Medium-term surgical outcomes and health-related quality of life after laparoscopic vs open colorectal cancer resection: SF-36 health survey questionnaire

BACKGROUND Previous studies that compared the postoperative health-related quality of life(HRQoL)outcomes after receiving laparoscopic resection(LR)or open resection(OR)in patients with colorectal cancer(CRC)have different conclusions.AIM To explore the medium-term effect of postoperative HRQoL in such patients.METHODS This study randomized 567 patients undergoing non-metastatic CRC surgery managed by one surgeon to the LR or OR groups.HRQoL was assessed during the preoperative period and 3,6,and 12 mo postoperative using a modified version of the 36-Item Short Form(SF-36)Health Survey questionnaire,emphasizing eight specific items.RESULTS This cohort randomly assigned 541 patients to receive LR(n=296)or OR(n=245)surgical procedures.More episodes of postoperative urinary tract infection(P<0.001),wound infection(P<0.001),and pneumonia(P=0.048)were encountered in the OR group.The results demonstrated that the LR group subjectively gained mildly better general health(P=0.045),moderately better physical activity(P=0.006),and significantly better social function recovery(P=0.0001)3 mo postoperatively.Only the aspect of social function recovery was claimed at 6 mo,with a significant advantage in the LR group(P=0.001).No clinical difference was found in HRQoL during the 12 mo.CONCLUSION Our results demonstrated that LR resulted in better outcomes,including intra-operative blood loss,surgery-related complications,course of recovery,and especially some health domains of HRQoL at least within 6 mo postoperatively.Patients should undergo LR if there is no contraindication.

Social capital and health literacy in Taiwan

The argument of this study is that social capital is a key factor of health literacy. Data came from an island-wide sample. Position generator was adopted to measure social capital. A regression model is constructed to test the social capital which is known as a robust predictor of health literacy after controlling gender, age, education, income, and health communication ability. The results reveal that female, higher education, and better health communication ability are also correlated with health literacy. Implications for public health are discussed.

Khat chewing practice and its perceived health effects among communities of Dera Woreda, Amhara region, Ethiopia

Introduction: Khat chewing is believed to be rapidly increasing worldwide. Worldwide, it is estimated that 10 million people consume khat daily. Khat chewing practice renders certain influence on physical and psychological well being of the community and it can cause more serious adverse psychiatric, cardiovascular, dental and gastrointestinal effects. The recent sharp increase in khat consumption may not only affect the health of individuals but could also have serious socio-economic consequences. This study was conducted to assess prevalence of khat chewing practice, its associated factors and perceived health effects among communities in Dera woreda, Amhara region, Ethiopia 2013. Methods: Community-based cross-sectional study was conducted by using both quantitative and qualitative method of data. The sample size for quantitative was determined by using single population proportion formula and the households were selected by systematic sampling method and in the selected household, one respondent was selected by lottery among members of household aged 15 years and above. Data were collected by means of a pretested questionnaire;analysis was carried out using SPSS version 16. For the qualitative part ten in-depth interviews were conducted on purposely selected individuals and sample size for this method was determined through continuing to interview participants until no new information was obtained. Results: The response rate was 98.3%. Current prevalence of khat chewing practice was 17%. Males were more likely to chew khat (AOR, 18.53;95%CI, 7.20-47.66) compared to females. Muslims were more likely to chew khat (AOR, 4.34;95%CI, 2.07-9.11) compared to Orthodox Christians. Respondents who had family member chewing khat were more likely to chew khat (AOR, 2.67;95%CI, 1.15-6.21) compared to family member without a chewer. Among all the respondents, 92.8% perceived the health effects of khat chewing practice. Respondents who did not perceive health effect of khat were 5 times more likely to chew khat (AOR = 5.10, 95%CI;1.64-15.5) compared to those who perceived health effect of khat. Conclusions: The prevalence of khat chewing practice was 17% with high proportion of the khat chewers found in the urban setting. Sex, religion, residence, family chewing habit and perceived health effect were significantly associated factors with khat chewing practice. In this study 92.8% of the respondents perceived that khat chewing practice had harmful effects on health and the perceived health effects reported were sleeping disorder, hallucination, tooth staining, anxiety, and loss of appetite, depression, constipation, gastritis, hypertension and psychosis.

Inhibitory effect of angiotensinⅡreceptor antagonist on hepatic stellate cell activation in non-alcoholic steatohepatitis

AIM: To investigate the efficacy of angiotensinⅡreceptor antagonist on hepatic stellate cells (HSCs) activation in the patients with non-alcoholic steatohepatitis (NASH). METHODS: Seven patients with NASH were prescribed losartan, a selective angiotensinⅡtype 1 receptor antagonist (50 mg/d) for 48 wk. Liver biopsies were performed both at the entry and end of the study in all patients. Quiescent and activated HSCs were identified by double immunostaining using anti-p75 andα-smooth muscle actin antibodies, and the number of each phenotype was counted. Similarly, the liver specimens obtained from the eight patients with non-alcoholic fatty liver (NAFL) were also examined as controls. RESULTS: In NASH hepatic tissues, activated HSCs were dominantly distributed as compared with those in NAFL. The 48-wk losartan treatment induced a remarkable decrease in activated HSCs and a mild increase in quiescent phenotypes. CONCLUSION: Our data suggest the crucial involvement of HSCs in anti-fibrotic effect of angiotensinⅡreceptor antagonist on patients with NASH.

Estrogen receptor expression in chronic hepatitis C and hepatocellular carcinoma pathogenesis

AIM To investigate gender-specific liver estrogen receptor(ER) expression in normal subjects and patients with hepatitis C virus(HCV)-related cirrhosis and hepatocellular carcinoma(HCC).METHODS Liver tissues from normal donors and patients diagnosed with HCV-related cirrhosis and HCV-related HCC were obtained from the NIH Liver Tissue and Cell Distribution System. The expression of ER subtypes, ERα and ERβ, were evaluated by Western blotting and real-time RT-PCR. The subcellular distribution of ERα and ERβ was further determined in nuclear and cytoplasmic tissue lysates along with the expression ofinflammatory [activated NF-κB and IκB-kinase(IKK)] and oncogenic(cyclin D1) markers by Western blotting and immunohistochemistry. The expression of ERα and ERβ was correlated with the expression of activated NF-κB, activated IKK and cyclin D1 by Spearman's correlation. RESULTS Both ER subtypes were expressed in normal livers but male livers showed significantly higher expression of ERα than females(P < 0.05). We observed significantly higher m RNA expression of ERα in HCV-related HCC liver tissues as compared to normals(P < 0.05) and ERβ in livers of HCV-related cirrhosis and HCV-related HCC subjects(P < 0.05). At the protein level, there was a significantly higher expression of nuclear ERα in livers of HCV-related HCC patients and nuclear ERβ in HCV-related cirrhosis patients as compared to normals(P < 0.05). Furthermore, we observed a significantly higher expression of phosphorylated NF-κB and cyclin D1 in diseased livers(P < 0.05). There was a positive correlation between the expression of nuclear ER subtypes and nuclear cyclin D1 and a negative correlation between cytoplasmic ER subtypes and cytoplasmic phosphorylated IKK in HCV-related HCC livers. These findings suggest that dysregulated expression of ER subtypes following chronic HCVinfection may contribute to the progression of HCVrelated cirrhosis to HCV-related HCC.CONCLUSION Gender differences were observed in ERα expression in normal livers. Alterations in ER subtype expression observed in diseased livers may influence genderrelated disparity in HCV-related pathogenesis.

Routine blood tests to predict liver fibrosis in chronic hepatitis C

AIM: To verify the usefulness of FibroQ for predicting fi brosis in patients with chronic hepatitis C, compared with other noninvasive tests. METHODS: This retrospective cohort study included 237 consecutive patients with chronic hepatitis C who had undergone percutaneous liver biopsy before treatment. FibroQ, aspartate aminotransferase (AST)/alanine aminotransferase ratio (AAR), AST to platelet ratioindex, cirrhosis discriminant score, age-platelet index (API), Pohl score, FIB-4 index, and Lok's model were calculated and compared. RESULTS: FibroQ, FIB-4, AAR, API and Lok's model results increased significantly as fibrosis advanced (analysis of variance test: P < 0.001). FibroQ trended to be superior in predicting signifi cant fi brosis score in chronic hepatitis C compared with other noninvasive tests. CONCLUSION: FibroQ is a simple and useful test for predicting signifi cant fi brosis in patients with chronic hepatitis C.

Estradiol agonists inhibit human Lo Vo colorectal-cancer cell proliferation and migration through p53

AIM: To investigate the effects of 17β-estradiol via estrogen receptors(ER) or direct administration of ER agonists on human colorectal cancer. METHODS: Lo Vo cells were established from the Bioresource Collection and Research Center and cultured in phenol red-free DMEM(Sigma, United States). To investigate the effects of E2 and/or ER selective agonists on cellular proliferation, Lo Vo colorectal cells were treated with E2 or ER-selective agonists for 24 h and 48 h and subjected to the MTT(Sigma) assay to find the concentration. And investigate the effects of E2 and/or ER selective agonists on cell used western immunoblotting to find out the diversification of signaling pathways. In order to observe motility and migration the wound healing assay and a transwell chamber(Neuro Probe) plate were tased. For a quantitative measure, we counted the number of migrating cells to the wound area post-wounding for 24 h. We further examined the cellular migration-regulating factors urokinase-type plasminogen activator(u-PA), tissue-type plasminogen activator(t-PA) and matrix metalloproteinase(MMP)-9 in human Lo Vo cells so gelatin zymography that we used and gelatinolytic activity was visualized by Coomassie blue staining. And these results are presented as means ± SE, and statistical comparisons were made using Student's t-test.RESULTS: The structure was first compared with E2 and ER agonists. We then treated the Lo Vo cells with E2 and ER agonists(10-8 mol/L) for 24 h and 48 h and subsequently measured the cell viability using MTT assay. Our results showed that treatment with 17β-estradiol and/or ER agonists in human Lo Vo colorectal cancer cells activated p53 and then up-regulated p21 and p27 protein levels, subsequently inhibiting the downstream target gene, cyclin D1, which regulates cell proliferation. Taken together, our findings demonstrate the anti-tumorigenesis effects of 17β-estradiol and/or ER agonists and suggest that these compounds may prove to be a potential alternative therapy in the treatment of human colorectal cancer. These results demonstrate that 17β-estradiol and/or ER agonists downregulate migration-related proteins through the p53 signaling pathway in human Lo Vo colorectal cancer cells. These findings suggest that p53 plays a critical role in the 17β-estradiol and/or ER agonist-mediated protective activity against colorectal cancer progression. In addition, 17β-estradiol and/or ER agonists dramatically inhibited cell migration and reduced the expression of u-PA, t-PA and MMP-9 as well as MMP-2/9 activity in Lo Vo cells, which regulate cell metastasis. Moreover, we observed that pretreatment with a p53 inhibitor significantly blocked the anti-migration effects of E2 and/or ER agonists on Lo Vo cells. That E2 and/or ER agonists may impair Lo Vo cell migration by modulating migration-related factors via the p53 tumor suppressor gene.CONCLUSION: Direct ER treatment may prove to be an attractive alternative therapy in the treatment of human colorectal tumors in the future.

Gadoxetic acid-enhanced magnetic resonance imaging can predict the pathologic stage of solitary hepatocellular carcinoma

BACKGROUND Although important for determining long-term outcome, pathologic stage of hepatocellular carcinoma (HCC) is difficult to predict before surgery. Current state-of-the-art magnetic resonance imaging (MRI) using gadoxetic acid provides many imaging features that could potentially be used to classify single HCC as pT1 or pT2. AIM To determine which gadoxetic acid-enhanced MRI (EOB-MRI) findings predict pathologic stage T2 in patients with solitary HCC (cT1). METHODS Pre-operative EOB-MRI findings were reviewed in a retrospective cohort of patients with solitary HCC. The following imaging features were examined: Hyperintensity in unenhanced T2-weighted images, hypointensity in unenhanced T1-weighted images, arterial enhancement, corona enhancement, washout appearance, capsular appearance, hypointensity in the tumor tissue during the hepatobiliary (HB) phase, peritumoral hypointensity in the HB phase, hypointense rim in the HB phase, intratumoral fat, hyperintensity on diffusionweighted imaging, hypointensity on apparent diffusion coefficient map, mosaic appearance, nodule-in-nodule appearance, and the margin (smooth or irregular). Surgical pathology was used as the reference method for tumor staging. Univariate and multivariate analyses were performed to identify predictors of microvascular invasion or satellite nodules. RESULTS There were 39 (34.2%;39 of 114) and 75 (65.8%;75 of 114) pathological stage T2 and T1 HCCs, respectively. Large tumor size (≥ 2.3 cm) and two MRI findings, i.e., corona enhancement [odds ratio = 2.67;95% confidence interval: 1.101-6.480] and peritumoral hypointensity in HB phase images (odds ratio = 2.203;95% confidence interval: 0.961-5.049) were associated with high risk of pT2 HCC. The positive likelihood ratio was 6.25 (95% confidence interval: 1.788-21.845), and sensitivity of EOB-MRI for detecting pT2 HCC was 86.2% when two or three of these MRI features were present. Small tumor size and hypointense rim in the HB phase were regarded as benign features. Small HCCs with hypointense rim but not associated with aggressive features were mostly pT1 lesions (specificity, 100%). CONCLUSION Imaging features on EOB-MRI could potentially be used to predict the pathologic stage of solitary HCC (cT1) as pT1 or pT2.

传染性肺结核治疗成功的影响因素

背景:传染性肺结核的治疗成功能减少结核的扩散和耐多药性的发生。目的:探索与治疗成功痰阳性肺结核有关的因素。设计:研究使用一个基于人口的回顾性队列设计,确认为居住在台湾南部,从2003年1月1日到6月30日登记的所有PTB病人已经确认身份,每个病人的医疗记录都来自治疗医院和回顾性复查了自PTB确诊后15个月的记录。结果:有399个PTB病人纳入研究。与治疗成功密切联系的因素包括肺科专家治疗(OR=1.937),直接观察下治疗(DOT)(OR=1.767),在胸科医院接受治疗(OR=5.41),年纪大的病人治疗成功可能性较低(OR=0.97)。接受肺科专家的治疗,以及那些在胸科医院治疗的病人有更高的治疗成功率(94.1%和69.9%)。结论:用直接观察督导治疗(DOT),并且由肺科专家主治的病人,尤其是在胸科医院治疗者,有更高的治疗成功率。因此,DOT、专业护理的训练和机构因此是影响结核成功治疗的重要因素。

Bayesian methods in reporting and managing Australian clinical indicators

Sustained clinical improvement is unlikely without appropriate measuring and reporting techniques. Clinical indicators are tools to help assess whether a standard of care is being met. They are used to evaluate the potential to improve the care provided by healthcare organisations(HCOs). The analysis and reporting of these indicators for the Australian Council on Healthcare Standards have used a methodology which estimates, for each of the 338 clinical indicators, the gains in the system that would result from shifting the mean proportion to the 20 th centile. The results are used to provide a relative measure to help prioritise quality improvement activity within clinical areas, rather than simply focus on "poorer performing" HCOs. The method draws attention to clinical areas exhibiting larger between-HCO variation and affecting larger numbers of patients. HCOs report data in six-month periods, resulting in estimated clinical indicator proportions which may be affected by small samples and sampling variation. Failing to address such issues would result in HCOs exhibiting extremely small and large estimated proportions and inflated estimates of the potential gains in the system. This paper describes the 20 th centile method of calculating potential gains for the healthcare system by using Bayesian hierarchical models and shrinkage estimators to correct for the effects of sampling variation, and provides an example case in Emergency Medicine as well as example expert commentary from colleges based upon the reports. The application of these Bayesian methods enables all collated data to be used, irrespective of an HCO's size, and facilitates more realistic estimates of potential system gains.

The study of technology acceptance for e-wallets application of clinic fees payment

The purpose of this study was to investigate the demand of application of e-wallet in domestic retail industry by examining the needs of adoption of small amount paying method and the reasons for customers’ using of IC stored value card in this industry and aimed at providing suggestions on the e-development of small amount paying methods for domestic retail and banking industries. This study was developed in a way that the model constructs in TAM were adapted to the context of using e-wallets for clinic fees. Scale items on the survey include those measuring perceived usefulness, perceived ease of use, a user's attitude toward using and intention. The questionnaire contains no identifying information about the individual participants. A total of 320 Taipei City Hospital patients’ feedbacks were collected. Results indicate most of the relationships in the proposed model are statistically significant and in the predicted directions. Each observed variables influence with two ways: direct effect and indirect effect, and the total effect is the sum of direct effect and indirect effect. The Main effect of most of these observed variables is direct effect, but the information technology experience with the perceived usefulness. In this study, it could be finding that the perceived usefulness, the perceiver ease of use is positively associated with users’ attitude toward using, and the perceiver ease of use is positively associated with the perceived usefulness. It means the useful and easily operation of payment clinic fees with e-wallet products (such as Taipei Easy Card) is very important for the users. Besides, the easier for e-wallet using, the more people think it is usefulness. This suggestion is the same as the point at issue of Davis [1]. The users’ attitude toward using is positively associated with the intention using.

Acute and delayed psychiatric sequelae among patients hospitalised with COVID-19:a cohort study using LIFE study data

Background Characterising the psychiatric sequelae of coronavirus disease 2019(COVID-19)can inform the development of long-term treatment strategies.However,few studies have examined these sequelae at different time points after COVID-19 infection.Aims The study aimed to investigate the incidences and risks of acute and delayed psychiatric sequelae in patients hospitalised with COVID-19 in Japan.Methods This retrospective cohort study was conducted using a database comprising healthcare claims data from public health insurance enrollees residing in a Japanese city.We analysed a primary cohort comprising patients hospitalised with COVID-19 between March 2020 and July 2021 and two control cohorts comprising patients hospitalised with influenza or other respiratory tract infections(RTI)during the same period.We calculated the incidences of acute(1–3 months after infection)and delayed(4–6 months after infection)psychiatric sequelae.These sequelae were identified using diagnosis codes and categorised as mood/anxiety/psychotic disorder,mood disorder,anxiety disorder,psychotic disorder or insomnia.Multivariable logistic regression models were used to estimate the odds ratios(ORs)of psychiatric sequelae occurrence after COVID-19 infection compared with influenza and other RTI.Results The study population with acute psychiatric sequela consisted of 662 patients with COVID-19,644 patients with influenza,and 7369 patients with RTI who could be followed for 3 months;the study population with delayed psychiatric sequelae consisted of 371 patients with COVID-19,546 patients with influenza,and 5397 patients with RTI who could be followed for 6 months.In the analysis of acute psychiatric sequelae,COVID-19 had significantly higher odds of mood/anxiety/psychotic disorder(OR:1.39,p=0.026),psychotic disorder(OR:2.13,p<0.001),and insomnia(OR:2.59,p<0.001)than influenza,and significantly higher odds of insomnia(OR:1.44,p=0.002)and significantly lower odds of anxiety disorder(OR:0.56,p<0.001)than other RTI.In the analysis of delayed psychiatric sequelae,COVID-19 had significantly higher odds of psychotic disorder(OR:2.25,p=0.007)than influenza,but significantly lower odds of anxiety disorder(OR:0.55,p=0.011)than other RTI.Conclusions COVID-19 was generally associated with an increased risk of psychiatric sequelae occurring within 3 months after infection,but had a lower risk of new psychiatric sequelae developing 4–6 months after infection.

A study of nurses’ job satisfaction: The relationship to professional commitment and friendship networks

We suggest that employees’ job satisfaction has relationship to friendship network other than professional commitment, and argue that friendship network in the same ward and across wards will have different effects on employees’ job satisfaction. A cross-sectional survey design utilizing questionnaires was selected to fulfill the research objectives. All of the 405 nurses in the En Chou Kong Hospital were surveyed. Three hundred and three nurses completed the questionnaire representing a response rate of 74.8%. The instruments included friendship network nomination, professional commitment scale, and nurses’ job satisfaction scale (NJSS). The regression model of job satisfaction was constructed, using friendship network variables in the ward and across wards and professional commitment as independent variables. R square for each model is 0.22-0.36 for the four dimensions of job satisfaction. Professional commitment is the robust predictor. The efficiency of friendship network in the ward is a good predictor, while it is negative related to satisfaction of work load. Further, the indegree in the ward is negative related to work load. Implication was discussed.

What CanWe Learn from Brazil’s Health Care System?

In the current issue of The Innovation,Zhao and colleagues published results of a trend analysis on hospital admission rates for all diseases in Brazil over the periods of 2000–2015.The authors identified that both hospital admission rates and length of hospital stay(LOS)have decreased largely since 2000.However,the decrease in disease burdens was accompanied by increasing health care costs.

Convexity Properties for a Function of Two Integer Variables

Sufficient conditions are given for any local minimum of a function of two integer variables to be a global minimum. An example is given to show that a function of two integer variables need not be discrete convex for this condition to hold.

Can Tracheostomy Improve Outcome and Lower Resource Utilization for Patients with Prolonged Mechanical Ventilation？

Background：It is not clear whether the benefits oftracheostomy remain the same in the population.This study aimed to better examine the effect of tracheostomy on clinical outcome among prolonged ventilator patients.Methods：Data were from the medical claims data in Taiwan.A total of 3880 patients with ventilator use for more than 14 days between 2005 and 2009 were identified.Among them,645 patients with tracheostomy conducted within 30 days of ventilator use were compared to 2715 patients without tracheostomy on death during hospitalization and study period,and successful weaning and medical utilization during hospitalization.Cox proportional hazards and linear regression models were used to examine the associations between tracheostomy and the main outcomes.Results：The tracheostomy rate was 30％,and 55％ of tracheostomies were performed within 30 days of mechanical ventilation.After adjustments,patients with tracheostomy were at a lower risk of death during hospitalization （hazard ratio [HR] =0.51;95％ confidence interval [CI] =0.43-0.61） and 5-year observation （HR =0.73;95％ CI =0.66-0.81）,and a lower probability of successful weaning （HR =0.88;95％ CI =0.79-0.99）.Higher medical use was also observed in patients with tracheostomy.Conclusions：The beneficial effect for tracheostomy observed in our data was the reduction of death.However,patients with tracheostomy were less likely to wean and more likely to consume medical resources.

Antiarrhythmic drug usage and prostate cancer： a population-based cohort study

Even though the relationship between antiarrhythmic drug usage and subsequent prostate cancer （PCa） risk has recently been highlighted, relevant findings in the previous literature are still inconsistent. In addition, very few studies have attempted to investigate the association between sodium channel blockers or potassium channel blockers for arrhythmia and the subsequent PCa risk. Therefore, this cohort study aimed to find the relationship between antiarrhythmic drug usage and the subsequent PCa risk using a population-based dataset. The data used in this study were derived from the Longitudinal Health Insurance Database 2005, Taiwan, China. We respectively identified 9988 sodium channel blocker users, 3663 potassium channel blocker users, 65 966 beta-blocker users, 23 366 calcium channel blockers users, and 7031 digoxin users as the study cohorts. The matched comparison cohorts （one comparison subject for each antiarrhythmic drug user） were selected from the same dataset. Each patient was tracked for a 5-year period to define those who were subsequently diagnosed with PCa. After adjusting for sociodemographic characteristics, comorbidities, and age, Cox proportional hazard regressions found that the hazard ratio （HR） of subsequent PCa for sodium channel blocker users was 1.12 （95% confidence interval [CI]： 0.84-1.50）, for potassium channel blocker users was 0.89 （95% CI. 0.59-1.34）, for beta-blocker users was 1.08 （95% Ch 0.96-1.22）, for calcium channel blocker users was 1.14 （95% Ch 0.95-1.36）, and for digoxin users was 0.89 （95% Ch 0.67-1.18）, compared to their matched nonusers. We concluded that there were no statistical associations between different types of antiarrhvthmic drug usage and subsequent PCa risk.

Comparisons of Subjective and Objective Measures of Free-Living Daily Physical Activity and Sedentary Behavior in College Students

Purpose To compare physical activity and sedentary behavior between four commonly used subjective and objective meas-ures:the 7-day Physical Activity Recall (7DPAR),International Physical Activity Questionnaire (IPAQ),pedometer,and accelerometer.Methods A total of 130 college students completed four measures for the same 7 days.Body composition was measured using a bioelectric impedance analyzer.Wilcoxon signed rank tests and Spearman correlations were performed to compare estimates between activity measures.The Spearman correlations between different activity measures were further examined separately for the higher and the lower body fat groups.Results Compared with accelerometer-derived data,both the 7DPAR and the IPAQ overestimated light physical activity(P < 0.001) while underestimated sedentary behavior (P < 0.001).Across comparisons,the highest correlation was found between accelerometers and pedometers on steps/day (r =0.72,P < 0.001).The 7DPAR and the IPAQ were correlated with each other for all physical activity variables and sedentary behavior (r =0.37-0.45).There were low correlations (r=0.20-0.47) between the 7DPAR,the IPAQ,and accelerometers in sedentary behavior,light physical activity,and vigorous physical activity.Higher correlations between different activity modalities were observed among individuals with lower body fat(r=0.41-0.80) than among those with higher body fat (r=0.31-0.65).Conclusions The 7DPAR and the IPAQ yielded comparable estimation of moderate physical activity relative to accelerom-eters.There were significant differences in sedentary time across activity measures.Body compositions should be considered when comparing the estimates of activity levels between subjective and objective instruments.