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Purpose: As the life expectancy of cancer survivors continues to improve, cancer survivors start or resume their life roles as caregivers themselves. We aim to assess the associations between caregiving, cancer diagnosis, and self-reported well-being., Methods: Data were obtained from the Behavioral Risk Factor Surveillance System (BRFSS) 2016, 2018, and 2020. Outcomes included self-reported general health, physical health, mental health, depression, physical inactivity, and poor sleep. Weighted multivariable logistic regression models were used to calculate self-reported well-being's adjusted odds ratio (aOR)., Results: Comparable to the proportion of caregivers in the general population, approximately 1 out of 5 cancer survivors were caregivers to others. Individuals with dual roles were significantly more likely to report poor general health (aOR = 2.45; 95%CI: 1.46-4.11), physical health (aOR = 2.17; 95%CI: 1.32-3.56), mental health (aOR = 2.47; 95%CI: 1.31-4.64), depression (aOR = 1.64; 95%CI: 1.15-2.41), physical inactivity (aOR = 1.56; 95%CI: 1.05-2.31), and poor sleep (aOR = 1.48; 95%CI: 1.00-2.19) than the general population. Differential impacts of an additional cancer diagnosis on the well-being of caregivers were observed by sex, race, and time since cancer diagnosis., Conclusions: Nearly four million cancer survivors in the USA are concomitant caregivers. Individuals with dual roles reported diminished well-being across a variety of measures than caregivers only., Implications for Cancer Survivors: Significant unmet health and psychosocial needs exist among individuals with dual roles. Our findings urge for increased awareness of this additional role/responsibility in cancer survivors and provide direct evidence for healthcare providers and policymakers to develop substantial support from the structural level., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Peacetime military service has both positive and negative effects on human capital. While it depreciates academic skills, it also enhances non-cognitive ones. The net effect of conscription is hard to identify due to issues of self-selection, endogenous timing and omitted variables bias. We exploit the compulsory service of men in the Republic of Cyprus preceding university enrolment to deal with the first two problems. After controlling for prior academic performance and other relevant controls in a selection on observables model, we find that duration of service has a positive and significant effect on men's subsequent academic performance as measured by grade point average. Two exogenous reforms-one at the extensive margin and one at the intensive margin of military service-allow us to deal with omitted variables bias. We estimate difference-in-differences models, where female students act as a control group, and show that an increase (reduction) in the average length of army service has a positive (negative) and significant effect on men's academic performance., Supplementary Information: The online version contains supplementary material available at 10.1007/s00148-023-00944-2., Competing Interests: Conflict of interestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

This paper uses data from the Survey of Health, Ageing, and Retirement in Europe to analyze the effect of spousal health shocks on own labor supply decisions. The results suggest minimal changes to the probability of work and the intensity of work for both husbands and wives of disabled spouses. Wives do, however, experience an increase in the probability of retirement after their husbands experience a work-limiting health shock. The results suggest that this increased probability is due to the desire to consume joint leisure. Finally, the analysis finds substantial cross-regional heterogeneity in the effects that spousal health shocks have on the various labor market outcomes examined here, which suggests an important role for country-specific factors in the estimates provided in the earlier literature., Supplementary Information: The online version contains supplementary material available at 10.1007/s00148-022-00929-7., Competing Interests: Conflict of interestThe authors declare no competing interests., (© The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2022, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

Despite the overall decreasing incidence, nasopharyngeal cancer (NPC) continues to cause a significant health burden among Asian Americans (AAs), who are a fast-growing but understudied heterogeneous racial group in the United States. We aimed to examine the racial/ethnic disparities in NPC incidence, treatment, and mortality with a specific focus on AA subgroups. NPC patients aged ≥15 years were obtained from the Surveillance, Epidemiology, and End Results (SEER) 18 (1975-2018). AAs were divided into Chinese, Filipino, Vietnamese, Hawaiian, Japanese, Laotian, Korean, Cambodian, Indian/Pakistani and other Asian/Pacific Islanders (APIs). Age-adjusted incidence was calculated using the SEER*Stat software. Cox proportional and Fine-Gray subdistribution hazard models were used to calculate overall and cause-specific mortalities after adjusting for confounders. Among the total 11 964 NPC cases, 18.4% were Chinese, 7.7% Filipino, 5.0% Vietnamese, 1.2% Hawaiian, 1.0% Japanese, 0.8% Laotian, 0.8% Korean, 0.6% Cambodian, 0.5% Indian/Pakistani and 4.4% other APIs. Laotians had the highest age-adjusted NPC incidence (9.21 per 100 000), which was 18.04 times higher than it in non-Hispanic Whites (NHWs). Chinese and Filipinos observed lower overall mortalities, however, Chinese saw increased NPC-specific mortality than NHWs. Disparities in mortality were also found across different histology subtypes. This is the first and largest study examining the NPC incidence and outcomes in AA subgroups. The significant disparities of NPC within AAs underline the importance of adequate AA-subgroup sample size in future studies to understand the prognostic role of ethnicity in NPC and advocate more ethnically and culturally tailored cancer prevention and care delivery., (© 2022 UICC.)

Introduction: Prior research has revealed rural populations have lower rates of breast and colorectal cancer screening compared to their urban counterparts in the USA. An increasing number of rural hospitals have closed, with rural residents reporting skipping diagnosing imaging and preventative care due to a lack of access. Considering increasing rural hospital closures, this study investigated disparities in breast and colorectal cancer screening between urban and rural women in the USA., Methods: This cross-sectional study analyzed the Behavioral Risk Factor Surveillance System (BRFSS) data 2014-2019. Focusing on women aged 50-74 years, this study evaluated the prevalence of breast cancer and colorectal cancer (CRC) screening overall and by urban-rural location using multivariable logistic regressions., Results: During the study period, the adjusted prevalences of breast cancer screening were 80.0% and 77.1% (p<0.001) in urban and rural settings, respectively. The adjusted CRC screening prevalences were 72.8% and 68.4% (p<0.001) in urban and rural settings, respectively. By year, this study found that by 2019 there was no significant difference between urban and rural screening: 80.8% versus 79.6% in breast cancer and 78.9% versus 76.6% in CRC screening in urban and rural groups, respectively. Screening disparities existed between different racial groups., Conclusion: Breast cancer and CRC screening disparities between urban and rural women have narrowed; however, they continue to exist within these groups. The implementation of screening initiatives targeting underscreened rural regions and racial groups continues to be necessary.

Purpose: To identify mammography screening prevalence and predictors in Asian American women, focusing on the potential disparities in race and its influence on screening behaviors., Design: A secondary analysis utilized the California Health Interview Survey (CHIS) 2015-2016., Setting: California, U.S., Sample: Cisgender women who were non-Hispanic (NH) White, Chinese, Filipino, Vietnamese, Japanese, Korean, or "other Asian", aged 40 or above (unweighted N=13 451)., Measures: Socioeconomics, chronic health conditions, and preventive care utilization were mesuared as potential risk factors, where up-to-date mammography screening as the outcome variable., Analysis: Multivariable adjusted logistic regressions were generalized to identify the up-to-date mammography screening behaviors in relation to potential factors, stratified by race and ethnicity., Results: The prevalence for up-to-date mammography screening in NH-White and Asian American women were 68.06% and 65.97%, respectively. In NH-White women, receiving an up-to-date mammogram was associated with age, birthplace, smoking status, diabetes, hypertension, health insurance coverage, and a preventive care visit in the past 12 months, whereas only age and a preventive care visit were significant predictors in Asian women., Conclusions: The findings indicate that utilization disparities exist in mammogram in relation to socioeconomics, chronic health conditions, preventive care utilization, when comparing between race and ethnicity. Asian American women with borderline hypertension and no preventive care visits may require more public health outreach and cancer education.

Background: Research is lacking for understanding the health disparities in cancer survivorship in the lesbian, gay, and bisexual (LGB) population in the United States. Self-reported health status is used as a predictor of health disparities., Methods: This secondary data analysis study used 2018 Behavioral Risk Factor Surveillance System data to analyze cancer survivorship characteristics by sexual orientation and sex through the use of logistic regressions., Results: Overall, 17,656,329 US cancer survivors were included in this study after weighting, with percentage estimates of 1.52% for gays/lesbians and 1.41% for bisexuals. LGB participants were younger and more ethnically diverse. Significantly, bisexuals had current smoking (32.3% vs 13.6%) and binge drinking rates (17.1% vs 9.1%) twice those of heterosexuals; 16.6% of bisexuals versus 4.1% of heterosexuals reported no health insurance coverage (P < .0001). After adjustments for socioeconomic, health-related behavioral risk, and health care access factors, bisexual females reported poorer general health (odds ratio [OR], 1.33; 95% confidence interval [CI], 1.31-1.36) as well as mental health (OR, 2.43; 95% CI, 2.39-2.46) than their heterosexual peers (P < .0001). Bisexual males were 5.14 times more likely to be told that they had depressive disorders than their heterosexual counterparts (95% CI, 5.05-5.23), whereas bisexual females were 3.23 times more likely for the same outcome (95% CI, 3.18-3.28). All LGB groups reported significantly more inadequate sleep than their heterosexual counterparts (especially lesbians: OR, 2.14; 95% CI, 2.10-2.18)., Conclusions: This study indicates that LGB cancer survivors have worse survivorship than their heterosexual peers with heterogeneity in subgroups. Future studies should use larger sample sizes, further investigate disparities, and promote survivorship in LGB populations., Lay Summary: It has been observed that lesbian, gay, and bisexual (LGB) cancer survivors may face challenges in cancer survivorship that are not as prevalent in the heterosexual community. This cross-sectional study has found that LGB cancer survivors, especially bisexuals, have overall poorer physical and mental health, are more likely to be told that they have depressive disorders, and have worse sleep quality in comparison with their heterosexual counterparts. These results also differ by sex, and this can provide rationales for future studies and guide interventions to relocate resources to better promote equality., (© 2021 American Cancer Society.)

Multiple myeloma (MM) is an incurable malignancy of plasma cells with a clinical course characterized by multiple relapses and treatment refractoriness. While recent treatment advancements have extended overall survival (OS), refractory MM has a poor prognosis, with a median OS of between 4 and 6 months. Nuclear export inhibition, specifically inhibition of CRM1/XPO1, is an emerging novel treatment modality that has shown promise in treatment-refractory MM. Initially discovered in yeast in 1983, early clinical applications were met with significant toxicities that limited their utility. The creation of small molecule inhibitors of nuclear export (SINE) has improved on toxicity limitations and has led to investigation in a number of malignancies at the preclinical and clinical stages. Preclinical studies of SINEs in MM have shown that these molecules are cytotoxic to myeloma cells, play a role in therapy resensitization, and suggest a role in limiting bone disease progression. In July 2019, selinexor became the first nuclear export inhibitor approved for use in relapsed/refractory MM based on the STORM trial. As of May 2020, there were eight ongoing trials combining selinexor with standard treatment regimens in relapsed/refractory MM. Eltanexor, a second-generation SINE, is also under investigation and has shown preliminary signs of efficacy in an early clinical trial while potentially having an improved toxicity profile compared with selinexor. Results in ongoing trials will help further define the role of SINEs in MM.

Background: Potential deceased organ donors are screened for human immunodeficiency virus (HIV-1), hepatitis B virus (HBV), and hepatitis C virus (HCV) with serologic tests and nucleic acid tests (NATs). The results of these tests on the utilization of donors have not been directly measured., Methods: Twenty-six organ procurement organizations (OPOs) provided primary HIV, HBV, and HCV screening results and utilization information for donor referrals evaluated from 2004 to 2017. Additional information regarding donor organ utilization was obtained from the Organ Procurement and Transplantation Network database. Data were analyzed using logistic regression., Results: Test results were submitted for 38 166 potential deceased organ donors; 31 (0.1%) were HIV NAT-negative but seropositive, 5.2% were HBV core antibody-positive and NAT-negative, while 1.8% were HCV antibody-positive and NAT-negative. Organ utilization of HBV and/or HCV NAT-negative organs increased over time despite positive antibody status., Conclusions: Nucleic acid test detected infections in seronegative donors, especially for HCV. The use of NAT for deceased donor screening correlated with increased utilization of donor organs., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Previous studies have demonstrated a tactile Simon effect in which stimulus codes are generated based on the stimulated hand, not on limb position in external space (the somatotopic Simon effect). However, given evidence from visual Simon effect studies demonstrating that multiple stimulus codes can be generated for a single stimulus, we examined whether multiple stimulus codes can be generated for tactile stimuli as well. In our first experiment using four stimulators (two on each side of the hand), we found novel evidence for a hand-centered Simon effect, along with the typical somatotopic Simon effect. Next, we examined whether the potential salience of these somatotopic codes could be reduced, by testing only one hand with two stimulators attached. In Experiments 2-4, we found a strong hand-centered Simon effect with a diminished somatotopic Simon effect, providing evidence that stimulus salience can change the weighting of somatosensory stimulus coding. Finally, we also found novel evidence that the hand-centered Simon effect is coded in external, not somatotopic, coordinates. Furthermore, the diminished somatotopic Simon effect when testing on one hand only provides evidence that salience is an important factor in modulating the tactile Simon effect., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Background: Infectious diseases (ID) specialists with experience in managing infections in transplant recipients and other immunocompromised hosts are increasingly needed as these fields expand., Methods: To evaluate experiences and identify trainee-described needs in transplant infectious diseases (TID) training, the American Society of Transplantation, Infectious Diseases Community of Practice (AST IDCOP) surveyed ID fellows across the United States and TID fellows in the United States and Canada and received responses from 203 ID fellows and 13 TID fellows., Results: Among ID fellows, the amount of TID training during ID fellowship was rated between less than ideal and adequate. Reasons cited included limited frequency of didactic activities and limited exposure to transplant patients during training. In particular, ID fellows at low-volume transplantation centers expressed interest in more TID training time, away training opportunities, and specific TID didactics. Educational resources of high interest among trainees were case-based interactive websites, mobile phone applications with TID guidelines, and a centralized collection of relevant articles. Pediatric ID fellows reported lower satisfaction scores with TID training, while TID fellows were overall satisfied or more than satisfied with their training experience., Conclusion: Findings from this survey will inform local and national TID educational initiatives., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Organ Procurement & Transplantation Network policy requires post-transplant screening of recipients of organs from donors at increased risk for transmission of HIV, hepatitis B virus, and hepatitis C virus. Available data suggest that follow-up testing of recipients is not routinely conducted. Data on increased risk donors and recipients of their organs from 2008 to 2012 were retrospectively collected from 6 transplant centers after IRB approval. Descriptive statistics were performed. About 363 (60%) recipients were screened for transmission of HIV, HBV, and/or HCV at some time point; 257 (70.8%) within 90 days of transplant. The type of test used to screen for infection was variable with many recipients (25%-43%) screened with serology alone. Our results reveal that post-transplant screening for HIV, HBV, and HCV in recipients of increased risk donor organs did not universally occur and testing methods were variable., (© 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)