Age Discrepancy Research Articles

Polypharmacy in Pediatric Palliative Care: Exploring Discrepancies Between Physicians and Pharmacists

Background/Objectives: Off-label drug use is prevalent in pediatric care, particularly in pediatric palliative care (PPC), due to the scarcity of pediatric-specific formulations and clinical trials. Differences in perception between healthcare professionals regarding off-label prescriptions underscore the complexity of this practice and highlight the need for improved collaboration to optimize therapeutic outcomes. Methods: A cross-sectional observational study was conducted from August to October 2021 at the PPC center of the University Hospital of Padova, Italy. Data were collected from medical records of 169 patients. Off-label prescriptions were independently assessed by two physicians and two clinical pharmacists using respective reference sources. Discrepancies were resolved through consensus. Statistical analyses included the χ2-test for categorical variables and t-tests for continuous data. Results: Among the 993 drug prescriptions analyzed, the pharmacists reported a higher proportion of off-label uses (32.9%) compared to the physicians (18.4%; p < 0.05). After a consensus, 26.5% of the prescriptions were identified as off-label, with 67.9% due to indications, 49.6% due to dosage, and 44.4% due to age discrepancies. Conclusions: This study suggests a high prevalence of off-label prescribing in pediatric palliative care (PPC) and highlights differing professional perspectives, underscoring the potential benefits of exploring standardized protocols and enhanced interdisciplinary collaboration. Enhanced communication between healthcare providers, alongside the development of registries and clinical trials, is essential for improving the safety and efficacy of off-label drug use in pediatric populations. A flexible regulatory framework and customized galenic formulations could further support these goals.

P0963 Nationwide analysis of targeted telemedicinal patient education in IBD – a randomized-controlled trial

Abstract Background Data suggest that patients’ knowledge about their chronic disease is associated with treatment adherence, and education may help improve disease outcomes. The effectiveness of educational activities depends on the source of the information. Our study aimed to compare the effectiveness of targeted educational activities in written and podcast formats for patients with inflammatory bowel disease (IBD). Methods In this nationwide randomized controlled trial, IBD patients were enrolled between December 2023 and May 2024. At baseline, enrolled patients completed an online questionnaire assessing general knowledge of their disease (Inflammatory Bowel Disease Knowledge [IBD-KNOW]) and health-related quality of life (Short Inflammatory Bowel Disease Questionnaire [SIBDQ] and Patient Health Questionnaire-9 [PHQ-9]). Patients were randomized (1:1) into a control and an intervention group and the latter received targeted telemedical educational material, either in podcast format or as a written version, covering topics on anatomy, medical and surgical therapy, quality of life, epidemiology, diet/lifestyle, reproduction, and vaccination. This content was developed by IBD experts. Two months after the educational material was distributed, intervention group was re-tested, and satisfaction was measured. Descriptive statistics, Welch’s test, and Fisher’s exact test were used, with p-values <0.05 considered significant. Results A total of 221 patients were recruited, among whom 129 (58%) had Crohn’s disease (median age was 42 years [IQR 34-49], and median disease duration was 10 years [IQR 4-19], Table 1). Higher baseline IBD-KNOW scores were associated with longer disease duration (95% CI for B: 0.08-0.22, p < 0.001) and lower PHQ-9 scores (95% CI for B: 0.23-0.001, p = 0.052). Of the 221 patients, 95 were randomized into the intervention group to receive educational content, with 46/95 receiving the written version and 49/95 the podcast. Baseline characteristics and overall IBD-KNOW scores did not differ significantly between groups, except for a clinically irrelevant age discrepancy. After the educational intervention, the intervention group had higher overall IBD-KNOW scores compared to the control group (26.7 vs. 23.7, p < 0.001), while the format of the educational activity or quality of life had no significant impact on scores (Figure 1). Patient satisfaction was high (mean score of 8 ± 1.98) and was not influenced by the format of the educational content. Conclusion Telemedical education may enhance disease knowledge among IBD patients, with both forms of educational materials proving equally effective. Although no clear predictors of educational efficacy were identified, disease duration was associated with higher baseline knowledge.

AS YOUNG AS YOU FEEL? TRACKING SUBJECTIVE AGE AND PHYSICAL WELL-BEING BEFORE A LUNG CANCER SCAN

Abstract Research has not yet considered how cancer-related events trigger poor quality of life. Here, researchers examined whether the discrepancy between felt and chronological age was related to physical well-being, and if these fluctuated as patients with lung cancer approached a triggering event – repeated CT scans. 25 patients treated with curative intent treatment for lung cancer were recruited within 6 months of their upcoming CT scan. Patients were predominantly white (80%; Black: 12%), women (96%), between 43 and 78 years old (M = 62.33, SD = 8.10). Baseline surveys collected age, and repeated monthly surveys gathered physical well-being and felt age every 30 days until one’s scan. Following a monthly response rate of 100% (59 of 59 received), researchers calculated proportional discrepancy felt age scores by subtracting chronological age from felt age and dividing by chronological age. Using this score, researchers investigated the monthly relationship between age discrepancy and physical well-being. Results showed that on months when patients felt closer to, or older than, their chronological age they reported increases in physical well-being (γ10 = 1.75, t = 2.13, p =.04). The present model accounted for 33% of the within-person, and 39% of the between-person variance of physical well-being. In contrast to studies in non-clinical populations, results showed that feeling older was associated with better physical well-being in the months prior to a CT scan. Qualitative interviews could identify themes in coping with repeated scans that may mitigate the effects cancer treatment can have on physical well-being.

Prevalence of Idiopathic Macular Hole in a Specialized Ophthalmological Referral Center: A Retrospective Cross-Sectional Study (2018-2022).

An idiopathic macular hole (IMH) is a foveal opening in the neurosensory retina caused by perifoveal vitreomacular traction and detachment. IMH prevalence varies considerably across populations,highlighting a need for further investigation, especially in underrepresented groups such asHispanics. This retrospective, descriptive, cross-sectional study analyzed IMH prevalence in a Hispanic population over four years. Electronic records of patients were reviewed at a single referral center.All patients aged 18 years and above who presented for a first-time comprehensive ophthalmology evaluation were included. IMH diagnosis was clinically made and confirmed with optical coherence tomography (OCT). Data analysis involved descriptive and inferential statistics, adhering to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) guidelines. Of 116,655 electronic records analyzed from March 2018 to July 2022, 397 subjects were identified in our analysis. The estimated prevalence of IMH was 0.34% (95% confidence interval (CI): 0.307-0.375), with a female-to-male ratio of 4:1. The mean age of the participants was 67.75 ± 9.38 years.Initial visual acuity, laterality, comorbidities, and clinical findings were assessed.No significant gender differences were documented. Subgroup analyses revealed significant age discrepancies based on comorbidities and clinical symptoms. Our study provides insight into the prevalence of IMHs in a Hispanic population.Its findings are similar to those published for other populations.The observed prevalence emphasizes the importance of proactive screening for IMHs in older patients, especially if they are women. Clinical markers such as the Watzke-Allen sign are helpful in the early detection of IMHs.

Evaluation of disease knowledge and attitude with selected self-care and sociodemographic factors among outpatients with hypertension: a cross-sectional study

BackgroundLots of interplays between many patient-related factors may influence disease progression among patients with hypertension. This study evaluated disease knowledge and attitude, as well as selected self-care and sociodemographic factors among patients with hypertension.MethodsA cross-sectional study was carried out among outpatients with hypertension in a cross-sectional study involving three tertiary hospitals. An interviewer-administered semi-structured questionnaire was administered for data collection.ResultsSelf-reported medication adherence revealed that majority, 180(60.4%), had high medication adherence out of 298 that participated. Medication discrepancy was observed among 153(51.3%) patients, while 131(44.0%) had high health literacy and blood pressure was controlled among 200 (67.1%) patients. Average hypertension knowledge assessment score was 10.89 ± 1.79 out of a maximum obtainable score of 13. Average hypertension attitude score was 52.60 ± 5.49, out of the maximum obtainable of 60. Significant associations observed with patients’ hypertension knowledge were with disease control (Beta = − 0.484, p = 0.019), educational level (Beta = 1.260, p < 0.001) and disease attitude (Beta = 0.698, p < 0.001); while significant association with disease attitude were with age (Beta = 2.360, p < 0.001) and disease knowledge (Beta = 2.637, p < 0.001). Significant differences were observed between hypertension knowledge and level of formal education (p < 0.001), health literacy (p < 0.001) and disease attitude (p < 0.001); while for disease attitude, significant differences were observed with patients’ age (p = 0.002), level of formal education (p = 0.005), and health literacy (p < 0.001). Significant differences were also observed between patients’ age and medication discrepancy (p = 0.047), medication adherence and age (p = 0.046), level of formal education and health literacy (p < 0.001).ConclusionsDisease knowledge and attitude among the patients were satisfactory, and the majority were medication adherent. Health literacy level was average. The determinants of disease knowledge are disease control, educational level and disease attitude while for disease attitude are age and disease knowledge.

Couples age discrepancies in a large‐scale European sample: Evolutionary and sociocultural perspectives

AbstractThis study examines age discrepancies in couples formed at various stages of life. Both evolutionary and sociocultural perspectives suggest that people's preferences for their partner's age gradually change throughout their lifespan. This study includes European couples (N = 35,996; 51% women and 49% men) surveyed in two waves of the panel study Survey of Health, Ageing, and Retirement in Europe (SHARE). A linear regression model was employed to analyze age differences in couples concerning when the relationship began. For men, the projected age of their partner decreased by nearly 1 year for every 5 years of their age. A similar but smaller effect was observed for women. These findings were consistent across 29 countries and indicated that men tended to be more inclined to start relationships with younger partners as they grew older. Conversely, women's initial tendency to partner with slightly older individuals shifted toward same‐aged partners as they aged. These results indirectly suggest that preferences in age‐related mate selection may systematically change as individuals grow older. An evolutionary and sociocultural rationale for age disparities seems plausible for men, regardless of their age, whereas sociocultural influences come into play for women as they age.

Persistent Inequality in Access to Rheumatology Care for Females After the COVID-19 Pandemic.

To examine the effect of biological sex on wait-times to first rheumatology appointment in a central triage system before, during and after the COVID-19 pandemic. De-identified data of patients referred to one centralised Rheumatology referral centre between November 2019 and December 2023 were extracted from the electronic medical record. Variables collected and analysed included time from referral to first appointment, biological sex, referral period, triage urgency, age, and geographic location. 19,681 referrals were identified. In the pre-COVID period, there was no significant difference in wait-times by biological sex or age. After adjusting for triage level, age and geographic location, females waited significantly longer in the peri-COVID period versus males (10.2days, 95% CI 7.1, 13.3), which persisted in the post-COVID period (7.5days, 95% CI 4.0, 11.1). Similarly, younger patients waited longer than older patients in the peri-COVID period (4.7 fewer days per decade increase in age (95% 3.9, 5.6)). This age discrepancy persisted through the post-COVID period (2.3days, 95% CI 1.6, 3.5). Geographic location was a significant predictor of wait-times in the post-COVID period, with those outside of Edmonton waiting longer than in Edmonton. Once the change in referral pattern from Northwest Territories was accounted for, this discrepancy ceased. Female and younger patients have been disproportionately impacted by wait-time increases during the COVID-19 pandemic, with minimal improvements observed during the post-COVID period. These findings should prompt further investigation into the underlying causes of these observed inequities in access to rheumatology care to identify solutions.

Long-term functional outcome of limb-sparing surgery for paediatric bone sarcoma around the knee.

Surgical limb sparing for knee-bearing paediatric bone sarcoma is considered to have a clinically significant influence on postoperative function due to complications and leg-length discrepancies. However, researchers have not fully evaluated the long-term postoperative functional outcomes. Therefore, in this study, we aimed to elucidate the risk factors and long-term functional prognosis associated with paediatric limb-sparing surgery. We reviewed 40 patients aged under 14 years who underwent limb-sparing surgery for knee bone sarcoma (15 cases in the proximal tibia and 25 in the distal femur) between January 2000 and December 2013, and were followed up for a minimum of five years. A total of 35 patients underwent reconstruction using artificial materials, and five underwent biological reconstruction. We evaluated the patients' postoperative complications, survival rate of reconstruction material, and limb, limb function, and leg-length discrepancy at the final follow-up, as well as the risk factors for each. Complications were observed in 55% (22/40) of patients. The limb survival and reconstruction material rates at five and ten years were 95% and 91%, and 88% and 66%, respectively. Infection was the only risk factor in both survivals (p < 0.001, p = 0.019). In the 35 patients with limb preservation, the median International Society of Limb Salvage (ISOLS) score at the final follow-up was 80 (47% to 97%). Younger age (p = 0.027) and complications (p = 0.005) were poor prognostic factors. A negative correlation was found between age and leg-length discrepancy (R = -0.426; p = 0.011). The ISOLS scores were significantly lower in patients with a leg-length discrepancy of more than 5 cm (p = 0.005). Young age and complications were linked to an unfavourable functional prognosis. Leg-length correction was insufficient, especially in very young children, resulting in decreased function of the affected limb. Limb-sparing surgery for these children remains a considerable challenge.

Sediment source-to-sink patterns along the southeast China coast during the late Quaternary: New insights from sediment geochemistry and OSL ages in Ningde Bay

The geomorphology and environmental conditions of the southeast China coast are significantly influenced by sediment discharge from the Yangtze River, a major river located to the north. Nonetheless, the extent to which the Yangtze River affects sediment transport processes from source to sink along the southeast coast remains unclear. Our recent findings in coastal/marine deposits from the late Quaternary period (MIS5e, MIS3, and MIS1) in Ningde Bay offer new perspectives on this issue. Provenance discrimination of the late Quaternary boreholes was carried out using sediment geochemical analysis and OSL dating of fine- and medium-grained quartz. The results indicate varying provenances during sea-level fluctuation, with distal Yangtze River origins during MIS5e, MIS3, and MIS1, and a local source during MIS4. The findings also suggest that the southward transport of Yangtze sediments along the southeast China coast has occurred since MIS5e. However, OSL ages of the fine-grained quartz in the MIS3 deposit range from approximately 90 to 140 kyr, notably older than those of medium-grained quartz (40–80 kyr). This remarkable age discrepancy indicates that Yangtze-derived sediments previously deposited on the shelf of the East China Sea during MIS5 were reworked and transported southward in MIS3. This phenomenon can be elucidated by the insufficient supply of Yangtze sediments during MIS3, which could be linked to the weakened East Asian monsoon. This new source-to-sink pattern for the southeast China coast is characterized by a compensating mechanism of inner shelf old sediment in response to the inadequate supply of Yangtze sediments. This study contributes to a better understanding of the significant impacts of reduced Yangtze sediment input on its distal sedimentary systems over time.

Palaeoenvironmental implications of Late Quaternary bioerosion traces in central Patagonia (Southern Atlantic, Argentina)

ABSTRACTBioerosion is a valuable tool for inferring palaeoenvironmental and palaeoclimatic changes over time and across different regions. However, studies of bioerosion traces are scarce in the Southern Hemisphere. Most ichnological studies within Argentina are concentrated in San Jorge Gulf (Patagonia, Argentina) and little is known about deposits located north of the Gulf. Here, we focus on bioerosion traces on Quaternary mollusc shells. Samples were collected from Quaternary marine deposits at the Bahía Vera–Cabo Raso sites in northern San Jorge Gulf. To resolve age discrepancies reported in the literature, we use amino acid racemization and radiocarbon dating to confirm the presence of beach ridge deposits from Marine Isotope Stage (MIS) 5 and MIS 1. Fourteen ichnotaxa are recorded in the study area. Additionally, distinct variations in the pattern of bioerosion across different ages are observed, indicating that environmental changes occurred in the northern San Jorge Gulf between the MIS 5 interglacial and the Holocene. This reinforces the hypothesis that there is an association between bioerosion, productivity and circulation in the Southern Atlantic Ocean.

SIMS U-Pb dating of baddeleyite-zircon pairs in mafic rocks to determine the ages of magmatic mineralization and hydrothermal remobilization in a Ni-Cu-(PGE) deposit

Ni-Cu-(PGE) sulfide deposits associated with mafic–ultramafic rocks are the most important sources of Ni and platinum-group elements (PGE) in the world. These deposits also contain significant amounts of Cu. Such deposits are generally considered to have formed by multiple stages of primary magmatic concentration and secondary hydrothermal remobilization. However, constraining the ages of Ni-Cu-(PGE) sulfide deposits has proven challenging, particularly those that have experienced post-magmatic hydrothermal overprinting and remobilization. The lack of robust geochronology data has hindered understanding of the geological controls on this important type of mineralization. The Chibaisong Ni-Cu-(PGE) sulfide deposit in the North China Craton is characterized by disseminated and net-textured ores formed by magmatic processes and overprinted by hydrothermal Cu-rich vein stockwork. The Cu-rich vein stockwork is fracture-controlled, and contains a mineral assemblage of Ni-Cu sulfides (chalcopyrite, pyrrhotite, pentlandite), amphibole and quartz. Chalcopyrite in the hydrothermal stockwork is relatively depleted in Ni but enriched in Ag and Cd compared with disseminated magmatic chalcopyrite, typical of hydrothermal superimposed ores as documented elsewhere. We identified baddeleyite-zircon pairs associated with Ni-Cu sulfides in hydrothermal superimposed ores of the Chibaisong deposit, in which the baddeleyite is unequivocally of primary igneous origin whereas the zircon represents the replacement product of baddeleyite during hydrothermal alteration. In situ SIMS U-Pb dating of baddeleyite and zircon yielded weighted mean 207Pb/206Pb ages of 2181 ± 21 Ma and 1892 ± 33 Ma, respectively, interpreted as the timing of magmatic mineralization and subsequent hydrothermal remobilization of the Ni-Cu-(PGE) deposit. Our results explain the large discrepancies in sulfide Re-Os ages previously obtained from this deposit. This study demonstrates that on the basis of detailed BSE imaging, in situ SIMS U-Pb dating of baddeleyite-zircon pairs can provide robust age constraints for both magmatic mineralization and hydrothermal remobilization of Ni-Cu-(PGE) sulfide deposits hosted in mafic–ultramafic intrusions, although further studies are needed to test whether the formation of such deposits commonly entails multiple stages of hydrothermal remobilization. Since baddeleyite or baddeleyite-zircon pairs are common accessory minerals in Ni-Cu-(PGE)-bearing mafic–ultramafic rocks, the dating approach employed in this study may be applicable to similar deposits elsewhere.

Detrital zircon U-Pb ages and provenance of Paleogene paleochannel strata, Sierra Nevada and western Nevada: Implications for paleotopographic evolution

The Paleogene paleotopography of the western United States, which may grant insight into Farallon subduction dynamics and North American Cordillera orogenic processes, can be constrained by reconstructing drainage networks through sediment provenance studies. In the northern Sierra Nevada, the provenance of SW-directed, Paleogene paleochannel deposits is controversial; prior studies favor either sources proximal to the deposits or distal source areas in central Nevada. These different hypothesized source areas would have contrasting implications for the paleotopography of the Sierra Nevada and western Basin and Range. We conducted a new provenance analysis of paleochannel deposits in the Sierra Nevada and western Nevada using new and compiled detrital zircon U-Pb age data from across the preserved paleochannel network, together with compiled bedrock geochronologic ages of potential sediment source areas for the paleochannel deposits. The geochro­nology compilation of potential source areas reveals systematic longitudinal variations in bedrock ages within the study area. Jurassic ages are present primarily in the western Sierra Nevada batholith, Cretaceous ages are dominant in the eastern Sierra Nevada batholith, and Eocene ages are present only in north-central Nevada. The distribution of potential source ages allows confident inference of sediment provenance from detrital zircon U-Pb ages. The distributions of detrital zircon U-Pb ages in the paleochannel depos­its can be categorized into three distinct types. The first type, found in the vicinity of Malakoff Diggins State Historic Park (SHP) and further northwest, is dominated by Jurassic, Paleozoic, and Precambrian ages reflecting derivation from local sources in the western Sierra Nevada, and also contains scattered Eocene ages. The lack of Late Cretaceous ages in these samples, despite the presence of Late Cretaceous plutons in close proximity to the east, suggests small sediment source areas with fluvial transport of zircon grains no farther than 50 km. The few Eocene ages in these samples likely reflect volcanic air fall, consistent with an overlying tuff at one sample site that is interpreted to have its volcanic source to the north, outside the paleochannel network. The second zircon age distribution type, from samples south of Malakoff Diggins SHP, includes Cretaceous and Jurassic ages representative of exposed bedrock across the entire width of the Sierra Nevada batholith but no Eocene ages. This combination of ages suggests a sediment source area that encompassed the entire batholith but did not include north-central Nevada. The third zircon age distribution type, from samples to the northeast of Malakoff Diggins SHP, contains Jurassic, Cretaceous, and Eocene ages consistent with fluvial derivation of sediment from the entire width of the Sierran batholith as well as from north-central Nevada. This third type only occurs in fluvial deposits interbedded with Oligocene ignimbrite tuffs, whereas samples older than the Oligocene tuffs belong to zircon age distribution types 1 or 2. Thus, prior to the emplacement of Oligocene ignimbrites, there is no evidence of fluvial transport of sand-sized sediment from north-central Nevada sources to Sierran paleochannel deposits. The lack of pre-Oligocene fluvial transport across the Sierra Nevada may reflect either a Paleogene drainage divide that separated the Sierra Nevada from north-central Nevada or a large-scale knick zone with a low-gradient upstream reach that trapped sand and larger sediment. The first arrival of fluvially transported Eocene zircon grains following Oligocene ignimbrite emplacement suggests that ignimbrite volcanism, and related hinterland uplift, established or promoted sediment transport from north-central Nevada across the Sierra Nevada by driving drainage reorganization or steepening existing channels. Our provenance analysis broadly confirms previous paleochannel network reconstructions, especially for the Ancestral Yuba River, and thus validates the use of paleochannel deposits as a datum by which to infer post-Paleogene tilting of the northern Sierra Nevada. Azimuthal trends in Ancestral Yuba River paleochannel gradient suggest ~0.6° SW-directed, post-Paleogene tilting of the northern Sierra Nevada, which would have resulted in ~1 km of uplift of the range crest. Such a magnitude is consistent with Eocene–Oligocene stable isotope paleoelevation estimates.

Transcallosal white matter and cortical gray matter variations in autistic adults ages 30-73 years: A bi-tensor free water imaging approach.

Background: Autism spectrum disorder (ASD) has long been recognized as a lifelong condition, but brain aging studies in autistic adults aged >30 years are limited. Free water, a novel brain imaging marker derived from diffusion MRI (dMRI), has shown promise in differentiating typical and pathological aging and monitoring brain degeneration. We aimed to examine free water and free water corrected dMRI measures to assess white and gray matter microstructure and their associations with age in autistic adults. Methods: Forty-three autistic adults ages 30-73 years and 43 age, sex, and IQ matched neurotypical controls participated in this cross-sectional study. We quantified fractional anisotropy (FA), free water, and free water-corrected FA (fwcFA) across 32 transcallosal white matter tracts and 94 gray matter areas in autistic adults and neurotypical controls. Follow-up analyses assessed age effect on dMRI metrics of the whole brain for both groups and the relationship between dMRI metrics and clinical measures of ASD in regions that significantly differentiated autistic adults from controls. Results: We found globally elevated free water in 24 transcallosal tracts in autistic adults. We identified negligible differences in dMRI metrics in gray matter between the two groups. Age-associated FA reductions and free water increases were featured in neurotypical controls; however, this brain aging profile was largely absent in autistic adults. Additionally, greater autism quotient (AQ) total raw score was associated with increased free water in the inferior frontal gyrus pars orbitalis and lateral orbital gyrus in autistic adults. Limitations: All autistic adults were cognitively capable individuals, minimizing the generalizability of the research findings across the spectrum. This study also involved a cross-sectional design, which limited inferences about the longitudinal microstructural changes of white and gray matter in ASD. Conclusions: We identified differential microstructural configurations between white and gray matter in autistic adults and that autistic individuals present more heterogeneous brain aging profiles compared to controls. Our clinical correlation analysis offered new evidence that elevated free water in some localized white matter tracts may critically contribute to autistic traits in ASD. Our findings underscored the importance of quantifying free water in dMRI studies of ASD.

Baseline lung allograft dysfunction after bilateral deceased-donor lung transplantation: A single-center experience in Japan

BackgroundBaseline lung allograft dysfunction (BLAD) refers to a condition in which a lung transplant recipient does not achieve normal pulmonary function (i.e., forced expiratory volume in 1 s or forced vital capacity of <80% of predicted values). Although BLAD is reportedly associated with a poor prognosis, the condition has not been examined in Japanese patients. MethodsIn this study, we retrospectively examined 38 Japanese adults who underwent bilateral lung transplantation from 2015 to 2022 in a single center. ResultsTwenty-one (55%) patients met the criteria for BLAD. No significant differences were found in recipient or donor factors between the BLAD and non-BLAD groups, but the donor–recipient ratio of the predicted vital capacity was lower in the BLAD group (p = 0.009). The intensive care unit length of stay, ventilator duration, and blood loss during transplant surgery were significantly higher in the BLAD group (p < 0.05). No significant difference was found in survival. The median observation period was significantly shorter in the BLAD than non-BLAD group (744 vs.1192 days, respectively; p = 0.031). The time to reach the normal threshold of pulmonary function after lung transplantation varied among the patients, ranging from 6 months to 4 years. ConclusionsThe characteristics of these Japanese patients with BLAD were similar to those of other patients in previous reports. The effects of the observation period and donor–recipient age discrepancy on BLAD require further exploration.

Variability of soil enzyme activities and nutrients with forest gap renewal interacting with soil depths in degraded karst forests

Forest gaps serve as crucial starting points for forest self-renewal. Within these gaps, soil enzymes play an essential role in driving nutrient transformation and species renewal. However, how forest gap renewal regulates soil fertility through soil enzyme across various soil depths remains unclear. This investigation delved into the dynamics of soil enzymes and nutrients within karst forest gaps at four developmental age stages: Infancy (<10 years), Youth (10–20 years), Middlescence (20–30 years), and Elder (>30 years) across different soil depths (0–10 cm, 10–20 cm, and 20–30 cm). The study determined the contents of CNP and the activities of soil enzymes such as polyphenol oxidase, catalase, protease, and alkaline phosphatase. Two-way ANOVA was employed to assess the variations in gap ages and soil depths, along with their interaction. Redundancy analysis (RDA) was used to reveal the correlations between soil enzyme activities and CNP fertility indicators. The results indicated that gap age significantly influenced the activities of alkaline phosphatase, polyphenol oxidase, and protease, as well as the contents of total and available nitrogen, phosphorus, and organic carbon, alongside the ratios of N/P, C/N, and C/P. Catalase activity, however, did not vary significantly with gap age, although soil depth influenced these parameters, excluding total phosphorus and the C/N ratio. Notably, in the 0–10 cm soil layer, alkaline phosphatase activity, total nitrogen, available nitrogen, and organic carbon contents significantly increased with gap age increase, followed by a significant decrease after the middlescence stage. In the 10–20 cm and 20–30 cm soil layers, Alkaline phosphatase and polyphenol oxidase activities, along with N/P and C/N ratios initially decreased and then increased with gap age increase. During the Infancy, Youth, and Middlescence stages, Polyphenol oxidase and protease activities, CNP contents, as well as N/P and C/P ratios generally decreased with soil depth increase or after an increase in the 10–20 cm soil layer. RDA highlighted the variational positive and negative correlations between soil enzyme activities and CNP fertility indicators across soil depths during forest gap renewal, with explanatory rates ranging from 88.05 % to 94.67 % across soil layers. Overall, this study suggests that forest gap renewal significantly influences soil enzymes, CNP content and stoichiometry, modifying soil CNP content through stoichiometric regulation across different soil depths, and ultimately sustaining soil fertility via soil enzymes.

Brain age revisited: Investigating the state vs. trait hypotheses of EEG-derived brain-age dynamics with deep learning

Abstract The brain’s biological age has been considered as a promising candidate for a neurologically significant biomarker. However, recent results based on longitudinal magnetic resonance imaging (MRI) data have raised questions on its interpretation. A central question is whether an increased biological age of the brain is indicative of brain pathology and if changes in brain age correlate with diagnosed pathology (state hypothesis). Alternatively, could the discrepancy in brain age be a stable characteristic unique to each individual (trait hypothesis)? To address this question, we present a comprehensive study on brain aging based on clinical Electroencephalography (EEG), which is complementary to previous MRI-based investigations. We apply a state-of-the-art temporal convolutional network (TCN) to the task of age regression. We train on recordings of the Temple University Hospital EEG Corpus (TUEG) explicitly labeled as non-pathological and evaluate on recordings of subjects with non-pathological as well as pathological recordings, both with examinations at a single point in time TUH Abnormal EEG Corpus (TUAB) and repeated examinations over time. Therefore, we created four novel subsets of TUEG that include subjects with multiple recordings: repeated non-pathological (RNP): all labeled non-pathological; repeated pathological (RP): all labeled pathological; transition non-patholoigical pathological (TNPP): at least one recording labeled non-pathological followed by at least one recording labeled pathological; and transition pathological non-pathological (TPNP): similar to TNPP but with opposing transition (first pathological and then non-pathological). The results show that our TCN reaches state-of-the-art performance in age decoding on non-pathological subjects of TUAB with a mean absolute error of 6.6 years and an R2 score of 0.73. Our extensive analyses demonstrate that the model underestimates the age of non-pathological and pathological subjects, the latter significantly (-1 and -5 years, paired t-test, p = 0.18 and p = 6.6e−3). Furthermore, there exist significant differences in average brain age gap between non-pathological and pathological subjects both with single examinations (TUAB) and repeated examinations (RNP vs. RP) (-4 and -7.48 years, permutation test, p = 1.63e−2 and p = 1e−5). We find mixed results regarding the significance of pathology classification based on the brain age gap biomarker. While it is indicative of pathological EEG in datasets TUAB and RNP versus RP (61.12% and 60.80% BACC, permutation test, p = 1.32e−3 and p = 1e−5), it is not indicative in TNPP and TPNP (44.74% and 47.79% BACC, permutation test, p = 0.086 and p = 0.483). Additionally, all of these classification scores are clearly inferior to the ones obtained from direct EEG pathology classification at 86% BACC and higher. Furthermore, we could not find evidence that a change of EEG pathology status within subjects relates to a significant change in brain age gap in datasets TNPP and TPNP (0.46 and 1.35 years, permutation test, p = 0.825 and p = 0.43; and Wilcoxon-Mann-Whitney and Brunner-Munzel test, p = 0.13). Our findings, thus, support the trait rather than the state hypothesis for brain age estimates derived from EEG. In summary, our findings indicate that the neural underpinnings of brain age changes are likely more multifaceted than previously thought, and that taking this into account will benefit the interpretation of empirically observed brain age dynamics.

Donor to recipient age matching in lung transplantation: A European experience

BackgroundThe age profile of organ donors and patients on lung transplantation (LT) waiting lists have changed over time. In Europe, the donor population has aged much more rapidly than the recipient population, making allocation decisions on lungs from older donors common. In this study we assessed the impact of donor and recipient age discrepancy on LT outcomes in the UK and France. MethodsA retrospective analysis of all adult single or bilateral LT in France and the UK between 2010 and 2021. Recipients were stratified into 3 age groups: young (≤ 30 years), middle-aged (30 to 60) and older (≥60). Their donors were also stratified into 2 groups <60, ≥ 60. Primary graft dysfunction (PGD) rates and recipient survival was compared between matched and mismatched donor and recipient age groups. Propensity matching was employed to minimize covariate imbalances and to improve the internal validity of our results. ResultsOur study cohort was 4,696 lung transplant recipients (LTRs). In young and older LTRs, there was no significant difference in 1 and 5-years post-transplant survival dependent on the age category of the donor. Young LTRs who received older donor grafts had a higher risk of severe grade 3 PGD. ConclusionOur findings show that clinically usable organs from older donors can be utilized safely in LT, even for younger recipients. Further research is needed to assess if the higher rate of PGD3 associated with use of older donors has an effect on long-term outcomes.

Americium-241 in peat bogs as a global marker of the beginning of the Anthropocene: examples from Europe and North America

Fallout radionuclides are being considered as potential global indicators of the beginning of the Anthropocene, yet questions persist about their preservation in bogs. This study assessed the reliability of 241Am records in peat cores from acidic, ombrotrophic bogs. The source of 241Am (half-life 432.7 years) in these natural archives is radioactive decay of the short-lived plutonium isotope 241Pu (half-life 14.329 years) present in fallout from the atmospheric testing of nuclear weapons. We leveraged previously gathered data to gauge the congruence of 241Am records with 210Pb dates, examining the alignment of the 241Am activity peak with the depth corresponding to the year AD 1963, as determined using the 210Pb constant rate of supply (CRS) model. Our analysis employed 35 peat cores from 30 sites across Europe and North America, collected over the last three decades for trace metal deposition studies. Each core underwent independent 210Pb dating. Among the 35 cores, 10 were excluded because of significant uncertainty in 241Am peak quantification. Among the remaining 25 cores, 22 displayed a single 241Am peak and 3 exhibited two peaks with similar 241Am activities. Of the 22 cores with a single peak, 18 were within 10 years of AD 1963, with 10 of those being within 5 years. For 10 of the 22 cores, 14C dates obtained from the atmospheric bomb pulse curve enabled comparison, with 9 showing ≤10 years of difference and 7 of those showing ≤5 years from the 210Pb CRS model AD 1963. Factors contributing to age discrepancies included (i) analytical limitations of 241Am measurements in peat using gamma spectrometry, (ii) the impact of peat accumulation rates on 241Am activities, i.e., dilution effects, (iii) post-depositional migration of 241Pu and (or) 241Am, (iv) uncertainties introduced during 210Pb age-modelling, and (v) the limited number of samples dated using 14C. The usefulness of 241Am as an Anthropocene marker (assuming AD 1963) hinges on the accepted uncertainty level in defining this epoch. Detection of 241Am through gamma spectrometry was statistically validated as a real peak in 22 out of a total of 35 cores: this fraction (63%) is within the range reported in other studies. Given that the cores were gathered from 16 European and 14 North American sites, these peaks can be taken to denote the hemispheric onset of the Anthropocene. Lastly, common post-depositional migration of 137Cs in ombrotrophic peatlands contrasts with its immobility in minerotrophic peatlands, where the presence of mineral matter and neutral pH inhibit its movement. This observation suggests that fens and swamps, characterized by minerotrophic conditions, may also serve as repositories of nuclear weapons test fallout, including 241Am.

Relationships Between Longevity Via Age Difference and Health Age Versus Three Critical Lifestyle Factors, Food Portion, Daily Exercise, and Sleep Hours Using Viscoplastic Energy Model of GH-Method: Math-Physical Medicine (No. 1054, VMT #452)

Moderate food portions, consistent exercise, and sufficient sleep are crucial for health maintenance and potential lifespan extension. Statistical evidence from various epidemiological and clinical studies demonstrates a strong correlation between these three lifestyle factors and increased longevity. The author, who avoids smoking, alcohol, and illicit drugs, and has minimal exposure to environmental hazards, acknowledges the limitations of changing his physical age, genetic makeup, or family history. Consequently, he has chosen to concentrate on modifiable lifestyle factors that can impact his lifespan. Through 15 years of his medical research work, he observed that many deaths are predominantly linked to four chronic diseases, particularly diabetes, with obesity often serving as a precursor. Unhealthy eating habits contribute to weight gain, while regular exercise is essential not only for body weight management but also for diabetes control. Additionally, adequate sleep duration and quality also play a significant role in the management of chronic diseases. Hence, he focused on these three critical factors to explore their effects on longevity. The author developed an estimated “health age" formula: Health Age = Real Biological Age * (1 + ((MI - 0.735)/0.735)/2) Age difference = health age - real age In this article, the author examined two outcomes—age discrepancy (Age Diff) and health age (H. Age) —through separate analyses, each related to three consistent lifestyle factors: food portion (Food P.), daily exercise (Steps), and sleep hours (Sleep H.). To analyze these two scenarios, he employs the space-domain Viscoplastic Medicine Theory (SD-VMT) energy model, facilitating a comprehensive understanding of the effects of these three lifestyle factors on the specified medical symptom of longevity. He also selected three normalization factors, i.e. his targets for these three factors, 0.4 for food portion (40% of his food portion in 2012), 16000 walking steps per day, and 7 hours of night sleep.

Correlation between Human Boca virus and IL-23in some Iraqi patients with ischemic heart disease

Heart diseases in the Iraqi population are a significant public health concern. Iraq has experienced in the prevalence of heart diseases, including coronary artery disease, heart failure and hypertension. Different researches have shown that human Boca virus (HBoV) may be a risk factor, for some cardiac disorders. Hence, goals of resent work is to investigate roles of human Boca virus in ischemia heart disease (IHD) and to investigate roles of serum level of IL-23 in these diseases. 40 heart diseases patients and 40 controls were included. Controls were females (n=30) followed by males (n=10), while patients with IHD were 27 males and 13 females. There were highly significant variations in ages of patients and controls with (p≤0.01). The mean ± SE of age of patients with IHD was 37.90 ±0.75 years, while the mean ± SE of controls was 40.52 ±0.79 years. Lipid profile was measured. There were significant variations between patients' and controls. Also, mean ± SE of HDL was statistically significant between ischemia and control groups (85.28 ±4.31 and 55.10 ±1.23 mg/dl) with p≤0.01, respectively. The serum levels of IgG and IgM were assessed using ELISA. There was no significant variation in mean ± SE of serum level of IgM between ischemia and healthy controls (0.251 ±0.04 and. 0.341 ±0.07 ug/Ml). respectively. There were significant variations in mean ± SE of serum level of IgG between ischemia and controls (0.723 ±0.16 and. 0.076 ±0.004 ug/ml). There were highly significantly differences in Mean ± SE of serum level of 1L-23 between IHD heart diseases (0.407 ±0.073 Pg/mL) and healthy controls (0.0121 ±0.003 pg/mL) with p&lt;0.001, respectively.