Young Adult Population Research Articles

Anti-acne preparations containing tetracycline, azelaic acid and azeloglycine: Optimization of stability and physicochemical properties.

Acne vulgaris is a common inflammatory skin condition affecting almost 85% of the adolescent and young adult population. The etiopathogenesis of this dermatosis involves an imbalance in the skin microbiome, leading to inflammation of both the skin and hair follicles. The aim of this study was to develop topical anti-acne formulations with increased therapeutic efficacy and reduced risk of developing antibiotic resistance. Six hydrogel formulations containing azelaic acid or its derivative, azeloglycine, in combination with tetracycline hydrochloride were prepared as part of the study. The investigated formulations were prepared using an Eprus U500 pharmaceutical mixer and the pH was determined using an ERH-11S electrode designed for dense substances and a CPC-505 Elmetron pH-meter. The formulations were analyzed for tetracycline stability in the presence of additional active ingredients and varying pH over a period of 35 days using high-performance liquid chromatography (HPLC). In addition, the effects of azeloglycine and azelaic acid on the viscosity of the prepared formulations were evaluated using a Brookfield DV2T rotational viscometer. Chromatographic analysis showed significant stability of tetracycline in most formulations, with azeloglycine-containing formulations showing less degradation of the antibiotic than azelaic acid-containing preparations. In addition, azeloglycine-containing gels exhibited more favorable rheological properties, which may facilitate better application and be more beneficial to patients. The results suggest that formulations containing azeloglycine and tetracycline may be a promising strategy for acne therapy, offering increased tetracycline stability and an optimal rheological profile, which may result in prolonged therapeutic effect and more effective drug delivery to the skin.

Suicidal Ideation in Adolescents and Young Adults: The Role of Defeat, Entrapment, and Depressive Symptoms—From a Systematic Review to a Tentative Theoretical Model

Suicide stands as one of the leading causes of non-accidental death among adolescents and young adults. The Integrated Motivational–Volitional Model (IMV) of suicidal behavior identifies feelings of defeat and entrapment as pivotal factors in the complex dynamics underlying suicidal behaviors. Additionally, depressive symptomatology plays a crucial role in the development of these behaviors. The aim of this work was to provide a systematic review of the scientific literature on the association of three risk factors—entrapment, defeat, and depressive symptomatology—with suicidal ideation in the adolescent and young adult population and to test a tentative theoretical model. The databases used were PubMed, Web of Science, and ProQuest. Primary studies were selected that examined the role of entrapment, defeat, and depressive symptomatology in suicidal ideation among adolescents and young adults (ages 10–35). Additionally, a model based on structural equation modeling was analyzed to assess the relationships between entrapment, defeat, and depressive symptomatology and suicidal ideation. Eleven studies met the established inclusion criteria. The results showed defeat and entrapment to be associated with depressive symptomatology and suicidal ideation, regardless of the country studied. Additionally, the model indicates that entrapment and defeat lead to depressive symptomatology, which in turn contributes to the occurrence of suicidal ideation. These findings suggest that defeat and entrapment could be universal factors in explaining suicidal behavior in adolescents and young adults. Consequently, the results of this work may contribute to the development of strategies for preventing suicidal ideation in this population.

Association of magnesium intake with predicted atherosclerotic lesions and cardiovascular risk in young adults based on PDAY score: a cross-sectional study

BackgroundMagnesium deficiency has been shown to accelerate atherosclerosis. We hypothesized that dietary magnesium intake at a young age is associated with future atherosclerotic lesions and cardiovascular risk in a large, nationally representative cohort of U.S. adults.MethodsWe included U.S. adults aged 20 to 34 years old from the National Health and Nutrition Examination Survey (NHANES) 2007 to 2018, a population-based cross-sectional study. Dietary magnesium intake was assessed using 24-hour diet recalls. Atherosclerotic lesions in the young adult population were predicted by the Pathobiological Determinants of Atherosclerosis in Youth (PDAY) score that was based on age, sex, smoking status, lipids, blood pressure, and obesity. Information on cardiovascular disease (CVD) risk factors including hypertension, non-HDL-C dyslipidemia, and diabetes was also collected. We used multivariable logistic analysis models to test the association between magnesium intake levels and the PDAY score and CVD risk factors, respectively, after adjusting for several potential confounding factors.Results7,244 eligible participants were included in the analysis. The magnesium intake level was classified into three categories based on the tertile distribution in the population (i.e., ≤ 224, 225–340, and ≥ 341 mg/day). Compared with the lowest tertile, the multivariable-adjusted odds ratio (OR) and 95% confidence interval (95% CI) for the PDAY score were 0.83 (95% CI, 0.72 to 0.96) and 0.60 (95% CI, 0.49 to 0.74) in the second and the third tertiles of magnesium intake, respectively (P value for trend < 0.001), and there was a negative dose-response relationship (test for trend P value < 0.001). In addition, the highest dietary magnesium intake was significantly inverse associated with non-HDL-C dyslipidemia compared with the lowest magnesium intake (OR = 0.65; 95% CI, 0.46 to 0.91).ConclusionsDietary magnesium intake is inversely associated with the risk of future cardiovascular events assessed by the PDAY score and non-HDL-C dyslipidemia in young adulthood years.

To assess the knowledge, awareness, and perception of non-dentists offering orthodontic treatment among the Malaysian young adult population

BackgroundThe increasing number of young adults seeking cheaper and easily accessible orthodontic treatment from unlicensed practitioners in Malaysia poses significant risks to patients. Therefore, it is essential to evaluate their motivations and awareness regarding such practices. The objective of our study was to assess the knowledge, awareness, and perceptions of non-dentists offering orthodontic treatment among the Malaysian young adult population.MethodsThis was a cross-sectional study. An online self-administered questionnaire was distributed to Malaysian citizens aged 18–37 years. The questionnaire consisted of 11 questions that investigated their awareness of non-dentists offering orthodontic treatment, the harmful effects of braces fitted by non-dentists, and potential strategies to mitigate this phenomenon.ResultsThe study was completed by 426 participants, predominantly Malay, with a mean age of 22.9 years. A total of 76.1% reported awareness of braces fixed by non-dentists, primarily through social media platforms such as Instagram and Facebook. Lower cost emerged as the predominant motive (83.6%) for opting for non-dentist orthodontic treatment, followed by no waiting list (48.8%). Notably, the majority of participants acknowledged the illegality (70%) and potential harm (77%) associated with non-dentists providing orthodontic treatment. Legal enforcement (53.1%) was identified as the preferred method for mitigating this practice. Occupation significantly influenced knowledge of illegal orthodontic treatment (p < 0.05), however no significant association was found for gender and level of education (p > 0.05).ConclusionThe survey revealed that young adults are aware of and informed about non-dentists offering orthodontic treatment. While they identified cost as the primary reason for seeking such services, they also recognized legislation and public awareness through campaigns and social media as effective strategies to address this issue. Additionally, significant differences in legal awareness were observed among different occupational levels.

Exploratory dietary patterns, the global diet quality score, and their associated socio-demographic factors among young adults in Rwanda: a cross-sectional study using a food list-validated, semi-quantitative food frequency questionnaire

BackgroundEconomic growth in Rwanda is associated with significant changes in food systems, access to health and other services, lifestyle, and nutritional transitions. Nevertheless, our knowledge of dietary patterns in Rwanda remains limited. The present study aimed to identify the dietary habits of young adult population in Rwanda and to assess associated factors.MethodsA developed and validated semi-quantitative food frequency questionnaire covering a one-year period was used to collect data on food intake of 1,218 participants (18–35 years old) from end of January to April 2023 in a cross-sectional study. Dietary habits were assessed using two indicators: the Global Diet Quality Score (GDQS) and dietary patterns. The latest was developed using exploratory factor analysis.ResultsRwandan adults had a mean GDQS of 24.1; 64.4% had high GDQS, especially urban, and educated respondents. The Southern province led at 77.4%. Three dietary patterns were identified: “Modern” (high in processed foods and drinks), “Traditional” (rich in cereals, roots, and plant-based proteins), and “low variety” (low in diverse foods but high in sugar and salt). Dietary patterns significantly varied by residency, province, sex, age, social category, asset, and education level.ConclusionThis study identified distinct dietary patterns among adult population of Rwanda, suggesting a nutritional transition associated with urbanization. The findings highlight the need for further research into the relationships between diet, obesity, and metabolic syndrome in Rwandan population.

Lean Mass Longitudinally Confounds Sedentary Time and Physical Activity With Blood Pressure Progression in 2513 Children.

Randomized controlled trials have reported no effect of moderate-to-vigorous physical activity (MVPA) on reducing blood pressure (BP) in youth, probably due to short trial durations. This study examined the longitudinal effect of sedentary time (ST), light PA (LPA) and MVPA on BP in 11-year-old children followed up for 13 years to determine the confounding and mediating role of body composition. Data included 2513 children from the Avon Longitudinal Study of Parents and Children (ALSPAC), UK birth cohort who had data on at least one time-point measure of accelerometer-based movement behaviour across the follow-up and complete BP measures at ages 11, 15 and 24 years. Body composition was assessed with dual-energy x-ray absorptiometry at all time points. Multivariate adjusted generalized linear mixed-effect model and structural equation causal mediation model analyses were conducted. Among 2513 participants (61% female, mean [SD] age 11.72 [0.21] years), ST steadily increased from ~6 h/day in childhood (age 11 years) to ~9 h/day in young adulthood (age 24 years), whereas LPA and MVPA decreased, but BP had an inverted U-shaped increase. In the longitudinal analysis, after full adjustment, a 1-min cumulative ST from ages 11 to 24 years was positively associated with increased systolic BP (0.009 mmHg [95% CI 0.007-0.011]; p < 0.001) and diastolic BP. A 1-min cumulative LPA was inversely associated with systolic BP (-0.007 mmHg [-0.009 to -0.004]; p < 0.001), but not diastolic BP. In isotemporal substitution analyses, longitudinal replacement of 10 min of ST with equal time in LPA during childhood, adolescence and young adulthood cumulatively decreased systolic BP by -2.63 mmHg [95% CI -3.17 to -2.08] (p < 0.0001) and diastolic BP by -1.93 mmHg [95% CI -2.36 to -1.50] (p < 0.0001). Replacing 10 min of ST with 10 min of MVPA had no statistically significant effect due to an absolute confounding effect of lean mass. The association of ST with systolic BP was fully mediated by increased lean mass (93% mediation). Increased total fat mass partially mediated (19%-27%) the inverse associations of cumulative MVPA with cumulative systolic and diastolic BP. Theoretically replacing 10 min/day spent sedentary with 10 min/day of LPA during growth from childhood through young adulthood may lower systolic BP by -3 mmHg and diastolic BP by -2 mmHg. Lean mass seems more significant than fat mass in the relations of ST and PA with BP and should be accounted for in future intervention studies in the paediatric and young adult population.

Comparison of inflammatory mediator cytokine responses to inactivated virus platform COVID-19 vaccines between elderly and young adult populations

The coronavirus disease 2019 (COVID-19) pandemic has encouraged global vaccine research, yet vaccine effectiveness in the elderly remains a concern due to immunosenescence. The aim of this study was to compare the cytokine response elicited by an inactivated virus-based COVID-19 vaccine between elderly and young adults, focusing on key cytokines involved in cellular and humoral immunity: tumor necrosis factor-alpha (TNF-α), interleukin (IL)-2, IL-6, IL-10, and interferon-gamma (IFN-γ). A cross-sectional study was conducted in the Jakarta-Bogor region of Indonesia from January 2023 to December 2023. The study population was divided into two age cohorts: elderly (60−85 years) and younger adults (30−40 years). Blood samples were collected twice, after the first booster dose and four weeks after the second booster dose. Serum cytokine concentrations were measured using Luminex assays with microparticles conjugated to monoclonal antibodies against TNF-α, IL-2, IL-6, IL-10, and IFN-γ. Comparisons of the cytokine levels were conducted using Student’s t-tests or Mann-Whitney U tests as appropriate. A total of 74 individuals were included, with 37 each in the elderly and young adult groups. The results showed significant differences in cytokine responses between the two age groups. After the first booster, the levels of IL-6 and IFN-γ were significantly higher in young adults compared to the elderly. After the second booster, the levels of IL-6 were still significantly higher in the young adult group compared to the elderly group (p=0.001). Data indicated that after the second booster dose, the levels of TNF-α increased significantly in the young adult group only (p=0.004), while the levels of IL-2 (p=0.040) and IFN-γ (p=0.006) increased in the elderly group only compared to after the first dose. IL-10 levels increased in both groups (both had p=0.020). This study highlights that young adults had stronger pro-inflammatory responses, while the elderly relied more on IL-2 and IFN-γ for T-cell immunity, suggesting the need for vaccination strategies for the elderly to optimize immune responses.

Implementing Screening for Eating Disorders in Adolescents and Young Adults with a History of Cancer.

Eating disorders are prevalent in the adolescent and young adult (AYA) population, with 2.7% of adolescents effected. AYAs with cancer possess several risk factors for eating disorders that may place them at an even higher risk. Since these patients see their oncology team frequently, oncology clinics are opportune settings for eating disorder screening. Here, we describe a study to implement screening for eating disorders in AYA patients in an oncology clinic. During regularly scheduled oncology visits, eligible patients were given the SCOFF questionnaire. A total of 163 eligible patients filled out the SCOFF questionnaire with 11 positive results (6.75%). Eating disorder screening was successfully implemented in our pediatric oncology clinic. With a rate more than double than the general population, we observed that AYA patients with a history of cancer are at a higher risk for eating disorders and should undergo routine screening in oncology clinics.

NCOG-23. CLINICIAN AND PATIENT REPORTED OUTCOMES IN YOUNG ADULTS WITH GLIOBLASTOMA: RESULTS FROM A MULTIMODAL PROSPECTIVE STUDY

Abstract The median age for glioblastoma (GBM) is 65 years old, however, younger patients have a similarly dismal prognosis. The adolescent and young adult (AYA) population (15-39 years) is a unique and understudied population. Our study aimed to identify survivorship needs in adult patients in AYA population (&amp;lt;40 yrs) with GBM through analysis of patient and clinician-reported outcomes (PROs and CROs). The Molecular, Imaging and Neurological assessment Database (MIND-CNS) captures Neurological Assessment in Neuro-Oncology (NANO) scores, MDASI-BT and FACIT-SP12 responses at first clinic visit and follow-ups for patients with GBM. We tested associations of the two age groups (18-39 vs. 40 years and older) with each domain of NANO, MDASI-BT and FACIT-SP12 at baseline and at follow-up visits using multivariate logistic regression models, adjusting for MGMT promoter methylation and extent of resection. There were 104 patients with GBM enrolled, including 11 young adults, (median =30 years) and 93 older adults (median =65 years). Young and older adults scored similarly in the domains of NANO, MDASI-BT, and FACIT-SP12 at baseline. MDASI domains at follow-up showed statistically significant lower scores on weakness, fatigue, distress, irritability, drowsiness, and disturbed sleep in younger vs. older adults (adjusted p&amp;lt;0.05). Younger adults had less difficulty with memory and concentration, and their symptoms interfered less with work, walking, and overall enjoyment of life. They also reported feeling more peaceful, finding greater comfort and strength in their faith and beliefs. A comparison of NANO score at baseline and progression will be performed at data maturation. While PROs were similar at baseline, young adults reported lower severity in their physical symptoms and higher spiritual well-being compared to older adults at follow-up visits, highlighting different survivorship experiences. Data maturation will allow for deeper analysis to better inform supportive strategies.

Relapsed AML in a Patient Presenting to a College Health Center: A Case Report

Acute myelogenous leukemia (AML) represents nearly 40% of all cancers affecting the adolescent and young adult (AYA) population. Although overall survival has improved, cure rates for AYAs lag behind younger leukemia patients. The primary care provider (PCP), including the college health provider, is a crucial member of the medical team for children and AYA cancer survivors. In the college setting, the PCP plays a key role in close monitoring for relapse and late effects. This case highlights the presentation of a college student to their university's health center for complaints later found to be due to relapsed leukemia. The PCP must distinguish the unique needs of AYA cancer survivors to provide early recognition and referral to treatment for concerns.

The prevalence of synovitis during hip arthroscopy for labral tears – An observational study

Objectives: Hip pain, secondary to labral tears (LT), can significantly impact the quality of life in the young adult population. LTs can be an incidental finding or can arise from underlying pathology, most commonly from femoroacetabular impingement (FAI). The cause of hip pain in young adults can represent a diagnostic challenge to clinicians. Magnetic resonance imaging (MRI)/magnetic resonance arthrography may be inconclusive in some cases. Therefore, diagnostic hip arthroscopy may be performed to provide a definitive diagnosis and to address intra-articular pathology. During hip arthroscopy, synovitis is often an initial finding. Synovitis can have multiple causes or can also be idiopathic. The aim of this study was to determine the incidence of synovitis detected during hip arthroscopy in patients with an MRI-confirmed LT. Materials and Methods: We conducted a prospective review of 50 consecutive patients undergoing hip arthroscopy who had a confirmed LT on MRI. We recorded the presence or absence of synovitis during the initial insertion of the arthroscope. In addition, we recorded demographic data and the grade of LT identified. Results: During hip arthroscopy, 31 patients had synovitis present, while 19 did not have synovitis. No significant difference was identified when comparing Visual Analog Score and EQ5D scores between both cohorts. Conclusion: Our study found that synovitis is a common finding during hip arthroscopy for FAI syndrome, with 62% of patients with an MRI diagnosis of LT associated with FAI having global hip synovitis present at the time of surgery.

Adolescent microsurgical varicocelectomy and changes in sperm parameters: A matched cohort analysis.

Varicocele, a common vascular abnormality surrounding the testis, is known to be associated with impaired semen parameters and male infertility in adults. However, its impact on the adolescent and young adult (AYA) population is less well known. The study aimed to assess the improvement in sperm parameters following varicocelectomy in the AYA population, comparing them to matched adult counterparts, and investigating potential advantages of early intervention. A retrospective analysis was conducted using a comprehensive database at the University of Miami spanning from 2012 to 2023. We included AYA (under 25 years of age) men who underwent varicocelectomy. To ensure comparability, they were matched with adult patients (over 30 years of age) based on preoperative follicle-stimulating hormone (FSH) values and varicocele grade in a 1:2 ratio. Semen parameters were evaluated before and after surgery, including sperm count, motility, morphology, and overall semen quality. We included 45 patients in the Adolescents and Young Adults (AYA) category, and matched them with 116 adults based on FSH and varicocele grade, all of whom underwent microsurgical varicocelectomy. The AYA group exhibited greater improvements post-varicocelectomy compared to the matched cohort. Furthermore, postoperative sperm concentration in the AYA men demonstrated a remarkable increase, with a 1.7-fold increase in mean concentration compared to the adult group (p<0.001). Additionally, motility also displayed significant enhancement among the AYA men, with a final mean total motile sperm count (TMSC) improvement of 2.25-fold compared to the adult cohort (p=0.002). This study highlights the potential benefits of varicocelectomy as a viable treatment option for adolescents and young adults with varicocele, particularly those with impaired semen parameters. By intervening at an earlier stage of development, patients in this age group can achieve significant improvements in semen quality, as compared to their adult counterparts. These findings underscore the importance of considering varicocelectomy as a valuable therapeutic approach for the younger demographic, potentially alleviating future fertility concerns.

Racial and ethnic disparities in outcomes of diffuse large B cell lymphoma in adolescent and young adults: a SEER database analysis.

Data regarding racial disparities in the incidence, treatment, and outcomes of diffuse large B-cell lymphoma (DLBCL) is limited in the adolescent and young adult (AYA) population. We utilized the surveillance, epidemiology, and end-result (SEER) registry research plus database to evaluate racial/ethnic disparities in 8605 AYA patients with DLBCL. Race/ethnicity was categorized into three main subsets: non-Hispanic Whites (NHW), non-Hispanic Blacks (NHB), and 'other races' that included Hispanics (H), American Indian/Alaskan Native (AI/AN), Asian or Pacific Islander (A/PI). NHB were more likely to present with advanced stage disease (p < 0.001) and B symptoms (p < 0.001) and were less likely to receive chemotherapy(p < 0.001) compared to non-Hispanic white (NHW) patients and other races respectively. NHB patients had inferior 5-year disease specific survival (DSS) (70% vs 85% vs 80%, p < 0.001) and 5-year overall survival (OS) (66% vs 82% vs 77%, p < 0.001) compared to NHW and other races respectively. Black race was independently associated with both inferior DSS (HR 1.55, 95% CI 1.17-2.05, p = 0.002) and OS (HR 1.41, 95% CI 1.10-1.83, p = 0.007) after adjusting for age, gender, stage, presence of B symptoms, receipt of chemotherapy and radiation. NHB-DLBCL patients also had a lower 1-year relative survival rate (RSR) compared to NHW and other races. The low RSR in NHB patients persisted up to 5 years from diagnosis unlike NHW and other races. Our study shows that despite significant therapeutic advances in DLBCL over the last two decades, NHB AYA patients with DLBCL continue to have inferior survival outcomes compared to other ethnic and racial groups with disparities arising as early as the first year of diagnosis.

Comparison of subjective and objective refraction in a population of healthy young adults

Comparison of subjective and objective refraction in a population of healthy young adults

Machine learning-based estimation of respiratory fluctuations in a healthy adult population using resting state BOLD fMRI and head motion parameters.

External physiological monitoring is the primary approach to measure and remove effects of low-frequency respiratory variation from BOLD-fMRI signals. However, the acquisition of clean external respiratory data during fMRI is not always possible, so recent research has proposed using machine learning to directly estimate respiratory variation (RV), potentially obviating the need for external monitoring. In this study, we propose an extended method for reconstructing RV waveforms directly from resting state BOLD-fMRI data in healthy adult participants with the inclusion of both BOLD signals and derived head motion parameters. In the proposed method, 1D convolutional neural networks (1D-CNNs) used BOLD signals and head motion parameters to reconstruct the RV waveform for the whole fMRI scan time. Resting-state fMRI data and associated respiratory records from the Human Connectome Project in Young Adults (HCP-YA) dataset are used to train and test the proposed method. Compared to using only BOLD-fMRI data for a CNN input, this approach yielded improvements of 14% in mean absolute error, 24% in mean square error, 14% in correlation, and 12% in dynamic time warping. When tested on independent datasets, the method demonstrated generalizability, even in data with different TRs and physiological conditions. This study shows that the respiratory variations could be reconstructed from BOLD-fMRI data in the young adult population, and its accuracy could be improved using supportive data such as head motion parameters. The method also performed well on independent datasets with different experimental conditions.

Public health prevention programmes for mental illness in school-age children and adolescents

Abstract Background Psychiatrists, psychotherapists and other mental health professionals have long stated the importance of adequate social groups and early intervention for the prevention of severe mental diseases. With psychiatric illness incidence increasing most in the adolescent and young adult populations, we propose the use of school-age directed public mental health initiatives to combat remaining social stigma and promote mental wellbeing, as well as educate children and adolescents in how to recognise symptoms and ask for help. Methods We conducted a systematic review on PubMed as well as government and NGO websites to identify public health initiatives in the prevention and early identification of mental illness among young individuals. Results Preliminary results show that, while certain countries have delineated guidelines on how to support students’ mental health, very few have implemented nation-wide, or even region-wide programmes that directly target prevention and education. A particular note should be made regarding substance abuse and addiction, one of the few illnesses for which many countries have already enacted in-school programmes, that however often overlook the medical aspect of such diseases. Of further note are certain local programmes aimed at offering quality and accessible care to adolescents struggling with mental diseases. Conclusions With psychiatric diseases projected to become one of the greatest contributors to the global burden of disease by 2030, and the importance of early intervention in preventing severe psychiatric illness, we advocated for European public health initiatives implemented in schools, which could be crucial in curbing the spread of mental illness. Key messages • Adolescent and young adults are those most affected by the rising prevalence of mental illness. Consequently, we advocate for in-school programmes to aid in early identification and intervention. • Early identification of mental diseases is crucial in the prevention of severe psychiatric illness, but little has been done so far in terms of public health interventions to tackle such problems.

Impact of HIV-Related Stigma on Antiretroviral Therapy Adherence, Engagement and Retention in HIV Care, and Transition to Adult HIV Care in Pediatric and Young Adult Populations Living With HIV: A Literature Review.

HIV-related stigma is associated with negative effects on mental health and lower health-related quality of life in pediatric and young adult populations living with HIV. We reviewed literature on the impact of HIV-related stigma on suboptimal antiretroviral therapy (ART) adherence, engagement and retention in HIV care, and transition to adult HIV care in children, adolescents, and young adults living with HIV. PubMed and Embase® were searched for publications reporting relevant data published from January 1, 2012, to April 13, 2023. The output was not a systematic review; it was a targeted literature review. Overall, 67 studies were selected for analysis based on pre-specified criteria (eg, quality). Most quantitative studies supported negative associations between HIV-related stigma and ART adherence (n = 8/11), engagement and retention in HIV care (n = 3/4), and transition to adult HIV care (n = 2/3) in pediatric and young adult populations living with HIV. Qualitative studies reported that stigma was a barrier to ART adherence (n = 26), engagement and retention in HIV care (n = 18), and transitioning to adult HIV care (n = 11). Prominent interview themes across all topics included anticipated stigma, enacted stigma, and fear of HIV status disclosure. Results reaffirm that HIV-related stigma is a significant barrier to ART adherence, engagement and retention in HIV care, and transition to adult HIV care among pediatric and young adult populations living with HIV, potentially impacting virologic suppression, onward transmission, and longer-term health. Additional interventional studies are needed to evaluate and reduce the impact of stigma in these important populations.

Hepatitis C Infection Is Not a Cardiovascular Risk Factor in Young Adults.

Background: Cardiovascular diseases are one of the leading causes of hospitalization and death in Poland and around the world and are still an ongoing problem for modern medicine. Despite advances in diagnosis and treatment, both conservative and invasive, the prevention of cardiovascular disease directed at reducing risk factors remains a problem. The main classical risk factors for the development of cardiovascular disease in Poland include hypertension, lipid disorders, obesity, diabetes and smoking. A new non-classical risk factor is HCV infection. Most of the studies on the impact of HCV infection on cardiovascular disease involve elderly populations with long-term infections and advanced liver fibrosis. Methods: Hence, we set out to analyze the prevalence of risk factors and cardiovascular disease in a population of young adults under 45 years of age infected with HCV, according to gender, HCV genotype and the duration of infection. The study group consisted of 217 patients of both sexes aged 21 to 45 years (mean age 36 years). Results: No cardiovascular disease was found among the young adults infected with HCV in the study group. The most common risk factor was cigarette smoking, which affected 20.7% of the subjects, followed by hypertension (12%) and diabetes mellitus (5.5%); the prevalence was lower than in the general population. Most of the patients were characterized as overweight, with a mean BMI of 26.39 kg/m2. The mean values of other metabolic parameters-total cholesterol, LDL, HDL, uric acid and glucose-were within the population norm. The mean value of CRP was 1.43, which may indicate a moderate cardiovascular risk. Conclusions: Based on the conducted research, it was found that HCV infection in young individuals was not a risk factor for cardiovascular diseases, and the prevalence of risk factors was similar to that in the general population. The effect of HCV on the increase in C-reactive protein requires further study. The early detection of HCV infection and treatment can be considered as a prevention of cardiovascular disease.

Individual variation in the functional lateralization of human ventral temporal cortex: Local competition and long-range coupling.

The ventral temporal cortex (VTC) of the human cerebrum is critically engaged in computations related to high-level vision. One intriguing aspect of this region is its asymmetric organization and functional lateralization. Notably, in the VTC, neural responses to words are stronger in the left hemisphere, whereas neural responses to faces are stronger in the right hemisphere. Converging evidence has suggested that left-lateralized word responses emerge to couple efficiently with left-lateralized frontotemporal language regions, but evidence is more mixed regarding the sources of the right-lateralization for face perception. Here, we use individual differences as a tool to adjudicate between three theories of VTC organization arising from: 1) local competition between words and faces, 2) local competition between faces and other categories, 3) long-range coupling with VTC and frontotemporal areas subject to their own local competition. First, in an in-house functional MRI experiment, we demonstrated that individual differences in laterality are both substantial and reliable within a right-handed population of young adults. We found no (anti-)correlation in the laterality of word and face selectivity relative to object responses, and a positive correlation when using selectivity relative to a fixation baseline, challenging ideas of local competition between words and faces. We next examined broader local competition with faces using the large-scale Human Connectome Project (HCP) dataset. Face and tool laterality were significantly anti-correlated, while face and body laterality were positively correlated, consistent with the idea that generic local representational competition and cooperation may shape face lateralization. Last, we assessed the role of long-range coupling in the development of VTC laterality. Within our in-house experiment, substantial correlation was evident between VTC text laterality and several other nodes of a distributed text-processing circuit. In the HCP data, VTC face laterality was both negatively correlated with frontotemporal language laterality, and positively correlated with social perception laterality in the same areas, consistent with a long-range coupling effect between face and social processing representations, driven by local competition between language and social processing. We conclude that both local and long-range interactions shape the heterogeneous hemispheric specializations in high-level visual cortex.

Adverse childhood experiences and left hippocampal volumetric reductions: A structural magnetic resonance imaging study

BackgroundAdverse childhood experiences (ACEs) have been associated with volume alterations of stress-related brain structures among aging and clinical populations, however, existing studies have predominantly assessed only one type of ACE, with small sample sizes, and it is less clear if these associations exist among a general population of young adults. ObjectiveThe aims were to describe structural hippocampal volumetric differences by ACEs exposure and investigate the association between ACEs exposure and left and right hippocampal volume in a student sample of young adults. Methods959 young adult students (18–24 years old) completed an online questionnaire on ACEs, mental health conditions, and sociodemographic characteristics. Magnetic resonance imaging (MRI) was used to measure left and right hippocampal volume (mm3). We used linear regression to explore the differences of hippocampal volumes in university students with and without ACEs. ResultsTwo thirds of students (65.9%) reported ACEs exposure. As ACEs exposure increased there were significant volumetric reductions in left (p < 0.0001) and right hippocampal volume (p = 0.001) and left (p = 0.0023) and right (p = 0.0013) amygdala volume. After adjusting for intracranial brain volume, sex, age, and depression diagnosis there was a negative association between ACEs exposure and left (β = −22.6, CI = −44.5, −0.7, p = 0.0412) but not right hippocampal volume (β = −18.3, CI = −39.2, 2.6, p = 0.0792). After adjusting for intracranial volume there were no associations between ACEs exposure and left (β = −9.2, CI = −26.2, 7.9 p = 0.2926) or right (β = −5.6, CI = −19.9,8.8 p = 0.4466) amygdala volume. ConclusionsHippocampal volume varied by ACEs exposure in young adult students. ACEs appear to contribute to neuroanatomic differences in young adults from the general population.