Intermediate Age Groups Research Articles

Dynamical Evolution of Four Old Galactic Open Clusters Traced by Their Constituent Stars with Gaia DR3

We investigate the evolutionary stages of four open clusters—Berkeley 39, Collinder 261, NGC 6819, and NGC 7789—of ages ranging from 1.6 to 6 Gyr. These clusters have previously been classified into dynamically young and intermediate age groups based on the segregation level of BSS with respect to red-giant-branch stars and main-sequence stars, respectively. We identify members of these four clusters using the ML-MOC algorithm on Gaia DR3 data. To examine the relative segregation of cluster members of different evolutionary stages, we utilize cumulative radial distributions, proper motion distributions, and spatial distributions in galactocentric coordinates. Our analysis shows that Berkeley 39 and NGC 6819 exhibit moderate signs of population-wise segregation from evolved to less-evolved members. NGC 7789 shows signs of mass segregation only in the cumulative radial distributions. On the other hand, Collinder 261 exhibits high segregation of BSS in the cumulative radial distribution, while other populations show the same level of segregation.

Magnitude and kinetics of a set of neuroanatomic volume and thickness together with white matter hyperintensity is definitive of cognitive status and brain age

Even among the subjects classified as cognitively normal, there exists a subset of individuals at a given chronological age (CA) who harbor white matter hyperintensity (WMH) while another subset presents with low or undetectable WMH. Here, we conducted a comprehensive MRI segmentation of neuroanatomic structures along with WMH quantification in groups of cognitively normal (CN), cognitively impaired (CI) individuals, and individuals with an etiological diagnosis of cognitive impairment owing to Alzheimer’s Disease (CI-AD) across the early (50–64 years), intermediate (65–79 years), and late (≥80 years) age groups from the NACC cohort. Neuroanatomic volumetry quantification revealed that thinning of the parahippocampal gyrus in the early (p = 0.016) and intermediate age groups (p = 0.0001) along with an increase in CSF (p = 0.0009) delineates between CI and CI-AD subjects. Although, a significant loss of ~5–10% in volume of gray matter (p(CN vs CI) < 0.0001, p(CN vs CI-AD) < 0.0001), white matter (p(CN vs CI) = 0.002, p(CN vs CI-AD) = 0.0003) and hippocampus (p(CN vs CI) = 0.007, p(CN vs CI-AD) < 0.0001) was evident at the early age groups in the CI and CI-AD compared to CN but it was not distinct between CI and CI-AD. Using the neuroanatomic and WMH volume, and the supervised decision tree-based ML modeling, we have established that a minimum set of Three brain quantities; Total brain (GM + WM), CSF, and WMH volume, provide the Optimal quantitative features discriminative of cognitive status as CN, CI, and CI-AD. Furthermore, using the volume/thickness of 178 neuroanatomic structures, periventricular and deep WMH volume quantification for the 819 CN subjects, we have developed a quantitative index as ‘Brain Age’ (BA) depictive of neuroanatomic health at a given CA. Subjects with elevated WMH load (5–10 ml) had increased BA ( + 0.6 to +4 years) than the CA. Increased BA in the subjects with elevated WMH is suggestive of WMH-induced vascular insult leading to accelerated and early structural loss than expected for a given CA. Henceforth, this study establishes that quantification of WMH together with an optimal number of neuroanatomic features is mandatory to delve into the biological underpinning of aging and aging-associated cognitive disorders.

Aging promotes accumulation of senescent and multiciliated cells in human endometrial epithelium.

What changes occur in the endometrium during aging, and do they impact fertility? Both the transcriptome and cellular composition of endometrial samples from women of advanced maternal age (AMA) are significantly different from that of samples from young women, suggesting specific changes in epithelial cells that may affect endometrial receptivity. Aging is associated with the accumulation of senescent cells in aging tissues. Reproductive aging is mostly attributed to the decline in ovarian reserve and oocyte quality, whereas the endometrium is a unique complex tissue that is monthly renewed under hormonal regulation. Several clinical studies have reported lower implantation and pregnancy rates in oocyte recipients of AMA during IVF. Molecular studies have indicated the presence of specific mutations within the epithelial cells of AMA endometrium, along with altered gene expression of bulk endometrial tissue. Endometrial transcriptome profiling was performed for 44 women undergoing HRT during the assessment of endometrial receptivity before IVF. Patients younger than 28 years were considered as the young maternal age (YMA) group (age 23-27 years) and women older than 45 years were considered as the AMA group (age 47-50 years). Endometrial biopsies were obtained on Day 5 of progesterone treatment and RNA was extracted. All endometrial samples were evaluated as being receptive based on the expression of 68 common endometrial receptivity markers. Endometrial samples from another 24 women classified into four age groups (YMA, intermediate age group 1 (IMA1, age 29-35), intermediate age group 2 (IMA2, age 36-44), and AMA) were obtained in the mid-secretory stage of a natural cycle (NC) and used for validation studies across the reproductive lifespan. A total of 24 HRT samples (12 YMA and 12 AMA) were subject to RNA sequencing (RNA-seq) and differential gene expression analysis, 20 samples (10 YMA and 10 AMA) were used for qPCR validation, and 24 NC samples (6 YMA, 6 IMA1, 6 IMA2 and 6AMA) were used for RNA-seq validation of AMA genes across the woman's reproductive lifespan. Immunohistochemistry (IHC) was used to confirm some expression changes at the protein level. Computational deconvolution using six endometrial cell type-specific transcriptomic profiles was conducted to compare the cellular composition between the groups. Comparisons between YMA and AMA samples identified a lower proportion of receptive endometria in the AMA group (P = 0.007). Gene expression profiling identified 491 differentially expressed age-sensitive genes (P adj < 0.05) that revealed the effects of age on endometrial epithelial growth and receptivity, likely contributing to decreased reproductive performance. Our results indicate that changes in the expression of the cellular senescence marker p16INK4a and genes associated with metabolism, inflammation, and hormone response are involved in endometrial aging. Importantly, we demonstrate that the proportion of multi-ciliated cells, as discovered based on RNA-seq data deconvolution and tissue IHC results, is affected by endometrial aging, and propose a putative onset of age-related changes. Furthermore, we propose that aging has an impact on the transcriptomic profile of endometrial tissue in the context of endometrial receptivity. The raw sequencing data reported in this article are deposited at the Gene Expression Omnibus under accession code GSE236128. This retrospective study identified changes in the endometrium of patients undergoing hormonal replacement and validated these changes using samples obtained during a NC. However, future studies must clarify the importance of these findings on the clinical outcomes of assisted reproduction. The findings reported in this study have important implications for devising future strategies aimed at improving fertility management in women of advanced reproductive age. This research was funded by the Estonian Research Council (grant no. PRG1076), Horizon 2020 innovation grant (ERIN, grant no. EU952516), Enterprise Estonia (grant no. EU48695), MSCA-RISE-2020 project TRENDO (grant no. 101008193), EU 874867 project HUTER, the Horizon Europe NESTOR grant (grant no. 101120075) of the European Commission, the EVA specialty program (grant no. KP111513) of the Maastricht University Medical Center (MUMC+), MICIU/AEI/10.13039/501100011033 and FEDER, EU projects Endo-Map (grant no. PID2021-12728OB-100), ROSY (grant no. CNS2022-135999), and the National Science Fund of Bulgaria (grant no. KII-06 H31/2). The authors declare no competing interests.

Polycythemia vera and essential thrombocythemia of intermediate-age: A real-life, multicenter analysis of first-line treatment approach.

The treatment of patients with polycythemia vera (PV) and essential thrombocythemia (ET) is conducted according to well-defined risk stratification systems. We hypothesized that adherence to the guidelines, namely the decision to refrain from introducing cytoreduction in non-high-risk patients, is particularly difficult in patients diagnosed when they are between 40 and 59 years of age (intermediate-age group). To evaluate the group of intermediate-age PV and ET patients, focusing on a first-line treatment approach adapted at diagnosis. The study group consisted of 308 PV and ET patients recruited from 6 Polish Adult Leukemia Group (PALG) Centers. Patients were analyzed with respect to disease phenotype, risk group, treatment approach, cardiovascular (CV) risk factors, and occurrence of bleeding or thrombosis. Overall, 74% of patients in the study group were started on cytoreduction at diagnosis, including 70% of the low-risk PV patients and 85-89% of the non-high-risk ET patients. Factors influencing the decision to start the treatment included higher hemoglobin (Hb) concentration (in PV) as well as higher platelet (PLT) count, and the presence of CV risk factors (in ET). Introducing cytoreduction at diagnosis had no impact on thrombotic events. Patients harboring CV risk factors experienced a higher incidence of complications both at diagnosis and follow-up, independently of the treatment strategy. We underline the low adherence to recommendations in the treatment of intermediate-age PV and ET patients. Moreover, we emphasize the importance of CV risk factors and stress their impact on disease phenotype in this patient population.

An ecological study of the spatiotemporal dynamics and drivers of domestically acquired campylobacteriosis in Ireland, 2011-2018.

In 2021, Campylobacteriosis was the main gastrointestinal disease in the European Union since 2007 according to the European Centre for Disease Prevention and Control. In the Republic of Ireland, the incidence of the disease is particularly high with approximately 3,000 cases per annum, raising significant concerns for national health authorities with an expected increase in the number of cases in the light of climate change. The current study sought to assess the spatio-temporal patterns of campylobacteriosis in the Republic of Ireland using 20,391 cases from January 2011 to December 2018. An ensemble of spatial statistics techniques including seasonal decomposition, spatial clustering and space-time scanning, were used to elucidate the main individual and spatio-temporal characteristics of the disease in the country. Findings revealed that cases from the paediatric age group (i.e., under 5 years old) were more likely to occur in rural areas (aOR: 1.1.27, CI 95% 1.14-1.41) while cases from the intermediate age group (i.e., >5 & <65 years old) were associated with urban living (aOR: 1.30, CI 95% 1.21-1.4). The disease exhibited a peak during Irish summer, with a stronger seasonal signal reported in counties located on the Western part of the country. Infection hotspots were more likely to occur in urban areas, and more particularly on the Southern part of the island and around the main metropolitan areas. Overall, research findings pointed out the influence of local and spatio-temporally specific socio-demographic and environmental risk factors (i.e., cooking habits, local weather, dietary types) therefore highlighting the need for initiating spatio-temporally targeted health management and surveillance strategies.

Vascular risk, gait, behavioral, and plasma indicators of VCID.

Cost-effective screening tools for vascular contributions to cognitive impairment and dementia (VCID) has significant implications. We evaluated non-imaging indicators of VCID using magnetic resonance imaging (MRI)-measured white matter (WM) damage and hypothesized that these indicators differ based on age. In 745 participants from the Mayo Clinic Study of Aging (≥50 years of age) with serial WM assessments from diffusion MRI and fluid-attenuated inversion recovery (FLAIR)-MRI, we examined associations between baseline non-imaging indicators (demographics, vascular risk factors [VRFs], gait, behavioral, plasma glial fibrillary acidic protein [GFAP], and plasma neurofilament light chain [NfL]) and WM damage across three age tertiles. VRFs and gait were associated with diffusion changes even in low age strata. All measures (VRFs, gait, behavioral, plasma GFAP, plasma NfL) were associated with white matter hyperintensities (WMHs) but mainly in intermediate and high age strata. Non-imaging indicators of VCID were related to WM damage and may aid in screening participants and assessing outcomes for VCID. Non-imaging indicators of VCID can aid in prediction of MRI-measured WM damage but their importance differed by age. Vascular risk and gait measures were associated with early VCID changes measured using diffusion MRI. Plasma markers explained variability in WMH across age strata. Most non-imaging measures explained variability in WMH and vascular WM scores in intermediate and older age groups. The framework developed here can be used to evaluate new non-imaging VCID indicators proposed in the future.

Pediatric age-related distribution of calcium oxalate monohydrate and calcium oxalate dihydrate in urinary tract stones: metabolic, gender and ethnic correlates.

Previous studies of pediatric urolithiasis have suggested possible associations between the relative proportions of calcium oxalate dihydrate (COD) and calcium oxalate monohydrate (COM) stones with age, gender, and ethnicity. This study aimed to investigate the composition and distribution of calcium oxalate stones according to these clinical factors and the metabolic correlates of the different subtypes in pediatric stone formers. We retrospectively reviewed the database of all first-time stone formers between 2014 and 2019. Infrared spectrometry was used to determine stone composition. Stones were categorized by their highest relative component and reported as a percentage of occurrences in the cohort as a whole and by patient gender, age (divided into three age groups: 1-5, 6-12, 13-18 years), and ethnicity. Clinical and metabolic correlates were analyzed. Of 2,479 consecutive stones submitted to our chemical stone lab, 220 first-time pediatric stone formers were identified. COD stones were the predominant subtype in the youngest group, and COM stones in the oldest group (OR 0.39, 95% CI:0.18-0.86, p=0.036). In the intermediate-age group (6-12 years), COM stones were more prevalent in Arab boys and COD stones in girls of either ethnicity. COD stones were associated with hypercalciuria (p< 0.0001), and COM stones with hyperoxaluria (p=0.0024). Hypercalciuria and hypocitraturia were the most prevalent abnormalities at ages 1-5 and 13-18, respectively. Analysis of calcium oxalate stone subtypes and their metabolic correlates in stone formers has significant clinical relevance, specifically in children. In the present study, COD stones and hypercalciuria were more common in younger children, and COM stones and hypocitraturia in adolescents. These findings suggest unique, complex interactions driving stone formations in children that may guide a more practical, limited, and cost-effective approach to metabolic evaluations, choice of treatment, and preventive measures, particularly in first-time calcium oxalate pediatric stone-formers.

Dynamical Origin for the Collinder 132–Gulliver 21 Stream: A Mixture of Three Comoving Populations with an Age Difference of 250 Myr

We use Gaia DR3 data to study the Collinder 132–Gulliver 21 region via the machine-learning algorithm StarGO and find eight subgroups of stars (ASCC 32, Collinder 132 gp 1–6, Gulliver 21) located in close proximity. Three comoving populations were identified among these eight subgroups: (i) a coeval 25 Myr old moving group (Collinder 132), (ii) an intermediate-age (50–100 Myr) group, and (iii) the 275 Myr old dissolving cluster Gulliver 21. These three populations form parallel diagonal stripe-shape overdensities in the U–V distribution, which differ from open clusters and stellar groups in the solar neighborhood. We name this kinematic structure the Collinder 132–Gulliver 21 stream, as it extends over 270 pc in the 3D space. The oldest population, Gulliver 21, is spatially surrounded by the Collinder 132 moving group and the intermediate-age group. Stars in the Collinder 132–Gulliver 21 stream have an age difference up to 250 Myr. Metallicity information shows a variation of 0.3 dex between the youngest and oldest populations. The formation of the Collinder 132–Gulliver 21 stream involves both star formation and dynamical heating. The youngest population (Collinder 132 moving group) with homogeneous metallicity is probably formed through filamentary star formation. The intermediate-age and oldest populations were then scattered by the Galactic bar or spiral structure resonance to intercept Collinder 132's orbit. Without mutual interaction between each population, the three populations are flying by each other currently and will become three distinct groups again in ∼50 Myr.

Prevalence of chronic comorbidities in people with multiple sclerosis: descriptive study based on administrative data in Tuscany (Central Italy)

ObjectiveChronic comorbidities are common in people with multiple sclerosis (PwMS), thus worsening their prognosis and quality of life, and increasing disease burden. The aim of the present study was to evaluate the prevalence of common comorbidities in PwMS in Tuscany (Central Italy) and to compare it with the general population.MethodsThe prevalence of comorbidities, including diabetes, chronic obstructive pulmonary disease (COPD), hypertension, stroke, heart failure (HF), cardiac infarction and ischemic heart disease (IHD), was assessed in PwMS and in general population resident in Tuscany, aged > 20 years, using administrative data.ResultsIn total, we identified 8,274 PwMS. Among them, 34% had at least one comorbidity, with hypertension being the most common (28.5%). Comparing PwMS with the general population, PwMS had a higher frequency of hypertension and stroke when considering the whole group, and of diabetes, COPD, and IHD when considering sex and age subgroups. This increased risk was especially evident in the young and intermediate age groups, where multiple sclerosis may play an important role as risk factor for some comorbidities.In PwMS, as well as in the general population, prevalence of chronic diseases was higher in males and increased with age.ConclusionsComorbidities frequently coexist with multiple sclerosis and they may have an impact on this complex disease, from the health, clinical, and socioeconomic points of view. Therefore, a routine screening of chronic comorbidities should be a crucial step in clinical practice, as well as the promotion of healthy lifestyles to prevent the onset and to reduce their burden.

Age-Related Posterior Cruciate Ligament Surgical Anatomy in a Skeletally Immature Population: An MRI Study

Background: Magnetic resonance imaging (MRI) analysis of the developmental morphology of the anterior cruciate ligament (ACL) in pediatric and adult patients has led to the identification of anatomical risk factors for injury and optimization of surgical reconstruction. Similar work regarding the pediatric posterior cruciate ligament (PCL) is limited. The aim of this study was to describe age-dependent changes in ligamentous and osseous anatomy of the pediatric PCL by comparison of MRI measurements. Methods: Sixty randomly selected patients were categorized into three skeletal age groups (ages 7-9 years, 10-12 years, and 13-15 years) with 20 patients in each. Twelve anatomical dimensions were measured on MRI by two independent reviewers. Pairwise comparisons were conducted between the youngest and intermediate, as well as the intermediate and oldest age groups. Results: Statistically significant growth in femoral physis width (p&lt;0.001), tibial physis width (p&lt;0.001), and medial femoral condyle (MFC) width (p&lt;0.001) and height (p&lt;0.001) was found across all skeletal age groups. Growth in femoral PCL height (p=0.02), femoral PCL footprint to femoral physis height (p=0.004), tibial PCL insertion width (p&lt;0.001), tibial PCL footprint to tibial physis distance (p&lt;0.001), and tibial epiphysis height (p=0.003) and width (p&lt;0.001) was only statistically significant between the youngest and intermediate groups. Only MFC height (p=0.03) and width (p=0.001), femoral PCL height (p=0.05), and tibial physis width (p=0.02) were significantly larger in the oldest compared to the intermediate group. Intrarater reliability for all measurements was excellent; interrater reliability was variable. Conclusions: Morphological changes of the pediatric PCL and associated surgical anatomy vary by skeletal age throughout childhood and adolescence. Differences were most evident between preadolescents with open physes compared to adolescents with closing physes, who demonstrated slowed or plateaued growth in most dimensions. The femoral physis was located proximal to the origin of the PCL in all age groups. The relationship of the distal PCL footprint to posterior proximal tibial physis varied. Young children (7-9 years) had footprints significantly more distal to the tibial physis, thus, native PCL reconstruction in this age group may be possible. Anatomical reconstruction in adolescents poses greater risk as the PCL footprint is closest to the tibial physis. Analysis of age-dependent transformations of the PCL and surrounding anatomy may inform surgical planning and enhance understanding of physeal location in this active population.

Assessment of Neutralizing Antibody Response Against SARS-CoV-2 Variants After 2 to 3 Doses of the BNT162b2 mRNA COVID-19 Vaccine

Although 2 and 3 doses of vaccine have been implemented against the SARS-CoV-2 pandemic, the level of immunity achieved by these additional vaccinations remains unclear. To investigate the induction of neutralizing antibodies against the SARS-CoV-2 Omicron variant after 2 and 3 doses of the BNT162b2 messenger RNA (mRNA) vaccine among recipients of different ages. A cohort study was conducted from June 1, 2021, to January 12, 2022, among 82 physicians at Kobe University Hospital who had received 2 doses of the BNT162b2 mRNA vaccine. The rates of positive test results and the titers of neutralizing antibodies against the Omicron variant after 2 and 3 doses of the vaccine were compared with those against other variants and compared among 3 age groups (≤38 years [younger age group], 39-58 years [intermediate age group], and ≥59 years [older age group]). A total of 82 physicians (71 men [87%]; median age, 44 years [IQR, 33-58 years]) participated; 31 (38%) were in the younger age group, 32 (39%) were in the intermediate age group, and 19 (23%) were in the older age group. At 2 months after 2 doses of the vaccine, 23 participants (28%) had neutralizing antibodies against the Omicron variant, with a titer of 1.3 (95% CI, 1.2-1.4), which was 11.8-fold (95% CI, 9.9-13.9) lower than the titer against the D614G variant and the lowest among the variants tested. Although the titer of the neutralizing antibody against the Delta variant tended to be low among the older age group (2.9 [95% CI, 2.0-4.1]), the titers of the neutralizing antibody against the Omicron variant were low among all age groups (younger age group, 1.3 [95% CI, 1.1-1.6]; intermediate age group, 1.3 (95% CI, [95% CI, 1.1-1.5]; and older age group, 1.2 [95% CI, 1.0-1.4]). At 7 months after 2 doses of the vaccine, 5 participants (6%) had the neutralizing antibody against the Omicron variant, but after the booster (third dose) vaccination, all 72 participants who received the booster had the neutralizing antibody, and the titer was 41 (95% CI, 34-49), much higher than that at 7 months after 2 doses of the vaccine (1.0 [95% CI, 1.0-1.1]). This increase in titers was observed regardless of age groups; the titers were 44 (95% CI, 32-59) among the younger age group, 44 (95% CI, 32-59) among the intermediate age group, and 30 (95% CI, 22-41) among the older age group. In this cohort study of 82 Japanese participants, 2 doses of the BNT162b2 mRNA vaccine did not induce sufficient neutralizing antibody against the Omicron variant. However, booster vaccination was associated with induction of a high level of neutralizing antibodies against the Omicron variant, irrespective of the recipient's age.

Age-Related Changes on Mri Of Posterior Cruciate Ligament Morphology in A Skeletally Immature Population

Background:Magnetic resonance imaging (MRI) analysis of the developmental morphology of the anterior cruciate ligament (ACL) in pediatric and adult patients has led to the identification of anatomical risk factors for injury and optimization of surgical reconstruction. Similar work regarding pediatric posterior cruciate ligament (PCL) morphology is limited despite increasing incidence of PCL injury and rising favorability of surgical reconstruction.Purpose:The aim of this study was to describe age-dependent changes in ligamentous and osseous anatomy of the pediatric PCL by comparison of MRI measurements across pre-adolescent and adolescent age groups.Methods:Sixty patients with a knee MRI and wrist radiographs who were seen from 2008 to 2018 at a single tertiary care center were randomly selected from a departmental database and categorized into skeletal age groups (ages 7-9 years, 10-12 years, and 13-15 years) with 20 patients in each group (Table 1). Skeletal age was determined from wrist radiographs and patients with a PCL injury or prior knee surgery were excluded. Twelve dimensions of the PCL substance or its osseous attachment sites were measured on MRI by two independent reviewers. Pairwise comparisons were conducted between the youngest and intermediate, as well as the intermediate and oldest skeletal age groups.Results:There was statistically significant growth across skeletal age groups in femoral physis width (p<0.001), tibial physis width (p<0.001), and medial femoral condyle (MFC) width (p<0.001) and height (p<0.001). Growth in femoral PCL height (p=0.02), femoral PCL footprint to femoral physis height (p=0.004), tibial PCL insertion width (p<0.001), tibial PCL footprint to tibial physis height (p<0.001), and tibial epiphysis height (p=0.003) and width (p<0.001) was only statistically significant between the youngest and intermediate groups. Only MFC height (p=0.03) and width (p=0.001), femoral PCL height (p=0.05), and tibial physis width (p=0.02) were significantly larger in the oldest compared to the intermediate group. Intrasubstance PCL width did not demonstrate significant age-related change (Table 2). Intrarater reliability for all measurements was excellent; interrater reliability was variable.Conclusions:Morphological changes of the pediatric PCL and associated osseous anatomy vary by skeletal age throughout childhood and adolescence. These changes were most pronounced in preadolescents with open physes (ages 7-12 years) compared to adolescents with closing physes (ages 13-15 years), who demonstrated slowed or plateaued growth in most dimensions. These skeletal age-dependent transformations of the PCL and surrounding osseous anatomy may guide surgical planning and inform injury risk prediction and prevention in this active population.Table 1.Cohort characteristics. (N=60)Table 2.MRI measurement summary by skeletal age group.

Evaluation of inflammatory and oxidative profile in patients with recurrent wheezing

Wheezing is a clinical expression of numerous respiratory-related conditions. Although asthma is the leading cause of wheezing during childhood. The present study aims to evaluate the inflammatory and oxidative profile of pediatric patients with recurrent wheezing. Seventy-eight volunteers were divided into three groups according to their age (≤ 36, 36 to 72 and ≥ 73 months). Blood was collected for hematological evaluation, serum detections of total immunoglobulin E (IgE), and C-reactive protein (PCRus). The oxidative profile was evaluated by total antioxidant capacity (FRAP), malondialdehyde (MDA) and carbonylated protein markers. There was no significant difference in the IgE and PCRus levels among the three groups evaluated. However, a significant positive correlation was observed for PCRus with total leukocyte and with neutrophils for the group of patients ≥ 73 months of age. The intermediate age group presented significantly reduced FRAP values in the serum, while significant values of oxidative damage markers were observed in the group of patients ≥ 73 months of age. When determining the correlation between inflammatory and oxidative markers, only the ≥ 73 months group showed significant. The group ≥ 73 months stands out with significant alterations of the oxidative stress markers and their correlations with the inflammatory profile.

Concordance of Guideline-Based Risk Stratification and Selection of Patients for Transcatheter Aortic Valve Implantation or Surgical Replacement

The 2020 American Health Association/American College of Cardiology valve guidelines recommend surgical aortic valve replacement (SAVR) for symptomatic patients with aortic stenosis (AS) age <65 years and transcatheter aortic valve implantation (TAVI) for patients with AS age >80 years. We analyzed TAVI versus SAVR practice patterns using age-based recommendations. We compared 2016-to-2019 TAVI and isolated SAVR in northern New England at 5 centers according to guideline-recommended age groups. Multivariable logistic regression was performed to identify independent predictors of TAVI for the intermediate age group. The study was approved by each site's institutional review board in accordance with ongoing participation and quality improvement efforts in the Northern New England Cardiovascular Study Group. Among 4,161 patients with isolated severe AS, TAVI increased from 2016 to 2019: 55.8% versus 76.1%, p <0.01 for trend. SAVR for patients with AS age >80 years was uncommon and decreased over time: 13.1% versus 1.6%, p <0.01. TAVI utilization nearly doubled over time in young patients with AS age <65 years (14.3% vs 26.2%, p <0.01). Preference for SAVR decreased by 50% over time (p <0.01) in the intermediate age group (65 to 80 years). Independent predictors of TAVI among patients aged 65 to 80 years included older age, chronic obstructive pulmonary disease, previous stroke, and coronary artery bypass grafting, whereas vascular disease and clinical urgency favored SAVR. In conclusion, consistent with current American Health Association/American College of Cardiology guidelines, TAVI was the treatment of choice in >97% of severe patients with AS age >80 years by 2019. TAVI utilization in patients <65years has doubled over time and thus may not reflect current guideline recommendations. TAVI is the preferred choice in those aged 65 to 80 years, especially among patients with previous stroke or coronary artery bypass grafting.

Twelve- and Fourteen-Year-Old School Children Differentially Benefit from Sensorimotor- and Multisensory-Enriched Vocabulary Training

Both children and adults have been shown to benefit from the integration of multisensory and sensorimotor enrichment into pedagogy. For example, integrating pictures or gestures into foreign language (L2) vocabulary learning can improve learning outcomes relative to unisensory learning. However, whereas adults seem to benefit to a greater extent from sensorimotor enrichment such as the performance of gestures in contrast to multisensory enrichment with pictures, this is not the case in elementary school children. Here, we compared multisensory- and sensorimotor-enriched learning in an intermediate age group that falls between the age groups tested in previous studies (elementary school children and young adults), in an attempt to determine the developmental time point at which children’s responses to enrichment mature from a child-like pattern into an adult-like pattern. Twelve-year-old and fourteen-year-old German children were trained over 5 consecutive days on auditorily presented, concrete and abstract, Spanish vocabulary. The vocabulary was learned under picture-enriched, gesture-enriched, and non-enriched (auditory-only) conditions. The children performed vocabulary recall and translation tests at 3 days, 2 months, and 6 months post-learning. Both picture and gesture enrichment interventions were found to benefit children’s L2 learning relative to non-enriched learning up to 6 months post-training. Interestingly, gesture-enriched learning was even more beneficial than picture-enriched learning for the 14-year-olds, while the 12-year-olds benefitted equivalently from learning enriched with pictures and gestures. These findings provide evidence for opting to integrate gestures rather than pictures into L2 pedagogy starting at 14 years of age.

Educating Adults with a Location-Based Augmented Reality Game: A Content Analysis Approach

With the exception of Pokémon Go, relatively little is known about other Mobile Augmented Reality (MAR) games, and the attitudes of middle-aged and elderly adults towards them are hitherto poorly examined. The aim of this research is to examine the opinions of young, middle-aged, and elderly adults about the location-based MAR game Ingress. The responses to questions related to Ingress were collected from 24 adult players aged 20–60 from Greece and subsequently were analyzed by means of content analysis, both qualitatively and quantitatively, using the Jaccard index of similarity. Our findings showed that opinions of young people (20–35) agree more with those of elderly adults (&gt;52) than with those of the intermediate age group of 36–51. It was also revealed that knowledge of geography facilitates the ability to play the game better, the game’s scenario is very interesting to adults, and the feeling of playing locally in a global game is also appreciated by all age groups. Along with these findings, with this research, it was shown that (a) content analysis is a valuable method for exploring opinions and attitudes of adult users towards MAR games and (b) Jaccard indices can be used to quantitatively explore themes emerging from content analysis.

Assessment of a Location-Based Mobile Augmented-Reality Game by Adult Users with the ARCS Model

In mobile augmented reality (MAR) games, learning by doing is important to supplement the theoretical knowledge with practical exercise in order to maximize the learning outcome. However, in many fields, the users are not able to apply their knowledge in practical ways, despite having achieved a good understanding of the theoretical fundamentals and this is even more important to adult learners. The aim of this research is to examine young, middle-aged and elderly adults’ opinions about the location-based MAR game Ingress, by applying John Keller’s “ARCS learning motivation model” (Attention, Relevance, Confidence and Satisfaction). The users’ responses to closed questions related to Ingress were collected from 45 adult players aged 20–60 from Greece and were subsequently analyzed by means of pre- and post-quantitative measures of the four ARCS factors. The results show that: (a) game training improves all the factors of ARCS, primarily attention and satisfaction; (b) the responses of young people (20–35) agree more with those of elderly adults (&gt;52) than with those of the intermediate age group of 36–51. Our findings, therefore, highlight the potential and the applicability of the ARCS model in MAR games.

Aortic valve replacement with biological prosthesis in patients aged 50-69 years.

There is no consensus regarding the use of biological or mechanical prostheses in patients 50-69 years of age. Previous studies have reported a survival advantage with mechanical valves. Our goal was to compare the long-term survival of patients in the intermediate age groups of 50-59 and 60-69 years receiving mechanical or biological aortic valve prostheses. We conducted a retrospective analysis of patients in the age groups 50-59 years (n = 329) and 60-69 years (n = 648) who had a first-time isolated aortic valve replacement between 2000 and 2019. Kaplan-Meier and competing risk analyses were performed to compare survival, incidence of aortic valve reoperation, haemorrhagic complications and thromboembolic events for mechanical versus biological prostheses. Patients aged 50-59 years with a biological prosthesis had a higher probability of aortic valve reintervention (26.3%, biological vs 2.6% mechanical; P < 0.001 at 15 years). The incidence of haemorrhagic complications or thromboembolic events was similar in the 2 groups. Patients aged 60-69 years with a mechanical prosthesis had a higher risk of haemorrhagic complications (6.9%, biological vs 16.2%, mechanical; P = 0.001 at 15 years). Biological prostheses had a higher overall probability of reintervention for valve dysfunction (20.9%, biological vs 4.8%, mechanical; P = 0.024). In both age groups, there was no difference in long-term survival between patients receiving a biological or a mechanical prosthesis. There was no difference in long-term survival between mechanical and biological prostheses for both age groups. Mechanical prostheses had a higher risk of bleeding in the 60-69-year group whereas biological valves had higher overall reintervention probability without an impact on long-term survival. It may be safe to use biological valves based on lifestyle choices for patients in the 50-69-year age group.

Prevalence and risk factors of ischaemic stroke in the young: a regional Australian perspective.

There is no universally accepted age cut-off for defining young strokes. We aimed to determine, based on the profile of young stroke patients in our regional centre, an appropriate age cut-off for young strokes. A retrospective analysis of all ischaemic stroke patients admitted to our centre from 2015 to 2017. We identified 391 ischaemic stroke patients; 30 patients between the ages of ≤50, 40 between 51-60 inclusive and 321 ≥ 61 years of age. We collected data on demographic profiles, risk factors and stroke classification using the Trial of Org 10 172 in Acute Stroke Treatment criteria. We found significant differences between the ≤50 and ≥61 age groups for most of the risk factors and similarities between the 51-60 inclusive and ≥ 61 age groups. At least one of the six risk factors assessed in the study was present in 86.7% of the youngest group, 97.5% of the intermediate age group and 97.2% in the oldest group. In terms of the mechanisms of stroke, the youngest and oldest age groups in our study differed in the prevalence of cryptogenic, cardioembolic and other causes of stroke. The middle and older age groups had similar mechanisms of stroke. The prevalence of vascular risk factors and mechanisms of stroke likewise differed significantly across age groups. This study suggests that 50 years is an appropriate age cut-off for defining young strokes and reinforces the importance of primary prevention in all age groups.

The association between cervical lordosis and age, sex, history of cervical trauma and sedentarity: A CT study

Purpose: We evaluated the association between cervical lordosis and age, sex, sedentarity, and history of cervical trauma. Methods: CT scans of 206 individuals, 111 with and 95 without a history of cervical trauma were divided into three age groups (18-39, 40-59 and 60+ years). The cervical lordosis measurements [C0-C7 (total), C0-C3 (upper), C2-C7 (mid-lower), and C3-C7 (lower)] were obtained from CT scans using the Cobb method. Results: A history of cervical trauma was associated with total and mid-lower cervical lordosis, indicating a reduction of the lordosis compared to the group with no history of cervical trauma. Significant sex differences in the non-trauma group were found only in the young (20-39) and intermediate (40-59) age groups with males exhibiting greater lordosis angles than females. Older females, without a history of cervical trauma, had greater mid-lower and lower cervical lordosis than younger females. Sedentary work predicted the magnitude of the upper cervical lordosis. Subjects working in a sedentary position develop forward head posture, which may eventually advance to head and neck pain.