American Journal of Preventive Medicine最新文献

{"title":"Crisis Circumstances in Adult U.S. Suicide Deaths: A Latent Class Analysis","authors":"Amanda M. Sursely PhD ,&nbsp;Emily K. Roberts PhD ,&nbsp;Sarah H. Nash PhD ,&nbsp;Anne G. Sadler PhD, RN, LMFT ,&nbsp;James C. Torner PhD ,&nbsp;Jonathan M. Platt PhD","doi":"10.1016/j.amepre.2025.108016","DOIUrl":"10.1016/j.amepre.2025.108016","url":null,"abstract":"<div><h3>Introduction</h3><div>Suicide is a critical public health issue in the U.S., where it ranks as the 11th leading cause of death. Precipitating crises are life events that occur prior to a suicide and increase risk. This study aimed to identify distinct groupings of precipitating crises in adults who died by suicide.</div></div><div><h3>Methods</h3><div>Data from the National Violent Death Reporting System included 55,448 suicides from 2013 to 2021, where the decedent had experienced a precipitating crisis in the 2 weeks surrounding death. Crisis variables were used to model latent classes of circumstances through Latent Class Analysis. Models were fit with 2–10 classes, and the optimal solution was selected through fit statistics, entropy, and interpretability. Logistic regression was used to assess the associations between demographic characteristics (age, sex (male/female), race, ethnicity, military status, rurality) and class membership. All analyses were performed in 2024.</div></div><div><h3>Results</h3><div>A 6-class model best fit the data, including (1) co-occurring substance use, alcohol, relationship, and eviction; (2) physical health; (3) other; (4) criminal legal; (5) co-occurring job, financial, and intimate partner; and (6) intimate partner crises. There was significant variation in class membership by demographic characteristics. For example, adults aged 55–65 years had higher odds of belonging to Class 2 than younger adults (AOR=18.53; 95% CI=13.12, 26.93).</div></div><div><h3>Conclusions</h3><div>This study identified 6-crisis profiles with patterns of life events that can be recognized by healthcare providers. Individuals experiencing single-circumstance crises may benefit from addressing the specific stressor, whereas those in multifaceted-crisis profiles likely require comprehensive interventions that tackle overlapping stressors simultaneously.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 5","pages":"Article 108016"},"PeriodicalIF":4.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increased Risk of Rotator Cuff Tear in U.S. Army Soldiers With a History of Prior Shoulder Impingement Syndrome","authors":"Soothesuk Kusumpa MPA, MPH ,&nbsp;Kathryn M. Taylor ScD ,&nbsp;Jason L. Judkins PhD, ScD","doi":"10.1016/j.amepre.2025.108030","DOIUrl":"10.1016/j.amepre.2025.108030","url":null,"abstract":"<div><h3>Introduction</h3><div>Military populations and comparable groups of highly physically active civilians may experience increased shoulder loading due to occupational demands, fitness standards, and physical activity. These heightened upper extremity demands may increase the risk of developing shoulder impingement syndrome. Shoulder impingement is hypothesized to increase the risk of rotator cuff tears, an injury with long-term performance implications.</div></div><div><h3>Methods</h3><div>This is a nested, matched, case-control study using data from active-duty U.S. Army Soldiers from 2016 to 2021 (N=869,651). Incident rotator cuff cases were matched to 4 controls without a prior rotator cuff tear by age, sex at accession (male or female), calendar date of entry into the study, and service time. Poisson regression was used to determine incidence rates, and Cox models were used to estimate hazard ratios. This study was approved by the IRB of the U.S. Army Medical Research and Development Command.</div></div><div><h3>Results</h3><div>The incidence of shoulder impingements and rotator cuff tears was 2.24 (95% CI=2.10, 2.39) and 0.94 (95% CI=0.86, 1.03) per 1,000 person-years, respectively. Soldiers with a history of impingements had a higher hazard rate for developing a tear (hazard ratio=2.46, 95% CI=2.28, 2.66) than soldiers with no history of impingement.</div></div><div><h3>Conclusions</h3><div>Shoulder impingement syndrome is associated with an increased risk for rotator cuff tears. Across age groups, the injury risk window for a rotator cuff tear was 2–4 years and less than 1–2 years for those with a prior shoulder impingement.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 5","pages":"Article 108030"},"PeriodicalIF":4.5,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144790595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and Sociodemographic Correlates of Blunt Use During Early Pregnancy","authors":"Kelly C. Young-Wolff PhD, MPH ,&nbsp;Catherine A. Cortez MPH ,&nbsp;Alisa A. Padon PhD ,&nbsp;Judith J. Prochaska PhD ,&nbsp;Aurash J. Soroosh RD, MSPH ,&nbsp;Cynthia I. Campbell PhD, MPH ,&nbsp;Qiana L. Brown PhD, MPH, LCSW","doi":"10.1016/j.amepre.2025.108015","DOIUrl":"10.1016/j.amepre.2025.108015","url":null,"abstract":"","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 5","pages":"Article 108015"},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Accountability and Funding for State-Level School Physical Education and Recess Laws","authors":"Hannah R. Thompson PhD, MPH ,&nbsp;Ursula Lochner-Bravo MPH ,&nbsp;Jonanne Talebloo BA ,&nbsp;Jennie N. Davis PhD ,&nbsp;Jennifer Falbe ScD, MPH","doi":"10.1016/j.amepre.2025.108017","DOIUrl":"10.1016/j.amepre.2025.108017","url":null,"abstract":"<div><div>School physical education and recess provide important opportunities to increase youth physical activity and socioemotional development. However, compliance with existing laws is low at the elementary level. Reported barriers to law implementation include limited accountability and funding. However, the number of state physical education and recess laws that stipulate accountability and/or funding remains unknown. This cross-sectional review of active U.S. state-level laws related to public elementary school physical education and recess was conducted between October and December 2024. The Classification of Laws Associated with School Students and the National Association of State Boards of Education databases, along with web searches, were used to identify laws. Laws were double coded for inclusion of accountability- and funding-related language. Forty-nine U.S. states (96.1%) had physical education laws, and 22 (43.1%) had recess law; 21 (41.2%) had both. Among states with physical education law, 12 (25.5%) and 1 (2.0%) included language on accountability and funding, respectively. Among states with recess laws, 5 (22.7%) included language related to accountability, and none contained funding-related language. State-level physical education and recess legislation is highly prevalent, but most laws do not contain accountability-related language; virtually none contain funding-related language, which may be inhibiting implementation and driving inequities in related health outcomes. Additional research examining the relationship between accountability and funding language in physical education and recess laws and the degree of implementation of the laws is necessary to help inform the development of stronger laws to support the provision of quality physical education and recess in schools nationally.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 5","pages":"Article 108017"},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alcohol, Smoking, and Their Synergy as Risk Factors for Incident Type 2 Diabetes","authors":"Indira Paz-Graniel PhD ,&nbsp;Junko Kose PhD ,&nbsp;Pauline Duquenne PhD ,&nbsp;Nancy Babio PhD ,&nbsp;Jordi Salas-Salvadó PhD ,&nbsp;Serge Hercberg PhD ,&nbsp;Pilar Galan PhD ,&nbsp;Mathilde Touvier PhD ,&nbsp;Léopold K. Fezeu PhD ,&nbsp;Valentina A. Andreeva PhD","doi":"10.1016/j.amepre.2025.108011","DOIUrl":"10.1016/j.amepre.2025.108011","url":null,"abstract":"<div><h3>Introduction</h3><div>Smoking has been independently related to an increased risk of Type 2 diabetes, whereas the role of alcohol remains controversial. The joint impact of tobacco and alcohol use on Type 2 diabetes risk is understudied. This study investigated individual and combined effects of smoking and alcohol on Type 2 diabetes risk.</div></div><div><h3>Methods</h3><div>Data from 110,076 participants in the NutriNet-Santé cohort (2009–2023), who were free from Type 2 diabetes at baseline and with alcohol and smoking data, were analyzed. Multivariable Cox regression models assessed the association of alcohol consumption (&lt;2 vs ≥2 portions/day, &lt;10 vs ≥10 portions/week, grams/day of ethanol) and smoking (never versus former/current smoking) with Type 2 diabetes risk. Combined effects of heavy smoking (≥20 cigarettes/day) and heavy drinking (&gt;8 and &gt;15 portions/week for women and men, respectively) were also evaluated.</div></div><div><h3>Results</h3><div>Over 7.5 years of follow-up (820,470 person-years), 1,175 Type 2 diabetes cases were identified. Alcohol consumption, including heavy intake, was not significantly associated with Type 2 diabetes risk. People who formerly or currently smoke had a 36% higher risk of Type 2 diabetes than people who have never smoked (hazard ratio=1.36; 95% CI=1.20, 1.53). Those who smoked heavily had over twice the risk of those who smoked lightly or moderately (hazard ratio=2.10; 95% CI=1.46, 3.02). Combined exposure to smoking and heavy alcohol use did not significantly increase Type 2 diabetes risk (hazard ratio=1.11; 95% CI=0.95, 1.29).</div></div><div><h3>Conclusions</h3><div>These findings support smoking as an independent risk factor for Type 2 diabetes and show that alcohol consumption did not confer protection. The combined effect of alcohol and tobacco use on Type 2 diabetes risk and the mechanisms behind this relationship should be further explored.</div></div><div><h3>Trial registration</h3><div>This trial is registered at NCT03335644 at ClinicalTrials.gov.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 5","pages":"Article 108011"},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Breast Cancer Screening and Access to Care in a Safety-Net System","authors":"Malcolm Su MD ,&nbsp;Shifa Kanjwal MD ,&nbsp;Madeleine Hopson MD, MPH ,&nbsp;Sarah Kashanian MD ,&nbsp;Chul Ahn PhD ,&nbsp;Samira Syed MD ,&nbsp;Glenda Maria Delgado-Ramos MD ,&nbsp;Nisha Unni MD ,&nbsp;Navid Sadeghi MD","doi":"10.1016/j.amepre.2025.108014","DOIUrl":"10.1016/j.amepre.2025.108014","url":null,"abstract":"<div><h3>Introduction</h3><div>Screening mammography reduces cancer-related mortality by detecting breast cancer at earlier stages. However, variable guidelines and limited access to primary care providers hinder screening uptake. This study characterizes screening mammography uptake patterns prior to breast cancer diagnosis within a safety-net system.</div></div><div><h3>Methods</h3><div>A retrospective study was performed to identify patients diagnosed with new invasive breast cancer between 2018 and 2019 at Parkland Health. Patients were categorized on the basis of screening mammography uptake: never screened (no screening mammography within 5 years of diagnosis), ever screened (last screening mammography between 2 and 5 years prior to diagnosis), and recently screened (screening mammography within 2 years of diagnosis).</div></div><div><h3>Results</h3><div>The study identified 468 patients with newly diagnosed breast cancer, with 237 (50.6%) never-screened, 113 (24.1%) ever-screened, and 118 (25.2%) recently screened patients. Among 57 women diagnosed at age &lt;40 years, 15 (22.8%) were diagnosed with Stage IV breast cancer, and 24 (42.1%) had a primary care provider at time of diagnosis. Nodal status (<em>p</em>&lt;0.001), tumor size (<em>p</em>&lt;0.001), and stage (<em>p</em>&lt;0.001) correlated with screening mammography uptake behaviors. Patients already established with primary care providers at time of diagnosis were more likely to have early-stage disease (<em>p</em>&lt;0.001).</div></div><div><h3>Conclusions</h3><div>Half of the patients diagnosed with breast cancer did not have a mammogram within the preceding 5 years. In addition, 131 (27.9%) patients were aged between 40 and 49 years at diagnosis, reflecting the impact of a gap in prior screening guidelines, now addressed in the updated U.S. Preventive Services Task Force guidelines. Connecting patients with primary care providers and engaging in shared decision making may promote screening mammography uptake, especially in vulnerable patient populations.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 5","pages":"Article 108014"},"PeriodicalIF":4.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144769253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transformation and Development of the Wellness Industry in Resource-based Cities Driven by Healthy Lifestyles: A Case Study of Panzhihua, China","authors":"Jun Wang ,&nbsp;Juncheng Wu ,&nbsp;Wanhong Mu ,&nbsp;Lei Song","doi":"10.1016/j.amepre.2025.107933","DOIUrl":"10.1016/j.amepre.2025.107933","url":null,"abstract":"<div><h3>Background</h3><div>In recent years, alongside the continuous advancement of socioeconomic development, the global trend of industrial convergence has become increasingly prominent. The integration of the sports industry with wellness-preservation industries demonstrates significant value in enhancing market efficiency, diversifying service portfolios, and leveraging demographic aging as a strategic catalyst to propel the in-depth evolution of wellness sectors.</div></div><div><h3>Method</h3><div>Employing methodologies such as in-depth interviews and ASEB grid analysis, this study systematically examines the developmental pathways for wellness-oriented transformation in resource-based cities.</div></div><div><h3>Results</h3><div>Taking Panzhihua as a case study, the city’s wellness transformation process exemplifies how policy opportunities, institutional safeguards, and talent development can synergize to deepen industrial collaboration, technological integration, and regulatory guidance. These efforts culminate in a sports-wellness industrial model with Chinese characteristics, aligning with the national fitness strategy while driving the industry toward diversification and value-added sophistication.</div></div><div><h3>Conclusions</h3><div>The key conclusions are as follows: 1. The convergence of sports and wellness industries constitutes an innovative economic phenomenon under the \"Sports + Wellness\" paradigm. 2. Sustainable integration requires establishing a \"sports-to-wellness reciprocity mechanism.\" This involves categorizing sports-wellness resources, developing specialized markets, and constructing cross-industry platforms to achieve consumption upgrading and structural optimization. 3. Cultivating healthy lifestyles from a wellness industry perspective necessitates a dual \"hardware + culture\" model, integrating infrastructure development with cultural embeddedness.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107933"},"PeriodicalIF":4.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"AI-Driven Multimodal Preventive System for Adolescent Mental Health: A Randomized Controlled Trial","authors":"Chenxuan He,&nbsp;Zhen Li","doi":"10.1016/j.amepre.2025.107924","DOIUrl":"10.1016/j.amepre.2025.107924","url":null,"abstract":"<div><h3>Introduction</h3><div>To develop and validate a multimodal AI system for early detection and prevention of adolescent mental health disorders (e.g., anxiety, depression), targeting suicide risk reduction and emotional resilience enhancement through personalized interventions.</div></div><div><h3>Method</h3><div>A 12-month randomized controlled trial (RCT) enrolled 1,200 adolescents (aged 12–18) to evaluate an AI platform integrating neuroimaging, behavioral sensors, and natural language processing (NLP). The AI model, trained on 10,000 multimodal datasets, assessed vocal tone, facial microexpressions, and social media text to predict suicide/depression risks (accuracy=89%). Intervention modules included AI-guided cognitive behavioral therapy (CBT), mindfulness exercises, and peer support matching. Outcomes included suicidal ideation rates, emotional resilience scores, and school absenteeism.</div></div><div><h3>Results</h3><div>The AI system reduced suicidal ideation by 34% (p&lt;0.01) and improved emotional resilience by 27% (p&lt;0.001) versus controls. Longitudinal data showed sustained benefits at 6-month follow-up, with 38% lower school absenteeism (OR=0.62, 95% CI: 0.51–0.75). Key predictors of risk included vocal tremor frequency (AUC=0.85) and repetitive negative social media posts (p=0.002). Federated learning ensured data privacy compliance during interventions.</div></div><div><h3>Discussion</h3><div>This AI-powered preventive system demonstrates scalable potential for early intervention in adolescent mental health, addressing digital-age psychosocial risks. By integrating real-time risk detection with targeted behavioral support, it offers a public health framework to mitigate suicide and emotional disorders, aligning with global priorities for youth mental well-being.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107924"},"PeriodicalIF":4.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Research on the Pathways for Mental Health Maintenance and Happiness Enhancement from a Preventive Medicine Perspective","authors":"Rongmei Li","doi":"10.1016/j.amepre.2025.107928","DOIUrl":"10.1016/j.amepre.2025.107928","url":null,"abstract":"<div><h3>Introduction</h3><div>As societal pressures increase, mental health and well-being have become crucial topics in global public health. Preventive medicine aims to 'prevent illness before it occurs,' focusing not only on physical health but also increasingly on mental health. However, current academic discussions about the mechanisms and practical approaches of preventive medicine in maintaining mental health and enhancing well-being are still insufficient, and there is also a lack of interdisciplinary integration strategies.</div></div><div><h3>Method</h3><div>This study employs literature review, survey, in-depth interviews, and multidimensional mixed research methods to systematically review theoretical frameworks and empirical studies on preventive medicine, mental health, and well-being both domestically and internationally. It integrates the bio-psychosocial medical model, combines relevant case studies and data analysis, and introduces the framework of positive psychology to explore the dynamic relationships and intervention effects among the three areas.</div></div><div><h3>Results</h3><div>Preventive medicine promotes mental health. Community lifestyle interventions and mental health screenings can significantly reduce symptoms of depression and anxiety; digital tools have lowered the barriers to psychological services and increased intervention efficiency. The bidirectional relationship between mental health and happiness is evident. Positive mental states enhance happiness, which in turn further promotes healthy mental behaviors.</div></div><div><h3>Discussion</h3><div>This article systematically analyzes innovative approaches in preventive medicine for promoting mental health and enhancing well-being, proposing practical strategies that integrate environmental interventions, digital technology, and policy coordination, aiming to provide scientific basis for building an efficient mental health service system.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107928"},"PeriodicalIF":4.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regulation of Fatty Acid Metabolism Defines Distinct Molecular Subtypes in Stomach Adenocarcinoma: Implications for Tumor Microenvironment and Precision Therapeutics","authors":"Yuntong Zhang ,&nbsp;Qi Xie ,&nbsp;Youhui Wang ,&nbsp;Lin Wang","doi":"10.1016/j.amepre.2025.107873","DOIUrl":"10.1016/j.amepre.2025.107873","url":null,"abstract":"<div><h3>Introduction</h3><div>Stomach adenocarcinoma (STAD) is a major global gastrointestinal malignancy, significantly impacting morbidity and mortality rates worldwide. Advances in lipidomics and metabolomics shed light on fatty acid metabolism's role in various malignancies, including STAD. However, the specific influence of fatty acid metabolism-related genes (FAMGs) on STAD's therapeutic response remains unclear.</div></div><div><h3>Methods</h3><div>This work merged high-dimensional datasets from TCGA and GEO to assess FAMGs' predictive value in STAD. These datasets encompassed molecular variables (mRNAsi, genomic mutations, CNV, TMB), enabling the construction of a robust predictive model via Lasso regression. Co-expression network analysis delineated FAMGs' functional roles and therapeutic implications.</div></div><div><h3>Results</h3><div>FAMGs were consistently overexpressed in high-risk STAD, suggesting their potential as prognostic biomarkers. High-risk groups displayed enrichment in immunological and tumor-associated pathways. Candidate genes (APOD, FLRT2, MMRN1, CD36) surfaced as potential contributors to STAD's oncogenic basis. Immunological processes and m6a gene expression varied across risk strata, emphasizing divergent prognostic trajectories. The predictive model showed strong associations with genomic features and drug susceptibility profiles.</div></div><div><h3>Discussion</h3><div>FAMGs play a crucial role in STAD pathogenesis and clinical course. The derived FAMG signature serves as a potent prognostic tool and paves the way for targeted therapeutic research in STAD.</div></div>","PeriodicalId":50805,"journal":{"name":"American Journal of Preventive Medicine","volume":"69 2","pages":"Article 107873"},"PeriodicalIF":4.5,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144723406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}