Age-sex Groups Research Articles

Transition in dietary quality: evidence from India.

Despite significant economic growth over the past decades, poor nutritional status in India is a serious concern. The social transformation led by growth in income influences both the composition of food and the quality of diet consumed. Against this backdrop of changing lifestyles and the rise in obesity and non-communicable diseases, in this study, we examined changes in diet quality and the critical socio-economic correlates of this quality from 1983 to 2012 using three rounds of nationally representative surveys providing information on food consumption for more than 100000 households in each round. We constructed diet quality indices at the household level using deficient and excess intake of macro and micronutrients compared with the recommended daily allowances (RDA) for different age-sex groups of the Indian population. We found that in relation to the RDA, fat consumption increased over time while protein and energy consumption decreased. The average diet quality index improved in the rural sector while it deteriorated in the urban sector. Caste and religion are significant correlates of the diet quality index. The deficiency index of nutrients decreased for poor households as they get richer; however, it increased with affluence level for the non-poor. It is suggested that the Indian Government may play a more proactive role in implementing coherent national policies in trade, food and agriculture to protect public health by promoting the demand for a healthy diet.

Variation of cerebrospinal fluid in specific regions regulates focality in transcranial direct current stimulation.

BackgroundConventionally, transcranial direct current stimulation (tDCS) aims to focalize the current reaching the target region-of-interest (ROI). The focality can be quantified by the dose-target-determination-index (DTDI). Despite having a uniform tDCS setup, some individuals receive focal stimulation (high DTDI) while others show reduced focality (“non-focal”). The volume of cerebrospinal fluid (CSF), gray matter (GM), and white matter (WM) underlying each ROI govern the tDCS current distribution inside the brain, thereby regulating focality.AimTo determine the regional volume parameters that differentiate the focal and non-focal groups.MethodsT1-weighted images of the brain from 300 age-sex matched adults were divided into three equal groups- (a) Young (20 ≤ × < 40 years), (b) Middle (40 ≤ × < 60 years), and (c) Older (60 ≤ × < 80 years). For each group, inter and intra-hemispheric montages with electrodes at (1) F3 and right supraorbital region (F3-RSO), and (2) CP5 and Cz (CP5-Cz) were simulated, targeting the left- Dorsolateral Prefrontal Cortex (DLPFC) and -Inferior Parietal Lobule (IPL), respectively. Both montages were simulated for two current doses (1 and 2 mA). For each individual head simulated for a tDCS configuration (montage and dose), the current density at each region-of-interest (ROI) and their DTDI were calculated. The individuals were categorized into two groups- (1) Focal (DTDI ≥ 0.75), and (2) Non-focal (DTDI < 0.75). The regional volume of CSF, GM, and WM of all the ROIs was determined. For each tDCS configuration and ROI, three 3-way analysis of variance was performed considering- (i) GM, (ii) WM, and (iii) CSF as the dependent variable (DV). The age group, sex, and focality group were the between-subject factors. For a given ROI, if any of the 3 DV’s showed a significant main effect or interaction involving the focality group, then that ROI was classified as a “focal ROI.”ResultsRegional CSF was the principal determinant of focality. For interhemispheric F3-RSO montage, interaction effect (p < 0.05) of age and focality was observed at Left Caudate Nucleus, with the focal group exhibiting higher CSF volume. The CSF volume of focal ROI correlated positively (r ∼ 0.16, p < 0.05) with the current density at the target ROI (DLPFC). For intrahemispheric CP5-Cz montage, a significant (p < 0.05) main effect was observed at the left pre- and post-central gyrus, with the focal group showing lower CSF volume. The CSF volume correlated negatively (r ∼ –0.16, p < 0.05) with current density at left IPL. The results were consistent for both current doses.ConclusionThe CSF channels the flow of tDCS current between electrodes with focal ROIs acting like reservoirs of current. The position of focal ROI in the channel determines the stimulation intensity at the target ROI. For focal stimulation in interhemispheric F3-RSO, the proximity of focal ROI reserves the current density at the target ROI (DLPFC). In contrast, for intrahemispheric montage (CP5-Cz), the far-end location of focal ROI reduces the current density at the target (IPL).

Variation in intraocular pressure by sex, age, and geographic location in China: A nationwide study of 284,937 adults.

ObjectiveTo investigate the distribution characteristics of intraocular pressure (IOP) by sex, age, and geographic location in China and to build the corresponding reference intervals (RIs).Material and methodsA cross-sectional, multi-centered, population-based study was conducted. All data were collected from participants without eye diseases who underwent ophthalmological examinations in 170 Health Screening Centers in mainland China in 2018. The non-contact tonometer was used to measure IOP. The age-, sex-, and province-specific RIs of IOP were investigated. The IOP of different age–sex groups was further explored by stratifying according to height, body mass index (BMI), blood pressure, altitude, and geographic area.ResultsDuring the study, a population-based sample of 284,937 participants was included. The distribution of measured IOP followed an approximately Gaussian distribution, with a higher mean value in men than in women. The IOP showed a general trend of decline with age for both men and women and varied across geographical locations. The mean IOP was 15.4 (95% CI: 9.1-21.6) mmHg for men and 14.9 (95% CI: 9.0-20.8) mmHg for women. For men, it decreased from 11.0-23.5 mmHg at age 18-24 years to 10.5-20.5 mmHg at age ≥70 years. For women, it decreased from 10.5-22.0 to mmHg at age 18-24 years to 10.0-21.0 mm Hg at age ≥70 years.ConclusionsThe IOP varied with age, sex, metabolic disorders and geographic location. These RIs should be considered in the clinical process of glaucoma diagnosis and treatment.

16-year trends in asthma hospital admissions in Canada

BackgroundAsthma hospitalizations declined rapidly in many parts of the world, including Canada, in the 1990s and early 2000s. ObjectiveTo examine whether the declining trend of asthma hospitalizations persisted in recent years in Canada. MethodsUsing the Canadian comprehensive nationwide hospitalization data (2002-2017), we identified hospital admissions with the main International Classification of Diseases codes for asthma. We analyzed sex-specific age-standardized trends in annual hospitalization rates among pediatric (< 19 years) and adult (19+ years) patients. We used change-point analysis to evaluate any substantial changes in the trends in the sex-age groups. ResultsThere were 254,672 asthma-related hospital admissions (59% pediatric, 50% female) during the study period. Among children, age-adjusted annual rates per 100,000 decreased by 55% in females (152-69) and by 60% in males (270-108) from 2002 to 2017. Among adults, the rates decreased by 59% in both sexes (females: 61-25; males: 27-11). Change-point analysis indicated a substantial plateauing of the annual rate in both pediatric (from −15.3 [females] and −25.8 [males] before 2010 to −0.6 [females] and −0.8 [males] after 2010) and adult (from −5.4 [females] and −2.6 [males] before 2008 to −0.6 [females] and −0.2 [males] after 2008) groups. ConclusionAfter a substantial decline in hospital admissions for acute asthma, there has been minimal further decline since 2010 for children and 2008 for adults. In addition to adhering to the contemporary standards of asthma care, novel, disruptive strategies are likely needed to further reduce the burden of asthma.

Survival among patients with multiple myeloma in the U.S. military health system compared to the Surveillance, Epidemiology, and End Results (SEER) program.

6524 Background: Multiple myeloma (MM) is the second most common hematologic malignancy and remains incurable despite therapeutic advances. The US Military Health System (MHS) provides universal healthcare to beneficiaries and has been associated with improved survival across multiple malignancies. It is unknown whether access to universal healthcare via the MHS translates to improved survival for MM patients. We sought to answer this question by comparing survival data from the Department of Defense’s Automated Central Tumor Registry (ACTUR) and the NCI’s SEER database. Methods: Patients 18 years and older diagnosed with histologically confirmed MM between 1987-2013 were identified in ACTUR (N=1,488) and SEER (N=2,976) databases. Two SEER patients were matched to an ACTUR patient by age group, sex, race, and diagnosis year group. Five and 10-year survival was compared between ACTUR and SEER patients using Kaplan-Meier curves and log-rank tests. Cox proportional hazard model was used to estimate hazard ratios (HR) and 95% confidence intervals (95% CI) adjusted for potential confounders of age at diagnosis, sex, race and diagnosis year. The proportional hazards assumption for the analysis was assessed with log-log survival curves. Results: Median survival in the ACTUR patients was 47.1 months (95% CI: 43.9-50.4) compared to 33.0 months (95% CI: 32.0-35.0) in the SEER group. Five and 10-year survival was superior in patients from the ACTUR group compared to the SEER group with an aHR of 0.74 (95% CI: 0.68-0.81) and 0.79 (95% CI: 0.74-0.85) after adjustment for potential confounders, respectively. The survival advantage of ACTUR patients was preserved when stratified by age, sex, race, and diagnosis year. Conclusions: Patients treated with MM in the MHS had superior 5 and 10-year overall survival when compared to the general population. This benefit remained despite age, sex, race, and diagnosis year. Our study findings suggest the benefits of universal healthcare provided by the MHS improve survival among MM patients. Further research is warranted to delineate factors which improve survival and reduce disparity in the treatment of MM patients.[Table: see text]

20-YEAR TRENDS IN ASTHMA HOSPITAL ADMISSIONS IN CANADA

TYPE: Late Breaking Abstract TOPIC: Obstructive Lung Diseases PURPOSE: To investigate 20-year trends in asthma-related hospitalizations in Canada. METHODS: Using the Canadian comprehensive nationwide hospitalization data (1998–2017), we identified hospital admissions with the main diagnostic International Classification of Diseases codes for asthma. We analyzed sex-specific age-standardized trends in annual hospitalization rates among pediatric (<19 years) and adult (19+ years) patients. We used change-point analysis to examine any substantial change in the trends in each of the sex-age groups. RESULTS: There were 452,228 asthma-related hospital admissions (53% pediatric, 52% female) during the study period. Among pediatric patients, age-adjusted annual rates per 100,000 decreased by 74% in both sexes from 1998 to 2017 (females: 262 to 69; males: 407 to 108). Among adult patients, the rates decreased by 87% in females (197 to 25) and 88% in males (96 to 11). Change-point analysis (Figure 1) indicated a substantial plateauing of the annual rate of decline in both pediatric (26.9 [females] and 34.9 [males] before 2003 to 0.1 [females] and 0.9 [males] after 2012) and adult patients (from 36.9 [females] and 18.6 [males] before 2003 to 2.3 [females] and 1.1 [males] after 2003). CONCLUSIONS: Following a major decline in hospital admissions for acute asthma, there has been minimal further decline since 2012 for all sex and age groups. CLINICAL IMPLICATIONS: The current hospitalisation rates represent an avoidable source of burden. Our study calls for future research to identify specific factors contributing to these trends, thereby potentially identifying avenues where we can further improve asthma outcomes with existing preventive and therapeutic interventions and policies. DISCLOSURE: Nothing to declare. KEYWORD: Asthma

Resting Frequency of Echolocation Calls within a Lesser Horseshoe Bat Population (Southern Poland) and its Relation to Body Size, Condition and Mass

The echolocation calls emitted by stationary bats are characterised by their resting frequency (RF). The ecological role of RF has been widely discussed across the literature concerning the Rhinolophidae family, where it has been found that the RF may vary depending on many factors, although its role in shaping the variability of different populations remains unclear, and the data for many species – includingRhinolophus hipposideros– is scarce. In this study, we aimed to determine how sex, age and biometric parameters (body mass, forearm length and the body condition index) affected the RF in aR. hipposiderospopulation and to investigate the individual variability in this parameter. Bats were captured in front of two Carpathian caves in Southern Poland during the mating season. The echolocation calls of the hand-held bats were recorded, and later their peak frequency was measured with computer software. The analyses showed higher RF values for females than for males, but (in contrast to previous reports) no differences between the age classes were identified. RF did not correlate with any biometric parameters in the studied population, which rules out the possibility of quality characteristic signalling through this parameter. However, we observed significant individual differences in RF within the sex-age groups, which might reflect some communication potential. The discrepancies among the research results available for this topic indicate the need for further studies aimed at investigating the variability of RF and its role across species distribution ranges and their phenology.

Modeled Substitution of Traditional Oils with High–Oleic Acid Oils Decreases Essential Fatty Acid Intake in Children

High-oleic acid (OA) vegetable oils are replacing some traditional vegetable oils in the US food supply. This may lead to reduced intake of the essential fatty acids (EFAs) linoleic acid (18:2n-6) and α-linolenic acid (18:3n-3) in children, who need EFAs for growth and development and reduced risk for cardiometabolic disease into adulthood. The objectives of this study were the following: 1) to estimate trends in daily intake of EFAs among children aged 1-8 y, 2) identify top food sources of EFAs, and 3) evaluate the effects of replacing traditional oils with high-OA oils on meeting daily recommended intakes of EFAs. Dietary data from 7814 children aged 1-8 y were acquired from the NHANES (2007-2016). Using a diet model, we evaluated the effect of replacing 20%, 40%, 60%, and 80% of traditional oils with high-OA oils on meeting adequate intakes (AIs) for EFAs. Major food sources of EFAs among all age-sex groups were grain dishes (35-40% of daily intake), meat and seafood dishes (17-21%), and fruit and vegetable dishes (12-14%). Replacing 40% or more of traditional oils with high-OA oil varieties will lead to inadequate daily intakes of EFAs. Replacement of traditional vegetable oils with high-OA varieties will place children at risk of not meeting the AI levels for EFAs. A balanced approach of including traditional oils and high-OA oils in the US food supply is needed to prevent inadequate intakes of EFAs in children.

Device-measured sedentary time in Norwegian children and adolescents in the era of ubiquitous internet access: secular changes between 2005, 2011 and 2018.

BackgroundAccess to screen-based media has been revolutionized during the past two decades. How this has affected sedentary time (ST) accumulation in children is poorly understood.MethodsThis study, based on the Physical Activity among Norwegian Children Study (PANCS), uses accelerometer data from population-based samples of 9- and 15‐year-olds, collected in 2005 (n = 1722), 2011 (n = 1587) and 2018 (n = 1859). Secular changes between surveys were analysed using random-effects linear regression models adjusted for survey-specific factors. Data on ST were collected using hip-worn ActiGraphs and ST was defined using a threshold equivalent to <100 counts/min. Sedentary bouts were grouped by duration: <1, 1–5, 5–15, 15–30 and ≥30 min.ResultsBetween 2005 and 2018, ST increased by 29 min/day in 9-year-old boys (95% CI: 19, 39; P <0.001), by 21 min/day in 15-year-old boys (95% CI: 8, 34; P = 0.002) and by 22 min/day in 15-year-old girls (95% CI: 10, 35; P <0.001), but not in 9-year-old girls at 6 min/day (95% CI: -3, 16; P = 0.191). All age-sex groups accumulated less ST in bouts lasting <5 min and more ST in longer bouts, particularly in 5–15-min bouts. Adolescent girls also increased ST accumulation in 15–30-min and ≥30-min bouts. Changes were largely mirrored before, during and after school on weekdays and during weekend days.ConclusionsCoinciding with the introduction of smartphones, tablets and near-universal internet access, total daily ST and ST accumulated in prolonged sedentary bouts increased between 2005 and 2018 in children and adolescents.

Study protocol for CELLAR (COVID-related Eating Limitations and Latent dietary effects in the Atlantic Region): population-based observational study to monitor dietary intakes and purchasing during COVID-19 in four Atlantic Canadian provinces

IntroductionPoor diet is a leading preventable risk for the global burden of non-communicable disease. Robust measurement is needed to determine the effect of COVID-19 on dietary intakes and consumer purchasing,...

Subphenotyping of Mexican Patients With COVID-19 at Preadmission To Anticipate Severity Stratification: Age-Sex Unbiased Meta-Clustering Technique.

BackgroundThe COVID-19 pandemic has led to an unprecedented global health care challenge for both medical institutions and researchers. Recognizing different COVID-19 subphenotypes—the division of populations of patients into more meaningful subgroups driven by clinical features—and their severity characterization may assist clinicians during the clinical course, the vaccination process, research efforts, the surveillance system, and the allocation of limited resources.ObjectiveWe aimed to discover age-sex unbiased COVID-19 patient subphenotypes based on easily available phenotypical data before admission, such as pre-existing comorbidities, lifestyle habits, and demographic features, to study the potential early severity stratification capabilities of the discovered subgroups through characterizing their severity patterns, including prognostic, intensive care unit (ICU), and morbimortality outcomes.MethodsWe used the Mexican Government COVID-19 open data, including 778,692 SARS-CoV-2 population-based patient-level data as of September 2020. We applied a meta-clustering technique that consists of a 2-stage clustering approach combining dimensionality reduction (ie, principal components analysis and multiple correspondence analysis) and hierarchical clustering using the Ward minimum variance method with Euclidean squared distance.ResultsIn the independent age-sex clustering analyses, 56 clusters supported 11 clinically distinguishable meta-clusters (MCs). MCs 1-3 showed high recovery rates (90.27%-95.22%), including healthy patients of all ages, children with comorbidities and priority in receiving medical resources (ie, higher rates of hospitalization, intubation, and ICU admission) compared with other adult subgroups that have similar conditions, and young obese smokers. MCs 4-5 showed moderate recovery rates (81.30%-82.81%), including patients with hypertension or diabetes of all ages and obese patients with pneumonia, hypertension, and diabetes. MCs 6-11 showed low recovery rates (53.96%-66.94%), including immunosuppressed patients with high comorbidity rates, patients with chronic kidney disease with a poor survival length and probability of recovery, older smokers with chronic obstructive pulmonary disease, older adults with severe diabetes and hypertension, and the oldest obese smokers with chronic obstructive pulmonary disease and mild cardiovascular disease. Group outcomes conformed to the recent literature on dedicated age-sex groups. Mexican states and several types of clinical institutions showed relevant heterogeneity regarding severity, potentially linked to socioeconomic or health inequalities.ConclusionsThe proposed 2-stage cluster analysis methodology produced a discriminative characterization of the sample and explainability over age and sex. These results can potentially help in understanding the clinical patient and their stratification for automated early triage before further tests and laboratory results are available and even in locations where additional tests are not available or to help decide resource allocation among vulnerable subgroups such as to prioritize vaccination or treatments.

Contact call acoustic structure is associated with inter-individual distances during antiphonal vocal exchanges in wild red-tailed monkeys (Cercopithecus ascanius schmidti)

Abstract Contact calls allow animals to maintain group cohesion when visibility is restricted. To maximise call detection, animals should produce calls that are audible to closest neighbours or respond to individuals that produce preceding calls (i.e., antiphony). Antiphonal exchanges are more likely to occur between older conspecifics that respond more reliably or close neighbours that are more likely to detect calls when groups are travelling. Because animals should produce calls that are optimised for propagation, call structure should be associated with the distance between individuals calling in antiphonal exchanges. I investigated whether acoustic structures of red-tailed monkey (Cercopithecus ascanius) contact calls (phrased grunts) reflected increased sound propagation as nearest neighbour distances increased, depending on three factors: (1) the occurrence of a preceding grunt, (2) neighbour age-sex class, and (3) group travel speed. I recorded grunts from five habituated monkey groups at Kibale National Park, Uganda. Per grunt, I measured five parameters associated with sound propagation. Grunt mean entropy and frequency related negatively to neighbour distance when the neighbour produced a preceding grunt or when there was no preceding grunt, but not when a more distant individual grunted prior. Neighbour age-sex class and group travel speed did not influence whether grunt structure was associated with neighbour distance, but monkeys produced grunts with higher mean entropy and frequency as groups travelled faster. Variation in grunt mean entropy and frequency was associated with propagation to either nearest neighbours or more distant individuals that produced preceding calls, providing quantitative evidence for antiphonal calling. By calling antiphonally, animals in cohesive groups can spread out to avoid intra-group competition while maintaining contact with other group members. Higher grunt entropy and frequency as groups travel faster may counteract more variable sound attenuation as animals move through acoustically complex (e.g., densely vegetated) environments.

Positional Behavior and Substrate Use in Wild Tibetan Macaques.

Simple SummaryBody size and individual development are essential factors that affect primate movement through the canopy and access to food. However, only a few studies have been conducted on immature wild macaques. Although adults are significantly heavier than the other age groups, this study found that they did not exhibit higher frequencies of climbing and bridging. Jumps and suspensions were more frequent in juveniles than adults. We also found that juveniles exhibited rare behaviors during play, such as cling locomotion, suspensory locomotion, and bounding. We hypothesized that juveniles would exhibit diverse positional behaviors associated with altered skeletal muscle development. Diverse positional abilities facilitate habitat exploitation and the avoidance of danger.Body size and individual development significantly affect positional behavior and substrate use. However, only a few studies have been conducted on immature wild macaques. We studied wild Tibetan macaques (Macaca thibetana) inhabiting Mt. Huangshan, China, to explore the degree of interspecific variation in positional behavior in relation to body weight and individual development. From September 2020 to August 2021, we used instantaneous scan sampling (duration 5 min, interval 10 min) to record age–sex groups, locomotions, postures, and substrate attributes. The results showed that Tibetan macaques used terrestrial substrates in nearly two-thirds of the recorded observations. The main postural modes were sitting and quadrupedal standing. The main locomotor modes were quadrupedal walking and climbing among all age–sex group records. Positional behavior and substrate use in adults only significantly differed from those in juveniles and infants. Although adult males were larger than the other age–sex groups, they did not climb and bridge more frequently than the other age–sex groups. The frequency of climbing, leaping, and suspension was significantly higher in juveniles than in adults. In addition, adult males used terrestrial and larger substrates more frequently, while juveniles and infants used arboreal substrates and terminals more frequently than adult males during traveling and feeding. We hypothesize that the more positional behavioral spectrum of Tibetan macaque juveniles’ may be related to rapid skeletal muscle development. These results suggest that differences in interspecific positional behavior may be caused by the individual development and survival needs of individuals, rather than just body size.

Influence of Sexual Dimorphism, Aging, and Differential Cell Capture Efficiency of Blood Separation Systems on the Quality of Platelet-Rich Plasma.

Few studies have checked the impact of the hormonal/immunological dimorphism of patients on the cellular composition of platelet-rich plasma products (PRP). Whole blood (WB) from 26 volunteers was concentrated using a device previously characterized. Platelet and white blood cell (WBC) counts in WB and PRP were compared between genders, and after the population was split into pre (≤50 years)- and post (>50 years)-menopausal ages. In WB, platelet–total WBC densities were comparable in men and women. The phagocytic cell composition differed (p ≤ 0.04). After dividing by ages, phagocytic cell discrepancies were linked to women > 50 years (p ≤ 0.05), and differences emerged in lymphocyte counts (lower in >50 years groups, within and between genders, p ≤ 0.05). In PRP, densities were significantly higher, but the PRP/WB ratios varied according to blood cell (lower for phagocytic cells) and between subjects (more favorable at a lower density of a particular blood cell in WB). This “system compensatory efficiency” reduced/reverted PRP differences in the leukocyte composition between genders/age–sex groups in WB. In PRP, neutrophils were higher in younger men than older women (p < 0.05). WB lymphocyte differences between age–sex groups persisted. Age is a more determining factor than sex in the preparation of PRP. Post-menopause, sexual dimorphism strongly influences the composition of leukocytes, also conditioned by the capture efficiency of the system.

National, regional, and global causes of mortality in 5–19-year-olds from 2000 to 2019: a systematic analysis

SummaryBackgroundInvestments in the survival of older children and adolescents (aged 5–19 years) bring triple dividends for now, their future, and the next generation. However, 1·5 million deaths occurred in this age group globally in 2019, nearly all from preventable causes. To better focus the attention of the global community on improving survival of children and adolescents and to guide effective policy and programmes, sound and timely cause of death data are crucial, but often scarce.MethodsIn this systematic analysis, we provide updated time-series for 2000–19 of national, regional, and global cause of death estimates for 5–19-year-olds with age-sex disaggregation. We estimated separately for countries with high versus low mortality, by data availability, and for four age-sex groups (5–9-year-olds [both sexes], 10–14-year-olds [both sexes], 15–19-year-old females, and 15–19-year-old males). Only studies reporting at least two causes of death were included in our analysis. We obtained empirical cause of death data through systematic review, known investigator tracing, and acquisition of known national and subnational cause of death studies. We adapted the Bayesian Least Absolute Shrinkage and Selection Operator approach to address data scarcity, enhance covariate selection, produce more robust estimates, offer increased flexibility, allow country random effects, propagate coherent uncertainty, and improve model stability. We harmonised all-cause mortality estimates with the UN Inter-agency Group for Child Mortality Estimation and systematically integrated single cause estimates as needed from WHO and UNAIDS.FindingsIn 2019, the global leading specific causes of death were road traffic injuries (115 843 [95% uncertainty interval 110 672–125 054] deaths; 7·8% [7·5–8·1]); neoplasms (95 401 [90 744–104 812]; 6·4% [6·1–6·8]); malaria (81 516 [72 150–94 477]; 5·5% [4·9–6·2]); drowning (77 460 [72 474–85 952]; 5·2% [4·9–5·5]); and diarrhoea (72 679 [66 599–82 002], 4·9% [4·5–5·3]). The leading causes varied substantially across regions. The contribution of communicable, maternal, perinatal, and nutritional conditions declined with age, whereas the number of deaths associated with injuries increased. The leading causes of death were diarrhoea (51 630 [47 206–56 235] deaths; 10·0% [9·5–10·5]) in 5–9-year-olds; malaria (31 587 [23 940–43 116]; 8·6% [6·6–10·4]) in 10–14-year-olds; self-harm (32 646 [29 530–36 416]; 13·4% [12·6–14·3]) in 15–19-year-old females; and road traffic injuries (48 757 [45 692–52 625]; 13·9% [13·3–14·3]) in 15–19-year-old males. Widespread declines in cause-specific mortality were estimated across age-sex groups and geographies in 2000–19, with few exceptions like collective violence.InterpretationChild and adolescent survival needs focused attention. To translate the vision into actions, more investments in the health information infrastructure for cause of death and in the related life-saving interventions are needed.FundingBill & Melinda Gates Foundation and WHO.

CLINICAL AND EPIDEMIOLOGICAL FEATURES OF ENT PATHOLOGY IN CHILDREN

Relevance. The insufficiency of studies on the field study of the structure and level of ENT morbidity, which affects the quality and life expectancy of a person in all social and age-sex groups of the population, indicates the relevance of this work.&#x0D; Purpose of the study A retrospective analysis of the indicators of the appealability of pediatric patients with ENT pathology.&#x0D; Material and research methods. In accordance with the set goal and objectives, the study was conducted in the period 2015-2019. An assessment was made of the condition of the ENT organs in children.&#x0D; Results of researches. The obtained data of statistical analysis confirm the high incidence of patients with allergic and catarrhal rhinitis, chronic pharyngitis, sinusitis, inflammatory diseases of the tonsils and adenoid vegetations, etc. Along with the high prevalence of adenoid vegetations, an increase in chronic rhinosinusitis was also observed. On average for 5 years, such diseases of the paranasal sinuses as acute rhinosinusitis 20.7±1.40% and chronic rhinosinusitis 7.8±0.93% prevail. At the same time, the prevalence of injuries to the bones of the nose and nosebleeds decreased during the study period. The data obtained determine the need for timely detection of diseases of the upper respiratory tract in children at the early stages of their development and the organization of measures for systematic dispensary observation.&#x0D; Conclusions.&#x0D; &#x0D; The pathological incidence of ENT diseases in children, being high, nevertheless does not exceed the similar indicators recorded at the final stage of the research.&#x0D; In the structure of ENT pathology of preschool age, the leading place belongs to diseases of the ear.&#x0D; Considering that the lowest prevalence rates of ENT diseases fall on the last year of observation, further reorganization of ENT care for the children's population and periodic preventive medical examinations with the involvement of certain individuals in medical examinations are necessary.&#x0D;

Associations among the anterior maxillary dental arch form, alveolar bone thickness, and the sagittal root position of the maxillary central incisors in relation to immediate implant placement: A cone-beam computed tomography analysis.

PurposeThis study evaluated the associations of the dental arch form, age-sex groups, and sagittal root position (SRP) with alveolar bone thickness of the maxillary central incisors using cone-beam computed tomography (CBCT) images.Materials and MethodsCBCT images of 280 patients were categorized based on the dental arch form and age-sex groups. From these patients, 560 sagittal CBCT images of the maxillary central incisors were examined to measure the labial and palatal bone thickness at the apex level and the palatal bone at the mid-root level, according to the SRP classification. The chi-square test, Kruskal-Wallis test, and multiple linear regression were used for statistical analyses.ResultsSignificant differences were found in alveolar bone thickness depending on the arch form and SRP at the apex level. The square dental arch form and class I SRP showed the highest bone thickness at both levels of the palatal aspect. The taper dental arch form and class II SRP presented the highest bone thickness at the apex level of the labial aspect. No association was found between the dental arch form and SRP. Elderly women showed a significant association with thinner alveolar bone. Age-sex group, the dental arch form, and SRP had significant associations with alveolar bone thickness at the apex level.ConclusionThe patient’s age-sex group, dental arch form, and SRP were associated with alveolar bone thickness around the maxillary central incisors with varying magnitudes. Therefore, clinicians should take these factors into account when planning immediate implant placement.

Prevalence of overweight and obesity in children

The growing prevalence of overweight and obesity is an urgent problem not only in adults but also in children in both developed and developing countries. The purpose of this study was to analyze the prevalence of overweight and obesity and other forms of nutritional disorders in Russian children. Material and methods. The nutritional status of 17 329 children aged 2-18 years was assessed on the basis of anthropometric data, obtained by the Federal State Statistics Service during the "Sample Survey of the Population's Diet" in 2018. The prevalence of various forms of malnutrition was assessed by the Z-score categories: underweight, stunted growth (short stature), thinness, overweight, obesity. Results. Population mean and median values of Z-scores in all sex-age groups do not exceed ±0.5 in relation to WHO standards, which indicates the applicability of the standards to assessing the nutritional status of Russian children population. High body weight (WAZ>2) occurs in 7.6% of children, underweight in 2.6%. The incidence of short stature in boys and girls is 7.0 and 6.8%, respectively. The prevalence of overweight and obesity in boys is 20.4 and 10.4%, respectively, while in girls, 15.4 and 7.6%. In general, in the population of children 2-18 years old, the prevalence of overweight is 18%, and obesity is 9.1%. The index of malnutrition, including the sum of the frequency of various combinations of low Z-scores (<-2), characterizing underweight, short stature, thinness, and their combinations was 8.0%. The multilevel logistic regression showed that overweight and obesity inversely depend on age; the risk of developing these conditions is lower in the city, but higher in male children compared to female children. Conclusion. The population of children 2-18 years old in the Russian Federation is characterized by a low incidence of forms of malnutrition, such as underweight and thinness. However, the prevalence of overweight and obesity is higher than in European countries.

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Currently, the atrophic rhinitis of pigs is registered in some pig breeding farms of the Armavir and Kotayk regions. According to investigations swines of all breed and sex-age groups are susceptible to the disease but the inherent symptoms are manifested in the 3-5-month-old fattened gilts. In Armenia the spread of the mentioned disease is promoted by the disposing factors and economic relationships between pig breeding farms. Rehabilitation of insecure pig breeding farms, as well as measures to prevent the further spread of the pathogen, were carried out in accordance with the directive on measures for the prevention and control of diseases. Sulfaprim 48-BT preparation was used for treatment.

The influence of camera-trap flash type on the behavioural response, detection rate and individual recognition of Eld’s deer

Context Camera traps are available with infrared or white flash, with the former being more commonly used. However, white flash produces colour night-time photographs that can be critically useful for both species and individual identification. White flash was thought to cause more disturbance to wildlife than was infrared and this may lead to camera avoidance. Evaluating the extent of this response, and differences between the flash types, is useful to develop improved survey designs. Aims This research aimed to quantify the behavioural responses of Eld’s deer to white and infrared flash, to determine whether white-flash cameras were suitable for use in population surveys of this species. Methods A behavioural ethogram was used to quantify the responses of the deer to the two flash types, as well as the responses of different sex-age classes and group sizes when encountering a camera trap. Additionally, the detection rate for white flash and infrared flash cameras was compared through time, to determine any pattern of avoidance. Key results While deer were more likely to observe and be startled by white flash than infrared, this did not adversely affect the detection of the deer, with no significant change in the detection rate between the two different flash types over time. Group size was found not to influence behavioural response when encountering camera traps, whereas different age–sex classes of deer showed very few differences in response to camera traps. Conclusions White flash cameras were found to be suitable for Eld’s deer population surveys and were beneficial in providing colour night-time photos that allow for spotted female deer to be individually identified. Implications Practitioners should not be concerned about the influence of white flash when using camera traps to monitor populations of Eld’s deer, and using white flash is recommended when individual identification is required.