Age Bands Research Articles

The Risk of Venous Thromboembolism in Children With Inflammatory Bowel Disease.

Recent studies of children with inflammatory bowel disease (IBD) demonstrate an increased venous thromboembolism (VTE) risk. However, estimates of risk are variable and case numbers are limited. The aim of this study was to provide national estimates of the risk of VTE in children with IBD. Hospital Episode Statistics was used to identify patients diagnosed with either IBD or VTE before reaching 18 years of age between 2001 and 2019. Populations and subgroups are described, and the risks of developing VTE in the general and IBD populations were calculated. Children with VTE following a diagnosis of IBD or in the previous 6 months (n = 85) and with VTE without IBD (n = 4160) were studied. The absolute risk in children with IBD was 9.42 (95% confidence interval [CI], 7.4-11.4) per 10 000 patient-years, compared with 0.18 (95% CI, 18-0.19) in children without IBD. Between 6 months prior to and 1 year following IBD diagnosis was the highest absolute risk period for VTE (18.0; 95% CI, 13.7-22.4). The relative risk of VTE in children with IBD vs children without IBD was greatest in younger patient groups: the relative risk for the age band 0 to 8 years was 96.5 (95% CI, 51.8-179.9) and for 9 to 11 years was 153.1 (95% CI, 81.2-288.8) vs 14.3 (95% CI, 10.3-20.0) for 15 to 17 years. Cerebral venous sinus thrombosis represented 17.6% of pediatric VTE events in IBD patients compared with 4.2% in children without IBD (P = .001). This study confirms the increased risk of VTE in children with IBD compared with children without IBD. The time of greatest VTE risk was around diagnosis. Cerebral venous sinus thrombosis was significantly more common in children with IBD than other children.

Functioning profile and related impairments of children and adolescents with cerebral palsy - PartiCipa Brazil preliminary results.

Limited information is available about functioning and related impairments of children and adolescents with Cerebral Palsy (CP) in low- and middle-income countries (LMIC) like Brazil. The aim of this study is to describe the characteristics, functioning, and impairments of Brazilian children and adolescents with CP. Cross-sectional preliminary study as part of the PartiCipa Brazil multicentered cohort study. Families of children and adolescents with CP from Brazil, 4 months to 15 years, were enrolled. They responded to an online survey with questions about their child's health condition, impairments, contextual factors, and functioning according to the Gross Motor Function Classification System (GMFCS) and the Manual Ability Classification System (MACS). Data were described as frequencies, percentages, means, and standard deviations, according to age bands. Of the 404 participants (6.5±3.6 years) enrolled in this preliminary analysis, 54.7% are male, 90.4% under 12 years of age, 77.7% have bilateral CP, 49% in GMFCS levels IV and V, and 50.7% in MACS levels II and V. Most participants are from Southeast (63.4%) and Centre-west (19.5%) of Brazil. Regarding the impairments and functioning limitations: 1 in 2 did not talk; 1 in 2 has epilepsy; 2 of 5 reports pain, 1 of 4 has visual impairments, 3 out of 5 did not feed themselves, 1 out of 20 has a hearing impairment and 1 of 4 did not go to school. This first preliminar Brazilian study shows a high prevalence of children at MACS levels II and V and GMFCS levels IV and V, representing almost half of the group, indicating more impairments and limitations than children/adolescents from high-income countries. This study provides a preliminary deeper understanding of the key impairments and limitations in activities among children and adolescents with CP from various Brazilian regions.

Antibiotic prescribing in health and justice settings (HJS)-surveillance and opportunities for quality improvement

Abstract Introduction Improving surveillance of antibiotic prescribing and reducing health inequalities in antimicrobial resistance (AMR) are priorities in the new 5 year AMR national action plan (2024-2029)1. People in contact with the justice system are one of the inclusion groups in the CORE20plus5, a national NHE England approach to support reduction of health inequalities.2 Aim This project aimed to collate and analyse all antibiotic prescribing data from English prisons in order to identify opportunities for quality improvement. Method This project analysed antibiotic prescribing data from September 2022 to current date for the first time in HJS from the IT system used in all prisons in England. No ethical approval is required as surveillance is of anonymised data only. Data was broken down by age band (18 and under, 19-49, 50 and over), category of prison, region, ICB, individual prison and antibiotic type. The dashboard allows benchmarking across sites and comparison with primary care, as prisoners in HJS are considered to have similar infections to primary care patients. Results The majority of prescribing is in male prisoners, reflecting the male/female population split. The most frequently prescribed antibiotics are those used for: skin and soft tissue (including acne), respiratory tract, dental and urinary tract infections. A number of focus areas for quality improvement have been identified, including: Broad spectrum antibiotics (Cephalosporins, Co-amoxiclav and Quinolones), target of <10% total antibiotic prescribing in primary care, in HJS, currently 11%. Appropriate quinolone prescribing is a target in all settings due to recent MHRA alert3. Acne prescribing represents a significant proportion of antibiotic prescribing in HJS. Lymecycline 12%, whereas in primary care <3%. Duration of Antibiotic Courses: In primary care there is a medicines optimisation opportunity ambition to achieve 75% prescribing amoxicillin 500mg as 5 day duration. In HJS only 27% is for 5 days. When prescribing 100mg doxycycline for respiratory infections, NICE guidance recommends a 5 day course, but in HJS only 3% is prescribed as a 5 day course. For UTI in female prisons, nitrofurantoin 100mg MR is most commonly prescribed, NICE guidance for UTI in women is for 3 days; 47% in HJS are for 3 days, but 35% are 7 day courses. Discussion and Conclusion This dashboard provides insight into antibiotic prescribing data allowing opportunities for quality improvement opportunities to be identified and antimicrobial stewardship interventions to be evaluated. This work will progress to tackle the focus areas identified. Next steps are to work with antibiotic champions from HJS to co-produce intervention plans, share patient safety messages, trial available resources, rollout interventions and monitor impact via the dashboard. Limitations Indications are not available from the data but extrapolated from the antibiotic prescribed. The dashboard is currently an excel spreadsheet in NHSE. It will be moved to a platform that enables access by individual prisons.

The role of age and sex in non-linear dilution adjustment of spot urine arsenic

BackgroundPrevious research introduced V-PFCRC as an effective spot urinary dilution adjustment method for various metal analytes, including the major environmental toxin arsenic. V-PFCRC normalizes analytes to 1 g/L creatinine (CRN) by adopting more advanced power-functional corrective equations accounting for variation in exposure level. This study expands on previous work by examining the impacts of age and sex on corrective functions.MethodsLiterature review of the effects of sex and age on urinary dilution and the excretion of CRN and arsenic. Data analysis included a Data Set 1 of 5,752 urine samples and a partly overlapping Data Set 2 of 1,154 combined EDTA blood and urine samples. Both sets were classified into age bands, and the means, medians, and interquartile ranges for CRN and TWuAs in uncorrected (UC), conventionally CRN-corrected (CCRC), simple power-functional (S-PFCRC), sex-aggregated (V-PFCRC SA), and sex-differentiated V-PFCRC SD modes were compared. Correlation analyses assessed residual relationships between CRN, TWuAs, and age. V-PFCRC functions were compared across three numerically similar age groups and both sexes. The efficacy of systemic dilution adjustment error compensation was evaluated through power-functional regression analysis of residual CRN and the association between arsenic in blood and all tested urinary result modes.ResultsSignificant sex differences in UC and blood were neutralized by CCRC and reduced by V-PFCRC. Age showed a positive association with blood arsenic and TWuAs in all result modes, indicating factual increments in exposure. Sex-differentiated V-PFCRC best matched the sex-age kinetics of blood arsenic. V-PFCRC formulas varied by sex and age and appeared to reflect urinary osmolality sex-age-kinetics reported in previous research.V-PFCRC minimized residual biases of CRN on TWuAs across all age groups and sexes, demonstrating improved standardization efficacy compared to UC and CCRC arsenic.InterpretationSex differences in UC and CCRC arsenic are primarily attributable to urinary dilution and are effectively compensated by V-PFCRC. While the sex and age influence on V-PFCRC formulas align with sex- and age-specific urinary osmolality and assumed baseline vasopressor activities, their impact on correction validity for entire collectives is minimal.ConclusionThe V-PFCRC method offers a robust correction for urinary arsenic dilution, significantly reducing systemic dilution adjustment errors. Its application in various demographic contexts enhances the accuracy of urinary biomarker assessments, benefiting clinical and epidemiological research. V-PFCRC effectively compensates for sex differences in urinary arsenic. Age-related increases in TWuAs are exposure-related and should be additionally accounted for by algebraic normalization, covariate models, or standard range adjustments.

Differences in foot morphology across age groups for women active in sport.

Foot morphology in the general population has been shown to change with age and active older adults have reported a need for wide-fitting footwear. This study recruited 374 women active in racket sports and team sports in the United Kingdom who had their feet scanned while 50% weight bearing. Participants were grouped into 10-year age bands ranging from 18-29 years to 70-79 years. Data analysis was performed on the widths, heights and circumferences of participants' right feet normalised to foot length, as well as an assessment of hallux valgus angle and deformity. The 18-29-year group had significantly smaller in measures of foot width, ball of foot circumference and short heel circumference (p<0.05, η2 =0.042- η2 =0.056) compared to the older groups. The foot dorsum height and circumference at 50% foot length were significantly less in the oldest age groups compared to the middle age groups (p= 0.0001, η2 = 0.055 and p= 0.0007, η2 = 0.044 respectively). There was some evidence of increased hallux valgus deformity with age. Designers and manufacturers of athletic footwear should be aware of the changes in footwear morphology with age in order to provide more inclusive footwear.

Women's environmental quality of life is key to their overall quality of life and health: Global evidence from the WHOQOL-100.

Gender inequalities in health-related quality of life (QoL) are generally few and small, even in large surveys. Many generic measures limit assessment to QoL overall and its physical and psychological dimensions, while overlooking internationally important environmental, social, and spiritual QoL domains. Unique cross-cultural legacy data was collected using four WHOQOL-100 surveys of adults living in 43 cultures world-wide (17,608 adults; ages 15-101). It was first used to examined gender profiles of its five QoL international domains, and their component facets. Few significant gender differences (p < .001) were found. Women reported higher spiritual QoL than men on faith, and spiritual connection facets specifically. Men reported higher physical and psychological QoL domains than women. We aimed to identify those QoL dimensions that contribute to women's overall QoL in health, as this information could inform gender inequalities interventions in health. Environmental QoL explained a substantial 46% of women's overall QoL and health (n = 5,017; 17 cultures) (stepwise multiple regression adjusted for age, education, and marital status covariates). Five environmental QoL facets contributed significantly to this result; home environment offered most explanation. Age band analysis was conducted to understand when interventions might be best timed in the lifespan to improve women's QoL. Younger women (< 45 years) reported the poorest QoL across the lifetime, and on every domain. After 45, all domains except physical QoL increased to very good at about 60, and high levels were sustained beyond 75, especially environmental QoL. Global findings show that assessing environmental, social, and spiritual QoL domains are key to fully understanding women's QoL and health. These assessments should be prioritized in surveys that aim to improve international conservation, and public health policies.

Characteristics of inpatient and outpatient respiratory syncytial virus mortality in Gavi-eligible countries

The current understanding of the RSV-related mortality age distribution in low- and lower-middle-income countries (LMICs) relies on a limited number of disease incidence studies reporting wide age bands, and lacking specificity to Gavi-eligible countries. Understanding the age distribution of RSV-related deaths is crucial for the implementation of RSV interventions in LMICs that rely on support from Gavi. This study aims to provide the age profile of RSV mortality specifically in Gavi-eligible countries.Utilizing data from the RSV GOLD project, an ongoing global online mortality registry focusing on children under the age of 5 with laboratory-confirmed RSV infection, we employed two models (Complete Data Model and Prospective Data Model) to estimate the age profiles. To mitigate biases related to age group representation, we applied post-stratification weighting in our analysis.We included 423 pediatric deaths, including 145 from the community, under 2 years of age from 15 Gavi-eligible countries. Both models identified a peak age at 1 month and found that the majority of RSV-related mortality cases (59–77 %) from Gavi-eligible countries occur before 6 months of life. However, the models exhibited disparities in other age-related metrics. We present fitted age-at-time-of-death probability distributions to aid impact and cost-effectiveness studies.We expect that implementing infant RSV immunization strategies, such as maternal vaccination or infant immunoprophylaxis, will have high impact on RSV-related mortality in Gavi-eligible countries. The divergent results from the two models underscore the importance of carefully considering potential biases in retrospective and surveillance data when interpreting the age profile of RSV mortality cases in future research.

Are physical activity and everyday mobility independently associated with quality of life at older age?

BackgroundPhysical activity and everyday mobility are concepts that overlap but tend to be located in different disciplinary fields. We used the English Longitudinal Study of Ageing (ELSA) to: identify whether physical activity and everyday mobility are separate constructs at younger (60–69) and/or older (>=70) age bands, and for men and women; derive measures of the two constructs from variables in the ELSA; and assess whether they are independently associated with quality of life (QoL). MethodsWe derived composite measures for physical activity and everyday mobility from ELSA variables. ‘Physical Activity’ combined items recording directly-measured activity for movement (walk-speed) and self-report measures of physical mobility difficulties and amount of vigorous, moderate and mild physical activity undertaken. ‘Everyday Mobility’ combined self-report responses about activities likely to involve leaving the house. QoL was measured using the ‘CASP-19′ scale. Using Wave 9 of ELSA (data collection in 2018–2020), we used a factor analysis to explore the constructs, and a regression analysis to examine associations with QoL. ResultsThe factor analysis confirmed that these were discrete constructs, which explained between them 36% of the variance. This was robust across age bands, and in factor analyses for men and women separately. The regression analysis identified that lower physical activity and everyday mobility are independently associated with lower QoL, when controlling for a range of contextual variables including age. ConclusionsFindings suggest that a social model of QoL at older age should focus on the broader mobility determinants of QoL as well as individual levels of physical activity.

Promoting emotion understanding in middle childhood: A systematic review of school-based SEL programs

Emotion understanding (EU) describes the ability to identify, interpret, and communicate about emotions, and is often targeted by social-emotional learning (SEL) programs. Still, the theoretical framing of SEL programs and their impact on specific areas of social-emotional development, such as EU, for different age bands is not always transparent. This systematic review synthesized emotion-focused content in SEL programs used in quantitative outcome studies in middle childhood to identify which EU components are targeted and examine content congruence with an integrated EU development model drawing on the Pons EU developmental model and the Crick and Dodge social-information processing (SIP) model that posits emotion identification as fundamental to social decision-making in childhood. A total of 38 programs for Grades 3 to 5 across 54 studies in 20 countries were reviewed. Program aims, lesson topics, and activities were extracted and mapped to a 10-component EU framework integrating the nine Pons model components (‘recognition, external cause, reminder, desire, belief, hiding, regulation, mixed, morality’) with one based on the SIP model (‘decision/action’). At least 87% of emotion-focused SEL content targeted EU components of recognition, regulation, and social decision-making. Findings indicate a good level of congruence between emotion-focused SEL program content and prevailing EU development models. Many programs emphasized the external causes of emotions, underscoring the importance of scenarios to explain emotions—discussed further in light of cross-cultural variation in emotion socialization. We encourage SEL intervention research to be more transparent in reporting SEL program content and activities to move toward causal explanations of program impact.

Patients' Expectations of Doctors' Clinical Competencies in the Digital Health Care Era: Qualitative Semistructured Interview Study Among Patients.

Digital technologies have impacted health care delivery globally, and are increasingly being deployed in clinical practice. However, there is limited research on patients' expectations of doctors' clinical competencies when using digital health care technologies (DHTs) in medical care. Understanding these expectations can reveal competency gaps, enhance patient confidence, and contribute to digital innovation initiatives. This study explores patients' perceptions of doctors' use of DHTs in clinical care. Using Singapore as a case study, it examines patients' expectations regarding doctors' communication, diagnosis, and treatment skills when using telemedicine, health apps, wearable devices, electronic health records, and artificial intelligence. Findings were drawn from individual semistructured interviews with patients from outpatient clinics. Participants were recruited using purposive sampling. Data were analyzed qualitatively using thematic analysis. Twenty-five participants from different backgrounds and with various chronic conditions participated in the study. They expected doctors to be adept in handling medical data from apps and wearable devices. For telemedicine, participants expected a level of assessment of their medical conditions akin to in-person consultations. In addition, they valued doctors recognizing when a physical examination was necessary. Interestingly, eye contact was appreciated but deemed nonessential by participants across all age bands when electronic health records were used, as they valued the doctor's efficiency more than eye contact. Nonetheless, participants emphasized the need for empathy throughout the clinical encounter regardless of DHT use. Furthermore, younger participants had a greater expectation for DHT use among doctors compared to older ones, who preferred DHTs as a complement rather than a replacement for clinical skills. The former expected doctors to be knowledgeable about the algorithms, principles, and purposes of DHTs such as artificial intelligence technologies to better assist them in diagnosis and treatment. By identifying patients' expectations of doctors amid increasing health care digitalization, this study highlights that while basic clinical skills remain crucial in the digital age, the role of clinicians needs to evolve with the introduction of DHTs. It has also provided insights into how DHTs can be integrated effectively into clinical settings, aligning with patients' expectations and preferences. Overall, the findings offer a framework for high-income countries to harness DHTs in enhancing health care delivery in the digital era.

Age disparity in couples and the sexual and general health of the male partner.

Several robust epidemiological studies suggest that men are often engaged in sexual relationships with younger women with a variable, age-dependent age difference. However, the ageing process determines a significant worsening of the andrological status, which favors the onset of erectile dysfunction and hypogonadism. To analyze the effects of differences in age between the partners [delta (Δ) age (M - F)] on patients referring to the Andrology Unit of Careggi University Hospital for male sexual dysfunction. A monocentre cohort of 4055 male subjects was evaluated by SIEDY structured interview. The cross-sectional analysis assessed the psychobiological and relational correlates. The rate of forthcoming major cardiovascular events (MACE) was investigated in the longitudinal analysis. All the models have been adjusted for age, education, lifestyle, and chronic disease score. ∆ age (M-F) shows a stepwise increase, according to the increasing age bands of the male partner. ∆ age (M-F) was associated with a greater number of children, at the cost of more conflictual relationships within the family. The phenotype of these relationships is characterized by the report of a partner with a higher sexual desire and a higher ability to reach climax. Men seeking a younger partner show more often a histrionic personality (p=0.023) and higher testosterone levels (p=0.032). However, having a younger partner doesn't improve the ability to obtain a full erection. Kaplan-Maier analysis of a longitudinal subgroup of patients followed longitudinally (N=1402) for 4.3±2,59 years, showed that patients in the fourth quartile had a higher rate of forthcoming MACE versus those in the first quartile (p=0.005). In subjects with sexual dysfunctions (as in the general population) age-different relationships increase as a function of male ageing. A greater Δ age (M-F) is associated with specific men and relationship features and a higher risk of MACE.

Exploring ethnicity dynamics in Wales: a longitudinal population-scale linked data study and development of a harmonised ethnicity spine

ObjectiveThis study aims to create a national ethnicity spine based on all available ethnicity records in linkable anonymised electronic health record and administrative data sources.DesignA longitudinal study using anonymised individual-level...

Stratified epidemic model using a latent marked Hawkes process

We extend the unstructured homogeneously mixing epidemic model introduced by Lamprinakou et al. (2023) to a finite population stratified by age bands. We model the actual unobserved infections using a latent marked Hawkes process and the reported aggregated infections as random quantities driven by the underlying Hawkes process. We apply a Kernel Density Particle Filter (KDPF) to infer the marked counting process, the instantaneous reproduction number for each age group and forecast the epidemic’s trajectory in the near future. Taking into account the individual inhomogeneity in age does not increase significantly the computational cost of the proposed inference algorithm compared to the cost of the proposed algorithm for the homogeneously unstructured epidemic model. We demonstrate that considering the individual heterogeneity in age, we can derive the instantaneous reproduction numbers per age group that provide a real-time measurement of interventions and behavioural changes of the associated groups. We illustrate the performance of the proposed inference algorithm on synthetic data sets and COVID-19-reported cases in various local authorities in the UK, and benchmark our model to the unstructured homogeneously mixing epidemic model. Our paper is a “demonstration” of a methodology that might be applied to factors other than age for stratification.

3D U-Net Neural Network Architecture-Assisted LDCT to Acquire Vertebral Morphology Parameters: A Vertebral Morphology Comprehensive Analysis in a Chinese Population.

To evaluate the feasibility of acquiring vertebral height from chest low-dose computed tomography (LDCT) images using an artificial intelligence (AI) system based on 3D U-Net vertebral segmentation technology and the correlation and features of vertebral morphology with sex and age of the Chinese population. Patients who underwent chest LDCT between September 2020 and April 2023 were enrolled. The Altman and Pearson's correlation analyses were used to compare the correlation and consistency between the AI software and manual measurement of vertebral height. The anterior height (Ha), middle height (Hm), posterior height (Hp), and vertebral height ratios (VHRs) (Ha/Hp and Hm/Hp) were measured from T1 to L2 using an AI system. The VHR is the ratio of Ha to Hp or the ratio of Hm to Hp of the vertebrae, which can reflect the shape of the anterior wedge and biconcave vertebrae. Changes in these parameters, particularly the VHR, were analysed at different vertebral levels in different age and sex groups. The results of the AI methods were highly consistent and correlated with manual measurements. The Pearson's correlation coefficients were 0.855, 0.919, and 0.846, respectively. The trend of VHRs showed troughs at T7 and T11 and a peak at T9; however, Hm/Hp showed slight fluctuations. Regarding the VHR, significant sex differences were found at L1 and L2 in all age bands. This innovative study focuses on vertebral morphology for opportunistic analysis in the mainland Chinese population and the distribution tendency of vertebral morphology with ageing using a chest LDCT aided by an AI system based on 3D U-Net vertebral segmentation technology. The AI system demonstrates the potential to automatically perform opportunistic vertebral morphology analyses using LDCT scans obtained during lung cancer screening. We advocate the use of age-, sex-, and vertebral level-specific criteria for the morphometric evaluation of vertebral osteoporotic fractures for a more accurate diagnosis of vertebral fractures and spinal pathologies.

P-143 Comparison of clinical outcomes between overnight warmed and embryo transfer day warmed blastocysts in frozen embryo transfer cycles

Abstract Study question Is there any difference between clinical outcomes of overnight warmed (ONW) and embryo transfer day warmed (ETDW) blastocysts in frozen embryo transfer (FET) cycles? Summary answer ETDW blastocysts had better clinical outcomes compared to ONW blastocysts in FET cycles. What is known already Some studies reported that the resumption of mitosis in thawed cleavage-stage embryos resulted in significantly better clinical outcomes in FET cycles. Unnecessary transfer of non-functioning embryos can be avoided by incubating thawed embryos overnight to deselect embryos that developed abnormally or failed to undergo additional cleavage. The synchronisation between a viable embryo and a receptive endometrium is vital for successful implantation to take place. The optimal implantation rates occur with embryo-endometrial developmental asynchrony of ± 1.5 days or less. The implantation rates are progressively reduced when embryo-endometrial development asynchrony is greater than 3 days. Study design, size, duration This was a retrospective study involving 2368 FET cycles in KKIVF Centre, KK Women’s and Children’s Hospital, Singapore from Jan 2021 to Dec 2022. The transfer of embryos or blastocysts derived from thawed oocytes, cleavage-stage embryos, double blastocysts and cultured blastocysts from thawed cleavage-stage embryos were excluded. Only single vitrified-warmed blastocyst transfers (n = 1445) were included in this study. Participants/materials, setting, methods Cryopreserved blastocysts were routinely warmed one day before embryo transfer (ET) using Vit Kit - Warm (FUJIFILM Irvine Scientific®) and incubated overnight (ONW group). However, when ETs fell on Monday or post public holiday, vitrified blastocysts were warmed on ET day (ETDW group). Regardless of blastocyst age, surviving blastocysts were transferred into day 5 endometrium. Statistical analysis was performed using t-test or Chi-square test. Differences with P &amp;lt; 0.05 were considered as significant. Main results and the role of chance No statistical significant difference was observed in terms of maternal age distribution at the time of oocyte retrieval between ONW and ETDW groups (34.26 ± 3.29 vs. 34.49 ± 3.22, P = 0.221). Overall, clinical pregnancy rates (CPR) and live birth rates (LBR) were significantly higher in the ETDW group (CPR: 47.47% vs. 40.47%, P &amp;lt; 0.01; LBR: 34.99% vs. 28.78%, P &amp;lt; 0.05). Clinical outcomes were comparable in both ONW and ETDW groups for vitrified-warmed day 5 blastocyst transfers (CPR: 51.27% vs. 58.44%, P = 0.11; LBR: 37.06% vs. 44.81%, P = 0.07). CPR (45.02% vs. 25.71%, P &amp;lt; 0.0001) and LBR (32.03% vs. 17.45%, P &amp;lt; 0.0001) were significantly increased when vitrified day 6 blastocysts were warmed and transferred on the actual day of ET. 18.42% CPR and 13.16% LBR were achieved when vitrified-warmed day 7 blastocysts were transferred on the ET day itself. However, transfer of vitrified-warmed day 7 blastocysts in the ONW group did not result in any pregnancy. Limitations, reasons for caution Study subjects were not stratified according to patient’s age band and blastocyst quality. Age itself is an independent determinant of blastocyst quality which can affect clinical outcomes. Wider implications of the findings Warming of a vitrified blastocyst on ET day is preferred regardless of blastocyst age. However, to facilitate seamless operation in laboratory, overnight warming for vitrified day 5 blastocysts is feasible without compromising clinical outcomes. Trial registration number Not applicable

Breast cancer stage and molecular subtype distribution: real-world insights from a regional oncological center in Hungary

ObjectiveExamining the distribution of breast cancer (BC) stage and molecular subtype among women aged below (< 45 years), within (45–65 years), and above (> 65 years) the recommended screening age range helps to understand the screening program's characteristics and contributes to enhancing the effectiveness of BC screening programs.MethodsIn this retrospective study, female patients with newly diagnosed BC from 2010 to 2020 were identified. The distribution of cases in terms of TNM stages, severity classes, and subtypes was analysed according to age groups.ResultsA total of 3282 women diagnosed with BC were included in the analysis. Among these cases 51.4% were detected outside the screening age group, and these were characterized by a higher TNM stage compared to those diagnosed within the screening age band. We observed significantly higher relative frequency of advanced BC in the older age group compared to both the screening age population and women younger than 45 years (14.9% vs. 8.7% and 7.7%, P < 0.001). HR−/HER2− and HER+ tumours were relatively more frequent among women under age 45 years (HR−/HER2−: 23.6%, HER2+: 20.5%) compared to those within the screening age range (HR−/HER2−: 13.4%, HER2+: 13.9%) and the older age group (HR−/HER2−: 10.4%, HER2+: 11.5%).ConclusionsThe findings of our study shed light on potential areas for the improvement of BC screening programs (e.g., extending screening age group, adjusting screening frequency based on molecular subtype risk status) in Hungary and internationally, as well.

Age-stratified norms for Raven’s standard progressive matrices for Sri Lankan adults

Objective The aim of this study was to create age-stratified norms for the Raven’s Standard Progressive Matrices (SPM) for Sri Lankan adults. Methods A sample of 610 adults (age: 18–72 years; education: 1–19 years), underwent the 60-item version of the SPM under individual supervision of a test administrator. The sample was stratified into 5-year age bands, and the norms are presented as percentile tables and percentile curves. Results The age-related changes were more accurately predicted by a curvilinear model (overall R 2 = 0.961) than a linear regression model (R 2 = 0.639). The SPM norms are presented as age-stratified percentile tables, as well as sex-, age- and education-adjusted multiple regression equations. The highest percentiles in the younger end of the age spectrum showed a ceiling effect. In the context of age-stratified US (1993) and British (1992) norms, older individuals in the Sri Lankan sample scored much lower than their Western counterparts. However, the difference narrowed in the younger age bands, showing no difference among the 18-to-22-year age bands in the three countries. Conclusions This age-by-country interaction can be partly explained by poorer education in the older individuals in the present sample compared to those in the US and UK standardization samples. SPM norms presented in this paper fill a hiatus in assessment of general intellectual ability in Sri Lankan adults. Given that Sri Lanka improves its educational, socioeconomic and health standards faster than the nations who have already reached higher standards, these norms would require re-standardization in the coming decades.

Computerized Rotational Head Impulse Test: Age-Dependent Normative Data.

The objective of this study was to determine the normative vestibulo-ocular reflex gain output values of the computerized rotational head impulse test (crHIT) with stationary visual targets (earth bound) in healthy participants in each decade age band of life: 10-19, 20-29, 30-39, 40-49, 50-59, 60-69, and 70+ years. Seventy-seven community-dwelling participants (10-85 years of age) with normal lateral semicircular canal (SCC) functioning and no symptoms or history of vestibular dysfunction were recruited through convenience sampling and assessed with the crHIT using stationary targets. These participants were assessed using two standard protocols in a randomized order. Results from 77 participants (M age = 46 years; 43 women, 34 men) were analyzed. Pearson's correlation coefficient and simple linear regression indicated a statistically significant relationship between crHIT gain output and age (p > .05) for right gain, 1030°/s2, and left gain, 1005°/s2. Although a statistically significant relationship was found, the slope was minor, demonstrating that the clinical effect of age on crHIT gain output was insignificant. Furthermore, no statistically significant relationship exists between crHIT gain output and gender (p > .05). Age-dependent normative data were calculated using the 2.5th and 97.5th confidence interval (CI) percentile method. The responses of angular vestibulo-ocular reflex (aVOR) gain values for crHIT are expected to occur within the range for lower limit reference interval (RI) of 0.85-0.9 and upper limit RI of 1.11-1.18 for 1030°/s2 and lower limit RI of 0.86-0.92 and upper limit RI of 1.13-1.16 for 1005°/s2. It can be expected that 90% CI of the population with normal lateral SCC functioning will have aVOR gain values that fall within this range. Despite a statistically significant relationship that exists with aVOR gain output and age, the changes are minor, declining by 0.0088 units per 10 years, justifying the same normative data for all decade age bands.

Work and Retirement Among Women: The Health and Employment After Fifty Study.

Women increasingly work beyond age 50+ but their occupational health is under-researched. To investigate what jobs older contemporary women do, when they exit their jobs and what factors predict job exit. Data came from the Health and Employment After Fifty cohort, which recruited women aged 50-64 at baseline in 2013-14 and has followed them up annually collecting: demographic, lifestyle and work information. Exits from employment were mapped longitudinally over five follow-ups. Time-to-first event Cox regression analyses were used to identify risk factors for job exit. At baseline, 4436 women participated, 64% of whom were working. The proportions of women working at 50-54, 55-60 and over 60 years were 86%, 79% and 38%, respectively. Amongst all women, after adjustment for age, managing comfortably financially and not coping with the mental demands of the job were associated with exit. Risk factors for job exit differed in the age bands: 50-54; 55-59 and >60 years, reflecting socio-economic status, markers of health (musculoskeletal pain and poor self-rated health) and work factors (under-appreciation, job dissatisfaction, temporary/permanent contracts, coping with work's physical demands). Factors contributing to exit from work among older women differ by age group, after controlling for perceived financial position, age and mental demands of the job. A number of work characteristics predict job exit and suggest that employers can play an important role in supporting women to continue working until older ages. Identification and treatment of musculoskeletal pain could also enable work amongst older women.

The lived experience of hearing loss – an individualised responsibility

Objective This study aimed to provide a conceptual model to understand what typifies the lived experience of hearing loss. Design A grounded theory informed study of adults with hearing loss (n = 46) who participated in individual interviews. The data were analysed in line with the constant comparative approach of grounded theory. A substantial patient and public engagement (PPIE) strategy underpinned decisions and processes throughout. Study sample Adults were recruited from age bands (16–29; 30–49;50–79 and 80 upwards) to provide different lived experience. We recruited individuals from across the UK including urban, sub-urban and rural communities and included a typical constituency of each location including black and minority ethnic participants. Our PPIE groups included adults often marginalised in research including South Asian community groups, adults in residential care and those with additional disabilities. Results We identified the consistent features of the lived experience with hearing loss, as the individualised responsibility that hearing loss confers. These are an individual auditory lifeworld; social comparison and social support; individual and patient-centred care and individual agency and capability. Conclusions This work provides new insights for those practising audiology and highlights the importance of building social support systems through implementation of family and peer support approaches.