Linear Mixed-effects Models Research Articles

Life review-based academic service learning to address social work students’ knowledge, ageism and competencies in China: A pilot feasibility trial

ABSTRACT Life review-based academic service learning (LR-ASL) is a comprehensive educational program that addresses social work students’ knowledge, ageism and competencies. This study aimed to examine the acceptability and preliminary effectiveness of the LR-ASL program among undergraduate social work students in China. The study featured a quasiexperimental pretest‒posttest‒follow-up design and collected data from students at a college in China. The intervention group (n = 39) participated in the LR-ASL program, whereas the comparison group (n = 14) completed an aging knowledge examination. Most students (34 out of 39) in the LR-ASL group completed all the intervention sessions and assessments, indicating strong adherence to the LR-ASL program. Repeated-measures ANOVA and a linear mixed effects model were used to analyze the changes. Statistically significant within-group improvements over time in the intervention group were observed for knowledge, anxiety about aging, attitudes toward older adults, competency, and interest in working with older adults. Additionally, the intervention group improved more significantly than did the comparison group in terms of anxiety about aging, attitudes toward older adults, and interest in working with older adults. In conclusion, these findings support the acceptability and possible efficacy of the LR-ASL program among undergraduate social work students in China. LR-ASL may be a viable and promising academic service-learning program that can help inform future research and training related to reducing ageism and increasing gerontology competencies.

Performance of spondyloarthritis-specific health utilities based on ASAS Health Index: an ancillary analysis from ASAS-HI validation study.

To compare the utility values of Spondyloarthritis (SpA)-specific ASAS Health Index (U-ASAS-HI) to generic utilities and to understand the contribution of health outcomes, personal- and country-level factors to the U-ASAS-HI. Ancillary analysis of the ASAS-HI international validation study. SpA patients who completed the ASAS-HI, 5-level EuroQol-5D (EQ-5D-5L) and Short Form-36 (SF-36) questionnaires were selected, and utilities calculated. Correlations between U-ASAS-HI and generic utility values were tested. Potential explanatory variables were evaluated in a linear multivariable mixed-effects model analysis with multilevel modeling fitted by country. 1425 patients were included, with a mean age of 42 (Standard Deviation, SD : 13.5) and 65% male. The mean utility scores were EQ-5D-5L 0.75 (SD : 0.11), SF-6D 0.72 (SD : 0.24), and U-ASAS-HI 0.42 (SD : 0.29). Correlation between U-ASAS-HI and EQ-5D-5L and SF-6D was strong (r = 0.75 and r = 0.72; p< 0.001, respectively). The linear mixed-effects model showed that worse disease activity (ASDAS) and lower physical function (BASFI) were associated with lower U-ASAS-HI. Additionally, younger age, female gender, higher comorbidity score, and symptoms of depression were associated with lower U-ASAS-HI. SpA subtype had no influence on health utility. The random effects model indicated an intercept SD : 0.045 with a 5.5% variance ratio between countries and the total U-ASAS-HI variation. The U-ASAS-HI captures the physical and mental impact of SpA, as well as personal contextual factors such as age, gender, and comorbidities. The influence of the country of residence seems negligible. The U-ASAS-HI algorithm has sufficient support to be used in health economic evaluations for SpA patients across different countries.

Preliminary effectiveness of a trauma-informed mind-body intervention for survivors of human trafficking in the Philippines

ABSTRACT Human trafficking survivors report high rates of depression, anxiety, and post-traumatic stress disorder. Despite growing attention to the mental health needs of this population, there is a dearth of evidence-based mental health interventions and reintegration support programs for survivors in low-resource settings. We report findings from a pilot study exploring the preliminary effectiveness of a trauma-informed, mind-body intervention for survivors in Cebu, Philippines. Data were analyzed using linear mixed-effects models. Findings show significant reductions in symptoms of depression, anxiety, and PTSD among survivors over time. Findings demonstrate the promise of culturally-responsive, low-technology mind-body interventions to address survivors’ mental health needs.

Longitudinal Associations of PFAS Exposure With Insulin Sensitivity and β-Cell Function Among Hispanic Women With Gestational Diabetes Mellitus History.

We investigated associations between per- and polyfluoroalkyl substances (PFAS) and changes in diabetes indicators from pregnancy to 12 years after delivery among women with a history of gestational diabetes mellitus (GDM). Eighty Hispanic women with GDM history were followed from the third trimester of pregnancy to 12 years after delivery. Oral and intravenous glucose tolerance tests were conducted during follow-up. Plasma PFAS concentrations were measured at the third trimester of pregnancy and first postpartum visit. A linear mixed-effects model was used to analyze associations between PFAS and trajectories of diabetes indicators, adjusted for age, breastfeeding status, daily total calorie intake, and body fat percentage. Increased 2-(N-methyl-perfluorooctane sulfonamido) acetate level was associated with faster increase in concentrations of fasting glucose (P = 0.003). Increased perfluorononanoate (PFNA) and linear perfluorooctanoate (n-PFOA) concentrations were associated with faster increase in fasting insulin concentrations (P = 0.04 for PFNA; P = 0.02 for n-PFOA) and faster decrease in acute insulin response to glucose (P = 0.04 for PFNA; P = 0.02 for n-PFOA). PFAS exposure is associated with glucose intolerance, insulin resistance, and β-cell dysfunction, thus increasing type 2 diabetes risk.

Influence of Enterocytozoon bieneusi Infection on Child Growth: A Secondary Analysis of the MAL-ED Birth Cohort Study.

Malnutrition in the early days of life is a global public health concern that affects children's growth. It results from a variety of factors, including pathogenic infections. Enterocytozoon bieneusi is a microsporidian parasite that can cause diarrhea and malnutrition in children. The study aimed to assess the impact of E. bieneusi on child growth. The MAL-ED study, a multicountry birth cohort research project, investigated the relationship between enteric infections and malnutrition in participating children from eight countries. A customized real-time polymerase chain reaction-based TaqMan array card was used in this study to identify enteropathogens from stool samples, where E. bieneusi was one of the target pathogens. The impacts of E. bieneusi infection on growth measures were assessed. Mixed-effect linear models were used to investigate the relationship between E. bieneusi and growth outcomes, including length-for-age (LAZ), weight-for-age (WAZ), and weight-for-length (WLZ) Z scores. At the endpoint (last month of measurement), the infected group had significantly lower scores than the noninfected group for all outcomes. The adjusted difference-in-difference (D-in-D) values were -0.53 (95% CI: -0.67 to -0.38) for LAZ, -0.38 (95% CI: -0.52 to -0.23) for WAZ, and -0.22 (95% CI: -0.38 to -0.06) for WLZ. Enterocytozoon bieneusi infection has been identified as a factor associated with reduced linear growth, weight gain, and weight gain relative to linear growth in children, underscoring the importance of treating this infection.

How do extreme fluctuations in water level affect fish condition in Amazonian Floodplain Lakes?

The annual flood pulse is a defining feature of Amazonian floodplain lakes, creating a highly variable environment that influences resource availability, such as food and habitat. These cyclical changes necessitate a high degree of adaptability among fish species, many of which have evolved specialized strategies to cope with the fluctuating conditions. In 2023, the Amazon basin experienced a record-breaking drought event, leading to mass mortality of Amazonian fish and other wildlife. This study examines the effect of this extreme event on fish condition in white-water (Rio Solimões basin) and black-water (Rio Negro basin) floodplain lakes. These contrasting environments provide a unique opportunity to study how different water qualities and extreme water-level fluctuations impact fish condition. Research was conducted during the normal low-water period in November 2019 and the drastically decreased water levels in November 2023. The main objective was to understand how extreme water-level fluctuations affect fish health and nutritional status. A total of 585 fishes were analyzed, with 294 from white-water and 291 from black-water, representing different feeding types to provide a comprehensive picture of changes in fish condition. Water-level changes had a statistically significant impact on fish condition in both areas. Comparing low-water and extreme low-water levels, fish condition was consistently higher during the normal low-water period. The linear mixed-effects model revealed that the intensity of the low-water season had a significant effect on fish length-adjusted mass, suggesting that the decrease in water level is associated with an overall decrease in fish length-adjusted mass. When comparing the mean water-level effect (Glass's Δ) between low-water and extreme low-water levels, we found a bigger effect in the black-water system than in the white-water system. This difference may be attributed to the lower nutrient content and higher levels of humic acids and refractory dissolved organic matter in black-water, which can further limit primary productivity and food availability for fishes.

Internet-Based Dementia Prevention Intervention (DementiaRisk): Protocol for a Randomized Controlled Trial and Knowledge Translation.

Research has shown that engaging in a range of healthy lifestyles or behavioral factors can help reduce the risk of developing dementia. Improved knowledge of modifiable risk factors for dementia may help engage people to reduce their risk, with beneficial impacts on individual and public health. Moreover, many guidelines emphasize the importance of providing education and web-based resources for dementia prevention. Internet-based interventions may be effective, but few have been studied rigorously or widely disseminated. We created DementiaRisk, an award-winning, web- and email-based education platform for the public focused on modifiable risk factors, featuring multimedia e-learning and email "microlearning" content, to help raise awareness and improve knowledge of actions to reduce dementia risk. This protocol describes a randomized controlled trial to (1) evaluate whether exposure to DementiaRisk changes knowledge of dementia risk factors, intention to engage in risk reduction activities, and health behaviors related to dementia risk reduction and to (2) explore qualitative aspects including participants' engagement and satisfaction with the intervention and barriers and facilitators to use. Using a sequential explanatory mixed methods design, this study conducts a quantitative analysis followed by a qualitative inquiry to evaluate outcomes and feasibility. In total, 485 participants will be recruited on the web and randomly assigned to 2 groups: one accessing DementiaRisk and the other receiving alternative e-learning on mild cognitive impairment. Assessments will be delivered on the web at baseline (T1), at 4 weeks (T2), and at 2 months after the intervention (T3). Knowledge will be assessed using items from the Dementia Knowledge Assessment Scale, intentions to engage in risk reduction activities will be assessed using items in line with current evidence, and health behaviors related to dementia risk reduction will be assessed using items from the Godin-Shephard Leisure Time Physical Activity Questionnaire along with additional questions related to a range of health status domains. Outcomes and feasibility will be assessed using the Information Assessment Method for patients and consumers. A linear mixed effects model will be used to examine the relationship between each outcome score by group and time point. This study was approved by the Hamilton Integrated Research Ethics Board on August 24, 2022 (project ID 14886) and received funding in February 2023. Recruitment took place from March 28, 2023, to April 28, 2023, with the final participants completing the intervention by August 18, 2023. Analyses and interpretation of data are ongoing. DementiaRisk is a readily scalable, technology-enhanced solution for dementia prevention education. It has been designed using evidence-based principles of multimedia learning. It has the potential to scale and spread widely using the open internet, so it may be able to reach a wider audience than traditional in-person educational interventions. ClinicalTrials.gov NCT05383118; https://clinicaltrials.gov/study/NCT05383118. DERR1-10.2196/64718.

Role of major cardiovascular surgery-induced metabolic reprogramming in acute kidney injury in critical care.

Major cardiovascular surgery imposes high physiologic stress, often causing severe organ dysfunction and poor outcomes. The underlying mechanisms remain unclear. This study investigated metabolic changes induced by major cardiovascular surgery and the potential role of identified metabolic signatures in postoperative acute kidney injury (AKI). A prospective observational study included 53 patients undergoing major cardiovascular surgery in 3 groups: cardiac surgery with cardiopulmonary bypass (CPB n = 33), without CPB (n = 10), and major vascular surgery (n = 10). For each patient, peripheral blood samples were collected pre-surgery, and at 6h and 24h post-surgery. Untargeted metabolomics using mass spectrometry quantified 8668 metabolic features in serum samples. Linear mixed-effect models (adjusted for age, sex, and body mass index) and pathway analyses were performed. In the cardiac surgery with CPB group, 772 features were significantly altered (P < 2.8E - 05) across the 3 time points. These features were enriched in five classes, all related to protein metabolism, with glycine and serine metabolism being the most represented. Cardiac surgery with CPB showed a distinct metabolic signature compared to other groups. Patients who developed postoperative AKI exhibited increased protein catabolism (including valine, leucine, and isoleucine degradation), disruptions in the citric acid cycle, and plasmatic accumulation of acylcarnitines. Major cardiovascular surgery, particularly with CPB, induces significant changes in protein metabolism. Patients developing postoperative AKI exhibited specific metabolic signatures. These findings may be critical for designing interventions to minimize organ dysfunction, including AKI, and improve outcomes in major cardiovascular surgery.

Remote neurodegeneration in the lumbosacral cord one month after spinal cord injury: a cross-sectional MRI study.

To characterize structural integrity of the lumbosacral enlargement and conus medullaris within one month after spinal cord injury (SCI). Lumbosacral cord MRI data were acquired in patients with sudden onset (<7 days) SCI at the cervical or thoracic level approximately one month after injury and in healthy controls. Tissue integrity and loss were evaluated through diffusion tensor (DTI) and T2*-weighted imaging (cross-sectional area [CSA] measurements). Associations with the degree of neurological impairment were assessed using linear mixed-effects models. Twenty-one patients with SCI showed lower white matter (WM) fractional anisotropy (FA) (≤-13.3%) and higher WM radial diffusivity (≤14.6%) compared to 27 healthy controls. Differences were most pronounced in the lateral columns of WM. CSA measurements revealed no group differences. For the lateral columns, lower FA values were associated with lower motor scores and lower amplitudes of motor evoked potentials. For the dorsal columns, lower FA values were associated with lower amplitudes of somatosensory evoked potentials from the lower extremities. One month after SCI, first signs of WM degeneration were apparent, without indication of tissue loss. The more pronounced differences observed in the lateral column could be attributed to anterograde degeneration of the motor tracts. The variability among DTI measurements remote from the lesion site can be partially explained by the degree of the SCI-induced neurological impairment. Together with previous studies, our findings indicate that impaired tissue integrity precedes tissue loss. The presented techniques have potential applications in monitoring the progression of various neurological diseases.

Comparison of scenarios in the trajectory of body mass index among adolescents monitored in primary health care: the VigiNUTRI Brazil study

We compared the BMI-for-age (BMI/A) trajectory of Brazilian adolescents monitored in the primary health care (PHC) setting based on a simulated scenario. We used a real-life cohort of adolescents monitored by the Food and Nutrition Surveillance System (Sisvan) between 2008 and 2018. The LMS method was employed to estimate the simulated BMI/A evolution curve, assuming that the adolescents maintained the conditions observed during their first assessment (simulation curve). This curve was compared with that of the real-world cohort (Sisvan curve). Both curves were compared to the World Health Organization (WHO) reference cutoff. The difference in the BMI/A trajectory between the two curves was evaluated using linear mixed-effects models. When the participants started adolescence, their BMI/A was above the reference range. The Sisvan curve revealed that girls had a BMI/A that was higher than the simulated value at age 19 (p < 0.001) and that exceeded the WHO reference cutoff value; this finding was particularly pronounced in the southern region (Sisvan: 23.89 kg/m2; simulation: 23.57 kg/m2; WHO: 21.4 kg/m2). The BMI of boys decreased after age 13 (p < 0.001) but remained higher than the reference value. Monitoring nutritional status in the PHC setting may have been more effective at controlling excess weight in boys, emphasizing the importance of improving care.

Association Between Patient Characteristics and the Depth of Microvascular Penetration Into the Adult Human Meniscus.

Current knowledge on the microvascular anatomy of adult human menisci is based on cadaveric studies. However, considerable interindividual variation in meniscal microvascularization has been reported in recent studies with small sample sizes. To assess the association between patient characteristics and the depth of microvascularization of the meniscus. Descriptive laboratory study. Menisci from 174 patients who received total knee replacement between March 2021 and December 2023 were collected. A total of 174 lateral and 102 medial menisci were included. Three sections were made from each meniscus: the anterior horn, midbody, and posterior horn. Immunohistochemical staining (CD-31) was used to visualize the microvasculature. The 4 primary outcome measures were the correlation between the depth of microvascular penetration into the lateral meniscus (0%-100%) and (1) age, (2) smoking, (3) degree of osteoarthritis, and (4) history of cardiovascular disease. To account for repeated measurements within each patient, a linear mixed-effects model was estimated to study the association between microvascularization and the patient's characteristics previously introduced. The depth of vascular penetration ranged from 0% to 78% into the lateral menisci and from 0% to 67% into the medial menisci. No significant correlations were found between age, smoking, degree of osteoarthritis, or history of cardiovascular disease and the degree of vascular penetration into the lateral meniscus. The linear mixed-effects model analysis, adjusted for location within the meniscus (anterior horn, midbody, or posterior horn) and meniscal side (lateral or medial), showed no significant associations between the same patient characteristics and meniscal microvascularization. The degree of microvascular penetration into the meniscus has a wide range among adults >50 years. However, the depth of microvascularization was not associated with age, smoking, degree of osteoarthritis, or history of cardiovascular disease. Because no associations were found between depth of microvascular penetration into the meniscus and patient characteristics, the latter cannot be used to estimate the vascular status of a meniscal tear in clinical practice.

Efficacy of an Online Self-compassion Group Intervention for Sexual Minority Men Living with HIV: A Pilot Randomized Controlled Trial.

Sexual minority men living with HIV face challenges affecting their quality of life and medication adherence. While self-compassion has shown promise in improving quality of life, targeted interventions for this group remain limited. This pilot study evaluated the efficacy of an online self-compassion group intervention on quality of life and medication adherence among sexual minority men living with HIV. A six-week online intervention, adapted from the Mindful Self-Compassion program, was implemented in a two-arm randomized controlled trial with 28 participants, comparing the intervention to a waitlist control group. The primary outcomes were quality of life and self-compassion, with medication adherence as a secondary outcome. Measures were taken at baseline, mid-intervention, post-intervention, and 1-month follow-up. Linear mixed-effects model showed that the intervention significantly improved quality of life and medication adherence at post-intervention. Although self-compassion showed no significant improvement, over-identification, an uncompassionate self-responding component, showed marginal improvement at follow-up. This pilot study provides preliminary evidence that a self-compassion intervention may improve quality of life and medication adherence in sexual minority men living with HIV, warranting further research with larger sample sizes and a focus on the underlying mechanisms.

Hospital Variability in the Use of Vasoactive Agents in Patients Hospitalized for Acute Decompensated Heart Failure for Clinical Phenotypes.

The absence of practice standards in vasoactive agent usage for acute decompensated heart failure has resulted in significant treatment variability across hospitals, potentially affecting patient outcomes. This study aimed to assess temporal trends and institutional differences in vasodilator and inotrope/vasopressor utilization among patients with acute decompensated heart failure, considering their clinical phenotypes. Data were extracted from a government-funded multicenter registry covering the Tokyo metropolitan area, comprising consecutive patients hospitalized in intensive/cardiovascular care units with a primary diagnosis of acute decompensated heart failure between January 2013 and December 2021. Clinical phenotypes, that is, pulmonary congestion or tissue hypoperfusion, were defined through a comprehensive assessment of clinical signs and symptoms, vital signs, and laboratory findings. We assessed the frequency and temporal trends in phenotype-based drug utilization of vasoactive agents and investigated institutional characteristics associated with adopting the phenotype-based approach using generalized linear mixed-effects models, with random intercepts to account for hospital-level variability. Among 37 293 patients (median age, 80 years; 43.7% female), 88.6% and 21.2% had pulmonary congestion and tissue hypoperfusion status, respectively. Throughout the study period, both overall and phenotype-based vasodilator utilizations showed significant declines, with overall usage dropping from 61.4% in 2013 to 48.6% in 2021 (Ptrend<0.001). Conversely, no temporal changes were observed in overall inotrope/vasopressor utilization from 24.6% in 2013 to 25.8% in 2021 or the proportion of phenotype-based utilization. Notably, there was considerable variability in phenotype-based drug utilization among hospitals, with a median ranging from 48.3% to 77.8%. In multivariable-adjusted models, a higher number of board-certified cardiologists were significantly associated with lower rates of phenotype-based vasodilator utilization and reduced inappropriate inotrope/vasopressor utilization, while tertiary care hospitals were linked to more appropriate inotrope/vasopressor utilization. Substantial variability existed among hospitals in phenotype-based drug utilization of vasoactive agents for patients with acute decompensated heart failure, highlighting the need for standardized treatment protocols. URL: https://www.umin.ac.jp/ctr/index.htm; Unique identifier: UMIN000013128.

Impact of cariprazine on body weight and blood pressure among adults with bipolar I disorder, schizophrenia, or major depressive disorder in a real-world setting

BackgroundAtypical antipsychotics are a common treatment for serious mental illness, but many are associated with adverse effects, including weight gain and cardiovascular issues, and real-world experience may differ from clinical trial data. Cariprazine has previously demonstrated a favorable safety and tolerability profile in clinical trials. Here, we evaluated the effects of cariprazine on body weight and blood pressure for bipolar I disorder (BP-I), schizophrenia, or as adjunctive treatment for major depressive disorder (MDD) using real-world data.MethodsSymphony Health’s Integrated Dataverse® with electronic medical record access (3/1/2015–10/31/2018) was used to identify adults (≥ 18 years) diagnosed with BP-I depression, BP-I mania/mixed, schizophrenia, or MDD, with ≥ 2 cariprazine dispensings (first dispensing = index) and continuous clinical activity for ≥ 12 months pre-index (baseline) and ≥ 3 months post-index. The on-treatment period spanned from index to cariprazine discontinuation, exposure to another atypical or long-acting injectable antipsychotic, or end of clinical activity/data availability. Outcomes included estimated annual linear trajectories for weight, body mass index (BMI), systolic blood pressure (SBP), and diastolic blood pressure (DBP) during baseline and on treatment. Changes were estimated using linear mixed-effects models fitted over measurements pre-index and on treatment; 95% CIs were derived from nonparametric bootstrap procedures.ResultsThe body weight analysis included 612 patients (BP-I, n = 331 [BP-I depression, n = 172; BP-I mania/mixed, n = 159]; schizophrenia, n = 75; MDD, n = 206). The mean patient age was 43.4 years, 75.2% were female, and the mean (SD) on-treatment period was 219 (185) days. Among patients with measurements before and during cariprazine treatment, estimated annual weight trajectories were + 3.55 (95% CI 2.38, 4.59) kg/year before cariprazine initiation and + 0.91 (− 1.17, 2.82) kg/year during cariprazine treatment. Additionally, annual linear trajectories evaluated across the on-treatment period were + 0.31 (− 0.42, 1.01) kg/m2/year for BMI, − 2.38 (− 4.27, − 0.76) mmHg/year for SBP, and − 0.57 (− 1.75, 0.61) mmHg/year for DBP.ConclusionIn this real-world analysis, cariprazine was associated with an estimated weight gain of + 0.91 kg/year and had minimal impact on BMI and blood pressure when evaluated up to 12 months.

Social Activities and Cognitive Functioning Across Mid- and Late-Life: Evidence from China.

Social engagement is positively associated with cognitive health, yet the role of these activities across the life span and in different contexts remains under-explored. This study investigates the association between social activities and two domains of cognitive functioning among middle-aged and older Chinese individuals, a population with the highest number of dementia cases in the world. We pay particular attention to the unique role of activities in midlife on cognitive decline in the later years. Using longitudinal data from the China Health and Retirement Longitudinal Study (2011-2018), we conducted mixed-effects linear models to determine the intra- and inter- individual variation on the relationship between social activity and cognitive functioning (N = 26,622 observations nested within 8,089 individuals). Across domains (episodic memory, mental intactness, and total cognition), more social activities in a given year are associated with increased cognitive functioning, independent of age. Independent of these within-individual changes, participation in social activities in midlife predicts better cognitive function across mid and later life across all domains, controlling for childhood adversities, friendship, self-rated health. However, midlife social activities do not significantly predict a slower rate of cognitive decline. Midlife social engagement has a lasting association with cognitive health in later life, yet it is important to recognize that changes occurring throughout both midlife and later life are associated with changes in cognition. This highlights the potential for modification and improvement during this period in the lifespan for aging Chinese.

Social Security: Individuals in Socially Reciprocal Groups May Perceive Security from Predators

Abstract One of the most explored factors mediating antipredator behavior is group size, which generally predicts individuals in larger social groups allocate less time to antipredator vigilance while foraging. However, group size alone does not capture the full complexity of sociality. An individual’s ‘sense of security’, or their perceived risk of predation, is also influenced by an individual’s social connections. Further, group social structure – the pattern of all social interactions in a group – could explain additional variation in perceptions of security for the individuals that reside in the group. Using the time allocated to vigilance during foraging and flight initiation distance (FID) to quantify individuals’ social security, we explored whether individual yellow-bellied marmots (Marmota flaviventer) in tightly connected social groups looked less while foraging and had shorter FIDs. Using linear mixed effect models, we found modest support for the Social Security Hypothesis; individuals in more socially reciprocal groups may spend less time looking for predators while foraging. No measure of group social structure explained variation in FID. Measures of the immediate environment (the number of individuals within 10 meters for vigilance and the distance from burrow and alert distance for FID) had effect sizes an order of magnitude greater than measures of social structure, suggesting an individual’s immediate environment has more of an impact on their antipredator behavior than the structure of their social group.

Abstract B033: Long-Term quality of life and hearing preservation after stereotactic radiosurgery for vestibular schwannoma

Abstract Purpose/Objective(s): The aim of this study is to evaluate the long-term quality of life (QOL) and hearing preservation outcomes following definitive single-fraction Gamma Knife stereotactic radiosurgery (GKSRS) for vestibular schwannoma (VS). Materials/Methods: Baseline and follow-up QOL and audiogram data were collected from our prospectively maintained institutional database of VS patients treated with single-fraction GKSRS from 2006 to 2023. QOL metrics included the Hearing Handicap Inventory (HHI), Dizziness Handicap Inventory (DHI), Tinnitus Handicap Inventory (THI), and the 36-Item Short-Form Survey (SF-36). Serviceable hearing preservation was classified according to the Gardner-Robertson scale using pure-tone average (PTA) and speech discrimination (SD). Linear mixed-effects models were constructed for each QOL metric over time. Results: A total of 388 patients (median age 61 years) were included with a median follow-up of 48 months. Median tumor size was 1.6 cm (interquartile range [IQR] 1.1-2.1 cm), with a median tumor volume of 0.6 cc (IQR 0.2-1.6 cc). Most patients received a prescription marginal dose of 12.5 Gy with a median cochlear mean dose of 2.7 Gy (IQR 1.9-3.8 Gy). Baseline median HHI, DHI, THI, and SF-36 scores were 28, 12, 12, and 73 respectively. Linear mixed-effects analyses indicated no statistically significant decline in any of these QOL metrics up to 7 years after GKSRS. Of patients with serviceable hearing at baseline, hearing preservation was maintained in 79% at 12 months, 67% at 2 years, and 68% at 3 years. Conclusion: GKSRS preserves long-term patient quality of life and serviceable hearing in the definitive management of VS. Citation Format: Shayzal Siddiqui, Joseph S. Lee, Julia Abbo, Jessica Cummings, Avi Desai, Inga S. Grills, Peter Y. Chen, Jeffrey Jacob, Kuei C. Lee. Long-Term quality of life and hearing preservation after stereotactic radiosurgery for vestibular schwannoma. [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Translating Targeted Therapies in Combination with Radiotherapy; 2025 Jan 26-29; San Diego, CA. Philadelphia (PA): AACR; Clin Cancer Res 2025;31(2_Suppl):Abstract nr B033.

Determining Sources of Air Pollution Exposure Inequity in New York City Through Land-Use Regression Modeling of PM2.5 Constituents

Differences in exposures and resources to manage personal health contribute to persistent inequities in air pollution burden despite vast air quality improvements over the past 2–3 decades in the United States. These factors are, partly, linked to historic racist practices, such as redlining, a discriminatory housing policy that was practiced legally between 1935 and 1968. Using 100 m × 100 m resolution land-use regression predicted surfaces of PM2.5 constituents (black carbon, nickel, vanadium, and copper) as pollution source indicators, we fit Bayesian generalized linear mixed-effects models to examine differences in source exposures over two study periods, 2008–2015 and 2016–2019, comparing (1) redlined to not redlined and (2) high-asthma to low-asthma neighborhoods. We examine redlining as an indicator of historical, and structural racism and asthma rates as an indicator of present-day community burden. Redlined areas saw near elimination of disparities in exposure to residual oil boilers and marine residual oil but persistent disparities in traffic. High-asthma neighborhoods continue to have disproportionately high exposures to both residual oil boilers and traffic, with no discernable disparities related to marine residual oil emissions. Overall exposure disparities are small, with PM2.5 disparities by both asthma morbidity and redlining amounting to less than 1 µg/m3 and NO2 disparities by asthma and redlining amounting to less than 2 ppb in the post-2016 period. For context, 2019 NYC average PM2.5 and NO2 were 8.5 µg/m3 and 20 ppb, respectively. Our findings suggest that local pollution policy should focus on reducing traffic and building boiler emissions in high-asthma neighborhoods to reduce exacerbations.

Bayesian Analysis of Censored Linear Mixed-Effects Models for Heavy-Tailed Irregularly Observed Repeated Measures.

The use of mixed-effect models to understand the evolution of the human immunodeficiency virus (HIV) and the progression of acquired immune deficiency syndrome (AIDS) has been the cornerstone of longitudinal data analysis in recent years. However, data from HIV/AIDS clinical trials have several complexities. Some of the most common recurrences are related to the situation where the HIV viral load can be undetectable, and the measures of the patient can be registered irregularly due to some problems in the data collection. Although censored mixed-effects models assuming conditionally independent normal random errors are commonly used to analyze this data type, this model may need to be more appropriate for accommodating outlying observations and responses recorded at irregular intervals. Consequently, in this paper, we propose a Bayesian analysis of censored linear mixed-effects models that replace Gaussian assumptions with a flexible class of distributions, such as the scale mixture of normal family distributions, considering a damped exponential correlation structure that was employed to account for within-subject autocorrelation among irregularly observed measures. For this complex structure, Stan's default No-U-Turn sampler is utilized to obtain posterior simulations. The feasibility of the proposed methods was demonstrated through several simulation studies and their application to two AIDS case studies.

Effects of a 16-week dance intervention on loneliness and self-esteem in left behind children: a randomised controlled trial

Loneliness and low self-esteem are among the more prominent mental health problems among left-behind children, but most of the current research stays in cross-sectional surveys, with fewer studies proposing specific solutions. In addition, although the effective impact of dance interventions on loneliness and self-esteem has been demonstrated, the impact in the group of left-behind children remains under-explored. Therefore, this study validated the effectiveness of a dance intervention on loneliness and self-esteem in left-behind children through a 16-week randomised controlled trial. Stratified sampling was used to select one primary school from each of the 14 cities in Hunan Province, with a maximum of 100 children recruited from each primary school. Independent researchers used SPSS 29.0 to randomly assign the eligible 1270 participants to the Experimental group (n = 635) and Control group (n = 635) in a 1:1 ratio. The Experimental group performed 45 min of moderate-intensity dance training five times a week. The Control group maintained their original living conditions. Participants were measured three times using the Children’s Loneliness Scale and Rosenberg’s Self-Esteem Scale: baseline (T0), after 8 weeks (T1), and post-intervention (16 weeks, T2). Linear mixed-effects models for repeated measures were used to test the effects of time, group and time × group interactions. (a) The average age of the 1261 participants was 10 years (SD = 3.52), with high levels of loneliness (42.48 ± 12.04) and low levels of self-esteem (26.75 ± 6.39). (b) There was a significant negative correlation between loneliness and self-esteem among the LBC (p < 0.001, r = − 0.390). (c) After the dance intervention, the LBC’s loneliness significantly decreased [F (2, 1258) = 74.516, ηp2 = 0.106, p < 0.001] and their self-esteem significantly increased [F (2, 1258) = 73.64, ηp2 = 0.104, p < 0.001]. A 16-week dance intervention is an effective strategy to improve loneliness and self-esteem in LBC. Given the acceptability and practicality of the dance intervention, it could be included in a health programme to improve loneliness and self-esteem in LBC.