Whether fetal lung development may be vulnerable to gestational exposure to metals is unknown. We analyzed mother-child pairs in Project Viva, a prospective prebirth cohort in eastern Massachusetts, USA. Concentrations of 11 essential and nonessential metals were measured in maternal first-trimester erythrocytes (~10 weeks). Measures of lung function were obtained by spirometry, and asthma status by recall, at the mid-childhood visit (~8 years). We fit both Bayesian hierarchical models with weakly informative priors and conventional multivariable linear and logistic regressions (MLRs) to estimate associations of the metals with lung function and asthma. The analytic sample included 804 mother-child pairs (76.0% non-Hispanic White; 16.7% of children had current asthma). Each standard deviation increase in magnesium was associated with higher forced vital capacity (mean difference: 26 mL, 95% credible interval (CrI); 5, 47), higher forced expiratory volume in 1 second (FEV1) (25 mL, 95% CrI: 6, 44), and lower odds of current asthma (odds ratio: 0.88, 95% CrI: 0.71, 1.1). BHMs provided more modest and precise estimates than MLRs. Our results suggest early pregnancy intake of magnesium may enhance fetal lung development and may confer a modest reduction in the risk of asthma.

Categorization of the modified baseline and 2-year post-diagnosis lifestyle scores.

Cumulative incidence of all-cause mortality, breast cancer-specific mortality, and breast cancer recurrence among women diagnosed with invasive breast cancer in the Pathways Study, according to tertiles of the 2-year post-diagnosis lifestyle score, 2006–2018

Multivariable Cox Proportional Hazards Models for the Associations of Changes in Components of the Lifestyle Score on All-Cause Mortality and Breast Cancer Recurrence in the Pathways Study.

Descriptive characteristics among 4,403a women diagnosed with invasive breast cancer in the Pathways Cohort, 2006–2018

Hazard ratios (HR) and 95% confidence intervals (95% CI) for the association of 2-year post-diagnosis lifestyle with all-cause mortality, breast cancer-mortality, and breast cancer recurrence among women diagnosed with stage I–III breast cancer.

Posterior Median Hazard Ratios and 95% Credible Intervals from Piecewise Exponential Proportional Hazards Model for All-Cause Mortality, Breast Cancer-Specific Mortality, and Breast Cancer Recurrence in the Pathways Study

Subdistribution hazard ratios (sdHR) and 95% confidence intervals (95% CI) for the association of 2-year post-diagnosis lifestyle with breast cancer-specific mortality (n=1,736) and breast cancer recurrence (n=1,705).

BACKGROUND: Poor muscle health is an adverse prognostic factor in clear cell renal cell cancer (ccRCC), but mechanisms are unknown. We examined associations among six body composition features, ClearCode34 tumor molecular subtype, and survival. METHODS: In a cohort of 837 patients with localized ccRCC, we segmented pre-surgical CT scans for cross-sectional areas and radiodensities of skeletal muscle, visceral adiposity, and subcutaneous adiposity. RNA was extracted from archived tumor specimens and run on a custom Nanostring array. A centroid- based classification categorized tumors as ccA (less aggressive) or ccB (more aggressive) ClearCode34 subtype. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated for associations between body composition and ClearCode34 subtype. Hazard ratios (HRs) and 95% CIs were estimated for individual and joint effects of body composition features and ClearCode34 subtype on 5-year disease-free survival (DFS). RESULTS: The cohort was predominantly male, white, and had Stage I disease; 26% of tumors were ccB subtype. 95 DFS events occurred over 3532.2 person-years of follow-up. Patients with lower skeletal muscle radiodensity (SMD) were more likely to harbor ccB tumors (OR per 10-unit decrease in SMD: 1.30, 95% CI: 1.00-1.69). Exploratory joint effects analyses suggested patients with lower SMD and ccB subtype experienced the lowest DFS compared to patients without those characteristics (HR 2.68, 95% CI: 1.43-5.00). CONCLUSIONS: ccRCC patients with lower SMD (more fat- infiltrated skeletal muscle) at diagnosis may experience worse survival because they harbor more aggressive tumors. Future studies should determine how post-nephrectomy changes in body composition features are associated with survival.

Supplementary text providing additional information regarding methods.

Hazard Ratios and 95% Confidence Intervals for Associations of each of the 9 Components of the 2-Year Post-Diagnosis Lifestyle Score with All-Cause Mortality, Breast Cancer-Specific Mortality, and Breast Cancer Recurrence, Excluding Deaths and Recurrences Occurring within 4 Years of Diagnosis.

Interactions Between the 2-Year Post-Diagnosis Lifestyle score and Selected Characteristics with All-Cause Mortality, Breast Cancer-Specific Mortality, and Breast Cancer Recurrence in the Pathways Study.

Gender norms have been posited to impact intimate partner violence (IPV), but there is scant evidence of the longitudinal association between community-level gender norms and IPV. Using longitudinal data on 3,965 married girls surveyed in India, we fitted mixed-effects ordinal and binary logistic regression models for physical IPV intensity and occurrence of sexual IPV. We found a 26% increase in the odds that women experience frequent physical IPV per one unit increase in greater community-level equitable gender norms. We did not find an association between community-level equitable gender norms and sexual IPV. Findings suggest that the relationship between gender norms and physical and sexual IPV differs, indicating the need for tailored interventions for different types of IPV.

Introduction US safety net programs provide critical support to Americans with low income. This cohort study examined patterns of safety net program take-up over time and associations with sociodemographics and health. Methods Surveys among California households with low income (n=380) conducted in 2020-2021 and 2023 captured take-up of federal assistance programs [Medicaid; Supplemental Nutrition Assistance Program (SNAP); Special Supplemental Nutrition Program for Women, Infants, and Children; Earned Income Tax Credit; Child Tax Credit] in 2019 and 2021 and health in 2023. Latent transition analysis identified patterns and temporal shifts in program take-up among those eligible. Multivariable regressions examined associations of patterns with sociodemographics and mental and overall health. Analyses were completed in 2024. Results Three take-up patterns emerged: high take-up of “all programs,” “low SNAP,” and “low tax programs.” Most in “all programs” and “low SNAP” patterns in 2019 remained in 2021. Most starting in "low tax programs" transitioned to “all programs” by 2021. Higher income was associated with lower relative risk of “low tax programs” (RRR=0.37, 95%CI=0.28,0.49). Hispanic ethnicity was associated with higher relative risk of “low SNAP” (RRR=3.73, 95%CI=1.50,9.23). Having more children and depressive and anxiety symptoms were associated with higher relative risk of being in “all programs” at both timepoints. No associations were found with overall health. Conclusions Proportion of respondents with high take-up of all programs increased over the study period, perhaps due to pandemic-era policy changes. Take-up patterns showed associations with mental health, and key differences among sociodemographic subgroups suggest targeted interventions may improve participation.

A simplified causal diagram of the relationship between time-varying diet quality, physical activity and smoking on survival after breast cancer

Hazard ratios and 95% confidence intervals for associations of each of the 9 components of the 2-year post-diagnosis lifestyle score with all-cause mortality.

INTRODUCTION:Most studies on body composition in kidney cancer have been conducted among patients with metastatic disease. Given that aggressive tumours can adversely impact body composition and even non-metastatic tumours can be aggressive, we evaluated associations between pre-surgical body composition features and tumour pathological features in patients with non-metastatic clear cell renal cell cancer (ccRCC). METHODS:The Resolve Cohort consists of 1239 patients with non-metastatic ccRCC who underwent nephrectomy at Memorial Sloan Kettering Cancer Center between 2000 and 2020. The cross-sectional areas and radiodensities of skeletal muscle, visceral adipose, and subcutaneous adipose tissues were determined from pre-surgical computed tomography (CT) scans at the third lumbar vertebrae using Automatica software. Pearson's correlation coefficients describe inter-relationships among BMI and body composition variables, while odds ratios (OR) and 95% confidence intervals (CI) estimate associations between continuous body composition features (per 1-standard deviation) and advanced stage (Stage III vs. Stages I-II) and high Fuhrman grade (Grades 3-4 vs. 1-2) from multivariable logistic regression models that considered the potential impact of biological sex, contrast enhanced CTs, and early age at onset of ccRCC. RESULTS:The cohort was predominantly male (69%), white (89%), and had a median age of 58. The proportion of patients presenting with advanced stage and high-grade disease were 31% and 51%, respectively. In models that adjusted for demographics and all body composition variables simultaneously, decreasing skeletal muscle radiodensity (i.e., more fat infiltration) but increasing visceral adipose tissue radiodensity (i.e., more lipid depletion) were associated with advanced tumour features. Per 8.4 HU decrease in skeletal muscle radiodensity, the odds of presenting with advanced stage was 1.61 (95% CI: 1.34-1.93). Per 7.22 HU increase in visceral adipose tissue radiodensity, the odds of presenting with advanced stage was 1.45 (95% CI: 1.22-1.74). Skeletal muscle index (i.e., sarcopenia) was not associated with either tumour feature. Similar associations were observed for Fuhrman grade, a more direct marker of tumour aggressiveness. Associations did not differ by sex, contrast use, or age at onset of ccRCC. CONCLUSIONS:Lipid infiltrated skeletal muscle, but lipid depleted visceral adipose tissue were independently associated with advanced tumour features in non-metastatic ccRCC. Findings highlight the importance of evaluating the full range of body composition features simultaneously in multivariable models. Interpreting pre-surgical CTs for body composition for patients may be a novel and non-invasive way to identify patients with aggressive renal tumours, which is clinically relevant as renal biopsies are not routinely performed.

In this issue of Nature Metabolism, it is shown that the abundance of Caenorhabditis elegans branched-chain aminotransferase-1 (BCAT-1) — which catalyses the first step of branched-chain amino acid (BCAA) catabolism — declines sharply in aged wild-type nematodes but not in slowly ageing mutants, and that stimulating BCAA catabolism extends reproductive longevity.

12085 Background: Older HNC survivors often experience post-treatment pain, and they have concerningly high rates of unsafe opioid prescribing per CDC guidelines (e.g., high doses, concurrent benzodiazepines). Because interventions to improve opioid safety should target providers who prescribe opioids to HNC survivors, we aimed to identify post-treatment opioid prescriber specialty. Methods: Using the national linked Surveillance, Epidemiology, and End Results (SEER) registry and Medicare claims data, we identified adults age >65 diagnosed 2014-2017 with stage I-III HNC and who had ≥6 months treatment-free follow-up prior to censoring at further treatment, new cancer, hospice, death, or end 2019. Each opioid fill was assigned to a prescriber specialty: oncology (medical, radiation), surgery, primary care (internal medicine, family practice, geriatrics), pain, or other. Prescriber patterns (number of fills, duration of fill, annual opioid receipt) were summarized across follow-up and stratified by year. Multinomial logistic regression models captured trends in prescribing, accounting for clinical and sociodemographic characteristics. Results: Among 5547 HNC survivors, 2951 (53%) had ≥1 opioid fill (median 2.1 years follow-up). Primary care providers (PCPs) prescribed 49% of all fills (46%-53% each year). PCPs prescribed opioids to 49% of survivors with ≥1 opioid fill, a greater share than other specialties. PCPs prescribed longer supplies of opioids (median 30 days/fill and median 45 days/year) than oncologists or surgeons. The likelihood of an opioid being prescribed by an oncologist or surgeon was ≥5 times lower than by a PCP. Over follow-up, rates of opioid prescribing by oncologists decreased relative to rates of prescribing by PCPs (Table). Conclusions: Primary care involvement in opioid prescribing remains high over post-treatment HNC survivorship. Interventions to address unsafe opioid prescribing for HNC survivors should target the primary care setting, as is typical for opioid-reduction efforts in the non-cancer population. [Table: see text]

Joint effects for relationship between body composition features and tumor characteristics for disease free survival.