Estimation Equations Research Articles

Exploring sexual dimorphism through palatal rugae analysis in the Javanese population of Surabaya, Indonesia

This study investigates the potential of palatal rugae patterns as a tool for sex estimation in the Javanese population of Surabaya, Indonesia. Palatal rugae on the anterior part of the maxillary mucosa exhibit unique characteristics that make them valuable for forensic identification. Through a cross-sectional study involving 60 Javanese individuals, the research examines the prevalence of various palatal rugae patterns and their correlation with sex. Results indicate significant distinctions in rugae patterns between males and females, particularly in diverging, converging, and circular patterns. A discriminant function analysis is employed to establish an equation for sex estimation using palatal rugae patterns specific to the Javanese population. Overall, the study suggests that palatal rugae patterns hold promise as a supplementary method for sex estimation in forensic science, though further research with larger sample sizes is recommended for conclusive results.

Gompertz-Weibull {Gompertz} Type I: A Four-Parameter Generalization of the Weibull Family

AbstractIn this paper, we provide a construction method that provides greater flexibility in modeling real-world phenomenon by generalizing univariate probability distributions. The Gompertz distribution is used to provide new classes of models through T-X{Y} construction, in a manner we will define as a “proper” generalization, illustrated by application to the popular Weibull family. We provide moments and other properties of the model, including the necessary equations for maximum likelihood estimation, and we fit a set of real data to the model. A framework for classifying generalizations that includes many previously discovered methods and considerations for the research infrastructure are proposed in our methods and discussion.

Latent class analysis of post-acute sequelae of SARS-CoV-2 infection.

Symptoms post-SARS-CoV-2 infection may persist for months and cause significant impairment and impact to quality of life. Acute symptoms of SARS-CoV-2 infection are well studied, yet data on clusters of symptoms over time, or post-acute sequelae of SARS-CoV-2 infection (PASC), are limited. We aim to characterize PASC phenotypes by identifying symptom clusters over a six-month period following infection in individuals vaccinated (boosted and not) and those unvaccinated. Subjects with ≥1 self-reported symptom and positive RT-PCR for SARS-CoV-2 at CVS Health US test sites were recruited between January and April 2022. Patient-reported outcomes symptoms, health-related quality of life (HRQoL), work productivity and activity impairment (WPAI) were captured at 1 month, 3 months, and 6 months post-acute infection. Phenotypes of PASC were determined based on subject matter knowledge and balanced consideration of statistical criteria (lower AIC, lower BIC, and adequate entropy) and interpretability. Generalized estimation equation approach was used to investigate relationship between QoL, WPAI and number of symptoms and identified phenotypes, and relationship between phenotypes and vaccination status as well. LCA identified three phenotypes that are primarily differentiated by number of symptoms. These three phenotypes remained consistent across time periods. Subjects with more symptoms were associated with lower HRQoL, and worse WPAI scores. Vaccinated individuals were more likely to be in the low symptom burden latent classes at all time points compared to unvaccinated individuals.

Development of an Optimized Non-Linear Model for Precise Dew Point Estimation in Variable Environmental Conditions

Accurate dew point estimation is crucial for measuring water condensation in various fields such as environmental studies, agronomy, or water harvesting, among others. Despite the numerous models and equations developed over time, including empirical and machine learning approaches, they often involve trade-offs between accuracy, simplicity, and computational cost. A major limitation of the current approaches is the lack of balance among these three factors, limiting their practical applications under diverse conditions. This research addresses these key challenges by developing a new, streamlined equation for dew point estimation. Using the Magnus–Tetens equation, deemed as the most reliable equation, as a benchmark, and by applying a process of non-linear regression fitting and parametric optimization, a new equation was derived. The results demonstrate high accuracy with a streamlined implementation, validated through extensive data and computational simulations. This study highlights the importance of accurate dew point modeling, especially under variable environmental conditions, provides a reliable solution to existing limitations, paving the way for enhanced efficiency in related processes and research endeavors, and offers researchers and practitioners a practical tool for more effective modeling of water condensation phenomena.

Nutritional status and daily habits as determinants of hospitalization duration in ovarian cancer patients undergoing chemotherapy.

Adequate nutrition in a hospital setting is essential for achieving optimal health outcomes in oncology patients. This study specifically investigated the interrelationships between nutritional status, daily habits, and hospital length of stay (LOS) in ovarian cancer patients undergoing chemotherapy. A prospective longitudinal study was conducted from August 2019 to January 2022 in a tertiary hospital. Throughout the study, nutritional status, biochemical indicators, diet, and physical activity were meticulously recorded at different stages of chemotherapy: before chemotherapy (T0), the first course (T1), third course (T2), and fifth course (T3). To determine the factors influencing LOS, a generalized estimation equation (GEE) was employed. A total of 460 patients completed the follow-up period. The findings revealed a decline in nutritional risk among patients by 9.90% at T1, 17.62% at T2 and 18.26% at T3 (χ2 = 79.220, P < 0.001). The proportion of people receiving enteral nutrition showed an upward trend (χ2 = 15.202, P < 0.001). Notably, the proportion of patients adhering to a healthier diet increased by 40.44% by the study's conclusion, while the number of patients abstaining from physical activity or engaging in solely low-intensity activities decreased by 21.08%. Moreover, as the chemotherapy cycle progressed, daily activity steps exhibited an upward trajectory (F = 5.986, P < 0.001), while the LOS experienced a significant reduction (F = 21.298, P < 0.001). This study identified hypoproteinemia (protein level < 34g/L), a high nutritional risk (NRS 2002 score ≥ 3), a short duration of sleep (≤ 7h/day), and a lower daily activity level as risk factors for LOS. Receiving enteral nutrition support is a protective factor for LOS. Significant improvements in nutritional status, diet, and physical activity have been observed among ovarian cancer patients during their chemotherapy cycles. Reduced nutritional risks, implementation of nutritional support, good physical activity, and adequate sleep were associated with a shorter LOS.

Novel closed-form point estimators for the beta distribution

In this paper, we propose and investigate novel closed-form point estimators for the beta distribution. The estimators of the first type are a modified version of Pearson's method of moments. The underlying idea is to involve the sufficient statistics, i.e., log-moments in the moment estimation equations and solve the mixed type of moment equations simultaneously. The estimators of the second type are based on an approximation to Fisher's likelihood principle. The idea is to solve two score equations derived from the log-likelihood function of generalized beta distributions. Both two resulted estimators are in closed forms, strongly consistent and asymptotically normal. In addition, through theoretical analyses and extensive simulations, the proposed estimators are shown to perform very close to the maximum likelihood estimators in both small and large samples, and they significantly outperform the method of moment estimators.

Sex estimation by discriminant function analysis of long bones in prehistoric Southeast Asian populations

AbstractBiological sex estimation is an integral part of reconstructing the biological profile of an individual in forensic anthropological and bioarchaeological contexts. Formulating population specific discriminant function equations for metric variables is vital for reconstructing biological sex of fragmentary skeletal remains. This study aimed to develop multivariable and univariable sectioning point sex estimation equations from long bones of prehistoric Thailand and Cambodia people dated from 4700 to 1450 BP. A total of 481 individuals (236 females and 245 males) with 997 long bone measurements were analyzed. Discriminant function analysis was used to analyze sexually dimorphic measurements from long bones of humeri (177 females and 183 males), femora (169 females and 178 males), and tibiae (139 females and 151 males). Stepwise and direct multivariable functions offered the highest accuracies of 97.3% for humeri, 97% for femora, and 96.7% for tibiae. Univariable functions indicated that the recommended measurements for use in sex estimations with high cross‐validation accuracies are the humeral epicondylar breadth (89.1%), femoral maximum head diameter (87.1%), and tibial midshaft circumference (88.3%). These equations are applicable for use in sex estimation for the specific prehistoric Southeast Asian populations to improve our understanding of the prehistoric demography. Further evaluation and validation of the equations are required to test whether these equations can also be applied to estimate biological sex of contemporary Southeast Asian populations.

Norwegian and Swedish value sets for the EORTC QLU-C10D utility instrument.

This study aimed to develop utility weights for the European Organization for Research and Treatment of Cancer (EORTC) QLU-C10D, a cancer-specific utility instrument, tailored to the Norwegian and Swedish populations. The utility weights are intended for use in the specific welfare contexts of Norway and Sweden to support more precise healthcare decision-making in cancer treatment and care. This cross-sectional study included 1019 Norwegian and 1048 Swedish participants representative in age and gender of the two general populations. Participants completed a discrete choice experiment involving 960 choice sets, each consisting of two EORTC QLU-C10D health states described by the instrument's domains and the duration of each state. Utility weights were calculated using generalized estimation equation models, and non-monotonic levels were merged to ensure consistent valuation. In the Norwegian participants, the largest utility decrements were seen for the domain of physical functioning (decrement of -0.263 for highest level "very much"), followed by pain (decrement -0.205 for level "very much") and role functioning (-0.139). Among the cancer-specific domains, nausea had the largest utility decrement (-0.124). In the Swedish participants, the largest utility decrements were also observed for physical functioning (-0.207 for the response "very much"), followed by pain (-0.139), role functioning (-0.133), and nausea (-0.119). Emotional functioning also exhibited a sizable utility decrement (-0.115). This study provides the first set of utility weights for the EORTC QLU-C10D specific to Norway and Sweden, reflecting the unique health preferences of these populations. The generated utility decrements can inform cost-utility analyses and optimize resource allocation in cancer care within the Norwegian and Swedish healthcare systems.

Estimating the Greenhouse Gas Emission Potential Due to Construction Work on the 225 kV Segou - Bamako High Voltage BI-Ternal Electric Line in Mali in The Context of Climate Change

The aim of this study is to assess the carbon emissions resulting from the construction of the power line linking Bamako to Ségou. It focuses on direct emissions, more specifically those linked to the degradation and desctruction of the vegetation cover in the project right-of-way. To collect the data, surveys were set up on the project right-of-way, through which 3302 trees were inventoried in situ at the three sites. Circumference was measured at 1.30 m from the ground surface. Allometric equations for direct biomass estimation were used as a predictor o f tree diameter. Emission factors were then used to estimate the potential greenhouse gas emissions resulting from tree felling during power line construction. The standard error associated with the carbon fraction in dry biomass was calculated. In the Ségou, Koulikoro and Dioïla project areas, there are a number of plant species that provide local populations with various ecosystem services, including micro-climate regulation through carbon sequestration or absorption of atmospheric CO2. The implementation of the project will undoubtedly result in the felling of these trees. This felling will generate emissions of 22.11 t.eqCO2/ha in Ségou, 16.56 t.eqCO2/ha in Koulikoro and 15.43 t.eqCO2/ha in Dioïla. Across Ségou, Koulikoro and Dioïla, the trees in the project right-of-way represent a reservoir of 34.04 t/ha of above-ground woody biomass. This biomass represents a carbon stock of around 16.58 t.C/ha. This carbon stock will be transformed into a carbon source with emissions of 60.78 t.eqCO2/ha if the trees in the power line right-of-way are systematically felled. Mitigation measures are therefore urgently needed, with compensatory reforestation areas planted with species with high carbon sequestration potential.

Age estimation on post-mortem CT based on pelvic bone mineral density measurement and the state of putrefaction: a multivariate method.

Age-at-death estimation is an important issue in forensic medicine and anthropology. Initially, methods relied on morphological criteria, but with the advancement of radiology, new techniques such as morphological studies on multi-slice computed tomography (CT) reconstructions have emerged. Recent studies have shown promising results by investigating the correlation between age and bone mineral density (BMD). However, there is currently a lack of data on post-mortem CTs (PMCT) involving decomposed bodies, and limited information exists regarding changes in Hounsfield Units measurement in a post-mortem context. In light of these gaps, our study aimed to examine the relationship between age at death and pubic and ilium BMD using a sample of forensic bodies. We also aimed to determine whether post-mortem processes, such as putrefaction, could interfere with this correlation. Our retrospective analysis encompassed 637 PMCTs conducted before medicolegal autopsies at Tours University Hospital. Utilizing simple and multiple linear regressions, we investigated the correlation between age and pubic and ilium BMD, as well as the relationship between BMD and the radiologic alteration index (RAI), a scale employed to quantify the degree of putrefaction. Our findings indicate promising outcomes in age-at-death estimation using pubic and/or ilium BMD for bodies exhibiting no or moderate decomposition (RAI < 80), particularly among individuals under 40years old. However, for highly decomposed corpses (RAI ≥ 80), the presence of gas infiltration significantly influences the BMD of both the ilium and pubis. Consequently, we advocate for the incorporation of the RAI score into the age estimation equation to enhance the accuracy of our results in such cases. Further investigation involving a larger cohort of decomposed bodies could facilitate refinement and validation of our method within this specific population.

The relationship between walking speed, step parameters, and margins of stability in individuals after stroke

BackgroundIndividuals after stroke walk with different step parameters and consequently with different margins of stability compared to able-bodied peers. These differences might be a side effect of lower preferred walking speeds or primary limitations in regulating step parameters and margins of stability after stroke. MethodsTwenty-eight individuals after stroke (separated into more impaired and less impaired based on speed) and fourteen able-bodied peers completed five walking trials on an instrumented treadmill at 70 %, 85 %, 100 %, 115 %, and 130 % of their preferred speed. Center of pressure data were used to calculate stride frequency, stride length, step width and margins of stability in mediolateral and anteroposterior direction. Generalized estimation equations were used to analyze the (interaction) effects of group, speed, and most versus least affected leg on these parameters. FindingsWhen controlled for speed, all individuals after stroke walked with higher stride frequencies (P < 0.001) and shorter stride lengths (P < 0.001) than able-bodied peers. Less impaired individuals walked with larger step widths than able-bodied peers (P < 0.001). The interaction effect of group and speed suggested that individuals after stroke showed higher increases in stride length with increasing speed than able-bodied peers. When controlled for speed, mediolateral margins of stability were larger in less impaired individuals compared to able-bodied peers, but otherwise, margins of stability did not differ between groups. Only minor differences between the most and least affected leg were observed. InterpretationDifferences in step parameters between individuals after stroke and able-bodied peers seem independent of walking speed and function to enhance gait stability.

Fracture Toughness Estimate of H-Section Steel for Offshore Structure

In this study, a novel estimating equation based on the WES2808 standard was proposed to predict fracture toughness through the transition temperature of Charpy impact toughness and CTOD (Crack Tip Opening Displacement) fracture toughness. This equation was specifically developed for 460MPa class H-section steel materials used in marine structures, including the base material (BM), heat-affected zone (HAZ), and weld metal (WM). The experimental results confirmed that the proposed estimation equation accurately predicted the fracture toughness across these different material regions. These findings demonstrate the reliability and applicability of the proposed equation in estimated fracture toughness for marine structure materials, thereby contributing to improved safety and performance in harsh environmental conditions.

Alveolar Bone Reconstruction Simultaneous to Implant Removal due to Advanced Peri-Implantitis Defects: A Proof of Concept.

To evaluate the safety and effectiveness of alveolar bone reconstruction simultaneous to implant removal due to peri-implantitis. Partial or fully dentulous patients subjected to implant removal due to advanced peri-implantitis (≥ 50% of bone loss) lesions and seeking to have the failed implant replaced for esthetic or functional reasons were consecutively included. Guided bone regeneration was performed by means of a mixture of xenograft and autogenous bone and a ribose cross-linked barrier membrane. Re-entry for implant placement was performed at 4-month follow-up. Overall, six radiographic variables were assessed before (T0) and after (T1) alveolar bone reconstruction at four levels in ridge width (RW) and height (RH). Peri-implant conditions were evaluated at latest follow-up. Simple and multiple binary logistic regression models were calculated using generalized estimation equations to evaluate the effect of baseline upon reconstructive outcomes. In total, 20 patients (nimplant = 39) met the inclusion criteria. Alveolar RW and RH were augmented from T0 to T1 at all levels. All implants achieved primary stability. Only ~13% were subjected to ancillary bone regeneration simultaneous to implant placement. After a mean follow-up period after loading of ~2.2 years, ~70% implants demonstrated peri-implant health, while mucositis was diagnosed in the remaining implants. The performance of alveolar bone reconstruction in residual partially contained defects simultaneous to implant removal due to peri-implantitis lesions demonstrates being safe and effective for implant site development.

Examining the link between age of alcohol initiation, adolescent alcohol use and adult substance use

Abstract Background Understanding the relationship between adolescent alcohol use and adult substance use is important for prevention programmes. Existing evidence presents divergent findings and potential mechanisms are debated. Methods We estimated associations between the age of alcohol initiation and alcohol use at age 17 and substance use at age 20 in a nationally representative cohort (n = 4554). Weighted logistic regression models were fitted using Generalised Estimating Equations in multiply imputed and complete case data. Results Our analysis identified that 27% of participants reported first alcohol use at ≤ 14 years old, with 37% engaging in risky alcohol use by age 17. At age 20, 14% reported hazardous alcohol use, while 38% used tobacco, 24% cannabis, and 28% other drugs. The age at which alcohol was initiated and risky alcohol use at 17 years old were both strongly associated with alcohol, tobacco, cannabis and other illicit drug use at 20 years old. Sequential change in effect estimates coupled with non-overlapping confidence intervals suggest a dose-response relationship between age of alcohol initiation and tobacco and other drug use at age 20. Conclusions First use of alcohol at 14 or younger was common. Earlier alcohol initiation and risky alcohol use are each associated with substantially elevated risk for substance use at 20 years old even after accounting for common liability factors. Acknowledgement: Growing Up in Ireland (GUI) is funded by the Department of Children, Equality, Disability, Integration and Youth (DCEDIY). It is managed by DCEDIY in association with the Central Statistics Office (CSO). Results in this report are based on analyses of data from Research Microdata Files provided by the CSO. Neither the CSO nor DCEDIY take any responsibility for the views expressed or the outputs generated from these analyses. Key messages • Delaying alcohol initiation and preventing risky alcohol use during adolescence may reduce levels of substance use in young adults. • Self-reported early use of alcohol remains common.

High physical activity relates to higher risk of incident carotid plaque components

Abstract Background The rupture of carotid atherosclerotic plaque, primarily driven by plaque components, is among the leading causes of ischemic stroke. Although physical activity (PA) stands as a major modifiable target for prevention of atherosclerotic diseases, recent studies suggested a potential adverse impact of high-volume PA on atherosclerotic plaque burden in athletes. Data remains scarce from the community-dwelling population regarding to the impact of PA on the longitudinal change of carotid plaque components. Objectives To assess the association between PA and the incidence of carotid plaque components and explore whether the association of PA with stroke and all-cause mortality differs by the presence of plaque components. Methods Between 2007 and 2012, in a community- dwelling cohort in Netherlands, 1327 stroke-free persons (mean ± standard deviation age 72 ± 9 years, 45% women) with carotid atherosclerosis (carotid intima-media thickness &amp;gt; 2.5 mm) were invited for magnetic resonance imaging (MRI) to assess carotid plaque components. From these, 696 persons (1267 carotid arteries) underwent a follow-up MRI between 2014 and 2017 (median between-scan interval 6 years). Carotid plaque components included calcification, intraplaque hemorrhage (IPH), and lipid-rich necrotic core (LRNC). The volume of moderate, vigorous and total PA (unit: metabolic equivalent task hour, MET-h) was assessed using LASA Physical Activity Questionnaires around the time of the first MRI scan. Participants were followed for the occurrence of stroke or all-cause mortality until December 31, 2019. Generalized estimation equation and Cox regression models were used in the analyses, with adjustments for plaque size and other cardiovascular risk factors. Results Compared to lowest quintile PA group, participants in the highest quintile total PA group had a higher risk of new onset of plaque components, odds ratio (95%CI) 2.69 (1.21; 5.94) for calcification, 1.35 (0.82; 2.24) for LRNC and 1.93 (1.12; 3.34) for IPH (Figure 1). Similar associations were observed for vigorous PA but not for moderate PA. Over a median follow-up of 9.5 years, 118 persons suffered a stroke and 298 died. As shown in table 1, baseline IPH, rather than LRNC or calcification, modulated the associations of PA with stroke and all-cause mortality (P-interaction &amp;lt;0.05): higher total PA was associated with a lower risk of stroke among IPH-free persons, with the hazard ratio (95% CI) of 0.929 (0.867; 0.996) per 10 MET-h/week increase; no associations between PA and stroke were found among those with IPH. Similar associations were found between vigorous PA and all-cause mortality. Conclusions Among the middle-aged and elderly with subclinical atherosclerosis, high level PA, especially high vigorous PA, may lead to an unstable carotid plaque. The beneficial effect of PA on stroke and all-cause mortality is only among persons with a stable carotid plaque profile, especially without IPH.

Association of park renovation with park use in New York City

Abstract Background Equity-driven citywide park redesign and renovation, such as the Community Parks Initiative (CPI), has the potential to increase park use and opportunities for physical activity in underserved communities. The objective of this study was to evaluate changes in patterns of park use following park redesign and renovation in low-income New York City (NYC) neighborhoods. Methods The Physical Activity and Redesigned Community Spaces study was a prospective quality improvement pre-post intervention study design with 33 intervention and 21 matched control neighborhood parks. Data were collected at baseline (prerenovation) and 2 follow-up points (3 months and 1-year post renovation) between 2016 to 2022 summers. Main outcomes encompassed park use and physical activity levels assessed using the well-validated System for Observing Play and Recreation in Communities. Park use was quantified by total number of park users, categorized by age group (≤20 years vs ≥ 21 years), sex, and physical activity level (sitting or standing vs walking or vigorous activity). Changes in outcomes between groups were compared via the generalized estimation equation. Results A total of 28,322 park users were observed across 1,458 scans. At baseline, 59.7% were 20 years or younger, 46.3% were female, and 43.8% were sitting or standing. Intervention parks showed more net park users compared with control parks from baseline to the final follow-up (difference-in-difference relative rate ratio, 1.69 [95% CI, 1.22-2.35] users/scan). The association was driven by a significant increase in adult users at intervention parks and an overall decrease in all users at control parks. Conclusions In this quality improvement study, park redesign and renovation were positively associated with park use in low-income neighborhoods. However, park renovations may need to be accompanied by other programmatic strategies to increase physical activity.

Examining factors associated with cocaine use in late adolescence and early adulthood

Abstract Background In 2022, cocaine was the leading problem drug for which individuals sought treatment in Ireland, overtaking opioids for the first time. Despite increasing concerns about cocaine, there is limited longitudinal research examining factors associated with cocaine use in the general youth population. We describe levels of use and associated factors at 17 and 20 years old Methods Past-year cocaine use was studied at age 17 (N = 5965) and 20 (N = 4679) in a nationally representative cohort. Individual, family, social and environmental exposure variables were selected a priori. Weighted logistic regression models were fitted using Generalised Estimating Equations to multiply imputed and complete case data. Results Cocaine use was reported by 220 (4%) at age 17, and 1072 (23%) at age 20. Both individual and community factors predict use. Earlier alcohol initiation and having friends who use cannabis were strongly associated with increased odds of cocaine use at both ages. Those with parents who reported that neighbourhood intoxication or drug-taking was common had elevated odds of cocaine use at age 17. Conclusions Past-year cocaine use at 20 years old in this cohort is substantially higher than other international cohort studies. Levels of cocaine use increase significantly between 17 and 20 years old. Acknowledgement: Growing Up in Ireland (GUI) is funded by the Department of Children, Equality, Disability, Integration and Youth (DCEDIY). It is managed by DCEDIY in association with the Central Statistics Office (CSO). Results in this report are based on analyses of data from Research Microdata Files provided by the CSO. Neither the CSO nor DCEDIY take any responsibility for the views expressed or the outputs generated from these analyses. Key messages • Our study underscores significant cocaine use rates and correlations with early substance initiation and neighbourhood factors. • This emphasizes the necessity of a comprehensive, multilevel strategy for preventing cocaine use.

The evolution of carotid atherosclerotic plaque composition: a prospective study

Abstract Background The rupture of carotid atherosclerotic plaque is one of the major causes of ischemic stroke, and largely determined by the composition of the plaque. To date, most studies on carotid plaque composition focused on individual plaque components, whilst the interplay between different components within the same plaque may be a critical driving force for plaque evolution and rupture. Objectives To determine the interplay between carotid plaque components over time and describe the dynamics of plaque composition with a specific focus on age- and sex-specific changes in a population-based setting. Methods From a population-based cohort in Netherlands, 802 participants (mean age ± SD 68 ± 8 years, 43% women) with subclinical carotid atherosclerosis underwent repeat magnetic resonance imaging (MRI) of carotid plaque (first scan between 2007 and 2012, second scan between 2014 to 2017). We evaluated carotid plaque composition, including calcification, lipid-rich necrotic core (LRNC) and intraplaque hemorrhage (IPH). To assess the relationship between the incidence of one specific component and baseline plaque composition, plaques with this specific component present at the baseline were excluded. Generalized estimation equation models were used with adjustments for baseline plaque size and cardiovascular risk factors. We demonstrated the evolution of plaque composition along age and by sex. Results Baseline presence of calcification in carotid plaque is independently associated with a higher incidence of IPH (adjusted odds ratio: 2.25; 95% confidence interval: 1.40 to 3.63). No associations were found between baseline plaque composition and the new onset of calcification or LRNC. The proportion of complex plaques with multiple components significantly increased at follow-up (Figure 1a). The plaque composition dramatically evolved over time and the proportion of plaques with two or more components started with 10% around 55 years and increased to over 50% after 70 years of age (Figure 1b). Although the age distribution was comparable between men and women, men were more likely to have and develop plaques with multiple vulnerable plaque components such as IPH (Figure 2). Conclusions A higher incidence of IPH was found in plaques with baseline calcification. The pre-existing plaque composition strongly determines how the plaque will evolve over time. Given the interplay between individual components, the overall plaque composition exhibits significant age- and sex- specific characteristics.

Discrete Choice Experiment on Financial Incentives for Engaging Young Adults in Vaping Cessation Programs

Introduction Contingency management involves rewarding individuals based on objective evidence of behavioral changes. This study explores preferences for financial incentives in vaping cessation programs. Methods A discrete choice experiment (DCE) was conducted among young adult current e-cigarette users aged 19-29. DCE attributes (and levels) included reward amount ($100, $300), reward schedule (consistent value, escalating value), reward procedure (gain-framed, loss-framed), vaping education modules (yes, no), text messaging support (yes, no), and cost ($30, $100). Participants were randomized into one of the four blocks, each containing four choice sets. Each choice set presented two hypothetical vaping cessation programs. Choice data (n × choice sets × alternative programs = 154 × 4 × 2 = 1,232 observations) were analyzed using generalized estimation equation models. Results Participants showed a preference for vaping cessation programs offering a higher reward amount (odds ratio [OR] = 11.5; 95% CI,7.0-19.2), gain-framed rewards for sustained abstinence (OR = 1.4; 95% CI,1.0-1.8), text messaging support (OR = 1.9; 95% CI,1.4-2.5), and a lower program cost (OR = 2.6; 95% CI,1.8-3.8). Interaction tests showed significant effects of the rewards procedure among daily e-cigarette users (adjusted OR [AOR] = 2.1; 95% CI,1.3-3.5), but not some-day users; and among those with no quit attempts in the past six months (AOR = 2.7; 95% CI,1.5-4.7), but not those with previous quit attempts. Female participants preferred text messaging support (AOR = 3.6; 95% CI,2.3-5.4), whereas male participants did not show this preference. Conclusion A multifaceted vaping cessation intervention augmented with financial incentives might improve participation and engagement among young adults. Future studies should investigate how these attributes can enhance program reach and vaping abstinence outcomes in real-world settings.

Influences of tea consumption on self-rated health and life satisfaction among older adults: Evidence from the CLHLS.

The benefits of tea consumption as a special diet for health and life satisfaction have attracted considerable attention; however, it is not clear whether the effect of tea consumption on self-rated health (SRH) and self-rated life satisfaction (SRL) is equal among all types of tea, and it is unclear whether these associations are impacted by gender and age in older adults. This study aimed to examine the associations between tea consumption, SRH and SRL in older adults and to explore the role of gender and age. Participants aged 65-105 (N = 78,345) were interviewed in the years 2002, 2005, 2008, 2011, 2014 and 2018 in the Chinese Longitudinal Healthy Longevity Study (CLHLS). Generalized estimation equations (GEE) with the identity link function were adopted to estimate the cross-sectional associations of tea consumption with SRH and SRL. GEE with the logic link function were used to explore the longitudinal associations of tea consumption with SRH decline and SRL decline. Drinking tea at present, especially scented tea, was significantly associated with better SRH and SRL for older adults. Male participants benefited more from tea consumption than females, and the protective effect of green tea consumption on improving SRH and SRL in males was evident. Older adults aged 90-105 with current tea consumption daily had better SRH and reduced risk of SRL decline.