Age Discordance Research Articles

Origin of discordant U[sbnd]Pb dates in non-metamict zircons in intrusives deformed at granulite facies: Grain scale processes, and relevance to Cambrian orogeny, Eastern Ghats Belt, India

Interpreting the origin of UPb discordance in zircons in intrusives that experience high-T metamorphic-deformation events is challenging. We investigate in depth the origin of UPb dates obtained from garnet-bearing border zone granitoids and a sheared ferrodiorite dyke bordering the Balangir anorthosite pluton, eastern India. The crustal domain is known for discordant ages resulting in disputes regarding the age of intrusion and multiple granulite facies events. We shed light on the origin of the discordant dates utilizing CL imaging, electron backscatter diffraction analysis, trace element mapping in zircons, and Ti-in-zircon thermometry.Zircons in the foliated border zone granitoids (BZG) comprise (a) embayed cores with varying Y, U and Hf oscillatory zones, and (b) well-faceted chemically-homogeneous mantles crystallographically continuous with the cores, which truncate the oscillatory zones. In the intensely sheared ferrodiorite, cauliflower-shaped zircons possess profuse micropores and micro-fractures. Ti-in-zircon temperatures (700–950 °C) overlap in the texturally-distinct zircons, but are somewhat lower in the mantles/cauliflower-shaped zircons relative to the oscillatory-zoned cores in BZGs.LA-ICP-MS dates of zircons in four samples constitute a near-unique discordia line with the upper and lower intercepts at ca. 980 Ma and 495 Ma. Interestingly, dates from the mantles are highly variable with no correlation between age decrease and distance to the cores. The lack of concordant dates at the two intercepts, and the increase in discordance away from the intercepts preclude episodic zircon growth, and suggests a single-stage granulite facies event (ca. 495 Ma) that modified the ∼980 Ma zircon xenocrysts entrained from protoliths into the intrusives. We propose the age discordance was caused by melt-mediated high-T interface coupled dissolution-precipitation processes at ∼495 Ma. Variable inheritance of isotopic signatures of ∼980 Ma zircon xenocrysts in the younger zircons contributed to discordance in UPb systematics; the effect of variable inheritance of ∼980 Ma isotope signatures is less pronounced in the cauliflower-shaped zircons from the HFSE enriched ferrodiorite residual melts from high degree of plagioclase fractionation.Our results are consistent with a distinct Cambrian (∼495 Ma) orogeny involving emplacement of anorthosite pluton and related intrusives and high-T granulite-facies deformation-metamorphism in the ∼980 Ma Eastern Ghats Province, and are a direct record of Cambrian collision between the Eastern Ghats Province and the Archean cratonic nucleus.

Clinical and imaging characteristics of supratentorial glioma with IDH2 mutation.

The rarity of IDH2 mutations in supratentorial gliomas has led to gaps in understanding their radiological characteristics, potentially resulting in misdiagnosis based solely on negative IDH1 immunohistochemical staining. We aimed to investigate the clinical and imaging characteristics of IDH2-mutant gliomas. We analyzed imaging data from adult patients with pathologically confirmed diffuse lower-grade gliomas and known IDH1/2 alteration and 1p/19q codeletion statuses obtained from the records of our institute (January 2011 to August 2022, Cohort 1) and The Cancer Imaging Archive (TCIA, Cohort 2). Two radiologists evaluated clinical information and radiological findings using standardized methods. Furthermore, we compared the data for IDH2-mutant and IDH-wildtype gliomas. Multivariate logistic regression was used to identify the predictors of IDH2 mutation status, and receiver operating characteristic curve analysis was employed to assess the predictive performance of the model. Of the 20 IDH2-mutant supratentorial gliomas, 95% were in the frontal lobes, with 75% classified as oligodendrogliomas. Age and the T2-FLAIR discordance were independent predictors of IDH2 mutations. Receiver operating characteristic curve analysis for the model using age and T2-FLAIR discordance demonstrated a strong potential for discriminating between IDH2-mutant and IDH-wildtype gliomas, with an area under the curve of 0.96 (95% CI, 0.91-0.98, P = .02). A high frequency of oligodendrogliomas with 1p/19q codeletion was observed in IDH2-mutated gliomas. Younger age and the presence of the T2-FLAIR discordance were associated with IDH2 mutations and these findings may help with precise diagnoses and treatment decisions in clinical practice.

Study of Biomarker Discordance between Primary and Recurrent Sites and its Clinical Implications in Metastatic Breast Cancer : A Single Institutional Study from India.

S. Shanthala Immunophenotypic discordance of receptors between primary and metastatic sites significantly impacts treatment outcomes. Current international guidelines recommend rebiopsy of accessible metastatic lesions to reassess tissue biomarkers. While existing literature on biomarker changes is conflicting and heterogeneous, similar studies on the Indian cohort of breast cancer patients are lacking. In this context, we aimed to evaluate the frequencies of biomarker changes between biopsies from primary and recurrent sites, and their association with various clinicopathological characteristics, including the type of metastasis and treatment in metastatic breast cancer (MBC) patients. This is an ambispective study performed at a single center. Immunohistochemical (IHC) expression of paired primary and recurrence samples of MBC patients was reviewed for the expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2 (HER2), and Ki-67. Concordance, loss, and gain of receptors were assessed based on the Allred scores for ER, PR, and HER2. Ki-67 was assessed based on a 14% cutoff. Further, receptor changes were studied in relation to age, menopausal status, morphology, grade, stage, metastatic sites, interval between biopsies, and treatment. At progression, biopsies were obtained from 41.18% of locoregional recurrence and 58.82% of metastatic sites. Despite high discordance of 47% for ER and 68.6% for PR, true receptor conversion was observed in 9.8%, 21.56%, and 5.88% for ER, PR, and HER2, respectively. There was a significant correlation between age and ER discordance ( p = 0.029). Loss in PR significantly correlated with a gain in Ki-67. Of all the metastatic sites, the lung was significantly associated with PR and Ki-67 concordance ( p = 0.008 and p = 0.0425, respectively). Discordance of receptors was neither related to the sites of biopsy (local recurrence or metastatic site) nor to the time interval between biopsies, prior chemotherapy, or hormone therapy. In conclusion, metastatic progression of the disease is accompanied by age-dependent discordance of ER. Unparalleled changes in PR in relation to ER suggest that ER-independent pathways may influence PR expression in MBC. Furthermore, the concurrence of PR loss with Ki-67 gain indicates an aggressive phenotype with disease progression. Hence, follow-up testing of samples for receptor expression is beneficial in determining prognosis and guiding therapeutic decisions.

Adolescent Decision-Making Involvement in the Receipt of Genomic Testing Results

To examine hypothesized predictors of adolescent and parent involvement in the decision about which genomic results to receive. We conducted a longitudinal cohort study during phase 3 of the electronic Medical Records and Genomics (eMERGE) Network. Dyads reported on how they preferred to make choices (adolescent only, parent only, or jointly). Dyads used a decision tool to choose independently the categories of genetic testing results they wanted. We summarized independent choices, identifying initially discordant dyads. After a facilitated discussion, dyads made a joint decision. Dyads then completed the Decision-Making Involvement Scale (DMIS). Weconductedbivariate correlations between DMIS subscale scores and the following hypothesized predictors: adolescent age, preference for adolescent to make their own decision, and discordance on initial independent choices. The sample included 163 adolescents, aged 13-17years and parents (86.5% mothers). Dyads lacked agreement on how they wanted to make the final decision (weighted kappa statistic 0.04; 95% CI -0.08 to 0.16). These preferences, as well as the adolescent's age and adolescent-parent discordance on initial choices for specific categories of genetic testing results to receive, were associated with subsequent decision-making involvement behaviors as measured by DMIS subscales. Dyads with discordant initial preferences had significantly greater scores on the DMIS Joint/Options subscale than those with concordant initial preferences (adolescent report M [SD] 2.46 [0.60] vs 2.10 [0.68], P<.001). Through facilitated discussion, adolescents and parents can work together and reach agreement about receipt of genomic screening results.

I WISH I MAY, I WISH I MIGHT FEEL THE AGE I WISH TONIGHT

Abstract Subjective age has traditionally been considered by comparing felt age to chronological age, with those who feel younger reporting more adaptive developmental outcomes. Here we consider a new approach: subjective age discordance, which compares felt ages to the ideal ages of participants. Across eight study days, 116 older and 107 younger adults reported their daily felt and ideal ages. On the majority of days, both older and younger adults idealized ages younger than they felt. The opposite pattern, idealized ages older than felt ages, was rare and primarily seen in younger adults. Days when felt ages were less discordant from ideal ages were characterized by higher levels of positive affect than days with greater subjective age discordance. These findings suggest that positive developmental outcomes can occur not only from feeling younger, but through a greater alignment of ideal and felt ages.

A detailed and comprehensive TEM, EPMA and Raman characterization of high-metamorphic grade monazites and their U-Th-Pb systematics (the Góry Sowie Block, SW Poland)

Eleven monazite grains, two from a migmatitic gneiss and nine from two felsic granulites from the Góry Sowie Block (SW Poland) were studied with transmission electron microscopy (TEM), electron probe microanalysis (EPMA), Raman microspectroscopy and laser ablation inductively coupled plasma mass spectrometry (LA-ICPMS) U-Th-Pb analysis in order to assess processes affecting U-Th-Pb age record. Two monazite grains from the migmatitic gneiss are patchy zoned in BSE imaging and overgrown by allanite, whereas Raman results indicate moderate radiation damage. Monazite in the corresponding TEM foils shows twins and nanoinclusions of fluorapatite, thorianite, goethite, titanite, chlorite and CaSO4. Furthermore, monazite is partially replaced by secondary monazite, forming ca. 100 nm-thick layers, and calcite along grain boundaries. The submicron alterations had little or no effect on the Pb/U and Pb/Th dates, when compared to earlier age constraints on the metamorphism in the studied region. In contrast, monazite from both granulites is homogeneous in eight investigated TEM foils, contains no solid or fluid nanoinclusions or any signs of fluid-induced alterations, with only one exception of a ca. 140 nm-thick crack filled with monazite. The 206Pb/238U and marginally older 208Pb/232Th mean dates pulled for all data show good coherence. However, the 207Pb/235U isotopic record is disturbed due the presence of common Pb within the entire monazite grain in one granulite and in the cores of two monazite grains in the second granulite, where the UPb data of the rims are not compromised and concordant. Due to lack of TEM evidence for fluid-mediated alterations, the age discordance has to be related to addition of common Pb in the monazite lattice or in the micro-cracks. To summarize, the 208Pb/232Th data reveal the most accurate ages, which are consistent with previous geochronological studies in the region. Therefore, the Pb/Th chronometer, which is less compromised by age disturbance compared to Pb/U ages, is recommended for monazite geochronology. Application of the submicron scale investigations using TEM is recommended to evaluate potential presence of the submicron inclusions of Pb-bearing phases or compositional alterations of monazite that can remain unnoticed by using standard microanalytical instruments.

Abstract 35: Age, Gender And Race Bias In Provider Adherence To The 2018 AHA/ACC Cholesterol Guidelines: A Single-Center Retrospective Cohort Analysis

Background: Cholesterol treatment is central to cardiovascular risk reduction, but disparities in management may exist. Our hypothesis is that demographic factors may predict guideline adherence. Methods: This retrospective cohort analysis included patients seen at an urban academic medical center between November 2018 to March 2021. Patient and provider demographics, cardiovascular comorbidities, and lab values were examined to determine if provider adherence to the 2018 AHA/ACC cholesterol guidelines demonstrated bias by age, gender, or race. Logistic models were estimated via generalized estimating equations to account for clustering by patient and provider and used to calculate odds ratios (OR), confidence intervals, and p-values. Results: 24,733 lipid panels were obtained from patients with mean age 57.8 ± 15.6, BMI 29.4 ± 6.8, 56.9% female, 44.2% White, 42.1% Black, 6.8% Asian, 6.8% Other, 26.5% tobacco use, 12.7% ASCVD, 51.1% hypertension, 21.1% diabetes. Significant adjusted OR for appropriate treatment was 0.91 (p&lt;0.001) for each 1-year increase in age, 2.2 (p&lt;0.001) for female, 0.88 (p=0.02) for Black relative to White, 1.36 (p=0.003) for Asian relative to White, 0.73 (p&lt;0.001) for BMI&gt;40 relative to BMI&lt;25. Providers had mean age 51.1 ± 12.2, 60.5%female, 73.2% White, 6.9% Black, 18.6% Asian, 1.3% Other. On univariate analysis, OR for appropriate statin prescription were 0.82 (p=0.016) for provider-patient race discordance; 0.90 (p=0.251) for gender discordance, 0.34 (p&lt;0.001) if provider age 10+ years younger than the patient, and 4.72 (p&lt;0.001) if provider age 10+ years older. On multivariate analysis adjusted for clinical risk factors, none of these OR for patient-provider discordance were significantly different from 1: race 1.06 (p=0.42), gender 0.96 (p=0.34), provider 10+ years younger 1.05 (p=0.61), provider 10+ years older 0.91 (p=0.32). Conclusion: In this analysis, Black, male, morbidly obese and older patients were less likely to receive appropriate statin therapy. However, there was no evidence that inappropriate treatment was associated with patient-provider age, gender, or race discordance. Further investigation is needed to guide targeted interventions aimed at addressing these inequities.

How to Better Distinguish between Type II and III Selective Fetal Growth Restriction in Monochorionic Twin Pregnancies?

Objectives: The objective of this study is to determine additional variables, next to umbilical artery (UA) Doppler, to help differentiate between Type II and III selective fetal growth restriction (sFGR). Methods: Retrospective analysis categorizing monochorionic diamniotic twin pregnancies with sFGR and abnormal UA Doppler as either Type II or III sFGR based on the diameter of the artery-to-artery (AA) anastomosis of ≤2 or >2 mm, respectively on placental examination after birth. This exploratory study compared maternal characteristics, pregnancy outcome, placental characteristics, and ultrasound features between the two groups. Results: We included 40 sFGR placentas, 13 were classified as Type II and 27 as Type III. Maternal age was higher in Type II. Small Type II twins had lower birth weights (BWs) for gestational age and BW discordance was higher in Type II. Type III placentas were more unevenly divided, but Type III pairs differed less in BW than expected relative to their placental discordance. Type III placentas more commonly had a vein-to-vein anastomosis and larger artery-to-vein anastomoses than Type II placentas, and proximate cord insertions were only observed in Type III. On the ultrasound scan at first diagnosis, small Type II twins were more growth-restricted. An AA anastomosis was detected in half of the Type III cases and in none of the Type II group. Signs of high-output cardiac strain were observed only in large Type III twins. In contrast, placental dichotomy was detected in nearly half of the Type II cases and only one Type III case. Conclusions: The presence of an AA anastomosis, signs of cardiac strain in the large twin, and proximate cord insertions suggested Type III sFGR, whereas placental dichotomy and a severe growth restriction were typically present in Type II. Prospective studies need to validate if these markers help prenatal differentiation between Type II and III sFGR.

Partner-Level and Sexual Networking Factors Are Associated With Vaccine-Type and Nonvaccine-Type Human Papillomavirus Infection After Vaccine Introduction in Young Women.

The aim of this study was to determine individual-level, partner-level, and sexual networking factors associated with vaccine- and non-vaccine-type human papillomavirus (HPV) in young women, by vaccination status. Sexually experienced women 13 to 26 years old (n = 784) completed a survey and were tested for 36 HPV genotypes. We determined factors associated with 4-valent vaccine-type HPV (HPV-6, HPV-11, HPV-16, HPV-18) and non-vaccine-type HPV among vaccinated and unvaccinated women, using univariable and multivariable logistic regression models. Participants' mean age was 19.2 years, 77.7% had received ≥1 vaccine dose, and 7.7% were positive for vaccine-type HPV (HPV-6, HPV-11, HPV-16, and/or HPV-18). Factors associated with vaccine-type HPV in vaccinated women included gonorrhea history (adjusted odds ratio [AOR], 2.71), new female sex partner(s) (AOR, 4.79), age at vaccination (≥15 vs. <15 years; AOR, 2.47), and age discordance with most recent partner (don't know vs. discordant; AOR, 9.17). Factors associated with non-vaccine-type HPV in vaccinated women included history of sexually transmitted infection (AOR, 2.69), male most recent partner (AOR, 2.85), age of first sex (AOR, 1.15), and partner concurrency (don't know vs. 1 other partner; AOR, 2.03). Factors associated with vaccine-type HPV in unvaccinated women included new female sex partner(s) (AOR, 7.45) and partner concurrency (don't know vs. no; AOR, 2.95). Factors associated with non-vaccine-type HPV in unvaccinated women included race (White vs. multiracial; AOR, 4.10) and partner concurrency (don't know vs. 0; AOR, 4.65). Novel findings of this study, including associations between female sex partners and HPV, and between not knowing about partner concurrency and HPV, have implications for sexual education, clinical counseling, and public health interventions.

Exposure to ionizing radiation disrupts normal epigenetic aging in Japanese medaka.

Alterations to the epigenome are a hallmark of biological aging and age-dependent patterning of the DNA methylome (“epigenetic aging”) can be modeled to produce epigenetic age predictors. Rates of epigenetic aging vary amongst individuals and correlate to the onset of age-related disease and all-cause mortality. Yet, the origins of epigenetic-to-chronological age discordance are not empirically resolved. Here, we investigate the relationship between aging, DNA methylation, and environmental exposures in Japanese medaka (Oryzias latipes). We find age-associated DNA methylation patterning enriched in genomic regions of low CpG density and that, similar to mammals, most age-related changes occur during early life. We construct an epigenetic clock capable of predicting chronological age with a mean error of 61.1 days (~8.4% of average lifespan). To test the role of environmental factors in driving epigenetic age variation, we exposed medaka to chronic, environmentally relevant doses of ionizing radiation. Because most organisms share an evolutionary history with ionizing radiation, we hypothesized that exposure would reveal fundamental insights into environment-by-epigenetic aging interactions. Radiation exposure disrupted epigenetic aging by accelerating and decelerating normal age-associated patterning and was most pronounced in cytosines that were moderately associated with age. These findings empirically demonstrate the role of DNA methylation in integrating environmental factors into aging trajectories.

Daily experiences of subjective age discordance and well-being.

Subjective age discordance (SAD) captures the difference between how old one feels and how old one would ideally like to be. We investigated the presence, strength, and fluctuation of this discordance in daily life as well as its relationship to various indicators of physical and psychological well-being with an 8-day diary study. Participants were 116 older and 107 younger adults who completed daily measures of felt age, ideal age, positive and negative affect, physical symptoms, and stressors. We operationalized SAD as felt age minus ideal age divided by chronological age and compared the utility of this discordance to the more established proportional discrepancy of felt age from chronological age. Daily SAD was present in both age groups, such that individuals idealized younger ages than they felt. This discordance was larger in older than younger adults, although younger adults exhibited more daily fluctuations in SAD. Within-person increases in SAD were associated with lower positive affect, whereas larger SAD at the between-person level was associated with more physical symptoms and stressors. These relationships were over and above the associations of felt and chronological age with the outcomes suggesting the utility of daily SAD for understanding daily physical and psychological well-being. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

The association of hypertensive disorders of pregnancy with small for gestational age and intertwin birthweight discordance.

Available evidence shows conflicting results regarding the association between hypertensive disorders of pregnancy (HDPs)/preeclampsia (PE) and small for gestational age (SGA) and birthweight discordance (BWD). This retrospective study of 2131 twin pregnancies aimed to evaluate the association of HDPs/PE with the presence of SGA and BWD. The eligible pregnancies were categorized into four study groups: concordant pairs without SGA fetuses, discordant pairs without SGA fetuses, concordant pairs with SGA fetuses, and discordant pairs with SGA fetuses. We applied binary logistic regression models to compare the incidence of HDPs/PE and multinomial logit regression models to evaluate the severity of PE between the study groups. The models were adjusted for potential confounders. Increases in HDPs were observed in concordant (aOR, 2.33; 95% CI: 1.46–3.73) and discordant (aOR, 3.50; 95% CI: 2.26–5.43) pregnancies with SGA fetuses but not in discordant pregnancies without SGA fetuses (aOR, 1.42; 95% CI: 0.81–2.49); increases in PE were also found in concordant (aOR, 1.87; 95% CI: 1.08–3.23) and discordant (aOR, 3.75; 95% CI: 2.36–5.96) pregnancies with SGA fetuses but not in discordant pregnancies without SGA fetuses (aOR, 1.34; 95% CI: 0.71–2.52). Discordant pregnancies with SGA fetuses were associated with severe PE (aRRR, 3.48; 95% CI: 1.79–6.77), whereas concordant pregnancies with SGA fetuses were associated with only mild PE (aRRR, 2.54; 95% CI: 1.33–4.88). Our results suggest that SGA is associated with the development of HDP/PE, while discordant growth is associated with the severity of PE. These associations need to be further investigated using estimated fetal weight (EFW).

Gender Diverse Youth on Fertility and Future Family: A Qualitative Analysis

PurposeGender-affirming treatment for transgender and nonbinary adolescents has been shown to decrease anxiety, depression, and suicidality, but treatments have medical consequences. Specifically, hormone replacement and pubertal blocking may impact patients' fertility and childbearing capabilities. We interviewed gender diverse adolescents regarding their thoughts on family and fertility. MethodsWe completed semistructured interviews with 23 gender diverse adolescents recruited from the Seattle Children's Gender Clinic. Interviewees included transfeminine, transmasculine, and nonbinary youth. Interviews were recorded, transcribed, and analyzed using Braun and Clarke's theory of thematic analysis, a flexible framework for qualitative analysis. ResultsGender diverse adolescents have myriad views on fertility, but four main themes were identified: (1) an interest in future family, including ideas regarding adoption and biological children; (2) barriers to fertility, including cost and procedure-related dysphoria; (3) factors unique to the developmental stage of adolescents, including the age discordance of making fertility decisions as a teenager and parental influence on decision-making; and (4) suggestions for clinicians approaching fertility counseling with adolescents considering hormone therapy. ConclusionsMany gender diverse youth asserted an interest in building families, although the process of fertility preservation remains fraught. Relative to other studies, our participants were hopeful, imaginative, and interested in having children. Participants wanted to receive specific counseling on fertility, to receive help navigating the logistics of fertility preservation, and to be listened to when their hopes for children (or no children) were stated. Further research is needed to create care paradigms that address fertility of transgender youth in an affirming, developmentally appropriate manner.

Personal ideals of aging and longevity: The role of subjective discordances.

Following theoretical models on wishful thinking, we investigated (a) whether personal aging ideals are discordant from self-perceptions of aging, (b) how such aging discordances evolve across adulthood, (c) whether current aging discordances are related to anticipated future aging discordances, and (d) whether aging discordances are related to a lower psychological well-being. We captured subjective age discordance (SAD) as the discrepancy between current perceived age and ideal age, and we captured subjective life-expectancy discordance (SLED) as the discrepancy between perceived life expectancy and ideal life expectancy. For the analyses, we used cross-sectional data from 1,015 individuals (M = 40.0 years, SD = 17.9 years; 52.1% women) and 2-year longitudinal data from 258 individuals (M = 55.3 years, SD = 17.3 years; 70.5% women). Both aging discordances were clearly present across the adult life span; that is, ideal ages were lower than perceived ages, and ideal life expectancies were higher than perceived life expectancies. A stronger SLED was associated with a stronger SAD, both cross-sectionally and longitudinally. Both discordances were also associated with lower psychological well-being in the cross-sectional analyses. Over time, lower life satisfaction predicted increases in SAD, and SLED predicted increases in negative affect. The results indicate that SAD and SLED are both highly prevalent and potentially functional because they seem to be related to psychological well-being. The discussion focuses on SAD and SLED as constructs for future research, their antecedents, and potential consequences. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Sexual Mixing Patterns and Anal Human Papillomavirus Among Young Gay, Bisexual, and Other Men Who Have Sex With Men and Transgender Women in 2 Cities in the United States, 2012-2014.

Human papillomavirus (HPV) is a common sexually transmitted infection. Men who have sex with men (MSM) and transgender women (TGW) are at high risk for anal HPV infection and subsequent anal cancer. This study assessed the association of partner discordances with prevalent high-risk anal HPV (HRAHPV) among MSM and TGW. Participants were enrolled in the cross-sectional young men's HPV study of gay, bisexual, and other MSM, and TGW, aged 18 to 26 years, from 2 cities. Participants completed a confidential standardized computer-assisted interview and provided self-collected anal swabs for type-specific HPV DNA testing. Multivariate analyses were conducted for 3 discordances of interest (i.e., partner age, race/ethnicity, and concurrent partner) to calculate adjusted odds ratios (aOR) and 95% confidence intervals (CI). Eight hundred sixty-two participants were included for partner race/ethnicity discordance, 601 for partner age discordance, and 581 for concurrent partner analysis. Most reported being older than 21 years, cisgender male, and gay. Adjusted odds of HRAHPV were not significantly increased among participants reporting partner age discrepancy >10 years (aOR, 0.89; 95% CI, 0.51-1.56), partner race/ethnicity discordance (aOR, 0.88; CI, 0.62-1.24), or partner with concurrent partners (aOR, 0.85; 95% CI, 0.50-1.42), compared with those who did not. This analysis did not identify any partner discordances associated with HRAHPV. Because HPV infection can persist for years, sexual mixing patterns with early partners might be more relevant than the most recent sex partner. Prevalence of HRAHPV was high and could be preventable by preexposure vaccination, as recommended for everyone through age 26 years including MSM and TGW.

Gestational age, morbidity and mortality among twin births in New South Wales, Australia 2003-2014: A cohort study.

Evidence suggests that the trend toward early planned births observed among singletons may be evident among twin pregnancies. To describe trends in gestational age at birth, pregnancy characteristics, neonatal morbidity and mortality among twin pregnancies. Population-based data linkage study of twin births of ≥30weeks of gestation without a major congenital anomaly born in 2003-2014 in New South Wales (NSW), Australia. Linked pregnancy and birth, hospital and mortality data were used. Generalised linear regression was used to assess linear trends. Risk difference (RD) and 95% confidence intervals were estimated. Among 28076 eligible twin births (14038 pregnancies), 49% of births occurred prior to 37weeks and 69% of births were planned (pre-labour caesarean or induction of labour). There were increases over time in the proportion of twin births at preterm gestations (30-34weeks (RD 2.1, 95% CI 0.1, 4.0), 35-36weeks (RD 7.5, 95% CI 5.4, 9.7)) and in the rates of planned births (pre-labour caesarean (RD 6.4, 95% CI 4.0, 8.8), induction (RD 4.6, 95% CI 2.6, 6.6)). There was no significant change in stillbirth or neonatal death rates, but there was an increase in neonatal morbidity over the study period. Concurrently, there were increases in the prevalence of gestational diabetes; and decreases in pregnancy hypertension, assisted reproductive technology use, small-for-gestational age and birthweight discordance. Gestational age at birth among twin births is decreasing and birth intervention is increasing. There are increasing rates of neonatal morbidity, but no overall change in perinatal mortality.

Relationship Dynamics in the Context of Binge Drinking and Polydrug Use Among Same-Sex Male Couples in Atlanta, Boston, and Chicago.

An estimated one- to two-thirds of incident HIV infections among U.S. men who have sex with men (MSM) occur within the context of a primary relationship. The existing, yet limited, literature on sexual risk behavior among same-sex couples suggests that MSM with main partners are more often to report having lower perceived HIV risk, higher unrecognized HIV infection, and increased frequency of condomless anal intercourse with their primary partner. Furthermore, numerous studies document the strong relationship between polydrug use and binge drinking with HIV infection among MSM. However, more research is needed that identifies how individual- and relationship-level factors are related to polydrug use and binge drinking in the context of same-sex male relationships. We used baseline data collected as part of a prospective randomized controlled trial of 160 same-sex male couples (total N = 320 individuals). In 2015, recruitment commenced in three U.S. cities: Atlanta, GA, Boston, MA, and Chicago, IL. Participants completed a self-report assessment using an audio-computer-assisted self-interview system during their baseline enrollment visit. We collected information on participants' sociodemographic characteristics, drug and alcohol use, individual- and relationship-level variables of interest, as well as relationship quality. Multinomial logistic regression models were fit for three different categories of polydrug use and of binge drinking for which (1) both partners exhibited the behavior, (2) only the respondent exhibited the behavior, or (3) only the partner exhibited the behavior. Participants' age ranged from 18 to 69 (M = 35.9). The sample majority (77.5%) was White (248/320), with 12.2% Black (39/320) and 10.3% Multiracial (33/320); 68.4% had completed a college degree; and 9.6% were unemployed. A high proportion (62.2%) reported any drug use, including marijuana; 45% reported using drugs other than marijuana; and 18.1% reported polydrug use. Overall, 22.2% reported current binge drinking. Age discordance and being in a long-term relationship (6 or more years) were associated with a decreased odds of polydrug use among couples; being in an interracial dyad, recent history of arrest, living with HIV, and self-reported clinically significant depressive symptoms were associated with an increased odds of polydrug use. Additionally, being the older partner and reporting higher levels of internalized homophobia decreased odds for binge drinking, while recent history of arrest, living with HIV, and feeling more loved in their relationship were associated with an increased odds of binge drinking. Findings have implications for developing interventions to reduce substance use and promote health among same-sex male couples. Future research would benefit by using longitudinal study designs to understand the individual-, relationship-, and structural-level factors that potentiate polydrug use and binge drinking among same-sex male couples.

Do you talk to your older patients about sexual health? Health practitioners’ knowledge of, and attitudes towards, management of sexual health among older Australians

Research suggests that older patients want to talk about sexual health, but are reluctant to initiate these discussions with health practitioners. Little is known of the practitioners’ perspectives. The objective of this study was to explore health practitioners’ knowledge of and attitudes towards management of sexual health among older patients. Semi-structured interviews were conducted with 15 general practitioners (GPs) and six practice nurses in rural/metropolitan general practices in March to June 2017 in Victoria, Australia. Most GPs believed it was appropriate to discuss sexual health with older patients but did not routinely do so. Common barriers included age and gender discordance between GP and patient, complexity of patient comorbidities and patient–doctor relationships. Practice nurses identified the limitations of their role as a barrier, although some nurses initiated discussions during health assessments. Health practitioners generally believed the responsibility for initiation of sexual health discussions rested with patients, but understood patients’ reluctance. They saw the need for an intervention to assist in such discussions.

Reassessing the origin and chronology of the unique achondrite Asuka 881394: Implications for distribution of 26Al in the early Solar System

The achondrite Asuka 881394 has mineralogy broadly similar to that of eucrites but is isotopically, chemically and texturally distinct from them. Previous U-Pb chronology shows that it is very old; forming within the first 0.8 Ma of the formation of calcium-aluminum rich inclusions (CAIs). However, the age difference between Asuka 881394 and other very old Solar System materials (CAIs, quenched angrites) measured with the 26Al-26Mg and 53Mn-53Cr extinct radionuclide chronometers, and 207Pb/206Pb chronometer, is not the same. This could be interpreted to reflect heterogeneity in the distribution of 26Al and 53Mn in the early Solar System. Given the significant implications for the early Solar System chronology if 26Al and 53Mn are indeed heterogeneously distributed, in this study we further investigate the origin of Asuka 881394 and the apparent age discordance between short-lived and absolute chronometers, by focusing on measurement of its ε54Cr composition, renewed measurements of the absolute Pb-Pb age and new, high precision measurements of its 26Al-26Mg systematics.New Cr isotope data places additional constraints on the origin of Asuka 881394; its ε 54Cr value of −0.37 ± 0.10ε is resolvable outside of uncertainty from HED meteorites (−0.72 ± 0.10ε), reinforcing evidence from oxygen isotopic analyses that suggest it originated from a distinct parent body, unlikely to be 4 Vesta. New Pb-Pb analyses, combined with using a directly measured 238U/235U ratio for age calculation, result in a recalculated Pb-Pb age of 4564.95 ± 0.53 Ma, ∼1.5 Ma younger than the previously reported age. With this age Asuka 881394 remains one of the oldest known achondrites in our Solar System. New high precision 26Al-26Mg data produce an initial 26Al/27Al ratio of 1.48 ± 0.12 × 10−6, within error of previous data. This ratio corresponds to an Al-Mg age of 4563.69 ± 0.36 Ma or 4564.83 ± 0.21 Ma relative to CAIs and the D’Orbigny angrite, respectively. Thus, depending on which age anchor is used, the 26Al-26Mg age is either 1.26 Ma or 0.12 Ma younger than the new Pb-Pb age, the latter being unresolved within analytical uncertainty.Though a potential age discrepancy between 26Al-26Mg and Pb-Pb could be a result of heterogeneous distribution of 26Al, we demonstrate with our new high precision Mg isotope data, in conjunction with petrographic evidence, that the Mg isotope system has been disturbed in Asuka 881394. We suggest that the 26Al-26Mg system closed to diffusion after the U-Pb system, either due to slow cooling on the parent body or low-grade metamorphic re-equilibration of Mg. Thus, we can satisfactorily explain the observed age discrepancy between 26Al-26Mg and U-Pb systems in Asuka 881394 without invoking heterogeneous distribution of 26Al/27Al ratio in the early Solar System.Comparison of the Asuka 881394 data with that of other anomalous achondrites from distinct parent bodies suggests that these could also have evolved from a source region with a canonical 26Al/27Al ratio. Because these achondrites have significant differences in their ε54Cr-Δ17O systematics, which could be indicative of location within the early protoplanetary disk, it is consistent with homogeneous distribution of 26Al in the early Solar System. Angrites remain an outlier; either because they evolved from a source with a lower 26Al/27Al ratio or because their 26Al-26Mg or Pb-Pb data are problematic. In either case, this suggests that basaltic angrites are questionable as the age anchor for the entire Solar System as a whole, and other very old, well preserved achondrites should be considered for that role.

Tobacco Use and Sexual Orientation in a National Cross-sectional Study: Age, Race/Ethnicity, and Sexual Identity–Attraction Differences

The purpose of this study is to determine the past-year prevalence estimates of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder based on sexual identity among U.S. adults, and to examine potential variations in these estimates by age, race/ethnicity, and sexual identity-attraction concordance/discordance. The 2012-2013 National Epidemiologic Survey on Alcohol and Related Conditions collected data via in-person interviews with a cross-sectional nationally representative sample of non-institutionalized adults (response rate=60.1%) and analyses for the present study were conducted in 2017. Any past-year nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder were most prevalent among sexual minority-identified adults compared with heterosexual-identified adults, with notable variations based on sex, age, race/ethnicity, and sexual identity-attraction discordance. Elevated rates of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder among sexual minorities were most prevalent among younger lesbian women and gay men, and all age groups of bisexual men and women. The odds of any nicotine/tobacco use, cigarette smoking, and DSM-5 tobacco use disorder were significantly greater among sexual identity-attraction discordant women and significantly lower among sexual identity-attraction discordant men. These findings provide valuable new information about sexual minority subgroups, such as self-identified bisexual older adults and sexual identity-attraction discordant women, that appear to be at higher risk for adverse smoking-related health consequences as a result of their elevated rates of cigarette smoking. Additional attention is warranted to examine these high-risk subpopulations prospectively and, if the results are replicated with larger samples, this information can be used to target smoking-cessation and lung cancer screening efforts.