Longitudinal Study Research Articles

Real-world effectiveness of the heterologous SOBERANA-02 and SOBERANA-Plus vaccine scheme in 2–11 years-old children during the SARS-CoV-2 Omicron wave in Cuba: a longitudinal case-population study

Increased pediatric COVID-19 occurrence due to the SARS-CoV-2 Omicron variant has raised concerns about the effectiveness of existing vaccines. The protection provided by the SOBERANA-02-Plus vaccination scheme against this variant has not yet been studied. We aimed to evaluate the scheme's effectiveness against symptomatic Omicron infection and severe disease in children. In September 2021, Cuba implemented a mass pediatric immunization with the heterologous SOBERANA-02-Plus scheme: 2 doses of conjugated SOBERANA-02 followed by a heterologous SOBERANA-Plus dose. By December, before the Omicron outbreak, 95.4% of 2-18 years-old had been fully immunized. During the entire Omicron wave, we conducted a nationwide longitudinal post-vaccination case-population study to evaluate the real-world effectiveness of the SOBERANA-02-Plus scheme against symptomatic infection and severe disease in children without previous SARS-CoV-2 infection. The identification of COVID-19 cases relied on surveillance through first line services, which refer clinical suspects to pediatric hospitals where they are diagnosed based on a positive RT-PCR test. We defined the Incidence Rate ratio (IRR) as IRvaccinated age group/IRunvaccinated 1-year-old and calculated vaccine effectiveness as VE= (1-IRR)∗100%. 24 months of age being the 'eligible for vaccination' cut-off, we used a regression discontinuity approach to estimate effectiveness by contrasting incidence in all unvaccinated 1-year-old versus vaccinated 2-years-old. Estimates in the vaccinated 3-11 years-old are reported from a descriptive perspective. We included 1,098,817 fully vaccinated 2-11 years-old and 98,342 not vaccinated 1-year-old children. During the 24-week Omicron wave, there were 7003/26,241,176 person-weeks symptomatic COVID-19 infections in the vaccinated group (38.2 per 105 person-weeks in 2-years-old and 25.5 per 105 person-weeks in 3-11 years-old) against 3577/2,312,273 (154.7 per 105 person-weeks) in the unvaccinated group. The observed overall vaccine effectiveness against symptomatic infection was 75.3% (95% CI, 73.5-77.0%) in 2-years-old children, and 83.5% (95% CI, 82.8-84.2%) in 3-11 years-old. It was somewhat lower during Omicron BA.1 then during Omicron BA.2 variant circulation, which took place 1-3 and 4-6 months after the end of the vaccination campaign. The effectiveness against severe symptomatic disease was 100.0% (95% CI not estimated) and 94.6% (95% CI, 82.0-98.6%) in the respective age groups. No child death from COVID-19 was observed. Immunization of 2-11 years-old with the SOBERANA-02-Plus scheme provided strong protection against symptomatic and severe disease caused by the Omicron variant, which was sustained during the six months post-vaccination follow-up. Our results contrast with the observations in previous real-world vaccine effectiveness studies in children, which might be explained by the type of immunity a conjugated protein-based vaccine induces and the vaccination strategy used. National Fund for Science and Technology (FONCI-CITMA-Cuba).

Associations of vegetable and fruit intake with cognitive function and its decline: Two longitudinal studies

ObjectivesPrevious studies suggested protective associations of vegetables and fruits (VF) intake with cognitive function, but evidence on specific types of VF was insufficient. MethodsThe current study included 4066 participants from 1997 to 2006 in the China Health and Nutrition Survey (CHNS) and 6170 participants from 2013 to 2020 in the Health and Retirement Study (HRS). Dietary intake (using 3-day 24-h dietary recalls in CHNS and food frequency questionnaire in HRS) and cognitive function (using the Telephone Interview for Cognitive Status-Modified, TICS-m) were measured. Linear mixed-effects models were used to estimate the beta coefficients (β) and the 95% confidence intervals (CI) to evaluate the association of VF with cognitive function (z-score) and its decline. ResultsHighest intake of total VF was associated with better cognitive function and slower cognitive decline. Differences in cognitive function z-score between the highest and lowest tertiles of VF consumption were 0.039 (95% CI: 0.002, 0.076) for CHNS and 0.063 (95% CI: 0.026, 0.100) for HRS. The corresponding differences in annual cognitive decline were 0.011 (95% CI: 0.002, 0.021) and 0.012 (95% CI: 0.003, 0.020) units respectively. Vegetables and fruits showed independent associations with cognitive function and its decline. In specific VF subgroups, when comparing the highest to the lowest tertile intake, cruciferous vegetables (β = 0.058, 95% CI: 0.017, 0.100 in CHNS and β = 0.067, 95% CI: 0.032, 0.101 in HRS) and green leafy vegetables (β = 0.036, 95% CI: −0.001, 0.073 in CHNS and β = 0.082, 95% CI: 0.046, 0.117 in HRS) was associated with better cognitive function in both cohorts. Similarly, higher intake of dark-colored vegetables (β = 0.019, 95% CI: 0.008, 0.030 for red/yellow vegetables in CHNS and β = 0.004, 95% CI: 0.001, 0.007 for green leafy vegetables in HRS) were associated with slower cognitive decline in subsequent years. Moreover, rigorous sensitivity analyses confirmed the stability of the results. ConclusionsOur findings support the potential beneficial roles of VF, especially cruciferous vegetables, green leafy vegetables, and red/yellow vegetables, in maintaining cognitive function and slowing cognitive decline in middle-aged and older adults.

Influence of maternal past non-transport pro-environmental behaviours on young adults’ sustainable transport

Influence of maternal past non-transport pro-environmental behaviours on young adults’ sustainable transport

Examining carcinogenic and noncarcinogenic health risks related to arsenic exposure in Ethiopia: A longitudinal study.

The carcinogenic properties of arsenic make it one of the most hazardous chemicals globally. Nevertheless, the exact level of human exposure to arsenic and the associated risks of cancer and non-cancer effects through different pathways in Ethiopia are still uncertain. The primary aim of this study was to evaluate the risk of both cancer and non-cancer outcomes among children and adults who have been exposed to arsenic through drinking water in the Adami Tulu Jido Kombolcha district of Ethiopia. For this study, a longitudinal study design was employed. A total of 45 groundwater sources were sampled using the census sampling method. The concentrations of total arsenic were measured using Agilent 7900 series inductively coupled plasma mass spectrometry. Carcinogenic and noncarcinogenic risk assessments were conducted by calculating lifetime cancer risk and hazard quotients. Microsoft Office Excel was utilized to calculate human health risk indices, and descriptive statistical analysis were performed using SPSS software. Our findings revealed that during the dry season, the mean arsenic concentration in the groundwater samples was 11.15±9.38µg/L, while during the rainy season, it was 10.67±8.16µg/L. The total cancer risk for children, resulting from oral ingestion and skin contact, was 1.15×10-2 and 1.07×10-2 during the dry and rainy seasons, respectively. For adults, the total cancer risk from oral ingestion and skin contact during the dry and rainy seasons was 4.95×10-3 and 4.59×10-3, respectively. Furthermore, the total hazard quotients for children via oral ingestion and skin absorption were 25.9 and 24.0 during the dry and rainy seasons, respectively. For adults, the total hazard quotients from ingestion and dermal contact during the dry and rainy seasons were 11 and 10, respectively. The findings indicate that the risks of cancer and non-cancer effects resulting from arsenic exposure through ingestion and dermal exposure were found to exceed the acceptable thresholds in both seasons. These results emphasize the urgent need for focused attention on the study population in the study area due to the high likelihood of experiencing adverse health outcomes.

Selection of disease modifying therapies in multiple sclerosis based on patient's age and disease activity: Data from a nationwide registry

BackgroundKnowledge of the safety and efficacy of disease-modifying therapies (DMTs) in older patients with Multiple Sclerosis (pwMS) is limited due to their exclusion from clinical trials. Our purpose is to evaluate the choice of DMTs in pwMS older than 50 years old in a real-world setting. MethodsCross-sectional study of pwMS from the Argentine MS and NMOSD Registry. We included patients under 35 and above 50 years old prescribed DMTs. Disease activity was categorized as highly active (HA) or not highly active (NHA), and DMTs were classified as low efficacy therapies (LET) or high efficacy therapies (HET). Results1460 patients (65% females) were enrolled. The HA group comprised 241 patients, 198 young (82.2%) and 43 older (17.8%). The NHA group included 1219 patients, 893 young (73%) and 326 older (27%). In the NHA group, older patients received LET more frequently than younger patients (66% versus 44%; p < 0.01). In the HA group, older patients received LET in 61% of cases, whereas younger patients received HET in 71% (p = 0.01). ConclusionThe study shows the preference of LET in older patients regardless of disease activity. However it does not demonstrate a difference in disability in older patients based on low vs high efficacy DMTs used, probably due to the design of the study. Further longitudinal studies are warranted to address this issue.

Smartphone addiction and adolescent mental health: a cross-sectional study in West Sumatra province

In West Sumatra Province, Indonesia, approximately 13.01% of individuals aged 15 years or older are affected by mental and emotional disorders, ranking it as the third highest among the 34 provinces. Excessive smartphone use has emerged as a potential influencer of mental health, associated with social networking addiction, shyness, and low self-esteem. This study aimed to examine the relationship between smartphone addiction and mental health issues in adolescents using a cross-sectional design. The sample included 283 randomly selected students aged 15-17 years. Smartphone addiction was measured using the smartphone addiction scale-short version (SAS-SV), and mental health was assessed using the strength and difficulties questionnaire (SDQ). The study revealed a significant association (p&amp;lt;0.001) between smartphone addiction and mental health problems among adolescents, with 72.1% of respondents experiencing smartphone addiction and 26.9% classified as having abnormal mental health. These findings emphasize the need for increased awareness regarding the negative impact of excessive smartphone use on adolescent mental health. Schools should play a vital role in addressing this issue through the provision of guidance and counseling services. Future research should investigate causal relationships using longitudinal designs and consider diverse populations to enhance the generalizability of the results.

The characteristics and clinical outcomes of a pluripotent high-risk group with the potential to develop a diverse range of psychiatric disorders

BackgroundRecent studies have indicated that clinical high risk for psychosis (CHR-P) is highly specific for psychotic disorders other than pluripotential to various serious mental illnesses. However, not all CHR-P develop psychotic disorder only, and psychosis can occur in non-psychotic disorders as well. Our prospective cohort study aims to investigate the characteristics and clinical outcomes of a pluripotent high-risk group with the potential to develop a diverse range of psychiatric disorders. MethodsThe SPRIM study is a prospective naturalistic cohort program that focuses on the early detection of those at risk of developing serious mental illness, including psychosis (CHR-P), bipolar (CHR-B), and depressive disorder (CHR-D), as well as undifferentiated risk participants (UCHR). Our study has a longitudinal design with a baseline assessment and eight follow-up evaluations at 6, 12, 18, 24, 30, 36, 42, and 48 months to determine whether participants have transitioned to psychosis or mood disorders. ResultsThe SPRIM sample consisted of 90 CHR participants. The total cumulative incidence rate of transition was 53.3% (95% CI 32.5–77.2). CHR-P, CHR-B, CHR-D, and UCHR had cumulative incidence rates of 13.7% (95% CI 3.4–46.4), 52.4% (95% CI 28.1–81.1), 66.7% (95% CI 24.6–98.6) and 54.3% (95% CI 20.5–93.1), respectively. The cumulative incidence of psychosis, bipolar, and depressive disorder among all participants was 3.3% (95% CI 0.8–11.5), 45.7% (95% CI 24.4–73.6), and 11.2% (95% CI 3.1–36.2), respectively. ConclusionsOur study suggests that the concept of pluripotent high-risk for a diverse range of psychiatric disorders is an integrative approach to examining transdiagnostic interactions between illnesses with a high transition rate and minimizing stigma.

Long-term outcomes of bariatric surgery: An eight-year study at a tertiary care hospital in Lebanon

BackgroundObesity management presents a persistent challenge. Bariatric surgery, recognized for its transformative impact on weight loss and comorbidities, demands a thorough examination of its long-term implications. ObjectivesOur goal is to investigate different aspects of bariatric surgery, such as complications, comorbidities, infection rates, the long-term sustainability of weight loss, and factors predicting weight loss over an extended period following the procedure. SettingThis study involves 100 patients who underwent primary bariatric surgery. Methodsa sophisticated Longitudinal Observational Study design. With a Retrospective Component and a Follow-Up Component spanning eight years. ResultsThe study included participants with a mean age of 36.4 years (±12.1) and a pre-surgery BMI of 44.5 kg/m² (±7.5). Excess Weight Loss (%EWL) peaked at 75.09 % by the third year, while Total Weight Loss (%TWL) sustained at 33.41 % after two years. Among individuals with type 2 diabetes, medication discontinuation rates reached 26.3 % at 5 years. Zero leaks, a low incidence of major complications and no incidence of mortality have been noted. In an extended 7-year follow-up, 40 % of patients experienced weight regain. Multivariate analyses identified age and preoperative BMI as negatively associated significant predictors impacting %EWL at three years, with standardized beta coefficients of −0.488 (p = 0.001) and −0.450 (p < 0.001), respectively. Conversely, smoking and Type 2 Diabetes Mellitus exhibited positive associations, with standardized beta coefficients of 0.336 (p = 0.004) and 0.286 (p = 0.063), respectively. ConclusionsBariatric surgery is acknowledged as a safe and efficacy procedure for reducing weight and comorbidities, with a relatively low incidence of major complications.

Sex Differences in the Severity and Progression of Neuropsychiatric Symptoms Across Different Dementia Types.

Dementia presents not only differing neuropsychiatric symptoms (NPS) across Alzheimer disease (AD), frontotemporal dementia (FTD), dementia with Lewy bodies (DLB) but also subjective cognitive decline (SCD). This study examined sex-based variations in NPS severity and progression across these conditions. We performed a longitudinal cohort study including 1,068 participants. Hierarchical generalized linear mixed models were used to model NPS as a function of disease severity and biological sex at birth. Female participants with AD exhibited NPS more frequently than male participants. In FTD, female participants had more frequent delusions, hallucinations, and depression/dysphoria, while male participants had higher instances of agitation/aggression, apathy, disinhibition, and irritability/lability. In DLB, male participants showed higher instances of depression, and female participants more frequently experienced anxiety. In SCD, female participants showed higher nighttime behaviors. The trajectory of NPS significantly differed between sexes. These findings highlight sex-specific NPS impact in different neurodegenerative conditions.

The impact of bullying and cyberbullying on mental health: a systematic review

Bullying, including cyberbullying, has a devastating impact on mental health, particularly among adolescents. This literature study aims to identify mental health issues caused by bullying and cyberbullying. A systematic review was conducted in the last five years using the keywords "bullying, cyberbullying, mental health, adolescent" and the population, intervention, comparison, outcome, study design (PICOS) framework within Scopus (29 articles), ProQuest (187 articles), Science Direct (193 articles), and SAGE (58 articles) published databases in the last five years using the keywords of “bullying, cyberbullying, mental health, adolescent”. The selected articles are those applying quantitative and longitudinal studies published in 2018-2022 in which study participants were adolescents who had experiences as victims of bullying and cyberbullying. The 25 articles met the inclusion criteria for review. Based on the results of the review of the article, it was found that mental health problems can occur in all roles in bullying and cyberbullying, but the highest is in the role of victim. Mental health problems that occur in victims include anxiety, stress, depression, low self-esteem, suicidal ideation, and suicide attempts. Based on these results, different interventions are needed for the roles involved in bullying and cyberbullying, especially for victims, because psychological problems are more common in victims.

Commentaries on "Associations of Lower Extremity Muscle Strength, Area, and Specific Force With Lower Urinary Tract Symptoms in Older Men: The Baltimore Longitudinal Study of Aging".

Commentaries on "Associations of Lower Extremity Muscle Strength, Area, and Specific Force With Lower Urinary Tract Symptoms in Older Men: The Baltimore Longitudinal Study of Aging".

Patterns of Acute Ischemic Stroke Treatment from 2010 to 2020: An Evolving Landscape in Stroke Management Following Thrombectomy Trials.

Population-based studies on stroke can help guide the care of patients with acute ischemic stroke (AIS) by providing health care communities with information regarding the current usage of stroke treatments. It remains unclear how rapidly new techniques, particularly endovascular stroke treatment (EST), are being adopted and whether there is any disparity in their availability. Although studies using the National Inpatient Sample (NIS) have been conducted, updated studies over a longer period may provide further insights. This study aimed to understand patterns of AIS treatment, discharge disposition, in-hospital mortality, and mean length of stay (LOS) for each modality from 2010 to 2020 using the NIS database. This retrospective longitudinal study was conducted using NIS data from 2010 to 2020. Patients were categorized into groups based on whether they received intravenous recombinant tissue plasminogen activator (rt-PA), EST, both rt-PA and EST (combined therapy), or supportive care alone. Demographic, socioeconomic, regional, insurance, and hospital data were also obtained. The primary outcome was the proportion of patients receiving each modality, whereas the secondary outcomes were in-hospital mortality, mean LOS, and discharge disposition. The usage rates increased (p < 0.001) in all groups between 2010 and 2020 (rt-PA: 5.09% to 8.39%, EST: 0.31% to 4.40%, and rt-PA+EST: 0.46% to 1.09%). The highest increase in usage was observed for EST, with a thirteen-fold increase. Mortality decreased from 2010 to 2020 in all groups (rt-PA: 8.45% to 3.54%, EST: 25.22% to 12.50%, and rt-PA+EST: 21.12% in 2010 to 9.30%) (p < 0.001). Combination therapy demonstrated the greatest improvement, with an 11.2% reduction in absolute mortality. Mean LOS was reduced for patients who received rt-PA (6.8 to 4.8 days), EST (9.3 to 8.9 days), and combined therapy (10.0 to 8.3 days) (p < 0.001) over the study period. The proportion of patients discharged to home increased for rt-PA (29.01% to 41.85%), EST (14.13% to 17.70%), and combined therapy (12.89% to 24.29%) (p < 0.001). Overall, stroke treatment usage was higher among the higher income groups, regardless of race. Higher usage was also observed for Whites in the West and Hispanic ethnicities in the South and West. Regardless of income or treatment method, utilization rates were lower for Black patients. Utilization rates were lower for Black patients with Medicare, Medicaid, or self-pay than for White patients. Our study demonstrated that endovascular stroke treatment continues to expand, leading to better outcomes for mortality, LOS, and home discharge. Despite these positive patterns, there are visible inequities across regions, income status, and races.

The association of the dietary inflammatory potential with risk of overall and site-specific cancers: A community-based longitudinal study in the UK Biobank

ObjectivesThe association of the dietary inflammatory potential with cancer risk remains uncertain. We examined the relationship of the dietary inflammatory potential with risk of overall and site-specific cancers and explored its sex and age differences. DesignA community-based longitudinal study. SettingParticipants from the UK Biobank completed baseline surveys during 2006–2010 and were followed for up to 15 years to detect incident cancer. Participants170,899 cancer-free participants with dietary data available (mean age: 55.73 ± 7.95, 54.10% female). MeasurementsAt baseline, dietary intake was assessed with a 24-h dietary record for up to 5 times. The inflammatory diet index (IDI) was calculated to assess the dietary inflammatory potential as a weighted sum of 31 food groups (including 14 anti-inflammatory and 17 pro-inflammatory) based on plasma high-sensitivity C-reactive protein (hsCRP) levels, and tertiled as low (indicating low-inflammatory diet), moderate, and high IDI (as reference). Overall and site-specific cancers were ascertained via linkage to routine hospital admission, cancer registry, and death certificate data. Data were analyzed using Cox regression and Laplace regression. ResultsDuring the follow-up (median 10.32 years, interquartile range: 9.95–11.14 years), 18,884 (11.05%) participants developed cancer. In multi-adjusted Cox regression, low IDI scores were associated with decreased risk of rectal cancer (hazard ratio [95% confidence interval, CI] 0.76 [0.61, 0.94]), thyroid cancer [0.45 (0.27, 0.74)], lung cancer [0.73 (0.61, 0.88)]. However, the association between IDI score and the risk of overall cancer was not significant. Laplace regression analysis showed that 10th percentile differences (95% CIs) of cancer onset time for participants with low IDI scores was prolonged by 1.29 (0.32, 2.27), 1.44 (0.58, 2.30), and 2.62 (0.98, 4.27) years for rectal cancer, thyroid cancer, and lung cancer, respectively, compared to those with high IDI scores. Stratified analysis revealed that low IDI scores were associated with a lower risk of rectal cancer (p interaction between IDI score and sex = 0.035) and lung cancer in males, but not in females, and with a reduced risk of thyroid cancer in females, but not in males. Moreover, low IDI scores were associated with a reduced risk of rectal cancer and lung cancer in the participants aged ≥60 years, but not in those <60 years, and with a reduced risk of thyroid cancer in those aged ≥60 years and <60 years. ConclusionsA low-inflammatory diet is associated with decreased risk and prolonged onset time of rectal cancer and lung cancer, especially among males and individuals aged ≥60 years, and thyroid cancer among females.

Prevalence and correlates of alcohol use among the elderly in the Eastern Caribbean Health Outcomes Research Network (ECHORN) cohort study

BackgroundAlcohol use is pervasive in the Caribbean; however, the prevalence and correlates of alcohol use and drinking problems in the elderly have not been extensively studied. MethodsData were obtained from the Eastern Caribbean Health Outcomes Research Network (ECHORN) Cohort Study, a cohort study of Caribbean people from Puerto Rico, Barbados, Trinidad, and Tobago, and the U.S. Virgin Islands, collected between 2013 and 2018 (baseline study sample, ages 60+, n = 811). Descriptive statistics were used to compare the differences in drinking status (current vs. former vs. never), alcohol problems (Cut-down, Annoyed, Guilty, and Eye-opener (CAGE) scale score ≥2 vs. <2), and binge drinking days (0 days vs. 1–2 days vs. ≥3 days) across sample characteristics. Logistic regression analyses estimated the association of these alcohol measures with sociodemographic (e.g., sex), psychological (depression), and cultural (e.g., religion) correlates. ResultsThirty-six percent were 70 + years of age, 64 % were female, and 41 % had less than a high school education. Alcohol problems (≥2 CAGE score) was 21 %. Binge drinking ≥3 days was 30.6 %. Never attending religious services (vs. attending once a week or more) was associated with almost three times higher odds of alcohol problems (adjusted Odds Ratio: OR = 2.88, 95 % CI = 1.02, 8.15) four times higher odds of increasing binge drinking days (aOR = 4.04, 95 % CI = 1.11, 14.96). College education was protective against both the outcomes. ConclusionWe provide current estimates of alcohol problems among elderly Eastern Caribbean people. Among the sociodemographic, psychological, and cultural correlates examined, religious attendance was significant. Replicate longitudinal studies using DSM-5 alcohol dependence are recommended.

Automatic grading of intervertebral disc degeneration in lumbar dog spines.

Intervertebral disc degeneration is frequent in dogs and can be associated with symptoms and functional impairments. The degree of disc degeneration can be assessed on T2-weighted MRI scans using the Pfirrmann classification scheme, which was developed for the human spine. However, it could also be used to quantify the effectiveness of disc regeneration therapies. We developed and tested a deep learning tool able to automatically score the degree of disc degeneration in dog spines, starting from an existing model designed to process images of human patients. MRI midsagittal scans of 5991 lumbar discs of dog patients were collected and manually evaluated with the Pfirrmann scheme and a modified scheme with transitional grades. A deep learning model was trained to classify the disc images based on the two schemes and tested by comparing its performance with the model processing human images. The determination of the Pfirrmann grade showed sensitivities higher than 83% for all degeneration grades, except for grade 5, which is rare in dog spines, and high specificities. In comparison, the correspondent human model had slightly higher sensitivities, on average 90% versus 85% for the canine model. The modified scheme with the fractional grades did not show significant advantages with respect to the original Pfirrmann grades. The novel tool was able to accurately and reliably score the severity of disc degeneration in dogs, although with a performance inferior than that of the human model. The tool has potential in the clinical management of disc degeneration in canine patients as well as in longitudinal studies evaluating regenerative therapies in dogs used as animal models of human disorders.

The effects of diabetes, hypertension and subsequent health control behavior on the survival of a Taiwan cohort aged over 50 years

PurposeThis study used the Taiwan Longitudinal Study in Aging from 1996 to 2011 to investigate the effects of diabetes, hypertension, and healthy living behaviors of those aged over 50 years on the survival status in Taiwan. MethodsAmong the 5,131 participants aged 50 years and above in the 1996 survey were included in this study. Cox’s proportional hazards model was used to examine the incidence of diabetes, hypertension, and related mortality risk in those aged over 50 years. ResultsAfter adjusting for age, gender, education level, diabetes, hypertension, health behavior, and leisure activity, results from the Cox model show that the elderly without diabetes have a lower mortality risk than those with diabetes. Regular exercise was associated with a lower risk of mortality. The hazard ratios of elderly with regular exercise were 0.78 (95 % CI: 0.64–0.96) for two times a week or less, 0.81 (95 % CI: 0.69–0.96) for 3–5 times a week, and 0.84 (95 % CI: 0.77–0.93) for 6 + times a week, respectively. On the other hand, leisure activity positively reduces mortality risk. For example, the hazard ratios of the elderly with watching TV and reading were 0.63 (95 % CI: 0.55–0.72) and 0.80 (95 % CI: 0.72–0.89), respectively. Moreover, smoking can increase mortality risk 23 % whether the elderly are with diabetes or hypertension or not. ConclusionsRegarding preventing and controlling chronic diseases in the future, continuously encouraging improvement in health behavior and engaging in leisure activities for the middle-aged and over should be considered essential markers.

Tensor regression for incomplete observations with application to longitudinal studies

Tensor regression for incomplete observations with application to longitudinal studies

Defining "High Recurrence" of Depressive Episodes for Predicting Diagnostic Conversion from Major Depressive Disorder to Bipolar Disorder: A 5-year Retrospective Study.

This study determined the threshold for recurrent depressive episodes that predicted conversion from major depressive disorder (MDD) to bipolar disorder (BD). We retrospectively reviewed the medical records of 296 patients diagnosed with MDD for a minimum of 5 years in two university hospitals. We examined their the Diagnostic and Statistical Manual of Mental Disorders, 5th edition diagnoses and detailed clinical information at the initial admission and yearly assessments after discharge to establish the threshold for recurrent depressive episodes indicating a risk of diagnostic conversion from MDD to BD. Optimal cut-offs were derived using receiver operating characteristic (ROC) curves. ROC curve analysis revealed that more than four recurrent depressive episodes was indicative of potential diagnostic conversion from MDD to BD (area under the curve, 0.604; sensitivity, 0.353; specificity, 0.855; positive predictive value, 0.421; negative predictive value, 0.816). These findings suggest that the best predictor of conversion from MDD to BD is more than four recurrent depressive episodes. Our findings have the potential to enhance diagnostic accuracy and treatment efficiency. To validate our results, longitudinal prospective studies are necessary.

A Longitudinal study on the Kinetic of T-cells and certain hematological parameters during the Initiation of antiretroviral therapy and after two years on treatment

Background: T- cell are key regulators of the immune system and their role in the initiating and follow –up of patients on antiretroviral therapy (ART) is primordial. In the present work, we compared T-cells and certain biological parameters after 2 months of ART with those obtained after one year and 2 years of ART. Method: In this prospective cohort study, 150 HIV patients on primo ART treatment and consenting were recruited. Five ml of blood were collected at initiation (M0), after 2 months (M2), after 1 year (M12), and after 2 years (M24) of ART. CD4 cells, CD8 cells, and other hematological parameters were measured according to standard operating procedures. Results: The 88 retained participants included 18 (20.6%) men and 70 (79.4%) women, with a mean age of 35.5 years. After 2 months, there was a significant increase in CD4 count, monocytes, and platelets with p-values of 0.001, 0.02, and 0.04, respectively, while hemoglobin and CD8 cells did not significantly change (p-values of 0.06 and 0.82, respectively). After one year and after two years of therapy, the increases in these parameters were not statistically significant compared to the values obtained at M2. Conclusion: CD4 lymphopenia, monopénia and thrombopenia induced by HIV infection are corrected maximally during the first months after the beginning of ART and tend to stabilize over time, while anemia can continue to persist.

Longitudinal study of change in CD4+ cell counts on HIV-Positive patients at Dalhatu Araf Specialist Hospital, Lafia

The aim of this study was the Longitudinal Study of Change in CD4+ Cell Counts on HIV-Positive Patients at Dalhatu Araf Specialist Hospital, Lafia. The study deployed linear mixed effects models to check if the mean response CD4+ cell count varies with time. The study also attempted to test if the mean response varies in the two groups. An attempt to estimate the relationship between the response and observations according to gender. The study revealed that the trajectory of the mean response over time has a very high variability where we see that there is a general rise in the CD4+ cell counts at the initiation of ART. It was further seen that the CD4+ cell counts in male patients is observed to be higher with higher median value after the sixth observation. A linear mixed effect model was used and tested where it was noted that there is evidence of between-individual heterogeneity which further shows that the decision to choose a mixed effects model instead of an only fixed effects model was in order. The model summary showed that the mean CD4+ cell counts at the baseline (OBS1) was averagely good, but at the initiation of ART, there was a significant increase in the mean response where it was further revealed that the pattern of the mean response over time is not flat. In modelling the group effects, we see the difference between the mean CD4 cell count of male versus female is -113.62 CD4 cell count (i. e. 95% CI= -290.64 to 63.39) lower than female, adjusting with time. Finally, the Wald test does not show any significant evidence of interaction between the observations and gender (p=0.2925) which suggests that the mean response based on gender may be parallel.