Functional Relationship Research Articles

New Results of Differential Subordination for a Specific Subclass of p-Valent Meromorphic Functions Involving a New Operator

The present article aims to significantly improve geometric function theory by making an important contribution to p-valent meromorphic and analytic functions. It focuses on subordination, which describes the relationships of analytic functions. In order to achieve this, we utilize a technique that is based on the properties of differential subordination. This approach, which is one of the most recent developments in this field, may obtain a number of conclusions about differential subordination for p-valent meromorphic functions described by the new operator IHp,q,s j,pν1,n,α,lJ(ζ) within the porous unit disk Δ. Numerous mathematical and practical issues involving orthogonal polynomials, such as system identification, signal processing, fluid dynamics, antenna technology, and approximation theory, can benefit from the results presented in this article. The knowledge and comprehension of the unit’s analytical functions and its interacting higher relations are also greatly expanded by this text.

The hypothalamic-pituitary-thyroid axis, depression and risk of suicide: commentary, Luo et al.

There is a considerable literature on the relationship of thyroid function with risk of depression and responsiveness to depression treatment. This literature is briefly reviewed here, followed by a focus on the incremental advance provided by the findings of Luo et al on autoimmune thyroiditis and suicide attempts.

PF-MAAC: A learning-based method for probabilistic optimization in time-constrained non-adversarial moving target search

This paper investigates the multi-robot efficient search (MuRES) problem with a focus on maximizing the probability of capturing a moving target within a predefined time constraint. Given the complexity of the MuRES problem, traditional optimization algorithms often result in significant computational overhead. As a result, learning-assisted intelligent optimization, particularly reinforcement learning (RL), has emerged as a prominent research trend, providing more efficient and adaptive solutions. However, the non-additive nature of the objective to maximize capture probability complicates the direct application of canonical RL-based algorithms. To address the challenge, we propose the probabilistically factorized multi-agent actor-critic (PF-MAAC) algorithm, which serves as a lightweight solution aligned with probability theory specifically designed to handle the complexities of the maximal capture probability objective. PF-MAAC is composed of (1) a generalized temporal difference (GTD) module to establish the temporal-difference relationship of the central value function, (2) a probability-based factorization (P-FAC) module to decompose the central value function into individual ones in a probability-compliant manner, and (3) an extended policy gradient (EPG) module which updates each robot’s actor-network based on the decomposed individual value function. Comparative simulations across various MuRES test environments demonstrate that PF-MAAC outperforms state-of-the-art methods. Furthermore, we successfully deployed PF-MAAC in a real multi-robot system for moving target search in a self-constructed indoor environment, achieving the satisfactory results for different time constraints.

Early-Life Parental Affection, Social Relationships in Adulthood, and Later-Life Cognitive Function.

Although research has demonstrated the long-term health consequences of childhood adversities, less is known about the long-term impact of positive childhood experiences, such as parental affection. Using longitudinal data (1995-2014) from the Midlife in the United States (MIDUS) study, we analyze structural equation models estimating direct and indirect pathways from early-life parental affection to changes in later-life cognitive function through relationship quality in adulthood among Black and White older adults (N = 1983). Analyses revealed significant indirect effects of parental affection on better cognitive function through higher levels of social support (both average social support and family social support) in adulthood in the full sample and among Black respondents. Indirect pathways through relationship strain and through friend support were not significant. This work elevates the importance of promoting positive parental relationships during childhood, with implications for better social relationships in adulthood and cognitive function in later life.

Understanding Occlusion and Temporomandibular Joint Function Using Deep Learning and Predictive Modeling.

Advancements in artificial intelligence (AI)-driven predictive modeling in dentistry are outpacing the clinical translation of research findings. Predictive modeling uses statistical methods to anticipate norms related to TMJ dynamics, complementing imaging modalities like cone beam computed tomography (CBCT) and magnetic resonance imaging (MRI). Deep learning, a subset of AI, helps quantify and analyze complex hierarchical relationships in occlusion and TMJ function. This narrative review explores the application of predictive modeling and deep learning to identify clinical trends and associations related to occlusion and TMJ function. Debates persist regarding best practices for managing occlusal factors in temporomandibular joint (TMJ) function analysis while interpreting and quantifying findings related to the TMJ and occlusion and mitigating biases remain challenging. Data generated from noninvasive chairside tools such as jaw trackers, video tracking, and 3D scanners with virtual articulators offer unique insights by predicting variations in dynamic jaw movement, TMJ, and occlusion. The predictions help us understand the highly individualized norms surrounding TMJ function that are often required to address temporomandibular disorders (TMDs) in general practice. Normal TMJ function, occlusion, and the appropriate management of TMDs are complex and continue to attract ongoing debate. This review examines how predictive modeling and artificial intelligence aid in understanding occlusion and TMJ function and provides insights into complex dental conditions such as TMDs that may improve diagnosis and treatment outcomes with noninvasive techniques.

Relationship of female pelvic floor muscle function and body composition: cross-sectional study.

Investigate the relationship between female pelvic floor muscle (PFM) function and body composition. Cross-sectional study-participants answered sociodemographic and urogynecological questions. The amount of fat mass was measured by dual-emission X-ray densitometry (DXA), and subcutaneous fat thickness was assessed by abdominal ultrasound. PFM assessment was performed using the Modified Oxford Scale and vaginal manometry. Descriptive analysis, independent t test, spearman correlation, and univariate regression were performed. Ninety-nine women were included. All body composition variables evaluated, except subcutaneous fat thickness, indicated that women with a higher concentration of fat in the pelvic, android, and visceral region have lower maximum voluntary PFM contraction strength assessed by Modified Oxford Scale and manometry. The univariate model pointed out that the fat concentration increases the chances of reduced PFM strength in the entire body (0.6%), android (5.4%), visceral region (25.3%), and pelvic (89.9%). There was a correlation between the concentration of total, pelvic, and android fat with MVC/average peak. The accumulation of "total", "pelvic", "android", and "visceral" fat mass is correlated with reduction in PFM strength, and there is an association between MVC and the variables of total and segmented fat. However, pelvic fat concentration is predictive in 89.9% of cases.

The Relationship of Preseason Upper Extremity Function, Pain and Training on Normalized DIII Collegiate Swimming Performance.

Shoulder injuries comprise the largest proportion of swimming injuries and there is a large percentage of swimmers participating with pain. Therefore, it is assumed that shoulder pain decreases performance, but studies have not compared collegiate swimmers' performance with and without pain. 1) Determine if individual swimmer's shoulder pain and function are associated with a change in normalized swimming performance over a season.2) Determine if differences in normalized swimming performance exist among 3 collegiate teams. 3) Qualitatively describe and compare team's training regimes. Cross sectional study. Swimmers completed pre-(T1) and post-season (T2) surveys including pain ratings and shoulder function using the Kerlan-Jobe Orthopaedic Clinic (KJOC) shoulder and elbow questionnaire. Swimming times were obtained from published meet results. Coaches reported training programs through interviews and tracking logs. 52 NCAA Division III swimmers from 3 teams. Stepwise linear regression was used to determine if pain and function related to performance. Team demographics and normalized swimming performance (reduction in time per lap from season's beginning to end) were compared with ANOVAs with post-hoc tests. Initial KJOC scores, but not pain, related to individual swimming performance. Differences in team performance were found (p=0.006), with Team 3 having greatest reduction in time (1.01 sec/lap), lower percentage of females, a more experienced coach and a periodization schedule with large increases and decreases in yardage. There was a main effect (p=0.043) for baseline demographics with Team 3's swimmers being taller and having longer competitive experience. The initial KJOC score predicting swimming performance improvement demonstrates the need for athletic trainers to prioritize enhancement of pre-season function. Endurance training induced hypoalgesia and motivation may explain the lack of effect of shoulder pain on performance. Further research is needed to elucidate optimal periodization and dryland training.

The Association Between Cognitive Function and Oral Health in Home Dwellers and Nursing Home Residents: The HUNT Study.

To evaluate the relationships of cognitive function and care dependency with oral health in a Norwegian older adult population. This cross-sectional study included 2623 participants aged 70 and older from the fourth wave of the Trøndelag health study (HUNT4 70+) and the city of Trondheim (Trondheim 70+). Neurocognitive disorders (NCDs) were diagnosed by clinical experts according to the DSM-5 framework. Care dependency referred to nursing home residency. Oral health was assessed by using the Revised Oral Assessment Guide-Jönköping (ROAG-J). Individuals were considered as 'having oral problem' if the score was two or three in at least one of the nine ROAG-J items. Poisson regression was used to estimate prevalence ratios (PRs) and 95% confidence intervals (CIs). The prevalence of having oral problems was 19% higher in participants with NCDs than those with normal cognitive function after adjusting for potential confounders (PR 1.19, 95% CI: 1.09-1.29). Further analysis showed a higher prevalence of having oral problems for home dwellers with NCDs (PR 1.23, 95% CI: 1.13-1.33) and nursing home residents (PR 1.32, 95% CI: 1.20-1.45) compared to home dwellers with normal cognitive function. NCDs were associated with an increased prevalence of oral problems in this Norwegian older adult population. The study suggests the need for increasing oral care for home dwellers with NCDs and nursing home residents.

Association of dementia with impaired kidney function and plasma biomarkers: A population-based study.

Emerging evidence has linked impaired kidney function with dementia in older adults, but the neuropathological pathways underlying their association remain poorly understood. We sought to examine the relationships of kidney function with dementia and plasma biomarkers in a Chinese rural population. This population-based study used data from the baseline examination of the Multimodal Interventions to Delay Dementia and Disability in rural China (MIND-China) cohort (March-September 2018; n = 5715). Kidney function was assessed using estimated glomerular filtration rate (eGFR) based on serum creatinine level. Dementia, Alzheimer's disease (AD) and vascular dementia (VaD) were diagnosed according to the international criteria. Plasma biomarkers were measured using the SIMOA platform in a subsample (n = 1446). Data were analyzed using logistic, general linear, and mediation models. Of the 5715 participants, 306 were diagnosed with dementia, including 195 with AD and 100 with VaD. Impaired kidney function (eGFR <60 vs. ≥90 mL/min/1.73 m2) was associated with multivariable-adjusted odds ratios of 2.24 (95% confidence interval [CI] 1.44-3.46) for all-cause dementia, 1.85 (1.07-3.18) for AD, and 2.49 (1.16-5.22) for VaD. In the biomarker subsample, impaired kidney function was significantly associated with higher plasma amyloid-β (Aβ)40 (β-coefficient = 54.36, 95% CI 43.34-65.39), Aβ42 (β-coefficient = 3.14, 95% CI 2.42-3.86), neurofilament light chain (β-coefficient = 10.62, 95% CI 5.62-15.62), and total tau (β-coefficient = 0.68, 95% CI 0.44-0.91), and a lower Aβ42/Aβ40 ratio (β-coefficient = -4.11, 95% CI -8.08 to -0.14). The mediation analysis showed that plasma total tau significantly mediated 21.76% of the association between impaired kidney function and AD (p < 0.05). Impaired kidney function is associated with dementia and plasma biomarkers among rural-dwelling older Chinese adults, and the association with AD is partly mediated by plasma biomarkers for neurodegeneration.

Evaluating dyadic factors associated with self-care in patients with heart failure and their family caregivers: Using an Actor-Partner Interdependence Model

Dyadic conditions of patients with heart failure and their caregivers may affect both patient self-care and caregiver contribution to patient self-care (CCPS). The purpose of this study was to examine the relationships of patient-caregiver physical function and depressive symptoms to the patient self-care (maintenance and management) and CCPS. Data from 55 were analyzed using an Actor–Partner Interdependence Model to address the aim through AMOS. Patient self-care was very poor. Better patient physical function was related to better patient self-care management (actor effect) and poorer CCPS maintenance (partner effect). Better caregiver physical function was related to CCPS management (actor effect). Severer patient depressive symptoms were related to poorer patient self-care maintenance (actor effect) and poorer CCPS management (partner effect). Physical function and depressive symptoms in patient-caregiver dyads were related to patient self-care and CCPS. To improve patient self-care and CCPS, dyadic support for physical function and depressive symptoms is needed.

Relationship of Physical Function and Social Frailty with Post-discharge Clinical Events in Patients with Cardiovascular Disease

Relationship of Physical Function and Social Frailty with Post-discharge Clinical Events in Patients with Cardiovascular Disease

Relationship of Thyroid Volume and Function with Ankle-Brachial Index, Toe-Brachial Index, and Toe Pressure in Euthyroid People Aged 18-65.

Background and Objectives: The interrelationship between thyroid function and the state of the cardiovascular system has been investigated both in preclinical and human studies. However, it remains unclear whether there is any association between thyroid hormones and features of subclinical cardiovascular dysfunction in euthyroid patients. Material and Methods: This study involved 45 people (females: 57.8%) with no thyroid disease who, during planned hospitalization, underwent thyroid ultrasound, determination of biochemical parameters of thyroid function, and measurement of ankle-brachial index (ABI) and toe-brachial index (TBI). People with signs of acute illness or a deterioration of their health were excluded. Results: Significant correlations were found between free triiodothyronine (FT3) and several parameters of both ABI (R = 0.347; p = 0.019 for the mean ABI taken from right side and left side values) and TBI (R = 0.396; p = 0.007 for the mean TBI taken from right side and left side values), as well as the maximal toe pressure (TP) taken from right side and left side values (R = 0.304; p = 0.045). Thyrotropin (TSH) was shown to be significantly correlated only with the maximal TBI value (taken from right side and left side values) (R = 0.318; p = 0.033), whereas free thyroxin (FT4) was shown to be significantly correlated only with the minimal TBI value (taken from right side and left side values) (R = 0.381; p = 0.01). Thyroid volume (TV) was shown to be correlated with TP (R = 0.4; p = 0.008 for the mean TP taken from right side and left side values) and some parameters of TBI value (R = 0.332; p = 0.028 for the mean TBI taken from right side and left side values), but no significant correlations were found between TVand ABI parameters. Patients with a mean ABI value ≤ 1.0 or a mean TBI value ≤ 0.75 have lower TSH, FT3, FT4, and TV than the rest of the study population, but the difference was statistically significant only for FT3. Conclusions: Even in a population of euthyroid patients with no diagnosed thyroid disease, there are some significant correlations between the volume and function of the thyroid gland and the selected features of subclinical cardiovascular dysfunction such as ABI and TBI.

Prevalence &amp; Relationship of Physical Function with Knee Osteoarthritis Among Coal Mine Workers.

Prevalence &amp; Relationship of Physical Function with Knee Osteoarthritis Among Coal Mine Workers.

Relationship of Glymphatic Function with Cognitive Impairment, Sleep Disorders, Anxiety and Depression in Patients with Parkinson's Disease.

Previous studies have predominantly explored the relationship of the glymphatic system with motor symptoms in Parkinson's disease (PD); however, research on non-motor symptoms remains limited. Therefore, this study investigated the association between glymphatic function and non-motor symptoms, including cognitive impairment and sleep disorders, in PD patients. This study recruited 49 PD patients and 38healthy controls (HC). Glymphatic function was evaluated using enlarged perivascular spaces (EPVS) in the basal ganglia (BG) region and diffusion tensor image analysis along the perivascular space (DTI-ALPS) index. Cognition, sleep, anxiety, and depression scales were assessed in all participants. According to the scale scores, PD patients were further divided into several groups to identify the presence of non-motor symptoms. Differences in EPVS numbers and ALPS index between PD subgroups and HC group were compared. Spearman correlation analysis was performed to investigate the association between the PD non-motor symptoms and ALPS index. Additionally, receiver operating characteristic (ROC) curves analysis was conducted for ALPS index to predict cognitive impairment and insomnia in PD patients. PD patients with and without non-motor symptoms all showed more EPVS numbers than the controls, and the EPVS numbers in PD patients with cognitive impairment were also greater than those without. Notably, except for the depression subgroup, PD patients with non-motor symptoms showed significantly lower ALPS index than the controls. The Montreal Cognitive Assessment (MoCA) scores were positively correlated, whereas the Parkinson's Disease Sleep Scale (PDSS)-2 and REM Sleep Behavior Disorder Screening Questionnaire (RBDSQ) scores were negatively correlated with the ALPS index in PD patients (r=0.3618, P=0.0053; r=-0.4146, P=0.0015; r=-0.2655, P=0.0326, respectively). The ALPS index proved to be predictive of cognitive impairment and insomnia in PD patients (AUC=0.7733, P=0.001; AUC=0.7993, P=0.0004, respectively). Glymphatic function is closely associated with cognition and sleep of PD patients.

A longitudinal study of the mediator role of physical activity in the bidirectional relationships of cognitive function and specific dimensions of depressive symptoms

BackgroundThe bidirectional relationship between cognitive function and depressive symptoms has been extensively reported. However, the potential mechanisms are still not clear. We aim to longitudinally investigate whether physical activity mediates the bidirectional relationships between cognitive function and specific dimensions of depressive symptoms. MethodsData from 6,787 individuals aged ≥50 of 2014/15 (T1), 2016/17 (T2), and 2018/19 (T3) waves of the English Longitudinal Study of Ageing (ELSA). Cognitive function was assessed by domains of memory, orientation in time, and executive function. Physical activity was measured with the intensity and frequency of participation. Specific dimensions of depressive symptoms were assessed by the 8-item Center for Epidemiologic Studies Depression Scale, distinguishing between cognitive-affective and somatic symptoms. Cross-lagged panel models were used to investigate the mediating role of physical activity in the bidirectional relationships between cognitive function and two dimensions of depressive symptoms. ResultsPoorer cognitive function was indirectly associated with worse cognitive-affective symptoms (indirect effect = −0.002, 95%CI: −0.004, −0.001) through lower physical activity levels. Poorer cognitive function was also indirectly associated with worse somatic symptoms (indirect effect = −0.003, 95%CI: −0.006, −0.002) through lower physical activity levels, and the reverse mediation was observed as well (indirect effect = −0.002, 95%CI: −0.004, −0.001). LimitationsThere is no distinction between potential within-person and between-person effects. ConclusionsCollaborative interventions of physical activity are beneficial in protecting cognitive function and mental health in older adults.

Contrasting presentations of children with ADHD and subthreshold ADHD.

We aimed to explore the differences and relationships in body composition, social function, and comorbidities between children with attention-deficit/hyperactivity disorder (ADHD) and subthreshold ADHD. A case-control study was conducted to analyze the differences between children with ADHD and subthreshold ADHD. Logistic regression models were used to analyze the factors influencing social functional impairments and comorbidities. Children with ADHD and subthreshold ADHD had a higher fat mass index than healthy children (p < 0.05). The scores of all six social functional domains were higher in the subthreshold ADHD and ADHD groups than in the control group (p < 0.05). The prevalence of comorbidity was higher in children with subthreshold ADHD and ADHD compared to the control group (p < 0.05). Inattention and comorbid anxiety/depression increased the risk of functional impairments in children with ADHD (full syndrome/subthreshold), whereas a higher fat-free mass index reduced the risk. The severity of hyperactivity was associated with a higher risk of comorbidity in children with ADHD (full syndrome/subthreshold). Children with subthreshold ADHD and ADHD had more fat mass and higher rates of social functional impairments and comorbidities than healthy children. There were clinical correlations between body composition, social functional impairments, and comorbidities in ADHD. 1. Children with subthreshold ADHD and ADHD had higher fat mass levels than normal children. 2. The social function impairments and comorbidities of children with subthreshold ADHD were similar to those with ADHD. 3. Inattentiveness and anxiety/depression increased the risk of functional impairments in children with ADHD (full syndrome/subthreshold), while a higher fat-free mass index and skeletal muscle-to-body fat ratio reduced the risk.

Trajectory of Infant Problematic Feeding Symptoms: Study Protocol.

Infants with developmental risk factors are more likely to have feeding problems and develop chronic feeding disorders. Early detection and understanding of the progression of problematic feeding and its relationship with a child's biological functioning and the family feeding environment will enhance effective symptom management and development of interventions to prevent pediatric feeding disorders. The New Through Two (NewThru2) feeding study protocol is described. Study aims are to (a) characterize symptoms of problematic feeding and trajectories of symptoms from pre-discharge from neonatal intensive care through age 24 months; (b) determine the relationship of child biological function at discharge with symptom characteristics and trajectories; (c) describe the child's feeding environment and its relationship to symptoms from discharge through 24 months; and (d) determine the relationship between problematic feeding symptoms and growth and developmental outcomes. NewThru2 is a prospective, longitudinal, mixed method study following over 200 infants who received care in a neonatal intensive care unit and were identified as at risk for compromised development. The study follows enrolled infants through 24 months of age. Symptoms of problematic feeding are measured pre-discharge by clinical observation and medical record review and post-discharge by parent report. Biological function is measured by medical history and cardiorespiratory and autonomic nervous system function during feeding prior to discharge. Child feeding environment is measured by strategies parents use to manage feeding, the effect of feeding on the parent and family, and the use of feeding services. A subset of parents is interviewed to achieve a contextual understanding of the family feeding environment. Child outcome measures include parent-reported feeding skills and clinician-reported growth and neurodevelopment. The results of this study will improve understanding of pediatric feeding disorders during a time of development sensitive to adequate nutrition and with infants at risk for developmental delays or impairments.

Chronic systolic heart failure: association of remodeling of the right heart and renal dysfunction with cardiac arrhythmias

Introduction. Ischemic (ICMP) and dilated cardiomyopathy (DCMP) are the leading causes of chronic heart failure (CHF) with the most frequent indication for heart transplantation. The similarity of these diseases consists in the widespread and high mortality rate due to pathological remodeling of both the left and right chambers of the heart, which is accompanied by the progression of CHF, increasing the risk of sudden cardiac death.The purpose of the study. To study the relationship of systolic function of the left ventricle (LV) with remodeling of the right heart, renal dysfunction and their relationship with cardiac arrhythmia.Materials and methods. The study included 72 patients with CHF with reduced ejection fraction (CHFrEF), who were being treated at the N. V. Sklifosovsky Scientific Research Institute of EM in connection with worsening CHF. Group I consisted of 48 patients with DCMP; group II – 24 patients with ICMP.Results. LV ejection fraction (LV EF) in patients of both groups was &lt;30 %, but it was significantly lower in group I (p=0.001). The EF of the right ventricle (RV) in group I was low and amounted to 24.6 [19.5; 28.5]%. In group I, the volume of the right atrium (PP) and the size of the pancreas correlated with LV EF (r= –0.489, p=0.015 and r= –0.410, p=0.005, respectively); each subsequent increase in the volume of right atrium (RA) by 1 ml increased the likelihood of atrial fibrillation (AF) by 1.018 times (OR: 1.018, 95 % CI: 1.0042–1.033, p=0.011). The estimated glomerular filtration rate (eGFR) &lt;60 ml/min/1.73 m2 increased the chances of ventricular tachycardia (VT) by 9.5 times (OR: 9.5, 95 % CI: 2.32–38.87, p=0.002). Each subsequent decrease in eGFR by 1 ml/min/1.73 m2 increased the chances of developing VT by 1.03 times (OR: 0.967, 95 % CI: 0.937–0.988, p=0.036)].Conclusions. In patients with CHFrEF, regardless of the etiology, a decrease in LV EF leads to structural and functional changes in the right parts of the heart. In individuals with DCMP, an increase in RA volume by 1 ml increases the likelihood of AF by 1.018 times; a decrease in eGFR by 1 ml/min/1.73 m2 increases the chances of developing VT by 1.03 times.

Associations between thyroid function, thyroid diseases, and primary aldosteronism.

Previous studies focusing on primary aldosteronism (PA) and thyroid diseases were controversial. Hence, this study aimed to examine associations between thyroid function, thyroid diseases, and PA and its subtypes. This was a cross-sectional study, which enrolled 1023 patients with PA and 6138 patients with essential hypertension (EH) admitted to Hypertension Center of People's Hospital of Xinjiang Uygur Autonomous Region from August 2011 to June 2022. All patients with PA were accurately classified into aldosterone-producing adenoma (APA) and idiopathic hyperaldosteronism (IHA) by adrenal vein sampling (AVS). Multivariate logistic regression analysis was used to assess the relationship of thyroid function, thyroid nodules, and PA and its subtypes. A total of 7161 patients (327 APA and 696 IHA, and 6138 EH) were included with a mean age of 48.20 ± 8.83 years. PA patients and PA subtypes showed lower FT4, FT3, TT4, TT3, and prevalence of positive TPOAb, meanwhile higher prevalence of thyroid nodules than EH patients (PA: 56.10%, IHA: 56.90%, APA: 54.80%, and EH: 48.90%, respectively). PA (adjusted OR: 1.290, 95% CI: 1.035-1.607, P = .02) and its subtype (IHA) (adjusted OR: 1.316, 95% CI: 1.005-1.724, P = .04) were significantly associated with thyroid nodules. Compared to patients with lower plasma aldosterone concentration (PAC) levels (<12 ng/dL), patients with PAC levels ≥ 12 ng/dL presented a higher prevalence of thyroid nodules. PA patients had lower thyroid function and higher prevalence of thyroid nodules compared to EH patients. Therefore, the screening of thyroid function and thyroid nodules may be indispensable for PA patients.

The Flynn effect and cognitive decline among americans aged 65 years and older.

To contribute to our understanding of cohort differences and the Flynn effect in the cognitive decline among older Americans, this study aims to compare rates of cognitive decline between two birth cohorts within a study of older Americans and to examine the importance of medical and demographic confounders. Analyses used data from the National Health and Aging Trends Study (2011-2019), which recruited older Americans in 2011 and again in 2015 who were then followed for 5 years. We employed mixed-effect models to examine the linear and quadratic main and interaction effects of year of birth while adjusting for covariates such as annual round, sex/gender, education, race/ethnicity, heart disease, hypertension, diabetes, test unfamiliarity, and survey design. We analyzed data from 11,167 participants: 7,325 from 2011 to 2015 and 3,842 from 2015 to 2019. The cohort recruited in 2015 was born, on average, 5.33 years later than that recruited in 2011 and had higher functioning than the one recruited in 2011 across all observed cognitive domains that persisted after adjusting for covariates. In multivariable-adjusted analyses, a 1-year increase in year of birth was associated with increased episodic memory (β = 0.045, SE = 0.001, p < .001), orientation (β = 0.034, SE = 0.001, p < .001), and executive function (β = 0.036, SE = 0.001, p < .001). Participants born 1 year later had slower rates of decline in episodic memory (β = 0.004, SE = 0.000, p < .001), orientation (β = 0.003, SE = 0.000, p < .001), and executive function (β = 0.001, SE = 0.000, p = .002). Additionally, sex/gender modified this relationship for episodic memory (-0.007, SE = 0.002, p < .001), orientation (-0.005, SE = 0.002, p = .008), and executive function (-0.008, SE = 0.002, p < .001). These results demonstrate the persistence of the Flynn effect in old age across cognitive domains and identified a deceleration in the rate of cognitive decline across cognitive domains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).