Longitudinal Analysis Research Articles

The causal associations between interoception, self-regulation, non-purposeful eating behaviors, and weight status in college women: a longitudinal cross-lagged model analysis.

Excessive weight gain has led to increased obesity and mortality risk among college students. Issues with maintaining a healthy weight may be attributed to poor internal awareness and unhealthy eating behaviors. The study's purpose was to determine the longitudinal effects among interoception, self-regulation, nonpurposeful eating behaviors, and weight status (BMI) among college women. Data from 103 females were collected via Qualtrics over 3 timepoints (T1, T2, T3) during an academic semester. Repeated measures ANOVA and cross-lagged model analyses were used. Significant changes were found in interoceptive responsiveness, external, and uncontrolled eating throughout 3 timepoints. Longitudinally, significant causal effects were found among the study measures. Among all models, higher interoceptive responsiveness (T1) predicted increased self-regulation (T2). Higher non-purposeful eating behaviors (T1) predicted reduced self-regulation (T2). Higher BMI (T1) predicted reduced non-purposeful eating behaviors (T2), however higher BMI (T2) predicted increased non-purposeful eating (T3) and reduced interoceptive responsiveness (T3). Significant causal effects were found within each non-purposeful eating behavior models. Overall, the research study provided foundational evidence of the importance of self-regulatory skills to help prevent unhealthy eating behaviors and increased weight status in college women. Future interventions educating college women to become more internally aware and better self-regulate are needed.

Systolic Blood Pressure, Diastolic Blood Pressure and Pulse Pressure and the Risk of Subclinical Myocardial Injury: The HUNT Study.

Subclinical myocardial injury expressed as higher cardiac troponin concentrations may represent an important intermediary between hypertension and the risk of cardiovascular disease. The study aimed to assess the relative strength of associations between systolic blood pressure (BP), diastolic BP, and pulse pressure, and subclinical myocardial injury, and how change in BP variables over time associates with subclinical myocardial injury. cTnl (cardiac troponin I) was measured in 32 968 participants of the fourth wave of the population-based cohort HUNT4 (Trøndelag Health Study) without a history of cardiovascular disease. An additional longitudinal analysis included participants from HUNT4 with BP measurements from HUNT3 (n=18 681). Associations between BP variables and cTnI concentrations were assessed by linear and logistic regression analyses. The median cTnI concentration was 1.6 ng/L (25th-75th percentiles, 0.6-3.1 ng/L), median age was 52 years (39.1-65.6 years), and 57% were female subjects. Cross-sectionally, only systolic BP categories ≥130 mm Hg associated with higher cTnI concentrations, compared with a reference systolic BP of <110 mm Hg. All categories of diastolic BP and pulse pressure were positively associated with higher cTnI concentrations when diastolic BP 70 to 79 mm Hg and pulse pressure <40 mm Hg were used as references, respectively. When comparing systolic BP, diastolic BP, and pulse pressure as continuous variables, cross-sectionally, pulse pressure most strongly associated with cTnI concentrations (P for all comparisons <0.001), whereas longitudinally, change in diastolic BP was most strongly associated with cTnI concentrations (P for all comparisons <0.05). Subjects with high pulse pressure and longitudinal increase in diastolic BP are at higher risk for subclinical myocardial injury.

Longitudinal analysis within one hospital in sub-Saharan Africa over 20 years reveals repeated replacements of dominant clones of Klebsiella pneumoniae and stresses the importance to include temporal patterns for vaccine design considerations

BackgroundInfections caused by multidrug-resistant gram-negative bacteria present a severe threat to global public health. The WHO defines drug-resistant Klebsiella pneumoniae as a priority pathogen for which alternative treatments are needed given the limited treatment options and the rapid acquisition of novel resistance mechanisms by this species. Longitudinal descriptions of genomic epidemiology of Klebsiella pneumoniae can inform management strategies but data from sub-Saharan Africa are lacking.MethodsWe present a longitudinal analysis of all invasive K. pneumoniae isolates from a single hospital in Blantyre, Malawi, southern Africa, from 1998 to 2020, combining clinical data with genome sequence analysis of the isolates.ResultsWe show that after a dramatic increase in the number of infections from 2016 K. pneumoniae becomes hyperendemic, driven by an increase in neonatal infections. Genomic data show repeated waves of clonal expansion of different, often ward-restricted, lineages, suggestive of hospital-associated transmission. We describe temporal trends in resistance and surface antigens, of relevance for vaccine development.ConclusionsOur data highlight a clear need for new interventions to prevent rather than treat K. pneumoniae infections in our setting. Whilst one option may be a vaccine, the majority of cases could be avoided by an increased focus on and investment in infection prevention and control measures, which would reduce all healthcare-associated infections and not just one.

A longitudinal analysis of soil salinity changes using remotely sensed imageries

Soil salinization threatens agricultural productivity, leading to desertification and land degradation. Given the challenges of conducting labor-intensive and expensive field studies and laboratory analyses on a large scale, recent efforts have focused on leveraging remote sensing techniques to study soil salinity. This study assesses the importance of soil salinity indices’ derived from remotely sensed imagery. Indices derived from Landsat 8 (L8) and Sentinel 2 (S2) imagery are used in Random Forest (RF), eXtreme Gradient Boosting (XGBoost), Decision Tree (DT), and Support Vector Machine (SVR) are associated with the electrical (EC) conductivity of 280 soil samples across 24,000 hectares in Northeast Iran. The results indicated that the DT is the best-performing method (RMSE = 12.25, MAE = 2.15, R2 = 0.85 using L8 data and RMSE = 10.9, MAE = 2.12, and R2 = 0.86 using S2 data). Also, the results showed that Multi-resolution Valley Bottom Flatness (MrVBF), moisture index, Topographic Wetness Index (TWI), and Topographic Position Indicator (TPI) are the most important salinity indices. Subsequently, a time series analysis indicated a reduction in salinity and sodium levels in regions with installed drainage networks, underscoring the effectiveness of the drainage system. These findings can assist decision-making about land use and conservation efforts, particularly in regions with high soil salinity.

Associations between dietary diversity and dyslipidemia among Japanese workers: cross-sectional study and longitudinal study findings.

The aim of this study was to determine the associations between dietary diversity and risk of dyslipidemia in Japanese workers. The cross-sectional study included 1399 participants aged 20-63years and the longitudinal study included 751 participants aged 20-60years in 2012-2013 (baseline) who participated at least once from 2013 to 2017 with cumulative participation times of 4.9 times. Dietary intake was assessed using a food frequency questionnaire, and dietary diversity score (DDS) was determined using the Quantitative Index for Dietary Diversity. Dyslipidemia was diagnosed when at least one of the following conditions was met: hypertriglyceridemia, high LDL-cholesterol, low HDL-cholesterol, high non-HDL-cholesterol, and a history of dyslipidemia. Multivariable logistic regression was used to calculate the odds ratios (ORs) and 95% confidence intervals (CIs) for dyslipidemia with control of confounding factors in cross-sectional analysis. Generalized estimating equations were used for calculating the ORs (95% CI) for dyslipidemia in the follow-up period according to the DDS at baseline with control of confounding factors in longitudinal analysis. Cross-sectional analysis showed that the highest DDS reduced the odds of dyslipidemia in men (OR [95% CI] in Tertile 3: 0.67 [0.48-0.95], p value = 0.023). In longitudinal analysis, a moderate DDS reduced the risk of dyslipidemia (OR [95% CI] in Tertile 2: 0.21 [0.07-0.60], p value = 0.003) in women. The results of cross-sectional analysis in this study suggest that the higher diversity of diet might reduce the presence of dyslipidemia in men and the results of longitudinal analysis suggest that a moderate DDS might reduce the risk of dyslipidemia in women. Further studies are needed since the results of cross-sectional and longitudinal analyses in this study were inconsistent.

Challenges and directions for digital twin implementation in otorhinolaryngology.

Digital twin technology heralds a transformative era in Otorhinolaryngology (ORL), merging the physical and digital worlds to offer dynamic, virtual models of physical entities or processes. These models, capable of simulating, predicting, and optimizing real-world counterparts, are evolving from static replicas to intelligent, adaptive systems. Fueled by advancements in communication, sensor technology, big data analytics, Internet of Things (IoT), and simulation technologies, artificial intelligence (AI), digital twins in ORL promise personalized treatment planning, virtual experimentation, and therapeutic intervention optimization. Despite their potential, the integration of digital twins in ORL faces challenges including data privacy and security, data integration and interoperability, computational demands, model validation and accuracy, ethical and regulatory considerations, patient engagement, and cost and accessibility issues. Overcoming these challenges requires robust data protection measures, seamless data integration, substantial computational resources, rigorous validation studies, ethical transparency, patient education, and making the technology accessible and affordable. Looking ahead, the future of digital twins in ORL is bright, with advancements in AI and machine learning, omics data integration, real-time monitoring, virtual clinical trials, patient empowerment, seamless healthcare integration, longitudinal data analysis, and collaborative research. These developments promise to refine diagnostic and treatment strategies, enhance patient care, and facilitate more efficient and tailored ORL research, ultimately leading to more effective and personalized ORL management.

Longitudinal Analysis of Overlapping Psychosocial Factors Predicting Incident Hospitalization Among Mixed HIV Serostatus Men who have Sex with Men in the Multicenter AIDS Cohort Study.

Men who have sex with men (MSM) are at increased risk for certain types of chronic diseases and mental health problems. Despite having extended survival in the highly active antiretroviral therapy (HAART) era, MSM living with HIV contend with aging-related diseases and complications with treatment. Consequent hospitalizations incur high costs, fear, low quality of life, and frailty. Unlike heterosexual men, MSM experience more structural violence and "syndemics" of psychosocial factors that not only accelerate HIV acquisition and transmission risk but also may increase morbidity, leading to greater rates of hospitalization. We aim to examine the impact of "syndemic" psychosocial factors on the incidence of hospitalization among geographically diverse MSM in the US. Participants were 1760 MSM from the Multicenter AIDS Cohort Study (MACS) between 2004 and 2019. We examined the relationship between six psychosocial factors (depression, stimulant use, smoking, heroin use, childhood sexual abuse, and intimate partner violence) and incident hospitalization (admission to a hospital for treatment). We found a positive dose-response relationship between the number of syndemic factors and hospitalization. MSM reporting five or more syndemic factors had over twice the risk of hospitalization compared to MSM without syndemic factors [aRR = 2.14 (95% CI = 1.56, 2.94)]. Psychosocial factors synergistically increased hospitalizations over time. The positive dose-response relationship between the number of syndemic factors and hospitalization and the synergistic effects of these factors underscore the need for interventions that disentangle the syndemics to reduce hospitalization and related costs and improve the quality of life among MSM.

Plasma Leptin and Alzheimer Protein Pathologies Among Older Adults

Many epidemiologic studies have suggested that low levels of plasma leptin, a major adipokine, are associated with increased risk of Alzheimer disease (AD) dementia and cognitive decline. Nevertheless, the mechanistic pathway linking plasma leptin and AD-related cognitive decline is not yet fully understood. To examine the association of plasma leptin levels with in vivo AD pathologies, including amyloid-beta (Aβ) and tau deposition, through both cross-sectional and longitudinal approaches among cognitively unimpaired older adults. This was a longitudinal cohort study from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer Disease. Data were collected from January 1, 2014, to December 31, 2020, and data were analyzed from July 11 to September 6, 2022. The study included a total of 208 cognitively unimpaired participants who underwent baseline positron emission tomography (PET) scans for brain Aβ deposition. For longitudinal analyses, 192 participants who completed both baseline and 2-year follow-up PET scans for brain Aβ deposition were included. Plasma leptin levels as assessed by enzyme-linked immunosorbent assay. Baseline levels and longitudinal changes of global Aβ and AD-signature region tau deposition measured by PET scans. Among the 208 participants, the mean (SD) age was 66.0 (11.3) years, 114 were women (54.8%), and 37 were apolipoprotein E ε4 carriers (17.8%). Lower plasma leptin levels had a significant cross-sectional association with greater brain Aβ deposition (β = -0.04; 95% CI, -0.09 to 0.00; P = .046), while there was no significant association between plasma leptin levels and tau deposition (β = -0.02; 95% CI, -0.05 to 0.02; P = .41). In contrast, longitudinal analyses revealed that there was a significant association between lower baseline leptin levels and greater increase of tau deposition over 2 years (β = -0.06; 95% CI, -0.11 to -0.01; P = .03), whereas plasma leptin levels did not have a significant association with longitudinal change of Aβ deposition (β = 0.006; 95% CI, 0.00-0.02; P = .27). The present findings suggest that plasma leptin may be protective for the development or progression of AD pathology, including both Aβ and tau deposition.

Gut microbiome and resistome characterization of pigs treated with commonly used post-weaning diarrhea treatments

BackgroundThe global burden of antimicrobial resistance demands additional measures to ensure the sustainable and conscious use of antimicrobials. For the swine industry, the post-weaning period is critical and for many years, antimicrobials have been the most effective strategy to control and treat post-weaning related infections. Among them, post-weaning diarrhea causes vast economic losses, as it severely compromises piglets’ health and growth performance. In this study, 210 piglets were transferred from a farm with recurrent cases of post-weaning diarrhea to an experimental farm and divided into six different treatment groups to determine the effect of the different treatments on the growth performance and survival, the microbiome, and the resistome in a cross-sectional and longitudinal study. The different treatments included antimicrobials trimethoprim/sulfamethoxazole, colistin, and gentamicin, an oral commercial vaccine, a control with water acidification, and an untreated control. An extra group remained at the farm of origin following the implemented amoxicillin routine treatment. A total of 280 fecal samples from pigs at four different sampling times were selected for metagenomics: before weaning-treatment at the farm of origin, and three days, two weeks, and four weeks post-treatment.ResultsThe control group with water acidification showed a reduced death risk in the survival analyses and non-significant differences in average daily weight gain in comparison to the antibiotic-treated groups. However, the growth-promoting effect among antibiotic-treated groups was demonstrated when comparing against the untreated control group at the experimental farm. After four weeks of treatment, diversity indexes revealed significantly decreased diversity for the untreated control and the group that remained at the farm of origin treated with amoxicillin. For this last group, impaired microbial diversity could be related to the continuous amoxicillin treatment carried out at the farm. Analysis of the resistome showed that both gentamicin and amoxicillin treatments significantly contributed to the emergence of resistance, while trimethoprim/sulphonamide and colistin did not, suggesting that different treatments contribute differently to the emergence of resistance.ConclusionsOverall, this shotgun longitudinal metagenomics analysis demonstrates that non-antibiotic alternatives, such as water acidification, can contribute to reducing the emergence of antimicrobial resistance without compromising pig growth performance and gut microbiome.

Background TV and infant-family interactions: Insights from home observations.

Background television has been found to negatively impact children's language development and self-regulatory skills, possibly due to decreased parent-child interactions. Most of the research on the relationship between background TV and caregiver-child interactions has been conducted in laboratory settings. In the current study, we conducted home observations and investigated whether infants engage in fewer interactions with family members in homes where background TV is more prevalent. We observed 32 infants at the ages of 8, 10, and 18months in their home environments, coding for dyadic interactions (e.g., parent talking to and/or engaging with the child), triadic interactions (e.g., parent and infant play with a toy together), and infants' individual activities. Our findings revealed that background TV was negatively associated with the time infants spent in triadic interactions, positively associated with time spent engaging in individual activities, and not significantly related to the time spent in dyadic interactions. Apart from the relationship between background TV and individual activity time at 8months, these associations remained significant even after accounting for families' socioeconomic status. These findings imply a correlation between background TV exposure and caregiver-infant-object interactions, warranting a longitudinal analysis with larger sample sizes.

Abstract PO5-23-10: Development of a long-term in vitro assay able to identify compounds that can overcome resistance to CDK4/6 inhibitor plus endocrine therapy in ER+ HER2- breast cancer

Abstract CDK4/6 inhibitor plus endocrine therapy (ET) has emerged as the standard of care first line therapy in ER+ HER2- breast cancer. While this combination has shown the ability to extend overall survival, nearly all patients acquire resistance and progress after 2-3 years. Subsequently, interest has turned to identifying a third partner compound that can be integrated into the CDK4/6i plus ET backbone regimen with the goal of overcoming resistance and driving a deeper response. However, a comprehensive assay-based workflow proficient in identifying compounds with the most promising potential is lacking. To fill this need, we set out to develop a high-throughput in vitro assay with relevant multi-faceted readouts to assess the efficacy of potential triplet combinations using 12 human ER+ breast cancer lines. For this assay, cells were engineered to express nuclear RFP to enable accurate cell counting using basic imaging techniques in 384 well plates. Each third partner compound was tested at two different doses and, in addition to the triplet combination (CDK4/6i + ET + third partner), single agent as well as double agent combinations were investigated. The assay was imaged and re-dosed every 5 days until day 15. On day 15, the compounds were washed out and the cells underwent a 25-day drug holiday to monitor relapse. Duplicate plates of all conditions were monitored and imaged every two hours for 24 hours for live cell staining of apoptosis markers. Additional duplicate plates were fixed and stained on days 5 and 15 for markers of senescence and cell cycle. Images were subsequently fed into a python-based algorithm to determine the percentage of cell population expressing the various markers and phenotypic correlates were extracted. We are looking for triplet combinations that induce a deeper cell cycle arrest, senescence, and/or cell death compared with the CDK4/6 inhibitor plus ET only treatment. Our drug holiday results will help elucidate the treatments able to continue to induce suppression once washed out, indicating treatment options that may induce long-lasting, possibly irreversible effects on the cells. Finally, by extracting phenotypic correlates from brightfield images we hope to cluster the various compounds in their effects across cell lines of diverse backgrounds to help understand the best way to benefit multiple patient populations. Overall, the assay will be able to identify and differentiate various therapeutic combinations based on cell count, senescence, and cell death. The format of this assay enables depth of analysis not accessible using other techniques such as FACS, including full dose-response curves, combination matrices, and longitudinal analyses. Additionally, the assay can be modified to evaluate any number of cellular markers and can be useful across a number of applications. The approach developed here will be foundational in discovering next-step strategies for patients with therapy resistance. Citation Format: Stephanie Kronstadt, Neil Umbreit, Matt Niederst, Rens Janssens. Development of a long-term in vitro assay able to identify compounds that can overcome resistance to CDK4/6 inhibitor plus endocrine therapy in ER+ HER2- breast cancer [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO5-23-10.

Social connectedness and diabetes self-management across the COVID-19 pandemic: A mixed methods study.

Structural social connectedness is the structure and size of a person's social network, including whether persons live with or have regular contact with others. The COVID-19 pandemic disrupted structures that facilitate social connectedness. This study investigated how a person's structural social connectedness influenced diabetes self-management strategies through the COVID-19 pandemic. The study followed an explanatory sequential mixed methods design. First, quantitative data were collected via surveys of 54 patients living with diabetes (67% female, Mage of 60 [12] years) in 2021. Then in 2022, we interviewed 25 patients (64% female, Mage of 62 [9] years) as a follow-up to the survey to help explain quantitative findings. Longitudinal mixed methods analysis integrated both phases to offer a holistic view of the factors influencing diabetes self-management. A full-factorial analysis of covariance tested home and workplace social connectedness effects onto glycemic control and four self-management measures. In integrated analysis, researchers categorized patients into four groups by level of home and workplace social connectedness. Individuals with home social connectedness were more likely to overcome pandemic-related self-management challenges than those without home social connectedness. Although the workplace provided social connectedness, it imposed structural barriers to self-management. Structural social connectedness influenced how patients navigated diabetes self-management challenges through the COVID-19 pandemic. Results suggest clinicians should consider how home and workplace connectedness interact to facilitate or impede patient self-management. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Abstract PO3-10-08: Long-term uptake rate of a breast cancer screening program in Fukushima, Japan, following the 2011 Triple Disaster: a retrospective observational study

Abstract Introduction There has been a growing concern over the past few years about the effects of disasters and crises on breast cancer screening, an argument that has been further enhanced by the novel coronavirus disease 2019 (COVID-19) pandemic. However, little is known about how crises might affect the long-term uptake of breast cancer screening programs. This study aimed to clarify the long-term trend of breast cancer screening program uptake in Minamisoma City following the 2011 Triple Disaster in Fukushima, Japan (earthquake, tsunami, and nuclear disaster), and to evaluate the factors associated with this uptake. Material and Methods This study retrospectively analyzed data from the Basic Resident Registry and Breast Cancer Screening Program in Minamisoma City following the Triple Disaster. We calculated the annual breast cancer screening uptake rate for women aged 40–74 years who were of an even-numbered age at the end of each fiscal year and the incidence of at least one instance of uptake of the breast cancer screening initiative during the biennial intervals. We further performed cross-sectional and longitudinal regression analyses for the biannual screening uptake and investigated its associated factors. Results Breast cancer screening participation rates were 19.8% and 18.2% in 2009 and 2010, respectively. They decreased to 4.2% in 2011, and gradually increased thereafter, reaching the pre-disaster level of 20.0% in 2016. Similar but longer decrease of the uptake was observed in the biannual screening uptake rate. No pre-disaster screening uptake between 2009 and 2010, those living alone, or those who were evacuated, were factors that were found to be associated with non-uptake of the breast cancer screening program following the 2011 disaster. Conclusion This study showed a long-term decline in breast cancer screening uptake in the area affected by the Triple Disaster, which was the most severe among those under evacuation, those who were isolated, and those without previous uptake. The insights emerging from this study could be used to increase awareness of this issue and establish potential countermeasures. Nonetheless, we lack a complete understanding of the effects and variations of disasters on cancer screening in the affected areas. Therefore, global efforts should be intensified to conduct further studies on this topic. Citation Format: Kenji Gonda, Akihiko Ozaki, Kazunoshin Tachibana, Masahiro Wada, Hiroaki Saito, Yudai Kaneda, Yoshitaka Nishikawa, Michio Murakami, Kei Hirai, Hiromichi Ohira, Toyoaki Sawano, Tomohiro Kurokawa, Masaharu Tsubokura, Koji Kono, Thoru Ohtake, Seiichi Takenoshita. Long-term uptake rate of a breast cancer screening program in Fukushima, Japan, following the 2011 Triple Disaster: a retrospective observational study [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-10-08.

Longitudinal Analysis of Predictive Factors for Stroke and Bleeding Events in Atrial Fibrillation Patients: Insights From a Tertiary Care Center Cohort

Longitudinal Analysis of Predictive Factors for Stroke and Bleeding Events in Atrial Fibrillation Patients: Insights From a Tertiary Care Center Cohort

Abstract PS04-04: Adverse effects (AEs) reported via Patient Reported Outcome Measures (PROMs): A longitudinal analysis of the IMPORT HIGH breast radiotherapy trial (CRUK/06/003)

Abstract Background IMPORT HIGH is a multicentre phase III randomised controlled trial showing efficacy and safety of appropriately-dosed simultaneous integrated boost (SIB) in terms of local control, patient and clinician reported AEs among women with early breast cancer (BC)[1]. The PROMs sub-study collected baseline demographics and quality of life over 5 years. This exploratory analysis details the patient experience over time. Methods Women with higher-than-average risk of local relapse (≥18 years, breast conserving surgery, T1-3, pN0-pN3a, M0 invasive BC) were eligible. Randomisation (1:1:1) was between 40Gy whole breast and 16Gy sequential boost radiotherapy (control) and, 36Gy whole breast, 40Gy partial breast with either 48Gy SIB (test group 1), or 53Gy SIB (test group 2) radiotherapy. AEs from EORTC QLQ-BR23[2]; Body Image Scale (BIS)[3]; and protocol-specific (PS) items used in previous breast radiotherapy trials[4] were reported by patients at baseline (pre-randomisation), 6 months, and years 1, 3, 5. 24 AEs[4] were included in the analysis, dichotomised as none/mild versus moderate/marked. Anxiety and depression were measured over 5 years using Hospital Anxiety and Depression Scale. Surgical deficit was scored from baseline photographs. Multivariable generalized estimating equation models were fitted for each AE. Potential baseline predictors included those used previously[4] plus ethnicity, smoking, deprivation, employment, cardiovascular disease history, post-operative infection, haematoma, post-surgery complication. Backwards selection and Quasi-likelihood criterion were used for model selection. Results Between 2009-2013, 1338 patients were offered the PROMs sub-study and 1078 (81%) participated. Median age was 48.8 years (IQR 44.0-54.9). 17% reported ‘Borderline’ or 14% ‘Case’ anxiety at baseline. 11% reported ‘Borderline’ or 7% ‘Case’ depression at baseline. 747/1015 (74%), 686/986 (70%), 604/916 (66%), 532/845 (63%), 461/709 (65%) of participants reported at least 1 moderate/marked AE at baseline, 6 months, 1, 3 and 5 years. Number of moderate/marked AEs reported per person reduced over time after year 1 (p &amp;lt; 0.005). BIS reported moderate/marked AEs (except dissatisfaction with scar) decreased, whereas individual items from BR23 and PS items showed mixed patterns of reporting (increased, decreased, stayed the same) over time (Table 1). From multivariable analysis, ‘Borderline’ or ‘Case’ depression or anxiety (time-varying) was associated with increased reports for almost all AEs. Chemotherapy and younger age were associated with increased reports of moderate/marked AEs for items in BIS, and large surgical deficit predicted more breast symptoms. Conclusion Change of overall breast appearance was the most reported moderate/marked AE that persisted over time.Although patients reported fewer moderate/marked AEs over time, trends in individual moderate/marked AEs showed mixed patterns. This study identified factors associated with increased risks of patient-reported moderate/marked AEs. Early identification of patients more likely to report AEs could facilitate implementation of targeted support.

Abstract PO2-09-12: The magnitude and temporal variations of socioeconomic inequalities in quality of life after early breast cancer: results from the multicentric French CANTO cohort

Abstract Objective Previous studies showed that various outcomes in patients with early breast cancer (EBC), from incidence to survival, were influenced by social factors. However, there is limited research on the socioeconomic inequalities in quality of life (QoL) after treatment for EBC, and the magnitude and changes over time of these inequalities have not been quantified. This study examines the socioeconomic inequalities in QoL and their time trends among a large cohort of patients with EBC. Methods We conducted a comprehensive longitudinal analysis using data from the prospective multicentric CANTO study (CANcer TOxicity, NCT01993498), which included participants with EBC enrolled between 2012 and 2018. QoL was assessed using the summary score of the EORTC QLQ-C30 questionnaire at the time of diagnosis and 1 and 2 years post-diagnosis. We included patients with complete QoL data at diagnosis and 2 years post-diagnosis. Analyses were conducted for three indicators of socioeconomic status separately: self-reported financial difficulties, household income and educational level. We first analyzed trajectories of QoL by socioeconomic status from diagnosis to Year 1 and Year 2. Then, social inequalities in QoL were estimated using the regression-based slope indexes of inequality (SII) and compared across the follow-up periods. The SII represents the absolute change in the QLQ-C30 summary score along the two extremes of the socioeconomic gradient, taking into account the intermediate groups and their relative sizes. The analyses were adjusted for age at diagnosis, Charlson comorbidity index, disease stage, use and type of endocrine therapy, use and type of chemotherapy, breast surgery, radiotherapy use, and lymph node management. Results In the 5915 analyzed patients, compared to those with higher socioeconomic status, those reporting a high level of financial difficulty, lower income, or lower education were younger, most often premenopausal, with comorbidities, diagnosed with stage III BC, and treated with mastectomy and axillary lymph node dissection. There were no differences between socioeconomically-defined groups concerning BC histology, grade and IHC-defined subtype. Social inequalities in QoL at baseline were statistically significant for all socioeconomic status indicators (SIIfinancial difficulties = -7.6 [-8.9;-6.2], SIIincome= -4.0 [-5.2;-2.8]) and SIIeducation= -1.9 [-3.1;-0.7]). In multivariable analyses, social inequalities significantly increased (interaction p&amp;lt; 0.05) in Year 1 (SIIfinancial difficulties = -11.1 [-12.8;-9.4], SIIincome= -6.5 [-8.0;-5.0] and SIIeducation= -5.0 [-6.6;-3.5]) and Year 2 (SIIfinancial difficulties = -10.7 [-12.2;-9.1], SIIincome= -6.7 [-8.0;-5.3] and SIIeducation= -4.7 [-6.1;-3.3]) suggesting a widening socioeconomic gap in QoL outcomes irrespective of pre-diagnosis health, tumor characteristics and treatment. Similar results were observed in subgroups defined by menopausal status (pre/postmenopausal) and type of systemic treatment (chemotherapy, endocrine therapy). Conclusion Our study highlights and quantifies the association of several individual socioeconomic indicators with the QoL of patients with EBC in France. The magnitude of socioeconomic inequalities in QoL increased over time after EBC diagnosis in a country with a strong welfare system and universal healthcare coverage. In the era of precision medicine, these results underscore the importance of developing interventions to improve precision care, considering the conditions in which people are born, grow, work, live and age and the wider set of forces and systems shaping the conditions of daily life. Citation Format: José Luis Sandoval, Antonio Di Meglio, Arlindo Ferreira, Maria Alice Franzoi, Fabrice André, Barbara Pistilli, Christelle Jouannaud, Marion Fournier, Philippe Rouanet, Asma Dhaini Mermeche, Paul Cottu, Sibille Everhard, Anne-Laure Martin, Silvia Stringhini, Idris Guessous, Ines Vaz Luis, Gwenn Menvielle. The magnitude and temporal variations of socioeconomic inequalities in quality of life after early breast cancer: results from the multicentric French CANTO cohort [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO2-09-12.

Exploring functional abilities and competing risks among stroke patients: a longitudinal and survival analysis study at Felege Hiwot Referral Hospital, Ethiopia

ObjectivesThis study aimed to evaluate competing risks and functional ability measures among patients who had a stroke.DesignA joint model comprising two related submodels was applied: a cause-specific hazard submodel for...

So much for plain language: An analysis of the accessibility of U.S. federal laws over time.

So much for plain language: An analysis of the accessibility of U.S. federal laws over time.

The mediating roles of depressive symptoms and social participation in the relationship between the effects of pain and cognitive function among Chinese older adults: A longitudinal study

Decline in cognitive function poses a substantial burden on individuals, families, and society. However, the longitudinal potential mechanism underlying the link of pain and cognitive function remains unclear. Using data of 4247 participants aged 60 years and over from the China Health and Retirement Longitudinal Study in 2011, 2013, 2018, and 2020, we discussed the longitudinal predictive effect of pain on cognitive function and the mediating effects of depressive symptoms and social participation. The longitudinal mediation model analysis revealed that pain could not directly influence cognitive function, but it could indirectly predict cognitive function through the independent mediation effects of depressive symptoms and social participation. Moreover, the association between pain and cognitive function was serially mediated by depressive symptoms and social participation. Diversified interventions aimed at relieving pain and depressive symptoms, and increasing social participation in older adults would be beneficial for their cognitive function.

Seeing the teacher through my peers' eyes? A social network study on adolescents' teaching quality perceptions

Background: Prior research has documented the pervasive influence that peers can exert on adolescents’ lives. However, knowledge on whether adolescents’ perceptions of the quality of the teacher's instruction are also prone to peer influences is lacking. Method: This study (N = 248 German adolescents) used longitudinal social network analysis to investigate whether (a) friends become more similar in their teaching quality perceptions (influence effects) and/or whether (b) students with initially more similar perceptions of teaching quality were more likely to become friends (selection effects). We also explored whether (c) students with more positive teaching quality perceptions were better integrated socially. Results: We did not find support for influence or selection effects. However, students who rated their teacher's instruction more positively were better integrated socially. Conclusions: Our work adds to research on the role of peers in adolescence and enhances our understanding of peer influences on students’ perceptions of instruction.