Mean Age Of Participants Research Articles

Historic Cognitive Function Trajectories as Predictors of Sedentary Behavior and Physical Activity in Older Adults.

We examined whether trajectories of cognitive function over 10 years predict later-life physical activity (PA), sedentary time (ST), and sleep. Participants were from the Adult Changes in Thought (ACT) cohort study. We included 611 ACT participants who wore accelerometers and had 3+ measures of cognition in the 10 years prior to accelerometer wear. The Cognitive Assessment Screening Instrument (CASI) measured cognition and was scored using item-response theory (IRT). activPAL and ActiGraph accelerometers worn over 7 days measured ST and PA outcomes. Self-reported time in bed and sleep quality measured sleep outcomes. Analyses used growth mixture modeling to classify CASI-IRT scores into latent groups and examine associations with PA, ST, and sleep including demographic and health covariates. Participants (Mean age = 80.3 (6.5) years, 90.3% White, 57.1% female, 29.3% had less than 16 years of education) fell into 3 latent trajectory groups: average stable CASI (56.1%), high stable CASI (34.0%), and declining CASI (9.8%). The declining group had 16 minutes less stepping time (95% confidence interval [95% CI]: 0.6, 31.4), 1517 fewer steps per day (95% CI: 138, 2896), and 16.3 minutes per day less moderate-to-vigorous PA (95% CI: 1.3, 31.3) compared to the average stable group. There were no associations between CASI trajectory and sedentary or sleep outcomes. Declining cognition predicted lower PA providing some evidence of a reverse relationship between PA and cognition in older adults. However, this conclusion is limited by having outcomes at only one time point, a nonrepresentative sample, self-reported sleep outcomes, and using a global cognition measure.

Assessment the Incidence of Inferior Wall Myocardial Infarction, its Association with Right Ventricular Infarction and Function and its Clinical Outcome

Introduction: Myocardial infarction is one of the most common diagnoses in hospitalized patients. Myocardial infarction was previously thought to be a disease of mainly the left ventricle. Right ventricular infarction was just a pathological entity. Myocardial infarction may go undetected or may lead to catastrophic events leading to sudden cardiac death or causing severe hemodynamic derangements. Objective: To find out the Assessment the incidence of Inferior Wall Myocardial Infarction, its association with right ventricular infarction and function and its clinical outcome. Methods: The hospital based observational cross-sectional study was contacted at Department of Cardiology, Mymensingh Medical College Hospital, Bangladesh from 1st January 2022 to 30th January 2024. Conducted in intensive care unit, on an in-patient basis, consist of 50 cases of inferior wall MI. In patients with RVMI, the hospital death is high and major complications are greater. Right ventricular infarction leads to hemodynamic instability, atrio-ventricular conduction blocks, and in-hospital mortality in patients with inferior wall myocardial infarction. Results: Out of the total 150 cases of acute MI were included. The incidence of IMI among all the cases of AMI was 33.3%. In our study group of IMI RVI incidence was 30%. So, the incidence of RVI in all cases of AMI was 10%. There is a significant association between IWMI and RVMI and RVMI is seen in about 20% of cases and most common complication encountered was hypotension followed by complete heart block. The mean age of participants was 58.33 and maximum number of patients was in the age group of 40-60 (43%) and consists of 80% males and 20% females. Among them 51.4% was hypertensive, 22.8% were diabetic, 74.3% smokers, 11.42% were alcoholics. In this study 58.33% of patients with RVMI and 2% of patients without RVMI were presented with hypotension at the time of admission. Complete heart block seen in 13.33% of IWMI patients and Hypotension seen in 20% IWMI patients RVMI group. Right ventricular myocardial infarction seen in 20% of IWMI cases and TR is seen 66% of patients of IWMI with RVMI and 4% of patients of IWMI without RVMI. Conclusion: The incidence of mortality and complications can be reduced only when we are fully aware of the diagnosis and the complications that can occur in RVI. So, in all cases of IMI, RVI should be looked for by using simple and specific investigation like RPLs of ECG. Involvement of the right ventricle in inferior wall myocardial infarction significantly affects the mortality and morbidity and complications.

Differential Vulnerability of Hippocampal Subfields to Amyloid and Tau Deposition in the Lewy Body Diseases.

Alzheimer disease (AD) copathologies of β-amyloid and tau are common in the Lewy body diseases (LBD), dementia with Lewy bodies (DLB) and Parkinson disease (PD), and target distinct hippocampal subfields compared with Lewy pathology, including subiculum and CA1. We investigated the hypothesis that AD copathologies impact the pattern of hippocampal subregion volume loss and cognitive function in LBD. This was a cross-sectional and longitudinal, single-center, observational cohort study. Participants underwent neuropsychological testing and 3T-MRI with hippocampal segmentation using FreeSurferV7. PiB-PET and flortaucipir-PET imaging of comorbid β-amyloid (A) and tau (T) were acquired. The association of functional cognition, β-amyloid, and tau loads with hippocampal subregion volume was assessed. The contribution of subregion volumes to the relationship of AD-related deposits on functional cognition was examined with mediation analysis. The effects of AD-related deposits on the rate of subregion atrophy were evaluated with mixed-effects models. Of 103 participants (mean age: 70.3 years; 37.3% female), 52 had LBD with impaired cognition (LBD-I), 26 had normal cognition (LBD-N), and 25 were A- healthy controls (HCs). Volumes of hippocampal subregions prone to AD copathologies, including subiculum (F = 6.9, p = 0.002), presubiculum (F = 7.3, p = 0.001), and parasubiculum (F = 5.9, p = 0.004), were reduced in LBD-I compared with LBD-N and HC. Volume was preserved in CA2/3, Lewy pathology susceptible subregions. In LBD-I, reduced CA1, subiculum, and presubiculum volumes were associated with greater functional cognitive impairment (all p < 0.05). Compared with HC, subiculum volume was reduced in A+T+ but not A-T- participants (F = 2.62, p = 0.043). Reduced subiculum volume mediated the effect of amyloid on functional cognition (0.12, 95% CI: 0.005 to 0.26, p = 0.040). In 26 longitudinally-evaluated participants, baseline tau deposition was associated with faster CA1 (p = 0.021) and subiculum (p = 0.002) atrophy. In LBD, volume loss in hippocampal output subregions-particularly the subiculum-is associated with functional cognition and AD-related deposits. Tau deposition appears to accelerate subiculum and CA1 atrophy, whereas Aβ does not. Subiculum volume may have value as a biomarker of AD copathology-mediated neurodegeneration and disease progression.

Association of Ideal Cardiovascular Health in Youth with Cancer Risk in Adulthood: Cardiovascular Risk in Young Finns Study.

Lifestyle factors may affect cancer risk. This study aimed to identify whether American Heart Association (AHA) Ideal Cardiovascular Health (ICH) score and its individual variables in youth associate with subsequent cancer incidence. Study comprised of participants of the Cardiovascular Risk in Young Finns Study free of cancer at analysis baseline in 1986 (n=1873). Baseline age was 12-24 years and the follow-up occurred between 1986-2018. Among 1873 participants (mean age 17.3±4.1 years; 53.4% females at baseline), 72 incident cancer cases occurred during the follow-up (mean follow-up time 31.4±3.4 years). Baseline ICH score was not associated with future cancer risk (HR 0.96, 95% CI 0.78-1.12 per 1-point increment). Of individual ICH score variables, ideal physical activity (PA) was inversely associated with cancer incidence (age- and sex-adjusted HR 0.45 (0.23-0.88) per 1-category change [nonideal/ideal]), and remained significant in multivariable-adjusted model including also BMI, smoking, diet and socioeconomic status. A continuous physical activity index at ages 9-24 years and moderate to vigorous physical activity in youth were also related to decreased cancer incidence (p<0.05). BMI, smoking, diet, total cholesterol, glucose and blood pressure were not related to cancer risk. Of the dietary components, meat consumption was associated with cancer incidence (p=0.023). These findings indicate that higher PA levels in youth associate with a reduced subsequent cancer incidence whereas AHA´s ICH score in youth does not. This finding supports the efforts in promoting healthy lifestyle and encourages in physical activity during childhood yielding in subsequent healthier life.

Predictive value of sarcopenia components for all-cause mortality: findings from population-based cohorts

BackgroundLow grip strength and gait speed are associated with mortality. However, investigation of the additional mortality risk explained by these measures, over and above other factors, is limited.AimWe examined whether grip strength and gait speed improve discriminative capacity for mortality over and above more readily obtainable clinical risk factors.MethodsParticipants from the Health, Aging and Body Composition Study, Osteoporotic Fractures in Men Study, and the Hertfordshire Cohort Study were analysed. Appendicular lean mass (ALM) was ascertained using DXA; muscle strength by grip dynamometry; and usual gait speed over 2.4–6 m. Verified deaths were recorded. Associations between sarcopenia components and mortality were examined using Cox regression with cohort as a random effect; discriminative capacity was assessed using Harrell’s Concordance Index (C-index).ResultsMean (SD) age of participants (n = 8362) was 73.8(5.1) years; 5231(62.6%) died during a median follow-up time of 13.3 years. Grip strength (hazard ratio (95% CI) per SD decrease: 1.14 (1.10,1.19)) and gait speed (1.21 (1.17,1.26)), but not ALM index (1.01 (0.95,1.06)), were associated with mortality in mutually-adjusted models after accounting for age, sex, BMI, smoking status, alcohol consumption, physical activity, ethnicity, education, history of fractures and falls, femoral neck bone mineral density (BMD), self-rated health, cognitive function and number of comorbidities. However, a model containing only age and sex as exposures gave a C-index (95% CI) of 0.65(0.64,0.66), which only increased to 0.67(0.67,0.68) after inclusion of grip strength and gait speed.ConclusionsGrip strength and gait speed may generate only modest adjunctive risk information for mortality compared with other more readily obtainable risk factors.

Enhancing patient-clinician collaboration during treatment decision-making: study protocol for a community-engaged, mixed method hybrid type 1 trial of collaborative decision skills training (CDST) for veterans with psychosis

BackgroundPatient participation in treatment decision making is a pillar of recovery-oriented care and is associated with improvements in empowerment and well-being. Although demand for increased involvement in treatment decision-making is high among veterans with serious mental illness, rates of involvement are low. Collaborative decision skills training (CDST) is a recovery-oriented, skills-based intervention designed to support meaningful patient participation in treatment decision making. An open trial among veterans with psychosis supported CDST’s feasibility and demonstrated preliminary indications of effectiveness. A randomized control trial (RCT) is needed to test CDST’s effectiveness in comparison with an active control and further evaluate implementation feasibility.MethodsThe planned RCT is a hybrid type 1 trial, which will use mixed methods to systematically evaluate the effectiveness and implementation feasibility of CDST among veterans participating in a VA Psychosocial Rehabilitation and Recovery Center (PRRC) in Southern California. The first aim is to assess the effectiveness of CDST in comparison with the active control via the primary outcome, collaborative decision-making behavior during usual care appointments between veterans and their VA mental health clinicians, and secondary outcomes (i.e., treatment engagement, satisfaction, and outcome). The second aim is to characterize the implementation feasibility of CDST within the VA PRRC using the Practical Robust Implementation and Sustainability Model framework, including barriers and facilitators within the PRRC context to support future implementation.DiscussionIf CDST is found to be effective and feasible, implementation determinants gathered throughout the study can be used to ensure sustained and successful implementation at this PRRC and other PRRCs and similar settings nationally.Trial registrationClinicalTrials.gov NCT04324944. Registered on March 27, 2020. Trial registration data can be found in Appendix 1.

Application of modified Yamane technique in intrascleral intraocular lens fixation combined with or without iris reconstruction

AimsTo explore the application and long-term clinical effects of modified Yamane technique in intrascleral intraocular lens (IOL) fixation combined with or without iris reconstruction.Settings and designThe data of patients receiving IOL fixation with modified Yamane technique in an ophthalmology department between December 2021 and August 2023 were analyzed retrospectively. The longest follow-up duration was > 12 months.Methods and materialThe trailing haptic was fixed with the needle before the leading haptic. The silicone haptic stoppers were used to stabilize the IOL when iris reconstruction was combined. Preoperative and postoperative best-corrected visual acuity (BCVA), corneal endothelial cells (CECs), postoperative intraocular pressure (IOP), surgical indications and methods, and postoperative complications were recorded. Anterior segment optical coherence tomography (OCT) was used to evaluate IOL decentration and tilt. The paired sample t-test or Wilcoxon rank sum test were used to compare the results of the same index before and after the operation.ResultsTwelve patients (12 eyes) were included in this cohort. There were 1 case of IOL dislocation, eight cases of lens dislocation or subluxation, and three cases of aphakia. Traumatic lens dislocation was the main cause of aphakia. Primary lens extraction was performed in previous surgeries, and all three were combined with pars plana vitrectomy (PPV). Four of 12 patients underwent IOL fixation and iris reconstruction. The mean age of participants was 63 ± 10.61 years. The mean BCVA increased from 0.89 ± 0.72 logMAR to 0.39 ± 0.56 logMAR at the last visit (p < 0.05). The postoperative relative refractive error was − 0.13 ± 0.42 D (–0.60 D to + 0.57 D). The OCT showed that the IOLs were well centered, with a mean decentration of 0.20 ± 0.13 mm and a mean tilt of 2.31°±0.93°. Ten patients did not experience any complications.ConclusionsThe modified Yamane technique in IOL fixation surgery, especially combined with iris reconstruction, reduces operation difficulty, increases operational stability and safety, and improves postoperative visual acuity without serious intra- or postoperative complications. The long-term improvement effect was remarkable.

Association Between Microvascular Disease and Cardiorespiratory Fitness Among Adults With Type 2 Diabetes.

Little is known about the extent to which microvascular disease is associated with cardiorespiratory fitness (CRF) among individuals with type 2 diabetes. A total of 4,766 participants with type 2 diabetes underwent maximal exercise testing in the Look AHEAD (Action for Health in Diabetes) study at baseline. Low CRF was defined based on the Aerobics Center Longitudinal Study reference standards. Microvascular disease was defined as having one or more of diabetes-related kidney disease (DKD), retinopathy, and neuropathy. The burden of microvascular disease was defined as the number of microvascular beds affected. Of the 4,766 participants (mean age 58.9 ± 6.7 years, 58.5% women, 66.1% White individuals), 1,761 (37%) had microvascular disease. Participants with microvascular complications in three vascular territories had a lower CFR than those without any microvascular disease (mean adjusted metabolic equivalent of task [MET] 6.58 vs. 7.26, P = 0.001). Participants with any microvascular disease had higher odds of low CRF than those without microvascular disease (adjusted odds ratio [OR] 1.45, 95% CI 1.24-1.71). An increasing burden of microvascular disease was associated with higher odds of low CRF (for microvascular disease in three vascular territories, adjusted OR 2.82, 95% CI 1.36-5.85). Adjusted ORs for low CRF were 1.24 (95% CI 0.99-1.55), 1.34 (95% CI 1.02-1.76), and 1.44 (95% CI 1.20-1.73) for neuropathy, retinopathy, and DKD associations, respectively. In a large cohort of adults with type 2 diabetes, the presence of microvascular disease and its burden were independently associated with lower CRF.

The association of carotid plaque burden and composition and the coronary artery calcium score in intermediate cardiovascular risk patients.

Both the carotid ultrasound and coronary artery calcium (CAC) score quantify subclinical atherosclerosis and are associated with cardiovascular disease and events. This study investigated the association between CAC score and carotid plaque quantity and composition. Adult participants (n = 43) without history of cardiovascular disease were recruited to undergo a carotid ultrasound. Maximum plaque height (MPH), total plaque area (TPA), carotid intima-media thickness (CIMT), and plaque score were measured. Grayscale pixel distribution analysis of ultrasound images determined plaque tissue composition. Participants then underwent CT to determine CAC score, which were also categorized as absent (0), mild (1-99), moderate (100-399), and severe (400+). Spearman correlation coefficients between carotid variables and CAC scores were computed. The mean age of participants was 63 ± 11 years. CIMT, TPA, MPH, and plaque score were significantly associated with CAC score (ρ = 0.60, p < 0.0001; ρ = 0.54, p = 0.0002; ρ = 0.38, p = 0.01; and ρ = 0.49, p = 0.001). Echogenic composition features %Calcium and %Fibrous tissue were not correlated to a clinically relevant extent. There was a significant difference in the TPA, MPH, and plaque scores of those with a severe CAC score category compared to lesser categories. While carotid plaque burden was associated with CAC score, plaque composition was not. Though CAC score reliably measures calcification, carotid ultrasound gives information on both plaque burden and composition. Carotid ultrasound with assessment of plaque features used in conjunction with traditional risk factors may be an alternative or additive to CAC scoring and could improve the prediction of cardiovascular events in the intermediate risk population.

Comparison of Dialysis Catheter Insertion and Complications Under Ultrasound Guidance with or without Fluoroscopic Assistance: A Randomized Study

Background: Fluoroscopy is considered to be the gold standard and an essential requirement for catheter insertion. However, there is a paucity of data regarding the outcomes in ultrasound (USG)-guided insertion with and without fluoroscopy. We compared the complications of USG-guided tunneled dialysis catheter (TDC) insertion with and without fluoroscopy assistance. Materials and Methods: This was a single-center randomized controlled trial (RCT) done in a tertiary hospital in North India. After screening 153 patients, 149 were enrolled: 87 were randomized into USG-guided insertion without fluoroscopy (group A) and 62 were randomized into USG-guided insertion with fluoroscopy (group B). All insertions were done in a dedicated procedure room by trained nephrologists. Outcomes were analyzed at baseline and at 1-month follow-up. Mechanical complications as well as infective and thrombotic complications were compared between both the groups. Results: TDC insertion was successful (100%) in all the study participants (N = 149). One hundred twenty-nine catheters (86.5%) were inserted in the first attempt, 19 (12.5%) in the second attempt, and one catheter insertion required three attempts for insertion. The mean age of study participants was 43 years (±16.5), and males constituted 63% of the study cohort. Baseline laboratory characteristics of the two groups were comparable. The mean time of catheter insertion was 41.26 min (standard deviation [SD] 11.8) in group A and 47.74 min (SD 17.2) in group B (P = 0.007). The mean score of ease of catheter insertion, exit site bleed, infective and mechanical complications were not different between the two groups. Conclusion: Our study concluded that fluoroscopy has no additional advantage in reducing mechanical, infective, or thrombotic complications. In experienced hands, USG-guided TDC insertion without fluoroscopy assistance is as good as the insertion done with fluoroscopy assistance, with a shorter procedure time.

The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF): German Translation and Psychometric Assessment.

German-speaking mothers have breastfeeding rates below the international breastfeeding recommendations. Previous research has found that breastfeeding self-efficacy is an important and modifiable predictor of breastfeeding outcomes, thus improving breastfeeding rates. The Breastfeeding Self-Efficacy Scale-Short Form (BSES-SF) is used in many countries to assess maternal breastfeeding self-efficacy. This instrument has not been available in German. To translate the BSES-SF into German and assess its psychometric properties among breastfeeding mothers up to 12 weeks postpartum. This cross-sectional study was conducted online with 355 breastfeeding mothers recruited from breastfeeding groups through Facebook. The BSES-SF was translated into German using forward and back-translation. To test reliability, item-total characteristics, including Cronbach's alpha, were examined. We used principal component analysis, as well as known-groups comparisons for evaluating construct validity, and examined the relationship between breastfeeding self-efficacy and demographic variables. The mean age of participants was 32.4 years (SD = 4.32). The Cronbach's alpha coefficient was .88 and corrected item-total correlations ranged between .37 and .73. Principal components analysis yielded one component with factor loadings >.40 and an eigenvalue of 5.62, which explained 40% of the total variance. In addition, known group comparisons provided further evidence for construct validity. There was no significant difference in BSES-SF scores in terms of demographic and obstetrics characteristics. Our results provide evidence that the German version of the BSES-SF is a reliable and valid tool for measuring breastfeeding self-efficacy among mothers in German-speaking countries.

May Measure Month 2022 in Italy: A Focus on Fixed-dose Combination, Therapeutic Adherence, and Medical Inertia in a Nationwide Survey.

Hypertension is the main risk factor for cardiovascular diseases (CVD). Notably, only about half of hypertensive patients manage to achieve the recommended blood pressure (BP) control. Main reasons for the persistence of uncontrolled BP during treatment are lack of compliance on the patients' side, and therapeutic inertia on physicians' side. During the global BP screening campaign "May Measure Month" (MMM) (May 1st to July 31st, 2022), a nationwide, cross-sectional, opportunistic study endorsed by the Italian Society of Hypertension was conducted on volunteer adults ≥ 18 years to raise awareness of the health issues surrounding high BP. A questionnaire on demographic/clinical features and questions on the use of fixed-dose single-pills for the treatment of hypertension was administered. BP was measured with standard procedures. A total of 1612 participants (mean age 60.0±15.41 years; 44.7% women) were enrolled. Their mean BP was 128.5±18.1/77.1±10.4 mmHg. About half of participants were sedentary, or overweight/obese, or hypertensive. 55.5% individuals with complete BP assessment had uncontrolled hypertension. Most were not on a fixed-dose combination of antihypertensive drugs and did not regularly measure BP at home. Self-reported adherence to BP medications was similar between individuals with controlled and uncontrolled BP (95% vs 95.5%). This survey identified a remarkable degree of therapeutic inertia and poor patients' involvement in the therapeutic process and its monitoring in the examined population, underlining the importance of prevention campaigns to identify areas of unsatisfactory management of hypertension, to increase risk factors' awareness in the population with the final purpose of reducing cardiovascular risk.

Scoring facial attractiveness with deep convolutional neural networks: How training on standardized images reduces the bias of facial expressions.

In many medical disciplines, facial attractiveness is part of the diagnosis, yet its scoring might be confounded by facial expressions. The intent was to apply deep convolutional neural networks (CNN) to identify how facial expressions affect facial attractiveness and to explore whether a dedicated training of the CNN is able to reduce the bias of facial expressions. Frontal facial images (n = 840) of 40 female participants (mean age 24.5 years) were taken adapting a neutral facial expression and the six universal facial expressions. Facial attractiveness was computed by means of a face detector, deep convolutional neural networks, standard support vector regression for facial beauty, visual regularized collaborative filtering and a regression technique for handling visual queries without rating history. CNN was first trained on random facial photographs from a dating website and then further trained on the Chicago Face Database (CFD) to increase its suitability to medical conditions. Both algorithms scored every image for attractiveness. Facial expressions affect facial attractiveness scores significantly. Scores from CNN additionally trained on CFD had less variability between the expressions (range 54.3-60.9 compared to range: 32.6-49.5) and less variance within the scores (P ≤ .05), but also caused a shift in the ranking of the expressions' facial attractiveness. Facial expressions confound attractiveness scores. Training on norming images generated scores less susceptible to distortion, but more difficult to interpret. Scoring facial attractiveness based on CNN seems promising, but AI solutions must be developed on CNN trained to recognize facial expressions as distractors.

While You Are Sleeping: Marital Ambivalence and Blunted Nocturnal Blood Pressure.

Marital relationships offer health benefits, including a lower risk of cardiovascular disease (CVD). However, quality of the relationship matters; ambivalent behaviors may increase CVD risk by affecting blunted nocturnal blood pressure (BP) dipping. This study tracked daytime and nocturnal SBP and DBP in 180 normotensive individuals (90 couples; participant mean age 25.04; 91.58% white) over a 24 h period using ambulatory blood pressure monitors to explore the impact of martial quality. Results showed that perceptions of spousal ambivalence were associated with blunted nocturnal BP dipping. Perceptions of one's own behavior as ambivalent also showed blunted nocturnal dipping. When in an ambivalent relationship, a gender interaction was found such that women were most likely to have blunted SBP dipping, but men were more likely to have blunted nocturnal DBP dipping. Overall, this study found an association between ambivalence and BP dipping, thus uncovering one virtually unexplored pathway by which marital relationships may have adverse effects on health.

Impact of social determinants of health on health-related quality of life in cancer survivors.

11183 Background: Social determinants of health (SDoH) encompass the various environmental conditions that influence health, well-being, outcomes, and potential risks. Adverse SDoH can exacerbate health disparities and result in a reduced health-related quality of life (HRQoL). We conducted an investigation into the impact of SDoH on the HRQoL of cancer survivors. Methods: The study population was a nationally representative cohort of individuals aged 20-80 years who took part in the United States National Health and Nutrition Examination Survey (NHANES) 2001 to 2018 cycles. We evaluated HRQoL by measuring the number of physically unhealthy days, mentally unhealthy days, inactive days, as well as assessing social support and emotional well-being. We used logistic regression models to investigate the impact of each SDoH on the HRQoL of cancer survivors. Results: We included 4,780 participants in our analyses, comprising 2,533 women and 2,247 men. The participants mean age was 66 (±14) years at the time of enrollment, and 55 (±17) years at the time of cancer diagnosis. Among the total study population, non-melanoma skin cancer (16%) was the most prevalent cancer type. After adjusting for age, age at cancer diagnosis and gender, people who had the lowest self-reported health were more likely to have completed fewer years of education (OR 0.380 [95% CI: 0.32 - 0.45], p &lt; 0.0001), be unemployed (OR 2.30 [1.91 - 2.77], p &lt; 0.0001), have lower family income (OR 0.36 [0.28 - 0.45], p &lt; 0.0001), be food insecure (OR 3.90 [2.80 - 5.44], p &lt; 0.0001), not have private health insurance (OR 1.68 [1.37 - 2.07], p &lt; 0.0001), and have been hospitalized overnight in the last year (OR 5.23 [3.49 - 7.83], p &lt; 0.001) compared to those with the highest self-reported health. SDoH including employment status, family income, food security status, health insurance type, and overnight hospital patient status, were significantly associated with physical and mental health, and physically active days. Level of education and food security were significantly associated with social support and emotional well-being. Conclusions: Adverse SDoH were associated with the reduced HRQoL of cancer survivors in the United States. These findings underscore the importance of addressing and mitigating these social determinants in order to alleviate health disparities and improve the overall well-being and quality of life for cancer survivors.

Dysmenorrhea in Tunisian high school adolescent girls: frequency, effects, and absence from school.

Dysmenorrhea is a known phenomenon and not just recently, and investigations conducted recently have shown that female adolescents are very susceptible to this condition. Our goal is to determine the prevalence of dysmenorrhea in Tunisia, its risk factors, its impact on truancy rates, and the therapeutic attitudes of girls attending high school about this illness using an epidemiological survey. This eight-month study, which spans from October 2022 to May 2023, focuses on 160 high school girls between the ages of 13 and 21. It is a transversal descriptive study. The required data is gathered through the distribution of a self-administered questionnaire. The mean age of female adolescent participants is 16.44 years and 68 % of them reported dysmenorrhea. The most common symptoms of the pain were headaches (40.0 %). There is a notable prevalence of absenteeism during the menstrual cycle. There seems to be a trend toward self-medication. In Tunisia, primary dysmenorrhea is a common cause of school absenteeism among female adolescents. Girls' attitudes toward dysmenorrhea indicate a lack of knowledge, which is why it is crucial for midwives and physicians to educate teenage girls about the condition.

Gamified Exercise with Kinect: Can Kinect-Based Virtual Reality Training Improve Physical Performance and Quality of Life in Postmenopausal Women with Osteopenia? A Randomized Controlled Trial.

Osteopenia, caused by estrogen deficiency in postmenopausal women (PMW), lowers Bone Mineral Density (BMD) and increases bone fragility. It affects about half of older women's social and physical health. PMW experience pain and disability, impacting their health-related Quality of Life (QoL) and function. This study aimed to determine the effects of Kinect-based Virtual Reality Training (VRT) on physical performance and QoL in PMW with osteopenia. The study was a prospective, two-arm, parallel-design, randomized controlled trial. Fifty-two participants were recruited in the trial, with 26 randomly assigned to each group. The experimental group received Kinect-based VRT thrice a week for 24 weeks, each lasting 45 min. Both groups were directed to participate in a 30-min walk outside every day. Physical performance was measured by the Time Up and Go Test (TUG), Functional Reach Test (FRT), Five Times Sit to Stand Test (FTSST), Modified Sit and Reach Test (MSRT), Dynamic Hand Grip Strength (DHGS), Non-Dynamic Hand Grip Strength (NDHGS), BORG Score and Dyspnea Index. Escala de Calidad de vida Osteoporosis (ECOS-16) questionnaire measured QoL. Both physical performance and QoL measures were assessed at baseline, after 12 weeks, and after 24 weeks. Data were analyzed on SPSS 25. The mean age of the PMW participants was 58.00 ± 5.52 years. In within-group comparison, all outcome variables (TUG, FRT, FTSST, MSRT, DHGS, NDHGS, BORG Score, Dyspnea, and ECOS-16) showed significant improvements (p < 0.001) from baseline at both the 12th and 24th weeks and between baseline and the 24th week in the experimental group. In the control group, all outcome variables except FRT (12th week to 24th week) showed statistically significant improvements (p < 0.001) from baseline at both the 12th and 24th weeks and between baseline and the 24th week. In between-group comparison, the experimental group demonstrated more significant improvements in most outcome variables at all points than the control group (p < 0.001), indicating the positive additional effects of Kinect-based VRT. The study concludes that physical performance and QoL measures were improved in both the experimental and control groups. However, in the group comparison, these variables showed better results in the experimental group. Thus, Kinect-based VRT is an alternative and feasible intervention to improve physical performance and QoL in PMW with osteopenia. This novel approach may be widely applicable in upcoming studies, considering the increasing interest in virtual reality-based therapy for rehabilitation.

The Effect of Date Palm (Phoenix dactylifera L.) Pollen on the Serum Levels of Testosterone, Luteinizing, and Follicle Stimulating Hormones in Men

Background: Date Palm Pollen (DPP) has traditionally been used to increase sexual ability and fertility. In several animal studies, the effects of this herbal medicine on testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) have been shown. Objectives: This study was conducted to evaluate the effects of this drug on the serum levels of testosterone, LH, and FSH in men. Methods: In this semi-experimental study, a daily dose of 6 g dry powder of DPP in two separate doses (3 g every 12 hours) was administered orally to 30 eligible men for three months. The changes in mean serum levels of hormones were statistically evaluated after the intervention compared to the baseline. The serum concentration of the hormones was assayed through the enzyme-linked immunosorbent assay method. Data were analyzed using paired t-tests. Results: After recruitment, among 30 participants, 24 men received the intervention and finally were analyzed. The mean (SD) age and body mass index of participants were 32.85 (0.43) years and 26.5 (0.5) kg/m2 . DPP significantly increased the serum levels of testosterone (from 5.31±0.40ng/ml to 6.88±0.71 ng/ml; p=0.019) but did not affect the serum levels of FSH (from 4.31±0.50 IU/L to 4.70±0.61 IU/L; p=0.511). It also significantly decreased the serum levels of LH (from 5.65±0.81 IU/L to 4.52±0.90 IU/L; p= 0.033). There were no reported side effects. Conclusion: The results indicated an increasing effect of DPP on serum testosterone and decreasing effect on serum LH. However, DPP had no significant effect on FSH serum levels.

Deformation-encoding Deep Learning Transformer for High-Frame-Rate Cardiac Cine MRI.

Purpose To develop a deep learning model for increasing cardiac cine frame rate while maintaining spatial resolution and scan time. Materials and Methods A transformer-based model was trained and tested on a retrospective sample of cine images from 5840 patients (mean age, 55 years ± 19 [SD]; 3527 male patients) referred for clinical cardiac MRI from 2003 to 2021 at nine centers; images were acquired using 1.5- and 3-T scanners from three vendors. Data from three centers were used for training and testing (4:1 ratio). The remaining data were used for external testing. Cines with downsampled frame rates were restored using linear, bicubic, and model-based interpolation. The root mean square error between interpolated and original cine images was modeled using ordinary least squares regression. In a prospective study of 49 participants referred for clinical cardiac MRI (mean age, 56 years ± 13; 25 male participants) and 12 healthy participants (mean age, 51 years ± 16; eight male participants), the model was applied to cines acquired at 25 frames per second (fps), thereby doubling the frame rate, and these interpolated cines were compared with actual 50-fps cines. The preference of two readers based on perceived temporal smoothness and image quality was evaluated using a noninferiority margin of 10%. Results The model generated artifact-free interpolated images. Ordinary least squares regression analysis accounting for vendor and field strength showed lower error (P < .001) with model-based interpolation compared with linear and bicubic interpolation in internal and external test sets. The highest proportion of reader choices was "no preference" (84 of 122) between actual and interpolated 50-fps cines. The 90% CI for the difference between reader proportions favoring collected (15 of 122) and interpolated (23 of 122) high-frame-rate cines was -0.01 to 0.14, indicating noninferiority. Conclusion A transformer-based deep learning model increased cardiac cine frame rates while preserving both spatial resolution and scan time, resulting in images with quality comparable to that of images obtained at actual high frame rates. Keywords: Functional MRI, Heart, Cardiac, Deep Learning, High Frame Rate Supplemental material is available for this article. © RSNA, 2024.

Unintentional weight loss, body composition, and all-cause mortality among United States adults with cancer.

e22527 Background: While unintentional weight loss (UWL) is a common presenting symptom of malignancy, weight changes also occur regularly in patients with diagnosed cancer.UWL is often characterized by considerable muscle and fat loss and can lead to cachexia, which may increase risk of mortality. This nationally representative study aims to assess the association between UWL and mortality among adults with history of cancer and characterize differences in body composition. Methods: This was a retrospective cohort study of the National Health and Nutrition Examination Survey 1999-2018 linked to the 2019 National Death Index. We identified adults with self-reported history of cancer, excluding non-melanoma skin cancer. Weight change was determined as the difference between current weight and self-reported weight 1 year prior to interview. We categorized weight change into: UWL (unintentionally losing &gt; 5% of weight), intention weight loss (IWL) (intentional loss &gt; 5% weight), no weight change (NWC) (≤5% weight change), weight gain (WG) ( &gt; 5% weight gain). We estimated risk of all-cause mortality using gender-stratified multivariable Cox regression, adjusting for demographics (age, race, income, education, insurance status), sociobehavioral factors (smoking, alcohol, nutrition, physical activity, self-reported health), comorbidities, and albumin. We additionally identified participants with cancer who had whole-body dual x-ray absorptiometry scans (2011-2018) and assessed body composition measurements including total lean mass, lean-to-fat ratio, subcutaneous fat mass, and visceral fat mass by weight change category using multivariable linear regression. Results: Among 3,153 participants (mean age 62 years, 55% women, 82% non-Hispanic White), the top four primary cancers were breast (21%), prostate (14%), melanoma (11%), and cervical (11%). Approximately 9% of men and 11% of women experienced UWL. Adults with UWL were more likely to have lower socioeconomic status, more functional limitations, and higher comorbidity burden. Across a median 7 years (IQR, 3-11y) follow-up, 22% of females and 34% of men died. Both men and women experiencing UWL had more than 2 times the risk of all-cause mortality compared to NWC (adjusted HR [95% CI]; men: 2.02 [1.47, 2.78]), women: 2.43 [1.78, 3.34]). Participants with UWL had less subcutaneous fat mass (-113g, 95% CI [-242, 16]) and visceral fat mass (-65g, 95% CI [-146, 16]) compared to NWC, though not statistically significance. Conclusions: UWL in patients with history of cancer is independently associated with more than 2 times the risk of all-cause mortality in both men and women. UWL was associated with proportional loss of both subcutaneous and visceral fat mass. Further longitudinal studies examining UWL’s impact on body composition changes and downstream outcomes by cancer type and stage are needed.