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4+ visits) in the last year. Among all enrollees identified as overdue for CRC screening, FIT completion rates at 6 months were 14.8% overall and 18.5% in the subgroup reached. In a mailed FIT program, a health insurance plan attempted to reach as many enrollees overdue for CRC screening as possible, however 22.8% were not mailed a FIT. Additional efforts are needed to ensure that the hardest to reach enrollees can participate in CRC screening.Influenza and pneumonia vaccines can reduce morbidities and mortality associated with infectious diseases among older adults. Food security, good nutrition, and high-quality diets are critical for the wellbeing of older adults. However, little is known about the relationship between food insecurity and use of preventive health services, such as influenza and pneumonia vaccinations, among older adults. In this study, we analyzed data on 40,555 adults aged ≥ 65 years from the 2014-2018 National Health Interview Survey in the United States. Through multiple hierarchical logistic regression models, we investigated the associations between food insecurity and influenza and pneumonia vaccines uptake in this population. We found that, during 2014-2018, about 12.6 million (5.3%) adults aged ≥ 65 years lived in food-insecure households in the United States. Of those, 60.6% reported getting an influenza vaccine in the past 12 months, and 54.2% reported ever getting a pneumonia vaccine. Compared to food-secure older adults, food-insecure individuals were not significantly different in terms of influenza vaccine uptake. However, they were 25% less likely to have ever gotten a pneumonia vaccine (adjusted odds ratio = 0.75, 95% CI 0.65-0.86, P  less then  .001). Efforts should be made to develop strategies to improve immunization rates among food-insecure older adults. Healthcare providers could routinely assess their vaccination status and screen them for food insecurity. Also, community level screening and intervention programs should target food-insecure older adults, who often face structural disadvantages. Future studies could explore and identify the underlying predictive factors contributing to low pneumonia vaccination rates among food-insecure older adults.PURPOSE Previous studies focusing on phenotyping obstructive sleep apnea (OSA) have outlined its heterogeneity in clinical symptoms, comorbidities, and polysomnographic features. However, the role of anatomical or pathophysiological causality including craniofacial skeletal deformity has not been studied. We aimed to identify and characterize phenotypes of OSA based on multi-perspective clustering by incorporating craniofacial risks with obesity, apnea severity, arousability, symptom, and comorbidity. METHODS A total of 421 Korean patients with OSA (apnea-hypopnea index, AHI ≥ 5; age ≥ 20 years old) were recruited. A K-means cluster analysis was performed following principal component analysis with sagittal and vertical skeletal variables (ANB and mandibular plane angle), AHI, body mass index, and Epworth sleepiness scale. Inter-cluster comparison was conducted using demographic, cephalometric, and polysomnographic variables in addition to presence of diabetes and hypertension. Risk factors contributing to OSA severity were evaluated in each cluster using multivariable regression analysis with adjustment for age and gender. RESULTS Three phenotypic clusters were identified and characterized as follows Cluster-1 (noncraniofacial phenotype, 39%), non-obese moderate-to-severe OSA with no skeletal discrepancy representing low arousal threshold (ArTh), little sleepiness, and low comorbidity; Cluster-2 (craniofacial skeletal phenotype, 33%), non-obese moderate OSA with definite skeletal discrepancy showing low ArTh, mild sleepiness, and low comorbidity; and Cluster-3 (complicated phenotype, 28%), obese severe OSA with skeletal discrepancy exhibiting high ArTh, excessive daytime sleepiness, and high incidence of hypertension. CONCLUSIONS The three OSA phenotypes from multi-perspective clustering may provide a basis for precise therapeutic decision-making including craniofacial skeletal intervention beyond usual characterization of OSA subgroups.In the identification and reconstruction of the biological profile of skeletal remains in physical and forensic anthropology, sex estimation is a fundamental step, and is essential to achieve methods that allow the highest allocation accuracy. This study proposes a method to estimate the sex of skeletal remains using lumbar vertebrae. A total of 33 linear measurements for each lumbar vertebra were taken in 94 identified, contemporary, and adult skeletal remains (46 male and 48 female) from the cemetery of San José in Granada. The sexual dimorphism of each variable was analyzed, an intra- and interobserver error analysis was developed to assess the variables with best concordance, and the discriminant equations were obtained through a binary logistic regression analysis. All lumbar vertebrae show statistically significant sexual dimorphism with higher values in males than in females. Equations with an allocation accuracy of between 80% and 94.5% were obtained, showing that the lumbar vertebrae are a useful alternative for sex estimation when other skeletal elements are not well-preserved or available. The differences of biogeographic history between populations could translate into morphometric differences, which means that it is not advisable to use discriminant equations in a universal way. In spite of the high allocation accuracy of the equations developed, they should be applied in adults from populations similar to the present study to obtain reliable results of sexual estimation, until its validation in other populations.We describe the sudden death of a middle-aged man while having a sauna under the influence of α-pyrrolidinovalerophenone (α-PVP) (PM blood concentration 0.8 mg/L), amphetamine (0.34 mg/L), and other drugs (buprenorphine, benzodiazepines), and engaging in solitary sexual activities. The drugs' effects on the cardio-circulatory system and on body thermoregulation combined with the high temperatures are likely to have been central mechanisms leading to death. The high levels of adrenaline triggered by sexual arousal and the respiratory depression caused by buprenorphine, in association with benzodiazepines, may have also contributed to his death. This previously unreported type of accidental autoerotic death illustrates the risk of using amphetamine-like sympathomimetic drugs (e.g. cathinone derivates) in hot environments such as a sauna, and during sexual activities therein.PURPOSE The aim of this study is to clarify the short-term quality of life (QoL) of acute leukemia (AL) patients early after stem cell transplantation (SCT) and related predictors of QoL recovery. METHODS We investigated adult AL patients who underwent SCT at the Institute of Hematology and Blood Diseases Hospital after transplantation. Physical/functional and emotional/mental recovery were evaluated using the Short Form 36 (SF-36) questionnaire to identify its trajectory as well as related predictors for the physical component summary (PCS) and mental component summary (MCS). The score was also used to establish a QoL prediction model. RESULTS A total of 326 AL patients responded to our QoL survey. The results revealed the profile of patient follow-up from 2013 to 2015. Along follow-up after transplantation, there was a significant increase in PCS (p = 0.139) and MCS (p = 0.122). On multivariate regression analysis, apart from follow-up, marriage, financial situation, employment situation, and history of chronic graft-versus-host disease (cGVHD) had clinical significance for both PCS and MCS. A prediction model for patient risk hierarchy estimation was further established. The logistic results revealed that the significant characteristics of patients with high PCS and high MCS were unmarried, without financial burden, reliable on drugs, and with history of acute graft-versus-host disease (aGVHD). CONCLUSIONS This well-established study enabled evaluation of the QoL of AL patients post-HSCT in China. The established prediction model could provide more indications and insights into improvement in quality of life for better medical interventions.PURPOSE The implication of adolescence diet quality and of certain specific foods' intake on HRQoL remain underexplored, and little importance has been given to biological changes (e.g. growth, maturation, dimorphism, body composition), that remarkably increase the variability of diet and physical activity behaviours. The aim of this study was to analyse the relationship between diet quality and food intake with HRQoL in adolescents, considering maturity, body composition, and physical activity level. METHODS In total 669 Portuguese adolescents aged 10-17 years, attending three secondary schools, were enrolled in this cross-sectional study. Diet quality was assessed by Diet Quality International-Index (DQI-I), physical activity level was self-reported, and the HRQoL was assessed by the KIDSCREEN-52 questionnaire. The KIDSCREEN-52 includes ten dimensions (physical well-being, psychological well-being, moods and emotions, self-perception, autonomy, parent relations and home life, social support and peers, schoo age and physical activity level. CONCLUSION Our results showed that boys reported higher HRQoL and higher scores in the majority of HRQoL dimensions, compared to girls. The intake of unhealthy foods was negatively correlated with some HRQoL dimensions, whilst healthy foods showed positive correlations with some HRQoL dimensions. Biological maturity and physical activity level revealed to be important confounders in the study of diet quality and perception of school environment and social acceptance and bullying in adolescents.PURPOSE Diagnosing cancer early is an imperative, as help-seeking delays affect survival. Quality of life (QoL) deteriorates after diagnosis, but decline may start when cancer is suspected at the earliest stage of the pathway to treatment. This study examined whether offering guided feedback about personal QoL to adults with potential cancer symptoms, living in deprived communities, changes QoL and promotes help-seeking in primary care. METHODS Visitors to a CRUK mobile cancer roadshow were recruited in 43 sites. A prospective longitudinal (2 × 2) repeated-measures design was applied. Where they presented a potential cancer symptom, and were 'signposted' to a GP, they were allocated to a symptom condition, or a lifestyle condition, if seeking cancer risk advice. Randomisation was to an Intervention group, who received feedback about personal QoL results (WHOQOL-BREF and WHOQOL importance measures), or a Control group who assessed QoL without feedback. Depression was screened. RESULTS Of 107 participants, the mean age was 53; 50% were women, 57% were without tertiary education, 66% were unemployed and 45% were currently ill. Over 10 weeks, 54% of all those with symptoms sought help from a medical source and 42% specifically from a GP. Thirty-one completed all three assessments. With symptoms present, psychological, social and environmental QoL were poor, becoming poorer over time. When the symptoms group received feedback, psychological QoL increased, but GP visits were unaffected. However, feedback increased help-seeking from informal social contacts. Vacuolin-1 order Lifestyle groups reported consistently good psychological and social QoL. CONCLUSION This early cancer research offers practical and theoretical implications for QoL interventions in deprived communities.

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