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The rates of early-onset colorectal cancer (EO-CRC) have been rising by 0.5% to 2.4% annually for three decades, accounting for an estimated 12% of all colorectal cancer diagnosed in the United States in 2020. Enhancing the rigor and comprehensiveness of the epidemiology in terms of the exposures and prognostic biomarkers is essential if we are to modify risk factors and underlying mechanisms, ultimately arresting this unduly trend. This commentary serves to describe the disease trend, postulate underlying risk factors and mechanisms driving disease incidence, and proposes a call to action for cancer epidemiologists to promote increased and timely opportunities to intervene on this trend.

Amid internationalizing shifts in higher education, universities around the world are simultaneously becoming more integrated and more disparate. This paper examines the role of immigration policy in producing convergent and divergent educational attainment among international and domestic students at Indian and US universities and shows that student and work visas influence international students' decisions about where to study, what to study, and how much education to pursue. Using original data sources and a transnational data collection strategy, this study develops new approaches to measuring international student mobility and offers a window into transnational phenomena not easily observable in other datasets. An analysis of 7177 education histories and 105 in-depth interviews with international students, university administrators, and immigration lawyers shows that migration policy contributes to the growth of international student enrollment and multinational educations but also creates asymmetrical student flows and funnels international students into certain fields of study. The results of this study indicate that migration policies simultaneously contribute to integration and differentiation between the US and Indian university systems. The findings show that immigration policies play an important role in regulating the flow and nature of international student migration streams and lead to simultaneous convergence and divergence in the educational attainment and field of study between Indian international students enrolled in US universities and their domestically educated peers in India. Through an empirical case, this paper develops a conceptual bridge between two dominant frameworks on internationalization and theorizes the central role of migration policy in shaping processes of higher education internationalization.

Vitamin D deficiency and insufficiency are associated with serious sequelae in childhood cancer survivors. However, data on vitamin D deficiency in children with newly diagnosed cancer are scarce and the role of sociodemographic factors and vitamin D supplementation is largely unknown. We assessed vitamin D status and its socio-demographic and clinical correlates in 163 children with newly diagnosed cancer, using 25-hydroxy vitamin D (25(OH)D) concentrations and assessed longitudinal changes following vitamin D supplementation. Sixty-five percent of the patients with newly diagnosed cancer had low 25(OH)D concentrations. Fifty-two patients (32%) were vitamin D deficient (≤20 ng/mL 25(OH)D concentration), and 53(33%) were insufficient (21-29 ng/mL 25(OH)D concentration). Age over 10 (P = 0.019), Hispanic ethnicity (P = 0.002), and female sex (P = 0.008) were significantly associated with lower 25(OH)D concentration at diagnosis. Vitamin D supplementation resulted in significant increase in 25(OH)D concentrations (P

BackgroundSkin and soft tissue infections (SSTIs) are a key antimicrobial stewardship target because they are a common infection in hospitalized patients, and non-guideline-concordant antibiotic use is frequent. To inform antimicrobial stewardship interventions, we evaluated the proportion of veterans hospitalized with SSTIs who received guideline-concordant empiric antibiotics or an appropriate total duration of antibiotics.MethodsA retrospective medication use evaluation was performed in 34 Veterans Affairs Medical Centers between 2016 and 2017. Hospitalized patients who received antibiotics for uncomplicated SSTI were included. Exclusion criteria were complicated SSTI, severe immunosuppression, and antibiotics for any non-SSTI indication. Data were collected by manual chart review. The primary outcome was the proportion of patients receiving both guideline-concordant empiric antibiotics and appropriate treatment duration, defined as 5-10 days of antibiotics. Data were analyzed and reported using descriptive statistics.ResultsOf the 3890 patients manually evaluated for inclusion, 1828 patients met inclusion criteria. There were 1299 nonpurulent (71%) and 529 purulent SSTIs (29%). Overall, 250 patients (14%) received guideline-concordant empiric therapy and an appropriate duration. The most common reason for non-guideline-concordance was receipt of antibiotics targeting methicillin-resistant Staphylococcus aureus (MRSA) in 906 patients (70%) with a nonpurulent SSTI. Additionally, 819 patients (45%) received broad-spectrum Gram-negative coverage, and 860 patients (48%) received an antibiotic duration >10 days.ConclusionsWe identified 3 common opportunities to improve antibiotic use for patients hospitalized with uncomplicated SSTIs: use of anti-MRSA antibiotics in patients with nonpurulent SSTIs, use of broad-spectrum Gram-negative antibiotics, and prolonged durations of therapy.

BackgroundFiber-based prebiotic supplements are marketed for maintaining bowel health and promoting beneficial gut bacteria. However, the association between prebiotic supplement use and colorectal cancer risk and mortality is unknown.MethodsThe association between prebiotic use and colorectal cancer risk and mortality was evaluated in postmenopausal women in the Women's Health Initiative study. Self-reported prebiotic use was documented at study enrollment. Adjudicated colorectal cancer cases and mortality were captured using medical and death records. Cox proportional hazards models were used to estimate the HR related to prebiotic use and colorectal cancer risk and mortality.ResultsIn total, 3,032 colorectal cancer cases were diagnosed during an average 15.4 years of follow-up. Overall, 3.7% of women used a prebiotic with psyllium, the major fiber type. Use of any prebiotic supplement was not associated with colorectal cancer risk or mortality. The type of prebiotic supplement (none vs. insoluble or soluble) was not associated with colorectal cancer risk; however, use of insoluble fiber prebiotics compared with none was associated with higher colorectal cancer mortality [HR, 2.79; 95% confidence interval (CI), 1.32-5.90; P = 0.007]. Likelihood ratio tests indicated no significant interactions between prebiotic use and other colorectal cancer risk factors, including metabolic syndrome.ConclusionsPrebiotic fiber supplement use was not associated with colorectal cancer risk. Insoluble, but not soluble, prebiotic fiber use was associated with higher colorectal cancer mortality. These findings do not support the promotion of prebiotic fiber supplements to reduce colorectal cancer risk or colorectal cancer mortality.ImpactFurther investigation is warranted for findings regarding insoluble prebiotic fiber and higher colorectal cancer mortality in postmenopausal women.

Amid internationalizing shifts in higher education, universities around the world are simultaneously becoming more integrated and more disparate. This paper examines the role of immigration policy in producing convergent and divergent educational attainment among international and domestic students at Indian and US universities and shows that student and work visas influence international students' decisions about where to study, what to study, and how much education to pursue. Using original data sources and a transnational data collection strategy, this study develops new approaches to measuring international student mobility and offers a window into transnational phenomena not easily observable in other datasets. An analysis of 7177 education histories and 105 in-depth interviews with international students, university administrators, and immigration lawyers shows that migration policy contributes to the growth of international student enrollment and multinational educations but also creates asymmetrical student flows and funnels international students into certain fields of study. The results of this study indicate that migration policies simultaneously contribute to integration and differentiation between the US and Indian university systems. The findings show that immigration policies play an important role in regulating the flow and nature of international student migration streams and lead to simultaneous convergence and divergence in the educational attainment and field of study between Indian international students enrolled in US universities and their domestically educated peers in India. Through an empirical case, this paper develops a conceptual bridge between two dominant frameworks on internationalization and theorizes the central role of migration policy in shaping processes of higher education internationalization., Author(s): Elizabeth Jacobs [sup.1] Author Affiliations: (1) grid.25879.31, 0000 0004 1936 8972, Department of Sociology, University of Pennsylvania, , 3718 Locust Walk, McNeil Building, Philadelphia, PA, USA The internationalization of [...]

This paper revisits conventional wisdom on US degree premiums for immigrant workers and shows that, despite the benefits of a US degree, migration policies and substandard labor conditions contribute to international student motivations to return home. Using two original datasets, I find that about a third of Indian-born US graduates leave the US, seeking employment opportunities abroad and a respite from US work visa restrictions. I draw on 105 in-depth interviews and 7,177 employment histories constructed from LinkedIn, and the analysis demonstrates the use of digital data to shed new light on under-studied patterns of return migration in institutional perspective. I find that US work visas are related to the underemployment of immigrant workers, and gaps in visa availability are associated with US labor market departure for Indian international students. At the same time, foreign employers reward skills and credentials developed in the US, and the results suggest that US degrees carry a higher premium in foreign labor markets. The paper emphasizes the role of institutions in the skilled migration system and identifies disjunctures in US migration policy. I identify opportunities for policy reform to improve immigrant labor conditions and increase the retention of US-educated migrants in the US labor market. [ABSTRACT FROM AUTHOR]

Adult rats exposed to hyperoxia (>95% O2) die from respiratory failure in 60–72 h. However, rats preconditioned with >95% O2 for 48 h followed by 24 h in room air acquire tolerance of hyperoxia (H-T), whereas rats preconditioned with 60% O2 for 7 days become more susceptible (H-S). Our objective was to evaluate lung tissue mitochondrial bioenergetics in H-T and H-S rats. Bioenergetics was assessed in mitochondria isolated from lung tissue of H-T, H-S, and control rats. Expressions of complexes involved in oxidative phosphorylation (OxPhos) were measured in lung tissue homogenate. Pulmonary endothelial filtration coefficient (Kf) and tissue mitochondrial membrane potential (Δψm) were evaluated in isolated perfused lungs (IPLs). Results show that ADP-induced state 3 OxPhos capacity (Vmax) decreased in H-S mitochondria but increased in H-T. Δψm repolarization time following ADP-stimulated depolarization increased in H-S mitochondria. Complex I expression decreased in H-T (38%) and H-S (43%) lung homogenate, whereas complex V expression increased (70%) in H-T lung homogenate. Δψm is unchanged in H-S and H-T lungs, but complex II has a larger contribution to Δψm in H-S than H-T lungs. Kf increased in H-S, but not in H-T lungs. For H-T, increased complex V expression and Vmax counter the effect of the decrease in complex I expression on Δψm. A larger complex II contribution to Δψm along with decreased Vmax and increased Kf could make H-S rats more hyperoxia susceptible. Results are clinically relevant since ventilation with ≥60% O2 is often required for extended periods in patients with acute respiratory distress syndrome (ARDS). NEW & NOTEWORTHY: We assessed lung tissue mitochondrial bioenergetics in rats with tolerance (H-T) or susceptibility (H-S) to hyperoxia-induced ARDS. Results from studies in isolated mitochondria, tissue homogenate, and isolated perfused lungs show that mitochondrial bioenergetics are differentially altered in H-T and H-S lungs suggesting a potential role for mitochondrial bioenergetics in hyperoxia-induced ARDS. Results are clinically relevant since hyperoxia exposure is a primary therapy for patients with ARDS, and differential sensitivity to hyperoxia surely occurs in humans. [ABSTRACT FROM AUTHOR]

Mobile mammography units (MMUs) can enhance access to breast cancer screening by providing convenient, cost-effective service, particularly for uninsured and underinsured women. However, prior studies indicate that acceptability concerns about quality and privacy, among other issues, may prevent women from utilizing MMUs. The current study employs a within-participant experimental design exposing participants to messages about different MMU characteristics to determine which characteristics are most effective in persuading them to use an MMU. The study also examined how messaging interacts with participants' ethnic identity to influence outcomes. Data were collected from a diverse sample of uninsured and underinsured women as part of a formative study to promote the utilization of a mobile mammography facility in Central Texas. Results of mixed-effect linear models show that messages about equity, appointment convenience, privacy and comfort, and quality of equipment and staff were rated as more persuasive than messages about convenience of location and language accessibility. However, Hispanic women rated language accessibility higher than other participants did. The results can guide MMU organizers and promotion managers as they determine the best approach to promote mobile mammography services in different communities. [ABSTRACT FROM AUTHOR]

The fight or flight phenomena is of evolutionary origin and responsible for the type of defensive behaviours enacted, when in the face of threat. This review attempts to draw the link between fear and aggression as motivational levers for fight or flight defensive behaviours. Furthermore, this review investigates whether human biological motion is modulated by the affective behaviours associated with the fight or flight phenomenon. It examines how threat informed emotion and motor systems have the potential to result in the modulation of empathetic appraisal. This is of interest to this systematic review, as empathetic modulation is crucial to prosocial drive, which has the potential to alleviate the perceived threat. Hence, this review investigates the role of affective computing in capturing the potential outcome of threat perception and associated empathetic responses. To gain a comprehensive understanding of the affective responses and biological motion evoked from threat scenarios, affective computing methods used to capture these neurophysiological and behavioural responses are discussed. A systematic review using Google Scholar and Web of Science was conducted as of 2023, and findings were supplemented by bibliographies of key articles. A total of 26 studies were analysed from initial web searches to explore the topics of empathy, threat perception, fight or flight, fear, aggression, and human motion. Relationships between affective behaviours (fear, aggression) and corresponding motor defensive behaviours (fight or flight) were examined within threat scenarios, and whether existing affective computing methods are effective in capturing these responses, identifying the varying consensus in the literature, challenges, and limitations of existing research. [ABSTRACT FROM AUTHOR]

Adherence to the American Cancer Society's (ACS) Nutrition and Physical Activity Cancer Prevention Guidelines is associated with reductions in overall cancer incidence and mortality, including site-specific cancers such as colorectal cancer. We examined the relationship between baseline adherence to the ACS guidelines and (1) baseline adenoma characteristics and (2) odds of recurrent colorectal adenomas over 3 years of follow-up. Cross-sectional and prospective analyses with a pooled sample of participants from the Wheat Bran Fiber (n = 503) and Ursodeoxycholic Acid (n = 854) trials were performed. A cumulative adherence score was constructed using baseline self-reported data regarding body size, diet, physical activity and alcohol consumption. Multivariable logistic regression demonstrated significantly reduced odds of having three or more adenomas at baseline for moderately adherent (odds ratio [OR] = 0.67, 95% confidence intervals [CI]: 0.46⁻0.99) and highly adherent (OR = 0.50, 95% CI: 0.31⁻0.81) participants compared to low adherers (p-trend = 0.005). Conversely, guideline adherence was not associated with development of recurrent colorectal adenoma (moderate adherence OR = 1.16, 95% CI: 0.85⁻1.59, high adherence OR = 1.23, 95% CI: 0.85⁻1.79).

Introduction We examined the association of exposure to maternal depression during year 2 of a child's life with future child problem behavior. We conducted a secondary analysis to investigate whether race/ethnicity is a moderator of this relationship. Methods We used Fragile Families and Child Well-Being Study data (age 3 N = 3288 and 49% Black, 26% Hispanic, 22% non-Hispanic White; age 5 N = 3001 and 51% Black, 25% Hispanic, 21% non-Hispanic White; age 9 N = 3630 and 50% Black, 25% Hispanic, 21% non-Hispanic White) and ordinal logistic regression to model problem behavior at ages 3, 5, and 9 on maternal depression status during year 2. Results At age 9, children whose mother was depressed during year 2 were significantly more likely to have higher internalizing (AOR = 1.92, 95% CI: 1.42,2.61) and externalizing (AOR = 1.65, 95% CI: 1.10,2.48) problem behavior scores. In our secondary analysis, race/ethnicity did not have moderating effects, potentially due to a limitation of the data that required use of maternal self-reported race/ethnicity as a proxy for child race/ethnicity. Discussion Exposure to maternal depression after the prenatal and perinatal periods may have a negative association with children's behavioral development through age 9. Interventions that directly target maternal depression during this time should be developed. Additional research is needed to further elucidate the role of race/ethnicity in the relationship between maternal depression and child problem behavior., Author(s): Natalie Guerrero [sup.1] [sup.2] , Ronald Gangnon [sup.1] , Marah A. Curtis [sup.3] , Carmen R. Valdez [sup.4] , Deborah B. Ehrenthal [sup.5] , Elizabeth A. Jacobs [sup.6] Author [...]

ObjectiveFor individuals with 1-2 small (

Selenium supplementation may help to prevent colorectal cancer; as precursors of colorectal cancer, colorectal adenomas are a surrogate for colorectal cancer. Selenium supplementation may increase risk of type 2 diabetes (T2D). The Selenium and Celecoxib (Sel/Cel) Trial was a randomized, placebo controlled trial of selenium 200 µg daily as selenized yeast and celecoxib 400 mg once daily, alone or together, for colorectal adenoma prevention. Men and women between age 40 and 80 years were eligible following colonoscopic removal of colorectal adenomas. The primary outcome was adenoma development. Celecoxib was suspended because of cardiovascular toxicity in other trials, but accrual continued to selenium and placebo. A total of 1621 participants were randomly assigned to selenium or placebo, of whom 1374 (84.8%) were available for analysis. All statistical tests were two-sided. In the respective placebo and selenium arms of 689 and 685 participants, adenoma detection after medians of 33.6 (range = 0.0-85.1 months) and 33.0 months (range = 0.0-82.6 months) were 42.8% and 44.1% (relative risk [RR] = 1.03, 95% confidence interval [CI] = 0.91 to 1.16, P = .68). In participants with baseline advanced adenomas, adenoma recurrence was reduced by 18% with selenium (RR = 0.82, 95% CI = 0.71 to 0.96, P = .01). In participants receiving selenium, the hazard ratio for new-onset T2D was 1.25 (95% CI = 0.74 to 2.11, P = .41), with a statistically significantly increased risk of selenium-associated T2D among older participants (RR = 2.21; 95% CI = 1.04 to 4.67, P = .03). Overall, selenium did not prevent colorectal adenomas and showed only modest benefit in patients with baseline advanced adenomas. With limited benefit and similar increases in T2D to other trials, selenium is not recommended for preventing colorectal adenomas in selenium-replete individuals.

PurposeFollowing colonoscopic polypectomy, US Multisociety Task Force (USMSTF) guidelines stratify patients based on risk of subsequent advanced neoplasia (AN) using number, size, and histology of resected polyps, but have only moderate sensitivity and specificity. We hypothesized that a state-of-the-art statistical prediction model might improve identification of patients at high risk of future AN and address these challenges.MethodsData were pooled from seven prospective studies which had follow-up ascertainment of metachronous AN within 3-5 years of baseline polypectomy (combined n = 8,228). Pooled data were randomly split into training (n = 5,483) and validation (n = 2,745) sets. A prognostic model was developed using best practices. Two risk cut-points were identified in the training data which achieved a 10 percentage point improvement in sensitivity and specificity, respectively, over current USMSTF guidelines. Clinical benefit of USMSTF versus model-based risk stratification was then estimated using validation data.ResultsThe final model included polyp location, prior polyp history, patient age, and number, size and histology of resected polyps. The first risk cut-point improved sensitivity but with loss of specificity. The second risk cut-point improved specificity without loss of sensitivity (specificity 46.2 % model vs. 42.1 % guidelines, p

ObjectiveTo examine the prevalence of sun protection behaviors and sunburn history among adults in a region of the United States with high ultraviolet radiation exposure.Design and SettingData on self-reported sun protection and sunburns were obtained using supplemental questions added to the 2013 Arizona Behavioral Risk Factor Surveillance System survey. 3,370 Arizona adults over the age of 18 years completed questions about use sunscreen and protective clothing and reported sunburns within past 12 months. Weighted analyses were used; odds ratios (OR) and 95% confidence intervals (CI) were calculated.ResultsApproximately 20% of Arizona adults reported they protected their skin with sunscreen or protective clothing every time when going outdoors; however, among those aged 18-24 years, this percentage dropped to 8%. Additionally, 28% reported they experienced one or more sunburns in the past 12 months. Females were more likely to protect their skin (OR 2.06, 95%CI:1.47-2.87) than males. Binge drinking and heavy alcohol consumption were associated with a decreased likelihood of sun protection in males (OR 0.48, 95%CI: 0.27-0.83 and OR 0.32, 95%CI: 0.14-0.72, respectively), but not females. A recent history of sunburns was associated with being non-Hispanic white and a history of indoor tanning.ConclusionsA large percentage of Arizona adults are not adequately protecting themselves from the sun. Factors related to use of sun protection are not always the same as those related to sunburns. Comprehensive tailored approaches to skin cancer prevention are needed.