Extreme Age Research Articles

The Utilization of Lumbar MRI for Lower Back Pain at National Guard Hospital, Jeddah: A Retrospective Cohort Study.

IntroductionMagnetic reasoning imaging (MRI) is the imaging modality of choice for detecting spinal pathologies. The study of the appropriateness of MRI utilization in Saudi Arabia is lacking. As a result, this research aims to assess the use and misuse of lumbar MRI in lower back pain (LBP) at the National Guard Hospital (NGH) in Jeddah city.MethodsThis is a retrospective cohort study that included all adult patients who had lumbar MRI for LBP at NGH in 2019. A total of 1,225 patients were included. Patients with extreme ages, trauma, recent lumbar spine surgery, spine or spinal canal tumors, and infection were excluded, leaving a number of 805 patients. Specific MRI findings were obtained and assessed in association with history and physical examination.ResultsLBP with radiculopathy was the most common complaint (82.9%) followed by LBP without radiculopathy (12.8%), with the lowest being limb pain alone (2.6%). Overall, 72% of patients had negative MRI findings, which did not explain their symptoms, and 28% had positive MRI findings that were not associated with their symptoms (p < 0.001). A complete physical examination was performed on 27.5% of patients, of which only 12% had positive findings. MRI was ordered for 72.5% of patients without a complete physical examination. Finally, 88.2% of patients who had MRI were managed conservatively, while only 6.7% were managed with surgery (p < 0.04).ConclusionThe number of patients who had proper assessment prior to the ordering of MRI was significantly low. The decision to request MRI was not based on any scientific basis. This study has demonstrated that without proper and strict guidelines, MRIs will continue to be overutilized, which, in turn, will have negative consequences on the waiting time for an MRI and the cost of all the unnecessary MRIs. Furthermore, a good number of patients nowadays who do not have any indications for an MRI keep asking their physicians for it, and if the physician refuses, they transfer to another physician who will order the MRI.

A Cross-sectional Comparative Study to Observe the Obstetric Complication Associated with Extreme (&lt;18 - &gt;35) Maternal Age

Aim: To assess the frequency and association of obstetric complications in extreme of maternal ages.&#x0D; Methods: A cross-sectional comparative study was conducted at a tertiary care hospital of district Nawabshah, Sindh and Suleman Roshan Medical College during the period April 2019- May 2020. The data regarding adverse obstetric outcomes of all teenage (&lt;18 years) compared with the reference group of (19-22 years) and women of (&gt;35 years) were compared with reference (31-34 years of age) delivering at the facility. The frequencies, percentages were derived as part of descriptive statistics, chi-square was used for parametric testing with 0.05 level of significance and odds ratio were applied to compare the risk of extreme age groups with their respective reference groups.&#x0D; Results: A total of 104 participants were recruited in this study among 16.3% accounted for teenage (&lt;18 years) and 34.6% accounted for advanced maternal age (&gt; 35 years). Multivariate association between maternal age groups and the adverse obstetric variables were taken into account. Elevated rates for all adverse obstetric outcomes were observed between the variables among extreme-age mothers compared to reference group. The differences were statistically significant with p-value of 0.001 respectively. The chi-square test was found to be insignificant for other factors such as socio demographics, obstetric history and mode of delivery. Odds ratio was calculated to measure the risk associated with extreme age. Those women who were &lt;18 years of age attributed 3.2 odds of developing fetal complications and 3.9 odds of developing maternal complication whereas women &gt;35 years of age attributed 3.7 odds of developing fetal and odds 10.7 developing maternal complications.&#x0D; Conclusion: Women in extreme age group were at a higher risk for developing adverse fetal and maternal obstetric complications as compared to their reference group.

Epidemiology of Kawasaki Disease in children in Switzerland: a national prospective cohort study.

Kawasaki disease is a febrile illness which can lead to significant coronary artery lesions. Its incidence varies among countries and is highest in Japan (330.2 children under 5 years old/100,000 per year). Since the epidemiology of Kawasaki disease in Switzerland is unknown, we conducted a national prospective data collection between 2013 and 2017 to describe its incidence, diagnosis, and treatment. We collected demographic and clinical data of the children under 17 years old hospitalised with Kawasaki disease in Switzerland between March 2013 and February 2017 using anonymous data collection forms with the help of the Swiss Paediatric Surveillance Unit (SPSU). We defined Kawasaki disease per the 2004 American Heart Association criteria: patients with ≥5 days of fever and ≥4 of the 5 main clinical features were included as complete Kawasaki disease and patients with ≥5 days of fever and <4 of the 5 main clinical features were included as incomplete Kawasaki disease. The incidence was calculated with the data of the Federal Statistical Office of Switzerland, considering permanent residents of the country. The different groups were compared by the unpaired student t-test for continuous variables and Pearson's chi squared test for categorical variables, respectively. We included 175 patients: 60% were boys, with a mean age of 38.2 months. The incidence of Kawasaki disease was 3.1/100,000 [95% CI 2.6-3.7] per year in children under 17 years of age and 8.4/100,000 [95% CI 6.7-10.2] per year in children under 5 years of age. The most frequent clinical signs were a rash (85.4%) and changes of the lips and oral/pharyngeal mucosa (83.4%). The diagnosis of Kawasaki disease was made at a mean of 7.3 days after the first symptom. Echocardiography was abnormal in 52.3%. The treatment with intravenous immunoglobulins (IVIG) and acetylsalicylic acid was administered in accordance with international guidelines. Subgroup analysis showed that children older than 5 years old had significantly more complete Kawasaki disease than the younger ones (78.8% vs 57.4%, p = 0.021). Children with "extreme ages" (<1 year old and >8 years old) were diagnosed later (8.6 (±0.9) vs 7.0 (±0.3) days, p = 0.0129), had longer duration of fever (9.8 (±0.9) vs 8.1 (±0.3) days, p = 0.013) and had more echocardiographic abnormalities (n = 26 (70.3%) vs n = 65 (47.5%), p = 0.014) at diagnosis. One child died during the acute phase of the illness. The incidence of Kawasaki disease in Switzerland is in the lower range of other European countries.

Skeletal Muscle LINE‐1 Gene Regulation and Inflammatory Response to Chronic, Voluntary Endurance Training in Rodents

ObjectiveWe sought to determine the effects of chronic, voluntary wheel running on Long Interspersed Nuclear Element‐1 (LINE‐1) mRNA expression and promoter methylation, as well as markers of the cGAS‐STING inflammatory pathway, in skeletal muscle.HypothesesLINE‐1 mRNA expression will increase with age, and exercise will mitigate this increase. This difference in expression will be driven through changes in promoter methylation. The cGAS‐STING inflammatory pathway will be upregulated with age and downregulated with rats that exercise‐trained.MethodsPlantaris and soleus skeletal muscles were collected from female Lewis rats that belonged to one of three groups: a young control group (CTL; n=10; 6 mos old), an aged sedentary group (SED; n=12; 15 mos old), and an aged exercise group with access to a running wheel for 9 months (EX; n=12; 15 mos old). RNA, DNA, and protein were isolated from the tissues for analysis. Analysis included RT‐qPCR for LINE‐1 mRNA expression, methylated DNA Immunoprecipitation (MeDIP) to assess the methylation status of the LINE‐1 promoter via RT‐qPCR, and Western blotting for markers of the cGAS‐STING pathway and 4Hydroxynonenal (4HNE). Two primer sets were used for RT‐qPCR: L1‐3 probed for the most active form of LINE‐1 and L1‐Tot probed for all full‐length LINE‐1 elements.ResultsThere was no significant difference in plantaris LINE‐1 mRNA expression or for L1‐3 or L1‐Tot. Plantaris LINE‐1 promoter methylation was undetectable in most samples, so the results are not presented herein. Soleus L1‐3 mRNA was significantly higher in EX compared to CTL (p=0.036) and there was a trend between SED and EX (p=0.053). L1‐Tot also was trending (p=0.059), where EX was higher than CTL (p=0.025). Methylation of the LINE‐1 promoter was significantly different for both L1‐3 and L1‐Tot (p=0.021 and p=0.028, respectively). In both instances, LINE‐1 DNA in SED and EX were significantly more methylated compared to CTL. There were no differences in cGAS protein expression, p‐/pan STING protein expression, or 4HNE expression.ConclusionsContrary to the original hypothesis, LINE‐1 mRNA expression and DNA methylation were higher in the exercise group. Additionally, chronic exercise did not affect the cGAS‐STING inflammatory pathway, highlighting this pathway may be more relevant in extreme age and disease states. Previous skeletal muscle research has focused on using mixed muscle types to look at LINE‐1 expression and regulation, so the differences seen between type I (soleus) and type II (plantaris) fibers is a novel finding that warrants further investigation to understand the underlying mechanisms.

회전익 항공기 전력화에 관한 도입 방식 비교분석 연구

This study compared and analyzed the reality and problems of the rapid change in technology cliché amid the rapid change in the security environment and the 4th industrial revolution, resulting in the extreme aging of rotary wing aircraft operated by our military and discontinuation of repairs. To this end, we will examine the future battlefield environment and aviation operation based on the characteristics of the aviation industry, and suggest ways to develop rotorcraft in preparation for the future battlefield environment through overseas technology development and aviation industry growth. In addition, it can be considered reasonable to promote overseas introduction in case of urgency, such as domestic production and introduction based on the domestic development and production process, in the long term, and concerns over a power vacuum in the short term.

Structural and Functional Trajectories of Middle Temporal Gyrus Sub-Regions During Life Span: A Potential Biomarker of Brain Development and Aging.

Although previous studies identified a similar topography pattern of structural and functional delineations in human middle temporal gyrus (MTG) using healthy adults, trajectories of MTG sub-regions across lifespan remain largely unknown. Herein, we examined gray matter volume (GMV) and resting-state functional connectivity (RSFC) using datasets from the Nathan Kline Institute (NKI), and aimed to (1) investigate structural and functional trajectories of MTG sub-regions across the lifespan; and (2) assess whether these features can be used as biomarkers to predict individual’s chronological age. As a result, GMV of all MTG sub-regions followed U-shaped trajectories with extreme age around the sixth decade. The RSFC between MTG sub-regions and many cortical brain regions showed inversed U-shaped trajectories, whereas RSFC between MTG sub-regions and sub-cortical regions/cerebellum showed U-shaped way, with extreme age about 20 years earlier than those of GMV. Moreover, GMV and RSFC of MTG sub-regions could be served as useful features to predict individual age with high estimation accuracy. Together, these results not only provided novel insights into the dynamic process of structural and functional roles of MTG sub-regions across the lifespan, but also served as useful biomarkers to age prediction.

Preventing sour gas kicks during workover of natural gas wells from deep carbonate reservoirs with anti‐hydrogen sulfide fuzzy‐ball kill fluid

AbstractWorkover of natural gas wells in deep carbonate gas reservoirs (DCRs) is facing multiple challenges such as fluid leakage, high temperature, and hydrogen sulfide (H2S) gas kick. Hence, well‐killing fluids with satisfactory plugging ability, high‐temperature tolerance, and anti‐H2S ability are necessary. In this study, we developed a multifunctional anti‐hydrogen sulfide fuzzy‐ball kill fluid (AFKF) for preventing sour gas kicks in DCRs. The performance of the AFKF was optimized and analyzed via experiments and verified through a case study application. The results showed that the fuzzy‐ball structures in the AFKFs demonstrated good stability under extreme H2S aging. The rate of change of certain critical rheological parameters such as apparent viscosity, dynamic plastic ratio, and density of AFKFs before and after hot rolling were no more than 5%. After plugging the fractures with the AFKFs at temperatures between 110°C and 150°C, the inlet driving pressure of the fractures increased from 20.73°C to 21.07 MPa, and no fluid loss was observed at the core outlet after a secondary displacement of formation water. The permeability recovery rate was greater than 90%. Application of AFKF in well DW‐2 showed that the shut‐in pressure rose to 24.6 MPa with no trace of H2S gas at the wellhead after 4 days. The investigation of the H2S mitigation mechanisms revealed that the plugging of the seepage channels by AFKFs forms interconnected bonds that improve the mechanical properties of the reservoir. Additionally, AFKFs absorb H2S gases by protonation and dissociation reactions which convert the hazardous gas into an aqueous solution of sulfide ions (S2−). The proposed AFKF has proven to be effective means of mitigating H2S in DCRs, and minimize the negative impacts of environmental polution, health risks, and equipment corrosion.

Metagenomic and metabolomic remodeling in nonagenarians and centenarians and its association with genetic and socioeconomic factors.

A better understanding of the biological and environmental variables that contribute to exceptional longevity has the potential to inform the treatment of geriatric diseases and help achieve healthy aging. Here, we compared the gut microbiome and blood metabolome of extremely long-lived individuals (94-105 years old) to that of their children (50-79 years old) in 116 Han Chinese families. We found extensive metagenomic and metabolomic remodeling in advanced age and observed a generational divergence in the correlations with socioeconomic factors. An analysis of quantitative trait loci revealed that genetic associations with metagenomic and metabolomic features were largely generation-specific, but we also found 131 plasma metabolic quantitative trait loci associations that were cross-generational with the genetic variants concentrated in six loci. These included associations between FADS1/2 and arachidonate, PTPA and succinylcarnitine and FLVCR1 and choline. Our characterization of the extensive metagenomic and metabolomic remodeling that occurs in people reaching extreme ages may offer new targets for aging-related interventions.

One Challenge Disguised as Two? New Scholarship on the Economic and Social Effects of Border Changes and Modernisation in Twentieth-Century Poland

Few European countries have gone through as much as Poland during the twentieth century. Even among the countries of Central and Eastern Europe, which during the ‘Age of Extremes’ experienced the substantial losses and movement of tens of millions of people, Poland's history is somewhat unique, as most of these expulsions affected the Polish border regions. Although not the only culprit, one can make a strong case that the border changes were a primary factor, having – for better or worse – a strong effect on the economy, the society and the general development of Poland. Poland has, nevertheless, been economically successful since the 1990s. It is thus with good reason that two questions have played a major role in the historiography of economic and social trends in twentieth-century Poland. The first one was whether the ‘border changes’ were a burden, or if Poland was able to profit from them. The second question asks whether Poland was able to modernise because of them. At the same time, few authors recognised that both issues are closely intertwined. Emphasising their interconnection is the main purpose of this review.

Cell Type Diversity Statistic: An Entropy-Based Metric to Compare Overall Cell Type Composition Across Samples.

Changes of cell type composition across samples can carry biological significance and provide insight into disease and other conditions. Single cell transcriptomics has made it possible to study cell type composition at a fine resolution. Most single cell studies investigate compositional changes between samples for each cell type independently, not accounting for the fixed number of cells per sample in sequencing data. Here, we provide a metric of the distribution of cell type proportions in a sample that can be used to compare the overall distribution of cell types across multiple samples and biological conditions. This is the first method to measure overall cell type composition at the single cell level. We use the method to assess compositional changes in peripheral blood mononuclear cells (PBMCs) related to aging and extreme old age using multiple single cell datasets from individuals of four age groups across the human lifespan.

Cardiac Disease Increased Risk of Death and Early Comorbidities Impacting Prognosis of Lung Transplant Recipients with Extreme Ages

<h3>Purpose</h3> Current organ allocation rules prioritized aged patients on the lung transplantation waiting list. Optimizing decision-making algorithms to evaluate candidates, transplant and minimize morbidity, has become the goal of lung transplant programs worldwide. <h3>Methods</h3> This was a retrospective cohort study recruiting patients who underwent lung transplantation, between January 2016 and October 2020, at Wuxi Lung Transplant Center. <b>The transplanted organs were obtained from volunteer donations, and the next of kin voluntarily provided written informed consent. No lungs were obtained from executed prisoners.</b> <h3>Results</h3> Among the entire study cohort of 166 lung transplant recipients aged ≥65 years, subgroups of aged 65-70 years (111 recipients, Group 65-70) and ≥70 years (55 recipients, Group≥70) were included. Group D restrictive lung disease was the main indication of recipients ≥65 years, followed. We found significantly higher percentage of coronary artery stenosis (mid-to severe) in the Group≥70 (30.9% vs. 14.4%). Further, we found valve structural abnormality in both groups, ranging from 8.1% to 16.4%, including medium to severe valve stenosis or regurgitation. ECMO bridging to LT was performed in 5.4% (Group 65-70) and 7.3% (Group≥70). The average cold ischemic time was 434.6 minutes in Group 65-70 and 395.9 minutes in Group≥70, over 6.5 hours. We did more single left lateral lung transplantation in Group≥70 patients mainly consisted of pulmonary fibrosis. Significantly higher occurrence rate of acute rejection, cardiac arrhythmia, pleural effusion were observed in Group≥70. Subjects with cardiac abnormality had significantly increased risk of mortality compared to those without cardiac abnormality (Figure 1). <h3>Conclusion</h3> Our experience from the largest aged lung transplant recipients cohort in eastern population, supported that lung transplantation can be performed in candidates with advanced chronological age and provided life-extending benefits.

Extreme Age of Information for Wireless-Powered Communication Systems

The extreme or maximum age of information (AoI) is analytically studied for wireless communication systems. In particular, a wireless powered single-antenna source node and a receiver (connected to the power grid) equipped with multiple antennas are considered when operated under independent Rayleigh-faded channels. Via the extreme value theory and its corresponding statistical features, we demonstrate that the extreme AoI converges to the Gumbel distribution whereas its corresponding parameters are obtained in straightforward closed-form expressions. Capitalizing on this result, the risk of the extreme AoI realization is analytically evaluated according to some relevant performance metrics, while some useful engineering insights are manifested.

Is Age a Limitation for Organ Donation? A Comparison of Elderly and Non-elderly Donors in a Deceased Donor Organ Transplantation Program from South India.

To bridge the gap between demand and supply of organs, deceased donors with extreme ages can be utilized. The object of this study was to compare elderly with non-elderly donors and to assess the predictors of organ utilization or wastage. This was a retrospective chart analysis. Univariate and multivariate logistic regression analysis of cohorts was carried out to predict organ utilization or wastage. Of the 716 deceased donors, 16.2% were elderly (≥60 years) and 83.8% were not elderly (≤59 years). Donors in the elderly cohort were more likely to be diabetic, hypertensive, overweight, and smokers compared with non-elderly donors. They had deranged terminal creatinine and succumbed to cerebrovascular accident or intracerebral hemorrhage. They had a high kidney donor risk index (KDRI) of 1.83 ± 0.46. Those in the younger donor cohort, were more likely to have succumbed to road traffic accident-associated traumatic brain injury, were subjected to more efforts to revive them in the intensive care unit via cardiopulmonary resuscitation, had deranged liver function tests, and had a KDRI of 0.93 ± 0.28. The kidney discard rate (KDR) and liver discard rate (LDR) in the elderly donors was 50% and 8.6%, respectively (vis-a-vis the non-elderly at 13.3 % and 7.5%). The KDR was significantly higher than the LDR in elderly donors. The main reason for this was the high number of "marginal kidneys". We revealed that elderly donors formed a significant proportion of deceased donors. The utilization of the liver from deceased donors was more frequent compared with the kidney.

Oh to Be Young at Heart - Patterns and Implications of Extreme Age Mismatch in Heart Transplantation

<h3>Purpose</h3> While donor recipient age mismatch is common in heart transplantation, the distribution patterns and implications of extreme age mismatch are not well described. We also explored differences in age mismatch related to 2018 changes in adult criteria. <h3>Methods</h3> UNOS data from 1/1/2000 - 9/4/2020 was analyzed. Recipient and donor characteristics and fixed term graft survival were recorded. Ages (years) were categorized - Group 1 = 0-9, 2 = 10-17, 3 = 18-29, 4 = 30-49, 5 = 50-59, 6 = 60+. Groups 5/6 were deemed "older adults". Two sample Z test of proportions was used to compare graft survivals for selected cohorts. Chi-square was used to compare gender data. <h3>Results</h3> 15.4% of hearts accepted by pediatric recipients are from adult donors; 6.7% of hearts accepted by adult recipients are from pediatric (ped) donors. Ped recipients accept 2.8% of adult organs; adult recipients account for 31.2% of accepted ped donors. There is no difference in allocation of ped donors to adult recipients before/after 2018 adult status changes (p=0.42). <i>Extreme age mismatch:</i> 98% of listings for older adults include ped donors in age criteria; ped donors account for 5.8% of accepted donors for this group. Older adults taking ped hearts are more likely to be female (+10%, p=0.0001) and are more likely to accept male donors (+6.5%, p=0.0001). These recipients taking ped hearts are of lower listing status than their counterparts that accept adult hearts. There is no difference in 1 yr or 10 yr graft survival for ped donors with ped recipients vs older adult recipients (1 yr: 89.6% vs 91.2%, p=0.16, 10 yr: 58.2% vs 57.4%, p = 0.65). Older adults have better survival with ped donors vs adult, 57.4% vs 53.4%, p = 0.01. Extreme age mismatch accounts for 3.3% of heart transplants. <h3>Conclusion</h3> Older adults taking ped hearts are more likely to be female than those taking adult hearts and tend to accept a higher proportion of male donors. There is no significant difference in 1 or 10 yr graft survival for ped hearts that go to ped recipients compared to older adult recipients.

Early Salivary miRNA Expression in Extreme Low Gestational Age Newborns.

Background: MicroRNAs (miRNA) are small non-coding RNAs that regulate gene expression playing a key role in organogenesis. MiRNAs are studied in tracheal aspirates (TA) of preterm infants. However; this is difficult to obtain in infants who are not intubated. This study examines early salivary miRNA expression as non-invasive early biomarkers in extremely low gestational age newborns (ELGANs). Methods: Saliva was collected using DNA-genotek swabs, miRNAs were analyzed using RNA seq and RT PCR arrays. Salivary miRNA expression was compared to TA using RNA seq at 3 days of age, and longitudinal changes at 28 days of age were analyzed using RT PCR arrays in ELGANs. Results: Approximately 822 ng of RNA was extracted from saliva of 7 ELGANs; Of the 757 miRNAs isolated, 161 miRNAs had significant correlation in saliva and TA at 3 days of age (r = 0.97). Longitudinal miRNA analysis showed 29 miRNAs downregulated and 394 miRNAs upregulated at 28 days compared to 3 days of age (adjusted p < 0.1). Bioinformatic analysis (Ingenuity Pathway Analysis) of differentially expressed miRNAs identified organismal injury and abnormalities and cellular development as the top physiological system development and cellular function. Conclusion: Salivary miRNA expression are source for early biomarkers of underlying pathophysiology in ELGANs.

Outcomes of Transcatheter Aortic Valve Implantation in Nonagenarians Compared to Younger than 90 Year Old Patients

BackgroundGiven that life expectancy has improved, nonagenarians have become a significant proportion of world population. As aortic stenosis is primarily a disease of the elderly, the need for invasive cardiac approaches is expected to increase in people of extreme age. Herein, we compare the in-hospital adverse clinical outcomes and mortality after transcatheter aortic valve implantation (TAVI) procedures in nonagenarians to younger than 90 year old patients. MethodsA retrospective study was conducted on 1336 patients who underwent TAVI between January 2016 and March 2020 at Toulouse University Hospital, Rangueil, France. Post-TAVI adverse clinical outcomes were defined according to Valve Academic Research Consortium-2 Criteria. The studied population was divided into 2 groups according to age. ResultsOut of 1336 patients, 250 (18.7%) were nonagenarians with a mean age of 91.8 ± 1.9 years. Pacemaker implantation (12.4% vs 12.1%), stroke (2% vs 1.8%), and major vascular complications (9.2% vs 6.7%) were more common in nonagenarians, whereas acute kidney injury (1.2% vs 2.7%) and major bleeding events (3.2% vs 3.4%) were more common in the <90-year-old group. Nonagenarians are more likely to develop major vascular complications (odds ratio [OR] = 1.76 95% confidence interval [CI] 1.04-3, P = .03). The prevalence of in-hospital mortality in nonagenarians and <90-year-old patients were 5.2% and 2%, respectively. Survival analysis showed a significant difference in mortality during hospitalization period only ( P = .04). ConclusionThe prevalence of TAVI procedural success is remarkably high in nonagenarians and comparable to that of younger patients. However, the in-hospital mortality rate was 2-fold more than that of <90-year-old patients.

Association between ambient temperature and age-specific mortality from the elderly: Epidemiological evidence from the Chinese prefecture with most serious aging

Older people are main susceptible group affected by non-optimal temperature. The aim of the study was to determine how mortality of older people with different ages are affected by temperatures. For this study, we collected data of all-cause death of 256,037 people aged between 65 and 104 years of age from a prefecture located in the north subtropical area with most serious aging rate in 2000, 2010 and 2020 in China. A distributed lag nonlinear model under different age groups was used to estimate non-optimal temperature associations to mortality. The results revealed: (1) With increasing age, older people were more likely to die during moderate low temperature, the proportion of attributable fraction of moderate low temperature in all temperature gradually increased with age. (2) Moderate low temperature could be divided into two parts, the lower part caused most death at age 65–79 and the higher part was not so dangerous, while for age 80+, preventive actions should be taken for both parts. (3) A leveling-off and deceleration phenomenon was observed at age 95–99 for low temperature, but not 100–104, it may be virtually a consequence of “harvesting effect” in that susceptible and common people have died before age 95, it was coincidence with mortality deceleration at extreme old ages found by demographic scholars over the past 200 years. (4) Heat wave had much higher relative risk than cold spell compared with moderate high and low temperature because of steeper slope of relative risk at the period of moderate-extreme conversion of high temperature, the older people should pay more attention to weather with moderate-extreme conversion of high temperature. Furthermore, our findings could help improve the understanding of non-optimal temperature on health of older people and support the development of response strategies for different seasons at different ages.

Faktor-Faktor yang Berhubungan dengan Kejadian Preeklamsia pada Ibu Hamil di Rumah Sakit Muhammadiyah Palembang Tahun 2021

In Indonesia, the MMR is still relatively high. In general, the main causes of death are complications of pregnancy/delivery, namely bleeding 42%, eclampsia/preeclampsia 13%, abortion 11%, infection 10%, prolonged labor/labor stuck 9% and other causes 15%. Preeclampsia is still a problem that threatens pregnancy, especially in developing countries. Risk factors that can increase cases of preeclampsia include parity, extreme age and disease history. The purpose of this study was to determine the factors that influence the incidence of preeclampsia in pregnant women at Muhammadiyah Hospital Palembang in 2021. Design Quantitative research using an analytical survey method with a cross sectional approach. The population in this study were all pregnant women who had their pregnancy checked at Muhammadiyah Hospital Palembang in 2021 from January-May a total of 718 mothers with a sample of 88 mothers who were randomly selected by random sampling. Data analysis used univariate and bivariate analysis. The results showed that there was a relationship between maternal age (Pvalue = 0.035), parity (Pvalue = 0.035) and gestational age (Pvalue = 0.004) with the incidence of preeclampsia in pregnant women at Muhammadiyah Hospital Plembang in 2021. In conclusion, there was a significant relationship between maternal age, parity, and gestational age with the incidence of preeclampsia at the Palembang Muhammadiyah Hospital in 2021. It is hoped that the results of this study can be an illustration for health care providers to improve health quality, especially dealing with the incidence of preeclampsia.

Research on the prediction of longevity from both individual and family perspectives.

Increasing human longevity is of global interest. The present study explored the prediction of longevity from both individual perspective and family perspective based on demographic and psychosocial factors. A total of 186 longevous family members and 237 ordinary elderly family members participated in a cross-sectional study, and a sample of 62 longevous elderly and 57 ordinary elderly were selected for comparative research. The results showed that it was three times more female than male in longevous elderly group. Up to 71.2% of longevous elderly had no experience in education, which was significantly lower than that of ordinary elderly. Due to such extreme age, more widowed (81.4%) elderly than those in married (18.6%). Less than one-seventh of the longevous elderly maintained the habit of smoking, and about one-third of them liked drinking, both were significantly lower than that of ordinary elderly. In terms of psychosocial factors, longevous elderly showed lower neuroticism and social support, while higher extraversion, compared with the ordinary elderly. However, there were no significant differences between the two family groups in demographic and psychosocial variables, except longevous families showing lower scores in neuroticism. Regression analysis found that neuroticism, social support and smoking habit had significant impact on individuals’ life span, then, neuroticism and psychoticism were the key factor to predict families’ longevity. We conclude that good emotional management, benign interpersonal support, and moderation of habits are important factors for individual longevity, and the intergenerational influence of personality is closely related to family longevity.

Frailty in Very Elderly Patients is Not Associated with Adverse Surgical or Oncological Outcomes in Extremity Surgery for Soft Tissue Sarcoma.

BackgroundWhile surgery remains the mainstay of treatment for limb sarcoma, extreme old age is a relative contraindication to oncological surgery.MethodsPatients >80 years referred with primary extremity soft-tissue sarcoma (ESTS) between 2007 and 2016 were retrospectively reviewed. Prognostic variables, including ASA status and Clinical Frailty Scores, were collected. Endpoints were perioperative morbidity, locoregional (LRR) and distant recurrence (DR), disease-specific survival (DSS) adjusted using competing risk modelling, and overall survival (OS).ResultsA total of 141 primary tumours were identified, with 116 undergoing resections. Main motives for nonoperative management were severe frailty or significant comorbidity (56.0%). The operative group had a median age of 84 (range 80-96) years and median follow-up of 16 months (range 0-95). 45.7% of patients received radiotherapy. Median hospital stay was 7 (range 0-40) days, with frailty (p = 0.25) and ASA (p = 0.28) not associated with prolonged admission. 12.9% developed significant complications, with one perioperative mortality.24.1% had LRR, occurring at a median of 14.5 months. All patients with reported DR (28.4%), except one, died of their disease. Frailty did not confer a significant difference in adjusted LRFS (p = 0.95) and DMFS (p = 0.84). One- and 5-year adjusted DSS and OS was 87.0% versus 74.9% and 62.3% versus 27.4%, respectively. Frailty (CFS ≥4) was associated with worse OS (hazard ratio [HR] 2.49; 95% confidence interval [CI] 1.51-4.12; p < 0.001), however not with adjusted DSS (p = 0.16). Nonoperative management conferred a 1- and 5-year adjusted DSS was 58.3% and 44.4%, respectively.ConclusionsExtremity surgery for sarcoma is well tolerated in the frail very elderly population with low morbidity and comparable oncological outcomes.