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Epidemiological evidence regarding the relationship between coffee and tea consumption and the risk of ovarian cancer (OC) is inconsistent. Therefore, we aimed to quantitatively investigate this topic in a large prospective cohort study. This cohort study included 24,715 individuals recruited from the Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trials between 1993 and 2001. The data used for our analysis included the latest follow‐up information collected up to 2015. Coffee intake of ≥4 cups/day (hazard ratio [HR], 0.586; 95% confidence interval [CI]: 0.356–0.966) or caffeine intake of 458.787 mg/day (HR, 0.607; 95% CI: 0.411–0.895) were associated with the lowest HR of incident OC in the fully adjusted model. Participants who consumed varying amounts of tea did not exhibit a statistically significant reduction in the risk of OC. Our findings suggest that a higher consumption of coffee or caffeine is associated with a reduced risk of OC. However, no statistically significant association was observed between tea consumption and the risk of OC. [ABSTRACT FROM AUTHOR]

Aims: To estimate the changes in intraocular pressure (IOP) during the first 24 h after transscleral cyclophotocoagulation (TCP). Methods: A prospective single‐centre study, where patients with glaucoma destined for treatment with TCP were asked for participation. The IOP was measured prior to TCP and at 1, 2, 4, 6 and 24 h post‐TCP. An IOP spike was defined as an elevation of IOP of ≥5 mmHg compared with baseline. The visual acuity (VA) was examined at baseline and after 24 h. Results: The mean IOP prior to TCP in 58 eyes of 58 patients was 26.2 (±8.9 SD) mmHg. Twenty‐three eyes (40%) experienced an IOP spike at some examination timepoint during the first 24 h. The mean value of the IOP spike was 12.1 (±6.9) mmHg. Fifty‐six per cent of the eyes with pseudoexfoliation glaucoma (PEXG) experienced an IOP spike, and 16% had an IOP spike ≥20 mmHg. The IOP was significantly reduced at the 24 h examination by 8.1 (±7.8) mmHg (n = 58). The VA 24 h after TCP was unchanged compared with baseline. Conclusion: Clinically significant IOP spikes were common in the first 24 h post‐TCP. Almost one in five eyes had an increase of 10 mmHg and in almost one in 10 eyes, the IOP increase was 20 mmHg or higher. Eyes with PEXG had a higher occurrence of IOP spikes and displayed a greater magnitude of IOP elevation. Prophylactic post‐operative IOP‐lowering medication should be considered to prevent further glaucoma damage. [ABSTRACT FROM AUTHOR]

Objectives: Fever and increased inflammatory responses sometimes occur following endoscopic resection (ER). However, the differences in causes according to the organ are scarcely understood, and several modified ER techniques have been proposed. Therefore, we conducted a comprehensive prospective study to investigate the cause of fever and increased inflammatory response across multiple organs after ER. Methods: We included patients who underwent gastrointestinal endoscopic submucosal dissection (ESD) and duodenal endoscopic mucosal resection at our hospital between January 2020 and April 2022. Primary endpoints were fever and increased C‐reactive protein (CRP) levels following ER. The secondary endpoints were risk factors for aspiration pneumonia. Blood tests and radiography were performed on the day after ER, and computed tomography was performed if the cause was unknown. Results: Among the 822 patients included, aspiration pneumonia was the most common cause of fever and increased CRP levels after ER of the upper gastrointestinal tract (esophagus, 53%; stomach, 48%; and duodenum, 71%). Post‐ER coagulation syndrome was most common after colorectal ESD (38%). On multivariate logistic regression analysis, lesions located in the esophagus (odds ratio [OR] 3.57; P < 0.001) and an amount of irrigation liquid of ≥1 L (OR 3.71; P = 0.003) were independent risk factors for aspiration pneumonia. Conclusions: Aspiration pneumonia was the most common cause of fever after upper gastrointestinal ER and post‐ER coagulation syndrome following colorectal ESD. Lesions in the esophagus and an amount of irrigation liquid of ≥1 L were independent risk factors for aspiration pneumonia. [ABSTRACT FROM AUTHOR]

Background and Aim: Perforation is one of the most important complications of endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). Several studies have examined risk factors for intraoperative and delayed perforations, but most were retrospective analyses with small numbers of patients. Methods: This study represents a secondary analysis of a Japanese multicenter prospective cohort study. We investigated the factors associated with each type of perforation using 9015 patients with 9975 EGCs undergoing ESD between July 2010 and June 2012. Results: Intraoperative perforation occurred in 198 patients (2.2%) with 203 lesions (2.0%), necessitating emergency surgery for four lesions (0.04% [2.0%, 4/203]). Delayed perforation occurred in another 37 patients (0.4%) with 42 lesions (0.4%), requiring emergency surgery for 12 lesions (0.12% [28.6%, 12/42]). Factors showing significant independent correlations with intraoperative perforation were upper or middle third of the stomach; remnant stomach or gastric tube; procedure time ≥100 min; tumor size >35 mm; body mass index (BMI) < 18.5 kg/m2; and ≥72 years. Factors showing significant independent correlations with delayed perforation were procedure time ≥60 min; BMI < 18.5 kg/m2; ≥75 years; ulceration; and tumor size >20 mm. Intraoperative perforation occurred most frequently at the greater curvature in the upper third of the stomach (7.9%), whereas delayed perforation occurred most frequently at the greater curvature in the middle third (1.2%). Conclusion: This multicenter prospective cohort study clarified the risk and risk factors of intraoperative and delayed perforation related to ESD for EGCs, providing information to help endoscopists reduce perforation. [ABSTRACT FROM AUTHOR]

Thyroid cancer (TC) is substantially more common in women than in men, pointing to a possible role of sex steroid hormones. We investigated the association between circulating sex steroid hormones, sex hormone binding globulin (SHBG) and the risk of differentiated TC in men and women within the European Prospective Investigation into Cancer and nutrition (EPIC) cohort. During follow‐up, we identified 333 first primary incident cases of differentiated TC (152 in pre/peri‐menopausal women, 111 in post‐menopausal women, and 70 in men) and 706 cancer‐free controls. Women taking exogenous hormones at blood donation were excluded. Plasma concentrations of testosterone, androstenedione, dehydroepiandrosterone, estradiol, estrone and progesterone (in pre‐menopausal women only) were performed using liquid chromatography/mass spectrometry method. SHBG concentrations were measured by immunoassay. Odds ratios (ORs) were estimated using conditional logistic regression models adjusted for possible confounders. No significant associations were observed in men and postmenopausal women, while a borderline significant increase in differentiated TC risk was observed with increasing testosterone (adjusted OR T3 vs T1: 1.68, 95% CI: 0.96–2.92, ptrend =.06) and androstenedione concentrations in pre/perimenopausal women (adjusted OR T3 vs T1: 1.78, 95% CI: 0.96–3.30, ptrend =.06, respectively). A borderline decrease in risk was observed for the highest progesterone/estradiol ratio (adjusted OR T3 vs T1: 0.54, 95% CI: 0.28–1.05, ptrend =.07). Overall, our results do not support a major role of circulating sex steroids in the etiology of differentiated TC in post‐menopausal women and men but may suggest an involvement of altered sex steroid production in pre‐menopausal women. [ABSTRACT FROM AUTHOR]

Purpose: To assess marginal bone level changes, implant and restoration survival, condition of the peri‐implant mucosa, and the patient's satisfaction with the single restoration supported by a 6‐mm long implant in the posterior mandible after 10 years in function. Materials and Methods: Twenty‐one consecutive patients missing premolars or molars in the posterior mandible, with a bone volume consisting of a width of at least 6 mm and an estimated height of 8 mm between the top of the ridge and alveolar nerve, were included. Each patient received one or more 6‐mm implants. After 3 months, the implants were restored with custom‐made titanium abutments and cemented zirconia‐based porcelain crowns. The clinical examination and radiograph data were assessed at restoration placement and after 12, 60, and 120 months. The patients answered a questionnaire to score their satisfaction before treatment and after 12, 60, and 120 months with the restoration in function. Results: A total of 31 implants were placed. Implant survival was 100%. The 10‐year mean marginal bone loss was 0.18 mm (SE: 0.08). The plaque, calculus, gingiva, and bleeding indices scores were low as was the mean pocket probing depth. The patients' satisfaction was high. Conclusion: The 10‐year follow‐up data of this limited case series study reveal that 6‐mm dental implants inserted in the resorbed posterior mandible provide a solid basis for single tooth restorations. [ABSTRACT FROM AUTHOR]

Aim: To assess the association between plasma amyloid β (Aβ) 42/40, phosphorylated tau (p‐τ)181, glial fibrillary acidic protein (GFAP), or neurofilament light chain (NfL) and the risk of dementia and to determine whether these plasma biomarkers could improve the ability to predict incident dementia in a general older population. Methods: A total of 1346 Japanese community‐dwelling individuals aged ≥65 years without dementia were followed prospectively for 5.0 years. Plasma biomarkers were quantified using a Simoa HD‐X analyzer. A Cox proportional hazards model was used to estimate the hazard ratios of each plasma biomarker level for the risk of dementia. Results: During the follow‐up, 151 participants developed dementia, of whom 108 had Alzheimer disease (AD) and 43 non–Alzheimer dementia (non‐AD). Lower plasma Aβ42/40 levels and higher plasma p‐τ181 levels were significantly associated with developing AD but not non‐AD, whereas significant associations were observed between higher plasma levels of GFAP and NfL and risk of both AD and non‐AD (all P for trend <0.05). In addition, adding these four plasma biomarkers into a model consisting of the total score of the dementia risk model significantly improved the predictive ability for incident dementia. Conclusion: Our findings suggest that plasma Aβ42/40 and p‐τ181 are specific markers of AD, and plasma GFAP and NfL are potential biomarkers for all‐cause dementia in the general Japanese older population. In addition, the measurement of these plasma biomarkers may be a useful and relatively low‐invasive procedure for identifying individuals at high risk for developing dementia in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Little is known about patients' pre‐treatment expectations in Peyronie's disease (PD). Objective: To evaluate in detail patients' expectations of conservative therapy and surgery. Patients and methods: This multi‐center study prospectively enrolled 317 PD patients, who were scheduled to receive conservative therapy or surgery between 2019 and 2022 at the Department of Urology of the University Medical Center Hamburg‐Eppendorf, and the Center of Reproductive Medicine and Andrology, University Medical Center Muenster, both Germany. The primary end‐point was patients' pre‐treatment expectations of conservative therapy and surgery, measured with the Stanford Expectations of Treatment Scale (SETS). Secondary end‐points included patient‐reported psychological and physical symptoms, penile pain, symptom bother and erectile function, measured with the Peyronie's disease questionnaire (PDQ) and International Index of Erectile Function Erectile Function Domain (IIEF‐EF). Results: In total, 239 (75%) and 78 (25%) patients were scheduled for the conservative therapy and surgery, respectively. Patients undergoing surgery had higher positive and negative mean SETS expectations scores (14 vs. 11, p < 0.001; 9.6 vs. 6.0, p < 0.001). In multivariable analysis, surgery was an independent predictor of positive and negative patients' pre‐treatment expectations (all p ≤ 0.001). In thematic analysis, patients undergoing surgery emphasized distinct themes of pre‐treatment expectations. Patients undergoing surgery had higher mean PDQ symptom bother as well as higher psychological and physical symptom scores (14 vs. 10, p < 0.001; 9.2 vs. 7.1, p = 0.001). There were significant positive correlations between SETS negative expectation score and PDQ symptom bother (|ρ| = 0.25; p < 0.001) as well as PDQ psychological and physical symptoms score, respectively (|ρ| = 0.21; p = 0.001). Conclusion: PD patients expect both more benefit and more harm from surgery. In addition, patients undergoing surgery have more psychological and physical symptoms and more symptom bother. To set realistic expectations, it is of pivotal importance to assess patients' expectations before starting treatment. [ABSTRACT FROM AUTHOR]

Background: The association between macronutrient intake and diabetes is unclear. We used data from the China Health and Nutrition Survey to explore the association between macronutrient intake trajectories and diabetes risk in this study. Methods: We included 6755 participants who did not have diabetes at baseline and participated in at least three surveys. The energy supply ratio of carbohydrate, protein, and fat was further calculated from dietary data; different macronutrient trajectories were determined using multitrajectory models; and multiple Cox regression models were used to evaluate the association between these trajectories and diabetes. Results: We found three multitrajectories: decreased low carbohydrate‐increased moderate protein‐increased high fat (DLC‐IMP‐IHF), decreased high carbohydrate‐moderate protein‐increased low fat (DHC‐MP‐ILF), and balanced‐macronutrients (BM). Compared to the BM trajectory, DHC‐MP‐ILF trajectories were significantly associated with increased risk of diabetes (hazard ratio [HR]: 3.228, 95% confidence interval [CI]: 1.571–6.632), whereas no association between DLC‐IMP‐IHF trajectories and diabetes was found in our study (HR: 0.699, 95% CI: 0.351–1.392). Conclusions: The downward trend of high carbohydrate and the increasing trend of low fat increased the risk of diabetes in Chinese adults. [ABSTRACT FROM AUTHOR]

Background and Objective: To investigate the difference in lung function according to diabetes status in a community‐based prospective study. Methods: Individuals aged 40–69 years from two community‐based cohorts were followed prospectively for 16 years. A spirometer was used to evaluate lung function at baseline, and lung function tests were carried out biennially thereafter. Multivariable linear regression analysis was performed for the cross‐sectional and longitudinal analyses based on diabetes status. Results: Among the 6483 subjects, 2114 (32.6%) had prediabetes and 671 (10.4%) had diabetes. The prediabetes and diabetes groups had lower baseline % predicted values of forced expiratory volume in 1 s (FEV1) (mean, −1.853; 95% confidence interval [CI] –2.715 to −0.990 for prediabetes and mean, −4.088; 95% CI –5.424 to −2.752 for diabetes) and forced vital capacity (FVC) (mean, −2.087; 95% CI –2.837 to −1.337 for prediabetes and mean, −4.622; 95% CI –5.784 to −3.460 for diabetes) compared to the normoglycemia group after adjusting for relevant covariates. The rate of decline in FEV1% predicted (mean, −0.227; 95% CI –0.366 to −0.089) and FVC % predicted (mean, −0.232; 95% CI –0.347 to −0.117) during follow‐up were faster in the diabetes group than in the normoglycemia group. The diabetes group had a lower proportion of normal ventilation (ptrend = 0.048) and higher proportions of restrictive (ptrend = 0.001) and mixed (ptrend = 0.035) ventilatory disorders at the last follow‐up. Conclusion: Diabetes is associated with a lower baseline lung function and a faster rate of deterioration. [ABSTRACT FROM AUTHOR]

Objective: Prediabetes and lifestyle factors have been associated with the risks of multiple adverse outcomes, but the effect of a healthy lifestyle on prediabetes‐related complications remains unknown. We aimed to investigate whether the risks of multiple adverse outcomes including incident type 2 diabetes mellitus (T2DM), cardiovascular disease (CVD), and chronic kidney disease (CKD) among individuals with prediabetes can be offset by a broad combination of healthy lifestyle factors. Methods: This prospective study used data from the UK Biobank cohort. An overall lifestyle score ranging from 0 to 6 was created with 1 point for each of the 6 healthy lifestyle factors: no current smoking, moderate alcohol consumption, regular physical activity, healthy diet, no overweight or obese, and adequate sleep duration. T2DM, CVD, and CKD were ascertained during a median follow‐up of 14 years. Cox proportional hazard regression models were used to estimate the associations. Sensitivity analyses were performed to test the robustness of the results. Results: We included 202,993 participants without T2DM, CVD, and CKD at baseline (mean age 55.5 years [SD 8.1]; 54.7% were women). Among these participants, 6,745, 16,961, and 6,260 participants eventually developed T2DM, CVD, and CKD, respectively. Compared with the participants with normoglycaemia, those with prediabetes showed a higher risk of these adverse outcomes. In addition, those prediabetic participants with a lifestyle score of 0‐1 had a significantly higher risk of T2DM (hazard ratio [HR] 16.73, 95% CI 14.24, 19.65), CVD (HR 1.96, 95% CI 1.74, 2.21), and CKD (HR 1.92, 95% CI 1.58, 2.34) compared with those with no prediabetes and a score of 5–6. Moreover, among the participants with prediabetes, the HRs for T2DM, CVD, and CKD comparing a lifestyle score of 5–6 versus 0‐1 decreased to 0.43 (95% CI 0.36, 0.51), 0.52 (95% CI 0.44, 0.62), and 0.60 (95% CI 0.46, 0.79), respectively. Conclusions: Combined healthy lifestyle factors were associated with a significantly lower risk of multiple adverse outcomes, including T2DM, CVD, and CKD. This indicates that prioritising multifactorial approaches to behavioural lifestyle modification is crucial for preventing and postponing the development of complications related to prediabetes. [ABSTRACT FROM AUTHOR]

Purpose Methods Results Conclusion Elucidate the prevalence of myopia among young adults from a birth cohort of Swedish children and its relationship to possible risk factors during their childhood.Five thousand two hundred young adults, mean 23.4 years and 58% females, participating in the prospective birth cohort All Babies in Southeast Sweden (ABIS) answered a questionnaire including questions regarding health and physical activity, spectacle use, myopia and age at first optical correction. Questionnaires at previous follow‐ups at ages 2–3, 5–6 and 8 years included information on type of housing, time outdoors, screen time and hours of reading. Myopia prevalence and associations with potential risk factors were analysed in univariate and multivariate regression models with Bonferroni's correction of p‐values.In the ABIS Swedish birth cohort of young adults, the prevalence of myopia was 29%. A univariate logistic regression showed a higher odds ratio for myopia with female gender (OR 1.59; p < 0.05) and a completed and started university education (OR 1.52; p < 0.05). Significantly lower odds ratios were found for hours spent outdoors at 8 years of age (OR 0.82; p < 0.05). Multivariate logistic regression showed a higher odds ratio for myopia in females (OR 1.52–1.57; p < 0.05) and completed and started university education (OR 1.34–1.49; p < 0.05) in all models. In a model including accommodative effort, measured in diopter hours at 8 years of age, hours spent outdoors were associated with a lower odds ratio for myopia (OR 0.86; p < 0.05). No association could be detected between myopia and the type of housing or near work.The prevalence of myopia among young adults in a Swedish birth cohort was lower or unchanged compared to previous data. Female gender, higher education and less time spent outdoors in childhood were associated with an increased risk of developing myopia. Recommendations from child health services and schools should be given to stimulate children to spend enough time outdoors. [ABSTRACT FROM AUTHOR]

Aim: Anger expression is associated with an increased risk of cardiovascular disease. This positive association was confined to individuals with lower perceived social support and outdoor recreational activity. However, the effects of retirement status remain unclear. This study aimed to investigate whether retirement status after the age of 60 years modifies the association between anger expression and the risk of cardiovascular disease in the Japanese population. Methods: This longitudinal study included 499 community-dwelling retired and employed workers aged 60-79 years, who completed a cardiovascular risk survey in 1997. A Cox proportional hazards model was used to estimate the hazard ratios and 95% confidence intervals of incident cardiovascular disease (ischemic heart disease and stroke) according to anger expression in retired and employed workers after adjusting for potential cardiovascular risk factors. Results: A total of 37 participants experienced incident cardiovascular disease during the mean follow-up period of 14.8 years (standard deviation 5.5 years). In retired workers, anger expression was associated with an increased cardiovascular disease risk, whereas no such association was observed in employed workers. The respective hazard ratio per one-standard deviation increment of total anger expression was 1.77 (95% confidence interval 1.29-2.43) and 1.03 (95% confidence interval 0.64-1.66; P for interaction = 0.036) among retired and employed workers, respectively. Conclusions: A positive association between anger expression and the risk of cardiovascular disease was confined to retired workers, suggesting that continuing work after retirement age could reduce anger expression-related cardiovascular disease risk. [ABSTRACT FROM AUTHOR]

Summary: We explored patient front‐line treatment preferences in newly diagnosed stage III/IV classic Hodgkin lymphoma (cHL). The CONNECT patient survey, administered online from 30 December 2020 to 1 March 2021, examined preferences overall and by age at diagnosis in 182 adult patients diagnosed with stage III/IV cHL within the past 10 years in the United States. At diagnosis, patients' median age was 36 years; 66% of patients were younger (aged 16–41 years) and 34% older (aged 42–85 years). When asked about initial treatment goals, 74% of patients ranked cure as their first or second goal (86% younger vs. 52% older patients; p < 0.001). At diagnosis, 72% of patients preferred aggressive treatment, and 85% were willing to accept more short‐term risks in exchange for a better‐working therapy long term. For long‐term risks, younger versus older patients were significantly more concerned about second cancers (p < 0.001) and fertility issues (p = 0.007), whereas older patients were more concerned about lung damage (p = 0.028) and infections (p < 0.001). Most patients (94%) reported having a caregiver at some point, but 99% of these patients retained some control of treatment decisions. Collectively, these survey results highlight patient treatment preferences and differences in treatment goals and long‐term side effect concerns based on patient age. [ABSTRACT FROM AUTHOR]

Observational studies have shown associations between circulating levels of various biomarkers (eg, total cholesterol [TC], low‐density lipoprotein cholesterol [LDL], insulin‐like growth factor‐1 [IGF‐1], C‐reactive protein [CRP] and glycated hemoglobin‐1c [HbA1c]) and the risk of invasive breast cancer (IBC). Ductal carcinoma in situ of the breast (DCIS) is a nonobligate precursor of IBC and shares several risk factors with it. However, the relationship between these biomarkers and DCIS risk remains unexplored. We studied the association between circulating levels of TC, LDL‐C, high‐density lipoprotein cholesterol (HDL‐C), Lipoprotein (a) (Lp‐(a)), IGF‐1, CRP and HbA1c, with the risk of DCIS in 156801women aged 40 to 69 years and breast cancer‐free at enrolment when blood samples and information on demographic and health‐related factors were collected. Incident cases of DCIS were ascertained during the follow‐up via linkage to the UK cancer registries Multivariable‐adjusted Cox proportional hazards models were used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) for the associations of interest. In all, 969 DCIS incident cases were diagnosed during 11.4 years of follow‐up. Total cholesterol was inversely associated with the risk of DCIS (HRquintile(Q)5vsQ1 = 0.47, 95% CI: 0.27‐0.82, Ptrend =.008). Conversely, LDL‐C was positively associated with DCIS risk (HRQ3vsQ1 = 1.43, 95% CI: 1.01‐2.04, HRQ4vsQ1 = 1.60, 95% CI: 1.04‐2.47, HRQ5vsQ1 = 2.29, 95% CI: 1.36‐3.88, Ptrend =.004). In postmenopausal women, CRP had a weak positive association with DCIS risk, while HbA1c showed a nonlinear association with the risk. These results, in conjunction with those from previous studies on IBC, provide support for the association of several biomarkers with the risk of an early stage of breast cancer. [ABSTRACT FROM AUTHOR]

The European Union's soil strategy for 2030 has set the objective of achieving 'healthy soils' in Europe by 2050. To achieve this ambitious goal, dedicated soil science skills will be needed in the future. This article presents the results of a survey on soil science skills for the future conducted within the framework of the European Joint Program—EJP SOIL. The survey was distributed online in the 24 countries participating in the EJP SOIL. The skills were expressed as having knowledge in particular topics related to soils, practical know‐hows or abilities or outcomes of knowledge and know‐hows put into action. No significant differences in the importance of soil‐science related skills were found between countries or stakeholder categories. The two groups of skills that ranked at the top of stakeholders' concern were 'Having a scientific basis of knowledge on soils and their functioning' and 'Knowing how to mobilise agronomic drivers to manage and protect soils'. This means that there is a need for people with an in‐depth knowledge in soil science, but also soil scientists with integrated knowledge in agronomy and crop production. Three important findings relate to the knowledge of soil science itself: (i) there is a clear need to develop the knowledge of the biological and ecological functioning of soil; (ii) this should not happen at the expense of a strong general knowledge of the fundamentals of soil science; (iii) future soil scientists should be trained to have a more holistic appreciation of soil rather than be trained as a specialist of a specific aspect of soil science only. Being able to exchange knowledge with farmers, knowing how to assess soil fertility, quality or health and how to improve them are viewed as essential skills for the future. These findings offer a clear path for the evolution of soil science education curricula across Europe. [ABSTRACT FROM AUTHOR]

Background and Aim: Post‐endoscopic submucosal dissection coagulation syndrome (PECS) is a recognized complication of colorectal endoscopic submucosal dissection (ESD); however, there is a lack of interventions for preventing PECS. We therefore conducted a prospective study to evaluate the utility of maXium, a novel electrosurgical unit, for preventing PECS. Methods: This single‐center, prospective cohort study prospectively enrolled patients undergoing colorectal ESD. The voltage and power of the electrosurgical units were measured. PECS was defined as a visual analog scale (VAS) ≥ 30 mm, an increase of VAS ≥ 20 mm from baseline, body temperature ≥ 37.5°C, or white blood cell count ≥ 10 000/μL after ESD. PECS was classified into type I (without extra‐luminal air) and type II (with peri‐luminal air). The primary endpoint was the incidence of PECS. A sample size of 92 patients was required to ensure the upper limit of the 90% CI for the incidence of PECS was less than 15%. Results: At resistances greater than 400 Ω, the maXium unit allowed submucosal dissection with lower power than with the VIO300D unit. Ninety‐one patients meeting the inclusion criteria were included in the final study analysis. The incidence of PECS was 16% (90% CI, 10–23%), comprising type I (11%) and type II (5%) PECS. Simple extra‐luminal air without PECS was observed in 7% of patients. Conclusion: Use of the maXium electrosurgical unit did not reduce the incidence of PECS after colorectal ESD; however, the maXium unit had equivalent performance to a conventional electrosurgical unit used for colorectal ESD. [ABSTRACT FROM AUTHOR]

Objective: Cenobamate, a novel antiseizure medication with a dual mechanism of action, has been shown in pivotal trials to significantly improve seizure control in treatment‐resistant focal epilepsy. We aimed to evaluate whether these promising results could be confirmed in a real‐world setting with a follow‐up period of up to 12 months. Methods: Patients from a tertiary epilepsy center who received cenobamate add‐on between June 2021 and October 2023 were followed up prospectively at 3, 6, and 12 months after treatment initiation for assessment of seizure outcomes and treatment‐related adverse events. Results: The clinical cohort included 112 adult patients with 30% nonlesional cases and a wide spectrum of epileptogenic lesions underlying refractory focal epilepsy. We observed a significant reduction in monthly seizure frequency of all seizure types already after 3 months of treatment at a median cenobamate dose of 100 mg/day. Forty‐six percent of patients were responders with a ≥50% seizure reduction, 26% had a ≥75% seizure reduction, and 9% became seizure‐free. Among the 74 patients with available follow‐up of 12 months, the responder rates reached 55%, 35%, and 19% for ≥50%, ≥75%, and 100% seizure reduction, respectively. After 3 months of treatment, 38% of patients reported adverse effects, mainly (84%) mild to moderate in intensity. Adjustment of comedication allowed successful management of adverse effects in 32% of patients. At a group level, there was no correlation between the cenobamate daily dose and the incidence of adverse events. Significance: We found a clinically relevant response to cenobamate already at a low daily dose of 100 mg also in a patient cohort with a higher degree of drug resistance than in pivotal trials. Our prospectively collected data provide real‐world evidence for high efficacy and good tolerability of the drug, although no standardized treatment protocol or comparison with a control group was applied. [ABSTRACT FROM AUTHOR]

Aim: Reduced responses to controlled ovarian stimulation (COS) after radical trachelectomy (RT) have been previously reported. We aimed to assess the effect of RT on ovarian reserve by measuring anti‐Müllerian hormone (AMH) levels before and after the procedure in this prospective study. Methods: We included 12 patients who underwent RT between September 2019 and December 2021 in this study. Serum AMH levels were measured preoperatively, 1 month postoperatively, and 6 months postoperatively. Differences in the AMH levels were assessed using a paired t‐test. Results: The median age of the patients was 30.6 years, and the median follow‐up time was 30.1 months. AMH levels at 1 and 6 months postoperatively did not show a consistent trend. At 1 month postoperatively, the average AMH level decreased insignificantly but returned to preoperative levels at 6 months. The differences in AMH levels before and after RT were insignificant. Conclusion: Our findings indicate that RT did not affect ovarian reserve as measured by AMH levels. However, the relationship between unchanged ovarian reserve and reduced response to COS remains unclear. Further research with larger sample sizes and additional measures of ovarian function is needed to corroborate these results and investigate the long‐term effects of RT on ovarian reserve. Understanding these mechanisms will help guide surgical practices and provide patients with valuable information about their reproductive outcomes after RT. [ABSTRACT FROM AUTHOR]

Objective: Suicidal ideation and sleep problems are both common in nurses. However, few longitudinal studies are available to examine the temporal association between sleep and suicidal ideation in nurses. Method: Data from the Health Longitudinal Survey of Nurses in Shandong Province was analyzed, involving 623 female nurses who had completed data of concern in 2018 (T1) and 2019 (T2). Sleep problem was assessed by the Pittsburgh Sleep Quality Index, in which the transition patterns for global and specific sleep component and the cumulative number of sleep component problems were defined. Suicidal ideation was measured by the ninth item of the Patient Health Questionnaire. Binary logistic regression was used to explore the association between sleep and suicidal ideation. Results: Chronic and deteriorated global sleep problems is associated with a greater risk of suicidal ideation. For the specific component of sleep, sleep disturbance and short sleep duration are associated with a higher risk of suicidal ideation. The higher number of cumulative sleep component problems is associated with a higher risk of suicidal ideation. Conclusion: Findings indicate sleep disturbance and short sleep duration may be pathways to suicidal ideation. Initiatives that target at sleep problems may be important to reduce suicidal ideation in nurses. [ABSTRACT FROM AUTHOR]

Background/Objectives: Exposure to chemical phenols, which can act as tyrosine analogues and result in anti‐melanocyte autoimmunity, has been associated with vitiligo. Acetaminophen (N‐acetyl‐p‐aminophenol) is an over‐the‐counter analgesic of phenolic origin. The risk of vitiligo with systemic exposure to acetaminophen has not yet been evaluated. Methods: We examined the risk of vitiligo with regular use acetaminophen in women, the Nurses' Health Study (NHS) and in men, the Health Professionals Follow‐up Study (HPFS). Regular acetaminophen use was asked biennially from 1990 in NHS and from 1986 in HPFS, and the year of clinician‐diagnosed vitiligo was asked retrospectively in 2012 in the cohorts. Results: In NHS, a total of 161 vitiligo cases were identified during a follow‐up of 571,724 person‐years; in HPFS, a total of 183 vitiligo cases were identified during a follow‐up of 680,313 person‐years. Regular use of acetaminophen was associated with an increased vitiligo risk in NHS but not HPFS. The multivariable relative risk (RR) was 1.52 (95% confidence interval [CI] 1.03–2.25) in NHS and 1.09 (95% CI 0.76–1.55) in HPFS. The higher risk of vitiligo was similar by duration of acetaminophen use in women; the multivariable RRs were 1.47 (95% CI 0.98–2.21) for acetaminophen use under 5 years, and 1.78 (95% CI 1.11–2.84) for acetaminophen use over 5 years. Conclusions: Acetaminophen may be associated with a higher risk of vitiligo in women. [ABSTRACT FROM AUTHOR]

Objective: The effectiveness and security of radiofrequency ablation (RFA) in combination with toripalimab (anti‐PD‐1) for the treatment of recurrent hepatocellular carcinoma (HCC) was studied in this article. Methods: Total of 40 patients were enrolled in the study between September 2019 and November 2021. Data follow‐up ends in April 2022. The study's main focus is on recurrence free survival (RFS), while the secondary objectives was safety. Chi‐square tests, Kaplan‐Meier, and Cox proportional hazards models were utilized to analyze the data. Results: The median follow‐up period was 21.40 months, and the median RFS was 15.40 months in the group that received combination therapy, which was statistically significantly different (HR: 0.44, p = 0.04) compared with the RFA group (8.2 months). RFS rates (RFSr) at 6, 12 and 18 months in the combination therapy groups and RFA groups were 80% vs 65%, 62.7% vs 35% and 48.7% vs 18.8%, respectively. Between the two groups, significant difference of RFSr was found at 18 months (p = 0.04). No statistical differences were observed between the two groups in terms of safeness (p > 0.05). The subgroup analysis indicated that the combination of RFA and anti‐PD‐1 led to better RFS than RFA alone. Moreover, patients benefited more from combination therapy in the groups younger than 60 years (HR: 0.26, p = 0.018), male (HR: 0.32, p = 0.028) and Child‐Pugh grade A (HR: 0.38, p = 0.032). Conclusions: Combining RFA with anti‐PD‐1 showed improved RFS and was deemed safe for patients with recurrent HCC who had previously undergone RFA treatment alone. [ABSTRACT FROM AUTHOR]

Objective: The proper selection of the lower instrumented vertebra (LIV) remains controversial in the surgical treatment of Scheuermann's disease and there is a paucity of studies investigating the clinical outcomes of fusion surgery when selecting the vertebra one level proximal to the sagittal stable vertebra (SSV‐1) as LIV. The purpose of this study is to investigate whether SSV‐1 could be a valid LIV for Scheuermann kyphosis (SK) patients with different curve patterns. Methods: This was a prospective study on consecutive SK patients treated with posterior surgery between January 2018 and September 2020, in which the distal fusion level ended at SSV‐1. The LIV was selected at SSV‐1 only in patients with Risser >2 and with LIV translation less than 40 mm. All of the patients had a minimum of 2‐year follow‐up. Patients were further grouped based on the sagittal curve pattern as thoracic kyphosis (TK, n = 23) and thoracolumbar kyphosis (TLK, n = 13). Radiographic parameters including global kyphosis (GK), lumbar lordosis (LL), sagittal vertical axis (SVA), LIV translation, pelvic incidence (PI), pelvic tilt (PT), and sacral slope (SS) were measured preoperatively, postoperatively, and at the latest follow‐up. The intraoperative and postoperative complications were recorded. The Scoliosis Research Society (SRS)‐22 scores were performed to evaluate clinical outcomes. Results: A total of 36 patients were recruited in this study, with 23 in the TK group and 13 in the TLK group. In TK group, the GK was significantly decreased from 80.8° ± 10.1° to 45.4° ± 7.7° after surgery, and was maintained at 45.3° ± 8.6° at the final follow‐up. While in the TLK group, GK was significantly decreased from 70.7° ± 9.2° to 39.1° ± 5.4° after surgery (p < 0.001) and to 39.3° ± 4.5° at the final follow‐up. Meanwhile, despite presenting with different sagittal alignment, significant improvement was observed in LL, SVA, and LIV translation for both TK and TLK groups (p < 0.05). Self‐reported scores of pain and self‐image in TK group and scores of self‐image and function in TLK group showed significant improvement at the final follow‐up (all p < 0.05). Distal junctional kyphosis (DJK) was observed in two patients (8.7%) in TK group, and one patient (7.7%) in TLK group. No revision surgery was performed. Conclusion: Selecting SSV‐1 as LIV can achieve satisfactory radiographic and clinical outcomes for SK patients with different curve patterns without increasing the risk of DJK. This selection strategy could be a favorable option for SK patients with Risser sign >2 and LIV translation less than 40 mm. [ABSTRACT FROM AUTHOR]

Purpose: Intraoperative stabilisation of bony fragments with maxillo‐mandibular fixation (MMF) is an essential step in the surgical treatment of mandibular fractures that are treated with open reduction and internal fixation (ORIF). The MMF can be performed with or without wire‐based methods, rigid or manual MMF, respectively. The aim of this study was to compare the use of manual versus rigid MMF, in terms of occlusal outcomes and infective complications. Materials and Methods: This multi‐centric prospective study involved 12 European maxillofacial centres and included adult patients (age ≥16 years) with mandibular fractures treated with ORIF. The following data were collected: age, gender, pre‐trauma dental status (dentate or partially dentate), cause of injury, fracture site, associated facial fractures, surgical approach, modality of intraoperative MMF (manual or rigid), outcome (minor/major malocclusions and infective complications) and revision surgeries. The main outcome was malocclusion at 6 weeks after surgery. Results: Between May 1, 2021 and April 30, 2022, 319 patients—257 males and 62 females (median age, 28 years)—with mandibular fractures (185 single, 116 double and 18 triple fractures) were hospitalised and treated with ORIF. Intraoperative MMF was performed manually on 112 (35%) patients and with rigid MMF on 207 (65%) patients. The study variables did not differ significantly between the two groups, except for age. Minor occlusion disturbances were observed in 4 (3.6%) patients in the manual MMF group and in 10 (4.8%) patients in the rigid MMF group (p >.05). In the rigid MMF group, only one case of major malocclusion required a revision surgery. Infective complications involved 3.6% and 5.8% of patients in the manual and rigid MMF group, respectively (p >.05). Conclusion: Intraoperative MMF was performed manually in nearly one third of the patients, with wide variability among the centres and no difference observed in terms of number, site and displacement of fractures. No significant difference was found in terms of postoperative malocclusion among patients treated with manual or rigid MMF. This suggests that both techniques were equally effective in providing intraoperative MMF. [ABSTRACT FROM AUTHOR]

Objectives: To evaluate the effect of smoking on tooth whitening and color change after at‐home bleaching. Materials and Methods: This prospective clinical study evaluated two groups of participants: NS—non‐smokers (n = 24) and S—smokers (n = 16). All subjects were treated with at‐home bleaching using 22% carbamide peroxide (CP) for 1 h/day for 14 days. Color coordinates (L*—luminosity, a*—red‐green axis and b*—yellow‐blue axis) were obtained before bleaching (D0—baseline), 1 day (D1), 15 days (D15), and 1 month (D30) after bleaching. The whiteness index (WID) and CIEDE2000 color differences (ΔE00) were calculated for S and NS. Color changes between S and NS subjects for specific teeth (CI—Central Incisors, LI—Lateral Incisors, and C—Canines) were analyzed using the Mann–Whitney test (α = 0.05). Results: There was no significant difference in WID between S and NS subjects at baseline. NS participants showed higher WID than S at D1, D15, and D30 (p < 0.05). NS showed higher ΔWID for CI and C between D0 and the other evaluation times (D1, D15, and D30) compared to S. Smokers showed higher darkening of CI than NS in ΔWID D30–D1 (p < 0.05). Color changes showed similar overall behavior for ΔWID. For all evaluation times, ΔWID and ΔE00 values were below the corresponding acceptability thresholds. Conclusion: At‐home bleaching was effective on smokers and nonsmokers. Smoking negatively affected color stability after bleaching. ΔE00 and ΔWID were acceptable for both groups. Clinical Significance: Although smoking negatively affected color stability after bleaching, the observed changes were clinically acceptable. [ABSTRACT FROM AUTHOR]

Introduction: Recent reviews link higher levels of occupational physical activity (OPA) to cardiovascular disease (CVD). However, the evidence for women is inconsistent and studies of activity‐limiting symptomatic CVD are prone to healthy worker survivor effect. To address these limitations, this study investigated OPA effects on asymptomatic carotid artery intima–media thickness (IMT) among women. Methods: Participants include 905 women from the population‐based Kuopio Ischemic Heart Disease Risk Factor Study with baseline (1998–2001) data on self‐reported OPA and sonographic measurement of IMT. Linear mixed models with adjustment for 15 potential confounders estimated and compared mean baseline IMT and 8‐year IMT progression for five levels of self‐reported OPA. Analyses stratified by cardiovascular health and retirement status were planned because strong interactions between preexisting CVD and OPA intensity have previously been reported. Results: Light standing work, moderately heavy active work, and heavy or very heavy physical work were all consistently associated with greater baseline IMT and 8‐year IMT progression than light sitting work. The greatest baseline IMT was observed for heavy or very heavy physical work (1.21 mm), and the greatest 8‐year IMT progression for light standing work and moderately heavy active work (both 0.13 mm), 30% above sitting work (0.10 mm). Stratified analyses showed that these differences were driven by much stronger OPA effects among women with baseline carotid artery stenosis. Retired women experienced slower IMT progression than those working at baseline. Conclusions: Higher levels of OPA predict higher baseline IMT and 8‐year IMT progression, especially among women with baseline stenosis. [ABSTRACT FROM AUTHOR]

This study investigated the association between physical activity (PA) and midlife income. The population‐based data comprised employed members of the Northern Finland Birth Cohort 1966 (N = 2797). Using binned scatterplots and polynomial regressions, we evaluated the association between accelerometer‐measured moderate PA (MPA), vigorous PA (VPA), and moderate‐to‐vigorous PA (MVPA) at 46 years old and register‐based income at 50 years old. The models were adjusted for sex, marital status, number of children, education, adolescent PA, occupational physical strenuousness, and time preference. We found MPA (p < 0.001), VPA (p < 0.05), and MVPA (p < 0.001) to associate curvilinearly with income. In subgroup analyses, a curvilinear association was found between MPA (p < 0.01) and MVPA (p < 0.01) among those with physically strenuous work, VPA among all females (p < 0.01) and females with physically light work (p < 0.01), and MPA and MVPA among all males and males with physically strenuous work (p < 0.05; p < 0.01; p < 0.05; p < 0.05, respectively) and income. The highest income benefits occurred at PA volumes higher than current PA guidelines. Linear associations between PA and income were found among females for MPA (p < 0.05) and MVPA (p < 0.05), among those with physically light work for MPA (p < 0.05), VPA (p < 0.05), and MVPA (p < 0.05), and among females with physically strenuous work for VPA (p < 0.05). We conclude that PA up to the current recommended level is associated with income, but MPA exceeding 505.4 min/week, VPA exceeding 216.4 min/week, and MVPA exceeding 555.0 min/week might have a negative association with income. [ABSTRACT FROM AUTHOR]

Background: Anxiety affects approximately 40% of Parkinson's disease (PD) patients. However, little is known about its predictors and development over time. Objective: To identify the clinical factors and biomarkers associated with development of anxiety in patients with newly diagnosed PD, and to test which risk factors predict increases in anxiety over time. Methods: Data from the Parkinson's Progression Markers Initiative (PPMI) were utilized. The primary outcome was the State–Trait Anxiety Inventory (STAI). Covariates were demographics, motor and non‐motor symptoms, cognitive functions, dopamine transporter imaging data, and cerebrospinal fluid (CSF) biomarkers. We examined the association of risk factors at baseline and over 4 years with changes in anxiety scores over time. Results: A total of 252 patients met the inclusion criteria (mean age: 61.36 years, SD 9.53). At year 4, 42 patients had developed anxiety. Baseline predictors of increase in anxiety scores were greater autonomic dysfunction, dysexecutive function, CSF t‐tau levels, excessive daytime sleepiness, and lower olfactory function scores but not motor scores. Over 4 years, change in anxiety scores correlated with deterioration in overall cognitive function, excessive daytime sleepiness, as well as depression and disability, and to a lesser degree worsening of Movement Disorder Society‐Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) motor scores and caudate dopaminergic uptake changes. Conclusions: These findings suggest that development of anxiety in PD is not primarily based on a dopaminergic deficit in the basal ganglia but related to non‐dopaminergic or extrastriatal pathology. Early dysexecutive function predicts development of anxiety but increase in anxiety levels correlates most strongly with more global cognitive decline. [ABSTRACT FROM AUTHOR]

Background and Aims: Breastfeeding education and support have the potential to improve breastfeeding outcomes. However, there is a lack of research on the impact of breastfeeding education on predominant breastfeeding in Nepal and other South Asian countries. This study aimed to report the rate of predominant breastfeeding at the first, fourth, and sixth months of birth and examine the influence of breastfeeding promotion on predominant breastfeeding. Methods: A community‐based prospective cohort study was conducted in western Nepal. A total of 735 mother‐infant pairs were recruited within 30 days of childbirth and followed up at the fourth and sixth months to collect data on infant feeding practices. Results: The rate of predominant breastfeeding at first, fourth, and sixth months were 88.6% (N = 735), 78.2% (N = 715), and 26.3% (N = 711), respectively, showing a significant decline with infant age. Mothers who received support on breastfeeding skills (Adjusted Odds Ratio [AOR]: 2.55; 95% confidence interval [CI]: 1.73−3.75), those who received advice on keeping mother‐infant together (AOR: 2.19; 95% CI: 1.14−4.22) and who had initiated breastfeeding within 1 h of childbirth (AOR: 2.55; 95% CI: 1.73−3.75), and who were educated, had higher likelihood of predominant breastfeeding at sixth month. Conclusion: This study asserts a need for continuous and focused breastfeeding promotion programs to educate and support lactating mothers. Key points: What's knownBreastfeeding has numerous benefits for lactating mothers and children. Yet, the breastfeeding promotion effort has somehow been overlooked.What's newThis study has found that breastfeeding promotion and support in the early stage of childbirth were significantly associated with a higher likelihood of predominant breastfeeding.Early education and support to initiate and establish breastfeeding is essential to sustain desired breastfeeding practices.Clinical implicationBreastfeeding promotion activities recommended by the Baby Friendly Hospital Initiatives are equally effective at the community level. [ABSTRACT FROM AUTHOR]

The ongoing epidemic of SARS‐CoV‐2 is taking a substantial financial and health toll on people worldwide. Assessing the level and duration of SARS‐CoV‐2 neutralizing antibody (Nab) would provide key information for government to make sound healthcare policies. Assessed at 3‐, 6‐, 12‐, and 18‐month postdischarge, we described the temporal change of IgG levels in 450 individuals with moderate to critical COVID‐19 infection. Moreover, a data imputation framework combined with a novel deep learning model was implemented to predict the long‐term Nab and IgG levels in these patients. Demographic characteristics, inspection reports, and CT scans during hospitalization were used in this model. Interpretability of the model was further validated with Shapely Additive exPlanation (SHAP) and Gradient‐weighted Class Activation Mapping (GradCAM). IgG levels peaked at 3 months and remained stable in 12 months postdischarge, followed by a significant decline in 18 months postdischarge. However, the Nab levels declined from 6 months postdischarge. By training on the cohort of 450 patients, our long‐term antibody prediction (LTAP) model could predict long‐term IgG levels with relatively high area under the receiver operating characteristic curve (AUC), accuracy, precision, recall, and F1‐score, which far exceeds the performance achievable by commonly used models. Several prognostic factors including FDP levels, the percentages of T cells, B cells and natural killer cells, older age, sex, underlying diseases, and so forth, served as important indicators for IgG prediction. Based on these top 15 prognostic factors identified in IgG prediction, a simplified LTAP model for Nab level prediction was established and achieved an AUC of 0.828, which was 8.9% higher than MLP and 6.6% higher than LSTM. The close correlation between IgG and Nab levels making it possible to predict long‐term Nab levels based on the factors selected by our LTAP model. Furthermore, our model identified that coagulation disorders and excessive immune response, which indicate disease severity, are closely related to the production of IgG and Nab. This universal model can be used as routine discharge tests to identify virus‐infected individuals at risk for recurrent infection and determine the optimal timing of vaccination for general populations. [ABSTRACT FROM AUTHOR]

Methylation marks of exposure to health risk factors may be useful markers of cancer risk as they might better capture current and past exposures than questionnaires, and reflect different individual responses to exposure. We used data from seven case‐control studies nested within the Melbourne Collaborative Cohort Study of blood DNA methylation and risk of colorectal, gastric, kidney, lung, prostate and urothelial cancer, and B‐cell lymphoma (N cases = 3123). Methylation scores (MS) for smoking, body mass index (BMI), and alcohol consumption were calculated based on published data as weighted averages of methylation values. Rate ratios (RR) and 95% confidence intervals for association with cancer risk were estimated using conditional logistic regression and expressed per SD increase of the MS, with and without adjustment for health‐related confounders. The contribution of MS to discriminate cases from controls was evaluated using the area under the curve (AUC). After confounder adjustment, we observed: large associations (RR = 1.5‐1.7) with lung cancer risk for smoking MS; moderate associations (RR = 1.2‐1.3) with urothelial cancer risk for smoking MS and with mature B‐cell neoplasm risk for BMI and alcohol MS; moderate to small associations (RR = 1.1‐1.2) for BMI and alcohol MS with several cancer types and cancer overall. Generally small AUC increases were observed after inclusion of several MS in the same model (colorectal, gastric, kidney, urothelial cancers: +3%; lung cancer: +7%; B‐cell neoplasms: +8%). Methylation scores for smoking, BMI and alcohol consumption show independent associations with cancer risk, and may provide some improvements in risk prediction. What's new? Data from large, population‐based studies have long indicated that lifestyle factors are associated with increased cancer risk. But molecular markers might provide more accurate exposure data than questionnaires, and may also reveal variations in individual responses. In this study, the authors found that DNA methylation scores may provide such a biomarker. They found that changes in methylation associated with smoking, alcohol consumption and obesity are also associated with an increased risk of several types of cancer. These lifestyle methylation scores may thus provide improved risk prediction for these cancers. [ABSTRACT FROM AUTHOR]

Summary: Objective: Under the assumption of irreversibility, the Montreal classification provides a unidirectional assessment of the complications and behaviour of Crohn's disease (CD) that does not allow for downstaging. We examined the use of a bidirectional Montreal classification system that can capture disease regression. Design: From the BioCrohn Registry, an inception cohort of patients with CD for ≤12 months duration was defined and followed up for 5‐years. Cumulative probabilities for developing complications were estimated using the Kaplan–Meier method. Potential associations of explanatory variables with disease progression were estimated with Cox regression. Results: Among 393 incident CD patients (of whom 255 completed the entire follow‐up), the 5‐year cumulative probability of developing complications was 41.5% (15.6% and 25.9% for stricturing and penetrating complications respectively). Perianal disease (hazard ratio [95% confidence interval]: 8.45 [4.74–15.07]) and surgical resection of the intestine (2.71 [1.50–4.92]) in the very early phase of the disease were associated with a higher risk of developing a penetrating complication within the 5‐year follow‐up. The use of a bidirectional Montreal classification system which can account for disease regression demonstrated that 90% of patients exhibited inflammatory disease behaviour at 5 years, in contrast to 58%, if the hierarchical, unidirectional Montreal classification system was used. Conclusion: An additional bidirectional disease behaviour assessment capturing reversed or fully controlled complications may provide a more realistic appraisal of the complexity and unmet needs of patients treated with advanced therapies. [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to estimate the safety and efficacy of spray cryotherapy (SCT) in patients with chronic obstructive pulmonary disease (COPD). Methods: We recruited patients aged 40–80 years with a confirmed diagnosis of COPD without serious complications (defined as two consecutive years of chronic cough and cough for at least 3 months with lung function forced expiratory volume in 1 s [FEV1]/forced vital capacity [FVC] < 70% after inhaled bronchodilators and Global Initiative for Chronic Obstructive Lung Disease [GOLD] grade II–IV). The safety of this study was assessed by incidence of adverse events, and the efficacy was evaluated by St. George's Respiratory Questionnaire (SGRQ), COPD assessment test (CAT), Leicester Cough Questionnaire (LCQ) and changes in exercise capacity, histomorphology and lung function. Results: Eight patients eventually received three complete sessions of SCT, each lasting 41.10 ± 19.72 min. No adverse complications were recorded within 3 months after SCT. Clinically meaningful improvements in SGRQ, CAT, LCQ and exercise capacity were observed at 3 months after SCT: −15.75 ± 6.76 (95% confidence interval [CI] 10.10−21.40; p <.001), −6.88 ± 3.91 (95% CI 3.61−10.14; p =.002), −18.13 ± 13.81 (95% CI 6.58−29.67; p =.008) and 72.75 ± 33.11 (95% CI −100.43 to −45.07; p <.001), respectively. The density of airway epithelial goblet cells per unit area was significantly reduced (p <.05), and lung function parameters such as ∆FVC, ∆FEV1 and ∆ peak expiratory flow (∆PEF) were improved (p =.007,.021 and.012). Conclusions: SCT is a safe and effective strategy to provide a better quality of life for COPD patients. [ABSTRACT FROM AUTHOR]

Glyceraldehyde‐derived advanced glycation end products (glycer‐AGEs) could contribute to colorectal cancer development and progression due to their pro‐oxidative and pro‐inflammatory properties. However, the association of glycer‐AGEs with mortality after colorectal cancer diagnosis has not been previously investigated. Circulating glycer‐AGEs were measured by competitive ELISA. Multivariable Cox proportional hazards models were used to calculate hazard ratios (HRs) and corresponding 95% confidence intervals (CIs) for associations of circulating glycer‐AGEs concentrations with CRC‐specific and all‐cause mortality among 1034 colorectal cancer (CRC) cases identified within the European Prospective Investigation into Cancer and Nutrition (EPIC) study between 1993 and 2013. During a mean of 48 months of follow‐up, 529 participants died (409 from CRC). Glycer‐AGEs were statistically significantly positively associated with CRC‐specific (HRQ5 vs Q1 = 1.53, 95% CI: 1.04‐2.25, Ptrend =.002) and all‐cause (HRQ5 vs Q1 = 1.62, 95% CI: 1.16‐2.26, Ptrend <.001) mortality among individuals with CRC. There was suggestion of a stronger association between glycer‐AGEs and CRC‐specific mortality among patients with distal colon cancer (per SD increment: HRproximal colon = 1.02, 95% CI: 0.74‐1.42; HRdistal colon = 1.51, 95% CI: 1.20‐1.91; Peffect modification =.02). The highest HR was observed among CRC cases in the highest body mass index (BMI) and glycer‐AGEs category relative to lowest BMI and glycer‐AGEs category for both CRC‐specific (HR = 1.78, 95% CI: 1.02‐3.01) and all‐cause mortality (HR = 2.15, 95% CI: 1.33‐3.47), although no statistically significant effect modification was observed. Our study found that prediagnostic circulating glycer‐AGEs are positively associated with CRC‐specific and all‐cause mortality among individuals with CRC. Further investigations in other populations and stratifying by tumor location and BMI are warranted. [ABSTRACT FROM AUTHOR]

Epithelial–mesenchymal transition (EMT) plays a pivotal role in cancer metastasis and treatment resistance, which worsens prognosis. In phase III trials, eribulin improved overall survival in metastatic breast cancer (MBC) patients. In preclinical studies, eribulin suppressed EMT. However, clinical data on the use of eribulin for MBC patients are limited. In this exploratory, prospective study, we examined the effect of eribulin on EMT in MBC patients. Twenty‐two patients aged 44–82 years with recurrent breast cancer or MBC were treated with eribulin. Breast cancer tissue samples were obtained before treatment and on Day 15 ± 5 of the first cycle of eribulin treatment. EMT markers (E‐cadherin, claudin‐3, vimentin, and N‐cadherin) were analyzed using western blotting. EMT changes were evaluated based on the ratio of epithelial to mesenchymal markers before and after treatment in individual tumors. E‐cadherin/vimentin, claudin‐3/vimentin, E‐cadherin/N‐cadherin, and claudin‐3/N‐cadherin ratios were significantly higher after treatment (p =.007, p =.005, p =.006, and p =.011, respectively). Based on E‐cadherin/vimentin, 65.0% of tumors shifted to an epithelial phenotype, as compared to 66.7% based on claudin‐3/vimentin, 84.6% based on E‐cadherin/N‐cadherin, and 71.4% based on claudin‐3/N‐cadherin ratios. Thus, our results showed that eribulin suppressed EMT in breast cancer tissues. [ABSTRACT FROM AUTHOR]

Objective: To define risk factors for the early prediction of gestational diabetes mellitus (GDM) because the risk of pre‐eclampsia and preterm birth increases in mothers who are diagnosed with GDM. Materials and methods: A prospective study was designed and the data were collected by physicians prospectively from the patients who came to the clinic between the years 2019 and 2021; informed consent was obtained from the women. The prospective data comprised 489 patient records with 72 variables and the risk factors for early prediction of GDM were determined using logistic regression and random forest (RF), which is an advanced analysis method. Results: The obtained sensitivity and specificity values are 90% and 75% for logistic regression and 71% and 90% for the RF, respectively. Conclusion: In this prospective study of GDM in Turkish women; age, body mass index, level of hemoglobin A1c, level of fasting blood sugar, physical activity time in first trimester, gravidity, triglycerides, and high‐density lipoprotein cholesterol were confirmed to be risk factors in analysis results. Synopsis: Risk factors for early prediction of gestational diabetes mellitus were determined using logistic regression and random forest methods. [ABSTRACT FROM AUTHOR]

Objectives: Interventions promoting habitual fruit consumption have the potential to bring about long‐term behaviour change. Assessing the effectiveness of such interventions requires adequate habit and behaviour measures. Habits are based on learned context‐behaviour associations, so measures that incorporate context should be more sensitive to expected habit and behaviour changes than context‐free measures. This study compared context‐specific and context‐free measures of fruit consumption habit and behaviour following a 3‐week habit formation intervention. Design: Prospective online study (n = 58). Methods: Behaviour frequency was assessed across five timepoints, retrospectively (Time 1 [T1], T5) or via daily diary data (uploaded weekly at T2, T3 and T4). Habit strength was assessed before (T1) and immediately after the intervention (T4), and again 2 weeks later (T5). Analyses of variance were run, with time and context specificity as within‐subject factors, and habit and behaviour frequency as dependent measures. Results: An interaction between time and context specificity was found in both analyses (habit: F(2,114) = 12.848, p <.001, part.η2 =.184; behaviour: F(2,114) = 6.714, p =.002, part.η2 =.105). Expected habit formation patterns 5 weeks post‐baseline were only detected by the context‐specific habit measure. Likewise, increased behaviour frequency was only found when the target context was specified (p's <.001). Conclusions: Assessments of purposeful dietary habit and behaviour change attempts should incorporate context‐specific measurement. [ABSTRACT FROM AUTHOR]

The aim of this study was to prospectively evaluate the olfactory function in a series of individuals infected with SARS‐CoV‐2 and who had undergone psychophysical olfactory assessment prior to infection. Individuals unexposed to SARS‐CoV‐2 infection underwent a psychophysical evaluation of smell with the Sniffin' Sticks test. The subjects were followed prospectively and included in the study if they developed SARS‐CoV‐2 infection with a second test 60 days after recovery. At the 60‐day follow‐up of the 41 included subjects, 2 (4.9%) self‐reported persistent olfactory dysfunction (OD). The differences between TDI scores before and after infection were statistically significant (37 [interquartile range (IQR), 34.25‐39.25] vs 34.75 [IQR, 32.25‐38]; p =.021). Analyzing the individual olfactory domains, the differences were significant for threshold (T) (9.75 [IQR, 9‐11.25] vs 8.25 [IQR, 7.25‐10.25]; p =.009) but not for odor discrimination (D) (p =.443) and identification (I) (p =.159). SARS‐CoV‐2 causes a significant reduction in the olfactory function, in particular affecting the olfactory threshold, even in subjects who do not self‐report an OD. [ABSTRACT FROM AUTHOR]

Introduction: Use of medications is a common concern for breastfeeding women, particularly when they are strongly needed or unavoidable to manage maternal chronic conditions. Yet the influence of medication usage patterns on breastfeeding duration in mothers with chronic conditions is unclear. The objective of this study was to examine whether postpartum medication practices were associated with shorter breastfeeding duration or earlier than planned breastfeeding cessation among mothers with chronic conditions. Material and methods: We analyzed 346 mothers with chronic conditions enrolled in a prospective, community‐based pregnancy cohort study (Alberta, Canada) who initiated breastfeeding after birth. Data were collected through self‐report questionnaires spanning late pregnancy to 6 months postpartum. Based on reported use of preexisting medications while breastfeeding, women were classified as continuing medications (reference group), discontinuing one or more medications, or those who did not use preexisting medications. Cox proportional hazards regression was used to analyze the association of medication practices and overall breastfeeding duration in weeks. Logistic regression was used to analyze the association of medication practices and earlier than planned breastfeeding cessation. Multivariable models adjusted for demographic and health‐related factors. Results: Overall, 30.6% of women with chronic conditions stopped breastfeeding in the first 6 months, almost all of whom did so earlier than planned. In multivariable models, medication discontinuation was significantly associated with shorter breastfeeding duration (adjusted hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.03–2.70) and earlier than planned breastfeeding cessation (adjusted odds ratio [OR] 1.85, 95% CI 1.01–3.42), whereas medication non‐use was not associated with differences in breastfeeding outcomes. Conclusions: Women with chronic conditions who discontinued preexisting medications while breastfeeding had significantly shorter breastfeeding duration and were less likely to meet their breastfeeding goals in the first 6 months postpartum compared to women who continued preexisting medications. [ABSTRACT FROM AUTHOR]

Objectives: Impaired mental health status tends to be associated with poor academic performance, but few prospective studies have examined the association between mental health and academic performance among undergraduates while considering the interacting roles of multiple lifestyle behaviors. Participants and Methods: A total of 1823 Japanese undergraduate students (67% men) were followed up for 4 years. Their mental health status was measured by the six‐item Kessler Psychological Distress Scale (K6). We defined poor academic performance as a grade point average (GPA) <2.0. Cox proportional hazards models were used to determine the relationship between the students' mental health status and the incident risk of poor academic performance. Results: Our analyses revealed that impaired mental health status in the first semester of university study significantly predicted an increased incident risk of poor academic performance during the overall undergraduate period. This association remained significant when the health lifestyle behaviors were adjusted, and the hazard ratio (95% confidence interval) for poor academic performance was 1.62 (1.18–2.23). This significant association disappeared in the low‐lifestyle‐behavior‐risk group. Conclusion: Impaired mental health status in the first semester significantly predicts an increased incident risk of poor academic performance during the undergraduate period. [ABSTRACT FROM AUTHOR]

Background: Epidemiological studies of the dietary intake of specific n‐3 polyunsaturated fatty acids (PUFA) and anatomical subsite‐specific colorectal cancer (CRC) are limited. We examined the prospective associations of total n‐3 PUFA, marine‐derived n‐3 PUFA [combined eicosapentaenoic acid (EPA), docosapentaenoic acid (DPA), and docosahexaenoic acid (DHA)], and alpha‐linolenic acid (ALA) as plant‐derived n‐3 PUFA with the risk of CRC by subsite in the Japan Collaborative Cohort Study. Methods: The participants completed a self‐administered food frequency questionnaire and had no prior history of CRC. Cox proportional hazards model was used to determine the associations between n‐3 PUFAs intake and CRC risk overall and by anatomical subsite. Results: During the median 13.8‐year follow‐up period, 699 of the 42,536 participants aged 40–79 years developed incident CRC. An inverse association was found between dietary ALA intake and the risk of distal colon cancer; the multivariable hazard ratios and 95% confidence intervals for the highest quartiles (Q4) were 0.41 (0.21–0.81; p trend = 0.01) compared with the lowest quartiles (Q1). Marine n‐3 PUFA intake was not associated with CRC risk in the overall or anatomical subsite‐specific analyses. Conclusion: Our findings suggest that higher ALA intake may be beneficial for lowering the risk of distal colon cancer. [ABSTRACT FROM AUTHOR]

Introduction: The impacts of education on cognitive decline across different neighborhood environments (NEs) have rarely been studied. Methods: We investigated and compared the associations between educational attainment and cognitive decline using data of 1286 participants from the Taizhou Imaging Study (TIS) and the Shanghai Aging Study (SAS). Results: Compared with low‐educated participants, in TIS with disadvantaged NE, high‐educated participants manifested a significantly slower decline in global cognition (.062 Z score per year, P <.001), memory (.054 Z score per year, P <.05), and attention (.065 Z score per year, P <.01), whereas in SAS with advanced NE, highly educated individuals exhibited a slower decline only in attention (.028 Z score per year, P <.05). Discussion: We observed the additive effect of educational attainment and NE on cognitive decline in older adults. Education is especially important for maintaining cognitive health in a disadvantaged environment. [ABSTRACT FROM AUTHOR]

Background: A poor evidence basis exists regarding the objective donor site morbidity associated with osseous free flap harvest. This study prospectively assessed the objective donor site morbidity associated with osseous free flap harvest for the fibula, scapula, and iliac crest (DCIA) donor sites. Methods: A single‐site, prospective cohort clinical research study was conducted. Sixty‐four patients were recruited between 2017 and 2021. Patients were assessed using a donor site specific assessment tool pre‐operatively, and again >12 months post‐operatively. Results: There was a significant reduction post‐operatively in assessment tool scores compared to the pre‐operative period for the fibula, scapula and DCIA. Females were more likely to report a greater reduction in Harris Hip Score post‐operatively compared to males. Conclusions: The fibula, scapula, and DCIA donor sites are associated with reduced objective function post‐operatively compared to patient's pre‐operative baseline. The implications are least pronounced for the fibula. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the impact of intrapartum and post‐partum complications and newborn care practices on early initiation of breastfeeding (EIBF). Data for the study came from a prospective cohort study in Ethiopia that recruited and followed pregnant and post‐partum women from 2019 to 2021. Resident enumerators conducted interviews at enrolment in 2019 and follow‐ups at 6 weeks, 6 months and 1 year post‐partum. The present analysis is based on data from the baseline survey and 6 weeks follow‐up. Multivariable logistic regression was used to estimate the effects of newborn care practices and intrapartum and post‐ partum complications on EIBF (the proportion of newborns who initiated breastfeeding within the first hour of birth). Overall, 2660 mother–infant pairs were included in this analysis. After adjustment, EIBF was less likely among women who experienced intrapartum haemorrhage (adjusted odds ratio [AOR]: 0.76, 95% confidence interval [CI]: 0.59–0.97), malpresentation (AOR: 0.46, 95% CI: 0.30–0.72) and convulsions (AOR: 0.48, 95% CI: 0.34–0.66) during childbirth. Mother–newborn skin‐to‐skin contact increased the likelihood of EIBF (AOR: 1.47, 95% CI: 1.11–1.94). Women who experienced post‐partum haemorrhage (AOR: 0.63, 95% CI: 0.47–0.84), retained placenta for more than 30 min (AOR: 0.36, 95% CI: 0.24–0.52) and convulsions after delivery (AOR: 0.57, 95% CI: 0.41–0.79) were less likely to initiate breastfeeding early. Also, women who had a caesarean birth (AOR: 0.28, 95% CI: 0.18–0.41), delivered outside of a healthcare facility (AOR: 0.70, 95% CI: 0.50–0.99) or had twin birth (AOR: 0.43, 95% CI: 0.22–0.85) were less likely to initiate breastfeeding early. Skin‐to‐skin contact should be encouraged whenever possible, and women with obstetric complications should be encouraged and supported to initiate breastfeeding early. Key messages: Malpresentation, intrapartum haemorrhage, and convulsions during childbirth were associated with a lower likelihood of breastfeeding initiation within the first hour of birth.Retained placenta for more than 30 min, post‐partum haemorrhage, and convulsions after childbirth were associated with a lower likelihood of breastfeeding initiation within the first hour of birth.Out‐of‐facility delivery, multiple births and caesarean delivery were associated with a lower likelihood of breastfeeding initiation within the first hour of birth.Women who practised skin‐to‐skin contact after birth were more likely to initiate breastfeeding within the first hour of birth than those who did not practise skin‐to‐skin contact. [ABSTRACT FROM AUTHOR]

Objectives: To report the final results of the 2‐year TAURUS study, assessing weekly prophylaxis dosing regimens of octocog alfa (Kovaltry®/BAY 81–8973) used in standard clinical practice in patients with moderate‐to‐severe haemophilia A. Methods: TAURUS (NCT02830477) is a phase 4, multinational, prospective, non‐interventional, single‐arm study in patients of any age with moderate or severe haemophilia A (≤5% factor [F]VIII activity). TAURUS was designed to primarily investigate weekly prophylaxis dosing regimens used in standard clinical practice. Annualised bleeding rates (ABRs), treatment satisfaction and adherence, and safety were also assessed. Results: Of 302 patients included in the full analysis set, 84.4% (n = 255) maintained their octocog alfa prophylaxis baseline regimen throughout the study, with a majority of patients (76.5%, n = 231) on two times or three times weekly regimens at the end of the observation period (≥1–≤2 years). ABRs, treatment satisfaction, and adherence remained stable during the observation period. Octocog alfa was well tolerated and there were no new or unexpected adverse events. Conclusions: These data show that a smooth transition is observed when switching to octocog alfa from a previous FVIII treatment, with no safety issues and stable bleeding rates in a real‐world setting of patients with moderate‐to‐severe haemophilia A. [ABSTRACT FROM AUTHOR]

Background: Because of a relative dearth of longitudinal studies, the directionality of the relationship between mood and inflammation among patients with bipolar disorder (BD) is still unclear. We aimed to investigate the longitudinal associations of pro‐inflammatory markers with mood symptom severity in BD. Methods: Hundred and thirty‐two adult patients with BD were enrolled. At the baseline and 1‐year follow‐up visit, all participants received mood assessment with Montgomery Åsberg depression rating scale (MADRS) and Young mania rating scale, and underwent blood draws to quantify metabolic profile and serum levels of the pro‐inflammatory markers, including soluble interleukin‐6 receptor, soluble tumor necrosis factor‐α receptor type 1 (sTNF‐αR1), monocyte chemoattractant protein‐1, and C‐reactive protein. A four‐factor model of MADRS, consisting of sadness, negative thoughts, detachment, and neurovegetative symptoms, were applied. Results: At baseline, 65 patients with BD were in depressed state, and 67 patients with BD were in euthymic state. Among patients in depressed state, baseline MADRS total score positively correlated with sTNF‐αR1 level at follow‐up. While baseline sTNF‐αR1 level positively predicted sadness symptom in euthymic patients with BD who later developed depression (n = 22), sadness in patients with bipolar depression predicted later increase in serum sTNF‐αR1 level even after remission (n = 17). Moreover, lithium had a stronger effect of lowering peripheral sTNF‐αR1 level as compared with other mood stabilizers. Conclusion: Our results indicate the bidirectional inflammation‐depression relationship in BD. [ABSTRACT FROM AUTHOR]

Background & Aims: No multi‐national prospective study of drug‐induced liver injury (DILI) has originated in Europe. The design of a prospective European DILI registry, clinical features and short‐term outcomes of the cases and controls is reported. Methods: Patients with suspected DILI were prospectively enrolled in the United Kingdom, Spain, Germany, Switzerland, Portugal and Iceland, 2016–2021. DILI cases or non‐DILI acute liver injury controls following causality assessment were enrolled. Results: Of 446 adjudicated patients, 246 DILI patients and 100 had acute liver injury due to other aetiologies, mostly autoimmune hepatitis (n = 42) and viral hepatitis (n = 34). DILI patients (mean age 56 years), 57% women, 60% with jaundice and 3.6% had pre‐existing liver disease. DILI cases and non‐DILI acute liver injury controls had similar demographics, clinical features and outcomes. A single agent was implicated in 199 (81%) DILI cases. Amoxicillin‐clavulanate, flucloxacillin, atorvastatin, nivolumab/ipilimumab, infliximab and nitrofurantoin were the most commonly implicated drugs. Multiple conventional medications were implicated in 37 (15%) and 18 cases were caused by herbal and dietary supplements. The most common single causative drug classes were antibacterials (40%) and antineoplastic/immunomodulating agents (27%). Overall, 13 (5.3%) had drug‐induced autoimmune‐like hepatitis due to nitrofurantoin, methyldopa, infliximab, methylprednisolone and minocycline. Only six (2.4%) DILI patients died (50% had liver‐related death), and another six received liver transplantation. Conclusions: In this first multi‐national European prospective DILI Registry study, antibacterials were the most commonly implicated medications, whereas antineoplastic and immunomodulating agents accounted for higher proportion of DILI than previously described. This European initiative provides an important opportunity to advance the study on DILI. [ABSTRACT FROM AUTHOR]

Some individuals can flexibly adapt to life's changing demands while others, in particular those with Autism Spectrum Disorder (ASD), find it challenging. The origin of early individual differences in cognitive abilities, the putative tools with which to navigate novel information in life, including in infants later diagnosed with ASD remains unexplored. Moreover, the role of intelligence quotient (IQ) vis‐à‐vis core features of autism remains debated. We systematically investigate the contribution of early IQ in future autism outcomes in an extremely large, population‐based study of 8000 newborns, infants, and toddlers from the US between 2 and 68 months with over 15,000 cross‐sectional and longitudinal assessments, and for whom autism outcomes are ascertained or ruled out by about 2–4 years. This population is representative of subjects involved in the National Institutes of Health (NIH)‐funded research, mainly on atypical development, in the US. Analyses using predetermined age bins showed that IQ scores are consistently lower in ASD relative to typically developing (TD) children at all ages (p < 0.001), and IQ significantly correlates with social, non‐social, and total Calibrated Severity Scores (CSS) on the Autism Diagnostic Observation Schedule (ADOS) (p<0.01). Lower IQ is associated with greater autistic impairments. Note, verbal IQ (VIQ) is no better than the full‐scale IQ to predict ASD cases. These findings raise new, compelling questions about potential atypical brain circuitry affecting performance in both verbal and nonverbal abilities and preceding an ASD diagnosis. This study is the first to establish prospectively that low early IQ is a major feature of ASD in early childhood. Lay Summary: The role of IQ scores in autism remains debated. We systematically investigate the contribution of early IQ in an extremely large study of 8,000 children between 2 and 68 months with autism outcomes by about 2–4 years. We show that IQ scores are consistently lower in ASD relative to TD children. This study is the first to establish prospectively that low early IQ is a predictor for ASD diagnosis in early childhood. [ABSTRACT FROM AUTHOR]

Background: The Japanese government is promoting physician‐led home visits as well as end‐of‐life care at home. However, the proportion of deaths occurring at home has remained unchanged for the past 20 years. Objectives: To report the cumulative incidence of deaths at home and to explore the factors associated with deaths at home versus other places, mainly hospitals. Methods: This was a multicenter prospective cohort study in a primary care setting. We enrolled patients aged ≥65 years who had started to receive regular visits by family physicians from 13 facilities in and around Tokyo between February 1, 2013 and January 31, 2016. Patients were followed‐up until January 31, 2017. The primary outcome measures were mortality rate and cumulative incidence of deaths at home. Results: We enrolled 762 patients. Of 368 deaths, 133 occurred in the patient's home. The mortality rates at home were 137.6/1000 person‐years (95% confidence interval 116.1–163.1). In cumulative incidence function, the longer duration of care at home lowers the likelihood of death at home. Multivariable multinomial logistic models showed that younger age and higher Barthel Index score reduced the likelihood of deaths at home, while receiving oxygen therapy and the presence of a full‐time caregiver increased the likelihood of deaths at home relative to deaths at other locations. Conclusions: Of deceased patients, only one‐third died in patients' homes. We found several factors associated with deaths at home, which appeared to reflect the readiness of patients and their families for death. Geriatr Gerontol Int 2022; 22: 1005–1012. [ABSTRACT FROM AUTHOR]

This study aims to compare the accelerometer‐measured daily patterns of PA and sedentary behavior among participants with and without prevalent/incident depressive symptoms. We used data from 5582 individuals in The Maastricht Study (59.9 ± 8.6 years, 50.3% women). Daily patterns of sedentary time, light‐intensity physical activity (LiPA), moderate‐to‐vigorous physical activity (MVPA), and sit‐to‐stand transitions were objectively measured at baseline with the activPAL3 activity monitor. Depressive symptoms were assessed using the 9‐item Patient Health Questionnaire, both at baseline and annually (median follow‐up: 5.1 years). General linear models were used to compare patterns of physical activity and sedentary behavior between those with and without prevalent/incident depressive symptoms. Participants with prevalent depressive symptoms had significantly more sedentary time (18.6 min/day) and lower LiPA (26.8 min/day) and MVPA (4.8 min/day) than participants without depressive symptoms. Considering the daily patterns, participants with prevalent depressive symptoms had significantly more sedentary time early in the afternoon (12:00–18:00), early evening (18:00–21:00), and during the night (00:00–03:00), less time in LiPA in all periods between 09:00–21.00 and less MVPA in the morning (09:00:12:00), early afternoon (12:00–15:00), and evening (18:00–21:00), than those without. Similar differences in activity and sedentary behavior patterns between those and without incident depressive symptoms were observed albeit the differences were smaller. Overall, we did not find specific time slots particularly associated with both prevalent and incident depressive symptoms. These findings may indicate that less sedentary time and more intense PA can be important targets for the prevention of depression irrespective of the timing of the day. [ABSTRACT FROM AUTHOR]