Individuals In Age Group Research Articles

The state of cancer care in Russia: malignant tumors of the skin (C44). One- and five-years survival of patients, age characteristics. Part II.

In the first part of our study, we presented an analysis of the prevalence, quality of primary registration, annual mortality, and the peculiarities of changes in the localization and histological structure of malignant neoplasms (C44) of the skin. In the second part of our research, special attention will be focused on assessing the effectiveness of anti-cancer measures concerning observed and relative one-year and cumulative five-year survival rates in the Northwestern Federal District of Russia (NWFD). The database created in 2019 for the population cancer register (PCR) at the federal district level has significantly expanded the possibilities for conducting analytical research, including the potential to study rare tumors. In this work, we will pay special attention to the new opportunity to conduct an in-depth analysis of the dynamics of localization and histological structure. We will examine the survival of patients with skin neoplasms from any affected area (lips, ears, face, back, extremities, and other parts), which is not feasible when evaluating prevalence based on state reporting forms, not to mention calculating patient survival rates. The aim of this research is to study the patterns of one-year and five-year survival of patients with skin neoplasms (C44) taking into account the main parameters of the registration card. The conducted research revealed a positive trend in the one-year observed survival of patients with skin neoplasms (C44) in the Northwestern Federal District of the Russian Federation, which increased from 95.6% to 96.2% between 2000 and 2019, with higher rates for the female population at 96.3% and 96.9%, respectively. The specificity of the level and dynamics of individual age groups of patients was identified. For the first time, the one-year survival of patients with skin neoplasms was calculated based on detailed tumor localizations and the respective one-year survival rates, as well as the one-year survival calculated separately for each tumor histotype. The highest survival rate was observed for the histotype M-8090/3 at 97.4%, while the lowest was for M-8390/3 at 59.1%.

Factors associated with drowning in Portugal, 2019-2023

Abstract Worldwide, mortality from drowning amounted to 236.000 individuals in 2019, corresponding to 8% of the total global mortality, making drowning the third leading cause of death from unintentional injuries and a universal public health problem. Portugal has a coastal zone of 950 km long, with 658 bathing waters and, in 2023, 157 people died due to drowning. This work aims to determine the factors associated with drownings that occurred in Portugal, between 2019 and 2023. This epidemiological descriptive-analytical study used the National Maritime Authority database, regarding the users of the portuguese coastal zone who suffered maritime incidents between 2019 and 2023. SPSS was used for statistical analysis and the results of the Poisson regression models are presented as adjusted prevalence ratios (APR) with 95% confidence intervals, according to individual (sex, age group and nationality), temporal (period of the week and day) and environmental (maritime department and beach surveillance status) variables. The total sample was 406 drownings and 15 860 other maritime incidents. Overall, the frequency of drownings in Portugal was higher in men (APR=1.393, 95%CI=1.130-1.717, p=.002), in the >55y age group (APR=1.780, 95%CI=1.005-3.152, p=.048), in foreigners (APR= 1.293, 95%CI=1.037-1.612, p=.022), on weekends (APR=1.299, 95%CI=1.063-1.586, p=.010), in the afternoon (APR=1.584, 95%CI=1.127-2.226, p=.008) and on unsupervised beaches (APR=2.436, 95%CI=1.958-3.029, p<.001) in comparison with users who suffered other maritime incidents. Individual, temporal and environmental factors are associated with a higher frequency of drownings in Portugal. Despite the limitation of the study that only includes users suffering maritime incidents and not all users of the portuguese coastal zone, our results allow a preliminary characterization of the drowning profile in Portugal and can contribute to the design of preventive strategies and policies to address this public health problem. Key messages • This study shows that there are individual, temporal and environmental factors strongly associated with a higher frequency of drownings in Portugal. • Portugal has a large coastal zone and the characterization of a drowning profile is the first step for the development of prevention strategies in order to oppose drowning morbidity and mortality.

Optimising liver screening in patients with a Fontan circulation: a cost-effective approach to detection of Fontan associated liver disease which enhances patient care

Abstract Introduction Patients with Fontan circulation, require screening for liver cirrhosis and malignancy, to which they are susceptible with time. Surveillance biopsies reveal nearly all adult Fontan patients develop asymptomatic fibrosis, and a majority have abnormal liver function tests (LFTs). This presents significant financial healthcare burden and psychological stress with testing for patients. Objective We aim to present "real-world" liver screening data, from a leading Adult Congenital Heart Disease (ACHD) centre, to propose a cost-reducing testing regimen, which delivers effective screening, while taking account of the challenges of current guidance, patient compliance, and clinical practice. Methods We analysed liver screening data for Fontan patients at a leading ACHD centre, focusing on biochemical tests (bilirubin, ALT, GGT) and imaging. We evaluated the 10-year financial impact of current practices, versus a hypothetical model based on age and risk factors, alongside biannual and annual screening strategies. Tariffs for biochemical test were provided by the local pathology service and we used NHS HRG tariffs for imaging and phlebotomy. Results We included data from 114 patients with a Fontan circulation (median age 32 range 19-56, 42% females). Eighteen patients developed liver cirrhosis diagnosed on imaging (median age 32, range 22-48). None developed hepatocellular carcinoma. A lack of clear and agreed local screening guidelines (over years) resulted in vastly different investigations for FALD, with inconsistent time intervals for testing. Bilirubin was elevated in 59% (55% in age 18-29), ALT was elevated in 41% (31% in age 18-29), GGT was elevated in 83% (80% in age 18-29). We found 3 cases of cirrhosis in the age group 18-29, all with hypoplastic left heart; 4 cases of cirrhosis in age group 30-34 - all had significant comorbidities; 33% had normal bilirubin, LFT and GGT, potentially not requiring further screening until the age of 35. Eleven patients (22%) age 35+ had confirmed cirrhosis (Figure 1). Performing full FALD screening with biochemistry and liver ultrasound every 12-24 months would increase the cost of screening three- to six-fold. We propose rationalising liver screening by age and underlying risk (Figure 2) to minimise the economic burden and equally the psychological impact of frequent testing on patients. Conclusions Our analysis underscores the necessity for an optimised liver screening protocol in Fontan patients, balancing diagnostic accuracy with cost-efficiency. By integrating this data, we have identified a pathway to streamline screening, tailoring it to individual risk profiles and age groups, thereby reducing unnecessary tests, lowering costs and reducing the impact of testing on patients. This approach not only fosters better patient care, but also provides a framework for developing clearer, cost-effective screening guidelines, to monitor liver health, in these complex CHD patients.

B-170 Age-Specific reference intervals for ethanolamine plasmalogen species in red blood cells using liquid chromatography tandem mass spectrometry

Abstract Background Plasmalogens are critical membrane structural components that are mainly generated by de novo synthesis starting in peroxisomes. Hence, patients with defects in peroxisome biogenesis (PBD) exhibit markedly reduced plasmalogen levels. Plasmalogen ratios are traditionally measured by gas chromatography-mass spectrometry (GC-MS); however, this method entails a lengthy sample extraction and derivatization and does not report concentrations of individual plasmalogen species. We have developed a robust and easy-to-implement liquid chromatography-tandem mass spectrometry (LC-MS/MS) method to quantify the 18 most abundant ethanolamine plasmalogen (PlsEtn) species in packed red blood cells (RBCs). However, no reference intervals have been published for individual PlsEtn. Here, we describe the establishment of age-specific reference intervals for individual PlsEtn species and their total values (16:0, 18:0, 18:1 species, and total plasmalogens). Methods Plasmalogens were extracted using methanol containing two labeled internal standards, shaking for one hour at room temperature. Chromatographic separation was performed using an Acquity Premier BEH C18 UPLC column with a binary gradient of 5 mM ammonium acetate in water:methanol (15:85) and 5 mM ammonium acetate in methanol. Analysis was performed using a XEVO TQ-XS Mass Spectrometer with Ultra-High Performance Liquid Chromatography (Waters) in multiple reaction monitoring mode. Eighteen PlsEtn species were quantified using four commercially available standards; additionally, totals were calculated for 16:0, 18:0 or 18:1 species, and for total plasmalogens. Reference intervals were established using 376 RBCs from self-reported healthy volunteers and de-identified clinical samples referred for unrelated testing (182 females and 194 males; range 0 to 88 years). Data was analyzed using the R programming language. The study was approved by the Institutional Review Board of the University of Utah. Results Initial age groups were identified using a model-based clustering algorithm followed by iterative Harris-Boyd analysis. Finally, the adjacent groups were merged if their means differed by less than 10%. Once the final age groups were partitioned, data in each individual age group were analyzed using parametric or non-parametric statistics to determine reference intervals (95%, with 90%confidence intervals). PlsEtn species displayed the lowest concentration in the first few months of life, which increased in childhood until adolescence or adulthood (depending on PlsEtn). For most species, the concentrations increased over time reaching a plateau between 18 and 48 years of age, and then starting to decrease. The total values followed the same trend, with neonates showing significantly lower values compared to other age groups. Conclusions We applied a novel statistical approach to identify age groups and determine age-specific reference intervals for 18 individual PlsEtn in RBC and their totals. Lacking previously published data, this study is critical for supporting test implementation in clinical laboratories.

Muscle strength as a marker of metabolic health in kidney transplant recipients: A cross-sectional study

BackgroundMuscle strength is often used as an indirect indicator of metabolic health across different age groups in healthy individuals. However, in kidney transplant recipients, this measure may be less accurate due to metabolic changes induced by immunosuppressive medications. AimTo compare muscle strength between kidney transplant recipients with metabolic syndrome (MS) and those without this condition. MethodsA cross-sectional analytical study was conducted with 29 participants (22 men and seven women) aged 18–50 years, having undergone a kidney transplant for over a year and without experiencing graft failure. To determine the presence of MS, the criteria proposed by the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP-III) was used. Biochemical markers (triglyceride, total cholesterol, HDL, LDL, and glucose levels) were evaluated through a capillary sample. Muscle strength was assessed through three tests: long jump, elbow flexion, and grip strength. ResultsThe mean age was 36 ± 11.3 years, and the average transplant time was 4.5 ± 2.8 years. The prevalence of MS was 58.6%. Transplant recipients with MS performed less in all tests assessing muscle strength than those without this condition (p < 0.001∗). ConclusionsThe main finding of this research is that kidney transplant patients with MS performed worse in muscle strength tests compared to those without the condition.

Age Is Just a Number? The Impact of Age on Abdominoplasty Outcomes: A Single Surgeon Experience.

Abdominoplasty is among the most popular aesthetic procedures in plastic surgery worldwide. Common indications include prior massive weight loss, surgical or not, with remaining skin excess and post-pregnancy women looking to restore their youthful abdominal contour. Aging of the worldwide population results in a greater number of older patients interested in aesthetic procedures. Identifying the impact of age on abdominoplasty outcomes is crucial in ensuring the safety of care and determining sub-optimal patients that might not benefit from the procedure. Medical records of all abdominoplasty patients operated by the senior author were screened for appropriate patients. Patients were excluded from the study if the mandatory follow-up time was not met or in instances of incomplete medical records. Patients were further stratified into 5 age groups based on age and compared using pre-operative, intra-operative and post-operative characteristics. Further regression analysis was performed to estimate the risk of complications for each individual age group, in an unadjusted and adjusted model. Six hundred and seventy-three patients were included in the study. Statistically significant differences were noted between the groups in respect smokers, prior bariatric surgery, and hypertension, diabetes mellitus and dyslipidemia (p values <0.01). Seroma rates, were greatest in the oldest age group (P value = 0.039). Odds ratio of 3.3 was calculated for seroma development in patients aged greater than 60. In a multivariate analysis, the risk diminished and was found to be statistically insignificant. Abdominoplasty is a safe procedure in all age groups. Increased rates of specific complications must be assessed in relation to potential confounders that exist between different age groups. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Single Leg Hop Performance After Anterior Cruciate Ligament Reconstruction: Ready for Landing but Cleared for Take-Off?

Understanding former professional football players engagement with health promoting behaviors (physical exercise, high quality diet, and good sleep hygiene) will be helpful for developing lifestyle interventions to improve their feelings of well-being, a relatively understudied facet of health among this population. Examine associations among health-promoting behaviors and subjective outcomes related to well-being among former National Football League (NFL) players. Cross-sectional. Online or hard-copy survey. Former NFL players. Self-reported health-promoting behaviors (exercise frequency, diet quality, sleep duration and disturbance) and factors related to well-being (PROMIS ® Meaning and Purpose [MP], Self-Efficacy [SE], Ability to Participate in Social Roles and Activities [SRA]). Multivariable linear regression models were fit for each well-being-related factor with health-promoting behaviors as explanatory variables alongside select demographic, behavioral, and functional covariates. Models were fit for the full sample and separately for individual age groups: <30 years; 30-39 years; 40-49 years; 50-59 years; 60-69 years; and 70+ years. A total of 1,784 former NFL players (aged 52.3±16.3 years) completed the survey. Lower sleep disturbance was associated with better MP (β[standard error]=-0.196[0.024]), SE (β[standard error]=-0.185[0.024]), and SRA (β[standard error]=-0.137[0.017]) in the full sample and almost all the individual age groups. More frequent moderate-to-vigorous exercise was associated with higher MP (β[standard error]=0.068[0.025]) and SRA (β[standard error]=0.151[0.065]) in the full sample, and with better MP, SE, and SRA among select middle-aged groups (between 40-69 years old). Diet quality, resistance training exercise frequency, other wellness activity frequency, and sleep duration were not associated with well-being-related factors in the full-group and sparse significant associations were observed in individual age group models. Lower sleep disturbance and more frequent moderate-to-vigorous exercise frequency may be important targets for improving overall health and well-being among former NFL players.

Optimizing number of Raman spectra using an artificial neural network guided Monte Carlo simulation approach to analyze human cortical bone

This study presents a novel methodology for optimizing the number of Raman spectra required per sample for human bone compositional analysis. The methodology integrates Artificial Neural Network (ANN) and Monte Carlo Simulation (MCS). We demonstrate the robustness of ANN in enabling prediction of Raman spectroscopy-based bone quality properties even with limited spectral inputs. The ANN algorithms tailored to individual sex and age groups, which enhance the specificity and accuracy of predictions in bone quality properties. In addition, ANN guided MCS systematically explores the variability and uncertainty inherent in different sample sizes and spectral datasets, leading to the identification of an optimal number of spectra per sample for characterizing human bone tissues. The findings suggest that as low as 2 spectra are sufficient for biochemical analysis of bone, with R2 values between real and predicted values of v1/PO4/Amide I and ∼I1670/I1640 ratios, ranging from 0.60 to 0.89. Our results also suggest that up to 8 spectra could be optimal when balancing other factors. This optimized approach streamlines experimental workflows, reduces data and acquisition costs. Additionally, our study highlights the potential for advancing Raman spectroscopy in bone research through the innovative integration of ANN-guided probabilistic modeling techniques. This research could significantly contribute to the broader landscape of bone quality analyses by establishing a precedent for optimizing the number of Raman spectra with sophisticated computational tools. It also sets a novel platform for future optimization studies in Raman spectroscopy applications in biomedical field.

Extreme Body Condition Index Values in Small Mammals.

The body condition index (BCI) values in small mammals are important in understanding their survival and reproduction. The upper values could be related to the Chitty effect (presence of very heavy individuals), while the minimum ones are little known. In this study, we analyzed extremes of BCI in 12 small mammal species, snap-trapped in Lithuania between 1980 and 2023, with respect to species, animal age, sex, and participation in reproduction. The proportion of small mammals with extreme body condition indices was negligible (1.33% with a BCI < 2 and 0.52% with a BCI > 5) when considering the total number of individuals processed (n = 27,073). When compared to the expected proportions, insectivores and herbivores were overrepresented, while granivores and omnivores were underrepresented among underfit animals. The proportions of granivores and insectivores were higher, while those of omnivores and herbivores were lower than expected in overfit animals. In several species, the proportions of age groups in underfit and overfit individuals differed from that expected. The male-female ratio was not expressed, with the exception of Sorex araneus. The highest proportion of overfit and absence of underfit individuals was found in Micromys minutus. The observation that individuals with the highest body mass are not among those with the highest BCI contributes to the interpretation of the Chitty effect. For the first time in mid-latitudes, we report individuals of very high body mass in three shrew species.

Difference in Body Composition Patterns between Age Groups in Italian Individuals with Overweight and Obesity: When BMI Becomes a Misleading Tool in Nutritional Settings.

Little is known about the changes in body composition (BC) in people with overweight or obesity. The aim of this study was to assess the differences in BC patterns in this population based on gender and age. A total of 2844 Italian adults of mixed gender and a body mass index (BMI) of ≥25 kg/m2 underwent a BC assessment by means of dual-energy X-ray absorptiometry (DXA). The sample was categorized into three age groups: 'young' (20-39 years), 'middle' (40-59 years), and 'older' (60-80 years) adults, after being matched by body weight and BMI. Males showed higher total body fat percentage (BF%) and a lower total lean mass (LM), progressively from the young to the middle to the older age groups, while females showed similar values for these total compartments between the three age groups. However, in both genders, participants in the middle and older groups were more likely to have a higher trunk fat percentage by +1.23% to +4.21%, and lower appendicular lean mass (ALM) by -0.81 kg to -2.63 kg with respect to the young group, indicating expression of major central adiposity and sarcopenia. While our findings underscore the limitations of BMI to detect these differences between age groups, the identification of new tools suitable for this aim is greatly needed in this population. Moreover, further investigation that clarifies the impact of these differences in BC patterns between gender and age groups on health outcomes is also required.

Age, gender, and infectious status-wise assessments of hematological parameters among patients with dengue infection

BackgroundThe aim of this study was to examine the impact of different stages of dengue infection on immune cell counts among dengue patients and to compare them with cases of non-dengue febrile illness. MethodsThe recruited patients were divided into two groups: the first group served as a control (n = 55), representing non-dengue febrile illness, and the second group was identified as dengue febrile illness (n = 149), which was further divided into three groups based on infection stage. Blood samples were collected from the selected patients and subjected to blood cell component analysis. To find IgG and IgM as well as the dengue virus non-structural antigen-1 (NS1), an immunochromatographic test (ICT) kit was utilized. Additionally, a hematological analyzer was used to determine complete blood cell counts (CBC). Data was thoroughly analyzed using Graph Pad Prism 6 software. The differences in means of different groups were calculated by applying the student's t-test. ResultsThe findings revealed the presence of severe leucopenia and thrombocytopenia at stages 1 and 2, accompanied by lymphopenia at stage 1. Group comparisons indicated that only teenagers exhibited a significantly lower white blood cell count compared to older individuals, while no significant differences were observed in lymphocytes, platelets, and monocytes across all age groups. Comparing different age groups of normal individuals to dengue-infected patients, the results unveiled that leucopenia was most severe in adults, followed by teenagers and children, with no significant difference in the elderly. Furthermore, adults showed the greatest degree of thrombocytopenia, followed by teens and kids, with the elderly showing the greatest degree of thrombocytopenia. Adults and teens showed extreme neutrophilia, whereas young children and the elderly showed no discernible abnormalities. Elderly patients experienced a marked decrease in monocyte count, a phenomenon not observed in other age groups. ConclusionIn conclusion both, leucopenia & thrombocytopenia, are most severe in stages 1 and 2, whereas neutrophilia & lymphopenia are predominantly severe in stage 1. These results imply that the consequences associated with dengue infection are more severe in the early stages and tend to ameliorate as the patient progresses toward recovery.

The use of pulse transit time in diagnostics of sleep-disordered breathing in children

&lt;b&gt;&lt;br&gt;Introduction:&lt;/b&gt; Sleep is the physiological state of the body where proper morphology and duration are indispensable for human functions throughout both, physical and mental spheres. Disordered breathing during sleep impairs its morphology and results in major disorders in any age group. Adverse effects of Obstructive Sleep Apnea Syndrome in children and poor availability of centers offering children’s polysomnography call for a reliable and easily accessible screening method.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Aim:&lt;/b&gt; The aim of the study were to evaluate the usefulness of pulse transit time in the diagnostics of disordered sleep breathing in children and to attempt to employ the parameter in screening tests. Pulse transit time is a physiological parameter determining the time needed for the pulse wave to travel between two measurement points.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Material and methods:&lt;/b&gt; Enrolled in the retrospective study were 153 patients (100 boys and 53 girls) suspected of obstructive sleep apnea syndrome who underwent polysomnography at I. Mościcki ENT Hospital in Chorzów.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Results:&lt;/b&gt; Statistically significant relations between apnea/hypopnea index and pulse transit time were observed in both, individual age groups and all of the patients. Pulse transit time results proved a negative correlation with apnea/hypopnea index values commonly accepted as a parameter concluding the polysomnography procedures.&lt;/br&gt; &lt;b&gt;&lt;br&gt;Conclusions:&lt;/b&gt; The results of the study indicate that pulse transit time measurements may find application in screening tests of sleep-disordered breathing in children.&lt;/br&gt;

Similar Efficacy of Mesalazine in Adult and Older Adult Ulcerative Colitis Patients: Post Hoc Analysis of a Randomized Noninferiority Trial of 1600mg vs 400mg Tablets.

The efficacy data on treatment in older adults are scarce, while the greatest increase in ulcerative colitis (UC) prevalence is observed in age groups of individuals 40 to 65 years of age and ≥65 years of age. We assessed the difference in rates of clinical and endoscopic response and remission in UC adults (≤60 years) and older adults (>60 years) treated with mesalazine. We performed a post hoc analysis of data from a phase 3 noninferiority trial of 817 UC patients treated with mesalazine for 8 and additional 26 weeks in a double-blind and open-label study, respectively. We used Wilcoxon rank sum or chi-square test to analyze differences between groups and multivariable logistic regression to determine the associations between endoscopic remission as outcome (Mayo endoscopic subscore [MES] = 0 or ≤1) and independent variables including disease duration, baseline MES, age, sex, comedications, and comorbidities. Older adults had a longer disease duration, a higher number of comorbidities, concomitant medications, and higher baseline MES (2.38 ± 0.486 in older adults vs 2.26 ± 0.439 in adults; P = .008) compared with adults. We observed no difference in rates of combined clinical and endoscopic remission, clinical remission and response, and endoscopic remission and response at week 8 and 38 post-treatment. In addition to other well-known predictors of worse outcome, patients with ≥3 comedications were less likely to achieve an MES = 0 at week 8 and 38 and an MES ≤1 at week 38. We observed similar efficacy of mesalazine in adult and older adult UC patients. The increased comedication number rather than age may decrease effectiveness of UC medications, highlighting the importance of healthy aging.

Abnormal Development of the Corpus Callosum in Autism Spectrum Disorder: An MRI Study.

Altered size in the corpus callosum (CC) has been reported in individuals with autism spectrum disorder (ASD), but few studies have investigated younger children. Moreover, knowledge about the age-related changes in CC size in individuals with ASD is limited. Our objective was to investigate the age-related size of the CC and compare them with age-matched healthy controls between the ages of 2 and 18 years. Structural-weighted images were acquired in 97 male patients diagnosed with ASD; published data were used for the control group. The CC was segmented into 7 distinct subregions (rostrum, genu, rostral body, anterior midbody, posterior midbody, isthmus, and splenium) as per Witelson's technique using ITK-SNAP software. We calculated both the total length and volume of the CC as well as the length and height of its 7 subregions. The length of the CC measures was studied as both continuous and categorical forms. For the continuous form, Pearson's correlation was used, while categorical forms were based on age ranges reflecting brain expansion during early postnatal years. Differences in CC measures between adjacent age groups in individuals with ASD were assessed using a Student t-test. Mean and standard deviation scores were compared between ASD and control groups using the Welch t-test. Age showed a moderate positive association with the total length of the CC (r = 0.43; Padj = 0.003) among individuals with ASD. Among the subregions, a positive association was observed only in the anterior midbody of the CC (r = 0.41; Padj = 0.01). No association was found between the age and the height of individual subregions or with the total volume of the CC. In comparison with healthy controls, individuals with ASD exhibited shorter lengths and heights of the genu and splenium of the CC across wide age ranges. Overall, our results highlight a distinct abnormal developmental trajectory of CC in ASD, particularly in the genu and splenium structures, potentially reflecting underlying pathophysiological mechanisms that warrant further investigation.

Walking on a Balance Beam as a New Measure of Dynamic Balance to Predict Falls in Older Adults and Patients with Neurological Conditions.

Beam walking is a new test to estimate dynamic balance. We characterized dynamic balance measured by the distance walked on beams of different widths in five age groups of healthy adults (20, 30, 40, 50, 60years) and individuals with neurological conditions (i.e., Parkinson, multiple sclerosis, stroke, age: 66.9years) and determined if beam walking distance predicted prospective falls over 12months. Individuals with (n = 97) and without neurological conditions (n = 99, healthy adults, age 20-60) participated in this prospective longitudinal study. Falls analyses over 12months were conducted. The summed distance walked under single (walking only) and dual-task conditions (walking and serial subtraction by 7 between 300 to 900) on three beams (4, 8, and 12-cm wide) was used in the analyses. Additional functional tests comprised grip strength and the Short Physical Performance Battery. Beam walking distance was unaffected on the 12-cm-wide beam in the healthy adult groups. The distance walked on the 8-cm-wide beam decreased by 0.34m in the 20-year-old group. This reduction was ~ 3 × greater, 1.1m, in the 60-year-old group. In patients, beam walking distances decreased sharply by 0.8m on the 8 versus 12cm beam and by additional 1.6m on the 4 versus 8cm beam. Beam walking distance under single and dual-task conditions was linearly but weakly associated with age (R2 = 0.21 for single task, R2 = 0.27 for dual-task). Age, disease, and beam width affected distance walked on the beam. Beam walking distance predicted future falls in the combined population of healthy adults and patients with neurological conditions. Based on receiver operating characteristic curve analyses using data from the entire study population, walking ~ 8.0 of the 12m maximum on low-lying beams predicted future fallers with reasonable accuracy. Balance beam walking is a new but worthwhile measure of dynamic balance to predict falls in the combined population of healthy adults and patients with neurological conditions. Future studies are needed to evaluate the predictive capability of beam walking separately in more homogenous populations. Clinical Trial Registration Number NCT03532984.

A metric for comparison and visualization of age disparities in cancer survival

AimsDiagnostic age is an important determinant of cancer survival but the methods generally used to analyze age-group-specific survival are not developed for ready visualization of survival differences. We aim at developing a novel metric for comparing and visualizing age-group-specific survival data over different cancers, sexes, periods and countries. MethodsThe metric describes the mean absolute deviation between age-groups. The metric can be used in two variations, one showing the mean variation and its 95% confidence intervals and the other highlighting individually each age-groups distinguishing positive or negative deviations. We demonstrate the applications with age-group- specific 5-year relative survival data from the NORDCAN database ResultsThe mean absolute deviation between age-groups for Swedish colon cancer survival declined from about 5% in 1972–1981–1% in 1992–2001 and to 1.3% in 2012–2021. Patients diagnosed before age 50 years accounted for the largest positive deviation. For acute myeloid leukemia (AML) the mean deviation increased from 4% (female) to 17% and 23%. Patients diagnosed at age below 50 years showed the largest deviations. Comparing colon cancer mean deviations between the Nordic countries, a time-related decline was observed for all, those in Sweden ending at the lowest and in Finland the highest level. ConclusionsWe demonstrated the usefulness of the devised metric for summarizing age-specific survival data between cancers, sexes, periods and countries. The two variations of the metric allow a simple visual presentation of the survival experience as to deviation of the survival data, its 95%CIs and its highlighted individual age-group components.

Analyzing the correlation between body composition variables and cellular phase angle via computerized bioelectrical impedance analysis (BIA)

Background: Various diseases and pathological conditions, as well as inflammatory processes, either in isolation or in combination with advanced age, can lead to significant alterations in body composition. This study investigates the correlation between various body composition metrics and the cellular Phase Angle (PhA) through Computerized Bioelectrical Impedance Analysis (BIA) in a diverse age group of individuals ranging from 18 to 80 years. Objective: Our aim was to explore the interplay between body composition variables such as Body Mass Index, Lean Body Mass, Skeletal Muscle Mass, and their potential influence on the cellular integrity as indicated by PhA. Methods: Utilizing a dataset of 199 participants, we employed both linear and advanced machine learning models, including Random Forest regression, to analyze the predictive relationships and variable importance within our body composition metrics. Results: Initial analyses revealed strong correlations between mass-related measures and suggested complex relationships with the PhA, an indicator of cellular health and membrane integrity. The Random Forest model significantly outperformed simple linear regression in predicting PhA, emphasizing the nonlinear nature of these relationships and the importance of a comprehensive approach in body composition assessment. Conclusion: Our findings highlight the nuanced interactions between body composition variables and their collective impact on cellular health as measured by PhA. This study underscores the potential of utilizing PhA alongside traditional metrics for a more nuanced understanding of body composition and its implications for health. Future research should continue to leverage advanced statistical and machine learning techniques to further elucidate these complex relationships, with implications for nutritional, sports medicine, and biomedical fields. Initial analyses revealed strong correlations between mass-related measures and suggested complex relationships with the Phase Angle, an indicator of cellular health and membrane integrity. The Random Forest model significantly outperformed simple linear regression in predicting PhA, emphasizing the nonlinear nature of these relationships and the importance of a comprehensive approach in body composition assessment. Our findings highlight the nuanced interactions between body composition variables and their collective impact on cellular health as measured by PhA. This study underscores the potential of utilizing PhA alongside traditional metrics for a more nuanced understanding of body composition and its implications for health. Future research should continue to leverage advanced statistical and machine learning techniques to further elucidate these complex relationships, with implications for nutritional, sports medicine, and biomedical fields.

Using disability-adjusted life years measure for characterization of radiation risk from fluoroscopy

Medical diagnostics procedures involving the use of ionising radiation is one of the most intensively developing areas in medical diagnostics. At the same time, medical exposure of patients has a number of fundamental differences from other routine situations of planned exposure. As a rule, medical exposure is acute, and radiation doses in some types of examinations exceed the level of natural and man-made exposure associated with normal operation of radiation facilities. In such a situation, risk differentiation is of great importance, taking into account the different radiosensitivity of individual sex and age groups of patients. Radiation risks should be taken into account both when prescribing examinations involving the use of ionising radiation and when analysing the benefit-harm ratio associated with their application to specific patients. Another reason why risk assessment is an urgent task is the need to inform patients and/or their legal representatives about the health risks associated with the carrying out of examinations, including radiation risks. Within the framework of the present work, the risks associated with fluoroscopic examinations were assessed. To characterise the risk we used the DALY indicator, which is more and more frequently used in risk assessment, reflecting the possible number of lost years of healthy life as a result of radiation exposure during the study. The aim of the work was to calculate DALY values for different sex and age groups of patients from the Russian population during fluoroscopic examinations. To achieve this aim, the method of estimating the number of healthy life years lost due to exposure to ionising radiation, which was developed in the course of the research work, was used. The paper presents the results of calculating DALY values for three types of fluoroscopic examinations. This work represents the next step in the direction of harmonisation of radiation risk assessment methodology with the methodologies of risk assessment of other nature. One of the directions of using the calculation results is the development of methodological approaches to the calculation of sex- and age-dependent risk coefficients associated with medical exposure of patients. The analysis of the obtained results showed that the contribution of oncological diseases to the total radiation harm in older men was significantly higher than in women.

Concordance between SARS-CoV-2 index individuals and their household contacts on index individual COVID-19 transmission cofactors: a comparison of self-reported and contact-reported information

BackgroundFollowing the outbreak of the COVID-19 pandemic, several clinical trials have evaluated postexposure prophylaxis (PEP) among close contacts of an index individual with a confirmed SARS-CoV-2 infection. Because index individuals do not directly inform the efficacy of prevention interventions, they are seldom enrolled in COVID-19 PEP studies. However, adjusting for prognostic covariates such as an index individual’s COVID-19 illness and risk behaviors can increase precision in PEP efficacy estimates, so approaches to accurately collecting this information about the index individual are needed. This analysis aimed to assess whether surveying household contacts captures the same information as surveying the index individual directly.MethodsREGN 2069/CoVPN 3502, a randomized controlled trial of COVID-19 PEP, enrolled household contacts of SARS-CoV-2 index individuals. CoVPN 3502-01 retrospectively enrolled and surveyed the index individuals. We compared responses to seven similar questions about the index individuals’ transmission cofactors that were asked in both studies. We estimated the percent concordance between index individuals and their household contacts on each question, with 50% concordance considered equivalent to random chance.ResultsConcordance between index individuals and contacts was high on the most objective questions, approximately 97% (95% CI: 90–99%) for index individual age group and 96% (88–98%) for hospitalization. Concordance was moderate for symptoms, approximately 85% (75–91%). Concordance on questions related to the index individual’s behavior was only slightly better or no better than random: approximately 62% (51–72%) for whether they received COVID-19 treatment, 68% (57–77%) for sharing a bedroom, 70% (59–79%) for sharing a common room, and 49% (39–60%) for mask wearing at home. However, while contacts were surveyed within 96 h of the index individual testing positive for SARS-CoV-2, the median time to enrollment in CoVPN 3502-01 was 240 days, which may have caused recall bias in our results.ConclusionsOur results suggest a need to survey index individuals directly in order to accurately capture their transmission cofactors, rather than relying on their household contacts to report on their behavior. The lag in enrolling participants into CoVPN 3502-01 also highlights the importance of timely enrollment to minimize recall bias.

Global, regional and national temporal trends in prevalence for cardiovascular diseases in women of childbearing age, from 1990 to 2019: An age-period-cohort analysis

BackgroundEpidemiological studies on cardiovascular diseases (CVD) among women of childbearing age (WCBA) remain scarce. Our research aims to delineate the prevalence trends of CVD within this population over the past three decades, considering age, period, and birth cohort dynamics. MethodsEstimates of CVD prevalence for WCBA, along with their 95% uncertainty intervals (UI), were extracted from the Global Burden of Diseases 2019 (GBD2019). An age-period-cohort (APC) model was utilized to assess the annual percentage change (net drifts) in overall prevalence, annual percentage changes in prevalence for individual age groups (local drifts), and fitted longitudinal age-specific rates adjusted for age effects and period/cohort relative risks (period/cohort effect). ResultsIn 2019, the global prevalence of CVD among WCBA was 53.42 million (95% UI: 47.77 to 60.18). Eight countries recorded a prevalence exceeding one million, accounting for 54.17% of the global CVD prevalence in WCBA. Over the past 30 years, the annual net drift in CVD prevalence among the global WCBA was 0.27% (95% CI: 0.25 to 0.29). This value was 0.01% (95% CI: 0.04 to 0.06) in regions with a high sociodemographic index (SDI) and 0.21% (95% CI: 0.19 to 0.22) in those with a low SDI. Seventy-seven countries demonstrated an increasing trend in CVD prevalence, while 53 showed a decrease, and 74 remained relatively stable. Notably, as shown in local drift, there was a rise in CVD prevalence among adolescents aged 15–19 and adults aged 40–49 in regions categorized by five distinct SDI levels. This drift varied by SDI regions. Regions with a high SDI consistently had elevated period risks throughout the study duration, while other regions had lower period risks until 2000–2004 and displayed increased adverse period risks. The prevalence in low-middle and low SDI regions manifested detrimental trends, whereas other regions demonstrated an initial decline followed by a surge in successive birth cohorts. ConclusionsResources dedicated to CVD care for WCBA are largely insufficient, especially in low SDI regions. Thus, there is an urgent need to allocate cardiovascular healthcare resources variably across different SDI regions, aiming to diminish risks among successively younger birth cohorts. Throughout this endeavor, the formulation of targeted policies and the judicious distribution of resources are essential to reduce risks for women across all age groups.