Age Difference Research Articles

Menopausal hormone therapy in women with CADASIL: a health system-wide retrospective cross-sectional study.

Menopausal hormone therapy in women with CADASIL: a health system-wide retrospective cross-sectional study.

Trends and outcomes in Merkel cell carcinoma: A nationwide analysis of sociodemographic characteristics, inpatient utilization, and mortality (2016–2021).

e21592 Background: Merkel cell carcinoma(MCC) is an aggressive, rapidly progressing neuroendocrine malignancy of the skin. We aimed to analyse the burden of MCC in inpatient hospitalizations in the US. Methods: Patients admitted with MCC between 2016 and 2021 were identified from the Nationwide Inpatient Sample (NIS) using ICD-10 codes. The primary objective was to identify Sociodemographic characteristics using descriptive statistics. The secondary objectives were to determine the burden of inpatient hospital utilization, such as length of stay(LOS), Total hospitalization charges (THC), and mortality, using multivariate linear and logistic regression. Univariate linear regression models were used to examine the relationship of the outcomes across the years. Results: A total of 8,569 admissions were recorded, with 71% of the patients being male. The mean age of the population was 74.7 years. Among the cohort, 0.4% had a diagnosis of HIV, 5.3% had a history of solid organ transplantation (SOT), and 7.9% had a Concomitant hematological malignancy (CHM). Patients with HIV and SOT were significantly younger, with a mean age difference of 13.4 and 9.7 years, respectively (p < 0.005). The racial distribution showed that most patients were White (89.6%, OR of MCC 3.1, p < 0.001), belonging to zip codes with higher median incomes (28.6%). Medicare was the predominant payer, covering 79.8% of admissions. Hospital characteristics revealed that 93.5% of admissions took place in urban settings, with hospitals in the South having the highest number of admissions (37.3%), especially in the South Atlantic census division (21.7%). Regarding tumor location, the face was the most common site (24.4%), followed by the upper limb (18.6%) and scalp (16.3%). The odds hospitalization with MCC increased with age at 5.8% per year (OR 1.05, p < 0.001) and was higher among SOT (OR 4.7 p < 0.001) and CHM (OR 2.3, p < 0.001). No significant differences were observed among inpatient metrics based on age, gender, race, Median income, or the location of the MCC. Patients with HIV had shorter LOS (-6 days, p < 0.001), while patients with CHM had longer (+ 2 days, p < 0.05). The in-hospital mortality in patients with MCC was 6.8% , with the odds of mortality being higher with CHM (OR 2.8, p = 0.005). Though the odds of MCC hospitalizations increased from 2016 to 2021 by 7.5% per year(OR 1.07 p < 0.001), the trends in LOS, THC, and mortality did not reach statistical significance. Conclusions: The study shows that MCC hospitalizations have been increasing over the years and primarily involve elderly, White males in urban areas. Patients with SOT or CHM had worse outcomes, including more extended LOS and higher mortality. These findings highlight the need for targeted interventions for high-risk groups and further research to address disparities to improve care.

Burnout and related factors in mothers of preschool children

Abstract Purpose Being a parent, in addition to its rewarding aspects, also involves significant psychological and physical challenges. When the balance between caregiving burden and support resources is disrupted, it becomes almost inevitable for mothers to experience burnout. We designed our study to investigate the factors related to burnout complaints in mothers of preschool children. Methods The sample of our study consisted of 80 mothers who presented to psychiatry clinics with burnout complaints and 80 healthy controls. Data collection tools included the Maslach Burnout Inventory, the Parenting Stress Index, and the Spousal Support Scale. Scale scores were compared between the groups. The mediating role of the Spousal Support Scale (SSS) in the relationship between the Parenting Stress Index (PSI) and the Maslach Burnout Inventory (MBI) was tested using path analysis. Results No statistically significant age difference was found between the two groups (p > 0.05). The number of children among participants in the burnout group was higher (p = 0.018).In the burnout group, a positive and statistically significant relationship was found between the total scores of the Maslach Burnout Inventory (MBI) and the Parenting Stress Index (PSI) (r: 0.664; p: 0.000), and a negative and statistically significant relationship with the total score of the Spousal Support Scale (SSS) (r: -0.409; p: 0.000).The indirect effect of the Parenting Stress Index (PSI) on the Maslach Burnout Inventory (MBI) through the Spousal Support Scale (SSS) was found to be statistically significant ( $$\:\beta\:$$ = -0.3294, p < 0.001). Conclusion Parental stress is associated with the level of burnout in mothers. However, spousal support may weaken the relationship between parental stress and burnout. Further research on the relationship between spousal support and burnout, as well as awareness projects related to spousal support, is needed.

Assessment of Age and Sex Difference in Cardiopulmonary Function of Children and Adolescents with Ventricular Septal Defect

In the past, an isolated ventricular septal defect (VSD) was categorized as a simple lesion with assumed negligible long-term risks when treated correctly in childhood; however, evidence has suggested that patients with isolated congenital VSDs carry a substantial burden of cardiovascular morbidity throughout life. This study aimed to investigate the cardiopulmonary function (CPF) in isolated VSD patients of a young age and the relationship of CPF with age, sex and body mass index (BMI). This retrospective cohort study was conducted at a tertiary medical center in southern Taiwan. We recruited children and adolescents (aged 5 to 18 years) with isolated VSDs who underwent the symptom-limited treadmill exercise test. Data from 289 children and adolescents (157 males, 132 females) were included in the analysis. The participants were stratified into three groups according to age. The male patients had a significantly higher oxygen uptake at the anaerobic threshold (AT VO2) and a higher peak oxygen uptake (peak VO2) (all p < 0.05). Normalized AT VO2 (mL/kg/min) and normalized peak VO2 (mL/kg/min) were significantly negatively associated with BMI. In conclusion, male patients with isolated VSDs had similar or better CPF compared with female patients. BMI had a negative association with CPF in young VSD patients.

The Prevalence of Lymphoid Nodular Hyperplasia in Children and Adolescents with Autism Spectrum Disorder

Lymphoid nodular hyperplasia (LNH) is characterized by diffuse hyperplasia of lymphoid follicles in the gastrointestinal tract, commonly observed in children with abdominal pain, food allergies, and autism. Clinical evaluation, colonoscopy, and anatomopathology are key tools in diagnosing LNH in the terminal ileum, notably associated with autism, inflammatory changes, and eosinophil influx. This study examines the clinical-endoscopic correlation with anatomopathological findings in autistic children and adolescents undergoing ileocolonoscopy to investigate nodosity in the terminal ileum. A total of 100 cases were retrospectively analyzed, including 50 patients with autism spectrum disorder (ASD) and 50 controls without ASD, all under 16 and subjected to ileocolonoscopy at HUAP over the last 20 years. There was a predominance of males in the ASD group (χ2 = 10.18, p < 0.001), aged between three and 16 years. The control group showed a balanced gender distribution. No significant age difference was found between the groups. The incidence of LNH was significantly higher in ASD patients (χ2 = 36.99, p < 0.001), with moderate LNH more frequent in ASD (χ2 = 37.44, p < 0.001) and mild LNH more common in controls (χ2 = 39.60, p = 0.001). Clinical complaints did not differ significantly between groups except for abdominal distension, which was more frequent in ASD (χ2 = 4.17, p = 0.041), while blood in stool and diarrhea were more common in controls (χ2 = 16.88, p < 0.001 and χ2 = 5.88, p = 0.015, respectively). Endoscopic features of nodosity in the terminal ileum were reliably diagnosed through biopsy and confirmed by anatomopathological analysis. The study suggests a correlation between digestive and neurological symptoms, indicating a link between the Enteric Nervous System (ENS) and the Central Nervous System (CNS), supporting the "second brain" concept of the gut, and justifying gastrointestinal investigation in autistic patients with digestive symptoms.

Blood Pressure and Blood Pressure Variability in Relation to Chronic Low Back Pain Among Patients with Hypertension.

Chronic pain which tends to be localised particularly in the lower back and lower extremities is one of the risk factors for elevated blood pressure (BP). In this cross-sectional study, we evaluated whether chronic low back pain (cLBP) is associated with BP variability, which may be related to increased mortality and morbidity. We included 85 consecutive hypertensive patients with a median age of 62 years (IQR, 55-67) with cLBP, for which intensity was assessed using the Oswestry Disability Index (ODI). Ambulatory blood pressure monitoring (ABPM) was performed to evaluate the values and variability of systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) over 24 h, day- and nighttime BP variability assessed as BP standard deviation (SD). In the whole study population, the median ODI questionnaire score was 16 (IQR, 11-20). Patients with an equal/higher than median ODI score had lower nighttime DBP compared with other patients (p = 0.028). Equal/higher than median ODI score correlated with 24 h SD values for SBP and MAP (r = 0.263; p = 0.016, and r = 0.229; p = 0.036, respectively), as well as with day-night differences in SBP (r = 0.229; p = 0.035), DBP (r = 0.253; p = 0.019), and MAP (r = 0.263; p = 0.015). We performed a multivariate regression analysis adjusted for potential confounders, and equal/higher than median ODI score was predicted by age (OR, 1.07; 95% CI, 1.006-1.14; p = 0.031) and day-night DBP difference (OR 1.07; 95% CI 1.002-1.15; p = 0.044). To our knowledge, this is the first study to show that more intense cLBP is associated with BP variability among patients with hypertension.

Composite anthropometric data quality index for children under the age of 5 on the Brazilian National Food and Nutrition Surveillance System, 2019–2021

BackgroundA composite evaluation that merges various data quality indicators separately enabled the researchers to score the overall data quality of the research. In this context, the objective of the present study is to develop composite anthropometric data quality indices for children under 5 registered on the Brazilian National Food and Nutrition Surveillance System (SISVAN) from 2019 to 2021.MethodsAnthropometric data quality indicators were generated for 5,210 Brazilian municipalities: coverage, completeness, the ratio between the sexes, age difference index, preference for height and weight digits, biologically implausible z-score values, and standard deviation. Principal component analysis [PCA] was used to generate a composite anthropometric data quality index for standardized height-for-age (HAZ) and weight-for-height z score (WHZ) indices. The municipalities were ranked in descending order, following their anthropometric quality index values: lowest [worst quality] and highest values [best quality].ResultsIn total, 29,367,435 records and 8,930,881 children with anthropometric measurement information were identified. The dispersion indicators, the percentage of biologically implausible values [BIV] and the digit preference had the highest factor loadings. We observed that the worst index values were found in municipalities in the country’s poorest and most vulnerable regions [North, Northeast, and Central-West]. The correlation between the HAZ and WHZ quality indices was 0.74.ConclusionThe proposed index provides a coherent measurement to discriminate municipal anthropometric data quality.

AGE DISPARITY IN COUPLES AND THE SEXUAL AND GENERAL HEALTH OF THE MALE PARTNER

Abstract Objectives Several robust epidemiological studies conducted in different cultures suggest that men are often engaged in sexual relationships with younger women with a variable, age-dependent age difference. However, the ageing process determines a significant worsening of the andrological status, which favours the onset of erectile dysfunction and hypogonadism. The study aims to analyse the effects of differences in age between the partners (δage) (M-F) on patients referring to the Andrological Unit of Careggi University Hospital for male sexual dysfunction. Methods A monocentre cohort of 4055 male subjects has been evaluated by SIEDY® structured interview. The cross-sectional analysis assessed the psychobiological and relational correlates. The rate of forthcoming major cardiovascular events (MACE) was investigated in the longitudinal analysis. All the models have been adjusted for age, education, lifestyle and chronic disease score (CDS). Results δ age (M-F) shows a stepwise increase, according to the increasing age bands of the male partner. δ age (M-F) was associated with more successful fatherhood, at the cost of more conflictual relationships within the family. The phenotype of the relationship is characterized by the report of a partner with a higher sexual desire and a higher ability to reach climax. In a fully adjusted model, only the total testosterone was higher in the fourth percentile of delta age than in the first (p = 0.032). Although we found a non-significant difference in scoring into the major cardiovascular risk algorithms, including Framingham, Procam and Rischio Cuore, Kaplan-Mayer analysis of a longitudinal subgroup of the same patients followed longitudinally (n = 1402) for 4.3 ± 2,59 years, showed a significant difference in forthcoming MACE. In particular, those in the fourth quartile showed a highly significant difference in outcome vs those in the first quartile (p = 0.005). Conclusions In subjects with sexual dysfunctions (as in the general population) age-different relationships increase as a function of male ageing. A greater δ age (M-F) is associated with specific men and relationship features and a higher risk of MACE, particularly with a sexually desiring partner. Conflicts of Interest none.

Age-related differences in associative inference are larger than differences in direct associative memory.

Inferential reasoning is an important cognitive ability that allows us to make connections across past experiences to make decisions in the face of novel information. Making an inference involves the ability to remember separate experiences with overlapping elements (direct memory) and the ability to make connections between those experiences (inference/indirect memory). While older adults are known to have a deficit for direct associative memory, less is known about potential age differences in inference. In the present study, we administered an associative inference task to healthy young (aged 18-30; n = 83) and older adults (aged 60+; n = 80). We tested whether there is an age difference in inference abilities above and beyond age deficits in direct associative memory. Results showed an age-related deficit in inference that was larger than for direct associative memory. This finding is consistent with inferences in both age groups being based largely on overlapping memories encoded individually and recalled simultaneously when inferences were required, with older adults having more difficulty with this process than young adults. We also found that older adults were more likely than young adults to show source confusion after having made a successful inference, which is consistent with older adults tending to integrate across related experiences to a greater degree than young adults. Thus, we find a clear age-related deficit in inference abilities above and beyond direct associative memory, with age-related declines in flexible retrieval only partially offset by age-related increases in integration. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Whole-gland or Subtotal High-intensity Focused Ultrasound Versus Radical Prostatectomy: The Prospective, Noninferiority, Nonrandomized HIFI Trial

Whole-gland or Subtotal High-intensity Focused Ultrasound Versus Radical Prostatectomy: The Prospective, Noninferiority, Nonrandomized HIFI Trial

Postoperative Pain Management With Ketorolac, Acetaminophen, and Gabapentin in Femoral Shaft Fractures: A Prospective Cohort Study.

Postoperative pain management in orthopaedic trauma surgery is critical. Amid the opioid crisis, nonopioid analgesia offers a promising alternative. We aim to evaluate the feasibility of a multimodal regimen, including intravenous ketorolac, oral acetaminophen, and oral gabapentin, in managing postoperative pain after femur shaft fractures treated with intramedullary nailing. We conducted a prospective cohort study to evaluate the postoperative pain of patients with isolated femur shaft fractures treated with intramedullary nailing. The experimental group consisted of 29 patients, while the control group consisted of 42 patients who received standard opioid-based pain management. The outcomes measured were the Visual Analog Scale (VAS) scores and the morphine milligram equivalents every 12 hours until 48 hours postoperatively. Patient demographics were comparable between the experimental and control groups, with a significant age difference (31 vs. 40; P = 0.002) but not in sex, body mass index, smoking status, or diabetes prevalence. We observed no significant differences in VAS scores at 12, 24, 36, and 48 hours after surgery. In addition, there was a marked reduction in opioid usage in the experimental group, with P-values < 0.001 at each time point. The study concludes that the coadministration of ketorolac, acetaminophen, and gabapentin is an effective opioid-sparing alternative for postoperative pain in isolated femur shaft fractures. Future research could benefit from a more diverse patient population in orthopaedic trauma to further validate our results and explore long-term outcomes. Prospective Cohort Study; Level 2.

Relationship between leg length discrepancy and functional scoliosis in children and adolescents

PurposeAs the relationship between leg-length discrepancy (LLD) and scoliosis has not been clearly defined, the purpose of this study was to explore the impact and severity of LLD in children and adolescents with scoliosis and the consistency between lower limb length discrepancy and pelvic height difference.MethodsThis retrospective study was conducted using prospectively collected data from 63 patients with functional scoliosis-associated LLD who received treatment at our hospital from March 2021 to July 2024. The inclusion criteria included: ①Children or adolescents with functional scoliosis complicated with LLD; ②Scoliosis classified as thoracolumbar or lumbar curve; ③A bilateral acetabular dome line parallel to the superior sacral endplate. The patients’ whole-spine posteroanterior and full lower limb radiographs were obtained to collect data on age, sex, LLD, Cobb angle, and pelvic height difference. Correlation analysis evaluated the relationship between LLD, leg-length discrepancy ratio (LLDR), Cobb angle, and the pelvic height difference. Univariate regression analysis was used to analyze the data using the SPSS software.ResultsIn all cases, the convex side of the scoliosis corresponded to the shorter leg side. Female patients constituted 67% of the cohort. The patients’ mean age was 11.79 ± 3.52 years (range: 4 to 19 years). The average Cobb angle was 14.78 ± 4.99°, the average LLD was 11.22 ± 12.74 mm, and the mean pelvic height difference was 12.41 ± 10.32 mm. Significant correlations were observed when the bilateral acetabular dome line was parallel to the superior sacral endplate, and the scoliosis was thoracolumbar or lumbar, indicating associations between LLD and the Cobb angle (R = 0.440, P<0.05) and between LLDR and the Cobb angle (R = 0.445, P<0.05). Additionally, a strong positive correlation was identified between LLD and pelvic height difference (R = 0.874, P<0.05), indicating a high level of concordance between pelvic height difference and LLD.ConclusionsIn children and adolescents with functional scoliosis complicated by LLD, the Cobb angle significantly correlated with LLD. Additionally, LLDR also showed a significant correlation with the Cobb angle. A concordance was also observed between the pelvic height difference and LLD.Clinical trial numberNot applicable.

A Mixed Level Analysis to Investigate the Factors Associated with Teenage Pregnancy in Bangladesh

This study aims to identify the potential determinants associated with teenage pregnancy in Bangladesh utilizing the Bangladesh Demographic and Health Survey (BDHS), 2017-18 clustered dataset. Random frailty term has been taken into account with the survival regression model to analyze the clustered data sets. Findings of this study have identified division, education of women and their partners, religion, working status, women’s autonomy, and spousal age difference to be potential factors affecting women to experience pregnancy during adolescence age. Dhaka Univ. J. Sci. 73(1): 13-18, 2025 (January)

Характеристика фенотипу пацієнтів із цукровим діабетом 2-го типу та ішемічною хворобою серця

The aim – to evaluate the phenotypic characteristics of patients with type 2 diabetes mellitus (T2DM) with and without coronary artery disease (CAD), identify key features that may have prognostic significance, and assess their impact on the progression of these diseases. Materials and methods. We examined 246 patients with type 2 diabetes mellitus (T2DM), with and without coronary artery disease (CAD). All participants underwent anthropometric measurements, blood pressure assessment, and physical examination. Laboratory testing included fasting plasma glucose, glycated hemoglobin (HbA1c), C-peptide, total cholesterol, triglycerides, low- and high-density lipoprotein cholesterol (LDL-C, HDL-C), aspartate aminotransferase (AST), alanine aminotransferase (ALT), serum creatinine, hematological parameters, and albuminuria. The estimated glomerular filtration rate (eGFR) was calculated. CAD was diagnosed using the Bruce protocol treadmill test and confirmed by coronary angiography. Chronic kidney disease (CKD), diabetic neuropathy (DN), and heart failure (HF) were diagnosed according to relevant clinical guidelines. Data on T2DM, hypertension, history of myocardial infarction, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG) were obtained from medical records, including discharge summaries and clinical reports. Socioeconomic information was collected through questionnaires, covering family history of T2DM, smoking status, sleep quality, place of residence (urban or rural), and dietary habits. Statistical analysis was performed using IBM SPSS Statistics Version 20.0.0.2. Given the age difference between groups, age was included as a covariate. Statistical significance between groups was assessed using ANCOVA (Univariate Tests). Results and discussion. Patients with T2DM and concomitant CAD were significantly older than those without CAD (p&lt;0.05). The leukocyte count and serum creatinine levels were significantly higher in patients with CAD (p&lt;0.05). The prevalence of CKD among patients without CAD was 24 %, whereas in those with CAD it was significantly higher – 42 % (p&lt;0.05). Heart failure of NYHA functional class II was more frequently observed in the CAD group (48 % vs. 16 % in the non-CAD group, p&lt;0.05). The prevalence of peripheral neuropathy was also significantly higher in patients with T2DM and CAD (76 %) compared to those without CAD (55 %) (p&lt;0.05). Analysis of socioeconomic status revealed that parental history of T2DM was slightly more common among patients without CAD (15 % vs. 11 %), and the maternal history of diabetes was significantly more prevalent in this group (25 % vs. 14 %, p&lt;0.05). A significantly higher proportion of patients with T2DM and CAD reported parental exposure to famine (45 % for fathers and 46 % for mothers, p&lt;0.05). The proportion of patients living in urban areas was significantly lower in the CAD group (50 %) compared to the non-CAD group (70 %) (p&lt;0.05). According to our findings, patients with T2DM and CAD reported poorer sleep quality compared to those without CAD.Conclusions. The prevalence of CKD is significantly higher in patients with T2DM and concomitant CAD, suggesting an association between ischemic heart disease and the progression of renal damage. Elevated leukocyte counts in CAD patients indicate the presence of systemic inflammation, a key mechanism in the development of cardiovascular and renal complications. The significantly higher incidence of NYHA class II heart failure in patients with T2DM and CAD reflects more pronounced cardiovascular impairment, particularly myocardial ischemic damage and cardiac remodeling. Patients with T2DM and CAD also reported significantly poorer sleep quality, which may adversely affect overall health, increasing the risk of cardiovascular events and worsening metabolic control.

PTX3/NF-κB/TLR4 Pathway Evaluation in the Follicular Fluid to Successfully Predict Blastocyst Implantation: A Pilot Study.

Background: The implantation process is complex and involves numerous factors that can affect its success. In artificial reproductive treatments (ARTs), chronic inflammation seems to be associated with implantation failure, largely contributing to reproductive dysfunction. Pentraxin 3 (PTX3) is overexpressed in several pathological conditions by exerting a pivotal role both as a regulator and indicator of inflammatory response. Some literature data have shown that PTX3 could have an impact on follicle growth and development, influencing women's fertility. This study aimed to detect PTX3 in follicular fluids collected during an ART protocol in relation to implantation outcomes. Methods: The PTX3/NF-kB/TLR4 pathway and other cytokines were assessed in the follicular fluid of 169 subjects, under the age of 40 years, undergoing IVF cycles, including females without achieved implantation (n = 98) and those with implantation (n = 71). Furthermore, subgroup analyses were performed to evaluate PTX3 values according to age difference. Results: From our data, PTX3 emerged as a strong predictor, more than TNFα and IL-1β, of implantation failure and related inflammatory follicular state. Overall, the results point to PTX3 as a potential biomarker for ART success, and their testing may be helpful in women whose successful implantation remains unexplained. Conclusions: Therefore, PTX3 could constitute a reliable biomarker and a valuable target to improve ART outcomes.

Evaluation of blood components and their association with Interleukin-18 in chronic myeloid leukemia.

This study investigated the association between Chronic Myeloid Leukemia (CML), Interleukin-18 (IL-18), and blood components. A case-control, multi-center trial was conducted from November 12, 2023, to August 8, 2024, including 134 CML patients and 44 healthy controls. Results indicated a statistically significant difference between the control group and CML patients in IL-18 levels, platelet count (PLT), and white blood cell count (WBC) (p = 0.048, 0.033, and 0.029, respectively). A significant age difference was also observed between the control group and patients (p = 0.0441). Furthermore, there was a highly significant difference in age distribution (>40, 40-60, <60 years) between the two groups (p = 0.0001). Significant differences were also found in PDW, RBC, MCHC, RDW-CV, MCH, HCT, and PCT levels (p = 0.0001). MPV and RDW-SD also showed significant differences between groups (p = 0.0006 and 0.0498, respectively). Finally, a significant difference was observed in age distribution (less than 40, 40-60, and more than 60 years) between the two groups (p=0.048). These findings suggest that IL-18 and specific blood components may play a role in the pathogenesis of CML.

A New Score for Metabolic Age in Type 2 Diabetes Mellitus: Physical Rating Score.

Background: Metabolic age (met-age), a risk marker, may vary within the same chronological age group. Its association with chronological age, waist/height ratio, obesity degree, body mass index (BMI), and physical rating score (PRS)-risk factors for type 2 diabetes-remains unexplored. Methods: A total of 122 type 2 diabetes patients (50 males, 72 females) were analyzed. Bioimpedance measurements were taken using the Tanita MC-780MA, alongside anthropometric data. Variables were compared, and correlations with met-age were assessed. Results: The met-age-chronological age difference was higher in females with type 2 diabetes (p < 0.001). Females also had higher BMI, obesity degree, fat mass, and waist/height ratio (p < 0.05), but lower waist/hip ratio (p < 0.001). Males showed higher PRS, muscle mass, and fat-free mass (p < 0.001). Met-age positively correlated with chronological age and negatively with PRS in both sexes (p < 0.05). According to the linear regression model, in females, the met-age was influenced positively by chronological age and waist/height ratio and negatively by PRS (R2 = 0.983). In males, it was positively influenced by chronological age, obesity grade, and BMI, but negatively by PRS (R2 = 0.974). Conclusions: Met-age correlates with chronological age and PRS in type 2 diabetes patients. It increases with advancing age and lower PRS, with waist/height ratio impacting females and BMI/obesity degree affecting males.

Closed Reduction and Spica Cast Immobilization in Patients Aged 18 Months and Older With Developmental Dysplasia of the Hip.

For children aged 18 months and above with developmental dysplasia of the hip (DDH), treatment typically involves open reduction and hip reconstruction surgery. However, there is limited literature evaluating the efficacy of closed reduction in this patient population. The purpose of this study was to investigate the clinical efficacy of closed reduction and spica cast immobilization treatment for children aged 18 months and above with DDH, as well as the incidence of avascular necrosis of the femoral head (ANFH) and their associated risk factors. We retrospectively reviewed all children aged 18 months and above undergoing closed reduction and spica cast immobilization for DDH in our institution from January 2014 to December 2020. We found 51 hips suffered from closed reduction failure and identified 51 hips with successful closed reduction that matched the hips in the failure group in terms of age (difference < 1 month), weight (difference < 2 kg), and same gender. For patients with bilateral DDH, we prioritized self-matching, pairing the failed side with the successfully treated side. Relevant clinical data were collected and compared between the two groups. Multiple analyses of risk factors for closed reduction failure and ANFH were conducted by logistic regression. In all, 61 patients (102 hips) were included in our study, 2 boys and 59 girls. Compared with the success group, the failure group more commonly had a higher International Hip Dysplasia Institute (IHDI) classification (Type III: 23.53% vs. 15.69%; Type IV: 60.78% vs. 23.53%, p < 0.001), a higher preoperative acetabular index (AI) index (39.42 ± 5.50 vs. 34.03 ± 6.15, p < 0.001), and a higher preoperative migration percentage (MP) (0.81 ± 0.27 vs. 0.54 ± 0.36, p < 0.001). Adjusting for other factors, the IHDI classification Types III-IV was the independent factor associated with closed reduction failure. Compared with the IHDI classification Type I, the failure risk of Type III and Type IV was increased 16.87 and 52.13 times, respectively (p < 0.05). ANFH was observed in three patients (4 hips, 4/102, 3.92%). All cases of ANFH occurred in the closed reduction failure group. The higher preoperative MP was related to the ANFH occurrence significantly through the unilateral factor analysis (0.98 ± 0.05 vs. 0.66 ± 0.34, p < 0.001). Adjusting for other factors, we did not find any independent factor regarding the ANFH occurrence (p > 0.05). For patients aged 18 months and above with DDH, an IHDI classification assessment is necessary before closed reduction and spica cast immobilization. For patients classified as IHDI classification Types III and IV, active consideration of open reduction is advisable.

Inflammation and Cardiovascular Risk: Investigating the Link between CRP and Coronary Artery Disease

Objective: To evaluate the association between C-reactive protein levels and the severity of coronary artery disease in a population of patients. Methodology: This was a retrospective observational study involving 220 patients, divided into two groups based on their hs-CRP levels: Group A (&lt;3 mg/L) and Group B (≥3 mg/L). Data was collected from hospital records, including patient demographics, CRP levels, and coronary angiography results. Chi-square and T-tests were used for statistical analysis, with p &lt; 0.05 considered significant. Results: Of the 220 patients, Group B (hs-CRP ≥3 mg/L) was significantly older (55.1 ± 9.4 years vs. 50.2 ± 11.1 years, p = 0.0004). Chi-square test showed a significant correlation between CRP levels and CAD severity (χ² = 15.21, p = 0.0016), with more patients in Group B presenting with multi-vessel disease (TVD/DVD). T-test for age comparison between CRP groups revealed a significant age difference (t = -3.59, p = 0.0004). Conclusion: Elevated CRP levels are strongly associated with increased CAD severity and older age in patients, supporting CRP as an effective inflammatory marker for predicting cardiovascular risk. These findings highlight the importance of incorporating CRP testing into routine cardiovascular screening.

Fostering as a conservation breeding tool: Lessons from three case studies in the critically endangered European mink (Mustela lutreola)

ABSTRACT In conservation breeding programs offspring may become orphaned or require additional care to survive. Fostering represents a potential intervention to avoid the behavioral and physiological problems caused by human hand-rearing. We report five fostering events following the maternal loss of three litters (total of ten kits) in the critically endangered European mink. In two of these cases, we analyzed the dams’ and kits’ behavior during the first week after the fostering event and recorded the kits’ weight. Three fostering events were successful, with foster kits surviving until weaning age; two were unsuccessful, possibly due to the age and developmental stage difference between foster and biological kits. Behaviorally, dams appeared to care for all kits equally, without differences observed in average maternal behaviors or aggression between dams and kits, or among kits. Despite the weight being difference between foster and biological kits, we have verified that fostering can be successful in this species. Future fostering attempts should complement behavioral observations with physiological parameters to assess effects on growth and survival and match foster kits with similarly aged litters to maximize chances of acceptance.