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Background Postmenopausal women with cancer experience an accelerated physical dysfunction beyond what is expected through aging alone due to cancer and its treatments. The aim of this study was to determine whether declines in physical function after cancer diagnosis are associated with all-cause mortality and cancer-specific mortality. Methods This prospective cohort study included 8068 postmenopausal women enrolled in the Women's Health Initiative with a cancer diagnosis and who had physical function assessed within 1 year of that diagnosis. Self-reported physical function was measured using the 10-item physical function subscale of the 36-Item Short Form Health Survey. Cause of death was determined by medical record review, with central adjudication and linkage to the National Death Index. Death was adjudicated through February 2022. Results Over a median follow-up of 7.7 years from cancer diagnosis, 3316 (41.1%) women died. Our results showed that for every 10% difference in the physical function score after cancer diagnosis versus pre-diagnosis, all-cause mortality and cancer-specific mortality were reduced by 12% (hazard ratio [HR] = 0.88, 95% confidence interval  [95% CI] = 0.87 to 0.89 and HR = 0.88, 95% CI = 0.86 to 0.91, respectively). Further categorical analyses showed a significant dose-response relationship between postdiagnosis physical function categories and mortality outcomes (P  < .001 for trend), where the median survival time for women in the lowest physical function quartile was 9.1 years (Interquartile range [IQR] = 8.6-10.6 years) compared with 18.4 years (IQR = 15.8-22.0 years) for women in the highest physical function quartile. Conclusion Postmenopausal women with low physical function after cancer diagnosis may be at higher risk of mortality from all causes and cancer-related mortality. [ABSTRACT FROM AUTHOR]

Background: Studies on the association between vegetarian diets and nonalcoholic fatty liver disease (NAFLD) are limited and have inconsistent results. This study aims to explore the association between vegetarian diets and NAFLD and compare the stage of fibrosis between vegetarians and nonvegetarians in a US representative sample. Methods: Cross‐sectional data from 23,130 participants aged ≥20 years were obtained from the National Health and Nutrition Examination Survey, 2005–2018. Vegetarian status was classified based on two 24‐h dietary recalls. We examined the association between vegetarian diets and the risk of NAFLD using the propensity score weighting method. Results: Vegetarian diets were significantly associated with decreases in hepatic steatosis index (HSI), US fatty liver index and nonalcoholic fatty liver disease fibrosis score with mean differences of −2.70 (95% confidence interval [CI]: −3.69, −1.70), −3.03 (95% CI: −7.15, −0.91) and −0.12 (95% CI: −0.26, −0.01), respectively. While modelling the risk of NAFLD, we estimated that vegetarians were 53% less likely to have NAFLD assessed by HSI (odds ratios [OR]: 0.47; 95% CI: 0.34, 0.65). The effect of vegetarian diets was higher among individuals with lower waist circumferences (OR: 0.20) than among those with higher waist circumferences (OR: 0.53, pinteraction ${p}_{\text{interaction}}\,$= 0.004). However, the association was largely attenuated after adjusting for body mass index and diabetes status. No significant association was identified between vegetarian diets and advanced fibrosis. Conclusions: Vegetarian diets were associated with a lower prevalence of NAFLD among US adults, and the association appeared to be stronger in people with lower waist circumferences. Further studies are warranted to replicate our findings. Key points: Vegetarians had low risks of nonalcoholic fatty liver disease (NAFLD) development.A stronger association was observed among people with lower waist circumferences.Vegetarians were observed to have lower degrees of fibrosis among people with NAFLD.Future nutritional interventions may prioritise a low‐inflammatory dietary plan. [ABSTRACT FROM AUTHOR]

Hysterectomy is associated with an increased risk for adverse health outcomes. However, its connection to the risk of non‐Hodgkin's lymphoma (NHL) remains unclear. The aims of our study were to investigate the associations between hysterectomy, oophorectomy and risk of NHL and its major subtypes (eg, diffuse large B‐cell lymphoma [DLBCL]), and whether these associations were modified by exogenous hormone use. Postmenopausal women (n = 141,621) aged 50–79 years at enrollment (1993–1998) from the Women's Health Initiative were followed for an average of 17.2 years. Hysterectomy and oophorectomy were self‐reported at baseline. Incident NHL cases were confirmed by central review of medical records and pathology reports. During the follow‐up period, a total of 1719 women were diagnosed with NHL. Hysterectomy, regardless of oophorectomy status, was associated with an increased risk of NHL (hazard ratio [HR] = 1.23, 95% confidence interval [CI]: 1.05–1.44). Oophorectomy was not independently associated with NHL risk after adjusting for hysterectomy. When stratified by hormone use, the association between hysterectomy and NHL risk was confined to women who had never used hormone therapy (HR = 1.35, 95% CI: 1.06–1.71), especially for DLBCL subtype (P for interaction =.01), and to those who had undergone hysterectomy before the age of 55. Our large prospective study showed that hysterectomy was a risk factor of NHL. Findings varied by hormone use. Future studies incorporating detailed information on the types and indications of hysterectomy may deepen our understanding of the mechanisms underlying DLBCL development and its potential interactions with hormone use. [ABSTRACT FROM AUTHOR]

Optimization of components and micromorphology regulation are shown to be effective in boosting electromagnetic wave absorption (EMWA). One approach to achieve this enhancement is by utilizing the polarization effects of heterogeneous interfaces. Herein, NiSe2‐CoSe2@C@MoSe2 composites derived from NiCo‐MOF‐74 are fabricated via a facile selenization reaction and subsequent hydrothermal method. By varying the mass ratios of NiSe2‐CoSe2@C and MoSe2, a series of NiSe2‐CoSe2@C@MoSe2 composites with hierarchical flower‐like core–shell structures are obtained. The EMWA properties of the composites display a trend of initially increasing and then decreasing with the increasing content of MoSe2. Interestingly, when the mass ratio of NiSe2‐CoSe2@C and MoSe2 is 3:2, the minimum reflection loss (RL) value is −50.10 dB and an effective absorption bandwidth (RL< −10 dB) value can reach 4.80 GHz (13.20–18.00 GHz). The remarkable EMWA capability can be ascribed to the synergy effects of conductive loss, polarization loss, and suitable impedance matching. This work establishes a new pathway for the synthesis of transition metal dichalcogenides‐based composites, which hold great promise as high‐performance materials for EMWA applications. [ABSTRACT FROM AUTHOR]

Introduction: Sodium–glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of antihyperglycemic agents, with the potential to inhibit breast cancer development. However, the association between SGLT2 inhibitors and risk of breast cancer in human studies is unclear. Objective: The aim of our study is to use a large national claims database to assess the association between SGLT2 inhibitor use and risk of breast cancer. Methods: We considered a study population of 158,483 adult women with type 2 diabetes who newly initiated SGLT2 inhibitors or dipeptidyl peptidase 4 (DPP4) inhibitors using Optum's deidentified Clinformatics Data Mart Database between 1 January 2013 and 31 March 2022. The association between SGLT2 inhibitor use and risk of breast cancer was examined using Cox proportional hazard models stratified by age in the overall sample and in a subsample based on propensity score and medication initiation time matching. The effect of medication use duration was explored. Results: With an average follow-up of 2.2 years, 2154 breast cancer cases were identified. There was no significant association between SGLT2 inhibitor use and the risk of breast cancer in overall sample (HR = 0.96; 95% CI 0.87, 1.06), in women younger than 51 years old (HR = 0.88; 95% CI 0.59, 1.32), or in women aged 51 years or older (HR = 0.95; 95% CI 0.86, 1.04). The results remained nonsignificant using matching, medication use duration, and sensitivity analyses. Conclusion: Our findings suggest SGLT2 inhibitors use was not associated with breast cancer risk compared with DPP4 inhibitors use. Studies with longer follow-up and better adjustments are needed to confirm the finding. [ABSTRACT FROM AUTHOR]

To clarify the copyrights of 3D models of oblique photography (3DMOP) and guarantee their security, a novel security protection scheme of 3DMOP was proposed in this study by synergistically applying digital watermarking and data encryption. In the proposed scheme, point clouds were clustered first, and then the centroid and feature points of each cluster were calculated and extracted, respectively. Afterward, the watermarks were embedded into the point clouds cluster-by-cluster, taking distances between feature points and centroids as the embedding positions. In addition, the watermarks were also embedded using texture coordinates of 3DMOP to further enhance the robustness of the watermarking algorithm. Furthermore, Arnold transformation was performed on texture images of 3DMOP for security protection of classified or sensitive information. Experimental results have verified the strong imperceptibility and robustness of the proposed watermarking algorithm, as well as the high security of the designed data encryption algorithm. The outcomes of this work can refine the current security protection methods of 3DMOP and thus further expand their application scope. [ABSTRACT FROM AUTHOR]

Purpose: Cancer-related cognitive impairment is common during cancer treatment; however, it is unclear whether the impairment persists over time. Our study aimed to examine long-term cognitive impairment among older breast cancer survivors. Methods: Participants included 2420 community-dwelling women aged 65 years or older at enrollment (1986–1988) (404 breast cancer cases and 1:5 matched cancer-free controls) from the Study of Osteoporotic Fractures. Participants were followed for 20 years with measured cognitive function repeated up to 6 times. Cognitive impairment was defined by the Modified Mini-Mental State Examination and Trail Making Test B. Generalized linear models were used to model risk of cognitive impairment in relation to breast cancer status and time from breast cancer diagnosis. Results: Compared with controls, cognitive impairment in women with breast cancer significantly accelerated after cancer diagnosis. We also observed a more pronounced cognitive impairment after cancer diagnosis for women diagnosed with breast cancer at age ≥ 80 years or at advanced stage for both measures. Conclusion: Our study with more than 20 years of follow-up data found that breast cancer survivors had accelerated cognitive impairment after cancer diagnosis, especially among women diagnosed at older age or at advanced stage, relative to women without cancer. Implications for Cancer Survivors. Breast cancer survivors may be encouraged to engage in both physical activity and cognitive training. [ABSTRACT FROM AUTHOR]

Background Associations of weight changes and intentionality of weight loss with longevity are not well described. Methods Using longitudinal data from the Women's Health Initiative (N  = 54 437; 61–81 years), we examined associations of weight changes and intentionality of weight loss with survival to ages 90, 95, and 100. Weight was measured at baseline, year 3, and year 10, and participants were classified as having weight loss (≥5% decrease from baseline), weight gain (≥5% increase from baseline), or stable weight (<5% change from baseline). Participants reported intentionality of weight loss at year 3. Results A total of 30 647 (56.3%) women survived to ≥90 years. After adjustment for relevant covariates, 3-year weight loss of ≥5% vs stable weight was associated with lower odds of survival to ages 90 (OR, 0.67; 95% CI, 0.64–0.71), 95 (OR, 0.65; 95% CI, 0.60–0.71), and 100 (OR, 0.62; 95% CI, 0.49–0.78). Compared to intentional weight loss, unintentional weight loss was more strongly associated with lower odds of survival to age 90 (OR, 0.83; 95% CI, 0.74–0.94 and OR, 0.49; 95% CI, 0.44–0.55, respectively). Three-year weight gain of ≥5% vs stable weight was not associated with survival to age 90, 95, or 100. The pattern of results was similar among normal weight, overweight, and obese women in body mass index (BMI)-stratified analyses. Conclusions Weight loss of ≥5% vs stable weight was associated with lower odds of longevity, more strongly for unintentional weight loss than for intentional weight loss. Potential inaccuracy of self-reported intentionality of weight loss and residual confounding were limitations. [ABSTRACT FROM AUTHOR]

Aim: Objective measurements of physcial function, including gait speed, handgrip strength, and the chair stand test, have been shown to have predictive capacity for negative healthrelated outcomes. The aim of this study was to examine campariatively which of these common assessments may be optimal in terms of their predictive capacity for mortality. Methods: A total of 9834 community-dwelling older women aged 65-89 years from the Study of Osteoporotic Fractures (SOF) were followed for 20 years. Gait speed, handgrip strength, and the chair stand test were measured every 2-4 years on up to 9 visits. All deaths were adjudicated. Results: All three measurements of physical function were significantly associated with overall, cardiovascular disease and other mortality. Gait speed had the greatest magnitude of hazard ratios (HRs) for all outcomes of interest. A one-unit standard deviation increase in gait speed was associated with a 33% (HR = 0.67, 95% confidence interval [95% CI]: 0.64-0.70) lower risk for overall mortality, a 31% (HR = 0.69, 95% CI: 0.64-0.73) lower risk for cardiovascular disease mortality, a 15% (HR = 0.85, 95% CI: 0.78-0.92) lower risk for cancer mortality and a 42% (HR = 0.58, 95% CI: 0.55-0.62) lower risk for other mortality. Further examination of gait speed identified two cut-points (0.9 and 0.7 m/s) that were strongly indicative of increased mortality risk. Conclusion: Our large prospective study indicates that gait speed possesses a better prediction of mortality among older women compared with handgrip strength or the chair stand test. Using cut-points of 0.9 and 0.7 m/s can help identify older women at higher mortality risk, who may benefit from physical function improvement interventions. [ABSTRACT FROM AUTHOR]

Background: There is limited evidence of how dietary inflammatory potential influences nonalcoholic fatty liver disease (NAFLD) progression. Aims: Our study aims to evaluate the association of dietary inflammatory index (DII) with liver fibrosis, a hallmark feature of NAFLD, among US adults. Methods: Cross-sectional data consisting of 5,506 participants in the National Health and Nutrition Examination Survey from 2011 to 2018 were used. Energy adjusted-DII (E-DII) scores were calculated using 2 days of 24-h dietary recall data. We used a partial proportional odds model to determine risk at each stage of fibrosis according to the E-DII score. Results: The weighted prevalence of NAFLD (assessed by US fatty liver index) was 34.5%, with 23.2% (assessed by NAFLD Fibrosis Score) having mild fibrosis, 10.4% intermediate fibrosis, and 0.9% advanced fibrosis. When comparing the most pro-inflammatory diets to the most anti-inflammatory diets (AIDs) in the multivariable model, the marginal probability effect (MPE) of NAFLD, mild fibrosis and intermediate fibrosis increased by 11.7% (95% CI 6.6%, 16.9%), 7.0% (95% CI 3.5%, 10.4%) and 4.0% (95% CI 0.3%, 7.5%), respectively. The MPE of advanced fibrosis was not significant (MPE = 0.7%; 95% CI − 1.1%, 2.8%). Similar associations were observed when applying Fibrosis-4 and transient elastography as fibrosis diagnostic measurements. Conclusions: An AID was associated with lower risk of development of NAFLD and early-stage of fibrosis among US adults. But the associations became attenuated and dissipated as the fibrogenesis became severe. Further studies are needed to re-confirm our observations. [ABSTRACT FROM AUTHOR]

Objective: To assess the associations among several anthropometric measures, as well as BMI trajectories and colorectal cancer (CRC) risk in older women. Design: Prospective cohort study. Setting: Forty clinical centres in the USA. Participants: Totally, 79 034 postmenopausal women in the Women's Health Initiative Observational Study. Results: During an average of 15·8 years of follow-up, 1514 CRC cases were ascertained. Five BMI trajectories over 18–50 years of age were identified using growth mixture model. Compared with women who had a normal BMI at age 18, women with obesity at age 18 had a higher risk of CRC (HR 1·58, 95 % CI 1·02, 2·44). Compared with women who kept relatively low normal body size during adulthood, women who progressed from normal to obesity (HR 1·29, 95 % CI 1·09, 1·53) and women who progressed from overweight to obesity (HR 1·37, 95 % CI 1·13, 1·68) had higher CRC risks. A weight gain > 15 kg from age 18 to 50 (HR 1·20, 95 % CI 1·04, 1·40) and baseline waist circumference > 88 cm (HR 1·33, 95 % CI 1·19, 1·49) were associated with higher CRC risks, compared with stable weight and waist circumference ≤ 88 cm, respectively. Conclusion: Women who have a normal weight in early adult life and gain substantial weight later, as well as those who are persistently heavy over adulthood, demonstrated a higher risk of developing CRC. Our study highlights the importance of maintaining a healthy body weight over the life course for reducing the risk of developing CRC in women. [ABSTRACT FROM AUTHOR]

We sought to assess the relationship between sleep duration, sleep disturbance, and leukemia incidence among postmenopausal women. This study included 130,343 postmenopausal women aged 50–79 years who were enrolled in the Women's Health Initiative (WHI) during 1993–1998. Information on self-reported typical sleep duration and sleep disturbance was obtained by questionnaire at baseline, and sleep disturbance level was defined according to the Women's Health Initiative Insomnia Rating Scale (WHIIRS). WHIIRS scores of 0–4, 5–8, and 9–20 comprised 37.0%, 32.6%, and 30.4% of all women, respectively. After an average of 16.4 years (2,135,109 cumulative person-years) of follow-up, 930 of the participants were identified as having incident leukemia. Compared with women with the lowest level of sleep disturbance (WHIIRS score 0–4), women with higher sleep disturbance levels (WHIIRS scores of 5–8 and 9–20) had 22% (95% confidence interval (CI): 1.04, 1.43) and 18% (95% CI: 1.00, 1.40) excess risks of leukemia, respectively, after multivariable adjustment. A significant dose-response trend was found for the association between sleep disturbance and leukemia risk (P for trend = 0.048). In addition, women with the highest level of sleep disturbance had a higher risk of myeloid leukemia (for WHIIRS score 9–20 vs. WHIIRS score 0–4, hazard ratio = 1.39, CI: 1.05, 1.83). Higher sleep disturbance level was associated with increased risk of leukemia, especially for myeloid leukemia among postmenopausal women. [ABSTRACT FROM AUTHOR]

Rational design of the components and microstructure is regarded as an efficacious strategy for the high-performance electromagnetic wave absorbing (EMWA) materials. Herein, the CoTe2@MoS2 nanocomposites with CoTe2 nanorods and MoS2 nanosheets were synthesized via a hydrothermal method. The microstructure and composition of the samples were characterized by X-ray diffraction (XRD), scanning electron microscopy (SEM), energy dispersive X-ray spectroscopy (EDS), transmission electron microscopy (TEM), and X-ray photoelectron spectroscopy (XPS). The CoTe2@MoS2 composite was composed of stacked CoTe2 as the core and intertwined MoS2 nanosheets as the shell. The electromagnetic parameters of the CoTe2@MoS2 composites were investigated by vector network analyzer (VNA). The EMWA property of the composite showed a trend of first increasing and then decreasing with the increasing content of MoS2. When the mass ratio of MoS2 and CoTe2 was 1:1, the CoTe2@MoS2 composite exhibited the minimum reflection loss value of −68.10 dB at 4.71 GHz, and the effective absorption bandwidth value might reach 4.64 GHz (13.08–17.72 GHz) at a matching thickness of 1.60 mm with filler loading of 50 wt.%. The extraordinary EMWA property was attributed to the optimized impedance matching, multiple scattering and reflections, dipole polarization, conductive loss, and interfacial polarization. Therefore, the present approach to the design of microstructure and interface engineering offers a crucial way to construct high-performance EMW absorbers. [ABSTRACT FROM AUTHOR]

The relationship between optimism and cognitive functioning is not fully understood. We examined the association of optimism with risk of mild cognitive impairment (MCI) and dementia in the Women's Health Initiative Memory Study (WHIMS). Optimism was measured by the Life Orientation Test-Revised (LOT-R) total score, and optimism and pessimism subscales. A panel of experts adjudicated cognitive endpoints based on annual cognitive assessments. We used cox proportional hazard regression models to examine the association of LOT-R total score and optimism and pessimism sub-scores with MCI/dementia. We also examined the relationship between vascular disease, LOT-R total score, optimism and pessimism, and cognition. Mean age was 70.5 (SD = 3.9) years. The sample (N = 7249) was 87% white, and 29.8% of participants had < 12 years of education. Total LOT-R score (HR = 0.96, 95% CI: 0.94, 0.98, p < 0.001) was associated with lower risk of combined MCI or dementia. More pessimism (HR = 1.08, 95% CI: 1.05, 1.11, p < 0.0001) was associated with higher risk of MCI or dementia after adjustment for ethnicity, education, vascular disease, and depression. No significant relationships emerged from the optimism subscale. These data suggest that less pessimism, but not more optimism, was associated with a lower risk of MCI and dementia. [ABSTRACT FROM AUTHOR]

Although biological evidence suggests that tea consumption may protect against non-Hodgkin lymphoma (NHL), epidemiological evidence has been unclear. The aim of this study was to examine the association between tea-drinking habits and the risk of NHL in a large nationwide prospective cohort of postmenopausal US women. 68 854 women who were enrolled from 1993 through 1998 in the Women's Health Initiative Observational Study and responded to year 3 annual follow-up questionnaire comprised the analytic cohort. Newly diagnosed NHL cases after the year 3 visit were confirmed by medical and pathology reports. Multivariable-adjusted Cox proportional hazards models were performed to assess the associations of tea-drinking habits (specifically, the amounts of caffeinated/herbal/decaffeinated tea intake) with the overall risk of NHL and three major subtypes (diffuse large B-cell lymphoma (n 195, 0·3 %), follicular lymphoma (n 128, 0·2 %) and chronic lymphocytic leukaemia/small lymphocytic lymphoma (n 51, 0·1 %)). Among 62 622 participants, a total of 663 (1·1 %) women developed NHL during a median follow-up of 16·51 (sd 6·20) years. Overall, different amounts of type-specific tea intake were not associated with the risk of NHL regardless of its histologic subtypes after adjustment for confounders. Our findings suggest that tea intake at the current consumption level does not influence the risk of NHL, regardless of its histologic types. [ABSTRACT FROM AUTHOR]

Epidemiologic evidence is limited about associations between T2DM, metformin, and the risk of non‐Hodgkin's lymphoma (NHL). We aimed to examine associations between T2DM, metformin, and the risk of NHL in the Women's Health Initiative (WHI) Study. Information on T2DM status (diabetes status/types of antidiabetic drug use/diabetes duration) from study enrollment and during follow‐up were assessed. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated to evaluate associations of T2DM status with risks of overall NHL and its three major subtypes [diffuse large B‐cell lymphoma (DLBCL, n = 476), follicular lymphoma (FL, n = 301) and chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL, n = 136)] based on multivariable‐adjusted Cox proportional hazards models. During a median follow‐up of 18.86 years (range, 0.01‐25.13; SD ± 6.55), a total of 1637 women developed NHL among 147 885 postmenopausal women. Women with T2DM and with self‐reported oral medication use had 38% and 55% higher risk of DLBCL, respectively [multivariable‐adjusted model HR = 1.38, 95% CI (1.06‐1.81) and HR = 1.55, 95% CI (1.16‐2.06)] compared to the reference group (nondiabetics/untreated diabetes). Risks of NHL and DLBCL [multivariable‐adjusted model: HR = 1.28, 95% CI (1.06‐1.54) and HR = 1.56, 95% CI (1.13‐2.14), respectively] were significantly higher in associations with relatively short duration (≤7 years) of diabetes, compared to reference group. Additionally, an increased risk of DLBCL [HR = 1.76, 95% CI (1.13‐2.75)] was found in metformin users compared to the reference group. Postmenopausal women who had T2DM, who were oral antidiabetic drug users, especially metformin, and who had a shorter diabetes duration may have higher risks of DLBCL. Further well‐designed research is needed to confirm our findings. [ABSTRACT FROM AUTHOR]

Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs with demonstrated renal and cardiovascular disease benefit. This study evaluates the role of SGLT2 inhibitors on the survival of non-small cell lung cancer (NSCLC) patients. Methods: We used National Surveillance, Epidemiology and End Results (SEER)-Medicare linked data. Twenty four thousand nine hundred fifteen NSCLC patients newly diagnosed between 2014 and 2017 with pre-exiting diabetes and aged 66 years or older were included and followed to the end of 2019. Information on SGLT2 inhibitors use was extracted from the Medicare Part D file. Results: SGLT2 inhibitor use was associated with significantly reduced mortality risk after adjusting for potential confounders (HR = 0.68, 95% CI = 0.60–0.77) with stronger association for longer duration of use (HR = 0.54, 85% CI = 0.44–0.68). Further, we found that SGLT2 inhibitor use was associated with a significant reduced risk of mortality regardless of patients' demographic, tumour characteristics and cancer treatments. Conclusion: Our large SEER-Medicare linked data study indicates that SGLT2 inhibitors use was associated with improved overall survival of NSCLC patients with pre-existing diabetes. Further studies are needed to confirm our findings and elucidate the possible mechanisms behind the association. [ABSTRACT FROM AUTHOR]

Oblique photography technology based on UAV (unmanned aerial vehicle) provides an effective means for the rapid, real-scene 3D reconstruction of geographical objects on a watershed scale. However, existing research cannot achieve the automatic and high-precision reconstruction of water regions due to the sensitivity of water surface patterns to wind and waves, reflections of objects on the shore, etc. To solve this problem, a novel rapid reconstruction scheme for water regions in 3D models of oblique photography is proposed in this paper. It extracts the boundaries of water regions firstly using a designed eight-neighborhood traversal algorithm, and then reconstructs the triangulated irregular network (TIN) of water regions. Afterwards, the corresponding texture images of water regions are intelligently selected and processed using a designed method based on coordinate matching, image stitching and clipping. Finally, the processed texture images are mapped to the obtained TIN, and the real information about water regions can be reconstructed, visualized and integrated into the original real-scene 3D environment. Experimental results have shown that the proposed scheme can rapidly and accurately reconstruct water regions in 3D models of oblique photography. The outcome of this work can refine the current technical system of 3D modeling by UAV oblique photography and expand its application in the construction of twin watershed, twin city, etc. [ABSTRACT FROM AUTHOR]

High stability and efficient charge separation are two critical factors to construct high-performance photocatalysts. Here, an efficient strategy was provided to fabricate the nanocomposite of graphitic carbon nitride/ferroferric oxide/reduced graphene oxide (g-C3N4/Fe3O4/RGO). The degradation of rhodamine B (RhB) by g-C3N4/Fe3O4/RGO nanocomposite followed the pseudo-first-order kinetics. The g-C3N4/Fe3O4/RGO nanocomposite exhibited excellent stability and magnetically separable performance. It was ascertained that the quantum efficiency and separation efficiency of photoexcited charge carriers of g-C3N4/Fe3O4/RGO nanocomposite were obviously improved. Particularly, the g-C3N4/Fe3O4/RGO nanocomposite with 3 wt.% RGO presented 100% degradation efficiency under visible light irradiation for 75 min. The remarkable photocatalytic degradation activity is attributed to the synergistic interactions among g-C3N4, Fe3O4, and RGO, along with the efficient interfacial charge separation. [ABSTRACT FROM AUTHOR]

Purpose: The incidence of triple-negative breast cancer (TNBC) is higher in Black women compared to White women which is not explained by racial differences in body mass index (BMI). As BMI has limitations as an anthropometric measure, we used different anthropometric measures to examine associations with TNBC by race. Method: Of 161,808 postmenopausal participants in Women's Health Initiative, eligible were a subsample of 121,744 White and Black postmenopausal women enrolled from 1993 to 1998, 50–79 years of age with anthropometric measures who were followed for breast cancer incidence until March 2019. At entry, BMI, waist circumference (WC), and waist-hip ratio (WHR) were measured using standardized methods. Breast cancers were verified by central medical record review. Associations between anthropometric measures and triple-negative breast cancer risk were examined using Cox proportional hazards regression models. Results: After 17.6 years (median) follow-up, there were 87 Black women and 529 White women with incident triple-negative breast cancer. Overall, there were no significant associations between anthropometric measures and risk of triple-negative breast cancer. However, compared to White women with normal BMI, White women with obesity (BMI ≥ 30) (HR 0.76, 95% CI 0.60, 0.96) were significantly associated with a lower risk of triple-negative breast cancer. And larger waist circumference (HR per centimeter 0.99, 95% CI 0.99, 1.00) was significantly associated with a lower risk of triple-negative breast cancer among White women. Conclusion: Overall, among postmenopausal women, anthropometric measures were not associated with risk of TNBC. The association among White women with larger waist circumference and women with obesity with a lower risk of triple-negative breast cancer needs further confirmation. [ABSTRACT FROM AUTHOR]

Background: The association of cognitive function with symptoms of psychological distress during the coronavirus disease 2019 (COVID-19) pandemic or adherence to COVID-19 protective health behaviors is not well-understood.Methods: We examined 2 890 older women from the Women's Health Initiative cohort. Prepandemic (ie, within 12 months prior to pandemic onset) and peripandemic global cognitive function scores were assessed with the modified Telephone Interview for Cognitive Status (TICS-m). Anxiety, stress, and depressive symptom severity during the pandemic were assessed using validated questionnaires. We examined adherence to protective behaviors that included safe hygiene, social distancing, mask wearing, and staying home. Multivariable models were adjusted for age, race, ethnicity, education, region of residence, alcohol intake, and comorbidities.Results: Every 5-point lower prepandemic TICS-m score was associated with 0.33-point mean higher (95% confidence interval [CI], 0.20, 0.45) perceived stress and 0.20-point mean higher (95% CI, 0.07, 0.32) depressive symptom severity during the pandemic. Higher depressive symptom severity, but not anxiety or perceived stress, was associated with a 0.69-point (95% CI, -1.13, -0.25) mean decline in TICS-m from the prepandemic to peripandemic period. Every 5-point lower peripandemic TICS-m score was associated with 12% lower odds ratio (OR, 0.88; 95% CI, 0.80, 0.97) of practicing safe hygiene.Conclusions: Among older women, we observed that: (a) lower prepandemic global cognitive function was associated with higher stress and depressive symptom severity during the pandemic; (b) higher depressive symptom severity during the pandemic was associated with cognitive decline; and (c) lower global cognitive function during the pandemic was associated with lower odds of practicing safe hygiene. [ABSTRACT FROM AUTHOR]

Background: Although adherence to the American Cancer Society (ACS) Guidelines on Nutrition and Physical Activity for Cancer Prevention associates with lower risk of obesity-related cancer (ORC) incidence and mortality, evidence in Black and Latina women is limited. This association was examined in Black and Latina participants in the Women's Health Initiative (WHI).Methods: Semi-Markov multistate model examined the association between ACS guideline adherence and ORC incidence and mortality in the presence of competing events, combined and separately, for 9301 Black and 4221 Latina postmenopausal women. Additionally, ACS guideline adherence was examined in a subset of less common ORCs and potential effect modification by neighborhood socioeconomic status and smoking.Results: Over a median of 11.1, 12.5, and 3.7 years of follow-up for incidence, nonconditional mortality, and conditional mortality, respectively, 1191 ORCs (Black/Latina women: 841/269), 1970 all-cause deaths (Black/Latina women: 1576/394), and 341 ORC-related deaths (Black/Latina women: 259/82) were observed. Higher ACS guideline adherence was associated with lower ORC incidence for both Black (cause-specific hazard ratio [CSHR]highvs.low : 0.72; 95% CI, 0.55-0.94) and Latina (CSHRhighvs.low : 0.58, 95% CI, 0.36-0.93) women; but not conditional all-cause mortality (Black hazard ratio [HR]highvs.low : 0.86; 95% CI, 0.53-1.39; Latina HRhighvs.low : 0.81; 95% CI, 0.32-2.06). Higher adherence was associated with lower incidence of less common ORC (Ptrend  = .025), but conditional mortality events were limited. Adherence and ORC-specific deaths were not associated and there was no evidence of effect modification.Conclusions: Adherence to the ACS guidelines was associated with lower risk of ORCs and less common ORCs but was not for conditional ORC-related mortality.Lay Summary: Evidence on the association between the American Cancer Society Guidelines on Nutrition and Physical Activity for Cancer Prevention and cancer remains scarce for women of color. Adherence to the guidelines and risk of developing one of 13 obesity-related cancers among Black and Latina women in the Women's Health Initiative was examined. Women who followed the lifestyle guidelines had 28% to 42% lower risk of obesity-related cancer. These findings support public health interventions to reduce growing racial/ethnic disparities in obesity-related cancers. [ABSTRACT FROM AUTHOR]

Introduction: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a relatively new class of antidiabetic drugs. Emerging findings from laboratory studies indicate that SGLT2 inhibitors can improve liver function and suppress the proliferation of hepatocellular carcinoma (HCC) cells. The aim of this study was to test the hypothesis that initiation of SGLT2 inhibitors improves HCC prognosis in a human population. Methods: We used National Surveillance, Epidemiology and End Results (SEER)—Medicare linked data in the United States to evaluate the role of SGLT2 inhibitor initiation on the survival of HCC patients. 3,185 HCC patients newly diagnosed between 2014 and 2017 aged 66 years or older with pre-existing type 2 diabetes were included and followed to the end of 2019. Information on SGLT2 inhibitor initiation was extracted from the Medicare Part D file. Results: SGLT2 inhibitor initiation was associated with significantly lower mortality risk after adjusting for potential confounders (HR = 0.68, 95% CI = 0.54–0.86) with stronger association for longer duration of use (HR = 0.60, 95% CI = 0.41–0.88). Further, we found that SGLT2 inhibitor initiation was associated with a lower risk mortality risk ranging from 14% to 60% regardless of patient demographic variables, tumor characteristics, and cancer treatments. Conclusion: Our large SEER-Medicare linked data study indicates that SGLT2 inhibitor initiation was associated with improved overall survival of HCC patients with pre-existing type 2 diabetes compared with no SGLT2 inhibitor use. Further studies are needed to confirm our findings and elucidate the possible mechanisms behind the association. [ABSTRACT FROM AUTHOR]

Lake Dianchi is one of the most eutrophic lakes in China. The decline in water quality and the occurrence of massive algal blooms pose a significant threat to the health and environmental safety of the water ecosystem, making Lake Dianchi a key concern for algal bloom management in China. Obtaining the spatiotemporal dynamics of algal blooms for the longest time possible is crucial to algal bloom management and future prediction. However, it is difficult to acquire a long-term record of algal blooms from a single sensor in order to cover a more extended period of eutrophication in the lake due to the limitation of the spatial and temporal resolution of the sensors. In this study, Landsat and Moderate-Resolution Imaging Spectroradiometer (MODIS) images were combined with the Floating Algae Index (FAI) to reconstruct a unified time series of bloom areas to analyze the algal bloom dynamics in Lake Dianchi in recent decades. Regarding the interannual variation, the bloom area showed an increasing trend from 1987 to 2021, with larger bloom areas in 1991–1992, 2000–2003, 2012–2013, and 2020–2021. In terms of seasonal characteristics, the bloom area was significantly more prominent in the rainy season compared with the dry season during the year. The spatial distribution of the bloom frequency showed a pattern of higher frequencies in the north and lower frequencies in the south. From 2000 to 2021, the initial bloom time and bloom duration showed a trend of delaying and then advancing and decreasing and then increasing, respectively. We analyzed the importance of long-term records of algal blooms and found that the percentage of rainy season images is an essential factor in reconstructing time series based on different sensors. In addition, the relationship between environmental factors and algal blooms was analyzed. The results show that wind speed and air temperature were the main meteorological factors controlling the interannual variation in algal blooms in Lake Dianchi. Water quality factors such as nutrients have less of an influence on the variation in algal blooms because the algal growth demand has been met. Environmental management measures taken by local governments have led to improvements in the lake's trophic state, and continued strengthening of environmental pollution control is expected to curb the algal blooms in Lake Dianchi. This study provides a long-term record of algal blooms in Lake Dianchi, which provides essential reference information for a comprehensive understanding of the development process of algal blooms in Lake Dianchi and its sustainable development. [ABSTRACT FROM AUTHOR]

Metformin has been suggested to reduce thyroid cancer incidence and to improve thyroid cancer prognosis. We aimed to evaluate the associations between metformin and thyroid cancer incidence and prognosis (metastasis/recurrence/progression-free survival). Cochrane Library, PubMed, ClinicalTrials.gov, and U.S. National Library of Medicine Clinical Trials were searched through the end of December 2021. Data were collected from original observational studies or clinical trials on the incidence or prognosis of thyroid carcinoma outcomes in type 2 diabetes mellitus (T2DM) patients with and without metformin use. Risk of bias in non-randomized studies of interventions (ROBINS-I) tool and Grading of Recommendations, and Assessment, Development and Evaluations (GRADE) approach were used to evaluate the risk of bias and quality of the body of evidence, respectively. In general, 4 studies were related to the thyroid cancer incidence, including 1,705,123 participants metformin users and non-users and yielding a total of 3,238 thyroid cancer events; 3 studies reported the prognosis of thyroid carcinoma based on a total of 4,972 individuals with primary thyroid carcinoma and comorbid type 2 diabetes, and the number of thyroid cancer prognosis cases ranged from 3 to 79. The overall risk of bias of the included studies ranged from moderate to serious. In the random-effects model, the summary relative risk (SRR) for thyroid cancer incidence was 0.743 (95% CI: 0.453–1.220; I2 = 88.7%, low certainty) comparing metformin users to non-users; and SRR for the prognosis of thyroid cancer was 0.504 (95% CI: 0.178–1.430; I2 = 57.5%, low certainty). Non-statistically significant negative associations between metformin use and incidence and prognosis of thyroid cancer were found in the current analysis, although the quantity and quality of the evidence were limited. Futher investigation is needed to evaluate the clinical benefits of metformin on thyroid cancer prevention and treatments. [ABSTRACT FROM AUTHOR]

Designing electromagnetic wave absorption (EMWA) materials with wide bandwidth, strong absorption, and light weight is still a great challenge for practical applications. Herein, the novel nitrogen doped carbon (NDC)/MoS2 composite with rationally designed composition and structure was developed. The NDC particles were introduced into MoS2 nanosheets through the calcination of ZIF-8 precursor and consequent hydrothermal process. A series of characterizations were carried out to investigate the physical properties of the as-prepared nanocomposites. The NDC particles exhibited the shape of rhombic dodecahedron with the size of about 500 nm, which were decorated on flower-shaped MoS2 with the size of about 3 µm. With the increasing NDC content, the absorbing properties of NDC/MoS2 composites increased firstly and then decreased. The features of NDC/MoS2 composite including interconnected porous structure, nitrogen dopant, and appropriate electrical conductivity gave rise to the polarization, multiple reflection, multiple scattering, and impedance matching, resulting in the outstanding EMWA performance. With a filler loading ratio of 30 wt.%, the optimized EMWA property can be achieved when the mass ratio of NDC to MoS2 was adjusted to be 1:1. At a coating thickness of 3.0 mm, the effective EMWA bandwidth (< −10 dB) reached 6.08 GHz (8.56–14.64 GHz). These satisfactory achievements provide a way for the reasonable design of high-performance EMWA and new ideas for future research on wideband EMWA. [ABSTRACT FROM AUTHOR]

Purpose: Aging associated with progressive declines in physical function is well-known; however, it is unclear how breast cancer diagnosis affects the trajectories of physical function over a long period of time. The current study examined the trajectories in objective measures of physical function over 20 years for women with breast cancer and matched controls. Methods: 2712 community-dwelling women (452 breast cancer cases and 1:5 matched cancer-free controls) aged 65 years or older at baseline (1986–1988) within the Study of Osteoporotic Fractures were followed for 20 years. Objective physical function was assessed up to 9 times, including hand grip strength, timed chair stand, gait speed and quadriceps strength. Linear mixed models were used to model physical function changes in terms of secular time trend, group (cases or controls), period (pre-and post-diagnosis status), and their interaction terms. Results: We observed all measures of physical function declined over time. While no differences in trends between cases and controls during the pre-diagnosis period were observed, after cancer diagnosis, grip strength and gait speed declined significantly faster in cases than controls. Quadriceps strength significantly decreased ~ 7 pounds shortly after breast cancer diagnosis, and then improved over time. Conclusion: Our study revealed that older breast cancer survivors relative to older women without cancer had significantly worse declines in grip strength and gait speed. Breast cancer survivors also had a sharp, short-term drop followed by gradual improvement over time in quadriceps strength. These findings suggest exercise training targeting muscle strength and mobility would be beneficial among older breast cancer survivors. [ABSTRACT FROM AUTHOR]

As the core component of proton exchange membrane fuel cells, proton exchange membranes (PEM) have attracted much attention of researchers. To trade-off the proton conductivity, dimensional stability and anti-oxidation ability of PEM, graphene oxide (GO) and acidized multi-walled carbon nanotubes (MWCNT) using calcium ion as coordination bridge (GO-Ca2+-MWCNT) was synthesized, and then incorporated into sulfonated poly(arylene ether nitrile) (SPEN) to fabricate SPEN/GO-Ca2+-MWCNT organic–inorganic composite membranes by solution-casting method and explore the influence of varying loading on performances as PEM. It was found that the proton conductivity of the composite membranes was higher than that of SPEN, while maintaining better dimensional stability, excellent anti-oxidation ability and good mechanical properties. All of these were attributed to the formation of three-dimensional structure between GO and MWCNT bridged by Ca2+ and the interaction between the sulfonic acid group and calcium ions in SPEN/GO-Ca2+-MWCNT composites. Particularly, the SPEN/GO-Ca2+-MWCNT-1 composite membrane exhibited excellent tensile strength of 71.45 MPa, better thermal stability as well as high proton conductivity (0.054 S/cm at 30 °C, and 0.193 S/cm at 90 °C), above 10–2 S/cm, satisfying the requirement of PEM. All in all, the results indicate that the filler with three-dimensional network structure can effectively improve the performances of SPEN, and the prepared composite membranes show potential applications in many fields. [ABSTRACT FROM AUTHOR]

Pancreatic cancer (PC) is the fourth leading cause of cancer mortality among women in the United States. Obesity is positively associated with PC risk. Current health recommendations focus on weight maintenance for healthy-weight individuals and weight loss for overweight/obese individuals; however, little research has assessed associations between PC risk and changes in weight throughout the life course. Using prospective cohort study data, we examined the relationship between baseline adulthood weight patterns self-reported between 1993 and 1998 and PC risk in 136,834 postmenopausal women with 873 incident PC cases through September 30, 2015, in the Women's Health Initiative. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards models, adjusting for age, smoking habits, heavy alcohol consumption, and body mass index. Compared with women with stable weight, no significant associations were found between steady weight gain (HR = 1.01, 95% CI: 0.83, 1.22), sustained weight loss (HR = 1.26, 95% CI: 0.85, 1.87), or weight cycling patterns (HR = 1.08, 95% CI: 0.89, 1.30) and PC. Results were similar when the outcome definition was restricted to pancreatic adenocarcinoma cases. Overall, we did not find evidence to suggest that weight changes in adulthood significantly impact PC risk among postmenopausal women. [ABSTRACT FROM AUTHOR]

Food environments are associated with diabetes, obesity and cardiovascular health, but associations to colorectal cancer incidence and mortality have not been reported. We analyzed associations between Food Environment Index (FEI) and national adjusted colorectal cancer incidence and mortality rates. Better FEI scores (i.e., environments with less food insecurity and better access to healthy food) were associated with lower colorectal cancer incidence (p <.004) and mortality (p <.0001). Stronger associations were observed in areas with higher percent Black populations. Results suggest that food environments may contribute to colorectal cancer risk, and point to areas for further research on prevention and cancer survivorship. [ABSTRACT FROM AUTHOR]

Purpose: To examine the associations of long-chain omega-3 polyunsaturated fatty acids (LCω3PUFA) intake with sleep quality and duration in a cohort of American young adults, and to explore whether the associations of interest are modified by selenium (Se) and/or mercury (Hg) status. Methods: The study sample consisted of 3964 men and women from the longitudinal Coronary Artery Risk Development in Young Adults (CARDIA) study, aged 25.0 ± 3.6 at baseline. Intake of LCω3PUFA was assessed using an interviewer-administered dietary history questionnaire at baseline (1985–1986), Y7 (1992–1993), and Y20 (2005–2006). Toenail Se and Hg concentrations were quantified at Y2 (1987–1988). The outcomes were self-reported sleep quality and sleep duration measured by one question for each at Y15 (2000–2001) and Y20. Generalized estimating equation was used to examine the association between cumulative average intake of LCω3PUFA and sleep measures. Restricted cubic spline was performed to explore the potential non-linear associations of interest. Se and Hg were dichotomized by their median values to examine the potential effect modification of Se and/or Hg. Results: We did not observe any significant associations (linear or non-linear) of LCω3PUFA intake with either sleep quality or duration. Also, no significant association was observed in any subgroup classified by toenail Se and/or Hg concentrations. Similarly, sensitivity analysis indicated that the null associations between LCω3PUFA intake and sleep quality or duration persisted across subgroups classified by race, gender, obesity, or having small children. Conclusion: Findings from this longitudinal analysis did not support the hypothesis that LCω3PUFA intake is associated with sleep quality or sleep duration. [ABSTRACT FROM AUTHOR]

In the present study, high purity Ti3Sn(1-x)AlxC2 solid solution was successfully synthesized by Self-propagating high temperature synthesis (SHS) from Ti-Sn-Al-C reactants. Al plays a key role during the reaction process, which can replace Sn atom to form unstable Ti2Al(1-y)SnyC or Ti3Sn(1-x)AlxC2 solid solutions. Ti2Al(1-y)SnyC is likely to transform to Ti3Sn(1-x)AlxC2 at high temperature, and the unstable Ti3Sn(1-x)AlxC2 phase has been kept because the SHS reaction would suddenly completed in a few minutes. Otherwise, Ti2SnC is the dominant phase if the reactants only contain Ti, Sn and C powders. TiC and Sn are also appeared as second phases because Ti2SnC would like to decompose at high temperatures. Moreover, Ti3Sn(1-x)AlxC2 showed promising capability in lithium-ion storage. [ABSTRACT FROM AUTHOR]

Background: In the Women's Health Initiative (WHI) dietary modification (DM) randomised trial, the low-fat dietary intervention reduced deaths from breast cancer (P = 0.02). Extending these findings, secondary analysis examined dietary intervention influence on breast cancer mortality by metabolic syndrome (MS) components.Methods: In total, 48,835 postmenopausal women with no prior breast cancer were randomised to a low-fat dietary intervention or comparison groups. Four MS components were determined at entry in 45,833 participants: (1) high waist circumference, (2) high blood pressure, (3) high cholesterol and (4) diabetes history. Forest plots of hazard ratios (HRs) were generated with P-values for interaction between randomisation groups and MS component score. Primary outcome was death from breast cancer by metabolic syndrome score.Results: HRs and 95% confidence intervals (CI) for dietary intervention influence on death from breast cancer were with no MS components (n = 10,639), HR 1.09, 95% CI 0.63-1.87; with 1-2 MS components (n = 30,948), HR 0.80, 95% CI 0.62-1.02; with 3-4 MS components (n = 4,246), HR 0.31, 95% CI 0.14-0.69 (interaction P = 0.01).Conclusions: While postmenopausal women with 3-4 MS components were at higher risk of death from breast cancer, those randomised to a low-fat dietary intervention more likely had reduction in this risk.Registry: ClinicalTrials.gov (NCT00000611). [ABSTRACT FROM AUTHOR]

Heavy metal exposures may contribute to diabetes risk but prospective studies are uncommon. We analyzed the Australian Longitudinal Study on Women's Health (three cohorts aged 18–23, 45–50, or 70–75 at baseline in 1996, N = 34,191) merged with emissions data for 10 heavy metals (As, Be, Co, Cr, Cu, Hg, Mn, Ni, Pb, Zn) from the National Pollutant Inventory. Over 20-year follow-up, 2,584 women (7.6%) reported incident diabetes. Cox proportional hazards regression models showed that women aged 45–50 at baseline had higher diabetes risk in association with exposure to total air emissions, total water emissions, all individual metals air emissions, and six individual water emissions. After correction for false discovery rate, nine of 11 air emissions and five water emissions remained significant. Associations were not observed for land-based emissions, or for younger or older cohorts. Emissions were dominated by mining, electricity generation and other metals-related industrial processes. [ABSTRACT FROM AUTHOR]

Background: Triple-negative breast cancer (TNBC) is disproportionately higher in Black women relative to White women. The objective of this study was to examine to what extent the association between race/ethnicity and risk of TNBC is mediated by potentially modifiable factors. Methods: A total of 128,623 Black and White women aged 50–79 years from the Women's Health Initiative were followed for a mean of 15.8 years. 643 incident TNBC cases (92 Black women and 551 White women) were confirmed by medical record review. Mediation analyses were conducted using an approach under a counterfactual framework. Results: Black women had approximately twofold higher risk of TNBC compared with white women (HR = 1.93, 95% CI 1.52–2.45). We observed that 48% of the racial disparity was mediated by metabolic dysfunction defined by having 3 or more cardiometabolic risk factors including elevated waist circumference, having history of diabetes, high cholesterol and hypertension. The racial disparity was not significantly mediated by other factors studied, including socioeconomic, lifestyle or reproductive factors. Conclusion: Our study observed that approximately half of the racial disparity between postmenopausal Black and White women in TNBC incidence was driven by metabolic dysfunction. [ABSTRACT FROM AUTHOR]

Background: Triple‐negative breast cancer (TNBC) has a high recurrence risk and poor clinical outcomes. Associations between metabolic syndrome (MetS) risk components and mortality in postmenopausal women with TNBC were examined in the Women's Health Initiative. Methods: Five hundred forty‐four postmenopausal women were diagnosed with nonmetastatic TNBC. Baseline risk components included a high waist circumference (≥88 cm), high blood pressure, hypercholesterolemia, and diabetes. Groups were categorized by the number of MetS risk components: none, 1 or 2, or 3 or 4. Hazard ratios (HRs) and 95% confidence intervals (CIs) across groups were computed with multivariable adjusted Cox models. Outcomes included breast cancer–specific mortality and breast cancer overall mortality (breast cancer followed by death from any cause). Variables in the multivariable model included age at TNBC diagnosis; race/ethnicity; income; education; clinical/observational trial status; history of oral contraceptive, hormone, and/or statin use; cancer stage; and chemotherapy and/or radiation treatment status. Results: Of the 544 participants with TNBC, 33% had no MetS risk components (n = 178), 59% had 1 or 2 risk components (n = 323), and 8% had 3 or 4 risk components (n = 43). After a median follow‐up from diagnosis of 8.3 years, multivariable results showed that women with 3 or 4 risk components had a nonsignificantly higher risk of breast cancer mortality (HR, 2.05; 95% CI, 0.94‐4.47 trend P =.114) and a significantly higher risk of overall mortality (HR, 2.13; 95% CI, 1.22‐3.71; trend P =.006) versus women with 0 risk components. Conclusions: Postmenopausal women with TNBC and 3 or 4 MetS risk components have a nonsignificantly higher breast cancer mortality risk and a significantly higher overall mortality risk, likely because of negative influences of metabolic risk factors on several causes of death. Postmenopausal women with 3 or 4 metabolic risk components who are diagnosed with triple‐negative breast cancer have higher breast cancer–specific and overall mortality rates. [ABSTRACT FROM AUTHOR]

Background: Cardiometabolic abnormalities are a leading cause of death among women, including women with cancer. Methods: This study examined the association between prediagnosis cardiovascular health and total and cause‐specific mortality among 12,076 postmenopausal women who developed local‐ or regional‐stage invasive cancer in the Women's Health Initiative (WHI). Cardiovascular risk factors included waist circumference, hypertension, high cholesterol, and type 2 diabetes. Obesity‐related cancers included breast cancer, colorectal cancer, endometrial cancer, kidney cancer, pancreatic cancer, ovarian cancer, stomach cancer, liver cancer, and non‐Hodgkin lymphoma. Cox proportional hazards models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs) adjusted for important predictors of survival. Results: After a median follow‐up of 10.0 years from the date of the cancer diagnosis, there were 3607 total deaths, with 1546 (43%) due to cancer. Most participants (62.9%) had 1 or 2 cardiometabolic risk factors, and 8.1% had 3 or 4. In adjusted models, women with 3 to 4 risk factors (vs none) had a higher risk of all‐cause mortality (HR, 1.99; 95% CI, 1.73‐2.30), death due to cardiovascular disease (CVD) (HR, 4.01; 95% CI, 2.88‐5.57), cancer‐specific mortality (HR, 1.37; 95% CI, 1.1‐1.72), and other‐cause mortality (HR, 2.14; 95% CI, 1.70‐2.69). A higher waist circumference was associated with greater all‐cause mortality (HR, 1.17; 95% CI, 1.06‐1.30) and cancer‐specific mortality (HR, 1.22; 95% CI, 1.04‐1.42). Conclusions: Among postmenopausal women diagnosed with cancer in the WHI, cardiometabolic risk factors before the cancer diagnosis were associated with greater all‐cause, CVD, cancer‐specific, and other‐cause mortality. These results raise hypotheses regarding potential clinical intervention strategies targeting cardiometabolic abnormalities that require future prospective studies for confirmation. Lay Summary: This study uses information from the Women's Health Initiative (WHI) to find out whether cardiac risk factors are related to a greater risk of dying among older women with cancer. The WHI is the largest study of medical problems faced by older women in this country.The results show that women who have 3 or 4 risk factors are more likely to die of any cause, heart disease, or cancer in comparison with women with no risk factors.It is concluded that interventions to help to lower the burden of cardiac risk factors can have an important impact on survivorship among women with cancer. Among postmenopausal women with select early‐stage cancers associated with metabolic syndrome, a higher number of cardiometabolic abnormalities is associated with a significantly higher risk of overall death in addition to a higher risk of death due to cancer, heart disease, and other causes. These findings highlight a major gap in the care of patients with cancer and the need for improved efforts by public health systems to improve cancer survivorship. [ABSTRACT FROM AUTHOR]

Background: There are no epidemiologic data on the relation of depression before colorectal cancer diagnosis to colorectal cancer mortality among women with colorectal cancer, especially those who are postmenopausal. Our aim was to fill this research gap. Methods: We analyzed data from a large prospective cohort in the US, the Women's Health Initiative (WHI). The study included 2,396 women with incident colorectal cancer, assessed for depressive symptoms and antidepressant use before cancer diagnosis at baseline (screening visit in the WHI study) during 1993–1998. Participants were followed up from cancer diagnosis till 2018. We used Cox proportional hazards regression to estimate adjusted hazard ratios (HRs) between depression (depressive symptoms or antidepressant use) at baseline, and all-cause mortality and colorectal cancer-specific mortality. Results: Among women with colorectal cancer, there was no association between baseline depression and all-cause mortality or colorectal cancer-specific mortality after adjusting for age or multiple covariates. Conclusion: Among women with colorectal cancer, there was no statistically significant association between depression before colorectal cancer diagnosis and all-cause mortality or colorectal cancer-specific mortality. Further studies are warranted to assess depressive symptoms and antidepressant use, measured at multiple points from baseline to diagnosis, and their interactions with specific types of colorectal cancer treatment on the risk of death from colorectal cancer. [ABSTRACT FROM AUTHOR]

Physical activity is associated with decreased risk for many cancers. Studies on the association between physical activity and risk of bladder cancer are limited, and findings are inconsistent. Postmenopausal women (mean age = 63.3) were recruited into the Women's Health Initiative from 1993 to 1998. Self‐reported baseline information on physical activity and other covariates were available in 141 288 participants. Incident bladder cancer cases were collected through 2018 and centrally adjudicated. Hazard ratios (HRs) and 95% confidence intervals (CIs) were determined by Cox proportional hazard regression models. Effect modification due to smoking was assessed. During an average of 18.5 years of follow‐up, 817 bladder cancer cases were identified. Compared to physically inactive women, those who engaged in ≥15 MET‐hours/week of total physical activity, ≥8.75 MET‐hours/week of walking or ≥11.25 MET‐hours/week of moderate to vigorous physical activity had lower risk of bladder cancer (HR = 0.74, 95% CI: 0.59‐0.94, P for linear trend =.02; HR = 0.79, 95% CI: 0.63‐0.98, P for linear trend =.03; and HR = 0.76, 95% CI: 0.61‐0.94, P for linear trend =.02, respectively). No effect modification was found by smoking status (P for interaction =.06, 0.91 and 0.27, respectively). We found that total physical activity, walking and moderate to vigorous physical activity were inversely associated with bladder cancer incidence among postmenopausal women in a dose‐response manner. Physical activity may play a potential role in the primary prevention of bladder cancer. Further studies with objective measurements of physical activity are needed to confirm these findings. What's new? Women are diagnosed with bladder cancer at lower rates than men, but often have worse outcomes than men, even at similar stages. Studies of bladder cancer risk factors have more often focused on men than on women. Here, the authors examined different levels of physical activity as related to bladder cancer risk in postmenopausal women. Women who engaged in physical activity, whether it was walking or moderate‐to‐vigorous physical activity, had lower risk of bladder cancer than women who described themselves as physically inactive. [ABSTRACT FROM AUTHOR]

Objectives We examined whether social relationship variables (social support, social strain, social network size, and stressful life events) were associated with risk of developing type 2 diabetes among postmenopausal women. Method 139,924 postmenopausal women aged 50–79 years without prevalent diabetes at baseline were followed for a mean of 14 years. 19,240 women developed diabetes. Multivariable Cox proportional hazard models tested associations between social relationship variables and diabetes incidence after consideration of demographics, depressive symptoms, and lifestyle behaviors. We also examined moderating effects of obesity and race/ethnicity, and we tested whether social variable associations were mediated by lifestyle or depressive symptoms. Results Compared with the lowest quartile, women in the highest social support quartile had lower risk of diabetes after adjusting for demographic factors, health behaviors, and depressive symptoms (hazard ratio [HR] = 0.93, 95% confidence interval [CI] = 0.89–0.97). Social strain (HR = 1.09, 95% CI = 1.04–1.13) and stressful life events (HR = 1.10, 95% CI = 1.05–1.15) were associated with higher diabetes risks. The association between diabetes and social strain was stronger among African American women. Social relationship variables had direct relationships to diabetes, as well as indirect effects partially mediated by lifestyle and depressive symptoms. Discussion Social support, social strain, and stressful life events were associated with diabetes risk among postmenopausal women independently of demographic factors and health behaviors. In addition to healthy behaviors such as diet and physical activity, healthy social relationships among older women may be important in the prevention of diabetes. [ABSTRACT FROM AUTHOR]

BACKGROUND Coffee and tea are two of the most widely consumed beverages worldwide and have been associated with reduced risk of mortality in some studies. However, it is unknown whether consumption of these beverages is associated with survival to an advanced age. OBJECTIVE To examine associations of coffee and tea consumption with survival to age 90 years. DESIGN Prospective cohort study among participants from the Womenʼs Health Initiative, recruited during 1993 to 1998 and followed up until March 31, 2018. SETTING The setting included 40 US clinical centers. PARTICIPANTS A racially and ethnically diverse cohort of 27,480 older women, aged 65 to 81 years at baseline. MEASUREMENTS Women were classified as having either survived to age 90 years or died before this age. Consumption of caffeinated and decaffeinated coffee and caffeinated tea was assessed at baseline and categorized as 0, 1, 2 to 3, or 4 or more cups/day. Associations of coffee and tea consumption with survival to age 90 years were examined using logistic regression models adjusted for sociodemographic characteristics, lifestyle behaviors, dietary quality, and chronic disease history. RESULTS: A total of 14,659 (53.3%) women survived to age 90 years during follow‐up. Caffeinated coffee, decaffeinated coffee, or caffeinated tea consumption was not significantly associated with survival to age 90 years after adjusting for confounders. Findings did not significantly vary by smoking, body mass index, or race/ethnicity. CONCLUSION: No amount of coffee or tea consumption was associated with late‐age survival among older women. These findings may be reassuring to older women who consume coffee and tea as part of their daily diets but do not support drinking these beverages to achieve longevity. [ABSTRACT FROM AUTHOR]

Purpose: It has been hypothesized that selenium (Se) can prevent cancer, and that Se deficiency may be associated with an increased risk of breast cancer. However, findings from epidemiological studies have been inconsistent. The objective of this study was to assess the association between Se intake and risk of breast cancer in the Women's Health Initiative (WHI). Methods: This study included 145,033 postmenopausal women 50–79 years who completed baseline questionnaires between October 1993 and December 1998, which addressed dietary and supplemental Se intake and breast cancer risk factors. The association between baseline Se intake and incident breast cancer was examined in Cox proportional hazards analysis. Results: During a mean follow-up of 15.5 years, 9487 cases of invasive breast cancer were identified. Total Se (highest versus lowest quartile: HR 1.00, 95% CI 0.92–1.09, Ptrend = 0.66), dietary Se (highest versus lowest quartile: HR 0.99, 95% CI 0.89–1.08, Ptrend = 0.61), and supplemental Se (yes versus no: HR 0.99, 95% CI 0.95–1.03) were not associated with breast cancer incidence. Conclusions: This study indicates that Se intake is not associated with incident breast cancer among postmenopausal women in the United States. Further studies are needed to confirm our findings by using biomarkers such as toenail Se to reduce the potential for misclassification of Se status. [ABSTRACT FROM AUTHOR]

We conducted latent class analyses to identify women with homogeneous combinations of lifestyle and behavioral variables and tested whether latent classes were prospectively associated with diabetes incidence for women with or without baseline obesity. A total of 64,710 postmenopausal women aged 50–79 years without prevalent diabetes at baseline (years 1993–1998) were followed until 2018 with a mean follow-up of 14.6 years (sd = 6.4). Lifestyle variables included smoking, diet quality, physical activity, and sleep quality. Psychosocial variables included social support, depression, and optimism. Multivariable Cox proportional hazards regression models tested associations between latent classes and diabetes incidence controlling for age, race/ethnicity, and education. During follow-up, 8076 (12.4%) women developed diabetes. For women without baseline obesity, five latent classes were identified. Compared with a lower risk referent, diabetes incidence was higher in classes characterized by high probability of multiple lifestyle and psychosocial risks (HR = 1.45; 95% CI 1.28, 1.64), poor diet and exercise (HR = 1.23; 95% CI 1.13, 1.33), and psychosocial risks alone (HR = 1.20; 95% CI 1.12, 1.29). For women with baseline obesity, four latent classes were identified. Compared with a lower risk referent, diabetes incidence was higher for women with obesity in classes characterized by high probability of multiple lifestyle and psychosocial risks (HR = 1.48; 95% CI 1.32, 1.66), poor diet and exercise (HR = 1.32; 95% CI 1.19, 1.47), and intermediate probabilities of multiple risks (HR = 1.17; 95% CI 1.05, 1.30). Diabetes prevention efforts that focus on diet and exercise may benefit from attention to how lifestyle behaviors interact with psychosocial variables to increase diabetes risks, and conversely, how psychological or social resources may be leveraged with lifestyle changes to reduce the risk for women with and without obesity. [ABSTRACT FROM AUTHOR]

Objective: We studied associations between social support, social network size, social strain, or stressful life events and risk of coronary heart disease (CHD) in postmenopausal women with type 2 diabetes.Research Design and Methods: From the Women's Health Initiative, 5,262 postmenopausal women with type 2 diabetes at baseline were included. Cox proportional hazards regression models adjusted for demographics, depressive symptoms, anthropometric variables, and lifestyle factors were used to examine associations between social factors and CHD.Results: A total of 672 case subjects with CHD were observed during an average 12.79 (SD 6.29) years of follow-up. There was a significant linear trend toward higher risk of CHD as the number of stressful life events increased (P for trend = 0.01; hazard ratio [HR] [95% CI] for the third and fourth quartiles compared with first quartile: 1.27 [1.03-1.56] and 1.30 [1.04-1.64]). Being married or in an intimate relationship was related to decreased risk of CHD (HR 0.82 [95% CI 0.69-0.97]).Conclusions: Among postmenopausal women with type 2 diabetes, higher levels of stressful life events were associated with higher risk of CHD. Experience of stressful life events might be considered as a risk factor for CHD among women with type 2 diabetes. [ABSTRACT FROM AUTHOR]

Breast cancer has been suggested to potentially have prenatal origins. We examined associations between birth weight, body mass index (BMI) at four‐time points over 25 years of adulthood, and risk of postmenopausal breast cancer, with emphasis on whether the association between birth weight and risk of breast cancer was mediated by weight and height changes over the adult life course. Postmenopausal women (n = 70,397) aged 50–79 years without breast cancer at enrollment (1993–1998) were followed up to 25 years. Weight and height were measured at baseline. Birth weight, and weights at ages 18, 35 and 50 were self‐reported. Breast cancer cases were centrally adjudicated. Compared to women with birth weight of 6–8 pounds, women with birth weight of <6 pounds had lower risk of breast cancer (HR = 0.88 95% CI: 0.79–0.99). 44% and 21% of the relationship between birth weight and breast cancer risk was mediated by adult height and weight at baseline, respectively. Birth weight of 8 pounds or more was not associated with risk of postmenopausal breast cancer. Weight gain in adulthood was associated with increased risk of breast cancer regardless of time periods. In conclusion, lower birthweight was associated with lower risk of postmenopausal breast cancer, and this reduction in risk was significantly mediated by childhood or adolescent growth, especially by adult height. Our data suggest that reaching and maintaining a healthy weight during adulthood is key in the prevention of breast cancer. What's new? Higher birthweight is associated with increased risk of breast cancer, especially in premenopausal women. In this study, the authors analyzed the effect of adult weight and height on the association between birthweight and postmenopausal breast cancer. They enrolled 70,397 postmenopausal women and monitored their breast cancer incidence over a 25‐year follow up. Women under 6 pounds at birth had reduced cancer risk, but more than 40% of this effect was mediated by adult height. High birthweight was not associated with postmenopausal breast cancer risk. Adult weight gain was associated with increased risk, regardless of birthweight. [ABSTRACT FROM AUTHOR]

Introduction: Evidence on the association between diabetes and risk of bladder cancer has been controversial. In addition, findings on the associations between duration of diabetes, diabetes treatment, and risk of bladder cancer have been inconsistent.Methods: A total of 148,208 participants in Women's Health Initiative study were included. Information on diabetes status, diabetes duration, and treatment was collected both at baseline and during follow-up. Information on potential confounders including age, race/ethnicity, education, occupation, family history of cancer, smoking status, alcohol consumption, total physical activity, body mass index, and daily dietary intake were collected at baseline. Bladder cancer cases were collected and confirmed by a centralized review of pathology reports. Cox proportional hazard models with time-varying covariates were used to examine associations of diabetes status, duration of diabetes, and diabetes treatment with bladder cancer risk.Results: During a median follow-up of 18.5 years, 865 bladder cancer cases were identified. There were no significant associations of diabetes, duration of diabetes, or diabetes treatment with risk of bladder cancer. Participants with prevalent diabetes did not have significantly higher risk of bladder cancer compared with those without diabetes.Conclusion: Diabetes was not significantly associated with risk of bladder cancer among postmenopausal women. [ABSTRACT FROM AUTHOR]

Background: We evaluated associations between perceived social support, social integration, living alone, and colorectal cancer (CRC) outcomes in postmenopausal women. Methods: The study included 1431 women from the Women's Health Initiative who were diagnosed from 1993 through 2017 with stage I through IV CRC and who responded to the Medical Outcomes Study Social Support survey before their CRC diagnosis. We used proportional hazards regression to evaluate associations of social support (tertiles) and types of support, assessed up to 6 years before diagnosis, with overall and CRC‐specific mortality. We also assessed associations of social integration and living alone with outcomes also in a subset of 1141 women who had information available on social ties (marital/partner status, community and religious participation) and living situation. Results: In multivariable analyses, women with low (hazard ratio [HR], 1.52; 95% CI, 1.23‐1.88) and moderate (HR, 1.21; 95% CI, 0.98‐1.50) perceived social support had significantly higher overall mortality than those with high support (P [continuous] <.001). Similarly, women with low (HR, 1.42; 95% CI, 1.07‐1.88) and moderate (HR, 1.28; 95% CI, 0.96‐1.70) perceived social support had higher CRC mortality than those with high social support (P [continuous] =.007). Emotional, informational, and tangible support and positive interaction were all significantly associated with outcomes, whereas affection was not. In main‐effects analyses, the level of social integration was related to overall mortality (P for trend =.02), but not CRC mortality (P for trend =.25), and living alone was not associated with mortality outcomes. However, both the level of social integration and living alone were related to outcomes in patients with rectal cancer. Conclusions: Women with low perceived social support before diagnosis have higher overall and CRC‐specific mortality. Women from the Women's Health Initiative with low perceived social support before a diagnosis of colorectal cancer have higher overall and disease‐specific mortality. Levels of social integration and living alone are related to outcomes in patients with rectal cancer only. [ABSTRACT FROM AUTHOR]

This article reviews evidence for the public health impacts of coal across the extraction, processing, use, and waste disposal continuum. Surface coal mining and processing impose public health risks on residential communities through air and water pollution. Burning coal in power plants emits more nitrogen oxides, sulfur dioxide, particulate matter, and heavy metals per unit of energy than any other fuel source and impairs global public health. Coal ash disposal exposes communities to heavy metals and particulate matter waste. Use of coal in domestic households causes public health harm concentrated in developing nations. Across the coal continuum, adverse impacts are disproportionately felt by persons of poor socioeconomic status, contributing to health inequities. Despite efforts to develop renewable energy sources, coal use has not declined on a global scale. Concentrated efforts to eliminate coal as an energy source are imperative to improve public health and avert serious climate change consequences. [ABSTRACT FROM AUTHOR]