Demographic Indicators Research Articles

Dynamics of Scutellaria tuvensis (Lamiaceae) coenopopulations

The dynamics of density, abundance, ontogenetic structure and spatial organization of Scutellaria tuvensis coenopopulations under the influence of climatic factors in different habitat conditions has been studied. The decrease in the climate aridity in the basins of the Republic of Tuva in the last 10 years has a positive effect on the condition of the coenopopulations of S. tuvensis, occurring in dry and deseritied steppes. The coenopopulations of S. tuvensis are normal, stable, and in balance with the ecotope. The dynamics of the number, ecological density, spatial distribution of individuals in the coenopopulations, and the type of ontogenetic spectrum are influenced by climatic factors, while the values of demographic indicators in the coenopopulations are determined by the peculiarities of development of individuals in different habitats. Under a mildening climate (early warm spring and non-dry summer), optimal conditions are created for seed germination and further development of young plants. Recently, an increase in the number of young plants has been found in all habitats, a left-sided type of the ontogenetic spectrum is being formed, and coenopopulations are rejuvenating.

Harnessing Machine Learning to Predict Methadone Overdose Risk: Insights from Illinois's SUDORS Data

Knowledge of decedent characteristics associated with methadone involvement in unintentional drug overdose deaths can help to inform efforts to intervene in these deaths. ML models with existing data, offer a cost-effective means to help create effective interventions. In this study, we aim to develop an optimized ML algorithm for predicting overdose death patterns due to methadone using data from Illinois's State Unintentional Drug Overdose Reporting System (SUDORS). We utilized IL SUDORS 2019-2022 data for training (n = 11931) with selected indicators (n = 28). To address the imbalance in non-methadone-related deaths, we applied the Synthetic Minority Oversampling Technique. Next, we assessed various machine learning models, including logistic regression, support vector machine, random forest, neural network, and ridge regression. Model performance was evaluated using metrics such as accuracy, precision, area under the precision-recall curve (AUPRC), etc. Utilizing separate training (n = 15813), validation (n = 3388), and test (n = 3389) datasets, the Random Forest Model outperforms all other models with 92% accuracy, 91% precision, 93% recall, and 0.97 AUPRC. Notably, these outcomes were achieved using primarily demographic indicators. Through analyzing partial dependence plots, we were able to see how changes in each indicator dynamically influence methadone-related fatalities. This study demonstrates the potential of ML models in identification of methadone involvement in unintentional drug overdose deaths and contributes to the knowledge base for the prevention of these deaths. Leveraging SUDORS data, the Random Forest Model exhibited exceptional performance, highlighting its value for healthcare professionals, prevention and harm reduction specialists, and policymakers.

Effectiveness of demographic policy measures in addressing population decline in contemporary Russia

Demographic policy is one of the key tasks of almost any state at the present time. It correlates with the solution of pressing problems in the economic and social spheres, directly depends on the state of healthcare, education, migration policy and other factors and directly affects the socio-economic development of both individual regions and the country as a whole. Many Russian and foreign researchers believe that demographic indicators very accurately reflect the socio-economic and political situation of the state. The relevance of the study is due to the fact that for the progressive socio-economic development of any country, positive demographic dynamics are necessary. The main sign of the negative demographic situation that has developed in modern Russia and a number of countries, primarily European, is the growing scale of depopulation (population extinction). The purpose of this work was to analyze the existing demographic policy of Russia and compare demographic trends in Russia and other countries. The work uses methods of statistical data analysis, comparison of statistical indicators of fertility, mortality, natural population decline, migration, marriage rates in Russia and the Republic of Srpska, methods of retrospective analysis, research of the institutional environment created by the action of state and national programs “Demography”, “Providing accessible and comfortable housing and public services for citizens of the Russian Federation”, “Strategy of socio-economic development for the period until 2024”, Presidential decrees, etc. Research has shown that despite measures taken to overcome the demographic crisis, Russia’s population continues to decline. According to the Federal State Statistics Service of the Russian Federation (Rosstat), as of 1 January 2023, 146.45 million people lived in Russia. By 1 January 2046, according to a Rosstat forecast published in October 2023 the country’s population will decrease to 138.77 million people. To solve demographic problems in the Russian Federation, a national project “Demography” was developed and approved. The government has allocated more than 3 trillion rubles for its implementation. However, it is not possible to completely overcome the negative trend. The authors proposed a number of economic and ideological measures within the framework of agglomeration, migration, and family support policies that can be used within the framework of socio-economic development strategies and national programs aimed at overcoming the demographic crisis.

Changes in nonfunctional adrenal incidentaloma after COVID-19 infection and a model for predicting benign and malignant adrenal incidentaloma.

To compare nonfunctional adrenal incidentalomas (NFAI) in individuals with and without a history of COVID-19 infection, while also establishing predictive models for distinguishing between benign and malignant adrenal incidentalomas (AI). A retrospective collection of data from patients with AI who underwent surgery and were verified in our hospital between April 2022 and June 2023 was conducted. A total of 121 patients were included in the study. Demographic information, tumor characteristics, functional indicators, and complications were compared among the patients. Statistical analyses utilized the t-test for continuous variables and Pearson chi-square test or Fisher's exact test for categorical variables. Patients with COVID-19 exhibited a higher prevalence of obesity (84.2% vs. 63.3%, P=0.048) and elevated direct bilirubin (DBIL) levels (44.1% vs. 19.2%, P=0.043) compared to those without COVID-19. Moreover, patients with Malignant AI, in contrast to Benign AI, showed higher normal total protein (TP) levels (28.8% vs. 57.1%, P=0.016) and larger tumor sizes (20 vs. 32.5mm, P=0.009). Univariate analysis identified low TP (OR=0.303, 95% CI=0.111-0.825, P=0.020) and tumor size (OR=1.045, 95% CI=1.011-1.080, P=0.009) as potential risk factors for multivariate analysis. A predictive model comprising clinical risk factors (tumor size and low TP) demonstrated an AUC of 0.754 (95% CI, 0.603-0.904) with a sensitivity of 0.75 and specificity of 0.775. The calibration curve revealed a bias-corrected AUC of 0.77. No discernible differences in the clinical manifestations of adrenal incidentalomas were observed between cases with and without a history of COVID-19 infection. However, AI with larger tumor diameters and lower than normal levels of total protein exhibited a more pronounced malignant potential.

Cardiovascular risk and its influencing factors during exercise in apparently healthy Chinese adult population

BackgroundThere are few studies on the safety of sub-maximal exercise testing of aerobic exercise in apparently healthy Chinese populations. The purpose of this study was to explore the frequency of exercise electrocardiography (ECG) abnormalities and the corresponding exercise intensities, as well as the associated influencing factors, during a symptom-limited stepwise incremental cardiopulmonary exercise test (CPET) in an apparently healthy Chinese population.MethodsA cross-sectional study was done in four communities, one urban and one rural in the North (Beijing) and in the South (Hezhou, Guangxi) of China from 1 January 2017 to 31 December 2018, respectively. Total of 1642 participants was recruited, 918 were eligible and completed demographic indicators, routine blood indicators, physical activity status, symptom-limited CPET and exercise ECG were included in the analysis.ResultsOf the exercise ECG outcomes, 10 (1.1%) were positive and occurred at exercise intensities ≥ 62.50% heart rate reserve (HRR); 44 (4.8%) were equivocal and 864 (94.1%) were normal. Individuals with Cardiovascular Disease Risk Factor (CVDRF) = 3–4 were 2.6 times more likely to have a equivocal and abnormal exercise ECG than those with CVDRF = 0–2. Exercise ECGs of individuals with CVDRF = 5–7 were 5.4 times more likely to be positive and abnormal than exercise ECGs of individuals with CVDRF = 0–2.ConclusionsThe exercise intensity of 62.5% HRR can be used as a safe upper limit for safe participation in exercise in apparently healthy Chinese population; the greater the number of CVDRFs, the greater the likelihood of cardiovascular risk during exercise.

Novel therapeutic opportunities of kisspeptin

Diseases associated with disorders of sexual development, the reproductive system, delayed of puberty onset are of high relevance. This negatively affect the health of young people, the demographic indicators, fertility and require a search for therapy. This review presents current data on the role of the kisspeptin ligand-receptor system KISS/KISS1R, the discovery of which was of revolutionary significance for deciphering the genesis of neuroendocrine regulation of the reproductive system.A review and analysis of clinical and experimental research from recent decades, aimed at studying kisspeptin and its agonists as a potential therapeutic approach. Data are presented on the positive effect of kisspeptin on the pulse secretion of GnRH and gonadotropins, which can be used in the treatment of hypogonadotropic hypogonadism, ovulation disorders and other diseases of the reproductive system. Outside the human hypothalamus, kisspeptin and its receptor are expressed in the brain in key limbic and paralimbic regions, and in peripheral tissues. We summarise data on the pharmacological use of kisspeptin in reproductive disorders and fertility treatment, as well as its putative utility in hypoactive sexual desire disorder, osteoporosis and non-alcoholic fatty liver disease, now known as metabolic dysfunction-associated fatty liver disease.

Maternal Infant Feeding Knowledge And Dietary Diversity Of Children’s Diet Born Of Hiv-Positive Mothers, In Narok County, Kenya

Despite progress in the prevention of mother-to-child transmission (PMTCT) of HIV, children still acquire HIV infection (Frange et al., 2021), in 2020, the world had 31.6 million HIV positive people and sub-Sahara African countries had 83% pregnant women, 80% infants with HIV, and 78% of teenage women 15-24 years newly infected. Kenya had 1.4 million HIV positive people a prevalence rate of 4.5% and 5% in Narok County. Breastfeeding, especially early and exclusive breastfeeding, is one of the most important ways to improve infant survival (WHO, 2023c). However, the complementary feeding period, from 6 to 23 months of age, is one of the most challenging times to meet children’s nutrient demands. While children’s stomachs can only hold a small amount of food, their nutrient needs reach a lifetime peak leaving them vulnerable to growth faltering (Almasri et al., 2020). The overall objective of the study was to determine maternal infant feeding knowledge and dietary diversity of children’s diet born of HIV-positive mothers, in Narok County, Kenya The research was a cross-sectional analytical study and involved HIV+ mothers and their babies aged 0 – 23 months, purposively selected. A defined questionnaire was utilized for socio demographic indicators (e.g. age, marital status), anthropometry assessment (e.g. weight, Height) and secondary data/ hospital records. Through simple random sampling, mother baby pairs were generated by use of a computer and SPSS version 22.0 was utilized to analyse data. Socio-economic and demographic characteristics were analyzed using descriptive and inferential statistics

Características de la mortalidad por COVID-19 durante y después de la pandemia en el Perú

Introduction. The COVID-19 emergency caused a pandemic with a great impact on mortality in Peru. Objective. To analyze the magnitude of mortality due to COVID-19 and identify some sociodemographic characteristics. Methods. A descriptive ecological study was carried out, analyzing data on deaths due to COVID-19 during the period 2020-2023, as well as publicly accessible socioeconomic and demographic indicators. The variables included in the study were: year of death, number of deaths, sex, age group, province of origin, natural region, macroregion, human development index (HDI), unmet basic needs (UBN) and population density. Results. 220,628 deaths due to COVID-19 were reported, of which 219,374 (99.43%) occurred during the pandemic and 1,254 (0.57%) in the post-pandemic period; The cumulative mortality rate was 6.76 deaths/1000 inhabitants. The COVID-19 death curve shows that between 2020-2023, five waves occurred, with the second wave having the highest mortality, followed by the first wave. Mortality predominated in men, older adults (69.77%) and adults (28.11%). The macroregion of Metropolitan Lima and Callao had the highest mortality rates with 9.36 deaths/1000 inhabitants. The provinces with the highest cumulative mortality rates were those located on the coast, in quintiles with less NBI, in quintiles with a higher HDI and in those provinces with a higher population density. Conclusions. The COVID-19 pandemic caused high mortality in Peru, being higher in males, older adults, from coastal cities, with higher population density and better socioeconomic indicators.

REQUEST FOR CHANGES: PUBLIC EXPECTATIONS AND MODALITY OF PRESENTATION

The article analyzes the results of long-term sociological studies of the peculiarities of the transformation of Russian society associated with the growing public demand for change, the modality of which has not decreased for a long time. It is shown that this is due to increased social activism associated with “helping behavior”, mutual assistance and cooperation. This allowed us to understand that the administrative and bureaucratic class has built convenient “capsules” for itself, blocking the development of a natural, from the point of view of common sense, business and civic initiative of society, allowing its members to participate in making socially significant decisions. The society is set up to improve the institutional infrastructure of social development, first of all, to reduce the degree of corruption, alienation of the population from power, unblocking channels for promoting and realizing public interests. In addition, the problem of people’s dissatisfaction with the growing polarization of social incomes is being raised, which reduces the quality of social policy in terms of improving demographic indicators, increasing social upward mobility based on meritocratic principles, and improving the structure of social and labor motivation. This exacerbates the sense of social justice, which, when blocked, can lead to negative social consequences, forming “combustible material” and, accordingly, the risks of unconventional social actions associated with social explosions and revolutionary consequences of expressing discontent. It is shown that at the moment the majority of the population is set up in a reformist way, since they are only getting rid of the neurotic syndrome after the coronavirus pandemic and the onset of SMO. A certain energy impulse for change is also set by consolidated public opinion associated with the “rewiring” of Russian society along the line of differentiation from Western universalist approaches, the search for its own civilizational and cultural code of development, the revival of neotraditionalist narratives of the formation of a value-symbolic framework of public consciousness.

Analysis of the medical and demographic situation in the central region of Russia in the pre-pandemic period

Introduction. According to Federal State Statistics Service (Rosstat) , in 2021, the Vladimir Region took 69th place among all subjects of the Russian Federation in terms of natural population growth (loss). In terms of the frequency of general morbidity over 2010, the region was the most disadvantaged in the Central Federal District; in 2017, it was at the second place. The purpose of the study is to analyze the medical and demographic situation in the Vladimir region during the pre‒pandemic period. Materials and methods. The official statistical data of the Federal State Statistics Service and collections of the medical information and analytical center of the Vladimir region for 2001–2019 were used. The analysis of the main demographic indicators, as well as data on the general morbidity in children, adolescents, and adults in sixteen classes of diseases of the WHO classification (ICD-10) was carried out. Results. The population of the Vladimir Region has decreased by 192,247 people since 2001. A significant differentiation of morbidity values is shown both by different age groups and by administrative districts. Limitations of the study are usually related to the lack of access to detailed statistical information within administrative territories. The peculiarities of collecting and presenting statistical information on morbidity do not allow implementing a more detailed analysis within each age group, limited to three contingents. Conclusion. For the first time, a study of the medical and demographic situation in the Vladimir region, which developed over a nineteen-year pre-pandemic period, made it possible to establish risk territories with characteristic features of their health status.

Research on injury risk of elite male athletes in racing ice sports based on blood indexes.

This study aims to explore the relationship between blood biochemical indexes and injury risk of elite male athletes in racing ice sports. The male athletes compared the demographic indexes, monthly injuries, and longitudinal tracking data. The non-linear relationship was analyzed using an unrestricted cubic spline. Generalized estimating equations estimated the relative risk (OR) of injury occurrence. Receiver operating characteristics and the area under the curve determined diagnostic accuracy. In the snow sledding group, when creatine kinase rises to 489.46 u/L or Testosterone decreases to 41.32 ng/ml, the risk increases by 1.70 times (OR=1.70, p<0.001) and 1.69 times(OR=1.69, p<0.001) with statistical significance. the Creatine kinase (OR=1.01, P=0.007) and Testosterone (OR=1.00, P＜0.001) were included in the injury prediction model. The model exhibits excellent discrimination, with sensitivity and specificity of 82.8% and 86.5%, respectively. In the ice skating group, when Creatine kinase rise to 467.00 u/L, the risk increases by 2.56 times with statistical significance (OR=2.56, p<0.001). Creatine kinase (OR=1.01, P＜0.001) was included in the predictive model. The model demonstrates good discrimination, with sensitivity and specificity of 90.5% and 66.7%, respectively. Creatine kinase and Testosterone are the risk predictors of injury in elite snowmobile male athletes. Creatine kinase is an independent risk factor for injury in elite speed skaters.

Comparison of postoperative pulmonary complications and intraoperative safety in thoracoscopic surgery under non-intubated versus intubated anesthesia: a randomized, controlled, double-blind non-inferiority trial.

Traditional anesthesia for video-assisted thoracoscopy (VATS) such as double-lumen tracheal intubation (DLT) and one-lung ventilation (OLV), may lead to post-operative pulmonary complications (PPCs). Non-intubation VATS (NIVATS) is an anesthetic technique that avoided DLT and OLV, maybe avoiding the PPCs. So we hypothesized that NIVATS would non-inferiority to intubation VATS (IVATS) in the risk of developing PPCs and some safety indicators. This study is a randomised, controlled, double-blind, non-inferiority trial, 120 patients were randomly assigned to the NIVATS group and IVATS group according to 1:1. The primary outcome was the incidence of PPCs with a pre-defined non-inferiority margin of 10%. The second outcome was the safety indicators, including the incidence of cough/body movement, hypoxemia, malignant arrhythmia, regurgitation and aspiration, and transferring to endobronchial intubation intraoperatively (The malignant arrhythmia was defined as an arrhythmia that caused hemodynamic disturbances in a short period of time, resulting in persistent hypotension or even cardiac arrest in the patient). There was no significant difference in demographic indicators such as gender and age between the two groups. The incidence of PPCs in the NIVATS group was non-inferior to that in the IVATS group (1.67% vs. 3.33%, absolute difference: -1.67%; 95%CI -7.25 to 3.91). In additionan, no significant differences were found between the two groups for the incidence of cough/body movement (10.00% vs. 11.67%, p = 0.77), the incidence of hypoxemia (25% vs. 18.33%, p = 0.38), the incidence of malignant arrhythmia (1.67% vs. 6.67%, p = 0.36), the incidence of regurgitation and aspiration (0% vs. 0%, p > 0.999) and the incidence of transferring to endobronchial intubation intraoperatively (0% vs. 0%, p > 0.999). We conclude that when using the non-intubation anesthesia for VATS, the incidence of PPCs was not inferior to intubation anesthesia. Furthermore, NIVATS had little effect on perioperative safety.

Decreasing trend in thyroid cancer incidence: a study from central Italy (2007-2019).

Due to overdiagnosis, the incidence of thyroid cancer (TC) has increased in high-income countries, including Italy. Efforts have been made to address this issue since the mid-2010s, but more information is needed about how TC incidence has changed. We aim to examine the trend in TC incidence in the Lazio Region (central Italy) and assess the impact of the 2014 Italian Consensus for the Classification and Reporting of Thyroid Cytology (ICCRTC) to identify potential changes in TC diagnosis. To identify TC cases, we conducted a population-based study (period 2007-2019) using the data from the Lazio Region Cancer Registry (5.8 million residents). We calculated the annual age-standardized incidence rates of TC for both sexes and analyzed the impact of ICCRTC on monthly incidence rates using segmented linear regression applied to interrupted time-series (ITS). Throughout the 13 years, there was a significant decline in TC annual incidence rates, more pronounced in females. Our results are consistent with reports from outside Europe (United States and South Korea). Following ICCRTC implementation in 2014, a step-change reduction in both sexes was revealed. Our study indicates a significant decrease in the incidence of TC, particularly among females. The ITS analysis highlights the possible role of ICCRTC in reducing overdiagnosis. As the Lazio Region reflects the Italian population in terms of various demographic, health, and lifestyle indicators, our findings can be applicable at the national level.

Urothelial cancer: state of art in Ukraine and improvement pathways.

This study aims to assess the effectiveness of urothelial cancer treatment in Ukraine, utilizing population-based data from the National Cancer Registry. The primary goal is to evaluate trends and approaches to therapy, with a focus on overall survival rates in patients with urothelial tumors. A retrospective cross-sectional analysis was conducted based on the National Cancer Registry, involving 12698 patients (2008-2020) with urothelial tumors of the upper urinary tract (UTUC) and bladder cancer (BC) who underwent surgical treatment. Demographic indicators, surgical interventions, complications, and survival rates were analyzed. The average age for all patients was 70 years. The number of patients undergoing radical treatment was 1820 (15%) among BC and 573 (59%) among UTUC. The 30-day readmission rate was low for both, with a slightly higher preference for UTUC (2.3 vs. 4.6%). Whereas grade III or higher Cl-Dindo complications were seen in only 0.2% of cases. Notable findings include low frequency of neoadjuvant (7%) and adjuvant chemotherapy (28%) among patients with invasive urothelial carcinomas. Median eGFR for invasive UTUC before and after surgery was 63.2 and 51.4ml/min, respectively (P=0.00054). The directly opposite trend was seen in BC-61.2 and 68.7ml/min, respectively (P=0.0026).For BC, the overall survival rates by stages were: I-73%, II-49%, III-18%, and IV-11% (χ2=1807.207; P=0.000001). As for UTUC, the 5-year overall survival rates corresponded to the literature data, but there was a pronounced negative trend towards a decrease in this indicator after a 10-year period for all stages (χ2=146.298; P=0.000003). The study emphasizes the importance of effective systemic treatments, adherence to treatment guidelines, and the need for multidisciplinary consultations among Ukrainian patients with urothelial cancer.

Comparative analysis of cognitive and physical characteristics in late-onset, adult-onset and early-onset multiple sclerosis patients

BackgroundLate-onset multiple sclerosis (LOMS or L; MS) and early-onset MS (EOMS or E) are less common, and their prognosis can be different. To characterize the demographic and clinical features, and clinical outcomes of LOMS and EOMS patients, comparing them to adult-onset MS (AOMS or A) patients. MethodsThe study was conducted as a secondary analysis of a prospective study. The participants were divided into three groups according to age of MS onset: early onset (<18 years of age), adult-onset (20–40 years of age), and late-onset (>55 years of age). Demographic variables, oligoclonal bands, IgG index, and Expanded Disability Status Scale (EDSS) score in admission, first year, second year and current EDSS were evaluated. The Timed 25-Foot Walk Test (T25FW), Timed Up and Go (TUG), Multiple Sclerosis Walking Scale-12, Single Leg Standing Test, Activity-Specific Balance Confidence Scale, Nine-Hole Peg Test, Epworth Sleepiness Scale and Restless Legs Syndrome Severity Scale were performed. Appropriate statistical analysis was made. ResultsA total of 658 pwMS was included in the study and divided into three groups: EOMS (n = 117), AOMS (n = 499), and LOMS (n = 42). Statistically significant differences were determined between groups in terms of age [L (mean:59.86±5.45 years-y-)> A (36.87±9.12 y)> E(26.56±8.85 y), p < 0.001], education level, current EDSS score (L > E, p < 0.001), EDSS score in first admission, EDSS score in the first year, EDSS score in the second year (L > A > E, p < 0.001), reached an EDSS score 6 (E > L p = 0.001, E > A p = 0.015), disease duration (E > A, E > L, mean E = 11.66±9.7 y, A = 7.99±7.4 y, L = 6.31±4.67 y) time switching second-line treatment to the third line (E > L p < 0.001, A > L p = 0.002, mean E = 171.73±83.29 months-m-, A = 136.13±65.75 m, L = 65.85±45.96 m), number of relapses (A > E > L, median E = 4.0, A = 3.0, L = 2.0), distribution of MS type and oligoclonal band types. Significant differences were found in T25FW and TUG. Post-hoc analysis showed that participants in the LOMS group have longer T25FW (mean L = 7.8 ± 6.11, A = 6.25±5.09, E = 5.72±3.13, p = 0.011) and TUG (mean L = 11.01±5.53, A = 9.57±8.04, E = 8.38±5.51, p = 0.007) times than the AOMS and EOMS groups. ConclusionOur result revealed that individuals with LOMS face elevated disability levels and a heightened propensity to transition from first-line treatments to more advanced therapeutic interventions. LOMS have worse lower extremity functional status than AOMS and EOMS patient. Clinical evaluations and treatment choices require more attention in LOMS. However, according to the low number of LOMS in our cohort, these results were considered cautious, and more wide and multi-center studies must be designed.

Insights into earthquake insurance demand in high-risk regions: A case study of Turkey

Over the last three decades, earthquakes have caused approximately USD 1 trillion in economic damage globally. While earthquake insurance can help reduce this damage, there is a significant coverage gap, especially in emerging nations. This research focuses on Turkey, a nation with high vulnerability to seismic activity, to investigate the complex reasons for the low adoption of earthquake insurance. Utilizing a comprehensive set of indicators, including socioeconomic factors, real estate data, and earthquake hazards, this study applies multiple linear regression analysis across various districts. The findings reveal that insurance demand is influenced by peak ground acceleration, average household size, crude birth rate, and percentage of college graduates. While conventional factors such as marriage rate and home price per square have some impact, other expected indicators such as population growth and old age dependency do not show significant influence. By demonstrating how demographic, economic, and seismic risk indicators can predict insurance demand, this research offers fresh insights for policymakers and insurers to enhance their coverage strategies. This approach sheds light on the under-examined dynamics of earthquake insurance demand in high-risk regions and suggests a model that can be adjusted for comparable analyses in other emerging markets.

How to Link Assessment and Suitable Interventions for Adolescents: Relationships among Mental Health, Friendships, Demographic Indicators and Well-Being at School.

Over the last 10 years, a noticeable deterioration in mental health has affected adolescents' lives. This study was conducted in 12 secondary schools and 14 high schools located in different cities across Lithuania from October to December 2023. The survey included students aged 12 to 17 years. The adolescents filled out a questionnaire about the need for outside help, friendships, and well-being at school and the Strengths and Difficulties Questionnaire. The goal of our study was to analyze the risk factors that influence adolescents' psycho-emotional state. A total of 4124 students were involved in this study, with a mean age of 14.48 ± 1.15 years. The sample consisted of 50.9% males and 49.1% females. The boys showed a statistically significantly lower total difficulty score on the Strength and Difficulties Questionnaire (SDQ TDS) and internalizing score (IS) than the girls (12.45 ± 5.39 vs. 14.93 ± 5.76; 5.39 ± 3.30 vs. 7.49 ± 3.64, p < 0.001). Also, the SDQ TDS, IS, and externalizing score (ES) were statistically significantly lower in the group of adolescents who lived with both parents (13.50 ± 5.69 vs. 14.76 ± 5.72; 6.32 ± 3.61 vs. 6.98 ± 3.65; 7.18 ± 3.23 vs. 7.78 ± 3.35, p < 0.001). Linear regression analysis of the SDQ TDS (R2 = 0.406) indicated a significant impact on the feeling of safety at schools (β = -0.173, p < 0.001) and loneliness (β = 0.314, p < 0.001). Linear regression of the SDQ IS (R2 = 0.469) showed that there was a significant predictor effect of bullying (β = 0.170, p < 0.001) and loneliness (β = 0.345, p < 0.001). However, the linear regression of the SDQ ES (R2 = 0.256) showed that there was a significant predictor effect of the feeling of teacher care (β = -0.163, p < 0.001) and loneliness (β = 0.166, p < 0.001). We determined that gender (OR = 2.30) and loneliness (OR = 1.77) were the most significant factors associated with adolescents seeking help. It is crucial to determine specific risk factors and particular groups of teenagers who need psycho-emotional support the most. The findings of this study may offer valuable insights for advancing additional prevention or support programs aimed at adolescents within higher-risk groups.

Relationship between obesity, cardiac hemodynamics, and heart failure in adults with coarctation of aorta.

Patients with coarctation of aorta (COA) have arterial stiffening and left ventricular (LV) diastolic dysfunction similar to patients with heart failure with preserved ejection fraction (HFpEF) and obese subjects. However, the relationship between obesity, cardiac hemodynamics, and HF in adults with COA is unknown. The purpose of this study was to compare cardiac hemodynamics and prevalence of HFpEF between COA patients with vs without obesity, and to assess the relationship between obesity and HFpEF in this population. Adults with COA who underwent right heart catheterization were divided into an obese group (body mass index, BMI > 30 kg/m2) or a non-obese group (BMI ≤ 30 kg/m2). We also selected a control group of subjects without structural heart disease and with normal invasive hemodynamics at rest (n = 36). HFpEF was defined as having clinical symptoms of HF (exertional dyspnea or fatigue), LV ejection fraction of at least 50%, and pulmonary artery wedge pressure (PAWP) greater than 15 mm Hg at rest. Of 99 COA patients, 29 (29%) had obesity. The obese COA group had higher right atrial pressure and PAWP, and worse pulmonary and systemic vascular function compared with the non-obese COA group and the control group. The overall prevalence of HFpEF in adults with COA was 32%, and the prevalence was higher in COA patients with obesity (55%) compared with those without obesity (23%). Obesity was associated with HFpEF after adjustment for demographic indices, comorbidities, and vascular function. The abnormal hemodynamics and higher prevalence of HFpEF in COA patients with obesity underscores the need for intervention to address obesity in this population.

Prevalence and significance of fovea plana in patients with epiretinal membrane.

Fovea plana is indicative of an immature inner retina, yet its association with epimacular membrane (ERM) remains unexplored. This study aims to investigate the prevalence of fovea plana in the contralateral eye of patients diagnosed with ERM. A retrospective analysis was conducted on consecutive patients in a monocentric tertiary ophthalmic department between January and April 2021. The study included all patients referred for ERM, with dense optical coherence tomography (OCT) B-scans utilized to assess the incidence of fovea plana in the contralateral eye. Patients with bilateral ERM were excluded from the analysis. Out of 181 patients, 26 exhibited fovea plana in the contralateral eye, resulting in an incidence rate of 14.3%. Demographic characteristics, OCT patterns, and indications for surgery did not differ significantly between patients with and without fovea plana. The prevalence of fovea plana in patients with ERM did not exhibit a statistically significant increase compared to the reported incidence in patients undergoing preoperative cataract surgery. In our cohort, the incidence of fovea plana in patients with ERM was determined to be 14.3%.

Remote working and experiential wellbeing: A latent lifestyle perspective using UK time use survey before and during COVID-19.

Mental health in the UK had deteriorated compared with pre-pandemic trends. Existing studies on heterogenous wellbeing changes associated COVID-19 tend to segment population based on isolated socio-economic and demographic indicators, notably gender, income and ethnicity, while a more holistic and contextual understanding of such heterogeneity among the workforce seems lacking. This study addresses this gap by 1) combining UK time use surveys collected before and during COVID-19, 2) identifying latent lifestyles within three working mode groups (commuter, homeworker and hybrid worker) using latent class model, and 3) quantifying nuanced experiential wellbeing (ExWB) changes across workers of distinct lifestyles. The direction and magnitude of ExWB changes were not uniform across activity types, time of day, and lifestyles. The direction of ExWB change during the daytime activities window varied in accordance with lifestyle classifications. Specifically, ExWB decreased for all homeworkers but increased significantly for certain hybrid workers. Magnitude of ExWB change correlated strongly with lifestyle. To understand the significant heterogeneity in ExWB outcomes, a spatial-temporal conceptualisation of working flexibility is developed to explicate the strong yet complex correlations between wellbeing and lifestyles. The implications to post-pandemic "back-to-work" policies are 1) continued expansion of hybrid working optionality, 2) provide wider support for lifestyle adaptation and transitions.