Jacobs Institute of Women's Health
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The Fitness, Rest, and Exercise for Strength and Health (FRESH) Study: A Three-Year Comparison of College Students\u27 Perceived and Measured Health Metrics
No full textThe undergraduate college years are a critical transition period for young adults in establishing life-long health behaviors. : Within the FRESH Study, we aimed to understand the relationship between perceived physical health, perceived mental health, and specific health metrics (e.g., physical activity, food insecurity, sleep quality) among college students following the COVID-19 pandemic. : First-year undergraduate students (n = 271) from an urban university were recruited in three study waves (2021-2022, 2022-2023, and 2023-2024). Participants answered online surveys on demographics, health perceptions, physical activity, dietary patterns, beverage consumption, food insecurity, stress, and sleep quality. : Overall, participants rated their physical health better than their mental health (\u27good\u27, \u27very good\u27, or \u27excellent\u27; 89.6% vs. 62.2%), even though 30.7% were not of \u27healthy weight\u27 status, 34.5% did not meet physical activity recommendations, and 42.2% of students consumed some sugar-sweetened beverages (SSBs). Students reporting suboptimal (\u27fair\u27 or \u27poor\u27) physical and mental health were more likely to report food insecurity (p \u3c 0.001, p = 0.010), poor sleep quality (p = 0.012, p \u3c 0.001), and elevated stress (p = 0.001, p \u3c 0.001). In addition, fast-food consumption (p \u3c 0.001), breakfast consumption (p = 0.031), and food insecurity (p = 0.004) showed changes over three years. : These findings call for targeted wellness initiatives addressing nutrition, food insecurity, stress management, sleep improvement, and physical activity among students and in university health programs. The FRESH Study emphasizes the need for continued longitudinal research to track health behaviors and inform future interventions
One-quarter of freshwater fauna threatened with extinction
No full textFreshwater ecosystems are highly biodiverse and important for livelihoods and economic development, but are under substantial stress. To date, comprehensive global assessments of extinction risk have not included any speciose groups primarily living in freshwaters. Consequently, data from predominantly terrestrial tetrapods are used to guide environmental policy and conservation prioritization, whereas recent proposals for target setting in freshwaters use abiotic factors. However, there is evidence that such data are insufficient to represent the needs of freshwater species and achieve biodiversity goals. Here we present the results of a multi-taxon global freshwater fauna assessment for The IUCN Red List of Threatened Species covering 23,496 decapod crustaceans, fishes and odonates, finding that one-quarter are threatened with extinction. Prevalent threats include pollution, dams and water extraction, agriculture and invasive species, with overharvesting also driving extinctions. We also examined the degree of surrogacy of both threatened tetrapods and freshwater abiotic factors (water stress and nitrogen) for threatened freshwater species. Threatened tetrapods are good surrogates when prioritizing sites to maximize rarity-weighted richness, but poorer when prioritizing based on the most range-restricted species. However, they are much better surrogates than abiotic factors, which perform worse than random. Thus, although global priority regions identified for tetrapod conservation are broadly reflective of those for freshwater faunas, given differences in key threats and habitats, meeting the needs of tetrapods cannot be assumed sufficient to conserve freshwater species at local scales
Acral Lentiginous Melanoma. Part II. Staging, Surgical Management, The Role of Systemic Therapy, Shortcomings and Future Directions
No full textThis comprehensive review navigates the clinical management and challenges of acral lentiginous melanoma (ALM), including staging, surgical interventions, and systemic therapies. Multimodality treatment and clinical trials are recommended for advanced cases
Prevalence and Characteristics of Chronic Hand Eczema Among Adults in Denmark: A General Population-Based Study
No full textBACKGROUND: The epidemiology of chronic hand eczema (CHE) remains poorly examined. OBJECTIVE: To investigate the prevalence of CHE in a general adult population and describe the characteristics of affected individuals. METHODS: We investigated the prevalence and characteristics of CHE using a random sample from the general Danish population (The Danish Skin Cohort). CHE was defined as eczema on the hands or wrists during a minimum of three consecutive months or reoccurrence of hand eczema at least twice within 12 months. RESULTS: Out of 11 166 adults, 1306 experienced hand eczema (HE) at some point in their lifetime. Within the last 12 months, 408 (3.7%) experienced HE, of which 332 (81.4%) reported CHE. The crude 1-year period prevalence of CHE was 3.0% (95% confidence interval (CI), 2.7%-3.3%) while the standardised prevalence was 3.5% (95% CI, 3.3%-3.6%). Among adults with CHE, 70.8% were female, and the mean age was 48.0 years (standard deviation 16.6 years). Most individuals with CHE had two relapses (n = 309, 93.1%), while n = 206, 61.1%, had HE for more than 3 months. Compared to HE, CHE was more likely diagnosed by a dermatologist and affect the fingers and back of the hand. CONCLUSION: The standardised prevalence was 3.5% (95% CI, 3.3%-3.6%) and 4.2% (95% CI, 4.0%-4.4%) for CHE and HE, respectively. We identified a large overlap between HE and CHE (81.4%) in adults from the general population, indicating that many individuals affected by eczema on the hands may experience a chronic course
Longitudinal timing of physical activity and associated cardiometabolic and behavioral health outcomes in young adults
No full textBACKGROUND: This is the first study to examine longitudinal associations between self-selected timing of moderate-to-vigorous physical activity (MVPA) and health outcomes in young adults over 18 months. METHODS: Young adults (N = 434, Mage = 23.9, SDage = 4.6 years) enrolled in a weight management trial recorded 4-7 days of ActiGraph wear time at ≥1 time point (baseline, months 6, 12, and 18). Time-of-day categories were based on quartiles of the temporal distribution of MVPA min/h at baseline: morning (06:00-11:59), afternoon (12:00-15:59), evening (16:00-18:59), and night (19:00-00:59). The proportion of weekly MVPA accumulated during each time category was the predictor in longitudinal linear mixed-effects models predicting body mass index (BMI) and total weekly MVPA. Longitudinal quasibinomial generalized estimating equations models predicted cardiometabolic risk. Interactions were tested, and marginal trend estimates were generated for sex and age subgroups. RESULTS: The analytic sample was 79% female and 49% non-Hispanic White, with a mean (±SD) weekly MVPA of 311 ± 167 min at baseline. In adjusted models, there were no associations with BMI. Morning MVPA was inversely associated with cardiometabolic risk (OR [95% CI]: 0.99 [0.98-0.99]) for both sex and age groups. Evening MVPA was inversely associated with cardiometabolic risk for 26-35 year olds (0.98 [0.97-0.99]). Morning MVPA was associated with greater total MVPA across subgroups, and afternoon MVPA was associated with less total MVPA in women. CONCLUSIONS: Over 18 months, incremental health benefits may accrue with optimal activity timing in young adults. Activity-based interventions designed to improve cardiometabolic and behavioral health outcomes in young adults may be optimized by tailoring timing recommendations to demographic factors
Trends and Disparities in Prostate Cancer Mortality in the United States (1999-2020)
No full textBACKGROUND: Prostate cancer is a leading cause of cancer-related mortality among men in the United States. Over the past two decades, the observed decline in prostate cancer mortality can be attributed to advancements in screening, early detection, and treatment. However, persistent disparities related to race, geography, and age highlight the need for targeted interventions to improve outcomes. METHODS: This study evaluated trends in prostate cancer mortality among men aged 45 years and older in the United States, using data from CDC WONDER (1999-2020). Age-adjusted mortality rates (AAMRs) per 100,000 individuals were analyzed using a log-linear regression model to calculate annual percentage changes (APCs) and 95 % confidence intervals. Crude rates were utilized to calculate APCs within specific age subgroups. RESULTS: The AAMR related to prostate cancer significantly declined from 89.87 per 100,000 in 1999 to 52.92 in 2020. A steeper decline was noted from 1999 to 2013 (APC = -3.44), followed by a slower reduction thereafter (APC = -0.61), which coincided with changes in PSA screening guidelines introduced in 2012. African American men had the highest mortality rates but also experienced the most significant decline, decreasing from 199.91 per 100,000 in 1999 to 104.42 in 2020. Regional disparities evolved over time, with the West overtaking the South in mortality rates by 2020. Non-metropolitan areas consistently exhibited higher mortality rates compared to metropolitan regions. Age-stratified data indicated that AAMR increased with age, with the most notable declines seen in men aged 85 years and older. CONCLUSION: Prostate cancer mortality in the United States has significantly decreased over the past 2 decades; however, the rate of progress has slowed in recent years. It is crucial to address racial, geographic, and age-related disparities to further reduce mortality and enhance equity in health outcomes
Pediatric Cutaneous T-Cell Neoplasms: Clinical and Pathological Features, Updated Classifications, and Critical Differential Diagnoses
No full textCutaneous T-cell lymphoid neoplasms in childhood are exceedingly rare, presenting with a wide spectrum of clinical presentation and outcomes. Due to numerous clinical and pathological mimics, an integrated evaluation of clinical, histopathological, immunohistochemical, and molecular findings is critical for a diagnosis. Here, we review the clinical and pathological features, updated classifications, and critical differential diagnoses of cutaneous T-cell lymphoid neoplasms in children
Seizure Cycle app: A feasibility study
No full textBACKGROUND AND OBJECTIVE: Catamenial seizure exacerbation (CSE) is challenging to track given unreliable patient reports. This highlights the need for improved recognition of CSE. In this study, we discuss the feasibility of using the Seizure Cycle app for that purpose. DESIGN/METHODS: Eligible participants logged menstrual cycles and seizure data in the app for 6 months. CSE was defined based on criteria by Herzog et al [1], as two-fold increase in average daily seizure frequency (ADSF) during menstrual (C1) and ovulatory (C2) phases during ovulatory cycles, and the entire luteal phase during anovulatory cycles (C3). Feasibility was assessed by the proportion of participants who completed 4-month and 6-month documentation. RESULTS: Among 8 participants, 5 (62.5 %) shared \u3e 4-month data and 4 (50 %) shared 6-month data. Among the 6 participants who shared at least one month of data, CSE type C3 was identified based on number of seizures in one participant who had variable cycle length and was presumed to have anovulatory cycles. This was not confirmed with calculation of ADSF. CONCLUSIONS: Seizure Cycle app can serve as a feasible tool to improve diagnosis of this underrecognized condition. Despite the small sample size, CSE was potentially identified in one participant, although use of ADSF did not confirm this classification. Clearer definition of the C3 pattern may be useful. Future work will prioritize app automation to streamline data collection, facilitating larger and more robust datasets. These advancements will ultimately support the systematic assessment of therapeutic interventions to improve the diagnosis and treatment of CSE
Associations of fire smoke and other pollutants with incident rheumatoid arthritis and rheumatoid arthritis associated interstitial lung disease: reply
No full textMOMs Chat & Care Study: Rationale and design of a pragmatic randomized clinical trial to prevent severe maternal morbidity among Black birthing people
No full textBACKGROUND: Black birthing people are disproportionately affected by severe maternal morbidity (SMM). The MOMs Chat & Care Study (R01NR021134) is a pragmatic, randomized clinical trial designed to test the effectiveness of an integrated care model to facilitate timely, appropriate care for high-risk Black birthing people and reduce the risk for SMM. METHODS: We will recruit 674 adult, English and Spanish-speaking Black birthing people who are less than 17 weeks gestational age, considered high risk based on the Obstetrics-Comorbidity Index and/or history of preeclampsia, and receive care at a Northwell Health obstetric practice. Participants will be randomized to either MOMs High Touch or Low Touch. In both intervention arms participants will receive close monitoring via chatbot technology and navigation to timely care and services by the MOMs team throughout the prenatal and postpartum periods, Fitbit to track physical activity, and bi-weekly postpartum telehealth visits up to 6-weeks postpartum. MOMs High Touch will also receive 12 bi-weekly self-management support telehealth visits during pregnancy and a home blood pressure monitor. The two arms will be compared on incidence of SMM at labor and delivery (Aim 1), SMM-related hospitalizations at 1-month and 1-year postpartum (Aim 1a), time to preeclampsia diagnosis and treatment (Aim 2), perceived social support (Aim 3), and physical activity trajectories (exploratory Aim 4). Mixed methods will be used to examine facilitators and barriers to intervention implementation (Aim 5). CONCLUSION: Findings from this study will inform how to feasibly implement an effective and sustainable integrated care approach to address SMM disparities. REGISTRATION OF CLINICAL TRIALS: This trial is registered on www. CLINICALTRIALS: gov (NCT06335381). PROTOCOL VERSION: 07/22/2024, 24-0131-NH