Age Distribution Research Articles

Resonant and Ultra-short-period Planet Systems Are at Opposite Ends of the Exoplanet Age Distribution

Exoplanet systems are thought to evolve on secular timescales over billions of years. This evolution is impossible to directly observe on human timescales in most individual systems. While the availability of accurate and precise age inferences for individual exoplanet host stars with ages τ in the interval 1 Gyr ≲ τ ≲ 10 Gyr would constrain this evolution, accurate and precise age inferences are difficult to obtain for isolated field dwarfs like the host stars of most exoplanets. The Galactic velocity dispersion of a thin-disk stellar population monotonically grows with time, and the relationship between age and velocity dispersion in a given Galactic location can be calibrated by a stellar population for which accurate and precise age inferences are possible. Using a sample of subgiants with precise age inferences, we calibrate the age–velocity dispersion relation in the Kepler field. Applying this relation to the Kepler field’s planet populations, we find that Kepler-discovered systems plausibly in second-order mean-motion resonances have 1 Gyr ≲ τ ≲ 2 Gyr. The same is true for systems plausibly in first-order mean-motion resonances, but only for systems likely affected by tidal dissipation inside their innermost planets. These observations suggest that many planetary systems diffuse away from initially resonant configurations on secular timescales. Our calibrated relation also indicates that ultra-short-period (USP) planet systems have typical ages in the interval 5 Gyr ≲ τ ≲ 6 Gyr. We propose that USP planets tidally migrated from initial periods in the range 1 day ≲ P ≲ 2 days to their observed locations at P < 1 day over billions of years and trillions of cycles of secular eccentricity excitation and inside-planet damping.

Buprenorphine Prescribing Characteristics Following Relaxation of X-Waiver Training Requirements

Local-level data are needed to understand whether the relaxation of X-waiver training requirements for prescribing buprenorphine in April 2021 translated to increased buprenorphine treatment. To assess whether relaxation of X-waiver training requirements was associated with changes in the number of clinicians waivered to and who prescribe buprenorphine for opioid use disorder and the number of patients receiving treatment. This serial cross-sectional study uses an interrupted time series analysis of 2020-2022 data from the HEALing Communities Study (HCS), a cluster-randomized, wait-list-controlled trial. Urban and rural communities in 4 states (Kentucky, Massachusetts, New York, and Ohio) with a high burden of opioid overdoses that had not yet received the HCS intervention were included. Relaxation of X-waiver training requirements (ie, allowing training-exempt X-waivers) on April 28, 2021. The monthly number of X-waivered clinicians, X-waivered buprenorphine prescribers, and patients receiving buprenorphine were each summed across communities within a state. Segmented linear regression models to estimate pre- and post-policy change by state were used. The number of individuals in 33 participating HCS communities included 347 863 in Massachusetts, 815 794 in Kentucky, 971 490 in New York, and 1 623 958 in Ohio. The distribution of age (18-35 years: range, 29.4%-32.4%; 35-54 years: range, 29.9%-32.5%; ≥55 years: range, 35.7%-39.3%) and sex (female: range, 51.1%-52.6%) was similar across communities. There was a temporal increase in the number of X-waivered clinicians in the pre-policy change period in all states, which further increased in the post-policy change period in each state except Ohio, ranging from 5.2% (95% CI, 3.1%-7.3%) in Massachusetts communities to 8.4% (95% CI, 6.5%-10.3%) in Kentucky communities. Only communities in Kentucky showed an increase in the number of X-waivered clinicians prescribing buprenorphine associated with the policy change (relative increase, 3.2%; 95% CI, 1.5%-4.9%), while communities in other states showed no change or a decrease. Similarly, only communities in Massachusetts experienced an increase in patients receiving buprenorphine associated with the policy change (relative increase, 1.7%; 95% CI, 0.8%-2.6%), while communities in other states showed no change. In this serial cross-sectional study, relaxation of X-waiver training requirements was associated with an increase in the number of X-waivered clinicians but was not consistently associated with an increase in the number of buprenorphine prescribers or patients receiving buprenorphine. These findings suggest that training requirements may not be the primary barrier to expanding buprenorphine treatment.

24 Applying genomic analysis to refine unclassified renal cell carcinoma

Abstract Background Despite the improvements in genomic and pathological techniques to identify renal cell carcinoma (RCC), 2-6% of all patients with RCC cannot be classified into a particular subgroup, thus called “unclassified” RCC (uRCC). Ascertaining the genomic profile of those patients may help select proper treatment and find novel targets. Methods The American Association for Cancer Research (AACR) Project Genomics Evidence Neoplasia Information Exchange (GENIE) database v15.0 was used to select patients with RCC by using the OncoTree codes. All included patients were divided into four groups based on the most frequent subtypes of RCC: clear cell RCC (ccRCC), papillary RCC (pRCC), chromophobe RCC (chRCC), and uRCC. The Cancer Genome Atlas (TCGA) was additionally used to assess corresponding oncogenic signaling pathways. We employed the chi-squared test to compare categorical variables and applied the Benjamini-Hochberg correction to calculate Q-values, thereby controlling the false discovery rate. Results Overall, 1,990 tumor samples from 1,888 patients were evaluated. uRCC was observed in 184 patients (9.7%), whereas most had ccRCC (n=1339, 70.9%), followed by pRCC (n=224, 11.9%) and chRCC (n=141, 7.5%). Age distribution at sample sequencing was comparable between uRCC and other RCC subtypes (P&amp;gt;0.05). The proportion of female patients with uRCC was higher at 38.4%, compared to 26.5% in ccRCC (Q=0.002) and 16.3% in pRCC (Q&amp;lt;0.001), yet was comparable to chRCC at 48.6% (Q=0.210). The prevalence of uRCC was also greater among black patients, accounting for 8.6% vs. 2.1% in ccRCC (Q=0.001). Among patients with uRCC (n=224), the most common genomic alterations (GAs) were detected in NF2 (15.8%), SETD2 (15.8%), TP53 (13.9%), TERT (13.4%), and VHL (11.8%). NF2 alterations were also more prevalent in patients with uRCC than in patients with ccRCC (1.8%, Q&amp;lt;0.001), chRCC (0.7%, Q&amp;lt;0.001), and pRCC (5.8%, Q=0.058). Notably, median overall survival (OS) was poorer in uRCC patients with altered NF2 (n=29) than in those with unaltered NF2 (n=155, 30.7 vs. 87.1 months, p=0.058). Of patients with uRCC, 135 (72.5%) samples were from primary tumors and 39 (20.9%) from metastatic sites, with no difference in GA frequencies between the two. CDKN2A and CDKN2B were the most frequent co-mutated genes in uRCC (Q&amp;lt;0.001), followed by VHL and BAP1 (Q&amp;lt;0.001), and SETD2 and PBRM1 (Q=0.023). GAs in uRCC were primarily observed in pathways related to TP53 (42.8%), cell cycle (33.3%), PI3K (23.5%), and HIPPO (7.7%). Conclusions uRCC exhibited a unique genomic profile distinct from other common RCC subtypes. Notably, NF2 alterations were frequent and correlated with a poorer prognosis.

Estimation of the Salivary Copper Levels in Oral Submucous Fibrosis Condition: An In Vivo Study.

The aim of the present study was to estimate the salivary copper levels in oral submucous fibrosis (OSMF) condition. A total of 60 individuals of which an equal number of 30 each in normal healthy control group as well as in clinically and histopathologically (the biopsy was done once after the clinical confirmation of OSMF in the patient) confirmed patients of OSMF were included in the study group. Total of 51 males and 9 females were considered for the present study and the age distribution of these groups ranged from a minimum of 21 years to a maximum of 74 years. Unstimulated whole saliva was collected from the patient followed by the conventional biopsy practice. The collected saliva was then subjected for the analysis of copper levels. Trace element copper was estimated by using Digital Semiautomatic Analyzer with the help of copper kit. The clinical mouth opening of OSMF was estimated. Analysis of variance (ANOVA) and Tukey HSD post hoc test was used analyze the data wherein the participants were grouped into age ranges of 20-30, 31-40, 41-50, and >60 years. The mean salivary copper level among OSMF and control groups with respect to age in 20-30 years was 55.98 ± 15.50 and 30.87 ± 7.70, in 31-40 years was 63.96 ± 21.13 and 32.95 ± 4.56, in 41-50 years was 50.11 ± 6.83 and 30.46 ± 3.28, and >60 years was 45.65 and 13.67 µg/dL, respectively. The mean salivary copper levels among OSMF and Control groups with respect to males were 55.60 ± 15.27 and 31.18 ± 6.97 and among females were 67.0 ± 24.25 and 30.06 ± 5.77 µg/dL, respectively. The mean salivary copper levels with histopathological grades in very early stage was 47.18 ± 5.73, in early stage was 49.22 ± 7.65, in moderately advanced was 73.53 ± 10.62 and in OSMF with mild dysplasia was 79.98 ± 16.27 µg/dL, respectively. The mean salivary copper levels in individuals with clinical mouth opening more than 35 mm was 45.65 ± 6.57, in 25-35 mm was 48.94 ± 21.60, in 15-25 mm was 70.54 ± 3.52 and in less than 15 mm was 81.50 ± 16.66, respectively. The present study concluded that salivary trace element levels could be used as potential diagnostic and prognostic markers in patients with OSMF. Trace elements are involved in many different physiological and metabolic processes in humans, either directly or indirectly. Copper is involved in vital biochemical activities like different redox and free radical formation and in maintaining cellular proton homeostasis. It is also associated with the processing of oxygen and a component of arecanut in all forms, which is implicated in the etiology of OSMF. How to cite this article: Gupta R, Jayanti I, Das A, et al. Estimation of the Salivary Copper Levels in Oral Submucous Fibrosis Condition: An In Vivo Study. J Contemp Dent Pract 2024;25(5):498-502.

Questionnaire Development to Assess Risk Factors for Environmental Diseases of Children in Daejeon.

Background: Allergic diseases are common in children and adolescents. It is important to assess the prevalence and risk factors of environmental diseases to implement tailored countermeasures. Methods: This questionnaire study investigated factors associated with environmental diseases in elementary school children with an environmental disease from 150 households in Daejeon Metropolitan City, South Korea in 2021. Results: The participants comprised 55.7% girls and 44.3% boys, and the mean age was 10.1 years with an even age distribution. The typical risk factors observed were the type of roads nearby, the presence of mold or stains within the residence, pet ownership, and frequency of indoor ventilation and cleaning. Notably, 73.2% of the households had an eight-lane road nearby, 40.2% reported leaks, stains, or mold within their homes during the past year, and 37.1% ventilated their homes for less than 30 min. After education on preventing and managing environmental diseases, significant changes were observed in bedding washing frequency, average ventilation duration per session, and duration of humidifier usage (p < 0.05-0.001), with improvements in lifestyle. Conclusions: Our study can be used as a reference for expanding indoor air quality control education for parents with children with an environmental disease and providing tailored environmental consultations.

Epidemiological analysis of leptospirosis, dengue, and Co-infection rates among febrile illness cases in Dakshina Kannada, Karnataka

IntroductionLeptospirosis and dengue are two significant public health concerns in tropical and subtropical regions, often resulting in severe forms of disease and fatality. This study addresses the pressing public health issues of leptospirosis and dengue in the Dakshina Kannada district of Karnataka, India. Both diseases pose significant health risks and are relatively understudied in this region, making it essential to investigate their prevalence and clinical presentations for targeted healthcare planning. AimThe primary aim is to determine the frequency of leptospirosis and dengue among febrile illness cases to understand the epidemiological patterns and assess co-infection rates in Dakshina Kannada. MethodBetween 2020 and 2021, serum samples suspected of leptospirosis were tested using IgM ELISA (n = 1629) and the Microscopic Agglutination Test (MAT) (n = 92) for leptospirosis, while dengue was tested using NS1Ag and IgM antibodies ELISA (n = 1415). Data were collected through medical records and patient interviews. Seasonal trends, gender, and age distributions were analyzed. ResultThe study found a significant prevalence of leptospirosis (21 %) and dengue (10 %) among febrile illness cases in the study area, with a 1.3 % co-infection rate. Clinically, fever was common to both diseases, but leptospirosis also frequently exhibited symptoms such as abdominal pain, myalgia, and jaundice. MAT screening revealed a predominance of anti-leptospiral antibodies against the Djasiman, Pyrogenes, Hurstbridge, Hebdomadis, and Grippotyphosa serogroups in Dakshina Kannada. ConclusionThe study highlights the urgent need for focused public health interventions, improved diagnostic tools, and targeted epidemiological studies to manage these diseases. The findings underscore the necessity of enhancing diagnostic capabilities and public health awareness, particularly considering the significant health risks posed by leptospirosis and dengue in the region.

The relationship between clinical impairment and blood drug concentration: Comparison between the most prevalent traffic relevant drug groups

AimThe aim of the present study was to investigate the relationship between blood concentrations of four different drug classes; ethanol, benzodiazepines, amphetamines and tetrahydrocannabinol (THC) and driver impairment as assessed by a clinical test of impairment (CTI). MethodsData was retrieved from a national database on CTI assessments and accompanying blood drug concentrations from apprehended drivers. All drug concentrations in blood were quantified using Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS), and compared to the results of the CTI which were categorized as either “not impaired”, “mildly impaired”, “moderately impaired”, or “considerably impaired”. ResultsA total number of 15 514 individual mono drug-cases collected over 9 years was included. 89 % were men and the median age was 34 years. In addition, 3 684 individual cases with similar age and gender distribution where no drugs were detected, were included as a reference group. For ethanol and benzodiazepines the percentage of clinically impaired cases increased markedly from lower to higher concentration windows, from 60 % to 97 % for ethanol and from 38 % to 76 % for benzodiazepines. The corresponding increase for amphetamines and THC was modest, from 43 % to 58 % for amphetamines and from 41 % to 55 % for THC. The correlation between drug concentration and degree of impairment was high for ethanol (Spearman´s rho=0.548, p<0.001) and relatively high for benzodiazepines (Spearman´s rho=0.377, p<0.001), but low for amphetamines (Spearman´s rho=0.078, p<0.001) and THC (Spearman´s rho=0.100, p<0.001). ConclusionThe percentage of impaired drivers increased with increasing blood drug concentration for all four drug classes, most pronounced for ethanol and benzodiazepines and much less for amphetamines and THC. The median blood drug concentration increased with increasing magnitude of impairment for ethanol and benzodiazepines, while this was much less pronounced for amphetamines and THC. The ranges of drug concentrations, however, were wide for all four drug classes in all impairment categories as assessed by individual clinical examination.

The role of plume-lithosphere interaction in Hawaii-Emperor chain formation

Paleolatitudes of volcanic rocks reveal that prominent changes in volcanic trend of the Hawaii-Emperor hotspot chain represent meridional migration of the magma source. However, models assuming latitudinal plume migration fail to explain the observed age distribution, rock composition, and erratic paleolatitude changes of the oldest Emperor seamounts. Here we use data-assimilation models to better reproduce the Hawaii-Emperor hotspot track by systematically considering plate reconstruction, plume-lithosphere interaction, and simplified melt generation and migration. Our results show that plate drag and plume-ridge interaction are both important in explaining the observed seamount ages. These shallow dynamic processes could account for 50% of the observed paleolatitude’s secular reduction and erratic variations over time, where the necessary southward migration of the Hawaiian plume root is significantly less than previously thought. We conclude that plume-lithosphere interaction represents a common mechanism in affecting hotspot track, and has important implications in understanding mantle dynamics and plate reference frames.

Anatomic Features of the Lamina Cribrosa and Optic Disc in Ocular Hypertension, Glaucoma and Healthy Eyes.

Central lamina cribrosa thickness (LCT) was found to be higher in eyes with ocular hypertension (OHT) compared with primary open angle glaucoma (POAG) and healthy controls (HCs). To evaluate the anatomic features of lamina cribrosa (LC) and the optic disc (OD) using swept-source optical coherence tomography (OCT) in eyes with OHT. Treatment naive eyes with OHT and POAG and healthy eyes were included. All eyes underwent a complete ophthalmological examination in addition to swept-source OCT of the OD. Anatomic features of LC, including central LCT, LC depth, prelaminar depth (PLD), and prelaminar tissue thickness, were measured manually using the internal caliper function of the OCT device and compared within groups. OD ovality, disc-foveal angle, and OD torsion were measured on colored photographs, using imageJ software. Seventy-one eyes of 37 patients in the OHT group, 41 eyes of 26 patients in the POAG group, and 30 eyes of 30 patients in the HC group were enrolled in the study. Groups were similar in age and sex distribution. Central LCT was significantly higher in the OHT group, compared with HCs (333.8 ± 50.5 vs 304.5 ± 46.3 µm, P = 0.02) and POAG group (286.7 ± 140.4, P = 0.001). PLD and LC depth were both highest in POAG (282.3 ± 145.5 µm and 471.3 ± 195.2 µm), followed by OHT (244.8 ± 30.2 µm and 440.7 ± 18.7 µm) and HCs (170.1 ± 152.6 µm and 412.8 ± 80 µm), only the difference between POAG and HCs in PLD was statistically significant ( P = 0.03). Prelaminar tissue thickness, OD torsion, disc-foveal angle, and disc ovality showed no significant difference. LC was significantly thicker in eyes with OHT, compared with POAG and HCs. This finding may be relevant to optic nerve protection from high intraocular pressure in patients with OHT.

Prevalence and genotype distribution of HPV combined with cervical pathological results in women from Sichuan, China: A cross-sectional study based on post-vaccination period 2019 to 2023.

Human papillomavirus (HPV) screening and vaccination exert efficacy in controlling the progression of cervical cancer. Thus, examinations into HPV prevalence, age-stratified specificity, genotype distribution, and their correlation with pathological outcomes can furnish robust evidence for customizing high-quality population screening and management. A cohort of 17,923 women attending clinics in the Jintang area, Sichuan, from January 2019 through August 2023 were enrolled in the study. Genotyping of HPV was conducted using real-time polymerase chain reaction (RT-PCR). The epidemiology and the relationship between HPV infection and histologic/cytologic abnormalities were subjected to analysis. HPV infection was identified in 4387 women. The outpatient group exhibited a significantly higher HPV infection rate compared to the healthy examination group (26.5% vs. 17.5%, p < 0.05). The distribution of infection rates across different age groups exhibited a U-shaped pattern, with the highest infection rate in the group ≤20 years of age, succeeded by those >60 years of age. The 31-40 age group demonstrated the lowest prevalence of infection, but upon infection, its prevalence of the precancerous lesion CIN2-3 reached a maximum of 29.0%, constituting a novel finding. The most prevalent genotype was HPV52, followed by HPV16, 58, 53, 68, and 18. In the cytologic and histologic abnormalities group, the most common types were HPV52, 16, and 58. HPV16 predominantly appeared in high-grade intraepithelial neoplasia and carcinoma insitu, constituting over 60% of cases. While HPV type 52 was not individually detected in cervical cancer cases. And some other non-vaccine-covered HPV subtypes also showed high prevalence in Sichuan. The single infection rates of NH9-HPV (high-risk HPV subtypes covered by the non-nine-valent vaccine) in CIN2-3 and cervical cancer patients were 6.5% and 2.6%, respectively. Among them, HPV51, HPV53, HPV59, and HPV35 exhibited a significant preponderance, which even higher than HPV45 and HPV31 covered by the nine-valent vaccine types. And in NL9-HPV (low-risk HPV subtypes covered by the non-nine-valent vaccine), HPV42 accounted for the highest percentage in CIN2-3. A similar decreasing trend was observed in annual infection rates in the healthy examination population and in the 31-40 and 51-60 age groups, while the ≤20 age group showed an increase. Regarding type-specificity, HPV16 and HPV58 exhibited the most rapid declines. This study furnishes the latest insights into the characteristics of HPV infection rate, age distribution, and genotype prevalence in Sichuan.

The worldwide survival rate of total hip arthroplasties is improving: a systematic comparative analysis using worldwide hip arthroplasty registers.

The aim of this study was to evaluate the development of the worldwide survival rate of primary total hip arthroplasty (THA). The hypothesis was that survival improved over the last decade in worldwide arthroplasty registers. THA registers were screened in 2022 and compared between different countries with respect to the number of primary implantations per inhabitant, age, fixation type, and survival rate, and compared to similar data from 2009. The data from these reports were analyzed in terms of number, age distribution, and procedure type of primary THAs. Survival curves and a comparative analysis with respect to the development over time were calculated. We identified nine hip arthroplasty registers that contained sufficient data to be included. A large variation was found in the annual number of primary THA implantations per inhabitant, with more than the factor 4 for all age groups across regions. The procedure type varied strongly as well, e.g. in Sweden, 50% were cemented THAs, whereas in Emilia-Romagna (Italy), 96% of THAs were implanted cementless. We found an improved survival rate of 5%, with 90% of survival after 15 years in the cohorts from 2021 compared to 85% in the cohorts from 2009. The present study revealed a significant improvement in the survival of THA in worldwide arthroplasty registers within different countries and regions over the period of one decade. We believe that it is safe to state that the success of THA is still rising with respect to this main outcome.

Probing the strength of radial migration via churning by using metal-rich red giant stars from APOGEE

ABSTRACT Making use of the APOGEE DR17 catalogue with high quality data for 143 509 red giant branch stars we explore the strength of different mechanisms that causes a star to radially migrate in the Milky Way stellar disc. At any position in the disc we find stars that are more metal-rich than the local interstellar medium. This is surprising and normally attributed to the migration of these stars after their formation inside their current Galactocentric radius. Such stars are prime candidates for studying the strength of different migratory processes. We specifically select two types of metal-rich stars: (i) super metal-rich stars ($\mathrm{[Fe/H]}\gt 0.2$) and (ii) stars that are more metal-rich than their local environment. For both, we explore the distribution of orbital parameters and ages as evidence of their migration history. We find that most super metal-rich stars have experienced some amount of churning as they have orbits with $R_g\gtrsim 5 \,{\rm kpc}$. Furthermore, about half of the super metal-rich stars are on non-circular orbits ($\mathrm{ecc} \gt 0.15$) and therefore also have experienced blurring. The metallicity of young stars in our sample is generally the same as the metallicity of the interstellar medium, suggesting they have not radially migrated yet. Stars with lower metallicity than the local environment have intermediate to old ages. We further find that super metal-rich stars have approximately the same age distribution at all Galactocentric radii, which suggests that radial migration is a key mechanism responsible for the chemical compositions of stellar populations in the Milky Way.

Clinical Characteristics and Prognosis of Myelodysplastic Syndromes Patients with RUNX1 Gene Mutation

To investigate the clinical characteristics and survival analysis of myelodysplastic syndromes (MDS) with RUNX1 gene mutation. Clinical data of 177 newly diagnosed MDS patients admitted to the Department of Hematology, the Second Affiliated Hospital of Air Force Military Medical University from October 1, 2015 to October 31, 2022 were retrospectively analyzed. Gene mutation detection was performed by second-generation sequencing technology, and clinical characteristics and prognosis of patients with RUNX1 gene mutation were analyzed. A total of 30 cases (16.95%) of RUNX1 gene mutations were detected, including 15 missense mutations (50.0%), 9 frameshift deletion mutations (30.0%), 4 splice site mutations (13.3%), 1 insertion mutation (3.3%), and 1 nonsense mutation (3.3%). Patients with RUNX1 mutations had a median age of 68.5 years at diagnosis (range: 62.25-78.50 years old). There were no significantly differences between RUNX1 mutations and wild type patients in age distribution, gender, peripheral blood white blood cell count, hemoglobin level, bone marrow and peripheral blood blasts ratio, IPSS-R cytogenetics, IPSS-R stage, etc. (P >0.05). However, there were statistically significant differences in platelet count and whether complicated karyotype. Compared with patients without RUNX1 gene mutation, patients with RUNX1 gene mutation had lower platelet count (P =0.018), and were less likely to have complicatedkaryotype at initial diagnosis (P =0.01). Cox proportional hazards model analysis showed that when other covariates remained unchanged, the higher the platelet count, the better the survival of patients (HR=0.995, 95%CI : 0.990-0.999, P =0.036); In the IPSS-M prognostic stratification, keeping other covariates unchanged, the risk of progression or death of myelodysplastic syndrome was significantly lower in the medium to high-risk and low-risk groups compared with the high-risk group (HR=0.149, 95%CI : 0.031-0.721, P =0.018; HR=0.026, 95%CI : 0.003-0.234, P =0.001). Survival analysis showed that MDS patients with RUNX1 gene mutation had worse overall survival time (P < 0.001). Patients with RUNX1 mutation had worse OS than non-mutation patients in the early WHO group. RUNX1 mutation and IPSS-M risk stratification mean OS and mean LFS were worse in low-risk patients than in non-mutated patients. RUNX1 gene mutation is an adverse prognostic factor in MDS patients, especially in the IPSS-M prognosis stratification group of low-risk, medium-low risk, medium-high risk and WHO classification of early patients.

Comparison of epidemiological characteristics between hemorrhagic fever with renal syndrome patients and severe fever with thrombocytopenia syndrome patients.

Hemorrhagic fever with renal syndrome (HFRS) and severe fever with thrombocytopenia syndrome (SFTS) are both endemic in rural areas and some characteristics are similar between HFRS and SFTS, which usually lead to misdiagnosis. In this study, we summarized and compared some characteristics of HFRS and SFTS which will provide scientific information for differential diagnosis. From 2011 to 2022, a total of 4336 HFRS cases and 737 SFTS cases were reported in Zhejiang Province. Compared to SFTS, there was a higher proportion of males among HFRS cases (72.46% [3142/4336] vs. 50.88% [375/737], p = 0.000). The median age of all 4336 HFRS cases was 49 (39, 59), while the median age of SFTS cases was 66 (57, 74). In addition, the involved counties of HFRS were more than SFTS, but the number of counties affected by SFTS increased from 2011 to 2022. The majority of SFTS cases occurred in summer (from May to July), but besides summer, HFRS cases also showed a peak in winter. Finally, our results showed that the case fatality rate of SFTS was significantly higher than that of HFRS. Although there were some similarities between HFRS and SFTS, our study found several differences between them, such as gender distribution, age distribution, and seasonal distribution, which will provide scientific information for differential diagnosis of HFRS and SFTS. Further studies should be carried out to explore the mechanism of these differences.

Comparison of the Opinions of Adolescents With Different Orthodontic Treatment Needs.

The aim of this study was to compare oral health-related quality of life (OHRQoL) among adolescents granted (G) versus not granted (NG) publicly funded orthodontic treatment. Adolescents aged 15-20 years who were granted versus not granted publicly funded orthodontic treatment responded to a web-based survey, assessing OHRQoL in relation to functional impact, psychological impact, and motivators for orthodontic treatment. Before the survey, pretesting of the questionnaire was conducted to ensure its reliability. Differences between the groups were tested using the chi-squared and Mann-Whitney U-tests. Reliability was assessed using Cohen's κ and Pearson's correlation coefficient during the pretest phase. One hundred and forty patients, equally distributed between a G and an NG group, responded to the survey. Gender, age, and demographic distribution were comparable in both groups. All respondents expressed a high subjective treatment need and similar answers regarding functional aspects. Orthodontic treatment motivators (G: 86.2% and NG: 94.7%, p = 0.443) were primarily related to improved self-esteem, overall well-being, facial appearance, and being able to laugh without embarrassment. The NG group expressed a more negative OHRQoL impact due to the appearance of their teeth compared with the G group (p < 0.001) and a negative impact caused by the position of their teeth (p < 0.001). Orthodontic treatment need indices should aim to reinforce subjective measures as adolescents express similar motivators for orthodontic treatment, regardless of the clinician's objectively based decision about treatment need.

Hyponatremia Among Elderly Hospitalized Patients: An Observational Study.

Aim The aim of this study is to analyze the demographicdistribution (age and gender distribution), presenting symptoms, and evaluate the underlying etiology of hyponatremia among the study population. The presence of comorbidities and the volume status (hypovolemia, euvolemia, or hypervolemia) of elderly hyponatremic patients with varying severity of hyponatremia were assessed. Methods This cross-sectional, observational study was conducted in Dr. D. Y. Patil Hospital and Research Centre, Pune, India. After approval from the Institutional Ethics Sub-Committee (approval number: IESC/PGS/2022/09), it was conducted during the period between September 2022 and June 2024. The minimum sample size was calculated to be 96with a confidence interval of 95% using WINIPEPI software (version 11.38).The lab values of serum sodium of all patients aged above 60 years admitted in wards and intensive care units (ICUs) were studied. Out of these hyponatremic patients, a sample size of 100 patients was randomly selected. Patients above 60 years and the patients who were on diuretic therapy were excluded from the study. Results The study included 100 elderly patients with a mean age of 73.25 ± 7.03 years, ranging from 64 to 86 years. Males predominated (63%), and severe hyponatremia (<125 mEq/L) was the most common, affecting 61% of patients. Generalized weakness (22%) and disorientation (17%) were the most frequently reported symptoms. Post-operative conditions (13%) and gastroenteritis (10%) were the leading causes.Most participantshad no comorbidities (53%). Hypovolemia was present in 67% and euvolemia in 29% of the study subjects. Among hypovolemic patients, severe hyponatremia was present in 83.5% of patients. Conclusion This study highlights the significant burden of severe hyponatremia among elderly patients, particularly in male subjects andthose with hypovolemia. Majority of the participants did not have any comorbidities. Additionally, the study emphasizes the need for heightened clinical vigilance in elderly patients presenting with generalized weakness and disorientation, as these were the most common symptoms associated with hyponatremia. The identification of post-operative conditions and gastroenteritis as leading causes further supports the need for comprehensive management strategies in elderly inpatients to prevent the occurrence and complications of hyponatremia.

A Framework for Constraining Ocean Mixing Rates and Overturning Circulation from Age Tracers

Abstract The age of seawater refers to the amount of time that has elapsed since that water encountered the surface. This age measures the ventilation rate of the ocean, and the spatial distribution of age can be influenced by multiple processes, such as overturning circulation, ocean mixing, and air–sea exchange. In this work, we aim to gain new quantitative insights about how the ocean’s age tracer distribution reflects the strength of the meridional overturning circulation and diapycnal diffusivity. We propose an integral constraint that relates the age tracer flow across an isopycnal surface to the geometry of the surface. With the integral constraint, a relationship between the globally averaged effective diapycnal diffusivity and the meridional overturning strength at an arbitrary density level can be inferred from the age tracer concentration near that level. The theory is tested in a set of idealized single-basin simulations. A key insight from this study is that the age difference between regions of upwelling and downwelling, rather than any single absolute age value, is the best indicator of overturning strength. The framework has also been adapted to estimate the strength of abyssal overturning circulation in the modern North Pacific, and we demonstrate that the age field provides an estimate of the circulation strength consistent with previous studies. This framework could potentially constrain ocean circulation and mixing rates from age-like realistic tracers (e.g., radiocarbon) in both past and present climates. Significance Statement The age of seawater—the local mean time since local water from different pathways was last at the surface—is a valuable indicator of ocean circulation and the transport time scale of heat and carbon. We introduce a novel constraint that relates total age flow across a density surface to its geometry, which provides new insights into constraining ocean circulation and mixing rates from age-like realistic tracers (e.g., radiocarbon).

Functional Outcome of Forearm Fractures Managed With Screw Nails vs. Dynamic Compression Plates: A Prospective Study.

Background Fractures of the forearm are very frequently encountered in day-to-day practice. These fractures have a bimodal age distribution. The forearm fractures are considered intra-articular and need absolute stability for adequate healing. The current treatment modalities include using intramedullary devices such as a square nail, locking intramedullary nail, or using a plate for fixation. In this study, we aim to determine the functional outcome of forearm fractures managed with a screw nail used as an intramedullary device as compared to a locking plate using the Grace-Eversmann criteria. Methodology Patients with forearm fractures were divided into two groups and treated with a screw nail and a dynamic compression plate. Patients were followed up at one month, three months, six months, and one year postoperatively and assessment was done using the Grace-Eversmann criteria. Results The study included a total of 30 subjects, ranging in age from 18 to 65. The majority of the patients had encountered a road traffic accident, following which they incurred a forearm fracture. Grace-Eversmann criteria was used for these patients at follow-up, and a total of 13 patients (86.6%) had good to excellent scores, which was similar when compared to the plate osteosynthesis group (86.6%). A significant difference in the amount of blood loss was noted in the screw nail osteosynthesis group as compared to the plate osteosynthesis group (p<0.05). Conclusions Though a dynamic compression plate is considered a standard method for fixation of the forearm fractures, the use of an intramedullary screw nail as a fixation device gives a similar result with excellent functional outcomes (Grace-Eversmann criteria). It also gives an added benefit of reduced blood loss and preservation of fracture biology.

Comparison of Postoperative Muscle Strength Recovery Between Cisatracurium and Rocuronium.

Background Neuromuscular blocking agents are crucial for anesthesia but can cause reversible paralysis, leading to risks like postoperative residual dysfunction. Undetected paralysis in thepost-anesthesia care unit (PACU) jeopardizes patient safety by impairing airway function and increasing complications. Effective reversal, assessed clinically or via nerve stimulation, is critical to prevent residual postoperative curarization (RPOC), which is linked to significant morbidity and mortality. Evaluating agents like rocuronium and cisatracurium helps optimize anesthesia outcomes and patient recovery. Methodology The study included 100American Society of Anaesthesiologists (ASA) I and II patients approved by the Institutional Review Board of Kasturba Medical College, Mangalore, India. Patients were briefed about the study, provided written informed consent, and underwent pre-anesthetic evaluations, including discussions on anesthetic procedures and associated risks. They were instructed to fast overnight after consenting. Results The study compared 100 ASA I and II patients receiving rocuronium or cisatracurium during anesthesia, analyzing age distribution (p=0.429), gender (p=0.839), ASA status (p=0.228), and physical characteristics (height, weight, BMI, p>0.05). Recovery parameters such as hand grip, sustained head lift, and double burst stimulation (DBS) twitch response showed no significant differences between groups (p=0.538 for hand grip and sustained head lift; p=0.220 for DBS. Late recovery rates at 15 minutes were observed with 16% for hand grip, 14% for sustained head lift, and 26% for DBS in the rocuronium group; compared to 14%, 10%, and 16%, respectively, in the cisatracurium group. Conclusion The study found significant postoperative residual curarization in both groups, emphasizing the need for intraoperative and PACU peripheral nerve stimulation for effective assessment. Further research on intraoperative variables could improve understanding of residual paralysis in PACU, guiding better anesthesia management.

A Longitudinal Evaluation of the Effects of Moderate Physical Activity on Health, Metabolic, and Physiological Parameters in Individuals With Type 2 Diabetes Mellitus: A Comprehensive Study.

Background Diabetes mellitus (DM), especially type 2 diabetes mellitus (T2DM), is a serious worldwide health concern that is becoming more common and often develops at a young age, particularly in developing countries. Given the increasing incidence of diabetes in India, efficient management techniques are advantageous. The aim of this study is to evaluate the impact of physical activity on body measurements, biochemical markers, and clinical outcomes in Indian individuals with T2DM. Methodology Utilizing a universal sampling approach, a longitudinal interventional study was performed with T2DM patients at a metropolitan health and training facility over an eight-month duration. Over the course of six months, they were told to walk briskly for 2.5 hours each week. Initial and follow-up evaluations included monitoring arterial pressure, body mass, abdominal circumference, and glucose concentrations. During monthly follow-ups, participants self-reported their compliance. Results The study of 210 participants shows a diverse age distribution with the majority in the 35-54 years range and a higher number of females (56.19%) compared to males (43.81%). Most were Hindu (77.6%), with varying education levels and a predominance of unemployment (69.5%) and marital status (91.0% married). Post-exercise, significant improvements were observed in fasting blood glucose (160.45 to 140.20 mg/dL; p = 0.004), postprandial blood glucose (270.35 to 240.55 mg/dL; p = 0.002), body weight (70.00 to 66.50 kg; p = 0.03), and waist circumference (95.00 to 90.50 cm; p = 0.01). Conclusion The outcomes of this prolonged study reveal thatalong with promoting weight reduction in T2DM patients, regular engagement in moderate exercise can substantially improve both fasting and post-meal blood glucose levels.