Relevant Age Group Research Articles

Investigating the Prevalence of Malnutrition and Its Relationship with the Educational Status of Elementary School Students in Zahedan, Iran

Background: Malnutrition and improper nutrition may lead to physical and mental growth disorder and cognitive function. This study aims to determine the prevalence of malnutrition and its relationship with educational status among primary school children in Zahedan, Iran. Methods: During a cross-sectional study with a multi-stage random sampling method of 780 boy and girl students, first, second, and third grades of elementary school were included to study. Demographic and anthropometric of students were collected based on the sample size. Malnutrition was assessed according to World Health Organization indicators for the relevant age group. This assessment was based on body mass index (BMI) for age, height for age, and weight for age. Results: The prevalence of malnutrition was severe wasting, wasting, overweight, and obesity which were 0.8, 4.6, 6.4, and 5%, and severe underweight and underweight which were 0.9 and 4.7%, respectively. Severe stunting and stunting were observed in 0.3 and 2.8%, respectively. A statistically significant relationship was found between BMI for age, height for age and weight for age and educational status (P<0.05). Moreover, the educational status of students showed a statistically significant relationship with first and second-grade gender, birth rank, and Parent’s job and education (P<0.0001). Conclusion: Different forms of malnutrition among the students can negatively affect their performance, especially their educational status. Therefore, proper nutrition and increasing nutritional knowledge of primary school children and parents may help to prevent the problem.

Rapid classification of epidemiologically relevant age categories of the malaria vector, Anopheles funestus

BackgroundAccurately determining the age and survival probabilities of adult mosquitoes is crucial for understanding parasite transmission, evaluating the effectiveness of control interventions and assessing disease risk in communities. This study was aimed at demonstrating the rapid identification of epidemiologically relevant age categories of Anopheles funestus, a major Afro-tropical malaria vector, through the innovative combination of infrared spectroscopy and machine learning, instead of the cumbersome practice of dissecting mosquito ovaries to estimate age based on parity status.MethodsAnopheles funestus larvae were collected in rural south-eastern Tanzania and reared in an insectary. Emerging adult females were sorted by age (1–16 days old) and preserved using silica gel. Polymerase chain reaction (PCR) confirmation was conducted using DNA extracted from mosquito legs to verify the presence of An. funestus and to eliminate undesired mosquitoes. Mid-infrared spectra were obtained by scanning the heads and thoraces of the mosquitoes using an attenuated total reflection–Fourier transform infrared (ATR–FT-IR) spectrometer. The spectra (N = 2084) were divided into two epidemiologically relevant age groups: 1–9 days (young, non-infectious) and 10–16 days (old, potentially infectious). The dimensionality of the spectra was reduced using principal component analysis, and then a set of machine learning and multi-layer perceptron (MLP) models were trained using the spectra to predict the mosquito age categories.ResultsThe best-performing model, XGBoost, achieved overall accuracy of 87%, with classification accuracy of 89% for young and 84% for old An. funestus. When the most important spectral features influencing the model performance were selected to train a new model, the overall accuracy increased slightly to 89%. The MLP model, utilizing the significant spectral features, achieved higher classification accuracy of 95% and 94% for the young and old An. funestus, respectively. After dimensionality reduction, the MLP achieved 93% accuracy for both age categories.ConclusionsThis study shows how machine learning can quickly classify epidemiologically relevant age groups of An. funestus based on their mid-infrared spectra. Having been previously applied to An. gambiae, An. arabiensis and An. coluzzii, this demonstration on An. funestus underscores the potential of this low-cost, reagent-free technique for widespread use on all the major Afro-tropical malaria vectors. Future research should demonstrate how such machine-derived age classifications in field-collected mosquitoes correlate with malaria in human populations.Graphical

Iekļaujoša pirmsskolas izglītība bērniem ar autiskā spektra traucējumiem: teorētiskais aspekts

Although inclusive education is implemented in Latvia and children with autistic spectrum disorders must attend general education pre-school groups, where special education programmes are implemented for children with learning or speech development disorders, various educational policy planning documents indicate that children with autism are difficult to include. In order to understand the reasons for this phenomenon, identify possible obstacles and find possible solutions, the employed literature review includes the following parts: inclusive education development trends in the pre-school stage in the world and in Latvia in various political reports, educational policy planning documents, regulatory acts and scientific studies; development profile of a pre-school child with autism spectrum disorders, including the characteristic features of the relevant age group and developmental disorder, and identification of possible obstacles, indicating possible solutions for the provision of pre-school education for children with autism spectrum disorders.

Improving Drug Therapy for Pediatric Patients: Unfinished History of Pediatric Drug Development.

Improving Drug Therapy for Pediatric Patients: Unfinished History of Pediatric Drug Development.

MiniPI: Minimizing Power Imbalance among Stakeholders for Quality Software Product

The role of requirements elicitation is crucial in the software requirement engineering process as the requirement engineer has to extract the accurate requirements from different stakeholders. However, the problem emerges when the requirement team could not prioritize the extracted requirements because the requirement’s nature may vary as different categories of stakeholders have their own perspectives. This ultimately produces a power imbalance among stakeholders. Therefore, minimizing the power imbalance of software requirements among different categories of stakeholders is fundamentally important for a quality software product. Although many contributions have been made to this subject in the past, there is still a research gap available for minimizing the power imbalance among stakeholders. In this paper, we present a novel approach for minimizing the effects of power imbalance by age-sampling among different categories of stakeholders into three groups and then by age-mapping the requirements. After gathering questionnaires from stakeholders, the concerned parties determine the attributes of the Kano model through the filled Kano’s questionnaires and afterward, the satisfaction index is calculated by taking the values of the relevant age group into account, which eventually minimizes the power imbalance among stakeholders. In order to verify our methodology, we have performed quantitative analysis by calculating index values and applied verified Kano’s satisfaction formula to calculate the overall satisfaction index which improves the quality level of a software product.

Risk of venous thromboembolism and major bleeding in the clinical course of osteosarcoma and Ewing sarcoma

BackgroundPatients with osteosarcoma (OS) and Ewing sarcoma (ES) are considered to have a high venous thromboembolism (VTE) risk, although the exact incidence and prognostic impact are under-researched in general as well as in relevant age groups. AimsTo study the impact of VTE and major bleeding (MB) in OS and ES patients, subdivided in children, Adolescents Young Adults (AYAs; aged 18–39) and older adults. MethodsRetrospective single-center chart review in 519 OS and 165 ES patients treated between 1980 and 2018. Patients were followed from sarcoma diagnosis until an outcome of interest (VTE, MB) or death occurred. Cumulative incidences were estimated with death as competing risk. Cox models were used to determine prognostic impact. ResultsFive-year cumulative incidences of VTE were 12 % (95%CI 9.1–15) for OS and 6.7 % (95%CI 3.5–11) for ES patients, mostly happening in patients ≥18 years; the most frequent VTE presentation was catheter-related upper-extremity thrombosis (OS: 18/65, ES: 7/11). Five-year cumulative incidences for MB were 5.8 % (95%CI 4.0–8.1) in OS and 5.4 % (95%CI 2.5–9.8) in ES patients. 192 OS and 77 ES AYAs were included, who faced similar VTE and MB incidences as older adults. In OS, VTE and MB were both associated with mortality (adjusted HRs 2.0 [95%CI 1.4–2.9] and 2.4 [95%CI 1.4–4.0], respectively), whereas in ES this association was only present for MB (aHR 3.4 [95%CI 1.2–9.6]). ConclusionsVTE is a frequent complication in adult OS and to a lesser extent in ES patients, while the rate of MB was comparably high in both sarcoma types.

Assessing the effect of school closures on the spread of COVID-19 in Zurich.

The effect of school closure on the spread of COVID-19 has been discussed intensively in the literature and the news. To capture the interdependencies between children and adults, we consider daily age-stratified incidence data and contact patterns between age groups which change over time to reflect social distancing policy indicators. We fit a multivariate time-series endemic-epidemic model to such data from the Canton of Zurich, Switzerland and use the model to predict the age-specific incidence in a counterfactual approach (with and without school closures). The results indicate a 17% median increase of incidence in the youngest age group (0-14 year olds), whereas the relative increase in the other age groups drops to values between 2% and 3%. We argue that our approach is more informative to policy makers than summarising the effect of school closures with time-dependent effective reproduction numbers, which are difficult to estimate due to the sparsity of incidence counts within the relevant age groups.

Health-related Quality of Life using the EQ-5D-5L: normative utility scores in a Dutch female population

PurposeNormative utility scores represent the health related quality of life of the general population, are of utmost importance in cost-effectiveness studies and should reflect relevant sexes and age groups. The aim of this study was to estimate EQ-5D-5L normative utility scores in a population of Dutch females, stratified by age, and to compare these scores to those of female populations of three other countries.MethodsDutch women completed the EQ-5D-5L online between January and July 2020. Mean normative utilities were computed using the Dutch EQ-5D-5L value set, stratified by age, tested for differences using the Kruskall–Wallis test, and compared to normative utility scores of female populations elsewhere. Additionally, to support the use of the Dutch EQ-5D-5L data in other settings, normative utility scores were also calculated by applying the value sets of Germany, United Kingdom and USA.ResultsData of 9037 women were analyzed and the weighted mean utility score was 0.911 (SD 0.155, 95% CI 0.908–0.914). The mean normative utility scores differed between age groups, showing lower scores in older females. Compared to other normative utility scores of female populations, Dutch mean utilities were consistently higher except for age groups 18–24 and 25–34. With the three country-specific value sets, new age-specific mean normative utility scores were provided.ConclusionThis study provides mean normative utility scores of a large cohort of Dutch females per age group, which were found to be lower in older age groups. Utility scores calculated with three other value sets were made available.

“You can really be hurt by someone just like you”: Practitioners’ perceptions of preadolescent peer sexual abuse

Child sexual abuse (CSA) has received considerable recent attention from scholars, contributing to prevention and therapeutic intervention services worldwide. However, CSA is still defined as a form of abuse characterized by age and power gaps between victims and perpetrators, despite ample evidence to the contrary. This may explain why preadolescent peer sexual abuse (PAPSA) remains an understudied area of research. PAPSA is generally defined as sexual acts that are developmentally inappropriate and or harmful between children of the same or similar age. The current study was designed to examine educational and therapeutic practitioners’ perceptions of PAPSA and their interactions with children and youth in their care who experienced this form of abuse, specifically focusing on children between the ages of 6–12. Forty in-depth interviews were conducted with practitioners who have encountered PAPSA in their professional lives, using snowball purposeful sampling. The interviews were analyzed using the qualitative thematic analysis method. The results revealed that participants struggled to make meaning and understand the effects of the phenomenon. To make sense of their experiences in encountering PAPSA, they relied on specific contextual elements related to (1) the characteristics of the peers involved, such as age, gender, and personal history; (2) the type and severity of the sexual acts and the effects on the survivors’ lives; and (3) the social discourse on sexuality—in particular, on sexual abuse—within the relevant age group. Relating to each of these contexts helped them to make sense of their experiences. Additionally, the final theme that emerged was the potential of educational and therapeutic environments to become spaces where PAPSA can be addressed in a compassionate way. The discussion emphasizes the complex and multifaceted nature of the PAPSA phenomenon, the lack of clear definitions guiding intervention, and the urgent need to advance theory to promote both prevention and therapeutic intervention efforts.

The epidemiology of funnel chest repairs in Germany: monitoring the success of Nuss’ procedure

BackgroundIn recent years, the Nuss procedure was gaining ground in pectus excavatum repair, but the scientific focus had been on complications compared to conventional repairs. Despite a substantial prevalence of pectus excavatum in population-based studies, the adoption of minimally invasive funnel chest repair and subsequent replacement of conventional procedures has not been assessed on a population-based level.MethodsWe analysed German administrative case-based data on funnel chest repairs separate by age group and operative procedure: conventional or minimally invasive. Changes over time between 2010 and 2018 were analysed by linear regression.ResultsThere were x̅ = 256 operations per year, which did not change throughout the study time, but following the introduction of minimally invasive repairs, their usage increased particularly in males aged 15 to 19 years by 8.7 procedures per year (P = 0.0142) and was accompanied by a concomitant decrease in conventional repairs in all relevant age groups. We observed a shift of operations towards the age group of 15 to 19 years, whose numbers increased by 5.3 yearly procedures (P = 0.0222), whereas they decreased in all other relevant age groups. These shifts could not be observed in females in a similar fashion, but in both males and females, the numbers of minimally invasive per conventional repair increased.ConclusionsIn Germany, the introduction of the Nuss procedure did result in a concentration of funnel chest repairs in adolescence and a replacement of conventional repairs. Data from other healthcare systems are missing but are direly needed to assess the current situation in other healthcare systems.Level of evidenceIII.

CURRENT PRACTICES OF BP MEASUREMENT IN CHILDREN AND ADOLESCENTS ACROSS EUROPEAN COUNTRIES: A SURVEY BY THE HYPERCHILDNET COST ACTION WG ON DEVICES

Objective: Objective: The main objective was to carry out a survey on current practices of BP measurement used among health care providers involved in the care of children and adolescents. Design and method: Design and methods: A 22 questions survey was released online from September 2, 2021 to September 27, 2021. The survey's link was sent to primary care physicians and pediatricians from the 22 European COST country members and it was also posted on the HyperChildNET website. Results: Results: The survey was assessed by 476 individuals and fully completed by 293. It was answered by general practioneers and pediatricians as well as pediatric nephrologists, pediatric cardiologists and pediatric endocrinologists, half of them working in primary care and the other half in hospital settings. Office BP measurement was used for clinical decision-making by 49% of the survey respondents while 29.7% used ABPM (Ambulatory BP Monitoring) and 16% home BP measurements. Only 11% routinely screen for high BP in normotensive children (Figure). Auscultatory and oscillometric devices were used in 57% and 41% of the settings, respectively. The main reason for selecting a BP device was availability in the institution in 60%, ease to use in 25.5% and validation in the relevant age group in 11.5%. Cuff size was selected according to individual child or adolescent mid arm circumference by 55% of the responders. A usual pitfall was combining cuffs from different devices and manufactures reported by 47.7% of the responders. Moreover, 42% performed only one BP measurement at each office BP visit. There was heterogeneity on the reference values used to evaluate the BP status with 27.4% using country specific BP reference tables and the rest different guidelines’ staging schemes. Eighty-three % used published reference values and 15.4% internet-based application for BP staging in children and adolescents. Conclusions: Conclusions: Variation in practices among health care providers show the emerging need of defining criteria to benchmark the different BP measurement devices, as well as to promote awareness for the evaluation of hypertensive children across Europe.

Evaluation of prevention behaviour and its influencing factors with respect to cancer screening

PurposeEvery year, about 4.6 million people are diagnosed with cancer in Europe. However, based on preclinical changes and using appropriate examination procedures certain cancers can be detected in symptom-free patients at an early stage and treatment initiated.In Germany, various cancer screening examinations are currently offered to the relevant age groups and sexes free of charge. Participation rates are affected by a number of factors and barriers. The study aimed at identifying potential obstacles and barriers to uptake, taking into account demographic and socio-economic variables.Materials and methodsData collection was conducted in the context of routine examination appointments at the City of Kiel Occupational Health Department from September 2013 to September 2014 using an anonymised questionnaire. In addition to recording socio-demographic data and tobacco consumption, the questionnaire also catalogued participation in statutory health insurance cancer screening examinations using the “stages of change” from the Transtheoretical Model. Eight potential barriers to participation were recorded.ResultsThe results are based on 718 completed questionnaires. It was found that women, older age, and non-smoking status were associated with a higher probability of participating in cancer screening. It was also found that various barriers affecting (regular) participation were perceived significantly different according to the individual stages of change. This influence of the stages was moderated by gender.ConclusionThe results showed interesting trends in the different barriers and how they are influenced by socioeconomic factors and the stages of change. Especially the stages require different gender-specific approaches to mobilisation for cancer screening.

СТАТИСТИКА ОСВІТИ УКРАЇНИ В КОНТЕКСТІ ЄВРОІНТЕГРАЦІЇ

The paper examines the current state of harmonization of state statistical activity with the requirements of the European Statistical System. The purpose of the article is to determine the state of integration of the education statistics system of Ukraine into the European Union to ensure comparability of education data at the international level. The research was carried out on the basis of general scientific methods such as analysis and synthesis, comparison, time-series analysis, structural analysis, graphical method, etc. The legal framework for the implementation of obligations in the field of statistics and information exchange between Ukraine and the European Union was analyzed. The Law of Ukraine on amendments to certain laws of Ukraine related to the activity of state statistics was reviewed with regard to amendments to the Law of Ukraine "On Education". The main aspects and processes of education systems at the global level were outlined. Special attention is given to creating the necessary conditions for international comparability of education data and indicators. The International Standard Classification of Education is described to provide internationally comparable statistics. The compliance of coverage of relevant age groups by educational programs of Ukraine with international standards was analyzed. Student enrolment has been studied in comparison with European Union member and candidate countries. It was noted that Ukraine had completed a significant amount of work on the commitments towards European integration, despite the emergency situation in Ukraine as a result of the attack by the russian federation. The article draws conclusions about the state of integration of the system of education statistics of Ukraine into the European Union. The task of integrating the system of education statistics of Ukraine into the European space can be carried out effectively only on the condition of consensus, systematic, and compre­hensive consideration.

Association of Dietary Pattern, Lifestyle and Chronotype with Metabolic Syndrome in Elderly-Lessons from the Population-Based Hamburg City Health Study.

In aging populations, the increasing prevalence of metabolic syndrome and the resulting elevated risk of developing non-communicable diseases is a major challenge for worldwide health care. The elderly population-based Hamburg City Health Study (HCHS) allows investigating the association in the relevant age group 45–74 years. For 3513 of 10,000 participants, self-reported information on dietary patterns (DASH, MEDAS), chronotype, lifestyle, and data on metabolic syndrome parameters was available. Overall, having a “low” DASH score was a statistically significant risk factor (OR 1.23; 95% CI 1.01–1.48). Only for “late” chronotype, a slightly elevated OR (1.06) was found, but no statistically significant effect on the outcome of metabolic syndrome. Still, considering chronotype vastly improved the model. However, a trend of an increasing predicted probability from early to late chronotype was found for participants with low adherence to the DASH diet. Future research should focus on options for prevention in persons with late chronotype, so they can be supported better in adherence to, e.g., DASH diet to lower their risk.

Changes in chronotype and social jetlag during adolescence and their association with concurrent changes in BMI-SDS and body composition, in the DONALD Study

Background/objectivesAdolescence is a critical period for both the development of overweight and the transition toward a later chronotype, often accompanied by an increase in social jetlag. This study assessed whether changes in chronotype and social jetlag, are linked to changes in body composition during adolescence.Subjects/methodsWe used data from the DONALD open cohort study, collected between 2014 and 2019, from 213 adolescents (9–17 years at baseline, 45% females) having at least two measures of chronotype and anthropometry (N = 572). Chronotype was assessed with the Munich Chronotype Questionnaire and defined as: midpoint of sleep corrected for sleep-debt (MSFsc) accumulated over the week (later MSFsc represents later chronotype). Social jetlag (SJL) defines the difference between midpoint of sleep during week and weekend. Calculations for Fat Free Mass Index (FFMI [kg/m2)]) and Fat Mass Index (FMI) [kg/m2)]) were based on body fat percentage, weight, and height. To analyze the associations, we used linear mixed-effect regression models. Finally, the total cohort was split into three biologically relevant age groups (cut-off set at <12 years, ≥12 to ≤15 years and >15 years).ResultsMedian follow-up was 2.1 years. Overall, change toward a later chronotype was significantly related with an increase in FMI (ß: 0.05, 95% CI: 0.01–0.08). A 1 h increase in social jetlag predicted an increase in BMI-SDS of 0.08 SDS units (95% CI: 0.01–0.14) and in FMI of 0.04 kg/m2 (95% CI: 0.003–0.08). Associations were stronger for the age group ≥12 to ≤15 years (p for interaction: <0.001). No relationship was found with FFMI.ConclusionsChanges in MSFsc and SJL during adolescence were associated with concurrent changes in BMI-SDS and FMI. The age ≥12 to ≤15 years appears to be a sensitive period in which chronobiological changes were clearly associated with increasing body fatness.

Trends in vaccination coverage against influenza in the pediatric population: an Italian overview

Abstract Background Influenza is a major public health issue for its epidemiological, clinical and economic impact. Children are a relevant age group for the diffusion of the infection in the community as they shed the virus in greater amounts and for longer periods of time than adults of any age. Vaccination is the best strategy to fight the disease. In Italy, until last year, influenza vaccination for the pediatric population was offered free only to children in specific risk categories, while in the last season its was extended also to all subjects from 6 months to 6 years old. The purpose of this work is to analyze the trend of vaccination coverage among children in the last decade in Italy. Methods We retrieved vaccination coverage data by the Italian Ministry of Health relating to influenza vaccination in the age groups 0-2, 2-4, 5-8 and 9-14 in the years 2010-2020 and analysed trends in and between regions. Results A preliminary analysis shows that vaccination coverage in the age groups considered ranged from a minimum of 1.1% to a maximum of 4.5%. The highest average percentage reached was recorded in the season 2010-11 (3.8%), while the lowest in the 2015-16 (1.5%). The highest average values (12,9%; 10,5%) were found in Puglia and Toscana, while the lowest (0.3%) in Friuli Venezia Giulia. From 2010 to 2015 there was a progressive decline in vaccination coverage, while in the following years there was a slight increase, up to the year 2019-2020, in which the average percentage value was 3%. Further results are expected for next summer, when 2020-21 data will be available. Conclusions Our analysis shows that in the Italian regions influenza vaccination coverage in children is variable but still extremely low. Childhood vaccination could provide an opportunity to decrease the burden of disease in this age group but may also help to protect the population at risk of serious complications, such as the elderly, due to the social role children play in the spread of this virus. Key messages Influenza vaccination in children is a major public health issue. Additional efforts are needed to make vaccination available for children and improve the stakeholders’ awareness on this topic.

Assessment of Benefits and Risks of Probiotics in Processed Cereal-based Baby Foods Lactobacillus Paracasei ssp. Paracasei F19

The Norwegian Scientific Committee for Food Safety (VKM) has appointed an ad hoc-group of experts to answer a request from the Norwegian Food Safety Authority regarding benefit and risk assessment of Lactobacillus paracasei ssp. paracasei F19 (F19) in processed cerealbased baby foods intended for small children 1-3 years. This assessment is based on the literature provided by the notifier as well as that found by a MEDLINE search. &#x0D; &#x0D; A notification regarding two products of processed cereal-based baby foods (hereafter called cereals), intended for small children and supplemented with the bacterium F19 initiated this work.&#x0D; &#x0D; A daily supply of a monoculture of a particular bacterial strain in large quantities to an age group without a fully established intestinal flora, may have unknown adverse effects. There are however, to our knowledge, no studies investigating possible short or long term adverse health effects of F19 in processed cereal-based baby food given to children 13 months onwards.&#x0D; &#x0D; The documentation and information provided by the notifier regarding the genetic stability of F19 in the two products during processing and storage, is considered insufficient and does not allow any conclusions to be drawn. &#x0D; &#x0D; Moreover, the documentation obtained is not conclusive regarding the antibiotic resistance pattern of the bacterial strain used in the products in question, as the information on different antibiotics is partly inconsistent. The information about specific localization (chromosomal, plasmid) of the resistance genes is not sufficient. &#x0D; &#x0D; Studies demonstrate that F19, as well as other bacterial strains considered probiotic, is able to “crosstalk” with enterocytes in mice and that the result of the “crosstalk” depends upon the microbiota present. Whether F19 has a similar “crosstalk-profile” in humans is unknown. However, as the strain is originally of human origin, it seems reasonable to assume that such “crosstalk” may occur. Thus, before giving F19 daily for months and years, it seems reasonable to ask for additional molecular and physiological studies to unravel the functional impact of possible changes in genetic expression in children. &#x0D; &#x0D; Lactobacillus infections do occasionally occur, mainly as bacteremia, endocarditis and localized infections (e.g. abscesses, peritonitis, and meningitis) in patients with severe underlying diseases. Most of them are elderly, but children are not excluded. The species most often isolated are L. casei and L. rhamnosus, followed by L. paracasei. &#x0D; &#x0D; The increasing use of immunosuppressive therapy and broad spectrum antibiotics which are ineffective against Lactobacillus, might increase the importance of these bacteria as possible pathogens. In order to be able to draw any conclusions regarding beneficial effects of F19, there is a need for randomized placebo-controlled studies in larger populations and in the relevant age group. &#x0D; &#x0D; According to EFSA, Lactobacillus paracasei ssp. paracasei F19 is sufficiently characterized. The documentation provided is, however, not sufficient to claim positive health effects and thus F19 is not proven to be probiotic. &#x0D; &#x0D; There are no published dose-response studies of F19 in children, neither regarding survival of F19 in the gastrointestinal tract, nor possible negative health effects. Thus the potential for negative health effects as e.g. spreading of antimicrobial resistance or unfavourable impact on the genetic expression in children related to the frequency and/or dose of a monoculture of F19 cannot be assessed.

Classification of Cancer Types by Cluster Analysis Methods

Abstract&#x0D; Cluster analysis can be defined as the group of methods that aim to classify multivariate observations by using similarity/dissimilarity measures between observations. The clusters obtained as a result of the analysis are required to be homogeneous within themselves and heterogeneous among themselves. This study aims to cluster cancer types in datasets created by considering age group characteristics according to gender. In the study, clustering analysis was applied to four different datasets created from the data registered between 1982 and 2016 for 57 cancer types in men and women according to age groups at the Australian Institute of Health and Welfare, and the analysis results were evaluated and interpreted. In addition, in determining the clustering method and the number of clusters, Cophenetic correlation coefficients and 26 cluster validity indices were used, respectively. The distribution of cancer types in age groups determined by gender was observed in 4 different datasets created with 3 different age group characteristics that led to the best separation of cancer groups, and the clustering tendencies of cancers in the relevant age groups were investigated. R-3.5.1 package program was used for analyses. In this study, the analysis results of the k-means method and the average linkage method, which was decided to be the most successful method due to the high cophenetic correlation coefficient value, were evaluated and interpreted. The number of clusters was determined as 3 with the help of cluster validity indices. When the results obtained are examined, it is seen that breast cancer in women and prostate cancer in men is the most common type of cancer in the age group of 40 and above, and that these cancers are alone in a cluster. In addition, it is seen that the 0-14 age group characteristic fails to separate the clusters.

Video-Based Communication and Its Association with Loneliness, Mental Health and Quality of Life among Older People during the COVID-19 Outbreak.

The aim of the study was to examine the use of video-based communication and its association with loneliness, mental health and quality of life in older adults (60–69 years versus 70+ years) during the COVID-19 pandemic. A cross-sectional online survey was conducted in Norway, UK, USA and Australia during April/May 2020, and 836 participants in the relevant age groups were included in the analysis. Multiple regression analyses were conducted to examine associations between the use of video-based communication tools and loneliness, mental health and quality of life within age groups, while adjusting by sociodemographic variables. Video-based communication tools were found to be more often used among participants aged 60–69 years (60.1%), compared to participants aged 70 or above (51.8%, p < 0.05). Adjusting for all variables, the use of video-based communication was associated with less loneliness (β = −0.12, p < 0.01) and higher quality of life (β = 0.14, p < 0.01) among participants aged 60–69 years, while no associations were observed for participants in the oldest age group. The use of video-based communication tools was therefore associated with favorable psychological outcomes among participants in their sixties, but not among participants in the oldest age group. The study results support the notion that age may influence the association between the use of video-based communication tools and psychological outcomes amongst older people.

Validation of CP‐GEP (Merlin Assay) for predicting sentinel lymph node metastasis in primary cutaneous melanoma patients: A U.S. cohort study

BackgroundApproximately 85% of melanoma patients who undergo a sentinel lymph node biopsy (SLNB) are node‐negative. Melanoma incidence is highest in patients ≥65 years, but their SLNB positivity rate is lower than in younger patients. CP‐GEP, a model combining clinicopathologic and gene expression variables, identifies primary cutaneous melanoma (CM) patients who may safely forgo SLNB due to their low risk for nodal metastasis. Here, we validate CP‐GEP in a U.S. melanoma patient cohort.MethodsA cohort of 208 adult patients with primary CM from the Mayo Clinic and West Virginia University was used. Patients were stratified according to their risk for nodal metastasis: CP‐GEP High Risk and CP‐GEP Low Risk. The main performance measures were SLNB reduction rate (RR) and negative predictive value (NPV).ResultsSLNB positivity rate for the entire cohort was 21%. Most patients had a T1b (34%) or T2a (31%) melanoma. In the T1‐T2 group (153 patients), CP‐GEP achieved an SLNB RR of 41.8% (95% CI: 33.9‐50.1) at an NPV of 93.8% (95% CI: 84.8‐98.3). Subgroup analysis showed similar performance in T1‐T2 patients ≥65 years of age (51 patients; SLNB positivity rate, 9.8%): SLNB RR of 43.1% (95% CI: 29.3‐57.8) at an NPV of 95.5% (95% CI: 77.2‐99.9).ConclusionWe confirmed the potential of CP‐GEP to reduce negative SLNB in all relevant age groups. Our findings are especially relevant to patients ≥65 years, where surgery is often elective. CP‐GEP may guide SLNB decision‐making in clinical practice.