Age Categories Research Articles

Post-marketing safety concerns with rimegepant based on a pharmacovigilance study

PurposeThis study aimed to comprehensively assess the safety of rimegepant administration in real-world clinical settings.MethodsData from the Food and Drug Administration Adverse Event Reporting System (FAERS) spanning the second quarter of 2020 through the first quarter of 2023 were retrospectively analyzed in this pharmacovigilance investigation. This study focuses on employing subgroup analysis to monitor rimegepant drug safety. Descriptive analysis was employed to examine clinical characteristics and concomitant medication of adverse event reports associated with rimegepant, including report season, reporter country, sex, age, weight, dose, and frequency, onset time, et al. Correlation analysis, including techniques such as violin plots, was utilized to explore relationships between clinical characteristics in greater detail. Additionally, four disproportionality analysis methods were applied to assess adverse event signals associated with rimegepant.ResultsA total of 5,416,969 adverse event reports extracted from the FAERS database, 10, 194 adverse events were identified as the “primary suspect” (PS) drug attributed to rimegepant. Rimegepant-associated adverse events involved 27 System Organ Classes (SOCs), and the significant SOC meeting all four detection criteria was “general disorders and administration site conditions” (SOC: 10018065). Additionally, new significant adverse events were discovered, including “vomiting projectile” (PT: 10047708), “eructation” (PT: 10015137), “motion sickness” (PT: 10027990), “feeling drunk” (PT: 10016330), “reaction to food additive” (PT: 10037977), etc. Descriptive analysis indicated that the majority of reporters were consumers (88.1%), with most reports involving female patients. Significant differences were observed between female and male patients across age categories, and the concomitant use of rimegepant with other medications was complex.ConclusionThis study has preliminarily identified potential new adverse events associated with rimegepant, such as those involving the gastrointestinal system, nervous system, and immune system, which warrant further research to determine their exact mechanisms and risk factors. Additionally, significant differences in rimegepant-related adverse events were observed across different age groups and sexes, and the complexity of concomitant medication use should be given special attention in clinical practice.

STRESS TOLERANCE OF PEOPLE OF DIFFERENT AGES IN THE CONTEXT OF THEIR FINANCIAL LITERACY

The work is devoted to the analysis of the concept of “stress tolerance” in the context of personal financial literacy. An important aspect of this research is the study of age-related characteristics of people’s exposure to stress, hardiness, and constructive coping behaviour in situations of financial uncertainty. The results of the empirical study are presented and conclusions are drawn regarding the relationship between the level of financial literacy and stress tolerance of representatives of different age groups. The data presented in the article can form a basis for further research in this direction and substantiate the importance of developing financial literacy among people of different age categories.

Relative Age Effect and ACTN3 R577X and ACE I/D Polymorphisms in Brazilian Football Players: An Association Genetic Study

ABSTRACT The Relative Age Effect (RAE) suggests older athletes within an annual cohort have advantages over their younger peers. We hypothesized that younger athletes could overcome these disadvantages through favorable α-actinin-3 (ACTN3) and angiotensin converting enzyme (ACE) polymorphisms. This study aimed to: 1) examine RAE prevalence among Brazilian football players; 2) investigate the distribution of the ACTN3 and ACE polymorphisms; and 3) explore the association between polymorphisms and RAE across competitive levels and positions. The sample included 627 male players from first-division Brazilian teams in four age categories: U15 (n = 172), U17 (n = 166), U20 (n = 161), and Professionals (n = 128). A control group was established using data from the general Brazilian population documented in previous studies Results showed RAE presence across all competitive levels and positions. Players with the ACTN3 R allele, especially the RR genotype, had the strongest associations with football players, particularly among defenders. On the other hand, the distribution of ACE polymorphism was not significantly different between controls and players, except in the U17 category, where the I/I genotype was more common. Relatively older players had higher total genotype scores than younger counterparts in the overall sample and defender subgroups. In conclusion, RAE is prevalent among Brazilian football players, with older athletes benefiting from favorable ACTN3 and ACE polymorphisms, contrary to our initial hypothesis.

12395 Continuous Glucose Monitoring In Pseudohypoparathyroidism Type 1a

Abstract Disclosure: J. Tamaroff: None. A.E. Lee: None. A.H. Shoemaker: None. Background: Pseudohypoparathyroidism type 1A (PHP1A), due to heterozygous mutations in GNAS, is a rare disorder that leads to multi-hormone resistance, cognitive impairment, and early-onset obesity. Individuals with PHP1A have dysglycemia on oral glucose tolerance tests and increased rates of type 2 diabetes (T2DM). Individuals with rare diseases, like PHP1A, may travel significant distances for specialized clinical or research care. Wearable technology may alleviate barriers and provide useful information for clinical care or for use as potential biomarkers. The objective of this study is to evaluate glycemia in individuals with PHP1A and feasibility of utilizing continuous glucose monitors (CGMs) in this population. Methods: Observational study of individuals with PHP1A (3R01DK118407-03S1). CGMs (Dexcom Pro, Dexcom Inc, San Diego, CA) were placed on participants’ abdomens, typically by a family member, over secure-video call with study staff. CGMs collected data every 5 minutes for up to 10 days. Results: Seven participants (all female) with PHP1A without a diagnosis of diabetes had available data. Median age was 17 years (IQR: 14, 19; range: 8-23). Body mass index (BMI) categories (by percent of the 95th percentile for those under 18 years and BMI for adults) spanned from overweight to class 3 obesity. In terms of feasibility, 1 individual had to replace a CGM sensor due to an upcoming MRI and 1 individual had a “sensor failure” of unclear etiology. Both were able to place new CGMs. Individuals participated across 5 states in the United States. Median length of wear was 9.8 days (IQR 8.6, 9.9). Participants had a median average glucose of 104mg/dL (IQR 102, 111) and COV of 16% (15, 21). Percent of glucose > 140mg/dL was 5.0% (IQR: 1.8, 10.9; range:1.2-19.4%). One individual had 3.2% of glucose values ≥ 200mg/dL despite a normal hemoglobin A1c (HbA1c) level (5.5%). This level of hyperglycemia is qualitatively higher than published CGM data in healthy individuals. One study found individuals (6-24 years of age) had median percent of glucose values over 140mg/dL ranging from 1.2 to 2.4% with IQR values ranging from 0.3 to 4.4%, based on age categories.1Conclusions: In females with PHP1A, with overweight or obesity, CGM placement at home is a feasible way to collect real-world data. Participants with rare diseases often must travel for clinical and research care and CGMs may provide insight into glycemia without requiring an in-person visit. This “real-world” data mirrors research data reporting glycemia with normal HbA1c levels. The rate of hyperglycemia is higher than expected in some individuals with PHP1A though more data is needed. Ongoing studies will evaluate matched control participants and assess drivers of glycemia including inactivity and decreased sleep duration, as measured by actigraphy.

Reference equations for pulse wave velocity, augmentation index, amplitude of forward and backward wave in a European general adult population

Pulsatile hemodynamics have been shown to be independent predictors of cardiovascular events. The aim of the current study was to describe four pulsatile hemodynamic markers in a large, well-established, population-based cohort and to provide reference equations for sex- and age-based standardization of these measurements. 6828 adult participants from the Austrian LEAD (Lung, hEart, sociAl, boDy) cohort study, who were free from overt cardiovascular disease, non-diabetic based on blood test results, and had no history of pharmacological treatment for hypertension, dyslipidemia, and diabetes, comprised the “reference population”. Carotid-femoral pulse wave velocity (cfPWV), augmentation index (AIx), amplitude of forward wave (Pf), and backward wave (Pb) were described in different age categories for both sexes. Sex-specific reference equations for cfPWV, AIx, Pf, and Pb with age as the predictive variable were created using the Lambda-Mu-Sigma (LMS) method. All four parameters increased with age. CfPWV and Pf were higher in males than females, especially in young and middle-age groups (P < 0.001). AIx was higher in females than males in all age categories (P < 0.001). Pb was also higher in females than males in age groups older than 40 years (P < 0.01). Reference equations for the skewness (Lambda), median (Mu), and coefficient of variation (Sigma) values were determined, enabling the calculation of sex- and age-standardized values (z-scores) for each individual’s pulsatile hemodynamic measurement, and an online application was developed. Reference equations derived from a large population-based dataset constitute a suitable tool for the standardization of pulsatile hemodynamics and for the accurate interpretation of vascular aging.

Depopulation in rural areas of the North Kazakhstan region: social, economic problems and regulatory mechanisms

There are very few studies that have determined the causes of depopulation in rural areas of Kazakhstan and the North Kazakhstan region (NKR). Purpose of the study – to study the causes of the phenomenon of depopulation in rural areas of the NKR, determine its social and economic consequences and propose regulatory mechanisms. To determine the causes of the depopulation process in rural areas of the North Kazakhstan region and propose regulatory mechanisms, methods of empirical, hypothetical, scientific abstraction, dynamic analysis, synthesis, comparative analysis, and systems approach were used. The article provides an in-depth analysis of the rate of natural increase (loss) in the population of Kazakhstan. Having divided the population of the rural areas of the NKR into age groups, we determined which age category was decreasing and put forward a hypothesis about what they wanted. The Government of Kazakhstan has developed and continues to develop various programs for developing rural areas and population growth in the Northern region. However, the coefficient of natural increase (loss) of the population of the North Kazakhstan region has a negative value. The study results showed that the population aging rate in rural areas of this region is intensive. The government must identify groups and target areas that require support measures, taking into account the situation with specialization, labor potential, territorial characteristics, and age characteristics of the areas of the region.

Impact of age on antimicrobial prescriptions in hospitalized children at three academic centres in South Africa: a point prevalence survey.

Antimicrobial resistance is a global threat in children, and the emergence of multi-drug-resistant organisms is of concern. This secondary analysis of an antimicrobial point prevalence survey (PPS) in children evaluates the impact of age on antimicrobial use. The mean antimicrobial prescriptions were assessed in neonates, infants, young children (1-5 years), school-going children (6-12 years), and adolescents (13-15 years) from a cross-sectional PPS at three academic hospitals between September 2021 and January 2022. Primary and secondary diagnoses, antibiotic type (World Health Organization AWaRe and Anatomical Therapeutic Chemical classifications), and the incidence of healthcare-associated infections (HAI) were evaluated per age category. Multiple regression models were used to analyse age-related risk factors for HAI. The number of antimicrobials per child (1.7-1.9 per patient) was higher in neonates and infants compared to children 6-12 years old (1.4 per patient). Watch antibiotics, especially carbapenems, were commonly prescribed in neonates (32.5%) and infants (42.2%). Reserve antimicrobial use was notable in neonates (4.7%) and infants (4.1%). The incidence risk ratio (IRR) of HAI was higher in neonates and infants (IRR 2.13; 95% CI 1.23-3.70, IRR 2.20; 95% CI 1.40-3.45, respectively) compared to 6- to 12-year-olds. On multivariate analysis of participants according to age, being HIV infected, length of stay >6 days, high McCabe severity score, having surgery and receipt of blood transfusion were associated with an increased risk of HAI (P < .001 for all) while on univariate analysis only, being premature and/or underweight was associated with an increased risk of HAI in infants (P < .001 for both). Infants with risk factors for HAI significantly influenced antimicrobial prescribing, underscoring the necessity for tailored antimicrobial stewardship and enhanced surveillance. The increased use of Watch antibiotics, particularly carbapenems, in infants warrants closer scrutiny. Further research is required to identify inappropriate antimicrobial use in high-risk hospitalized young children.

Prevalence of Hypertension in Type 2 Diabetes Mellitus in the Working Area of Jatibaru Community Health Center in 2023

The World Health Organization (WHO) predicts an increase in the number of diabetes mellitus sufferers in Indonesia from 8.4 million people in 2000 to around 21.3 million people in 2030. The prevalence of type 2 diabetes increases with age and changes in unhealthy lifestyles. Several studies show that the incidence of hyperglycemia in diabetes is closely related to hypertension. According to the American Diabetes Association (ADA) 2017, two out of three people with diabetes have high blood pressure. At the Jatibaru Community Health Center, based on 2023 data, it is known that hypertension and diabetes are always included in the data on the 10 most common diseases every month. Based on this background and related to the incidence of Hypertension and type 2 diabetes mellitus is still relatively high, so researchers are interested to knowing the picture hypertension in type 2 diabetes mellitus in the Jatibaru. This research is a descriptive study with a cross-sectional approach using secondary data taken from Non-Communicable Disease data. The population in this study were all adult and elderly respondents registered in the non-communicable disease program register, who based on anamnesis, physical and laboratory examination, were diagnosed with type 2 diabetes mellitus and hypertension. The sample was taken by purposive sampling. In this research, it was found that people with hypertension and diabetes mellitus were found in all adult and elderly age categories. The distribution of hypertension and type 2 diabetes mellitus patients continues to increase with increasing age, the prevalence of sufferers being more female than male. As many as 65% of the total type 2 diabetes mellitus sufferers also experience hypertension.

Key performance indicators and reference values for turn performance in elite youth, junior and adult swimmers

ABSTRACT This study aimed to determine kinematic and kinetic key performance indicators (KPI) of swimming turn performance using principal component analysis (PCA) and multiple linear regression analysis and provide reference values using percentiles. Touch and tumble turn performances of male (n = 68) and female (n = 48) Swiss national team members from three age categories—adult (20.2 ± 2.7 yrs, 790 ± 57 points), junior (16.2 ± 0.8 yrs, 729 ± 53 points) and youth swimmers (14.4 ± 1.0 years of age, 667 ± 53 World Aquatics swimming points, respectively)—were assessed with a motion analysis system equipped with a force plate on the pool wall, one over- and four underwater cameras sampling forces at 500 Hz and footages at 100 Hz. The PCA reduced the 27 original variables by up to 15% depending on turn type and age category using Varimax component loading of >0.6 and explained up to 91% of the total variance. The highest Varimax component loadings for each principal component were used to determine KPI for each turn type and age category using multiple-regression analysis with total turn time as dependent variable. These KPI should be used to interpret turn performances and identify individual swimmers’ strengths, weaknesses and future potentials with the help of the percentiles as reference values.

Assessment of the Present Status of Milk Handling and Management Practices in Some Areas of Bangladesh

Milk contamination by dairy workers' spoiled hands, unclean utensils, microbes, and polluted water has caused many milk-borne epidemics. Most milk-borne zoonoses are also contracted by drinking infected milk. Bangladesh lacks milking hygiene and farmer awareness, and the milk cleanliness of dairy farmers awareness and practices in different regions was accessed. This study was aimed at documenting the present milking and management practices of dairy producers in particular districts of Bangladesh. From June 2020 to June 2022, 300 small dairy cow owners in twelve areas were surveyed using a preset questionnaire. Results revealed that male respondents (59.5%) outnumbered female respondents (41.33%) across various age categories. Most farmers milked animals at the shed and washed their hands before milking. Over half of dairy farmers cleansed the udder and teat before milking. More than two-thirds of farmers let the calf suckle before and after milking, while 98.02 percent used concentrate feed for teat massage. Most farmers (95.58%) manually milked cows twice daily. The majority of farmers sold their milk (77.25%) rather than drink it (10.17%). The study found that 93.92 percent of milkmen cleaned the milking pail using water, while 3.5-2.5 percent utilized sand, ash, or detergent. Only 53.66% of dairy farmers washed their cows' udders and teats after milking, which may not be aware of potential contamination from dipping teats in sterile cream. Mastitis prevention was not practiced by 85.42 percent of the respondents. Four to eight percent of producers know about antibiotics, milk adulteration, milk safety, and food safety issues. The application of scientific management approaches to milking is still lacking in the study areas. Therefore, training programs on improved milking management procedures can help farmers produce clean milk, increase dairy animal production, and increase farming income.

Effect of body mass index on ovarian reserve and ART outcomes in infertile women: a large retrospective study

BackgroundObesity poses a significant global health challenge, with profound implications for women’s reproductive health. The relationship between ovarian reserve and body mass index (BMI) remains a subject of debate. While obesity is generally associated with poorer outcomes in assisted reproductive technology (ART), the evidence remains inconclusive. This study aimed to investigate the effect of pre-pregnancy BMI on ovarian reserve and ART outcomes in infertile patients.MethodsWe conducted a retrospective cohort study involving women who underwent in vitro fertilization (IVF) or intracytoplasmic sperm injection (ICSI) procedures at Tongji Hospital between 2016 and 2023. The study included 30,746 initial fresh cycles and 5,721 singleton deliveries. Patients were stratified by age and further categorized into four BMI groups: lean (< 18.5 kg/m²), normal weight (18.5–24.9 kg/m²), overweight (25.0–29.9 kg/m²), and obese (≥ 30.0 kg/m²). The primary endpoints of the study were pregnancy and perinatal outcomes. To explore the association between BMI and these outcomes, we adjusted for relevant confounding factors and utilized multivariate linear regression models, complemented by multifactorial logistic regression analyses.ResultsAnti-Müllerian hormone (AMH) levels were significantly lower in the overweight and obese groups compared to the normal weight group. After adjusting for age, a negative correlation was found between AMH and BMI in the age subgroups of 20–30 and 30–35 years. Among women aged 20–35 years, those in the overweight and obese groups had significantly fewer retrieved oocytes, mature oocytes, and two-pronuclear (2PN) embryos than their normal weight counterparts. Despite these differences, pregnancy outcomes in the overweight and obese groups were comparable to those in the normal weight group across all age categories. Additionally, obesity was linked to an increased risk of gestational diabetes mellitus, hypertensive disorders of pregnancy, and macrosomia.ConclusionsAn age-related decrease in AMH levels was evident with increasing BMI. Although being overweight or obese is associated with poorer embryo and perinatal outcomes, it does not seem to have a substantial impact on fertility.

Job satisfaction of multidisciplinary staff working in intensive care units: a cross-sectional study in Qatar

Background/Aims Job satisfaction is an important contributor to the efficacy and success of organisations. An intensive care unit is a highly skilled area of healthcare that can be a physically and mentally challenging environment for staff, potentially impacting job satisfaction. This study aimed to assess job satisfaction levels among multidisciplinary staff members working in the intensive care units of a hospital in Qatar and evaluate how this is affected by sociodemographic and employment factors. Methods This was a cross-sectional, quantitative study that used a survey method. A total of 142 intensive care unit nurses, physicians and allied health professionals were recruited via random sampling from a tertiary hospital in Qatar. The Minnesota Satisfaction Questionnaire (short form) was used to collect data on respondents' intrinsic, extrinsic and overall job satisfaction levels, using statements scored with 5-point Likert scales. The survey also collected data on respondents' gender, age, job category and years of experience working in intensive care. Data were analysed using Shapiro-Wilk tests, Mann-Whitney U tests, Kruskal–Wallis tests and analysis of variance. Mean overall job satisfaction scores were classified as low (&lt;3.00), moderate (3.00–3.99) or high (&gt;4.00). A P value of &lt;0.05 indicated statistical significance. Results The mean overall job satisfaction score was 3.82 out of 5.00, indicating moderate satisfaction. There were strong correlations between job satisfaction and both intrinsic (0.940) and extrinsic (0.894) satisfaction. There was a significant difference in job satisfaction levels depending on respondents' years of experience working in intensive care units (P=0.0477), with those who had less than 10 years of experience having the highest job satisfaction levels and those with 20–24 years' experience having the lowest job satisfaction levels. There were no significant differences between the job satisfaction levels of participants in different gender, age and job categories. Conclusions This study suggests that intensive care unit staff with more years of experience may have lower job satisfaction than those with fewer years of experience. Healthcare organisations should consider implementing targeted interventions to enhance job satisfaction, such as opportunities for professional development, recognition programmes, mentorship programmes, stress management workshops and efforts to improve work-life balance.

‘The voice of the child? The child has no voice’: an Irish study exploring the voice of young children in decisions regarding contact

Since January 2016, Irish family law courts have been obliged to take into consideration the voices of children in proceedings where decisions regarding contact with parents are being made. This article examines the findings of an Irish study that shed light on how young children’s voices are heard in decisions regarding contact with parents who do not, or no longer, live together. The views of key stakeholders who have some involvement with contact arrangements for young children in the 0–6 years age category are highlighted. A thematic analysis of the data was conducted in order to understand various perspectives on how and under what circumstances young children are heard in contact cases. The findings demonstrate that the voices of young children are virtually absent in family law decisions regarding contact. Determining factors relate to the infrastructure of the courts, a significant lack of resources to support the Irish family law system and significant variation in practice approaches between social and legal professionals. As a result of these findings, suggestions are proposed for informing practice and improving service delivery in family law in a way that best meets the needs and rights of young children.

Assessment Of Functional Fitness Outcomes In 12-week Fitness Program Intervention Based On Age Categories Among Community Dwelling Seniors

Assessment Of Functional Fitness Outcomes In 12-week Fitness Program Intervention Based On Age Categories Among Community Dwelling Seniors

Sex, Acute Kidney Injury, and Age: A Prospective Cohort Study

Animal models of kidney disease suggest a protective role for female sex hormones but in humans, some authorities assert that female sex is a risk factor for acute kidney injury (AKI). To better understand the risk of AKI, we studied the strength of association between sex and AKI incidence in hormonally distinct age groups across the life span. Prospective cohort study. All patients hospitalized in the Montefiore Health System between 10/15/2015 and 1/1/2019, excluding those with kidney failure or obstetrics diagnoses. Male versus female sex. Acute kidney injury (AKI) occurring during hospitalization based on KDIGO definitions. Generalized Estimating Equation logistic regression adjusted for comorbidities, socio-demographic factors, and severity of illness. Analyses were stratified into 3 age categories, 6 months to ≤16 years, age >16 years - <55 years, and age ≥55 years. A total of 132,667 individuals were hospitalized a total of 235,629 times. The mean age was 55.2 (SD 23.8) years. The counts (%) of hospitalizations for women were 129,912 (55%). Hospitalization counts (%) among Black and Hispanic patients were 71,834 (30.5%) and 24,199 (10.3%), respectively. AKI occurred in 53,926 (22.9%) hospitalizations. In adjusted models, there was a significant interaction between age and sex (p<0.001). Boys and men had higher risk of AKI across all age groups, an association more pronounced in the age group >16 years to <55 years in which the OR for men was 1.7 (95% CI, 1.6-1.8). This age-based pattern remained consistent across prespecified types of hospitalizations. In a sensitivity analysis, women older than 55 years who received prescriptions for estrogen had lower odds of AKI than those without prescriptions. Residual confounding. The greatest relative risk of AKI for males occurred during ages >16 to <55 years. The lower risk among post-menopausal women receiving supplemental estrogen supports a protective role for female sex hormones.

Relative age effect in male and female elite international amateur boxing

ABSTRACT This study aimed to determine whether the Relative Age Effect (RAE) was present in different sexes and age categories in 12 elite-level international amateur boxing competitions. A total of 4813 athletes competing between 2013 and 2022 were analysed. Athletes were split into four quartiles according to their birth date and compared to the expected (equal) birth date distribution using chi-squared goodness of fit. The results revealed greater RAE prevalence in youth compared to the senior group. RAE was more prominent in males compared to females, with the female group showing an inverse RAE trend. Odds ratio (OR) showed an overrepresentation of male boxers born in Q1 compared to Q4 (OR > 1.19-1.33), while senior female boxers presented an inverse trend (OR < 0.95). Odds Ratios for medallists within the youth group were greater than 1.07 (except Q3 × Q4 = 0.93) highlighting an overrepresentation of boxers born earlier in the year. A shift in strategy to reduce the RAE in young boxers whereby coaches focus less on the short-term pursuit of sporting success is encouraged. Organisations and coaches should increase awareness and provide systematic education around RAE, whilst creating equal competitive opportunities for all young boxers to reduce the extent of RAE in boxing.

Analysis of consumer behavior of tourism products

The research of the tourism phenomenon reveals that its main characteristic is the orientation towards consumption. One of the purposes of such research is to identify the characteristics of the consumer’s behavior, which is particularly important for determining the type and frequency of accessing tourist products and services by consumers, the formation of the tourist offer, the evaluation of the level of utility of the consumption of tourist products and services. The purpose of the present study was to identify the characteristics of consumer behavior in the tourist services market according to several factors. As the main research method, the online survey method was used in which 100 respondents participated. The questionnaire included questions aimed at identifying the following aspects: age category, social status, household size, income, frequency of accessing tourist services, type of tourist products accessed, national affiliation of the tourist products accessed and the level of utility recorded.

Predictive factors of intraoperative conversion to reverse total shoulder arthroplasty in patients with anatomic total shoulder arthroplasty

BackgroundMany factors play a role in decision-making for arthroplasty type in patients with glenohumeral osteoarthritis (GHOA). The purpose of this study was to evaluate preoperative and intraoperative factors that might predict the need for Reverse Total Shoulder Arthroplasty (rTSA) versus Anatomic Total Shoulder Arthroplasty (aTSA) for patients with primary GHOA. Secondarily, American Shoulder and Elbow Surgeons (ASES) were compared. MethodsPatients with primary GHOA indicated for aTSA versus rTSA were identified. Preoperative records were reviewed for demographics, range of motion, rotator cuff strength, and glenoid morphology. Operative reports were assessed to identify intraoperatively rotator cuff pathology and glenoid deficiency. ASES scores at 2-years postoperative were collected. Results111 patients were included from 2018-2021. 94 patients underwent aTSA, while 17 were intraoperatively converted to rTSA. There were no significant differences in age, BMI, or preoperative Walch classification between cohorts. rTSA patients had significantly decreased preoperative external rotation (p=0.006). External rotation ≤30 degrees was the only preoperative predictive factor for performing rTSA versus aTSA (p=0.0004). The most common reason for intraoperative transition to rTSA was rotator cuff deficiency. At 2-year follow-up, median ASES scores were 94.2 (IQR 85-96.7) and 88.3 (IQR 73.3-94.5) for aTSA and rTSA, respectively (p=0.097). ConclusionMany patients with primary GHOA are well-served with aTSA. However, there are patients with primary GHOA in which rTSA may be ideal given rotator cuff deficiency or glenoid defects felt to limit aTSA glenoid component placement. This study highlights the need for preoperative external rotation and intraoperative evaluation of rotator cuff integrity and glenoid bone stock.

Childbirth at advanced reproductive age: the impact of biopsychosocial factors on the mode of delivery

Introduction Contemporary society reflects a clear trend towards delayed motherhood, raising significant concerns in the management of pregnancy and childbirth in women of advanced reproductive age. In this context, the mode of delivery and associated risks for this age category require increased attention. Birth methods have been thoroughly examined to identify risks and influencing factors within this specific cohort. Material and methods A descriptive cross-sectional study was conducted on a sample of 528 women. Data were collected using a pre-tested semi-structured questionnaire, and respondents were divided into three groups based on the mode of delivery: vaginal delivery, planned cesarean section, and emergency cesarean section. Sociodemographic, anthropometric, medical, and obstetric characteristics were analyzed using linear regression. Statistical analyses included descriptive and inferential statistics (Chi-square), with a 95.0% confidence interval. Results The analysis revealed statistically significant variations in the mode of delivery based on maternal age (p=0.013) and paternal age (p=0.001), with an increased rate of cesarean sections at more advanced ages. Significant variations were also found in relation to area of residence (p=0.003), education level (p=0.001), nature of work (p=0.028), GP appointments (p=0.020), number of GP appointments(p&lt;0.001), number of obstetrician appointments (p=0.032), time of informing on risk factors (p=0.005), parity (p&lt;0.001), multiple pregnancies (p=0.016), mode of first delivery (p&lt;0.001), pregnancy complications (p=0.003), delivery complications (p&lt;0.001), gestational age at birth (p=0.017), Apgar scores at 1 and 5 minutes (p&lt;0.001). Conclusions Advanced reproductive age has been associated with a higher risk of cesarean section compared to vaginal delivery. The influence of age is modulated by various sociodemographic, medical, and obstetric characteristics, including area of residence, education level, history of cesarean section, parity, pregnancy and delivery complications, pre-existing chronic conditions, antenatal care and provision of information on risk factors.

Should we reconsider age classification of ISO ski binding settings for children?

Should we reconsider age classification of ISO ski binding settings for children?