CI 2.16, 231; p = 0.020) cohorts demonstrated a significantly increased risk of young-onset genitourinary cancer. The latter was accompanied by an increased risk of hypertension (RR 3.30; 95%CI 1.28, 7.87; p = 0.009). Conclusions: Perinatal exposure to famine, especially in females, was associated with a higher risk of young-onset cancer. This was particularly evident for young-onset genitourinary cancers. These findings highlight the potential long-term impact of perinatal malnutrition on young-onset carcinogenesis.