Demographic Age Research Articles

Abstract A081: Comprehensive examination of disparities in cancer incidences by race, gender, and age over 65 years in Alabama's Black belt counties, USA

Abstract In the United States, significant disparities persist in cancer incidence, mortality, and treatment outcomes, particularly among Black populations. Despite advances in medical care, disparities continue to challenge efforts to achieve health equity. Understanding and addressing these complex issues are imperative to ensure that all individuals, regardless of race or ethnicity, have equal access to effective cancer prevention, diagnosis, and treatment. Alabama stands out as the leading state among the top ten in terms of densely populated Black Belt counties in the United States. With 67 counties in total, Alabama is home to 24 designated Black Belt counties. Given this concentration, Alabama becomes a key focus for comprehending cancer disparities. The ongoing research seeks to examine the occurrence of various types of cancer among the predominant racial groups in the United States, focusing particularly on the Black Belt counties of Alabama. Data on cancer occurrences, obtained from the database of National Cancer Institute (NIH) and the Centers for Disease Control and Prevention (CDC), offer insights into cancer incidences among various demographic groups, age categories, and specific types of cancer spanning the last five years (2016-2020). Analysis of the data, focusing on patients aged 65 years and older, was performed using GraphPad Prism 5 software. Graphs were created to visually represent and interpret the data regarding incidences per 100,000 populations. We observe significantly elevated incidences of major cancer types such as prostate, colon, lung, stomach, pancreas, and liver among Black males, and similarly heightened rates of uterus, cervix, stomach, pancreas, and kidney cancers among Black females, when compared to white populations. Notably, within Alabama's Black Belt regions, only a small number of counties have reported incidences of cancer regardless of gender and cancer types, except for prostate cancer in males and breast cancer in females. Moreover, in certain Black Belt counties, rates of colon and lung cancer (in both males and females), as well as prostate cancer in males and breast cancer in females, are exceptionally elevated compared to both the statewide average in Alabama and even the national average in the United States. Generally, females tend to have lower rates of cancer across various types compared to males. In conclusion, factors contributing to these disparities include genetic predispositions, socioeconomic status, healthcare accessibility, systemic biases, and cultural influences. Further investigations, including molecular screening studies, are imperative to corroborate these health disparities and foster community-wide cancer awareness and public health initiatives. Citation Format: Faith Onomeh, Anathbandhu Chaudhuri. Comprehensive examination of disparities in cancer incidences by race, gender, and age over 65 years in Alabama's Black belt counties, USA [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A081.

Unlocking Tourism Diversity in Winter: Clusters of Tourists in Lisbon Based on Motivations, Profiles, and Behaviour

Recent trends in Lisbon's winter tourism indicate a shift towards off-peak travel, attracting diverse visitors with its rich cultural heritage, sustainable initiatives, and extended stay options for digital nomads. The city's culinary scene, arts, wellness activities, and tech-driven tourism options enhance its appeal. Aligned with these recent trends, tourism in Lisbon's region during the winter season presents a unique and dynamic landscape influenced by a wide range of motivations, tourist profiles, and travel behaviours. This study aims to define distinctive clusters of winter tourists in Lisbon by analysing these key variables, providing valuable insights specific to the winter travel context. Based on a compiled dataset from the winter season in Lisbon, this study delves into examining the factors driving tourist visits, encompassing socio-economic backgrounds, travel frequency, and age demographics. We aim to reveal the distinctive subgroups that define Lisbon's winter tourist population, employing data analysis techniques such as cluster analysis. From an academic perspective, this study offers a novel tourist segmentation model based on motivations, profiles, and behaviour. This model enriches the existing body of knowledge in tourism studies, providing a valuable reference for future research. For tourism agents in Lisbon, this study provides actionable insights to enhance strategic decision-making. By segmenting winter tourists, they can tailor marketing strategies and product development to cater to diverse tourist segments. Moreover, this approach can lead to economic benefits, optimising resource allocation, and revenue generation.

A frailty census of older adults in the emergency department and acute inpatient settings of a model 4 hospital in the Mid-West of Ireland

Abstract Background Frailty is a risk factor for presentation to the ED, in-hospital mortality, prolonged hospital stays and functional decline at discharge. Profiling the prevalence and level of frailty within the acute hospital setting is vital to ensure evidence-based practice and service development within the construct of frailty. The aim of this cross-sectional study was to establish the prevalence of frailty and co-morbidities among older adults in an acute hospital setting. Methods Data collection was undertaken by clinical research nurses and advanced nurse practitioners experienced in assessing older adults. All patients aged ≥ 65 years and admitted to a medical or surgical inpatient setting between 08:00 and 20:00 and who attended the ED over a 24-h period were screened using validated frailty and co-morbidity scales. Age and gender demographics, Clinical Frailty Scale (CFS), Charlson Co-morbidity Index (CCI) and admitting specialty (medical/surgical) were collected. Descriptive statistics were used to profile the cohort, and p values were calculated to ascertain the significance of results. Results Within a sample of 413 inpatients, 291 (70%) were ≥ 65 years and therefore were included in the study. 202 of these 291 older adults (70%) were ≥ 75 years. Frailty was investigated using validated clinical cut-offs on the CFS (not frail < 5; frail ≥ 5). Comorbidities were investigated using the Charlson Comorbidity Index (mild 1–2; moderate 3–4; severe ≥ 5). The median CFS was 6 indicating moderate frailty levels, and the median CCI score was 3 denoting moderate co-morbidity. In the inpatient cohort, 245 (84%) screened positive for frailty, while 223 (75%) had moderate-severe co-morbidity (CCI Mod 3–4, severe ≥ 5). No significant differences were observed across genders for CFS and CCI. In the ED, 81 patients who attended the ED were ≥ 65 years. The median CFS was 6 (moderate frailty), and the median CCI was 5 (severe co-morbidity level). Seventy-four percent (60) of participants screened positively for frailty (CFS ≥ 5), and 31% (25) had a CFS of 7 or greater (severely frail). Ninety-six percent (78) of patients had a moderate-severe level of comorbidity. No significant associations were found between the CFS and CCI and ED participants age, gender, and medical/surgical speciality usage. Conclusion There is a high prevalence of frailty and co-morbidity among older adults who present to the ED and require inpatient care. This may contribute to increased waiting times, lengths of stay, and the need for specialist intervention. With an increased focus on the integration of care for older adults across care transitions, there is a clear need for expansion of frailty-based services, staff training in frailty care and multidisciplinary team resources across the hospital and community setting.

Matched pair analysis of the effect of longer hypothermic machine perfusion time on kidney transplant outcomes.

Hypothermic machine perfusion (HMP) has demonstrated benefits in terms of early kidney transplant function compared to static cold storage. While longer preservation times have shown detrimental effects, a previous paired study indicated that longer pump times (the second kidney in a pair) might lead to improved outcomes. To revisit the prior paired study's somewhat unexpected results by reviewing our program's experience. A total of 61 pairs of transplant recipients who received kidneys from the same donor (2012-2021) were analyzed. Patients were divided into two groups depending on whether they were transplanted first (K1) or second (K2). Therefore, the patients in each pair had identical donor characteristics, except for time on the pump. Statistical analyses included Kaplan-Meyer analysis and paired tests, including McNemar's test, student's paired t-test, or Wilcoxon's test, as appropriate. The two groups of recipients had similar demographics (age, body mass index, diabetes, time on dialysis, sensitization and retransplants). Cold ischemic times for K1 and K2 were 8.9 (95%CI: 7.9, 9.8) and 14.7 hours (13.7, 15.8) (P < 0.0001), respectively. Overall, K2 had a higher rate of freedom from biopsy-proven acute rejection at 1 year (P = 0.015). Delayed graft function was less common in K2, 12/61 (20%) than in K1, 20/61 (33%) (P = 0.046). Finally, K2 showed a higher graft survival than K1 (P = 0.023). Our results agree with a previous study that suggested possible advantages to longer pump times. Both studies should encourage further research into HMP's potential anti-inflammatory effect.

Big Data Analysis of Facial Fracture Epidemiology in South Korea From 2015 to 2020: Impacts of Aging and Personal Mobility.

The epidemiology of facial fractures is continuously evolving due to various influencing factors, including social, economic, and technological advancements. Thus, an updated analysis of facial bone fractures is necessary. This study aimed to provide an updated epidemiological analysis of facial bone fractures and assess severity using multiple factors. We retrospectively reviewed patients who underwent facial bone fracture surgery at 3 teaching hospitals in South Korea between January 2015 and December 2020. Data collected included patient demographics (sex and age), trauma mechanism, alcohol intoxication status, and fracture types. Trauma mechanisms were categorized into 7 groups: assault, fall, sports, occupational injury, motor vehicle crash, bicycle, and personal mobility. Severity was assessed using the modified facial injury severity scale. A total of 5953 patients (4437 males and 1516 females) were included, with ages ranging from 1 to 92 years (mean age: 36.37±18.61y). A steady decline in the number of patients was observed from 2015 to 2020. Falls were the most common cause of facial fractures (2300 cases, 39%), and nasal bone fractures were the most frequent type (3683 cases, 46%). The number of elderly patients (> 60y) and injuries caused by personal mobility devices increased steadily. Male sex and alcohol intoxication were associated with higher severity scores. Motor vehicle crashes had the highest severity scores (2.246). While the incidence of facial bone fractures has decreased in recent years, the proportion of elderly patients and injuries caused by personal mobility devices is increasing, posing a significant burden on the health care system.

A - 111 Neuropsychological Functioning in those with Chronic Traumatic Encephalopathy

Abstract Objective To differentiate neurocognitive performance between those with chronic traumatic encephalopathy neuropathologic change (CTE-NC) and matched CTE-negative individuals. Methods Data were obtained from the National Alzheimer’s Coordinating Center (NACC). Participants with mild cognitive impairment (MCI) or dementia and CTE-NC (n = 22) were matched approximately 1:3 to those with MCI/dementia but without CTE-NC (n = 64) on demographics (age of initial cognitive diagnosis, education, sex) and postmortem Alzheimer’s and Lewy body neuropathology. ANCOVAs (covarying for symptom duration and cognitive diagnosis) compared neurocognitive measures between groups (MMSE and neuropsychological battery composites of Attention, Executive Function, and Speed [AEFS], Memory, and Language). Results Participants were all male, 89.3% White, and averaged 16.3 years of education. They were, on average, 74.8 years of age (SD = 7.3) when diagnosed with MCI/dementia and had 4.2 years (SD = 4.2) of cognitive symptoms prior to MCI/dementia diagnosis. Rates of comorbid moderate/severe Alzheimer’s or Lewy body pathology were high (n = 13, 54%) in the CTE-NC group. At time of cognitive diagnosis, individuals with CTE-NC performed slightly better on the MMSE (F = 4.510, p = 0.037, CTE-NC+ M = 26.03 [1.05] vs. CTE-NC- M = 23.44 [0.58]). No differences in AEFS [F = 0.280, p = 0.599], Memory [F = 2.265, p = 0.137], or Language [F = 3.424, p = 0.069] were observed between groups. Conclusions Those with CTE-NC did not greatly differ in neuropsychological domains, but had relatively higher MMSE scores compared to those without CTE-NC. This is the largest clinicopathological investigation utilizing in-vivo neurocognitive data, though NACC lacks CTE-NC severity/distribution data for sensitivity analyses. Nonetheless, results have implications for CTE clinical criteria frameworks and larger clinicopathological studies are needed to determine if CTE-NC has distinct neurocognitive features.

B - 129 Examining the Influence of Age and Other Demographics on Word Choice (WC)

Abstract Objective Performance validity tests (PVTs) often vary by examinee characteristics including age and education among other demographics. Normative data on WC are limited to adults in the 16–69 age range. We examined relationships among demographic variables and WC in a mixed clinical sample. Method Local clinical data were retrospectively examined. Cases with WC and four independent PVTs were included; cases with dementia, intellectual disability or psychosis were excluded yielding a sample (N = 362) in which 61% of participants were female and 44% identified as Hispanic/Latino. Average age and education were 48 and 13 years, respectively. Outcome measures included WC and PVT scores and dichotomous cutoffs. Results WC was associated with age (r = −0.27) but not education. WC scores were significantly different by gender with a small effect (d = 0.39) but not by ethnicity. Using logistic regression with WC as outcome, age, education, and gender were significant predictors. Significantly more males (11%) scored below the WC cutoff than females (5%) in the valid group. Among participants 70 and older, 17% scored below the standard WC cutoff, but only 7% scored below expectation on two or more criterion PVTs. Lowering the WC cutoff resulted in improved specificity in the 70 and older subset: 15% with WC ≤ 40, and 11% with WC ≤ 36. Conclusions WC scores varied by age and gender. The standard WC cutoff showed an elevated false positive rate among adults 70 and older. Consideration might be given to adjusting the cutoff if subsequent research supports these preliminary findings. Further research might also examine relationships among gender, education, and WC.

Minor Ailments and Pharmacist Management in Ontario, Canada: Attachment and Primary Care

Minor ailments (MA) are health conditions that can be managed with minimal prescribed treatment and/or self-care strategies. In Ontario, Canada, pharmacists were given authority to deliver service for thirteen MAs on January 1, 2023, with an additional six MAs on October 1, 2023. This study aims to identify patterns of MA service provision and describe characteristics of recipients of MA services. A cross-sectional analysis of linked health administrative data, including pharmacist billing for MA services, patient demographics, and physician and hospital billing data, was conducted. Delivery of MA services prescribed in Ontario from January 1 to December 31, 2023 were analyzed with key demographics (age, sex, income, new arrival status, comorbidity), health care utilization (ED, hospitalization) and primary care attachment. In 2023, 547,673 (3.6%) Ontario residents received at least one MA service, with the top 5 services being urinary tract infections (199,282), conjunctivitis (153,021), herpes labialis (46,659), allergic rhinitis (41,521), and dermatitis (39,365). Compared to all Ontario residents, the MA service recipients were more likely to be people with a higher rate of ED visits (41.7% vs. 32.4%), comorbidities (17.5% vs. 9.7%), higher incomes (highest income quintile, 23.1% vs. 20.1%; lowest income quintile, 16.5% vs. 19.4%), and hospitalizations (23.6% vs. 17.6%), and less likely to be newcomers to Ontario (8.7% vs. 13.1%). They were more likely to be attached to a primary care provider (91.3% vs. 84.7%). This study provides insight into early users of this program, and sheds light on those with systemic vulnerabilities and equity deserving groups.

Employee Attrition and its Impact on National Cash Flow: A Case Study of the United States Economy in 2024

Purpose: This study investigates key drivers of attrition, including compensation, work environment, age demographics, and remote work dynamics. Methodology: Using real-time data from industry reports and economic indicators, we analyze trends across various sectors and geographic regions. Findings: The findings reveal that younger employees and those in lower compensation brackets are particularly prone to leaving their jobs, exacerbated by the growing demand for remote work flexibility. Furthermore, our analysis uncovers a strong correlation between attrition rates and economic factors such as unemployment and inflation, highlighting the broader economic impact. Unique Contribution to Theory, Policy and Practice: The study offers valuable insights for policymakers and business leaders aiming to mitigate the adverse effects of attrition on national cash flow and economic stability. By addressing the root causes of employee turnover, organizations can not only retain talent but also contribute to a more resilient economy.

Demographic and socio-economic inequalities in subjective wellbeing: analysis of repeated cross-sectional health surveys in England 2010-2019.

Good subjective wellbeing (SWB) is a key societal aspiration. The study of SWB determinants is of increasing interest. The present study aimed to examine national inequalities in SWB, and trends in these inequalities, for England across five demographic (sex and age) and socio-economic (educational level, household income and living alone) characteristics. The relative index of inequalities (RII) and slope index of inequalities (SII) were calculated from repeated cross-sectional data from the Health Survey for England from 2010 to 2019 (excluding 2017 and 2018 as our outcome variable was not collected in these years), in a total of 90 236 participants aged 16+. SWB was assessed using the Warwick-Edinburgh Mental Well-being Scale (WEMWBS), treated as a dichotomous variable with high and low levels of SWB>40 and≤40, respectively. There were significant inequalities in SWB by income (RII from 1.086 to 1.116), educational level (RII from 0.893 to 0.941) and between people living alone or not (RII from 0.908 to 0.937). The RII and SII trends were not statistically significant. Higher socio-economic status could play a protective role for SWB, and people in the most deprived socio-economic positions may be at higher risk for low SWB. These associations have remained stable over time.

FP2.13 - Do we really need Antibiotics for Simple Uncomplicated Diverticulitis? Results of Meta-Analysis of Randomised Controlled Trials

Abstract Aims Acute uncomplicated diverticulitis (AUD) is a common cause of acute abdominal pain. Recent guidelines advise selective use of antibiotics in AUD patients. This meta-analysis aimed to compare the effectiveness of no antibiotics versus antibiotics in AUD patients. Methods This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses to identify randomised controlled trials (RCTs) involving AUD patients which compared the use of antibiotics with no antibiotics. Pooled outcome data was calculated using random effects modelling with 95% confidence intervals (CI). Results Five RCTs with 1934 AUD patients were included. 979 patients were managed without antibiotics (50.6%). Patients in the no antibiotic and antibiotic groups had comparable demographics (age, sex and body mass index) and presenting features (temperature, pain score and C-reactive protein levels). There was no significant difference in rates of complicated diverticulitis (OR: 0.61, 95% CI :0.27-1.36, p=0.23), abscess (OR: 0.51, 95% CI: 0.08-3.25, p=0.47) or fistula (OR: 0.33, 95% CI: 0.03-3.15, p=0.33) formation, perforation (OR: 0.98, 95% CI: 0.32-3.07, p=0.98), recurrence (OR: 0.96, 95% CI: 0.66-1.41, p=0.85) need for surgery (OR: 1.36, 95% CI: 0.47-3.95, p=0.37), mortality (OR: 1.27, 95% CI: 0.14-11.76, p=0.82) or length of stay (MD: 0.215, 95% CI: -0.43-0.73, p=0.61) between the two groups. However, the likelihood of readmission was higher in the antibiotics group (OR: 2.13, 95% CI: 1.43-3.18, p=0.0002). Conclusion There is no significant difference in baseline characteristics, clinical presentation and adverse health outcomes between AUD patients treated without antibiotics compared to with antibiotics.

Incidences of Rocuronium Use during Anesthetic Induction in Adult Patients Undergoing Orthopedic Surgery Using Supraglottic Airway Devices: A Retrospective Analysis.

Background/Objectives: Neuromuscular blocking agents (NMBAs) are not usually necessary during the induction of general anesthesia in patients using supraglottic airway (SGA) devices. In this study, we assessed the incidences of rocuronium use in adult patients undergoing general anesthesia using SGA devices. Methods: From September 2022 to August 2023, the medical records of adult patients (≥19 years) who underwent orthopedic surgery using SGA devices were retrospectively investigated. The incidences of rocuronium use during anesthetic induction were analyzed according to the anesthetic induction drug. The association of rocuronium use during anesthesia was analyzed in terms of demographic (age, sex, height, and weight), surgical (surgical time), and anesthetic factors (premedication, anesthetic agent, anesthetic time). Results: In total, 321 patients were enrolled. The incidence rate of rocuronium use during anesthetic induction was 28.3%. In the subgroup analysis, patients receiving total intravenous anesthesia (TIVA) with propofol (PPF) and remifentanil showed a markedly lower incidence (14.4%) than the other anesthetic groups. Premedication or short anesthetic duration was associated with lower incidences of rocuronium use. Demographic and other anesthetic factors did not seem to affect the incidences of rocuronium use during anesthesia. Conclusions: The incidence of rocuronium use during anesthetic induction with SGA devices was significantly lower with the PPF-TIVA compared to that using remimazolam-TIVA or inhalational anesthesia. Premedication with midazolam and shorter operation times were associated with a significantly lower incidence of rocuronium use.

What drives China's healthcare expenditure? A theoretical and empirical study of determinants and trends.

As economic development advances, there is an increasing focus on improving health conditions, making healthcare expenditure a critical issue worldwide. In China, healthcare spending has shown a marked upward trend, highlighting the importance of understanding its underlying determinants to guide effective policy-making. This study introduces the application of an SV-TVP-FAVAR model to examine the drivers of healthcare expenditure in China from 2007 to 2022. The analysis reveals that economic factors, demographic composition, and policy interventions significantly influence healthcare spending dynamics. Economic growth is strongly linked to increased healthcare expenditure, with economic factors having a particularly pronounced impact during periods of prosperity. Although an aging population drives greater demand for healthcare, the growth rate of healthcare spending has not kept pace with demographic aging, especially following China's economic slowdown. Policy variables present a dual-edged impact: while increased fiscal outlays contribute to budget deficits, limiting the fiscal space for healthcare investment, government emphasis on scientific and technological progress tends to enhance healthcare spending, indicating a synergistic relationship between these areas. Furthermore, the study identifies a prolonged impact of the COVID-19 pandemic on healthcare expenditure, which continues to interact with other driving factors over an extended period. The empirical findings from this research provide crucial evidence to support the development of informed healthcare policies.

Analysis of bigmouth buffalo Ictiobus cyprinellus spawning phenology in Minnesota reveals 50-year recruitment failure and conservation concern

The bigmouth buffalo Ictiobus cyprinellus (Catostomidae) is a freshwater fish native to North America that is known for its longevity. During the 1970s, the bigmouth buffalo was recorded as declining in Canada, Minnesota, and North Dakota and became a protected species in Canada. In the USA, population declines are exacerbated by wasteful recreational bowfishing, lack of fisheries management, and overall lack of knowledge. However, recent studies have revealed the exceptional lifespan of bigmouth buffalo, their negligible senescence, slow growth, delayed maturity, and episodic recruitment. Yet little is known about the spawning phenology of bigmouth buffalo, nor their age demographics in east central Minnesota. In this 2021–2023 study of bigmouth buffalo from Rice Lake National Wildlife Refuge we found that 99.7% (389 of 390) of the extant population hatched prior to 1972 despite annual spawning in Rice Lake. Moreover, recruitment success declined significantly since water control measures were established (1953). We found males arrive to spawning grounds with females but depart later, that both the midpoint and duration of spawn significantly vary across years, and that more massive females of the same age range invest disproportionately more in ovaries. Extensive post-spawn seining revealed bigmouth buffalo young-of-the-year in low numbers, but by mid-to-late summer they were no longer evident having likely succumbed to predation. Overall, these findings thoroughly reveal one of the oldest populations of vertebrate currently known (median age of 79 years as of 2024) and expose the stark vulnerability of a bigmouth buffalo population for which substantial recruitment has not occurred for more than six decades. Multiple lines of evidence indicate that the long-lived bigmouth buffalo is vulnerable, that a precautionary approach is immediately needed, and that the unlimited and unregulated kill-fishery be closed.

Factors Influencing Vaccine Receipt During a 2018 Pediatric Typhoid Conjugate Vaccine Campaign in Navi Mumbai, India.

In 2018, the Navi Mumbai Municipal Corporation implemented phase 1 of a public sector typhoid conjugate vaccine campaign in Navi Mumbai, India, targeting all children aged 9 months to 14 years within its administrative boundaries. To assess associations with receipt of vaccine in phase 1, we used generalized estimating equations to calculate estimates of vaccination by child-, household-, and community-level demographics (child education and age; household head education, income, and occupation; community informal settlement percent). Campaign vaccine receipt was most associated with children enrolled in school (odds ratio [OR] = 3.84, 95% CI: 2.18-6.77), the lowest household income tertile when divided into three equal parts (OR = 1.64, 95% CI: 1.43-1.84), and lower community-level socioeconomic status (OR = 1.06, 95% CI: 1.04-1.08 per 10% informal settlement proportion). The campaign was successful in reaching the most underserved populations of its target communities.

Abstract P152: Association of Cannabis Use with Atherosclerotic Cardiovascular Diseases Outcomes: Insights from a Meta-Analysis of a Multinational Cohort of 1.9 Million Individuals

Background: Despite numerous reports suggesting a link between cannabis use and the risk of atherosclerotic cardiovascular diseases (ASCVD), the nature of this relationship—whether causal or not—remains uncertain. Objective: We aimed to consolidate data from observational studies to examine the association between cannabis use and ASCVD outcomes compared to non-users or controls. Methods: RevMan 5.4 was used for statistical analyses employing a random effects model, and outcomes were presented as risk ratios (RR) with corresponding 95% confidence intervals (CI). The study protocol has been registered with PROSPERO (CRD42024530366). Results: Our analysis integrated data from 17 studies, including 1,902,481 individuals aged 18 to 74, with a mean follow-up duration of 8.5 years. The pooled analysis revealed no statistically significant association between cannabis use and the risk of myocardial infarction compared to non-users, with an RR of 1.25 (95% CI: 0.91 to 1.71, p = 0.17). Similarly, the risk of stroke did not show a significant association with cannabis use (RR: 1.38, 95% CI: 0.88 to 2.16, p = 0.16). However, a statistically significant association was found between cannabis use and the composite outcome of any adverse cardiovascular events (RR: 1.48, 95% CI: 1.16 to 1.90, p = 0.002). Conclusion: The statistical correlations between cannabis use and composite adverse cardiovascular outcomes underscore its potential as a risk factor for cardiovascular disease. With rising trends in medical cannabis use and cannabis use disorder across age demographics, heightened risk awareness, CVD screening, and informed decision-making regarding cannabis consumption are critical priorities in healthcare and public health initiatives.

Financial Strain and Smoking Cessation and Relapse Among U.S. Adults Who Smoke: A Longitudinal Cohort Study

IntroductionThis study examines the prospective association between financial strain and smoking cessation and smoking relapse among US adults with established smoking. MethodsDiscrete-time survival models were fit to nationally representative data in Waves 1-5 (2013-2019) of the US Population Assessment of Tobacco and Health Study for smoking cessation (n=6,972) and smoking relapse (n=1,195). Models were adjusted for demographics (age, sex, race and ethnicity), socioeconomic positioning (education, income, health insurance status), and tobacco-related confounders (quit attempts, coupon receipt, and nicotine dependence). Data were collected between 2013 and 2019, and the analysis was conducted in 2023-2024. ResultsAmong adults with established cigarette smoking, financial strain was associated with a reduced likelihood of cigarette smoking cessation (HR: 0.81, 95% CI: 0.72, 0.92) and an increased likelihood of cigarette smoking relapse (HR: 1.56, 95% CI: 1.24, 1.96) in multivariable models. Results were robust to sensitivity analyses varying confounder control, sample restrictions, and survey weights used. ConclusionsThe results from this study suggest that financial strain is a barrier to cigarette smoking without relapse, which may be due to stress and coping processes. Smoking cessation interventions would benefit from considering the role that financial strain plays in inhibiting smoking cessation without relapse.

Ophthalmological Examination and Imaging Features that Better Predict Risk of Angle Closure in Siblings

Characteristics of individuals with angle closure may be useful in targeted screening of family members. Here, we assess if findings gathered during examination and imaging of patients with a known angle closure diagnosis (probands) could better determine the risk of angle closure in the patients' siblings. Cross-sectional study of patients with known angle closure and their siblings. Participants, and Controls: South Indian patients (probands) 30 years and older with open angles, suspect primary angle closure (PACS), or primary angle closure/primary angle closure glaucoma (PAC/PACG), and a biological sibling age 30 years or older (n=292 proband/sibling pairs). Demographic data, relevant ocular history, and a comprehensive ophthalmic examination with Anterior Segment Optical Coherence Tomography (ASOCT) were obtained. Three clinically relevant models were created to analyze the contribution of specific proband factors in predicting sibling angle closure diagnosis, using demographic (age, gender), ocular exam (gonioscopy, optic nerve exam, visual acuity, intraocular pressure [IOP]), and ASOCT features to improve prediction beyond proband diagnosis alone evaluated by log likelihood ratio testing and statistical comparison of receiver operating characteristics (ROC). Sibling angle closure diagnostic accuracy. Demographic and ocular exam metrics did not improve the prediction of sibling angle closure for all three outcomes (sibling diagnosis: (1) PACS/PAC/PACG vs OA, (2) PAC/PACG vs PACS/OA, and (3) PAC/PACG vs PACS), adding no model improvement when compared to diagnosis alone. Models adding ASOCT metrics to the prior model including proband diagnosis, demographics and ocular exam measures led to significantly improved prediction of 2 of the 3 angle closure outcomes. Specifically, improvement was noted via likelihood ratio testing for prediction of PAC/PACG vs PACS/OA (p=0.01), or PAC/PACG vs PACS (p=0.001). For all 3 angle closure outcomes, ROC comparisons demonstrated significant improvement in AUC between the three models predicting sibling outcomes, demonstrating an increase in AUC with each successive nested model across all 3 sibling angle closure outcomes. Structural features of eyes with angle closure may assist in stratifying the risk of angle closure in patients' siblings. Further studies should consider evaluating this approach to achieve more targeted screenings.

Heterogeneity in trajectories of traumatic distress at the start of the COVID-19 pandemic.

The COVID-19 outbreak has led to an increase in posttraumatic stress symptoms (PTSSs; Prout et al., 2020) for some individuals, whereas others appeared to be more resilient. It remains relatively unclear what characterizes these potentially different response trajectories ( Chen & Bonanno, 2020). This study sought to (a) assess individuals' PTSS levels at the start of the pandemic and at two subsequent timepoints 3 and 6 months later, (b) identify different trajectories of PTSSs over time, and (c) describe which individual characteristics influenced the likelihood of each of these different trajectories to occur. A community sample (n = 317) responded to an online survey during the first weeks of the pandemic, 3 and 6 months later. Among those who reported acute levels of PTSSs, latent class growth analyses identified three different resilience trajectories-resilient (low baseline PTSSs and a slight decrease over time), chronic (severe PTSSs at baseline and no change over time), and recovered (severe PTSSs at baseline but a sharp improvement over time). Baseline childhood adversity, depression, anxiety, defensive functioning, and somatization predicted trajectories. Demographics (age, gender, preexisting chronic illness) and COVID-related factors (knowing someone diagnosed with or who died of COVID-19) were unrelated to trajectories. Results suggest that although high PTSS levels decreased over time on average, heterogenous change trajectories can be identified based on baseline psychological characteristics. This implies that mental health, including past and present experiences, as well as adaptational mechanisms may shape individuals' experiences with pandemic-related ongoing stress. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The effects of population aging on industrial structure upgrading: Empirical analysis of provincial and threshold characteristics in China

Global population aging trends are intensifying, presenting multifaceted economic and social challenges for countries worldwide. As the world’s largest developing country, China has entered a phase of extreme demographic aging, posing significant questions about its impact on the ongoing upgrading of industrial structures. How does this demographic shift influence the upgrading of industrial structures, and does technological innovation mitigate or exacerbate this impact? The empirical results indicate that population aging impedes upgrading the industrial structure, while technological innovation positively affects the relationship between the two. Moreover, using technological innovation as a threshold variable, the impact of population aging on industrial structure upgrading evolves in a “gradient” manner from “impediment” to “insignificant” to “promotion” as the technological innovation levels increase. These findings offer practical guidance for tailoring industrial policies to different stages of technological advancement.