Gender Age Groups Research Articles

Hispanic Thrifty Food Plan (H-TFP): Healthy, Affordable, and Culturally Relevant.

The USDA Thrifty Food Plan (TFP) is a federal estimate of a healthy diet at lowest cost for US population groups defined by gender and age. The present goal was to develop a version of the TFP that was more tailored to the observed dietary patterns of self-identified Hispanic participants in NHANES 2013-16. Analyses used the same national food prices and nutrient composition data as the TFP 2021. Diet quality was measured using the Healthy Eating Index 2015. The new Hispanic TFP (H-TFP) was cost-neutral with respect to TFP 2021 and fixed at $186/week for a family of four. Two H-TFP models were created using a quadratic programming (QP) algorithm. Fresh pork was modeled separately from other red meats. Hispanic NHANES participants were younger, had lower education and incomes, but had similar or higher HEI 2015 scores than non-Hispanics. Their diet included more pulses, beans, fruit, 100% juice, grain-based dishes, and soups, but less pizza, coffee, candy, and desserts. The H-TFP market basket featured more pork, whole grains, 100% fruit juice, and cheese. The second TFP model showed that pork could replace both poultry and red meat, while satisfying all nutrient needs. A vegetarian H-TFP proved infeasible for most age-gender groups. Healthy, affordable, and culturally relevant food plans can be developed for US population subgroups.

Demographic related quality of life of the aging population in Thailand

Background: Thailand has a substantial elderly population, around one-sixth of its total populace, and ranks second among ASEAN countries. Remarkably, Thailand is the first developing nation to transition into a fully-fledged "Aged Society". This study aimed to assess the quality of life (QoL) of aging in Thailand and explore the demographic factors that affect it. Methods: The QoL and the demographic data of 15,600 adults aged 60 years and over were obtained from Regional Health (RH), Ministry of Public Health, and Thailand. The WHOQOL-BREF instrument in Thai was used to assess aging QoL. Outcome measures included WHOQOL-BREF's four domains (physical health, psychological, social relationships, and environmental scores. Cronbach’s coefficient assessed the reliability of the questionnaire. The relationships between QoL gender-age group, years, and RHs were investigated using multiple regression. The overall Cronbach’s coefficient of the WHOQOL-BREF questionnaire was 0.94 and Cronbach`s alpha was 0.67, 0.81, 0.72, and 0.87, respectively. Results: The scores of different gender-age groups, years, and RHs significantly differed in the four domains. The younger age for both sexes scored highest in physical, psychological, and environmental domains but not for the youngest females in social relationships. Years show a slight increase in the three domains but not the physical domain. Aging from RH 1-3 had the highest scores for all domains. The WHOQOL-BREF was reliable in the assessment of the QoL of the aging Thai population. Conclusions: To cope with the influencing demographic factors of the QOL, health authorities should support the aging population, especially the oldest physical health.

Adolescents and young adults are the most undiagnosed of HIV and virally unsuppressed in Eastern and Southern Africa: Pooled analyses from five population-based surveys.

Age and gender disparities within the HIV cascade of care are critical to focus interventions efficiently. We assessed gender-age groups at the highest probability of unfavorable outcomes in the HIV cascade in five HIV prevalent settings. We performed pooled data analyses from population-based surveys conducted in Kenya, South Africa, Malawi and Zimbabwe between 2012 and 2016. Individuals aged 15-59 years were eligible. Participants were tested for HIV and viral load was measured. The HIV cascade outcomes and the probability of being undiagnosed, untreated among those diagnosed, and virally unsuppressed (≥1,000 copies/mL) among those treated were assessed for several age-gender groups. Among 26,743 participants, 5,221 (19.5%) were HIV-positive (69.9% women, median age 36 years). Of them, 72.8% were previously diagnosed and 56.7% virally suppressed (88.5% among those treated). Among individuals 15-24 years, 51.5% were diagnosed vs 83.0% among 45-59 years, p<0.001. Among 15-24 years diagnosed, 60.6% were treated vs 86.5% among 45-59 years, p<0.001. Among 15-24 years treated, 77.9% were virally suppressed vs 92.0% among 45-59 years, p<0.001. Among all HIV-positive, viral suppression was 32.9% in 15-24 years, 47.9% in 25-34 years, 64.9% in 35-44 years, 70.6% in 45-59 years. Men were less diagnosed than women (65.2% vs 76.0%, p <0.001). Treatment among diagnosed and viral suppression among treated was not different by gender. Compared to women 45-59 years, young people had a higher probability of being undiagnosed (men 15-24 years OR: 37.9, women 15-24 years OR: 12.2), untreated (men 15-24 years OR:2.2, women 15-24 years OR: 5.7) and virally unsuppressed (men 15-24 years OR: 1.6, women 15-24 years OR: 6.6). In these five Eastern and Southern Africa settings, adolescents and young adults had the largest gaps in the HIV cascade. They were less diagnosed, treated, and virally suppressed, than older counterparts. Targeted preventive, testing and treating interventions should be scaled-up.

Common bile duct diameter reference values in patients with gallstone disease across various age-gender groups

Objective. Our goal was to establish common bile duct (CBD) diameter reference levels for abdominal ultrasound and percutaneous transhepatic cholecysto-cholangiography (PTCC) measurements with relevance to age and gender across the cohort of patients with underlying gallbladder disease excluding any intra- or extrahepatic bile ducts lesions.Materials and methods. 251 symptomatic patients with gallbladder disease and no signs of choledocholithiasis or biliary obstruction presenting to Liver and Pancreas Surgery Department, Sklifosovsky Research Institute for Emergency Medicine from January 2019 to June 2023 were reviewed. All the selected subjects underwent transabdominal ultrasound examination of hepato-biliary zone and PTCC. Common bile duct diameter, if not obscured, was measured at its widest visible portion by means of electronic calipers. The relationship between CBD size, age and gender was examined by nonparametric tests across stratified groups.Results. Mean sonographic CBD diameter was as high as 4.99 ± 1.17 mm with no evidence of correlation with age or gender. Mean cholecysto-cholangiography CBD diameter made up 6.49 ± 1.52 mm and reflected a considerable increase with age only: patients under 60 had CBD diameter significantly narrower, then those over 60. Basing upon the 95-percentile, we derived upper reference limit of 6.0 mm for US measurements without age and sex association, and for PTCC measurements regarding distinct age groups (8.0 mm in subjects &lt; 60 years and 9.0 mm in subjects ≥ 60 years). Diameter of common bile duct was substantially higher on cholangiograms versus sonograms.Conclusion. Present study displayed notable common bile duct diameter discrepancies not only between ultrasound and cholangiography measurements, but also throughout age-dependent groups on cholangiograms. We imply those variations to be taken in consideration in case of contrasting various radiological evaluations of common bile duct, and in case of ruling out the diagnosis of choledocholithiasis or bile flow abnormality.

Аспекты качества жизни лиц трудоспособного возраста с хроническими неинфекционными заболеваниями органов дыхания

Chronic noncommunicable diseases (NCD) are widespread and affect people of different age groups in all countries. The fight against this group of diseases is one of the priorities of the modern health care. Non-infectious diseases of the respiratory system as well as other diseases, affect social, physical and mental components of well-being. The qualitative assessment of their influence helps to assess the study of the quality of life. P u r p o s e : to assess the quality of life of the working-age population of the Nizhny Novgorod region and to develop measures to reduce the risk factors for chronic non-infectious diseases of the respiratory system in these cohorts. M a t e r i a l s a n d m e t h o d s . A one-stage comparative study was carried out using the method of standardized interviewing using the SF‑36 questionnaire. The quality of life of people of various age-gender groups with chronic non-infectious diseases of the respiratory system was assessed. All respondents were stratified into groups by pathology and age. R e s u l t s . The scientific article reflects the results of the study of assessing the quality of life of working-age patients with the chronic respiratory system pathology. The analysis of the data revealed statistically significant differences in age, gender and groups of pathologies among the respondents. Differences in indicators reflecting emotional states were revealed among men and women of the working age. Age-related changes in indicators of physical and psychological components of health and on all scales of the quality of life were presented. The obtained values of patient indicators show the need to develop specific measures to reduce behavioral risk factors for chronic non-infectious respiratory diseases of the population of the Nizhny Novgorod region. Findings. The comparative analysis of the results of the scales of the quality of life and health components reflects the age-related changes in indicators. The people of the older age group of the working age demonstrate significantly low results. The indicators of physical functioning are statistically significantly different in different pathologies of the respiratory system. Chronic obstructive pulmonary disease (COPD) restricts the physical activity of patients more strongly than other pathologies. Low values of the quality of life reflect the need to develop the measures to reduce the risk factors for chronic non-infectious diseases for the population of the Nizhny Novgorod region.

Fresh Pork as Protein Source in the USDA Thrifty Food Plan 2021: A Modeling Analysis of Lowest-Cost Healthy Diets.

The USDA Thrifty Food Plan (TFP) is an estimate of a lowest-cost healthy diet that meets dietary guidelines while respecting existing eating habits. In the US, the TFP provides the basis for federal food assistance. Included in the TFP are protein foods from both animal and plant sources. The present goal was to explore the place of fresh pork among protein foods in the revised TFP 2021. Our analyses used the same databases and the same quadratic programming (QP) methods as had been used by the USDA to develop the TFP 2021. Dietary intakes came from the National Health and Nutrition Examination Survey (NHANES 2015-16); nutrient composition data came from the Food and Nutrient Database for Dietary Studies (FNDDS 2015-16), and national food prices came from the 2021 TFP report. Amounts and prices were for foods as consumed. Our QP Model 1 used USDA modeling categories to replicate the TFP 2021. The non-poultry meat category was then separated into pork and beef. Model 2 examined whether the TFP 2021 algorithm would select pork or beef. Model 3 sought the lowest cost healthy diet, the same as the TFP 2021. Model 4 replaced beef and poultry with pork; whereas Model 5 replaced pork and poultry with beef. Weekly costs were calculated for a family of four and eight age-gender groups. All models met the nutrient requirements. The market basket cost for a family of four in Model 1 was USD 189.88, compared to the purchase price of USD 192.84 in the TFP 2021. In Model 2, fresh pork was selected preferentially over beef. The lowest-cost healthy food plan in Model 3 increased fresh pork to 3.4 lbs/week. Replacing beef and poultry with pork in Model 4 led to a modest decrease in the weekly cost. Replacing pork and poultry with beef in Model 5 led to a major increase in the weekly cost. We conclude, based on TFP-analogous modeling, that fresh pork is the preferred meat source, providing high-quality protein at a low cost. QP methods, as used in the TFP 2021, are a valuable tool for designing food plans that are affordable, acceptable, and nutrient-rich.

Age-specific risk factors for the prediction of obesity using a machine learning approach.

Machine Learning is a powerful tool to discover hidden information and relationships in various data-driven research fields. Obesity is an extremely complex topic, involving biological, physiological, psychological, and environmental factors. One successful approach to the topic is machine learning frameworks, which can reveal complex and essential risk factors of obesity. Over the last two decades, the obese population (BMI of above 23) in Korea has grown. The purpose of this study is to identify risk factors that predict obesity using machine learning classifiers and identify the algorithm with the best accuracy among classifiers used for obesity prediction. This work will allow people to assess obesity risk from blood tests and blood pressure data based on the KNHANES, which used data constructed by the annual survey. Our data include a total of 21,100 participants (male 10,000 and female 11,100). We assess obesity prediction by utilizing six machine learning algorithms. We explore age- and gender-specific risk factors of obesity for adults (19-79 years old). Our results highlight the four most significant features in all age-gender groups for predicting obesity: triglycerides, ALT (SGPT), glycated hemoglobin, and uric acid. Our findings show that the risk factors for obesity are sensitive to age and gender under different machine learning algorithms. Performance is highest for the 19-39 age group of both genders, with over 70% accuracy and AUC, while the 60-79 age group shows around 65% accuracy and AUC. For the 40-59 age groups, the proposed algorithm achieved over 70% in AUC, but for the female participants, it achieved lower than 70% accuracy. For all classifiers and age groups, there is no big difference in the accuracy ratio when the number of features is more than six; however, the accuracy ratio decreased in the female 19-39 age group.

Macroeconomic fluctuations and individual use of psychotropic medications: evidence from Swedish administrative data.

A growing literature finds that adult mental health worsens during economic downturns. Current insights on the relationship between macroeconomic fluctuations and psychotropic medication are based on self-reported information or aggregate measures on prescriptions. This study assesses the relationship between local macroeconomic conditions and individual use of psychotropic medication as reported in administrative registers. We use local information on unemployment linked to individual-level longitudinal data on detailed psychotropic drug consumption from administrative registers, for individuals in working age (20-65) in Sweden 2006-13. Any psychotropic medication uptake and the related number of redeemed prescriptions are the primary outcomes. Mortality is considered a secondary outcome. Among young men (aged 20-44) and older women (aged 45-65), we find reduced use of psychotropic medication (2-4% compared to the mean) when the local labor market conditions deteriorate. The relationship is driven by reduced use of antidepressants. The same age-gender groups experience a significantly higher risk of mortality in bad times. This study shows that economic downturns may not only put strain on individuals' mental health but also on their access to psychopharmaceutic treatments.

Insights on the effect of age and gender on in-mouth volatile release during wine tasting

This study focus for the first time, in looking for age-gender effects on in vivo volatile release during wine consumption, also considering oral physiological differences (e.g. saliva composition). To do so, the in-mouth Head Space Sorptive Extraction technique was used, which allowed monitoring the oral release of twenty-four different types of volatile compounds from white and red wines. Thirty-two individuals (n = 32) males and females, belonging to two different age groups: young (18–35 y.o) and senior (>55 y.o.) participated in this analytical in vivo study. Results showed differences in volatile release among age-gender groups, which also depended on the volatile compound and wine type. Senior groups (SM, SF) showed a similar release behaviour among them. Contrarily, young males showed a higher release (between 10 and 29%) of alcohols and esters indistinctly of the wine type, while young females showed the lowest oral volatile release among the four age-gender groups. Gender differences in volatile release were more evident in young than in seniors. A higher release of furanic compounds (furfural and 5-methyl furfural) in seniors was likely related to differences in their saliva composition (total protein content, minerals (Mg, Zn) and α-amylase activity).

Associations Between Dietary Inflammatory Index and Sex Hormones Among 6- to 19-Year-Old Children and Adolescents in NHANES 2015-2016.

ObjectivesThis study aimed to assess the relationship between dietary inflammatory index (DII) and sex steroids in children (6-11 years old) and adolescents (12-19 years old) in the U.S. National Health and Nutrition Examination Survey, 2015–2016.MethodsParticipants between the ages of 6-19 have 24-hour dietary intake data, serum sex hormones [total testosterone (TT), estradiol (E2)], and sex hormone-binding globulin (SHBG) available data (n = 1382). The free androgen index (FAI) is calculated as TT divided by SHBG and the ratio of TT to E2 (TT/E2). The constructed puberty state is defined as high levels of steroid hormones (TT≥50 ng/dL in men, E2≥20 pg/ml in women) or onset of menarche. Multiple linear regression analysis was stratified by gender-age and gender-pubertal status groups to evaluate the association between DII and sex hormone levels.ResultsAfter adjusting for covariates, the association between consecutive DII and sex hormone indicators by gender and age group. In male adolescents, DII was always negatively associated with TT (P-trend = 0.09), FAI (P-trend = 0.03) and E2 (P-trend = 0.01), and monotonically positively associated with SHBG (P-trend = 0.02).In female adolescents, with the increase of DII, a significant positive correlation with SHBG was observed (β 0.017, 95%CI: 0.009,0.053) (Table 3). Among female adolescents, a significant negative association between DII and TT and a significant positive association between SHBG were observed in this group. Moreover, DII was positively associated with SHBG of prepubertal males and negatively associated with FAI of prepubertal females.ConclusionsDII was associated with decreased levels of certain sex steroid hormones (TT, FAI, and E2) and increased levels of SHBG in adolescents or pubertal individuals, with the associations presenting somewhat sex-dependent pattern. However, there is little evidence that there is a significant association in children or prepubertal children. Further research needs to be carried out to verify our results.

Survival of patients with bladder cancer in Samara region

The morbidity and survival rates of patients with bladder cancer, depending on various causes, have been studied by many authors. However, there are a limited number of studies using the analysis of patient survival at the population level. Patient survival information can optimize the therapy and prevention of bladder cancer. The results of survival of patients with this disease in different gender and age categories should be studied more actively. The aim of the study was to study the observed and relative survival of patients with bladder cancer in gender-age groups in the Samara region for the period 2010–2012.The materials of the study were the primary records of 1059 patients for the period from 2010 to 2012. To obtain the results of survival, an actuarial method was used. To assess the reliability of the comparison of the obtained indicators, the Z and p criteria were used. In the course of the study, when assessing the 1-year and 5-year cumulative survival of patients with bladder cancer, there were lower rates of observed survival compared with the relative one.There were no statistically significant differences in the 1-year and 5-year relative survival rates for men and women. The 5-year observed survival rate for women was significantly higher than for men. With increasing age, survival rate for bladder cancer declines. The indicators of 1-year and 5-year relative survival of patients aged 50–59 years were significantly higher than the corresponding indicators of 60–69 years old. In the age group of 40–49-year-olds, there was a significantly higher relative survival rate of women compared with men.

CANCER EPIDEMIOLOGY IN UKRAINE: ANALYSIS FOR THE PAST DECADE

Aim. The paper aims at analyzing the state of cancer epidemiology in Ukraine for the past decade specifying the age, gender, territorial and nosological peculiarities.&#x0D; Materials and Methods. The study was conducted on the basis of the data analysis of the National cancer register of Ukraine for the 10-year period: starting from 2010 till 2019 years. The research was directed at studying and analyzing morbidity and mortality levels caused by malignant neoplasms, as well as age, gender, territorial and nosological peculiarities and the prevalence of nosological forms. Applied statistical methods include the analysis of the average and relative values, the calculation of indices of time series: growth rate and absolute growth, structural-and-logical analysis and systemic approach.&#x0D; Results and Discussion. The study has found that during the analyzed period of 2010-2019 years, the morbidity from malignant neoplasm in Ukraine increased, while the mortality level caused by oncologic pathology decreased. The morbidity and mortality among male population was higher in comparison with the female individuals. Over 50% of patients with firstly diagnosed "Malignant neoplasm" were identified in the early stages, but the share of detected patients with neglected form of oncologic pathology was increasing every year. One-year survival among the general population of patients with malignant neoplasms accounted 66,4-72,9%. The highest rates of morbidity have been fixed among male and female population, aged 70-79 years, while the highest death rate - among older individuals, 75-84 years of age. It has been defined that the age of 30-64 years wass characterized by high levels of morbidity and mortality rates in every sequential five-year group in comparison with the previous one. The hematological oncologic diseases were dominant in the structure of morbidity and mortality in young children and teenagers under 17 years. For the age category of 30-74 years, in female population the most common was breast cancer, in males - the cancer of the trachea, bronchi, lungs. For the analyzed period, Kirovograd Region occupies a leading position by morbidity level, while the Zaporizhzhia, Kirovograd and Dnipro Regions - are leaders in the mortality rate from malignant neoplasms.&#x0D; Conclusions. The analytical study of the oncologic and epidemiologic situation is an integral part in the development of an optimized system of oncologic care for Ukrainian population as it allowed to determine the age-gender and territorial groups, which require priory administrative attention concerning diagnostic and therapeutic decisions in oncology.

How are different sources of distraction associated with at-fault crashes among drivers of different age gender groups?

IntroductionDistracted driving has been well researched, however the comparison between different age-gender groups on the impact of distracted driving has not been explored. Most crash analysis research does not distinguish driver responsibility, so the role that distractions has in at-fault crashes is unknown. Without distinguishing at-fault crashes from all-cause crashes, distracted driving's detrimental effects could be underestimated. ObjectiveThis study aims to systematically assess the risk of at-fault crashes associated with different sources of distraction among six groups by driver age (Teens 16–19, Adults 20–64, Seniors 65+) and gender. MethodsCrashes where a study participant was deemed at fault were identified using human expert annotated variables from the Strategic Highway Research Program 2 (SHRP2) Naturalistic Driving Study dataset. Generalized linear mixed models were performed to assess the adjusted odds ratios of 10 distraction types associated with the at-fault crashes while controlling for environmental factors. ResultsThe main findings are (1) The highest contributing distraction types in at-fault crashes were In-Cabin Objects, Mobile Device, External Scenes, and In-Vehicle Information Systems (IVIS) as indicated by their influence on multiple age-gender groups and the magnitude of odds ratios; (2) Teens and adults were more distraction-prone than seniors, although seniors had the greatest at-fault crash risks associated with In-Cabin Objects, Mobile Device, and IVIS; (3) Distractions impacted females and males similarly; (4) At-fault crashes were more likely to have the significant distraction types present than all-cause crashes. ConclusionThis study adds to the limited literature on at-fault crashes particularly as it explores the role of driver demographics and distracted driving. Analyzing the risks of distracted driving by age-gender group shows that specific activities can be riskier for a certain population. The effects of distractions may be overlooked without fault determination. Distractions by external scenes, in-vehicle technologies, and in-cabin objects should not be overlooked, in addition to mobile device use.

Examining runner's outdoor heat exposure using urban microclimate modeling and GPS trajectory mining

It is important to quantify human heat exposure in order to evaluate and mitigate the negative impacts of heat on human well-being in the context of global warming. This study proposed a human-centric framework to examine human personal heat exposure based on anonymous GPS trajectories data mining and urban microclimate modeling. The mean radiant temperature (Tmrt) that represents human body's energy balance was used to indicate human heat exposure. The meteorological data and high-resolution 3D urban model generated from multispectral remotely sensed images and LiDAR data were used as inputs in urban microclimate modeling to map the spatio-temporal distribution of the Tmrt in the Boston metropolitan area. The anonymous human GPS trajectory data collected from fitness Apps was used to map the spatio-temporal distribution of human outdoor activities. By overlaying the anonymous GPS trajectories on the generated spatio-temporal maps of Tmrt, this study further examined the heat exposure of runners in different age-gender groups in the Boston area. Results show that there is no significant difference in terms of heat exposure for female and male runners. The female runners in the age of 45–54 are exposed to more heat than female runners of 18–24 and 25–34, while there is no significant difference among male runners. This study proposed a novel method to estimate human heat exposure, which would shed new light on mitigating the negative impacts of heat on human health.

Racial/ethnic, gender, and age group differences in cardiometabolic risks among adults in a Northern California health plan: a cross-sectional study

BackgroundIn the U.S., the prevalence of diabetes and hypertension are higher among African American/Black (Black), Latinx, and Filipino adults than non-Hispanic White (White) and Chinese adults. We compared the racial/ethnic-specific prevalence of several modifiable cardiometabolic risks in an insured adult population to identify behaviors that may drive racial/ethnic differences in cardiometabolic health.MethodsThis cross-sectional study used data for middle-aged (35–64) and older (65–79) Kaiser Permanente Northern California (KPNC) adult health plan members. Smoking status and BMI were derived from electronic health record data. Weighted pooled self-reported data from the 2014/2015 and 2017 KPNC Member Health Survey cycles were used to estimate daily number of servings of fruits/vegetables, general sodium avoidance, sugar-sweetened beverage (SSB) consumption frequency, alcohol use within daily recommended limit, weekly exercise frequency, and number of hours of sleep daily. Age-standardized estimates of all cardiometabolic risks were produced for middle-aged and older-aged women and men in the five racial/ethnic groups. Analyses focused on racial/ethnic differences within age-gender groups and gender and age group differences within racial/ethnic groups.ResultsIn both age groups, Black, Latinx, and Filipino adults were more likely than White and Chinese adults to have overweight and obesity and were less likely to engage in health promoting dietary (fruit/vegetable and SSB consumption, sodium avoidance (women only)) and sleep behaviors. Middle-aged Black and Filipino men were more likely than White men to be current smokers. Less racial/ethnic variation was seen in exercise frequency. Significant gender differences were observed for dietary behaviors overall and within racial/ethnic groups, especially among middle-aged adults; however, these gender differences were smaller for sleep and exercise. Age differences within gender and racial/ethnic groups were less consistent. Racial/ethnic and gender differences in these behaviors were also seen in the subsample of adults with diabetes and/or hypertension and in the subsample of adults who reported they were trying to engage in health promoting behaviors.ConclusionsBlack, Latinx, and Filipino adults were more likely than White and Chinese adults to report dietary and sleep behaviors associated with development and worsening of cardiometabolic conditions, with men exhibiting poorer dietary behaviors than women.

Refined Opium Extract (Shireh) Poisoning: A 10-Year Retrospective Study in a Referral Poison Control Centre in Iran

Background: There is limited data on refined opium extract (Shireh) abuse, especially the magnitude of its complications and its mortality rates. To bridge such a gap, in this study, we aimed to investigate the frequency of pure refined opium extract poisoning and its consequences in a sample of our patients. Methods:This retrospective study was conducted on all the patients presented to our center with pure refined opium extract poisoning. Patients’ demographics, clinical and laboratory data, and outcome were collected during a ten-year period between 2006 and 2016. The included patients were divided into two groups: those who remained conscious and those who developed loss of consciousness. However, they were compared subsequently. Results:A total of 227 patients were evaluated. Most (75.8 %) of them were male. Mean age was 38.26±25.91 years. We found a significant correlation between educational (.038), marital (<.001), and occupational status (<.001) and age-gender groups of the patients. The mean amount of refined opium extract consumed was 4400 mg which had significant correlation with hospitalization period (<.001) and on-arrival rhabdomyolysis (<.001). We also found a correlation in vomiting (<.001), dizziness (.015), respiratory distress (.001), and apnea (<.001) between the two groups. The mean hospitalization period was 2.3 days and the mortality rate was 1.76%. Conclusion: Naloxone therapy use effective in most cases of pure poisoning with refined opium extract. There were four deaths incidences three of which happened due to cardiopulmonary arrest following body packing. Further studies in this type of poisoning are recommended.

EQ-5D self-reported health in Barbados and Jamaica with EQ-5D-5L population norms for the English-speaking Caribbean

BackgroundThe EQ-5D instrument is increasingly used in clinical and resource allocation decision making in developed and developing countries. EQ-5D valuation and population norms studies have been undertaken for Trinidad and Tobago, however no population norms or value sets have been generated for the other Caribbean countries. The aims of this study were to provide population norms for Barbados and Jamaica, and to develop a set of population norms that could be used by the other English-speaking Caribbean countries.MethodsThe EQ-5D-5L self-reported health questionnaire was included in surveys of representative samples of adults in Barbados and adults in Jamaica in 2013. EQ-5D health states, mean EQ VAS scores and mean EQ-5D-5L index values (using the Trinidad and Tobago value set) were calculated for demographic groups in both countries based on 2347 respondents from Barbados and 1423 from Jamaica. A set of ‘Caribbean’ norms were developed by combining the Barbados and Jamaica data with norms recently published for Trinidad and Tobago.ResultsData were obtained for 2347 and 1423 respondents in Barbados and Jamaica respectively. The mean index and EQ VAS values were 0.943 and 81.9 for Barbados, and 0.948 and 87.8 for Jamaica. The health states most commonly observed in the two countries were similar. Generally the demographic patterns of self-reported health were consistent with those found in other studies. Some differences between the countries were observed in the patterns of rates of reporting problems on the EQ-5D dimensions among age-gender groups specifically for anxiety/depression and pain/discomfortConclusionThis study has produced a set of EQ-5D population norms that can be used as base-line values in clinical and clinico-economic analyses for Barbados and Jamaica and for the English-Speaking Caribbean region.

Seeking an Initial-Weight-Independent Metric in a Mediterranean Cohort of Gastric Bypass Patients: the %AWL Revisited.

Most relative weight-loss metrics follow the formula "Weight loss(%) = 100 · (Initial BMI - Final BMI) / (Initial BMI-a)," where a is the reference point that defines the metric. The percentage of total weight loss (%TWL, a = 0) and percentage of excess weight loss (%EWL, a = 25) are influenced by a patient's initial weight. Recently, the percentage of alterable weight loss metric (%AWL, a = 13) has been reported to produce initial-weight-independent outcomes. This study aimed to replicate the methodology used for %AWL determination in a Mediterranean cohort of bariatric patients. Multicenter study in 10 large hospitals in Spain. Two large prospective databases were retrospectively searched for all primary laparoscopic gastric bypass patients with 2years of follow-up. Outcomes at nadir were expressed and analyzed with 26 different metrics (a from 0 to 25), looking for the metric whose outcomes produced (1) the lowest coefficient of variation, (2) no differences between initially lighter and heavier patients, and (3) no correlation with patients' initial BMI. A cohort of 1793 patients was stratified into 4 gender-age groups: younger women (YW, n = 733), older women (OW, n = 674), younger men (YM, n = 197), and older men (OM, n = 189). The calculations suggested an optimal reference point of 18kg/m2, defining a new metric (percentage of Mediterranean alterable weight loss, %MAWL). When %TWL, %EWL, %AWL, and %MAWL were tested on the whole sample, only %MAWL produced initial-weight-independent results. In our Mediterranean cohort of patients, a reference point of 18 (and not 13) yielded initial-weight-independent outcomes.

Hazard-based duration analysis of the time between motorcyclists’ initial training and their first crash

The high fatality rates of motorcyclists relative to other motorized forms of highway transportation has been a focus of engineers and safety policies for many years. One of the most popular approaches to improve motorcycle safety has been to design training courses to improve riding competence. However, the effectiveness of these courses and the initial crash risk of motorcyclists is not well understood. The current study seeks to provide insight into motorcyclists’ initial crash risk by following the crash history of newly trained motorcyclists for up to 5 years after they complete their required motorcycle training. Specifically, attention is focused on the time until motorcyclists’ first crash. Using data from over 40,000 Florida motorcyclists, Weibull hazard-based duration models are estimated with gamma heterogeneity, and full random parameters, to determine the factors that affect the duration until motorcyclists’ first crash. The estimation results show that age and gender are driving factors in determining this duration and ultimately crash risk. In addition, estimation results show that most gender-age groups have an initial period of increasing crash risk, ranging from 30 to 96 days, where the likelihood of a crash increases the longer motorcyclists go without having a crash. After this initial period, crash risk declines over time as increasing riding experience reduces overall risk. This particular finding points to a critical motorcycle-safety opportunity in that policies and/or training can be modified to attempt to eliminate this initial high-risk period to arrive at a desirable lower initial risk and a declining risk over time as experience makes for safer and more cautious riding.

The frequency of the second mesiobuccal canal in maxillary first molars among a sample of the Kurdistan Region-Iraq population - A retrospective cone-beam computed tomography evaluation

Background/purposeOne of the most complexes in root and canal anatomy is the maxillary first permanent molar. This study aimed to analyze the frequency of mesiobuccal (MB2) canal and its apical portals of exit, in patients belonging to different gender-age groups and determine the possible relation with sex and age. Materials and methodsA CBCT scan images were accessed from a documented database of 343 patients (178 male, 165 female), who had an oral and maxillofacial examination. The age of the patients ranging from 12 to 63 years. The frequency of the MB2 canal and its portals of exit apically were observed. Age and gender correlation were calculated using the χ2 test. P < 0.05 was considered significant. ResultsA total of 634 maxillary first molars (335 male, 299 female) were included. The MB2 canal was found in 53.78% of the cases. A significantly higher incidence of the MB2 canal was detected in males than in females. No correlation in the presence and/or absence of the MB2 canal in terms of age. When MB2 canal present, a single apical foramen was observed in 66.28% of the cases, two apical foramina were present in 33.72% of the cases. ConclusionMB2 canals may be present in approximately half of the cases, from which one third of the cases have their own apical portal of exit.