Distinct Age Groups Research Articles

Age-related differences in foot mobility in individuals with patellofemoral pain

BackgroundAge-related changes in midfoot mobility have the potential to influence success with foot orthoses intervention in people with patellofemoral pain (PFP). The aim of this study was to determine whether older people with PFP demonstrate less foot mobility than younger adults with PFP.MethodsOne hundred ninety four participants (113 (58%) women, age 32 ± 7 years, BMI 25 ± 4.9 kg/m2) with PFP (≥ 6 weeks duration) were included, with foot mobility quantified using reliable and valid methods. K-means cluster analysis classified participants into three homogenous groups based on age. After cluster formation, univariate analyses of co-variance (covariates: sex, weight) were used to compare midfoot height mobility, midfoot width mobility, and foot mobility magnitude between age groups (significance level 0.05).ResultsCluster analysis revealed three distinct age groups: 18–29 years (n = 70); 30–39 years (n = 101); and 40–50 years (n = 23). There was a significant main effect for age for midfoot height mobility (p < 0.001) and foot mobility magnitude (p = 0.006). Post-hoc analyses revealed that midfoot height mobility differed across all three groups (moderate to large effect sizes), and that foot mobility magnitude was significantly less in those aged 40–50 years compared to those aged 18–25 years (moderate effect size). There were no significant main effects for age for midfoot width mobility (p > 0.05).ConclusionIndividuals with PFP aged 40–50 years have less foot mobility than younger adults with PFP. These findings may have implications for evaluation and treatment of older individuals with PFP.

The influence of sensorimotor experience on the aesthetic evaluation of dance across the life span.

Understanding how action perception, embodiment, and emotion interact is essential for advancing knowledge about how we perceive and interact with each other in a social world. One tool that has proved particularly useful in the past decade for exploring the relationship between perception, action, and affect is dance. Dance is, in its essence, a rich and multisensory art form that can be used to help answer not only basic questions about social cognition but also questions concerning how aging shapes the relationship between action perception, and the role played by affect, emotion, and aesthetics in social perception. In the present study, we used a 1-week physical and visual dance training paradigm to instill varying degrees of sensorimotor experience among non-dancers from three distinct age groups (early adolescents, young adults, and older adults). Our aim was to begin to build an understanding of how aging influences the relationship between action embodiment and affective (or aesthetic) value, at both brain and behavioral levels. On balance, our results point toward a similar positive effect of sensorimotor training on aesthetic evaluations across the life span on a behavioral level, but to rather different neural substrates supporting implicit aesthetic judgment of dance movements at different life stages. Taken together, the present study contributes valuable first insights into the relationship between sensorimotor experience and affective evaluations across ages, and underscores the utility of dance as a stimulus and training intervention for addressing key questions relevant to human neuroscience as well as the arts and humanities.

Age-related microvascular dysfunction: novel insight from near-infrared spectroscopy.

What is the central question of this study? Can near-infrared spectroscopy (NIRS)-derived post-occlusion tissue oxygen saturation recovery kinetics be used to study age-related impairments in microvascular function? What is the main finding and its importance? Using a previously established 5min cuff occlusion protocol, we found that NIRS-derived indices of microvascular function were markedly reduced in elderly compared with young participants. However, when we controlled for the absolute level of vasodilatory stimulus and matched the tissue desaturation level between groups, we found similar responses in young and elderly participants. Overall, these data highlight the important role NIRS can serve in clinical vascular biology, but also establishthe need for assessing tissue ischaemiaduring cuff occlusion protocols. Near-infrared spectroscopy (NIRS) has emerged as a promising tool to evaluate vascular reactivity invivo. Whether this approachcan be used to assess age-related impairments in microvascular function has not been tested. Tissue oxygen saturation (StO2) post-occlusion recovery kinetics were measured in two distinct age groups (<35 and >65years of age) using NIRS placed over the flexor digitorum profundus. Key end-points included the following: (i)the desaturation rate during cuff occlusion; (ii)the lowest StO2 value obtained during ischaemia (StO2min); (iii)StO2 reperfusion rate; (iv)the highest StO2 value reached after cuff release (StO2max); and (v)the reactive hyperaemia area under the curve (AUC). At first, using a conventional 5min cuff occlusion protocol, the elderly participants achieved a much slower rate of oxygen recovery (1.5±0.2 versus 2.5±0.2%s-1 ), lower StO2max (85.2±2.9 versus 92.3±1.5%) and lower reactive hyperaemia AUC (2651.8±307.0 versus 4940.0±375.8%s-1 ). However, owing to a lower skeletal muscle resting metabolic rate, StO2min was also significantly attenuated in the elderly participants compared with the young control subjects (55.7±3.5 versus 41.0±3.4%), resulting in a much lower ischaemic stimulus. To account for this important difference between groups, we then matched the level of tissue ischaemia in a subset of young healthy participants by reducing the cuff occlusion protocol to 3min. Remarkably, when we controlled for tissue ischaemia, we observed no differences in any of the hyperaemic end-points between the young and elderly participants. These data highlight the important role NIRS can serve in vascular biology, but also establish the need for assessing tissue ischaemia during cuff occlusion protocols.

Visual Tracking in Development and Aging.

A moving target is visually tracked with a combination of smooth pursuit and saccades. Human visual tracking eye movement develops through early childhood and adolescence, and declines in senescence. However, the knowledge regarding performance changes over the life course is based on data from distinct age groups in isolation using different procedures, and thus is fragmented. We sought to describe the age-dependence of visual tracking performance across a wide age range and compare it to that of simple visuo-manual reaction time. We studied a cross-sectional sample of 143 subjects aged 7–82 years old (37% male). Eye movements were recorded using video-oculography, while subjects viewed a computer screen and tracked a small target moving along a circular trajectory at a constant speed. For simple reaction time (SRT) measures, series of key presses that subjects made in reaction to cue presentation on a computer monitor were recorded using a standard software. The positional precision and smooth pursuit velocity gain of visual tracking followed a U-shaped trend over age, with best performances achieved between the ages of 20 and 50 years old. A U-shaped trend was also found for mean reaction time in agreement with the existing literature. Inter-individual variability was evident at any age in both visual tracking and reaction time metrics. Despite the similarity in the overall developmental and aging trend, correlations were not found between visual tracking and reaction time performances after subtracting the effects of age. Furthermore, while a statistically significant difference between the sexes was found for mean SRT in the sample, a similar difference was not found for any of the visual tracking metrics. Therefore, the cognitive constructs and their neural substrates supporting visual tracking and reaction time performances appear largely independent. In summary, age is an important covariate for visual tracking performance, especially for a pediatric population. Since visual tracking performance metrics may provide signatures of abnormal neurological or cognitive states independent of reaction time-based metrics, further understanding of age-dependent variations in normal visual tracking behavior is necessary.

Age-Related Trends in Adults with Community-Onset Bacteremia.

To understand the epidemiological variation in bacteremia characteristics among differently aged populations, adults with community-onset bacteremia during a 6-year period were studied in a retrospective cohort. A total of 2,349 bacteremic patients were stratified into four age categories: young adults (18 to 44 years old; 196 patients; 8.3%), adults (45 to 64 years old; 707 patients; 30.1%), the elderly (65 to 84 years old; 1,098 patients; 46.7%), and the oldest old (≥85 years old; 348 patients; 14.8%). Age-related trends in critical illness (a Pitt bacteremia score of ≥4) at bacteremia onset, antibiotic-resistant pathogens (extended-spectrum β-lactamase [ESBL]-producing Escherichia coli, Klebsiella species, and Proteus mirabilis [EKP]; methicillin-resistant Staphylococcus aureus [MRSA]; and levofloxacin nonsusceptible EKP), inappropriate empirical antibiotic therapy (EAT), and 4-week mortality rate were observed. Using a multivariate regression model, critical illness at bacteremia onset (adjusted odds ratio [AOR], 9.03; P < 0.001) and inappropriate EAT (AOR, 2.67; P < 0.001) were the two leading predictors of 4-week mortality. Moreover, ESBL-producing EKP (AOR, 12.94; P < 0.001), MRSA (AOR, 8.66; P < 0.001), and levofloxacin-nonsusceptible EKP (AOR, 4.27; P < 0.001) were linked to inappropriate EAT. In conclusion, among adults with community onset bacteremia, significant positive age-related trends were noted in antibiotic-resistant pathogens and bacteremia severity, which were related to the increasing incidence of inappropriate EAT and 4-week mortality with age. Thus, different empirical antimicrobial regimens should be considered for distinct age groups.

Oldest lamproites from Peninsular India track the onset of Paleoproterozoic plume-induced rifting and the birth of Large Igneous Province

Potassic and ultrapotassic magmatism from deep lithospheric sources in intra-cratonic settings can be the signal of subsequent voluminous mafic magmatism and the formation of Large Igneous Provinces (LIPs) triggered by mantle plumes. Here we report for the first time, precise zircon U–Pb age data from a suite of lamproites in the Bastar Craton of central India that mark the onset of Paleoproterozoic rifting and culminating in the formation of extensive mafic dyke swarms as the bar codes of one of the major LIP events during the Precambrian evolution of the Indian shield. The lamproites from the Nuapada field occur as dismembered dykes and are composed of phenocrysts and microphenocrysts of altered olivine together with microphenocrysts of phlogopite and magnetite within a groundmass of chlorite and calcite with accessory rutile, apatite and zircon. The rocks compositionally correspond to olivine phlogopite lamproite and phlogopite lamproite. Geochemical features of the lamproites correlate with their counterparts in Peninsular India and other similar suites elsewhere in the world related to rift settings, and also indicate OIB-like magma source. The associated syenite shows subduction-related features, possibly generated in a post-collisional setting. Magmatic zircon grains with high Th/U ratios in the syenite from the Nuapada lamproite form a coherent group with an upper intercept age of 2473±8Ma representing the timing of emplacement of the magma. Zircon grains in three lamproite samples yield four distinct age groups at ca. 2.4Ga, 2.2Ga, 2.0Ga and 0.8Ga. The 2.4Ga group corresponds to xenocrysts entrained from the syenite whereas the 2.2Ga group is considered to represent the timing of emplacement of the lamproites. The ca. 2.0Ga zircon grains correlate with the major thermal imprint associated with mafic magmatism and dyke emplacement in southern Bastar and the adjacent Dharwar Cratons. A few young zircon grains in the syenite and lamproites show a range of early to middle Neoproterozoic ages from 879 to 651Ma corresponding to younger thermal event(s) as also represented by granitic veins cutting across these rocks and extensive silicification. Zircon Lu–Hf isotope data suggest magma derivation from a refertilized Paleo-Mesoarchean sub-continental lithospheric mantle, or OIB-type sources. The differences in Hf-isotope composition among the zircon grains from different age groups indicate that the mantle sources of the lamproite are heterogeneous at the regional scale. A combination of the features from geochemical and zircon Hf isotope data is consistent with asthenosphere-lithosphere interaction during the lamproite magma evolution.The timing of lamproite emplacement in central India correlates with the global 2.2Ga record of LIPs. We link the origin of the related mantle plume to the recycling of subducted slabs associated with the prolonged subduction-accretion history prior to the Neoarchean cratonization, as well as the thermal blanket effect of the Earth's oldest supercontinent. Pulsating plumes and continued rifting generated voluminous dyke swarms across the Bastar and Dharwar Cratons, forming part of a major global rifting and LIP event.

A widespread Paleoproterozoic partial melting event within the Jiao-Liao-Ji Belt, North China Craton: Zircon U-Pb dating of granitic leucosomes within pelitic granulites and its tectonic implications

In the southern zone of the Paleoproterozoic Jiao-Liao-Ji Belt (JLJB), North China Craton (NCC), abundant granitic leucosomes are widespread within migmatites as irregular layers, lenses, and blocks. They are parallel to or as cross-cut foliations in the host rocks on various scales, and show distinct evidence of migmatization in the formation of these centimeter- to decimeter-scale segregations. The migmatites extend at least 1100 km in length, spreading over the whole JLJB, from the Ji’an Group in south Jilin, through the South Liaohe Group in Liaodong Peninsula, to the Jingshan Group in Jiaodong Peninsula, rather than as sporadic outcrops limited to the Jiaobei Terrane as reported in previous studies. The granitic leucosomes are comprised mainly of quartz, K-feldspar, and antiperthitic plagioclase (albite), with secondary minerals of garnet, biotite, zircon, etc. They are enriched in SiO2 (74.65–75.54 wt%), Al2O3 (13.25–14.87 wt%), and K2O + Na2O (8.19–8.95 wt%), but have a lower TiO2 + Fe2O3 + FeO + MgO + MnO content (0.42–1.34 wt%). The major element components are similar to those of granitic leucosomes of pelitic granulites in typical orogenic belts around the world. A combined study of whole-rock geochemistry, mineral inclusions, cathodoluminescence (CL) images, and laser ablation inductively coupled plasma mass spectrometry (LA-ICP-MS) U-Pb dates of zircons revealed the nature and timing of partial melting of the host pelitic granulites. All dated anatectic zircons from various granitic leucosomes display magmatic zones with distinct cores and rims, and contain mineral inclusions of Qtz + Kfs + Ab ± Ap in both domains. Both the cores and rims exhibit unusually high U and Th contents, and anomalously low Th/U ratios (<0.10), indicative of an anatectic origin. The anatectic zircon cores and rims from eight granitic leucosome samples in the Ji’an and Liaohe groups exhibit two distinct weighted mean age groups ranging from 1870 ± 8 to 1865 ± 9 Ma and 1843 ± 13 to 1835 ± 11 Ma, with age peaks at ca. 1868 ± 3 Ma and 1841 ± 4 Ma, respectively. Similarly, abundant anatectic zircon cores and rims from granitic leucosomes in the Jingshan Group from the Jiaobei Terrane also showed two distinct groups with age peaks at 1862 ± 2 Ma and 1843 ± 3 Ma, respectively. These two distinct age groups can be interpreted as the initial timing of partial melting and crystallization end age of melts for the migmatites in the whole JLJB. The southern zone of the JLJB experienced a complicated granulite facies metamorphic evolution characterized by clockwise P-T-t paths, rather than anticlockwise P-T-t paths as reported in previous studies. The post-peak MP-LP granulite facies retrogression with a near isothermal decompression P-T path occurred at 1870–1840 Ma, which is completely consistent with the ages of partial melting. These age data provide powerful evidence that the widespread partial melting event within the southern zone of the JLJB occurred at the post-peak near-isothermal decompression stage, rather than at the peak granulite facies stage or the late amphibolite facies cooling stage. Thus, decompression melting is a major control factor on the generation of partial melting, and formation of the granitic leucosomes and migmatites within the southern zone of the JLJB. Under water-unsaturated conditions, hydrous minerals such as biotite underwent dehydration melting, and water released from the biotite results in felsic minerals occurring partial melting. These lines of evidence suggest that the pelitic granulites in the JLJB underwent intensive partial melting during the MP-LP granulite facies “hot” exhumation stage related to the extension and thinning tectonic setting. The resultant melts did not escape from the host rocks, leading to regionally extensive migmatization and subsequent retrogression.

Self-reported exercise behaviour and perception of its importance to recreational divers.

This study examined self-reported physical activity and perceptions of exercise importance among certified divers in two distinct age groups. Questionnaires were distributed by hand at dive sites in three states of the United States, half to students from an academic programme in scuba diving at a regional university. The survey included questions about health status, dive history, certification levels, structured exercise activity levels and perceived importance of regular exercise to their health, diving ability, and safety. Also included was the Godin-Shephard Leisure-Time Physical Activity Questionnaire, a validated physical activity classification instrument for use among adults. Non-students were older than the students and had greater diving experience. There was no detectable difference between groups in perceived exercise importance to health (p = 0.69), diving ability (p = 0.75), or diving safety (p = 0.25). Fitting age, sex, occupation and number of dives to a generalised linear model to predict Godin-Shephard scores, number of dives was removed first (p = 0.43), followed by student status (p = 0.33). Remaining predictors of Godin-Shephard exercise scores were age (-0.004 per year, p < 0.0001) and sex (males = + 0.11, 95% CI 0.04-0.17, p = 0.0012). Both groups reported similar structured exercise regularity, overall health and perceived importance of regular exercise for health, diving and safety. Despite acknowledging the importance of exercise, Godin-Shephard scores for physical activity decrease with age.

Divergent Influences of Cardiovascular Disease Risk Factor Domains on Cognition and Gray and White Matter Morphology.

Hypertension, diabetes, dyslipidemia, and obesity are associated with preclinical alterations in cognition and brain structure; however, this often comes from studies of comprehensive risk scores or single isolated factors. We examined associations of empirically derived cardiovascular disease risk factor domains with cognition and brain structure. A total of 124 adults (age, 59.8 [13.1] years; 41% African American; 50% women) underwent neuropsychological and cardiovascular assessments and structural magnetic resonance imaging. Principal component analysis of nine cardiovascular disease risk factors resulted in a four-component solution representing 1, cholesterol; 2, glucose dysregulation; 3, metabolic dysregulation; and 4, blood pressure. Separate linear regression models for learning, memory, executive functioning, and attention/information processing were performed, with all components entered at once, adjusting for age, sex, and education. MRI analyses included whole-brain cortical thickness and tract-based fractional anisotropy adjusted for age and sex. Higher blood pressure was associated with poorer learning (B = -0.19; p = .019), memory (B = -0.22; p = .005), and executive functioning performance (B = -0.14; p = .031), and lower cortical thickness within the right lateral occipital lobe. Elevated glucose dysregulation was associated with poorer attention/information processing performance (B = -0.21; p = .006) and lower fractional anisotropy in the right inferior and bilateral superior longitudinal fasciculi. Cholesterol was associated with higher cortical thickness within left caudal middle frontal cortex. Metabolic dysfunction was positively associated with right superior parietal lobe, left inferior parietal lobe, and left precuneus cortical thickness. Cardiovascular domains were associated with distinct cognitive, gray, and white matter alterations and distinct age groups. Future longitudinal studies may assist in identifying vulnerability profiles that may be most important for individuals with multiple cardiovascular disease risk factors.

Effects of age on biological and functional characterization of adipose‑derived stem cells from patients with end‑stage liver disease.

Adipose‑derived mesenchymal stromal cells (ADSCs) possess a multilineage potential and immunoregulatory properties, and may have great potential in autologous cell‑based technologies. The aim of the present study was to investigate how the age of patients with benign end‑stage liver disease affected the biological and functional characteristics of ADSCs, which is important for increasing the potential effectiveness of autologous cell therapy. ADSCs were obtained and cultured from three distinct age groups: Infant, adult and elderly. Cell immunophenotypic characteristics and antiapoptotic capacity were determined by flow cytometry, and cell proliferation and migration were monitored with a Real‑Time Cell Analyzer. Multilineage differentiation potential was investigated by evaluating the induction response and by reverse transcription‑quantitative polymerase chain reaction. Suppression of T cell proliferation was assessed in a co‑culture system by MTT assay. The regulatory T cells (Tregs) were analyzed by flow cytometry, and ELISAs were performed to detect the cytokine profile in culture supernatants. All ADSC sample phenotypes were characterized as CD90+/CD73+/CD105+/CD45‑/CD34‑, and the apoptotic rate was not statistically different among all ages. However, the proliferation and migratory capacity were significantly increased in infant‑derived ADSCs. In addition, ADSCs derived from infant patients demonstrated a relatively high proclivity for osteogenic differentiation compared with cells derived from either adult or elderly patients. Furthermore, ADSCs co‑cultured with mitogen‑activated T cells significantly suppressed T‑cell proliferation, downregulated the secretion of interferon‑γ and increased the percentage of Tregs, with infant‑derived ADSCs being most effective. Results from the present study indicated that ADSCs derived from infant patients may have biological advantages compared with older cell sources, and may provide an effective reference for the clinical application of ADSCs.

Erratum to: The role of histone modifications and telomere alterations in the pathogenesis of diffuse gliomas in adults and children.

Genetic profiling is an increasingly useful tool for sub-classification of gliomas in adults and children. Specific gene mutations, structural rearrangements, DNA methylation patterns, and gene expression profiles are now recognized to define molecular subgroups of gliomas that arise in distinct anatomic locations and patient age groups, and also provide a better prediction of clinical outcomes for glioma patients compared to histologic assessment alone. Understanding the role of these distinctive genetic alterations in gliomagenesis is also important for the development of potential targeted therapeutic interventions. Mutations including K27M and G34R/V that affect critical amino acids within the N-terminal tail of the histone H3 variants, H3.3 and H3.1 (encoded by H3F3A and HIST1H3B genes), are prime examples of mutations in diffuse gliomas with characteristic clinical associations that can help diagnostic classification and guide effective patient management. These histone H3 mutations frequently co-occur with inactivating mutations in ATRX in association with alternative lengthening of telomeres. Telomere length can also be maintained through upregulation of telomerase reverse transcriptase (TERT) expression driven by mutation within the TERT gene promoter region, an alteration most commonly found in oligodendrogliomas and primary glioblastomas arising in adults. Interestingly, the genetic alterations perturbing histone and telomere function in pediatric gliomas tend to be different from those present in adult tumors. We present a review of these mutations affecting the histone code and telomere length, highlighting their importance in prognosis and as targets for novel therapeutics in the treatment of diffuse gliomas.

Abstract IA36: Caught in the middle: Viewing adolescent/young adult oncology patients as the medically underserved

Abstract Traditionally cancer has been thought to arise in two distinct age groups, pediatrics and adults. In the United States, pediatric patients range in age from newborn up to 21 years old while adult patients are considered to be older than 21. Recently a new patient population has begun to emerge, collectively known as the adolescent-young adult (AYA) population. In the United States, AYA patients span the age range from 15-39 years old. Much is known about a variety of “adult” cancers and our understanding of “pediatric” cancers is steadily growing. Despite these advances, there is very little data regarding AYA-specific cancers. Furthermore, the differences in normal human development and/or maturation that are encompassed within the AYA age range is extremely dynamic thus leading to the hypothesis that the molecular and clinical characteristics of malignancies in AYA patients may be inherently different than those which are observed in patients outside of this age range. This talk will highlight some of the unique challenges faced by this medically underserved population as it pertains to cancer care, treatment, and outcome. This talk will also focus on the importance of the AYA oncology population to cancer research and our biological understanding of different malignancies as it pertains to precision medicine and subsequent therapeutic strategies. Citation Format: Troy A. McEachron. Caught in the middle: Viewing adolescent/young adult oncology patients as the medically underserved. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2016 Sep 25-28; Fort Lauderdale, FL. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2017;26(2 Suppl):Abstract nr IA36.

Identifying modern and historic recharge events from tracer‐derived groundwater age distributions

AbstractUnderstanding groundwater ages offers insight into the time scales of recharge, aquifer storage turnover times, and contaminant protection time frames. The ability to quantify groundwater age distributions heavily depends on the choice of the interpretive model, and often important features of the age distribution cannot be identified with the subset of available models. In this paper, we implemented a multiple tracer method using a technique that assumes limited details regarding the shape of the age distribution and applied it to dewatering wells at a mine site in the Pilbara region of north‐western Australia. Using our method, we were able to identify distinct age components in the groundwater. We calculated the presence of four distinct age groups in the samples. All wells contained water aged between zero and 20 years. However, the rest of the samples were composed of water between 50 and 100 years, 100 and 600 years, or water approximately 1000 years old. These were consistent with local recharge sources (50–100 years) and knowledge of paleoclimate from lake sediment records. We found that although the age components were well constrained, the relative proportions of each component were highly sensitive to errors of environmental tracer data. Our results show that our method can identify distinct age groups in groundwater samples without prior knowledge of the age distribution. The presence of distinct recharge times gives insight into groundwater flow conditions over long periods of time.

The role of histone modifications and telomere alterations in the pathogenesis of diffuse gliomas in adults and children.

Genetic profiling is an increasingly useful tool for sub-classification of gliomas in adults and children. Specific gene mutations, structural rearrangements, DNA methylation patterns, and gene expression profiles are now recognized to define molecular subgroups of gliomas that arise in distinct anatomic locations and patient age groups, and also provide a better prediction of clinical outcomes for glioma patients compared to histologic assessment alone. Understanding the role of these distinctive genetic alterations in gliomagenesis is also important for the development of potential targeted therapeutic interventions. Mutations including K27M and G34R/V that affect critical amino acids within the N-terminal tail of the histone H3 variants, H3.3 and H3.1 (encoded by H3F3A and HIST1H3B genes), are prime examples of mutations in diffuse gliomas with characteristic clinical associations that can help diagnostic classification and guide effective patient management. These histone H3 mutations frequently co-occur with inactivating mutations in ATRX in association with alternative lengthening of telomeres. Telomere length can also be maintained through upregulation of telomerase reverse transcriptase (TERT) expression driven by mutation within the TERT gene promoter region, an alteration most commonly found in oligodendrogliomas and primary glioblastomas arising in adults. Interestingly, the genetic alterations perturbing histone and telomere function in pediatric gliomas tend to be different from those present in adult tumors. We present a review of these mutations affecting the histone code and telomere length, highlighting their importance in prognosis and as targets for novel therapeutics in the treatment of diffuse gliomas.

A Retrospective Analysis of Three Non-Invasive Tests for Initial Diagnosis of &amp;lt;i&amp;gt;Helicobacter pylori&amp;lt;/i&amp;gt; Infection in Children

Proper diagnosis in the pediatric population is required to eradicate Helicobacter pylori (H. pylori) and prevent gastric cancer. Our aim was to assess the performance of non-invasive tests to diagnose H. pylori infection in pediatric patients. A retrospective analysis was performed on 141 pediatric patients requiring endoscopic evaluation and diagnostic tests for H. pylori infection to define the cause of abdominal symptoms. Non-invasive tests included the 13C-urea breath test (UBT), a monoclonal stool antigen test using enzyme-linked immuno-sorbent assay (mSAT), and a serum immunoglobulin G antibody test using antigens derived from Japanese individuals (S-Ab). This study investigated sensitivity, specificity, likelihood ratios for a positive and a negative test (LR+ and LR-), and accuracy of non-invasive tests, in comparison with invasive tests. Eighty two of 141 patients (58%) were recognized as H. pylori positive by invasive methods. When UBT, mSAT or S-Ab were analyzed, all were found to be effective over 94% accurate. Specificity ranged between 86.7% and 95.8%, and sensitivity ranged between 93.8% and 97.1%. When subjects were stratified into three distinct age groups, the best performance was achieved for 1-6 years old with mSAT at 100% for sensitivity, specificity, and accuracy. S-Ab yielded the best results for children 7-12 years old and the UBT test performed best for 13-18 years old. These results demonstrate the utility of UBT, mSAT, and S-Ab non-invasive tests in diagnosing H. pylori but suggest that certain tests may be optimal for children of distinct ages. Three non-invasive tests, UBT, mSAT and S-Ab showed sufficient sensitivity, specificity and accuracy for the initial diagnosis of H. pylori infection among pediatric patients. Non-invasive tests may contribute to achieving minimum invasive diagnosis with combining with a histological test and a culture test in children.

Air pollution, educational achievements, and human capital formation

The link between air pollution and human health is well-documented in the epidemiology and economic literature. Recently, an increasing body of research has shown that air pollution—even in relatively low doses—also affects educational outcomes across several distinct age groups and varying lengths of exposure. This implies that a narrow focus on traditional health outcomes, such as morbidity and mortality, may understate the true benefit of reducing pollution, as air pollution also affects scholastic achievement and human capital formation.

Quantitative Analysis of the Flavonoid Mesquitol in the Medicinal Plant &amp;lt;i&amp;gt;Prosopis juliflora&amp;lt;/i&amp;gt; with Seasonal Variations in Marigat, Baringo County-Kenya

Several studies indicate that mesquitol exhibits significant free-radical scavenging properties, antioxidant and α-glucosidase inhibitory properties. This makes it a useful resource with potential for exploitation in both agro-food and pharmaceutical industries. The heartwood of the plant P. juliflora is noted to contain very high levels of the flavan-3-ol compound mesquitol. Previous studies showed that in non-tropical countries like the United States of America where they experience four seasons in a year, mesquitol shows varying seasonal abundance with the least abundant season being the winter period. Meanwhile limited data exists on its abundance trends in tropical arid and semiarid regions that only experience the dry and wet seasons in a year. Plants samples of two distinct age groups were collected during the dry and wet seasons and extracted serially via a soxhlet apparatus after which column chromatography was used to assist in the process of mesquitol isolation. Thin layer chromatography assisted in pooling of fractions with similar Rf values. The Rf values were compared to available literature to ascertain fractions that contained mesquitol. A HPLC-UV method was developed and validated illustrating high accuracy and precision for the quantification of the mesquitol content in different P. juliflora samples. On evaluation, mesquitol was found to be more abundant during the wet seasons reaching 642.893 μg/ml as compared to 181.245 μg/ml for dry seasons. This abundance could be attributed to chemo-seasonal dynamics that have been witnessed to affect biosynthesis and deposition of phyto-compounds in plants. The developed and validated HPLC method, illustrated satisfactory quantification of mesquitol at 3-6% of the crude extract. This paper presents useful information on seasonal abundance dynamics of mesquitol in the tropics as a basis for the resource valorization.

Systematic Literature Review Evidence of Pegaspargase for Treatment of Acute Lymphoblastic Leukemia (ALL)

Introduction: Advances in chemotherapeutic regimens have improved pediatric ALL survival rates from less than 10% in the 1960s to approximately 90% currently (Hunger et al NEJM 2015). Asparaginase (ASP), as a component of the multi-agent chemotherapy regimen has become a cornerstone treatment for ALL. Pegaspargase (Oncaspar, PEG) is a pegylated asparaginase with sustained asparaginase activity, offering less frequent administration and associated with less treatment-related anxiety compared to native E.coli L-asparaginase (Place et al Lancet Oncol 2015). Due to the ample amount of data available for PEG, a systematic literature review and quantitative synthesis of evidence was previously performed to assess the relative benefit of PEG versus native ASP in newly diagnosed ALL patients in terms of event free survival (EFS) and overall survival (OS) (Kilpatrick et al ICPE 2016). The main objective of this investigation was to update the literature review by identifying additional relevant scientific clinical evidence of PEG in first line treatment of ALL in pediatric patients, and to expand the investigation to include adult patients.Methods: All available evidence for newly diagnosed patients treated in pediatric and adult ALL protocols using PEG or native ASP was identified using a search algorithm. Randomized, observational and cohort studies were included. Outcomes were EFS and OS. Safety/immunogenicity was also examined. Feasibility was then explored in this order: direct comparison meta-analysis (MA) if at least two head-to-head trials were found, indirect comparison (network MA) if a common comparator could be identified or separate product MAs (pooled estimates) of PEG and native ASP using a random effects model. The individual product MA was analyzed for two important variables: risk category (standard & high risk) and by distinct age groups. Pooling was conducted, assuming normality, using the software Comprehensive Meta-Analysis, version 2.Results:There were 62 and 30 studies that met pre-specified inclusion criteria for abstraction for pediatric and adult populations, respectively. Some identified studies in both populations provided data for both asparaginases. Therefore, in pediatrics: 39 studies provided data for PEG and 41 for nativeASP, in adults: 10 studies provided data for PEG and 23 for nativeASP. Direct MA was not feasible as only one head-to-head study was identified. Also due to lack of common comparator, indirect MA was infeasible. Pooled estimate of EFS and OS data for pediatric ALL patients treated with PEG or native ASP is shown in table 1 below. Forest plot with pooled estimate of 5-year OS in adult ALL patients treated with PEG or native ASP is presented in figure 1, categorized by age group when available. Overall safety was consistent with product class for both asparaginases.Conclusions: A systematic literature review and quantitative synthesis constitute an important approach to critically appraise relevant research. Consistent with published data, better outcomes were observed in pediatric than adults patients. The result from this updated research synthesisdemonstrates a positive effectiveness profile of PEG in the treatment of newly diagnosed ALL patients with less frequent administration. [Display omitted] [Display omitted] DisclosuresLebedinsky:Shire: Employment. Hale:Shire: Employment. Patel:Shire: Employment. Casamayor:Shire: Other: Vendor; Quintiles: Employment. Wijnands:Shire: Other: Vendor; Quintiles: Employment. Desai:Shire: Employment.

Intravenous Vancomycin Dosing in the Elderly: A Focus on Clinical Issues and Practical Application.

The elderly population can be divided into three distinct age groups: 65–74 years (young-old), 75–84 years (middle-old), and 85+ years (old-old). Despite evidence of a shift in leading causes for mortality in the elderly from infectious diseases to chronic conditions, infections are still a serious cause of death in this population. These patients are at increased risk due to weakened immune systems, an increased prevalence of underlying comorbidities, and decreased physiologic reserves to fight infection. Additionally, elderly patients, especially adults in institutional settings, are at an increased risk of colonization and subsequent infection with methicillin-resistant Staphylococcus aureus at a rate that is five times higher than in younger individuals, causing an increase in empiric and definitive vancomycin use. Elderly patients have unique characteristics that make dosing vancomycin a challenge for clinicians, such as increased volume of distribution and decreased renal function. Using the best available evidence, it is recommended to initiate lower empiric maintenance doses and monitor vancomycin serum concentrations earlier than steady state to accurately calculate drug elimination and make appropriate dose adjustments.

Comparison of Obesity Rates in Early Childhood (4 to 80 months) by Parental Socioeconomic Status Using National Cohort Dataset in Korea

Child obesity has been on the rise and become a worldwide health issue. Low socioeconomic status (SES) is known as an influencing factor for childhood obesity, but relevant studies on a national level are scarce in Korea. The purpose of this study was to identify the prevalence of obesity for each age group by parental SES and analyze the trends of changes in weight status using a Korean national cohort dataset. In Korea, children are eligible for the National Children Health Examination, a mandatory seven-time health checkup for those aged 4 to 80 months. This study tracked 4 to 9-month-old children up to 80 months through seven distinct age groups. A total of 12,362 children had received all seven health exams consecutively. Parental SES was categorized as three stages according to national classifications. Z scores of weight-for-height (for children aged<24 months) and body mass index (for children aged ≥ 24 months) were used for detecting overweight and obesity. Children with low parental SES showed the highest prevalence of overweight and obesity in all age groups, although there was no consistency in statistical significance. Also, normal and underweight children of 4 to 9 months with low parental SES showed the highest change rate to either overweight or obesity, although no consistency of statistical significance was observed. Low parental SES can affect the weight status of offspring from early childhood. Thus, early obesity prevention interventions should be provided especially for children in low-income families.