This study aimed to analyze the intention and related factors of herpes zoster vaccination among ≥50-year-old patients with multiple chronic diseases in Zhejiang Province. A convenience sampling method was used to conduct a questionnaire survey among ≥50-year-old patients with multiple chronic diseases in Zhejiang Province from March to May 2024. A multinomial logistic regression was used to analyze the related factors of vaccination willingness. The results showed that among the 2 531 study subjects, 40.85% were willing to receive the herpes zoster vaccine, 26.75% were unwilling, and 32.39% were indifferent. A multinomial logistic regression revealed that the history of influenza vaccination (OR=1.71, 95%CI:1.36-2.16), history of pneumonia vaccination (OR=1.39, 95%CI:1.05-1.85), doctors' recommendations for vaccination (OR=3.32, 95%CI:2.58-4.26), knowledge of herpes zoster disease (OR=1.43, 95%CI:1.10-1.86), considering herpes zoster as contagious diseases (OR=1.75, 95%CI:1.33-2.30), believing that vaccines could prevent herpes zoster (OR=1.48, 95%CI:1.14-1.93), and believing that middle-aged and elderly people could more likely to get herpes zoster (OR=1.30, 95%CI:1.01-1.67) were more willingness to receive herpes zoster vaccine. The reasons for unwillingness to receive the herpes zoster vaccine were never having heard of this vaccine (57.01%),"I did not think I would get it/I did not feel it was necessary"(25.95%), and "it was too expensive to afford"(16.27%). Television, doctors, and family members were the main ways to obtain knowledge about the herpes zoster vaccine. Compared with other age groups, those aged 80 years and older were more likely to receive vaccine information from family members (59.75%). People in the age group of 50 to 59 years old gradually tended to obtain vaccine information through WeChat (55.51%) and TikTok (42.02%). In summary, the herpes zoster vaccination intention is low among ≥50-year-old patients with multiple chronic diseases in Zhejiang Province. The vaccination history, recommendations from doctors, knowledge of the disease and its contagiousness, and awareness of the vaccine are related factors for the willingness of patients with multiple chronic diseases to receive this vaccine.

ABSTRACT Objectives Youth weight and resistance training are growing in popularity, offering benefits like improved performance and injury prevention. However, improper technique and lack of supervision can lead to injuries – many of which are preventable with proper training and guidance. This study examined weightlifting-related injury trends and causes among youth in U.S. emergency departments. It was hypothesized that injuries would increase from 2014 to 2023, teens would have the highest injury rates, and crush injuries to fingers and toes would be the most common. Methods The National Electronic Injury Surveillance System (NEISS), a publicly available database representing approximately 100 US EDs, was used to identify fractures related to weightlifting in patients 0-18 years old. Fractures were included in this study if caused by improper use of equipment, dropped weights, crush injuries, or falls due to misplaced equipment. Queries were restricted to fractures from 2014 to 2023. Results From 2014 to 2023, an estimated 32,955 fractures related to weightlifting were identified, out of which, 28,647 were due to improper use. The mean age was 11.4 ± 5.9 years. Across the study period, the highest number of fractures from improper use in a year was in 2023 (NEISS cases = 114, NE = 3639, 12.7%). Most fractures occurred in males (NEISS cases = 679, NE = 20380, 71.1%). Adolescents (15-18) were the most injured age group (NEISS cases = 376, NE = 12646, 44.1%), with fractures occurring most frequently at home (29.6%) and at places of recreation or sports (21.1%). The most fractured body parts were the finger (38.9%) and toe (38%). There was a significant increase in finger fractures across time (p < .01). Conclusion Weight training-related fractures due to improper use display an observed increasing trend among male youth in the US, with an actual case count of 1386 in 2014 increasing to 2815 in 2023. Additionally, there was a significant increase in finger injuries. Future research should be focused on implementing more stringent safety guidelines, increased supervision, as well as proper equipment use, and education for youth in the US, especially in homes and places of recreation.

ABSTRACT Background Musculoskeletal injuries are common in youth football and can impact athletes’ development and performance. Understanding their incidence and characteristics is essential for prevention and management. Objective To analyze the incidence and characteristics of musculoskeletal injuries in youth categories of a Brazilian football club over one competitive season and assess associations with age group, playing position and training load. Design Prospective cohort study Methods We included 180 male athletes from four youth categories (U-11/13, U-15, U-17, U-20) monitored during the 2022 season. Data were collected from medical records, including injury diagnosis and severity, training load metrics (sRPE, TRIMP, ACWR, GPS).Injuries were defined as any condition causing at least one day of absence. Statistical analyses included correlations and group comparisons. Results A total of 181 injuries were recorded; 64.4% of athletes sustained at least one. Muscle injuries were most frequent (59%), followed by joint injuries (19.8%). The U-20 group had the highest incidence (33%), and forwards were most affected (34.2%). Bone injuries caused the longest absences (p < 0.0001). No significant associations were found between training load and injury outcomes. Conclusion Injury patterns varied by age and position. Muscle injuries predominated, highlighting the importance of integrated monitoring of injury characteristics, athlete profile, and physical demands to support injury prevention and early management in youth football.

The Australian Pharmaceutical Benefits Scheme was changed on 15 January 2021 to provide people aged <18 years access to government-subsidised pre-exposure prophylaxis (PrEP) for HIV. This study investigated healthcare and service providers' attitudes and practices in discussing PrEP and impacts on PrEP prescribing practices, and the differences in the provision of PrEP to young adults aged >18years compared with people aged <18years. An online cross-sectional survey, conducted February to November 2023, used purposive, convenience and snowball sampling to recruit healthcare providers eligible to prescribe PrEP (GPs, nurse practitioners) and non-prescribing healthcare/service providers (sexual health nurses, HIV community workers) in Australia. Young people were split into three age groups for comparison between young adults (aged 18-24 years) and adolescents, including those above (aged 16-17 years) and below (<16 years) the age of consent in Australia. Cross-tabulation with Pearson's chi-squared and Fisher's exact tests were performed to investigate sexual health and PrEP-related attitudes and practices. Of the 122 respondents, 40.2% (49/122) were nurses, 18.0% (22/122) GPs, 11.5% (14/122) HIV community workers, 11.5% (14/122) were another profession (including public health physician, LGBTIQA child and family practitioner, social worker, counsellor), 10.7% (13/122) were sexual health physicians, 6.6% (8/122) nurse practitioners and two were HIV specialists. Most (73.8%, 90/122) reported initiating PrEP conversations with 18-24-year-olds, compared with 13.1% (16/122) with those aged >16years. Of the 48 (39.3%) eligible PrEP prescribers, 47.9% (23/48) reported feeling 'extremely/somewhat' comfortable assessing PrEP eligibility, 41.7% (20/48) reported awareness of 2021 Pharmaceutical Benefits Scheme changes and 18.8% (9/48) reported changes to prescribing practices. Prescribers were significantly more likely than non-prescribers to consider PrEP suitable (54.2% vs 35.8%, P<0.05) for clients aged <16 years. Guidelines and prescribing criteria need to reflect current Pharmaceutical Benefits Scheme eligibility for young people to support healthcare prescriber decision-making in recommending and prescribing PrEP for HIV for young people where appropriate. Greater education, training and support is required for healthcare providers to improve provider confidence in discussing sexual health needs, and recommending and prescribing PrEP to young people to optimise the possible benefits of access to sexual health services and PrEP in this priority sub-group.

Multiple Sclerosis (MS) severity is influenced by several factors. Understanding the impact of age at disease onset may help to better characterize clinical and disease features across age groups. This study aimed to characterize the clinical features and disability outcomes of late-onset MS (LOMS) and very late-onset MS (vLOMS), compared to adult-onset MS (AOMS). We conducted an observational study using data from the MSBase registry and categorized patients based on age at MS onset: AOMS (18-39years), transition onset (40-49years), LOMS (50-59years), and vLOMS (≥ 60years). Disease progression was assessed using the 24week confirmed disability progression, EDSS4 and 6 milestones, conversion to secondary progressive MS(SPMS), and the first progression independent of relapse activity (PIRA) event. Cox proportional hazard regression models were used to determine unadjusted hazard ratios(HR), and propensity score inverse probability of treatment weighting(PS-IPTW) balanced covariate distributions. Among 81,236 patients, 5.2% had LOMS and 1% had vLOMS. Primary progressive MS was more frequent in LOMS and vLOMS (21.7 and 24%, respectively). Patients with LOMS and vLOMS had a significantly increased risk of 24week confirmed disability progression (HR:LOMS = 1.39, vLOMS = 1.80), EDSS 4 (HR:LOMS = 2.14, vLOMS = 2.95), EDSS 6 (HR:LOMS = 2.33, vLOMS = 6.33), SPMS (HR:LOMS = 1.62, vLOMS = 2.38), and first PIRA event (HR:LOMS = 2.12, vLOMS = 2.93). LOMS and vLOMS exhibited a more progressive disease onset and higher disability milestones compared with AOMS.

Sexually transmitted infections (STIs) contribute to female infertility by causing pelvic inflammatory disease (PID) and fallopian tube damage. Utilizing the Global Burden of Disease (GBD) database, we aim to comprehensively evaluate the global disease burden and spatiotemporal trends of STIs-related infertility, which is critical for formulating targeted intervention strategies. Using data from the GBD 2021 database, we extracted age-standardized prevalence rates (ASPR) and age-specific prevalences (in 5-year intervals from 15 to 49 years) for STIs-related primary infertility (SRPI) and secondary infertility (SRSI) across global, socio-demographic index (SDI) regions, and GBD regions from 1990 to 2021. The analysis of spatiotemporal trends involved calculating estimated annual percentage changes (EAPC) and developing age-period-cohort (A-P-C) models. From 1990 to 2021, global ASPR of SRPI and SRSI remained stable, with EAPCs of -0.18 (95% CI: -0.28 to -0.08) and 0.01 (95% CI: -0.04 to 0.07), respectively. Low SDI regions showed significant burden reduction, while high SDI regions exhibited rising trends. Pathogen-specific trends varied markedly: gonorrhoea-related infertility declined globally (SRPI EAPC = -0.95; SRSI EAPC = -0.61), whereas chlamydia-related SRSI increased slightly (EAPC = 0.10). Age-stratified analysis revealed rising SRPI burden in the 40-49 age group and increasing SRSI in the 15-34 age group. SDI and disease burden showed dynamic correlations: negative at low SDI (< 0.4) but positive at high SDI (> 0.7). The APC model further indicated age effects peak for SRPI and SRSI at 40-44 and 40-45 years, respectively, with declining period effects in high-SDI regions. The global burden of STIs-related infertility exhibits regional and age-specific heterogeneity. While low-SDI regions achieved notable progress, rising burdens in high-SDI areas demand urgent attention. Future strategies should integrate pathogen-specific interventions, age-targeted management, and SDI-driven resource allocation to enhance early screening, treatment, and global reproductive health equity. Not applicable.

Food group intake trends in the Spanish population (2003-2023) in women and men and by age groups, country of origin, and social class: a time-series analysis of nationally representative surveys.

Despite improvements in availability, young adults in many low- and middle-income countries still do not use reproductive health (RH) services much. However, there is not much research on this in oil producing and semi urban areas like Bonny Island, Nigeria. This study aims to model and understand how young adults in Bonny Island use RH services and to find the social-demographic, knowledge based and access related factors that affect this use. A community based cross sectional survey was done with 800 participants aged 15 – 29 years. The use of a single RH service was used to define RH service utilization. A pretested questionnaire was used for the purpose of data collection. Descriptive statistics were used to summarize the characteristics of the participants. Chi-square tests were then used to examine the relationships between pairs of variables. In addition, multivariable logistic regression using cluster-robust standard errors was used to calculate adjusted odds ratios (AORs) and 95% confidence intervals (CIs). The model’s performance was evaluated using the area under the receiver operating curve (AUC), pseudo –R 2 and calibration metrics. This showed that 59.6% of the participants reported using RH services. Furthermore, awareness of RH services was high, as 73.8% and 45.0% of the participants found the service locations convenient. In the multivariable analysis, none of the predictors reached statistical significance, and the effect estimates were small and uncertain, as indicated by confidence intervals that included one for all variables examined. These included gender [AOR: 1.01, 95% CI: 0.73 – 1.41], age groups, education, awareness of RH services [AOR: 0.87, 95% CI: 0.60 – 1.26], and service convenience [AOR: 0.86, 95% CI: 0.64 – 1.16]. The model showed poor discrimination [AUC: 0.549], had limited explanatory power (pseudo- R 2 ) and demonstrated poor calibration. Traditional socio-demographic, knowledge based and access related factors explained little of the RH service utilization observed among young people in Bonny Island. The model’s weak performance and the wide confidence intervals suggest that unmeasured factors, particularly service quality, confidentiality, stigma, and the nature of provider–youth interactions, are significant influences on utilization.

Abstract Purpose Rare diseases (RD) produce an important public health impact, but their specific morbimortality burden remains unknown. Based on Death Certificates (1997–2017), the secular trend (ST) and spatial distribution of deaths due to RD are analyzed. Methods The ICD-10 classified Death Certificates were obtained from the Ministry of Health. A Python web scraper was developed to query the orpha.net web catalogue to establish a correspondence between Orpha and ICD-10 codes. The RDs mortality rate per 1,000 deaths (RD*1000) was calculated by sex, age groups, and by ICD-10 chapters for the five regions of Argentina (Northwest, Northeast, Centro, Cuyo, and Patagonia), as well as for its 24 provinces and 513 departments. Secular trend (ST) was analyzed using Joinpoint software, while spatiality was assessed through Moran’s and LISA indices. Results The RD*1000 death rate at country level was 189.4. Patagonia exhibited the highest rate, followed by Cuyo, Centro, Northeast and Northwest, being these conditions higher in women. The ST was negative between 1997 and 2009 and positive between 2009 and 2017. The geographical distribution of the clusters exhibiting high and low rates was mainly observed in the central and northern regions of the country, respectively. According to ICD-10, the prevalent categories were neoplasms, followed by eye diseases, congenital malformations, diseases of the nervous and digestive systems and diseases of the blood. Conclusion The geographical distribution of RD deaths in Argentina exhibits significant heterogeneity, characterized by a latitudinal arrangement. This phenomenon can be attributed to socioeconomic inequalities, intricately linked to population dynamics and migratory patterns. Clinical trial registration Not applicable. This study involved the analysis of secondary data and did not require clinical trial registration.

Older adults remain highly vulnerable to severe SARS-CoV-2 outcomes despite multiple vaccinations, yet age-associated differences in immune responses to updated COVID-19 booster vaccines remain incompletely characterized. Here, we administered an XBB.1.5 trivalent recombinant protein booster (WSK-V102C) to 22 individuals (<38 years) and 20 individuals (≥73 years), all of whom had previously received 2-3 doses of inactivated COVID-19 vaccines. Neutralizing antibody responses against multiple SARS-CoV-2 variants were quantified and compared between age groups. Meanwhile, single-cell RNA sequencing was also performed on peripheral blood mononuclear cells (PBMCs) collected at baseline and 28 days post-vaccination to profile age-associated immune features following boosting. Following booster immunization, both age groups achieved significantly elevated antibody titers against all tested strains. Nevertheless, the magnitude of antibody fold increase was consistently lower in elderly individuals than in younger adults. Single-cell analyses revealed age-associated differences in post-vaccination immune organization. In elderly individuals, B-cell state transitions were characterized by transcriptional signatures consistent with memory B cell-to-plasmablast differentiation, whereas younger individuals predominantly exhibited transitions from naïve B cells. CD4+ T cells from elderly individuals displayed altered transcriptional trajectories and reduced T-cell receptor diversity relative to younger adults. In contrast, younger individuals showed coordinated B- and T-cell-associated transcriptional programs, including enrichment of transcription factors such as KLF7, CEBPB, CEBPD, and MAFB. Collectively, our study describes age-associated differences in immune coordination and cellular response patterns following XBB.1.5 booster vaccination. Further longitudinal and functional studies will be required to clarify the mechanistic basis and clinical implications of these observations.

To examine whether maternal red blood cell (RBC) folate concentrations (biomarker of folate status) and documented periconceptional folic acid supplementation (FAS) are associated with neonatal brain maturation at term-equivalent age (TEA), using standardized MRI and EEG scoring. We retrospectively analyzed 144 mother-infant pairs (March 2022-March 2024). Analyses used a two-factor design denoted GA × Folate, combining gestational age group (Preterm < 37weeks; Term ≥ 37weeks) and RBC folate status (Deficient < 906nmol/L; Sufficient ≥ 906nmol/L). All MRI/EEG was performed at term-equivalent age (TEA) 40 ± 1weeks postmenstrual age (PMA). MRI was scored using a modified Kidokoro system; EEG used standard neonatal metrics including Burdjalov aEEG background continuity and cycling, and conventional EEG delta-brush frequency. Readers were blinded to group. Analyses used two-way ANOVA (GA × Folate) with Benjamini-Hochberg FDR control, effect sizes, and ANCOVA adjusting for sex and birthweight. Maternal RBC folate sufficiency was associated with higher MRI myelination scores (Δ = 0.6 points, 95% CI 0.3-0.9, η2p = 0.08, q = 0.012) and greater EEG maturation (delta-brush frequency ↑ and aEEG continuity ↑; η2p = 0.07-0.10, q ≤ 0.02). Term infants outperformed preterm infants (main GA effect, q < 0.01). No GA × Folate interaction survived FDR. Maternal RBC folate correlated with MRI myelination (r = 0.42, 95% CI 0.27-0.55) and delta-brush frequency (r = 0.37, 95% CI 0.21-0.51), both q < 0.01. Inter-rater reliability: MRI ICC = 0.86; EEG ICC = 0.83. Higher maternal RBC folate at delivery is associated with more advanced structural and functional brain maturation at TEA. Documented periconceptional folic acid supplementation was more common among mothers with RBC folate sufficiency, suggesting supplementation may contribute to achieving adequate folate status.

Widespread vaccination for human papillomavirus (HPV) alters the landscape of cervical cancer (CC) risk, requiring adaptations to the CC screening program. To assess the cost-effectiveness and harm-benefit tradeoffs of adapting CC screening strategies on the basis of age at HPV vaccination. Individual-based mathematical modeling study. Published data. Hypothetical cohorts of women vaccinated in 7 different age groups (12, 13 to 15, 16 to 18, 19 to 21, 22 to 24, 25 to 27, and 28 to 30 years) with either bivalent or nonavalent vaccines in Norway. Lifetime. Extended health care sector (that is, including patient time and travel costs). HPV-based screening strategies that varied screening start age, interval, and number of lifetime screening tests. Incremental cost-effectiveness ratios, defined as the additional cost per quality-adjusted life-year (QALY) gained. "Preferred" (that is, cost-effective) screening for each age group was identified using a cost-effectiveness threshold of $55 000 per QALY. Harm-benefit tradeoffs were quantified as the ratio of colposcopy referrals to CC cases averted. For all vaccination age groups and both vaccines, less frequent screening with longer intervals between screening than the 5-year interval currently recommended was consistently preferred at the threshold of $55 000 per QALY, but the preferred strategy varied by age at vaccination. For women vaccinated between ages 12 and 24 years, preferred strategies involved screening every 15 to 25 years, resulting in screening 2 to 3 times per lifetime. Less frequent screening remained a preferred strategy under imperfect screening adherence and in scenarios that excluded bivalent vaccine cross-protection. The analysis did not address screening for unvaccinated women, who may benefit from herd immunity. A high-value screening program likely involves less frequent screening for women who were vaccinated against HPV by age 30 years. Strategies could be tailored on the basis of age at vaccination and type of HPV vaccine. Norwegian Cancer Society and National Cancer Institute.

BackgroundAlthough recognized as common, the frequency of and reasons for cancellations of congenital heart disease surgery to our knowledge, has not been described previously.MethodsPatients with congenital heart disease scheduled for surgical repair from January of 2018 through December of 2023 were reviewed. For patients with multiple scheduled procedures, only the principal surgery was included. Subsequent noncardiac procedures were excluded. Patients' age at surgery and the Thoracic Surgeons-European Association for Cardio-Thoracic Surgery (STAT) score (a measure of operative risk) were recorded. Cancellations were categorized into patient factors and institutional factors.ResultsA total of 729 cases were analyzed. Of these, 220 (30.2%) cases were canceled, including 146/220 (66.4%) cases for patient factors and 74/220 (33.6%) for institutional factors. The most common patient factor contributing to cancellation was a suspected or confirmed viral illness (69/146, 47.3%). The most common institutional factor was an urgent case taking priority (33/74, 44.6%). Cancellations were least common in neonates and STAT 5 procedures but were similar across all other age groups and STAT categories. Cancellations due to patient illness did not show a notable seasonal variation but increased after the COVID-19 pandemic. As surgical volume increased, cancellations related to institutional factors increased.ConclusionThe most common cause for cancellation of congenital heart disease surgeries is a viral illness. Although neonates and patients needing STAT 5 procedures were the least likely to be canceled, the rate of cancellation was similar across the other age and STAT categories. In a cohort including the COVID 19 pandemic, there was no obvious seasonal variation in cancellations.

Cognitive changes associated with aging bear both advantages and disadvantages for information processing that affect evaluations among older adults. Previous research showed that individuals evaluate objects more favorably when the object is framed positively (e.g. 85% success) rather than negatively (e.g. 15% failure). Evaluations are also sensitive to polarization levels of quantitative information (e.g. 90%/10% vs. 70%/30% success/failure). This paper examines how attribute framing and polarization levels moderate evaluations among older and younger adults. Study 1 examined older adults sampled from community centers for retired people and younger adults sampled in public places. The findings showed that older adults were more susceptible to attribute framing than younger adults, whereas their sensitivity to polarization levels was lower. To test older adults who are still working, Study 2 recruited both older and younger adults from an online panel. The findings replicated the effects of attribute framing and polarization level, but these effects were not significantly different across age groups. The difference between Study 1 and Study 2 in age-related effects suggests that chronological age is not the sole predictor of changes in evaluations and decision making among older adults. Future research should explore the contribution of cognitive - social aptitudes to these changes. The findings were interpreted in view of fuzzy-trace theory, suggesting that older adults rely more heavily on gist, owing to better experience-based abstractions, along with poorer verbatim representations, making them more susceptible to framing bias and less sensitive to polarization levels. Theoretical and practical implications are discussed.

Metabolic dysfunction-associated fatty liver disease (MAFLD) is a highly prevalent liver condition closely linked to obesity, insulin resistance, and metabolic syndrome. Early identification of MAFLD remains challenging in routine health examination settings remain challenging, especially in routine health examination settings where conventional indicators often fail to capture deeper metabolic disturbances. This study aimed to evaluate the predictive value of body composition parameters and develop and validate a non-invasive, machine learning-based classification model for MAFLD. A retrospective study was conducted using data from 23,348 adults who underwent health check-ups between 2017 and 2021 at a tertiary hospital in China. Body composition was assessed via bioelectrical impedance analysis, and MAFLD was diagnosed based on hepatic steatosis plus metabolic risk criteria. A total of 13 features, including body composition indicators and basic demographics, were initially considered. Feature selection was guided by multicollinearity diagnostics and model-based importance analysis. Eight machine learning models were constructed and evaluated using tenfold cross-validation. An independent external validation cohort of 3,357 participants from 2022 to 2023 was used to assess generalizability. Performance was evaluated using area under the receiver operating characteristic curve, accuracy, recall, F1 score, and calibration metrics. Among all models, tree-based algorithms including extreme gradient boosting, gradient boosting decision tree, and LightGBM achieved the highest discriminative performance, with internal validation area under the curve values exceeding 0.96 and external validation area under the curve values above 0.95. Visceral fat rating consistently emerged as the most important predictor, followed by waist circumference and body mass index. Logistic regression confirmed their independent associations with MAFLD after adjustment for key confounders. Stratified analyses revealed variable patterns across sex, age, and body mass index groups, with visceral fat remaining a robust predictor in all subgroups. Body composition analysis, particularly visceral fat estimation, demonstrates strong diagnostic discrimination for MAFLD using non-invasive measurements. Integrating these parameters with machine learning enables accurate identification, supporting scalable screening and aiding diagnostic assessment in routine health examination, clinical, and public health settings.

Choriocarcinoma is an aggressive malignant trophoblastic tumour of rare occurrence, which often presents with multiple metastases, including lungs, brain, liver, kidneys, and lymph nodes. However, primary choriocarcinoma of the pulmonary artery is an even rarer and highly malignant clinical entity that is difficult to diagnose and treat timely. Less than 15 cases have been reported so far in the literature. In this case report, a 38-year-old female presented with recurrent pulmonary thromboemboli despite being on adequate anticoagulation. Positron emission tomography/computed tomography (PET/CT) showed an abnormally hypermetabolic uptake in the pulmonary artery thrombi, suggesting tumour emboli. Catheter-guided aspiration thrombectomy followed by pathological examination confirmed non-gestational choriocarcinoma originating from the pulmonary arteries. The patient underwent treatment under a medical oncologist and responded well to the treatment. A literature search revealed only 12 reported cases. Diagnosis of primary pulmonary artery choriocarcinoma requires a high index of suspicion. Suspicion rises manifold when a reproductive age group female presents with recurrent pulmonary thromboembolism with raised serum βhCG levels.

Soil-transmitted helminths pose a significant public health challenge among school-age children in developing countries, such as Ethiopia. This study determined the prevalence of soil-transmitted helminths, associated factors, and nutritional status of school-age children in Mekhoni town, Tigray, Ethiopia, 2025. A school-based cross-sectional study design was conducted among 277 schoolchildren in Mekhoni town, Tigray, Ethiopia, from May 2024 to March 2025. A structured questionnaire was used to collect data on demographic characteristics of study participants, and stool samples were collected and processed using direct wet mount and Kato-Katz techniques. Anthropometric measurements were taken, and anthropometric indices were generated using the WHO AnthroPlus software to determine the nutritional status of schoolchildren. The data were analyzed using SPSS 27 software. Descriptive statistics were applied to present the data using frequency, tables, figures, and a bar graph. Bivariate logistic regressions were used to examine the correlation between the dependent variable and the individual independent variable, and multivariate logistic regressions were performed to determine the independent effect of the main explanatory variable on the outcomes of interest. A P-value < 0.05 was considered statistically significant. The overall prevalence of soil-transmitted helminth infections was 16.2% (n = 45), with Ascaris lumbricoides being the most identified parasite, at 10.1% (n = 28), followed by Trichuris trichiura at 6.1% (n = 17), and hookworms, at 2.9% (n = 8). Of the infected children, 31 (18.7%) were males, and 14 (12.6%) were females. The number of infections is also higher among children within the age group of 5-10, 22 (18.4%), than among those 11-14 years old, 23 (14.65%). Factors significantly associated with increased odds of infection were having large family size (AOR = 2.56, 95% CI: 1.18-5.55, P = 0.017), unclean fingernails (AOR = 2.63, 95% CI: 1.14-6.03, P = 0.022), untrimmed fingernails (AOR = 2.25, 95% CI: 1.006-5.03, P = 0.002), and lack of hand washing after visiting a toilet (AOR = 0.29, 95% CI: 0.13-0.63, P = 0.002). The overall prevalence of undernutrition was 37.5% (n = 104), with 22.2% being underweight (n = 117), 27.8% stunted (n = 77), and 11.19% wasted (n = 31). There was no statistically significant association between STH infection and nutritional status among study subjects. The prevalence of STH infections was less than 20% (n = 45). The most common species of STH infections identified were Ascaris lumbricoides. The study also revealed a high prevalence of undernutrition among school-age children. Ensuring access to clean toilets and hand-washing facilities in the schools, introducing a school health and nutrition program are vital.

Bumetanide, a specific NKCC1 co-transporter inhibitor, restores deficient GABAergic inhibition implicated in various brain disorders, including Autism Spectrum Disorders (ASD). In keeping with this mechanism, nine successful phase 2 clinical trials, conducted by seven independent teams using an identical protocol, have shown significant improvements in ASD symptoms among individuals treated with Bumetanide. Despite these promising results, two large phase 3 clinical trials (over 400 children recruited in approximately 50 centers and covering age groups 2-6 and 7-17 years) failed with no significant difference between patients treated by placebo or Bumetanide. This failure may stem from the substantial heterogeneity of ASD symptom profiles across the study population, potentially diluting the overall observed treatment effect. To address this, we reanalyzed the phase 3 data using Q-Finder, a supervised machine learning algorithm, aiming to identify subgroups of patients who responded to the treatment. This analysis was based on clinical parameters collected at the baseline of trial and used the same standard endpoints and success criteria defined in the original phase 3 protocol. It enabled the identification of responder subgroups showing a statistically significant difference between placebo and Bumetanide treatment arms. We report detailed descriptions and statistical evaluations of these subgroups. The discovered responder subgroups, representing up to 40% of participants, were cross validated between the two study populations. These findings suggest that meaningful treatment responses can be uncovered within negative phase 3 trials, highlighting the limitations of a one-size-fits-all approach for heterogeneous conditions such as ASD. Machine learning appears to be a promising tool to support this precision medicine strategy.

This study aimed to analyze allergen profiles associated with respiratory allergic diseases in pediatric populations in Guangzhou, China, and provide a theoretical basis for prevention and management strategies. A cross-sectional study was conducted among 1,230 children between 0 and 14 years of age who underwent allergen-specific immunoglobulin E antibody testing via immunoblotting at a hospital in Guangzhou, Guangdong Province, China, between January 2020 and January 2024. Positivity rates for allergens were analyzed and compared across categories (type and grade), age groups, seasons, and sex. Sensitization to at least one allergen was detected in 43.9% (n = 540) of the children. The overall sensitization rate did not differ significantly by sex or among age groups (p > 0.05). The predominant inhalant allergen was Dermatophagoides farinae / Dermatophagoides pteronyssinus (22.93%, n = 282), while the most common food allergen was egg white / egg yolk (10.73%, n = 132) (p < 0.05). Allergen positivity ranged from one to five allergen types, with frequency decreasing as the number of allergens increased (p < 0.05). A shift in the dominant allergen type was observed with increasing age: food allergens were common among infants and toddlers (p < 0.05), whereas inhalant allergens were dominant among preschool and school-age children (p < 0.05). The allergen sensitization spectrum among children with respiratory allergies in Guangzhou exhibits a distinct pattern that evolves with age. The predominant allergens among infants and toddlers were food-based, specifically milk, beef / lamb, and egg white / egg yolk, whereas among preschool and school-age children, inhalant allergies, particularly Dermatophagoides farinae / Dermatophagoides pteronyssinus and house dust, were most prevalent. These region-specific findings highlight the importance of implementing age-appropriate strategies for the diagnosis, prevention, and management of pediatric respiratory allergic diseases.

Background/Objectives: Whether saponins aid in whey protein supplementation remains unclear. We aimed to investigate the effects of Astragalus and Panax saponins (APS) on whey protein absorption, intestinal permeability, and muscle function in healthy adults across different age groups. Methods: A randomized, double-blind, placebo-controlled crossover trial was conducted with 30 healthy participants equally stratified into three age groups (18–25, 26–59, and 60–80 years), over two phases: a single-dose trial to measure immediate amino acid absorption from whey protein and a 4-week phase combining daily supplementation with resistance training to assess long-term effects on amino acid absorption kinetics, muscle function, and gut health. Results: Immediate APS supplementation resulted in a 6.67% higher area under the curve for valine, 3.62% for leucine, and 0.15% for isoleucine, compared with the placebo. After 4 weeks, APS supplementation significantly increased the absorption of valine (14.07%) and leucine (8.34%) and improved the absorption of isoleucine (6.33%). The effects were most pronounced in older adults (60–80 years), who showed a 12.74% increase in total essential amino acid absorption. APS also caused a substantially greater increase (APS: +5.20% vs. placebo: +2.44%) in grip strength, an increase (APS: +0.85% vs. placebo: +0.68%) in muscle mass, and a reduction in blood zonulin levels (APS: −13.01% vs. placebo: −0.9%), indicating improved muscle function and intestinal barrier integrity, without adverse effects on liver or kidney function. Conclusions: APS supplementation enhances amino acid absorption from whey proteins, muscle function and gut barrier integrity, especially in older adults. These findings highlight its synergistic role in improving protein supplementation efficacy for those with age-related muscle loss.