General Elderly Population Research Articles

Identification of genetic variants associated with exercise-induced atrial fibrillation in high-performing racehorses

Abstract Background Atrial fibrillation (AF) is the most common cardiac arrhythmia in athletes. Despite a lower burden of classical cardiovascular risk factors, the prevalence of AF in athletes is comparable to that in the general population of similar age (~13%, mean age 65.5), suggesting that exercise-induced AF may have different underlying mechanisms. The prevalence of AF in thoroughbred (TB) and standardbred (STB) racehorses is also relatively high (~5%), suggesting exercise as an independent risk factor. Due to selective breeding and complete control of pedigrees, racehorses are well-suited for genetic studies. Common and rare genetic variation explain a substantial part of AF variance, but no study has identified genetic variants associated with exercise-induced AF in any species. Objective In this project, we aimed to use the racehorse as a model to identify genetic variants associated with exercise-induced AF, and in a future study, possibly replicate the results in human athletes. Here we present preliminary results from the genome-wide association study (GWAS) of AF in racehorses. Methods We collected blood or hair samples from 181 STB and TB racehorses in which 71 had paroxysmal or persistent AF verified by ECG. We extracted DNA and performed whole-genome genotyping using a commercial equine genotyping platform (670k markers). We phased and imputed un-genotyped markers and increased the sample size of the control group, using publicly available equine data from similar breeds from the European Nucleotide Archive. We conducted a GWAS of 7.85 million markers in 71 cases and 296 controls using PLINK2 with covariates adjusted for population stratification, batch and sex. Results We identified one significant locus downstream of the protocadherin gene PCDH18 associated with AF in racehorses. The same locus has been associated with the ECG-trait P-wave terminal force in humans. Changes in P-wave terminal force is associated with increased atrial size, delayed interatrial conduction, left ventricular fibrosis and left atrial function, and considered a good predictor of AF occurrence. Several non-significant but interesting signals were also identified including the genes SLC6A15 (amino acid transport), MYBPH (myosin binding), MYF6 and MYOG (myoblast differentiation). Conclusion In these preliminary results, we have identified a new genetic locus associated with AF in racehorses. In addition, we have identified several candidate genes for further studies to elucidate the genetic background of exercise-induced AF. We aim to replicate our findings in a population of human athletes. Our results may aid the development of risk prediction tools for exercise-induced AF and new drugs for tailored treatment of AF in general.

Association between high versus low cardiovascular risk in individuals with corresponding unexpected absent versus severe subclinical coronary atherosclerosis, a nationwide, multicenter study

Abstract Background It remains unclear as to why some individuals at low risk of cardiovascular disease (CVD) develop severe coronary atherosclerosis, while those at high CVD risk may remain free from coronary atherosclerosis. Purpose Using Coronary Computed Tomography Angiography (CCTA), we aimed to identify factors associated with absence and severe coronary atherosclerosis in subjects from the general population with very high and low-moderate CVD risk, respectively. Methods We assessed cross-sectionally a nationwide, multicenter population-based cohort, consisting of 30,154 individuals randomly recruited from the general population (age range 50-64 years, 51.4% women). Coronary calcified plaque burden was estimated by coronary artery calcium score (CACS) assessed by CCTA. Absent coronary atherosclerosis was defined as CACS 0 and severe coronary atherosclerosis was defined as CACS ≥301. We investigated only individuals with low-moderate (<5%) and very high CVD risk (≥10%) according to SCORE2 were included. Individuals with CACS 0 and prevalent CVD were excluded, as well as those with moderate CACS (1-300) or SCORE2 risk 5-9%. Out of 26 722 subjects with complete data on CACS and SCORE2, 13 075 were included. Logistic regression was performed adjusted for age and sex. Results The overall distribution of CACS in relation to SCORE2 CVD risk is illustrated in the Figure. Study characteristics are displayed in Table 1. Severe-extensive CACS in combination with low-moderate CVD risk was present in 2.3% (n=296). A further 2.3% (n=311) had very high CVD risk but CACS 0. Factors associated with CACS 0 despite a very-high estimated CVD risk included: lower age, being female, being born in Sweden, not having hypertension or hyperlipidemia, fewer pack-years of smoking, and lower waist circumference in men. On the contrary, severe-extensive CACS despite a low-moderate estimated CVD risk was associated with higher age, being male, being an ex-smoker, reporting more pack-years of smoking, having higher HbA1c, higher BMI, higher waist circumference, and prevalent hyperlipidemia and hypertension (Table 2). Conclusions We identified extreme cardiovascular risk phenotypes (subgroups) in the general population that either lacked coronary calcifications despite being at very high estimated CVD risk or had severe subclinical coronary atherosclerosis despite being at estimated low-moderate CVD risk. Further studies are warranted to elucidate putative enhancing or protective mechanisms explaining this unexpected phenomenon.

Increased risk for thoracic and abdominal aortic aneurysm in the relatives of abdominal aorta aneurysm patients

Abstract Introduction Genetic susceptibilities in aneurysm genes are risk factors for developing aneurysms of the aorta. This translates to a high aneurysm prevalence in relatives of aortic aneurysm patients. For relatives of abdominal aorta aneurysm (AAA) patients, guidelines recommend abdominal ultrasound screening for early detection and management, while for relatives of thoracic aorta aneurysm patients (TAA), transthoracic ultrasound of the ascending aorta and aortic root is recommended. Neither of these guidelines are designed to detect aneurysms in the whole aorta. The incidence of TAA in relatives of AAA index-patients is unknown and may determine whether abdominal ultrasound screening is sufficient for relatives of AAA patients or whether whole aorta screening should be recommended. Furthermore, focused screening of high risk relatives of aneurysm patients may improve the yield of aneurysm detection now that population frequencies are declining. Methods Whole aorta non-contrast CTs of relatives of AAA index-patients were collected retrospectively in a tertiary referral (2016 to 2021). Family history and DNA testing of AAA index-patients were used to classify relatives into high genetic risk (familial disease and/or pathogenic/likely pathogenic variant (P/LP) in an aneurysm gene) or unknown genetic risk (no familial disease or no P/LP detected). TAA were defined as ascending diameters ≥ 45mm or descending diameters ≥ 40mm. Thoracic aortic dilatations (TAD) were defined as ascending diameters of 40-45 mm or descending diameters of 35-40 mm. Abdominal diameters ≥30mm were classified as AAA and diameters between 25-29 mm as abdominal dilatations (AAD). References 1-3. Results CT scans (n=301 relatives, 47% male, age 58(50-65)) showed 34% aortic aneurysms and/or dilatations versus 14% in the general population (age adjusted, p<0.001). TAA was 28-times more frequent (2%, p<0001) and AAA 3 times more frequent (8%, p<0.001) than in the general population. Thoracic and abdominal dilatations occurred in 18% and 17% of relatives. Overall, males were 4 times more likely to have an aneurysm than females (p<0.05). Aneurysms and dilatations occurred at the same rate in relatives with or without a family history or a P/LP in an aneurysm gene. These results endorse total aorta screening for relatives of all AAA patients rather than restricting screening to the abdominal aorta. Conclusions Relatives of AAA patients had a high risk for thoracic and abdominal aneurysms as well as dilatations. This indicates that imaging of the whole aorta will improve early detection of aortic aneurysms in relatives both with and without a family history of aneurysms.

Physical health challenges faced by elders with severe mental illness: population-based retrospective cohort study.

Severe mental illness (SMI), which includes schizophrenia, schizoaffective disorder and bipolar disorder, has profound health impacts, even in the elderly. To evaluate relative risk of hospital admission and length of hospital stay for physical illness in elders with SMI. To construct a population-based retrospective cohort observed from April 2007 to March 2016, data from a case registry with full but de-identified electronic health records were retrieved for patients of the South London and Maudsley NHS Foundation Trust, the single secondary mental healthcare service provider in south-east London. We compared participants with SMI aged >60 years old with the general population of the same age and residing in the same areas through data linkage by age-, sex- and fiscal-year-standardised admission ratios (SARs) for primary diagnoses at hospital discharge. Furthermore, we compared the duration of hospital stay with an age-, sex- and cause-of-admission-matched random group by linear regression for major causes of admission. In total, records for 4175 older people with SMI were obtained, relating to 10 342 admission episodes, showing an overall SAR for all physical illnesses of 5.15 (95% CI: 5.05, 5.25). Among the top causes of admission, SARs ranged from 3.87 for circulatory system disorders (ICD-10 codes: I00-I99) to 6.99 for genitourinary system or urinary conditions (N00-N39). Specifically, the diagnostic group of 'symptoms, signs and findings, not elsewhere classified' (R00-R99) had an elevated SAR of 6.56 (95% CI: 6.22, 6.90). Elders with SMI also had significantly longer hospital stays than their counterparts in the general population, especially for digestive system illnesses (K00-K93), after adjusting for confounding. Poorer overall physical health and specific patterns were identified in elders with SMI.

Epidemiological trends of SARS-CoV-2 infections during pregnancy in Chicago

Abstract Background The epidemiology of SARS-CoV-2 has varied significantly across age groups, specifically children. Immune and physiologic changes in pregnancy can lead to increased susceptibility to infection. Pregnant people were at increased risk of severe COVID-19 infections and obstetric complications, particularly before vaccine availability. We investigated epidemiologic trends of SARS-CoV-2 cases in pregnant people over time compared to trends in the general population and various age subgroups. We hypothesized that rates of SAR-CoV-2 infection in pregnant people may show a similar pattern to children rather than nonpregnant adults. Methods Cases of pregnant persons with SARS-CoV-2 infection who delivered at Prentice Women’s Hospital (Chicago, IL) were identified through the electronic medical record (March 2020-November 2022). Prentice has ~12,000 births annually. Clinical data collection for SARS-CoV-2 cases included the date of positive test, maternal demographics, vaccination status, severity, and latency (days between SARS-CoV-2 infection and delivery). SARS-CoV-2 cases rates in Chicago (cases/100,000; total; age 0-17 years, ≥18 years) were obtained from the Chicago Department of Public Health. Monthly average SARS-CoV-2 rates were calculated to visualize trends over the study period using Microsoft Excel. Results A total of 3,474 SARS-CoV-2 cases in pregnancy were included in the final dataset; 497 cases were excluded from analyses due to incomplete data to pinpoint timing of infection. The median maternal age was 33 years (IQR 30-36) with a median latency of 72 days (IQR 22-143.75). Over half (2206) of pregnant persons received COVID-19 vaccination. In terms of timing, 514 people (15%) tested positive during their 1st trimester, 1017 (29%) in 2nd trimester, and 1943 (56%) in 3rd trimester. The trends of SARS-CoV-2 cases over time among pregnant persons coincide closely with trends among children in Chicago rather than adults [Figure 1]. A steep spike and higher SARS-CoV-2 rates were observed in pregnancy during the initial Omicron variant surge (December 2021-January 2022) and in April-July 2022, during which children also led case rates. Earlier in the pandemic, pregnant people and children were less affected than non-pregnant adults. Conclusion We observed an interesting trend of SARS-CoV-2 cases among pregnant persons aligning with rates in children in Chicago rather than adults. Possible explanations include: 1) pregnant people exercising an abundance of caution prior to vaccine availability and knowledge about COVID-19 in pregnancy and 2) epidemiologic link of maternal exposure to children. This information may inform public health strategies and effective precautions in future epidemics/pandemics to keep patients safe during pregnancy. Figure 1. Cases of SARS-CoV-2 in age and pregnancy subgroups in Chicago. Blue bars represent SARS-CoV-2 positive cases among pregnant people who later delivered at Prentice Women’s Hospital [left y-axis] March 2020-November 2022. Colored lines represent case rate (cases/100,000) in Chicago according to Chicago Department of Public Health data (yellow = total, purple = adults ≥18 years, red = children 0-17 years) [right y-axis].

Association of hypertension and long-term blood pressure changes with new-onset diabetes in the elderly: A 10-year cohort study.

To explore the correlation between new-onset diabetes (NOD), hypertension and blood pressure management among elderly individuals in China. A cohort analysis involved 1380 participants aged 60 years or older, initially free of diabetes in 2008, from the Chinese Longitudinal Healthy Longevity Survey. Follow-up assessments occurred every 2-3 years. The relationship between hypertension, blood pressure changes and NOD was analysed using multivariable-adjusted Cox regression. By 2018, 102 participants developed diabetes, while 1278 remained without diabetes. The cumulative diabetes prevalence increased from 3.1% at 3 years to 7.4% at 10 years. Hypertension prevalence increased from 20.9% at baseline to 41.0% at 10 years, with higher rates in those diagnosed with diabetes during follow-up. Multivariate analysis identified age, gender, baseline hypertension and systolic blood pressure (SBP) as independent predictors of NOD. Hypertension combined with overweight/obesity significantly increased the risk of NOD (hazard ratio [HR] 2.837; 95% confidence interval [CI], 1.680-4.792). We evaluated participants' blood pressure management levels in 2008 and 2011, then tracked the onset of diabetes from 2011 to 2018. Compared with participants with an average SBP below 120 mmHg in 2008 and 2011, those with SBP of 140 mmHg or higher had an 8-fold higher risk of developing NOD (adjusted HR8.492, 95% CI 2.048-35.217, P = .003), the highest risk group. Participants with SBP of 130-139.9 mmHg also had a significantly increased risk (adjusted HR 5.065, 95% CI 1.186-21.633, P = .029), while those with SBP of 120-129.9 mmHg showed no significant difference (HR 2.730, 95% CI 0.597-12.481, P = .195). Consistently high SBP (≥ 130 mmHg) further increased NOD risk (adjusted HR 3.464, 95% CI 1.464-8.196, P = .005). Significant predictors of NOD included age, gender, baseline hypertension and blood pressure management. Maintaining SBP consistently below 130 mmHg may be an effective strategy to reduce the incidence of NOD in the general elderly population.

Profiling metabolites and exploring metabolism of parabens in human urine using non-target screening and molecular networking

Parabens are widely used as preservatives in food, pharmaceuticals, and cosmetics due to their excellent antimicrobial activities, cost-effectiveness, and stability. Previous studies have demonstrated their harmful potential and ubiquity in the environment and human tissues. This study revealed profiles of parabens and their metabolites in urine samples from a general population of different ages in China using non-target screening. Metabolism of parabens in human bodies was further explored through the identified metabolites in combination of molecular networking. A total of 34 paraben compounds were screened in the urine samples. In addition to 3 identified confidence level 1 (CL1) parent parabens, 3 CL2 compounds were also identified, namely 4-hydroxybenzoic acid, 3,4-dihydroxybenzoic acid, and ethylparaben sulfate. Furthermore, 6 CL3 compounds were tentatively identified, five of which were sulfonated and sulfated metabolites of parabens. The remaining 22 were CL4 features without certain chemical structures. Hazardousness assessment suggested toxic potential of the identified metabolites. Distribution of the parabens and metabolites in the urines showed age-dependent differences. Sulfonation and sulfation were potentially significant metabolic pathways of the parabens in human bodies. This study provides a new insight into understanding metabolism of parabens in human bodies and potential risks of human exposure to parabens.

Prevalence and associated risk factors of current hepatitis C infection among U.S. general population and injection drug users aged 20-59 years: NHANES 2009-2018.

The people who inject drugs (PWID) are attributed to high-risk groups for transmission of the Hepatitis C virus (HCV). This study assessed the prevalence and associated factors of current HCV infection (CHI) among U.S. general population and PWID of ages between 20 and 59 years old. This study utilized cross-sectional data from the 2009-2018 National Health and Nutrition Examination Survey, conducting separate analyses for the U.S. general population, including PWID and non-PWID, as well as specific analyses focusing solely on PWID. The analytical methods included the estimation of CHI prevalence, Rao-Scott chi-square test to compare CHI-positive and CHI-negative groups, and univariate and multivariable logistic regressions models to evaluate the associated risk factors of CHI. The prevalence of CHI among general population and PWID were 1% and 19%, respectively. Compared to non-PWID, the odds of CHI were significantly higher among PWID (OR = 32.6, 95% CI = 17.7-60.3) in general population. Among PWID, male vs. female (OR = 2.6, 95% CI = 1.1-5.9), adults aged 40-59 vs. 20-39 years old (OR = 2.9, 95% CI = 1.2-7.3), Non-Hispanic Black vs. White (OR = 4.6, 95% CI = 1.5-13.6), with high school diploma or less educational attainment vs. above college degree (OR = 3.5, 95% CI = 1.4-9.2) showed higher odds of having CHI. The prevalence of CHI was found to be higher among PWID especially those who were male, aged 40-59 years old, Non-Hispanic Black, and had lower educational attainment. Targeted intervention such as screening and awareness program among PWID population is recommended to reduce the burden of new HCV infections in the U.S.

The impact of the COVID-19 pandemic on the psychosomatic status of emeritus professors: The importance of active lifestyles

AbstractPurposeThe COVID-19 pandemic has had an enormous negative impact on the psychosomatic status of the general population, and especially of more vulnerable populations, such as older people. The present study aimed to assess changes in psychosomatic status before and after the COVID-19 pandemic among emeritus professors over 70 years of age.Materials/MethodsA total of 56 emeritus professors aged 77.4 ± 6.1 (74.1% male) participated in the study. The study was conducted between September 2022 and January 2023, after approximately two and a half years of the COVID-19 pandemic. Sociodemographic characteristics, including socioeconomic status, were assessed in the questionnaire, along with active involvement in academic life and healthcare/sports. Physical and mental fatigue were assessed using a self-report questionnaire, and the impact of fatigue on physical and cognitive function was measured using the Fatigue Impact Scale. Participants evaluated their physical/mental fatigue and physical/cognitive function before and after the COVID-19 pandemic.ResultsAmong the participating emeritus professors, 15% reported higher levels of physical fatigue (Z = −1.992, P = 0.046, r = 0.28) and mental fatigue (Z = −2.154, P = 0.031, r = 0.31) following the COVID-19 pandemic. A significant difference was found in physical function assessed before and after the COVID-19 pandemic, t(51) = −2.986, P = 0.004, g = 0.22, while cognitive function showed a non-significant difference, t(51) = −1.265, P = 0.212, g = 0.12. After the COVID-19 pandemic, 26.9% of participants reported reduced physical function and 19.2% showed reduced cognitive function. Infection with the COVID-19 virus resulted in increased mental fatigue and reduced cognitive function among the participating emeritus professors.ConclusionThe COVID-19 pandemic (and the introduction of restrictions on social activities) had a substantial and similar impact on the psychosomatic status of emeritus professors at both medical and sports universities. Furthermore, the reduction in physical and mental/cognitive function was exacerbated in those who were infected by SARS-CoV-2. Importantly, however, the overall impact of the COVID-19 pandemic was smaller in the population of emeritus professors than in the general elderly population. This may be due to the better maintenance of physical and mental activity in the former population, thus emphasising the importance of remaining physically and mentally active in old age, especially in the context of critical life events.

Sex-Related Differences in Life Expectancy Compared to General Population after Surgery for Ascending Aortic Aneurysm.

Background/Objectives: Understanding sex-based differences in cardiovascular outcomes is paramount to improving clinical outcomes. Surgery is an aggressive but effective therapy for ascending aortic aneurysm. We sought to determine if being a woman is a risk factor for long-term mortality after this surgery. We compared their life expectancy with a general population of the same age, sex, year, and region. Methods: We compared men and women undergoing AAA surgery at our institution from 2000 to 2019. After balancing the population with propensity score (PS) matching, we compared long-term mortality control with a Cox regression. We determined the RS using the Ederer II method and compared it to a healthy reference population of the same age, sex, and region. Results: From 2000 to 2019, 232 women and 506 men underwent ascending aortic aneurysm surgery. After a mean follow-up of 51.5 ± 34.5 months, sex was not an independent risk factor for long-term mortality in the multivariable analysis [HR: 0.68 (95% CI 0.43-1.07, p = 0.23)]. Matching by baseline characteristics, 196 pairs were analyzed with no differences regarding mortality in the Cox regression [HR: 1.11 (95% CI 0.65-1.9, p = 0.23)]. Men and women who survived the postoperative period presented a relative survival of 100.3% (95% CI 97.4-101%) and 100.3% (95% CI 98.9-101.1%), respectively, similar to the reference population without the disease. Conclusions: For patients undergoing AAA surgery, sex was not an independent predictor of mortality. Men and women who survived the postoperative period presented a similar life expectancy to that of the reference population (people free from the disease of the same age, sex, year, and region).

REM sleep behavior disorder and Prodromal Parkinson’s Disease in patients with Essential Tremor

Several studies suggested the presence of non-motor symptoms in Essential Tremor (ET), including REM sleep behavioral disorder (RBD). RBD is an essential criterion for Prodromal Parkinson's Disease (PPD), suggesting a link between ET and PD. Our objective was to assess the prevalence and features of ET patients with RBD and PDD.RBD was diagnosed by questionnaire screening, followed by polysomnography. PPD risk factors and prodromic markers were assessed with a structured protocol. Patients were characterized regarding tremor features. ET patients with RBD (ET-RBD) and PPD (ET-PPD) were compared to patients without RBD (ET-nonRBD) and without PPD (ET-nonPPD), respectively. ET-RBD patients were also compared with a group of isolated RBD (iRBD) regarding PPD features.We assessed a total of 64 ET patients. Five (8.3 %) and 4 (6.3 %) had criteria for RBD and PPD, respectively. ET-RBD patients did not differ from ET-nonRBD except for a higher prevalence of PPD. There were no significant differences between ET-RBD and iRBD (n = 12) groups. ET-PPD had a higher prevalence of positive DaT-Scans and RBD compared to ET-nonPPD. Three ET-RBD patients had PPD and 3 ET-PPD had RBD.Both RBD and PPD are more frequent in ET patients than in general aged population but not related with specific tremor features. ET-RBD patients did not differ significantly from iRBD patients, a group prone to develop PD. These data suggest a link between ET and PD and are in accordance with studies showing an increase incidence of lewy-body pathology and PD in ET populations.

Limbic-predominant age-related TDP-43 encephalopathy in the oldest old: a population-based study

Abstract Population-based cohort studies are essential for understanding the pathological basis of dementia in older populations. Previous studies have shown that limbic-predominant age-related TDP-43 encephalopathy neuropathological change (LATE-NC) increases with age, but there have been only a few studies, which have investigated this entity in a population-based setting. Here we studied the frequency of LATE-NC and its associations with other brain pathologies and cognition in a population aged ≥ 85 years. The population-based Vantaa 85+ study cohort includes all 601 individuals aged ≥ 85 years who were living in Vantaa, Finland in 1991. A neuropathological examination was performed on 304 subjects (50.5%) and LATE-NC staging was possible in 295 of those. Dementia status and Mini-Mental State Examination (MMSE) scores were defined in the baseline study and 3 follow-ups (1994-99). The LATE-NC stages were determined based on TDP-43 immunohistochemistry, according to recently updated recommendations. Arteriolosclerosis was digitally assessed by calculating the average sclerotic index of five random small arterioles in amygdala and hippocampal regions, and frontal white matter. The association of LATE-NC with arteriolosclerosis and previously determined neuropathological variables including Alzheimer’s disease neuropathological change (ADNC), Lewy-related pathology (LRP), hippocampal sclerosis (HS), and cerebral amyloid angiopathy (CAA), and cognitive variables were analysed by Fisher’s exact test, linear and logistic regression (univariate and multivariate) models. LATE-NC was found in 189 of 295 subjects (64.1%). Stage 2 was the most common (28.5%) and stage 3 the second most common (12.9%), whereas stages 1a, 1b and 1c were less common (9.5%, 5.1% and 8.1%, respectively). Stages 1a (P < 0.01), 2 (P < 0.001) and 3 (P < 0.001) were significantly associated with dementia and lower MMSE scores. LATE-NC was associated with ADNC (P < 0.001), HS (P < 0.001), diffuse neocortical LRP (P < 0.002), and arteriolosclerosis in amygdala (P < 0.02). In most cases LATE-NC occurred in combination alongside other neuropathological changes. There were only six subjects with dementia who had LATE-NC without high levels of ADNC or LRP (2% of the cohort, 3% of the cases with dementia), and five of these had HS. In all multivariate models, LATE-NC was among the strongest independent predictors of dementia. When LATE-NC and ADNC were assessed in a multivariate model without other dementia-associated pathologies, the attributable risk was higher for LATE-NC than ADNC (24.2% vs. 18.6%). This population-based study provides evidence that LATE-NC is very common and one of the most significant determinants of dementia in the general late-life aged population.

Controlled mitral valvuloplasty using steerable catheter- waist- formed balloon system: A clinical case series.

As the general population ages, the incidence of degenerative mitral stenosis (MS) among patients has increased. Percutaneous mitral valvuloplasty (PMV) has emerged as a well-established option for mitral rheumatic stenosis with specific characteristics. However, a blank therapeutic space must be filled with the treatment options for degenerative or rheumatic mitral stenosis in patients with many comorbidities and contraindication for valvuloplasty. We here present a comprehensive overview of the current possibilities, despite their scarce success. That is the reason why we propose a case series to facilitate a better understanding of our innovative technique in this challenging clinical context.

Denial of reproductive potential: a predictor of unperceived pregnancy in an Austrian neonaticide sample.

This study aims to describe the phenomenon of unperceived pregnancy followed by neonaticide with a focus on the lack of awareness of reproductive potential in an Austrian sample. An explorative comparative study of neonaticide cases with single and repeat perpetrators was conducted using nationwide register-based data from 1995 to 2017. A total number of 55 cases out of 66 were included in the analysis. A standardized coding sheet was used and calculations were performed. 48 women gave birth to 101 children, of which 55 were killed, 23 children lived out of home care and 23 lived with the perpetrator We found a higher fertility rate in both neonaticide perpetrators in the single (1,9) and the repeat group (4,25) in comparison to the general population (1,4). The use of contraception was only 31% among neonaticide perpetrators, deviating substantially from the general Austrian population age group (16-29yrs) which used contraception in 91%. The neonaticide perpetrators used an effective contraception method (pearl-index < 4) in only 2%, whereas 20% of the general population did so. The number of unperceived pregnancies was high in both groups (50/55) 91%. Future case reports and forensic evaluations should take reproductive behavior into account, as it may offer valuable insights into the events leading up to neonaticide. Our findings suggest that denial of reproductive potential often precedes unperceived pregnancies. In the Austrian cohort, women who experienced unperceived pregnancies resulting in unassisted births and subsequent neonaticide showed a low prevalence of contraceptive use. This is particularly noteworthy given that the primary motive for neonaticide is unwanted pregnancy.

The association between triglyceride-glucose index and the likelihood of cardiovascular disease in the U.S. population of older adults aged ≥ 60 years: a population-based study

BackgroundThe association between the triglyceride-glucose (TyG) index and the likelihood of developing cardiovascular disease (CVD) in the general elderly population in the United States aged 60 and above is not well understood. The objective of our study was to examine the relationship between the TyG index and CVD likelihood in the general elderly population over 60 years of age in the United States.MethodsData for this cross-sectional study were sourced from the 2003–2018 National Health and Nutrition Examination Survey. Weighted multivariable regression analysis and subgroup analysis were conducted to estimate the independent relationship between the TyG index and the likelihood of CVD. Non-linear correlations were explored using restricted cubic splines.ResultsA total of 6502 participants were included, with a mean TyG index of 8.75 ± 0.01. The average prevalence of CVD was 24.31% overall. Participants in the higher TyG quartiles showed high rates of CVD (Quartile 1: 19.91%; Quartile 2: 21.65%; Quartile 3: 23.82%; Quartile 4: 32.43%). For CVD, a possible association between the TyG index and the odds of CVD was observed. Our findings suggest a nonlinear association between the TyG index and the odds of CVD. The threshold of 8.73 for the likelihood of CVD. Interaction terms were employed to assess heterogeneities among each subgroup, revealing a significant difference specifically in alcohol consumption. This suggests that the positive association between the TyG index and the likelihood of CVD is dependent on the drinking status of the participants.ConclusionA higher TyG index is linked to an increased likelihood of CVD in US adults aged ≥ 60 years. TyG index is anticipated to emerge as a more effective metric for identifying populations at early likelihood of CVD.

Predicting the cognitive impairment with multimodal ophthalmic imaging and artificial neural network for community screening

Background/aimsTo investigate the comprehensive prediction ability for cognitive impairment in a general elder population using the combination of the multimodal ophthalmic imaging and artificial neural networks.MethodsPatients with cognitive impairment and...

Association between multiple-heavy-metal exposures and systemic immune inflammation in a middle-aged and elderly Chinese general population

BackgroundExposure to heavy metals alone or in combination can promote systemic inflammation. The aim of this study was to investigate potential associations between multiple plasma heavy metals and markers of systemic immune inflammation.MethodsUsing a cross-sectional study, routine blood tests were performed on 3355 participants in Guangxi, China. Eight heavy metal elements in plasma were determined by inductively coupled plasma mass spectrometry. Immunoinflammatory markers were calculated based on peripheral blood WBC and its subtype counts. A generalised linear regression model was used to analyse the association of each metal with the immunoinflammatory markers, and the association of the metal mixtures with the immunoinflammatory markers was further assessed using weighted quantile sum (WQS) regression.ResultsIn the single-metal model, plasma metal Fe (log10) was significantly negatively correlated with the levels of immune-inflammatory markers SII, NLR and PLR, and plasma metal Cu (log10) was significantly positively correlated with the levels of immune-inflammatory markers SII and PLR. In addition, plasma metal Mn (log10 conversion) was positively correlated with the levels of immune inflammatory markers NLR and PLR. The above associations remained after multiple corrections. In the mixed-metal model, after WQS regression analysis, plasma metal Cu was found to have the greatest weight in the positive effects of metal mixtures on SII and PLR, while plasma metals Mn and Fe had the greatest weight in the positive effects of metal mixtures on NLR and LMR, respectively. In addition, blood Fe had the greatest weight in the negative effects of the metal mixtures for SII, PLR and NLR.ConclusionPlasma metals Cu and Mn were positively correlated with immunoinflammatory markers SII, NLR and PLR. While plasma metal Fe was negatively correlated with immunoinflammatory markers SII, NLR, and PLR.

Study on Anxiety and Loneliness among General Population in a City of South India

Background: The outbreak of corona virus disease 2019 prompted people to face a distressing and unexpected situation. In particular, restrictions due to the quarantine increased feelings of loneliness and anxiety. The risk of contamination and the experience of social distancing changed people’s behaviors and deeply impacted individual feelings, daily habits, and relationships.Objectives: The objectives of the study are to know the prevalence of anxiety and loneliness among generalpopulation and to study factors associating anxiety and loneliness in Tumkur city.Materials &amp; Methods: This Cross sectional study was conducted in Tumkur, Karnataka state. Study subjects were general population of age 18 yrs to 65 yrs. Study duration was from June 2020 to January 2021. 374 subjects were selected by purposive sampling.Results: In our study, 374 subjects were examined ranging from age 18-65 years situated in, Tumkur. Out of 374 subjects 176 (47.1%) subjects had minimal anxiety followed by mild anxiety in 97 (25.9%) subjects and moderate anxiety in 64 (17.1%) subjects. 9.9% of the subjects had severe anxiety.Conclusion: Mild to moderate anxiety and loneliness was seen among general population. Thus by propercommunication by using the social network, video calling people can stay connected and thereby reducing the anxiety and loneliness during these tough times.

Specific intervention program for ARFID comorbid with ASD in a Children’s Youth Autism Day Hospital

IntroductionChildren and adolescents with ASD are more likely to have eating problems compared to the general population of the same age, one of the disorders whose prevalence is increased in people with ASD is avoidant/restrictive eating disorder Food (ARFID) ARFID is characterized by a lack of interest in eating or avoidance of food intake, which in the case of people with ASD is usually related to impaired sensory processing and cognitive rigidity. For this reason, the Autism Day Hospital carries out a specific food intervention program.ObjectivesTo retrospectively evaluate the results of the Food Program of the Autism Day Hospital during the year 2022.MethodsA retrospective analysis of the cases of patients admitted to the Food Program of the Autism Day Hospital during the year 2022 is carried out. Results of the sensory pattern and presence of genetic alterations of each one of the patients are compared. And the results of the intervention are evaluated by quantifying the new foods introduced into the diet at the end of the admission.ResultsThe sample is made up of a total of 5 children (4 boys and 1 girl) aged between 7 and 12 years. All of them meet diagnostic criteria for Autism Spectrum Disorder and present comorbidity with ARFID. Of the total sample, 1 of the patients presented in the genetic study a microdeletion S. in 15q13.3, duplication in 2q13 and duplication in 5p12-p11, with the genetic studies in the rest of the patients in the sample being normal. Regarding the results of the sensory pattern (Infant/Toddler Sensory profile test), all the patients presented differences in relation to other children of their age in the oral sensory pattern, this difference being definitive in 3 of the 5 patients in the sample. All the patients included in the program presented a satisfactory evolution, introducing at least 15-20 new foods into their usual diet, including different textures and consistencies.ConclusionsThe therapeutic approach to ARFID in children with ASD carried out from a multidisciplinary perspective; sensory integration, behavioral approach and, if necessary, psychopharmacological, has shown, based on the results obtained from the food program of the ASD Day Hospital, a favorable evolution of the eating disorder. For this reason, we consider the detection of this typical comorbidity of ASD and its referral to specific therapeutic programs to be of special importance.Disclosure of InterestNone Declared

The 10-year cardiovascular risk of physicians estimated by the Thai CV risk score and its association with current coronary artery disease: A retrospective study.

To assess the 10-year cardiovascular disease (CVD) risk among Thai physicians. The risk compared to the general population and their relationship with the current coronary artery disease (CAD) were also examined. This retrospective study collected data of Thai physicians who underwent cardiovascular assessments between February 14, 2022, and October 31, 2022. The CVD risk was calculated using the Thai CVD risk (TCVR) score, which incorporated variables of age, gender, smoking, diabetes mellitus, blood pressure, and total cholesterol. Additional collected data included family history of CAD, weekly work hours, fiber diet, exercise, body mass index, coronary artery calcium (CAC) score, and presence of CAD. The association between the risk levels with presence of CAD and clinical features including CAC score were analyzed. Of 1225 physicians, the risk for CVD development was categorized as low in 80.0%, moderate in 11.2%, high in 4.9%, and very high in 3.9%. Among these, 33.6% were found to have higher relative risk compared to the general population of the same age and gender. The overall prevalence of CAD was 11.2%. This prevalence was escalated by risk or relative risk groups: 4.9% in low-, 33.8% in moderate-, 35.1% in high-, and 46.8% in very high-risk groups or 7.2% in lower risk, 8.0% the same risk, and 18.4% higher relative risk groups. Approximately, 20% of Thai physicians in the study exhibited a moderate to very high 10-year risk of CVD. Furthermore, 33.6% of the physicians had higher risk than individuals of the same age and gender in the general population. The prevalence of CAD increased with higher CVD risk and higher relative risk.