Significant Age Group Differences Research Articles

Using multivariate partial least squares on fNIRS data to examine load-dependent brain-behaviour relationships in aging.

Researchers implementing non-invasive neuroimaging have reported distinct load-dependent brain activity patterns in older adults compared with younger adults. Although findings are mixed, these age-related patterns are often associated with compensatory mechanisms of cognitive decline even in the absence of direct comparisons between brain activity and cognitive performance. This study investigated the effects of cognitive load on brain-behavior relationships in younger and older adults using a data-driven, multivariate partial least squares (PLS) analysis of functional near-infrared spectroscopy (fNIRS) data. We measured bilateral prefrontal brain activity in 31 older and 27 younger adults while they performed single and dual 2-back tasks. Behavioral PLS analysis was used to determine relationships between performance metrics (reaction time and error rate) and brain oxygenation (HbO) and deoxygenation (HbR) patterns across groups and task loads. Results revealed significant age-group differences in brain-behavior relationships. In younger adults, increased brain activity (i.e., increased HbO and decreased HbR) was associated with faster reaction times and better accuracy in the single task, indicating sufficient neural capacity. Conversely, older adults showed a negative correlation between HbR and error rates in the single task; however, in the dual task, they demonstrated a positive relationship between HbO and performance, indicative of compensatory mechanisms under the higher cognitive load. Overall, older adults' showed relationships with either HbR or HbO, but not both, indicating that the robustness of the relationship between brain activity and behavior varies across task load conditions. Our PLS approach revealed distinct load-dependent brain activity between age groups, providing further insight into neurocognitive aging patterns, such as compensatory mechanisms, by emphasizing the variability and complexity of brain-behavior relationships. Our findings also highlight the importance of considering task complexity and cognitive demands in interpreting age-related brain activity patterns.

Sex Difference in Disease-Related Adverse Events Post-Diagnosis of Lung Cancer Brain Metastases in Medicare Individuals ≥ 66 Years of Age.

Sex differences are evident in adverse events (AEs) related to brain tumors, yet sex differences in AEs specific to brain metastases (BrMs) are underexplored. Lung cancer BrMs dominate among BrM, comprising over half of cases. This study examined sex differences in AEs associated with lung cancer BrMs in individuals aged 66 or older using the SEER-Medicare dataset. Multivariable logistic regression, adjusted for demographic factors and comorbidities, stratified by histological subtype, treatment, age, and year of diagnosis were used to analyze AEs among those with BrMs from primary lung tumors. Year of diagnosis was grouped into prior/post-2013, to account for shifts in treatment paradigms. The results showed nuanced sex-specific AEs. Females diagnosed post-2013 with small-cell, squamous-cell, or other non-small-cell carcinoma BrMs had a higher headache likelihood than males. Males with adenocarcinoma post-2013 were more likely to experience brain herniation. Females aged 76 and older with small-cell BrM exhibited increased vision difficulty risk compared to males of the same age, with no significant difference in other age groups. Males treated for adenocarcinoma faced heightened hemorrhagic stroke risk. This study reveals sex-specific disparities in AEs among older individuals with lung cancer BrMs, varying by histological subtype, age, diagnosis year, and treatment.

Surgical Outcomes in Octogenarians with Heart Failure and Reduced Ejection Fraction following Isolated Coronary Artery Bypass Grafting-A Propensity Score Matched Analysis.

Background/Objectives: The demographic shift towards an aging population necessitates a reevaluation of surgical interventions like coronary artery bypass grafting (CABG) in octogenarians. This study aims to elucidate the outcomes of CABG in octogenarians with heart failure and reduced ejection fraction (HFrEF), a group traditionally considered at high risk for such procedures. Methods: Conducted across four academic hospitals in Germany from 2017 to 2023, this retrospective multicenter study assessed 100 patients (50 octogenarians ≥80 years and 50 non-octogenarians <80 years) with HFrEF undergoing isolated CABG. Through propensity score matching, the study aimed to compare the incidence of major adverse cardiac and cerebrovascular events (MACCEs), as well as other clinical endpoints, between the two groups. Statistical analyses included chi-square, ANOVA, Mann-Whitney U test, Cox regression, and logistic regression, aiming to identify significant differences in outcomes. Results: The study revealed no significant difference in the combined incidence of MACCEs between octogenarians and non-octogenarians (OR: 0.790, 95% CI: 0.174-3.576, p = 0.759). Mortality rates were similar across groups (7% each, p = 1.000), as were occurrences of postoperative myocardial infarction (2% each, p = 1.000) and stroke (3% total). Secondary outcomes like delirium (17% total, no significant age group difference, p = 0.755), acute kidney injury (18% total, p = 0.664), and the need for dialysis (14% total, p = 1.000) also showed no differences between age groups. Interestingly, non-octogenarians required more packed red blood cells during their stay (p = 0.008), while other postoperative care metrics, such as hospital and ICU length of stay and ventilation hours, were comparable across groups. Conclusion: This multicenter study highlights that CABG is a viable and safe surgical option for octogenarians with HFrEF, challenging prior assumptions about the elevated risks associated with performing this procedure in older patients. The absence of significant differences in the incidence of MACCEs and other postoperative complications across age groups emphasizes the importance of careful patient selection and perioperative management. These findings advocate for a more inclusive approach to surgical treatment for octogenarians with HFrEF, suggesting that age alone should not be a determinant for CABG eligibility. This study contributes critical insights into optimizing care for a high-risk demographic, indicating a need for tailored guidelines that accommodate the aging population with complex cardiac conditions.

Distribution and Drug Resistance Characteristics of Pathogenic Bacteria in the Elderly Population in China in 2021

To study the distribution and drug resistance characteristics of pathogenic bacteria in the elderly population of China by collecting and analyzing the standardized case data on the pathogens of infections in elderly patients, and to facilitate the establishment of a standardized layered surveillance system for pathogenic bacteria in China. We collected the case data of elderly patients (≥65 years old) from 62 sentinel hospitals across the country in 2021. Then, we statistically analyzed the data by patient age, their geographical region, the distribution of pathogenic bacteria, and the drug resistance characteristics of main pathogens. A total of 3468 cases from across the country were included in the study. The top three sources of patients were the intensive care unit (13.2%), the department of respiratory medicine (11.2%), and the department of general surgery (8.4%). The top three types of specimens were urine (25.5%), sputum (20.6%), and blood (18.7%). A total of 3468 strains of pathogens were isolated, among which, 78.9% were gram-negative bacteria and 21.1% were gram-positive bacteria. The top five types of bacteria were Escherichia coli (20.9%), Klebsiella pneumoniae (18.3%), Pseudomonas aeruginosa (11.2%), Staphylococcus aureus (9.0%), and Acinetobacter baumannii (7.0%). The isolation rates of common important drug-resistant bacteria were 38.0% for methicillin-resistant Staphylococcus aureus (MRSA), 68.7% for carbapenem-resistant Acinetobacter baumannii (CRAB), and 38.2% for carbapenem-resistant Pseudomonas aeruginosa (CRPA), 20.1% for carbapenem-resistant Klebsiella pneumoniae (CRKP), 5.2% for carbapenem-resistant Escherichia coli (CRECO), and 2.1% for vancomycin-resistant Enterococcus (VRE). There were differences in the isolation rates of CRAB and CRKP in clinical care in the elderly population in seven geographical regions of China (P<0.05). Klebsiella pneumoniae is the most important pathogen in the elderly population ≥85 years old, and the isolation rates of CRKP showed significant differences in different age groups (P<0.05). There are significant differences in the drug resistance of pathogenic bacteria in the elderly populations of different regions and age groups in China. Therefore, monitoring the distribution and drug resistance of pathogenic bacteria in the elderly population and formulating targeted treatment plans according to the characteristics of the specific regions and age groups are of great significance to the improvement in the treatment outcomes and prognosis of the elderly population.

Young Children’s Responses to Social-Conventional Transgressions in Japanese Preschool Settings

&lt;p style="text-align: justify;"&gt;This study investigated young children’s recognition of social rules and responses to social-conventional transgressions in Japanese preschool settings. One hundred twenty-six children aged three to six years old heard four hypothetical stories that describe typical social-conventional transgressions in Japanese preschools. They were asked about their feelings when they witnessed each transgression (emotional response), whether they thought it was better to follow social rules and act like everyone else (social convention judgment), their justification for the judgment, and their willingness to play with the transgressor (interaction judgment). Most participants in all age groups valued following social rules and judged that the transgressor should act like everyone else, but five-year-olds generated more group- and other-oriented justifications for the judgment. Although there were no significant age group differences in interaction judgment, further analysis showed that three-year-olds’ willingness to play with the transgressor was positively related to their positive emotion, whereas such relationships were not found in four- and five-year-olds. The results demonstrate that Japanese children’s responses to social-conventional transgressions become more social and complex throughout young childhood in the Japanese cultural context.&lt;/p&gt;

EVALUATION OF DEPRESSION FREQUENCY AND ITS EFFECT ON PROGNOSIS IN PATIENTS TREATED FOR ACUTE ISCHEMIC STROKE

Background: Stroke is one of the most important causes of mortality and morbidity in the world. Although mortality and morbidity rates decrease with mechanical thrombectomy and intravenous thrombolytic treatments in suitable patients, post-stroke depression may develop in these patients. Poststroke depression occurs in approximately 30% of patients with stroke and is associated with poor prognosis and quality of life. Objective: Depression is a common complication that leads to dysfunction even years after a stroke. In this study, we aimed to evaluate the frequency of depression, determine the risk factors, the relationship between the infarct localization and stroke severity in patients who underwent acute ischemic stroke treatment (intravenous tissue plasminogen activator (IV-tPA) and/or endovascular mechanical thrombectomy (MT)). Methods: In this prospective study, 230 patients older than 18 years of age who were hospitalized with the diagnosis of acute ischemic stroke between 2021-2022 and treated for acute ischemic stroke were evaluated. Patient characteristics such as age, gender, education level, stroke risk factors, infarct localization were noted in the first month follow up outpatient clinic as well as their Modified Rankin Score (MRS), National Health Institutes Stroke Scale (NIHSS) and Beck Depression Scale (BDI). Results: There was a statistically significant difference in age groups compared to BDI values (x2=10.215, p=0.037). A statistically significant difference was found between BDI levels and MRS (x2=21.177, p&lt;0.001) and BDI score and NIHSS (x2=28.074, p&lt;0.001). There was a statistically significant difference between education levels and MRS values (x2=17.147, p=0.002) and NIHSS scores(x2=14.715, p=0.005). Conclusion: Whereas disability can lead to depression, depression is one of the leading causes of disability. Despite the benefit of acute stroke treatments, they are ineffective in preventing post-stroke depression and subsequent disability. Therefore identification, and prevention of risk factors and early treatment of depression are necessary to effectively prevent morbidity.

Correlation Analysis of Digital Mammography, Ultrasonography, and Pathologic Features in Pure Invasive Micropapillary Carcinoma of the Breast (PIMPC).

This study determined the digital mammography and ultrasonography imaging features of pure invasive micropapillary carcinoma of the breast (PIMPC) and the correlation with pathologic features. Nineteen patients diagnosed with PIMPC at Yantaishan Hospital from October 2015 to February 2022 were included in the study group. Forty patients with breast masses diagnosed as nonspecific invasive ductal carcinoma of the breast (NIDC) from July to December 2021 were included in the control group. Digital mammography and ultrasonography features were compared between the two groups. Patients with PIMPC had a younger age profile compared to patients with NIDC (P=0.017). Moreover, PIMPC masses were smaller than NIDC masses (P=0.040). Imaging features analysis revealed significant differences in age groups (<45 years: χ²=5.971, P=0.044) and the presence of spiculations or the crab claw sign (χ²=8.583, P=0.004) between patients with PIMPC and NIDC. However, there were no statistically significant differences in the presence of calcifications, blood flow grading, pathologic molecular subtypes between the study and control groups. The Ki-67 proliferative index (χ²=1.052, P=0.389), vascular invasion (χ²=2.263, P=0.197), and lymph node metastasis (χ²=1.968, P=0.386) showed no significant differences between PIMPC and NIDC patients. PIMPC imaging features show specificity, such as tiny breast masses, spiculated edges, or crab claw-like patterns, and malignant signs appeared when the lesion was <2 cm in diameter. PIMPC mainly occurs in middle-aged women 45-59 y of age. Patients with PIMPC and NIDC of the breast are frequently associated with lymph node metastases and greater than one-half of the cases (74%) were shown to have a Ki-67 index >30%, suggesting a significant risk of recurrence and metastasis. Early therapeutic care for these patients is crucial. These results warrant further validation with additional samples from several centers due to the limited single-center sample size in the current study.

IMPACT OF DEMOGRAPHIC FACTORS ON ECONOMIC ACTIVITY IN BULGARIA'S RURAL TERRITORIES

Bulgaria has one of the fastest rates of population decline in the EU and the world. In 2021, the value is observed to be 21.6% lower compared to the value recorded in 2001. Changes in rural areas are even more dynamic and have a negative impact on their development opportunities. This paper aims to examine and analyse the economic activity of the rural population using statistical data obtained from population censuses. The analysis is mainly focused on the interdependencies between economic activity, employment in agriculture and their implications for the rural economy. Correlation and regression analysis were applied to test the research hypotheses. The summary of the obtained results shows that the coefficient of economic activity rises until 2020, but activity is uneven and at different rates in different regions, with the coefficient being lower in villages at the expense of economic activity in cities; • The unemployment rate in Bulgaria has gone through three stages: until 2013, it was in double digits, then it dropped to 4.2 (in 2021), and in 2019, an increase began, which varied greatly by region. The unemployment rate is significantly higher in the villages, with the most significant differences in the younger age groups; • The correlation analysis revealed a weak, positive, and insignificant relationship between the rural population and the coefficient of economic activity, as well as the presence of a medium, positive, and significant relationship between the rural population and the agricultural labour force; According to the regression analysis, Annual work unit has a positive and significant influence on the population in rural areas, indicating that agricultural specialization and automation are still in their early stages in Bulgaria, and the workforce in the industry is structure-determining Demographic processes have a negative impact on rural development. A cyclical pattern emerges wherein a declining local economy and depopulation coexist and mutually reinforce one another. A decline in demographic potential and a lack of human capital may limit investment flow. For these reasons, investing in human capital is regarded as a critical means of reversing unfavourable trends in demographic structures and processes in all countries affected by accelerated aging and depopulation. This includes improving the health-care system, education and other social services, as well as raising the living standards of rural inhabitants. To achieve this goal, regional demographic policies must be developed that take into account the demographic and socioeconomic characteristics of each region. Key words: demographic processes, economic activity, rural territories. JEL: J11, J43

Sperm HSP70: may not be an age-dependent gene but is associated with field fertility in Bali bulls (Bos sondaicus).

This study aimed to analyze the characteristics of the HSP70 gene and protein in spermatozoa of Bali bulls of different age groups and to examine its potential as a biomarker determining bull fertility. This study used frozen semen produced from six Bali bulls divided into two groups based on age (≤ 9 years and ≥ 12 years). Parameters of frozen semen quality analyzed included sperm motility and kinetics using computer-assisted semen analysis, sperm morphological defects using Diff-Quick staining, acrosome integrity using FITC-PNA staining, and DNA fragmentation using acridine orange staining. HSP70 gene expression characterization was analyzed using qRT-PCR, and HSP70 protein abundance was analyzed using enzyme immunoassays. Fertility field data were obtained by analyzing the percentage conception rate for each bull based on the artificial insemination service data contained in the Indonesian-integrated system of the National Animal Health Information System (iSIKHNAS). The results showed significant differences (P<0.05) in total and progressive motility, morphological defects of the neck and midpiece, and tail of sperm, and acrosome integrity between the age groups of Bali bulls. HSP70 gene expression and protein abundance showed no significant differences (P>0.05) in different age groups. HSP70 gene expression correlated with fertility rate (P<0.05). Age affected several semen quality parameters but did not affect HSP70 gene expression and protein abundance. The HSP70 gene molecule could be a biomarker that determines the fertility of Bali bulls.

Basic Psychological Needs in Exercise Among Adult Exercisers

This study aimed to examine the basic psychological needs in exercise among adult exercisers regarding gender, type of exercise, age groups, and years of exercise. The Basic Psychological Needs in Exercise Scale was administered to 234 adult exercisers (Mage=25.11, SD = 8.89 years). The participants were classified into two age groups (18-29 and 30-45 years) and three groups based on years participating in exercise programs (6 months to less than one year, 1-3 years, and more than three years) and three types of exercise groups (individual, group, and both). We found statistically significant gender and age group differences on the relatedness subscale (p

Physician adherence to anaphylaxis guidelines among different age groups in emergency departments: 20-Year observational study

BackgroundAnaphylaxis is an acute and serious allergic reaction. Little is known about physician adherence to anaphylaxis guidelines among patients across different age groups. ObjectiveTo investigate real-world physician adherence to anaphylaxis guidelines among children, adults, and older adults in emergency departments. MethodsThis study retrospectively analyzed all consecutive patients with anaphylaxis who presented to 2 emergency departments at 2 branches of the largest tertiary hospital in Taiwan, between 2001 and 2020. Patients who met the diagnostic criteria for anaphylaxis were enrolled and grouped by age: children (<18 years), adults (18-64 years), and older adults (≥65 years). ResultsWe enrolled 771 patients with anaphylaxis (159 children, 498 adults, and 114 older adults). Intramuscular epinephrine was administered in 294 cases (38.1%). There was a significant age-group difference in the rate of intramuscular epinephrine administration (46.5% in children, 37.3% in adults, and 29.8% in older adults; P trend = .004). When stratified by severity, 14.3% of older adults with moderate reactions received intramuscular epinephrine, whereas 35.2% of adults and 55.3% of children received intramuscular epinephrine (P trend < .001), whereas such difference was not found in patients with severe reactions. Upon discharge from emergency departments, 15.3% received allergist referral (52.2% in children, 6.6% in adults, and 1.8% in older adults; P trend < .001); 12.5% received education on avoidance of triggers (18.9%, 11.4%, and 7.9%; P trend = .01), and 16.1% received education on alarm symptoms (21.4%, 15.1%, and 13.2%; P trend = .05). ConclusionThe real-world physician adherence to anaphylaxis guidelines remains suboptimal in emergency departments, particularly among older adults. Physician continuing education is needed to improve the gap between anaphylaxis guidelines and clinical practice.

Aortic regurgitation in athletes: the challenges of echocardiographic interpretation

BackgroundBicuspid aortic valve (BAV) is the most common congenital cardiac defect and prone to premature degeneration causing aortic regurgitation (AR). The assessment of AR in athletic individuals poses several challenges as the pathological left ventricle (LV) remodelling caused by AR may overlap with the physiological remodelling of intense exercise. The purpose of this study is to highlight these challenges, review the existing literature and discuss how to tackle these conundrums. As a real-world example, we compare the resting transthoracic echocardiographic (TTE) findings in a cohort of individuals with BAV and AR, sub-grouped into “highly active” or “lightly active”.MethodsAdult male subjects with an index TTE performed at a tertiary referral centre between 2019 and 2022 were included if the TTE confirmed a BAV and at least moderate AR. Further strict inclusion criteria were applied and parameters of valve disease severity was made in accordance with existing guidelines. Subjects completed a physical activity questionnaire over the telephone, and were classified into either group 1: “highly active” or group 2: “lightly active” based on their answers. Demographics and TTE parameters were compared between the two groups.Results30 male subjects (mean age 44 ± 13 years) with BAV-AR were included – 17 were highly active, and 13 lightly active. There was no significant difference in age (group 1, 45 ± 12.7 years vs. group 2, 42 ± 17 years; p = 0.49), height (p = 0.45), weight (p = 0.268) or severity of AR, when quantitative assessment was possible. Group 1 had a significantly higher stroke volume (131 ± 17mls vs. 102 ± 13 mls; p = 0.027), larger LV volumes, diastolic dimensions and significantly larger bi-atrial and right ventricular size. This LV dilatation in the context of AR and athleticism poses a diagnostic and management conundrum. Despite this, none of these 17 highly active individuals demonstrated any of the traditional criteria used to consider surgery.ConclusionThere is significant overlap between the physiological adaptations to exercise and those caused by AR. Multi-modality imaging and stress testing can aid clinicians in diagnostic and management decisions in exercising individuals when there is discordance between AR severity and symptoms.

Efficient organisation of the contralateral hemisphere connectome is associated with improvement in intelligence quotient after paediatric epilepsy surgery

ObjectiveAims of epilepsy surgery in childhood include optimising seizure control and facilitating cognitive development. Predicting which children will improve cognitively is challenging. We investigated the association of the pre-operative structural connectome of the contralateral non-operated hemisphere with improvement in intelligence quotient (IQ) post-operatively. MethodsConsecutive children who had undergone unilateral resective procedures for epilepsy at a single centre were retrospectively identified. We included those with pre-operative volume T1-weighted non-contrast brain magnetic resonance imaging (MRI), no visible contralateral MRI abnormalities, and both pre-operative and two years post-operative IQ assessment. The MRI of the hemisphere contralateral to the side of resection was anatomically parcellated into 34 cortical regions and the covariance of cortical thickness between regions was used to create binary and weighted group connectomes. ResultsEleven patients with a post-operative IQ increase of at least 10 points at two years were compared with twenty-four patients with no change in IQ score. Children who gained at least 10 IQ points post-operatively had a more efficiently structured contralateral hemisphere connectome with higher global efficiency (0.74) compared to those whose IQ did not change at two years (0.58, p = 0.014). This was consistent across thresholds and both binary and weighted networks. There were no statistically significant group differences in age, sex, age at onset of epilepsy, pre-operative IQ, mean cortical thickness, side or site of procedure, two year post-operative Engel scores or use of anti-seizure medications between the two groups. ConclusionsSurgical procedures to reduce or stop seizures may allow children with an efficiently structured contralateral hemisphere to achieve their cognitive potential.

38 Real-World Goal Setting and Follow Through in Young and Older Adults

Objective:The ability to generate, plan for, and follow through with goals is essential to everyday functioning. Compared to young adults, cognitively normal older adults have more difficulty on a variety of cognitive functions that contribute to goal setting and follow through. However, how these age-related cognitive differences impact real-world goal planning and success remains unclear. In the current study, we aimed to better understand the impact of older age on everyday goal planning and success.Participants and Methods:Cognitively normal young adults (18-35 years, n= 57) and older adults (60-80 years, n= 49) participated in a 10-day 2-session study. In the first session, participants described 4 real-world goals that they hoped to pursue in the next 10 days. These goals were subjectively rated for personal significance, significance to others, and vividness, and goal descriptions were objectively scored for temporal, spatial, and event specificity, among other measures. Ten days later, participants rated the degree to which they planned for and made progress in their real-world goals since session one. Older adults also completed a battery of neuropsychological tests.Results:Some key results are as follows. Relative to the young adults, cognitively normal older adults described real-world goals which navigated smaller spaces (p=0.01) and that they perceived as more important to other people (p=0.03). Older adults also planned more during the 10-day window (p&lt;0.001). There was not a statistically significant age group difference, however, in real-world goal progress (p=0.65). Nonetheless, among older participants, goal progress was related to higher mental processing speed as shown by the Trail Making Test Part A (r=0.36, p=0.02) and the creation of goals confined to specific temporal periods (r=0.35, p=0.01). Older participants who scored lower on the Rey Complex Figure Test (RCFT) long delay recall trial reported that their goals were more like ones that they had set in the past (r= -0.34, p=0.02), and higher episodic memory as shown by the RCFT was associated with more spatially specific goals (r=0.32, p=0.02), as well as a greater use of implementation intentions in goal descriptions(r=0.35, p=0.02).Conclusions:Although older adults tend to show decline in several cognitive domains relevant to goal setting, we found that cognitively normal older adults did not make significantly less progress toward a series of real-world goals over a 10-day window. However, relative to young adults, older adults tended to pursue goals which were more important to others, as well as goals that involved navigating smaller spaces. Older adults also appear to rely on planning more than young adults to make progress toward their goals. These findings reveal age group differences in the quality of goals and individual differences in goal success among older adults. They are also in line with prior research suggesting that cognitive aging effects may be more subtle in real-world contexts.

Oral health conditions in patients under antiresorptive therapy are comparable to unexposed during supportive periodontal care

ObjectivesTo investigate oral health and oral health-related quality of life (OHRQoL) of patients under antiresorptive therapy (ART) during supportive periodontal care (SPC) considering history of medication-related osteonecrosis of the jaw (MRONJ).Materials and methodsIn this cross-sectional study, 100 patients (50 receiving ART (exposed) and 50 without ART (unexposed)) in regular SPC were enrolled for a clinical oral examination and the evaluation of OHRQoL using the OHIP-G14-questionnaire. History of MRONJ was assessed by anamnesis and reviewing patient records.ResultsThere were no statistically significant group differences in age (exposed: 70.00 ± 9.07 versus unexposed: 71.02 ± 8.22 years), sex, distribution of systemic diseases and duration of SPC (on average 8.61 ± 5.73 years). Number of teeth (21.02 ± 5.84 versus 21.40 ± 5.42), DMFT (18.38 ± 3.85 versus 17.96 ± 4.08), probing pocket depth (2.31 ± 0.20 versus 2.38 ± 0.26), clinical attachment level (3.25 ± 0.76 versus 3.46 ± 0.58) and bleeding on probing (15.07 ± 11.53 versus 15.77 ± 13.08) were also not significantly different. The OHIP-G14 sum-score was significantly higher in exposed participants (6.10 ± 6.76 versus 3.62 ± 5.22, p = 0.043). History of MRONJ was prevalent in 8% of patients under ART. Periodontal/peri-implant-related MRONJ were reported in three participants with cancer (n = 1 before and n = 2 after active periodontal therapy). History of MRONJ due to endodontic/restorative reasons was reported in one patient with osteoporosis.ConclusionsPatients under ART in SPC demonstrated similar clinical periodontal and dental status but lower OHRQoL compared to unexposed (not statistically significant). Patient awareness of the MRONJ-risk and appropriate preventive measures should be ensured.Clinical relevanceSPC in osteoporotic patients under ART appeared safe regarding MRONJ, but further investigations on the MRONJ-risk in patients with different risk-profiles are necessary.Study registration: clinicaltrials.gov (#NCT04192188).

Identification of Auditory Processing Disorder Based on the Persian Version of Multiple Auditory Processing Assessment in School-aged Children in Arak City, Iran

Background and Objectives: Auditory processing (AP) takes place throughout the central auditory nervous system. Therefore, to correctly assess auditory processing disorder (APD), it is necessary to use a test battery so that each of these tests can evaluate specific auditory skills. Therefore, considering the importance of detecting children with APD, the Persian version of the multiple auditory processing assessment (MAPA-P) was used in the present study. Methods: The study method was descriptive-analytical and cross-sectional. A total of 300 children aged 9-12 years old in equal numbers in both genders and at any age, from 7 primary schools in Arak City, Iran were enrolled. After ensuring the health of children’s peripheral hearing level, to check their central auditory system, the MAPA-P test battery was performed on laptops with headphones. Analysis of variance (ANOVA) and independent t-test were used to analyze the results. The mean scores in each age group were calculated and finally, the prevalence of APD was determined based on the cut-off point of the whole test. Results: The results showed that the mean scores in all 5 tests had a statistically significant difference in different age groups (P&lt;0.0001), and the mean scores increased with age. Also, no significant difference was observed in the scores of any of the 5 tests between the two genders (P&gt;0.05). The prevalence of APD in the school-age population was 5%. Conclusion: According to the valid results of the MAPA model in many studies, the Persian version of this test battery has been introduced as a standardized test battery. In addition to covering the three crucial domains of AP, it can easily be used in a calm classroom using a CD-RAM. The results of the present study showed that 5% of the children were suspected of APD, which was consistent with the results of the other studies.

Evaluation of alterations in interstitial fluid dynamics in cases of whole-brain radiation using the diffusion-weighted image analysis along the perivascular space method.

In the current study, we assessed changes in interstitial fluid dynamics resulting after whole-brain radiotherapy using the diffusion-weighted image analysis along the perivascular space (DWI-ALPS) method, which is a simplified variation of the diffusion tensor image ALPS (DTI-ALPS) method using diffusion-weighted imaging (DWI) with orthogonal motion-probing gradients (MPGs). This retrospective study included 47 image sets from 22 patients who underwent whole-brain radiotherapy for brain tumors. The data for the normal control group comprised 105 image sets from 105 participants with no pathological changes. DWI was performed with the three MPGs applied in an orthogonal direction to the imaging plane, and apparent diffusion coefficient images for the x-, y-, and z-axes were retrospectively generated. The ALPS index was calculated to quantify interstitial fluid dynamics. The independent t-test was used to compare the ALPS index between normal controls and patients who underwent whole-brain radiotherapy. Patients were compared in all age groups and individual age groups (20-39, 40-59, and 60-84 years). We also examined the correlation between biologically equivalent doses (BEDs) and the ALPS index, as well as the correlation between white matter hyperintensity and the ALPS index. In the comparison of all age groups, the ALPS index was significantly lower (p <0.001) in the postradiation group (1.32 ± 0.16) than in the control group (1.44 ± 0.17), suggesting that interstitial fluid dynamics were altered in patients following whole-brain radiotherapy. Significant age group differences were found (40-59 years: p <0.01; 60-84 years: p <0.001), along with a weak negative correlation between BEDs (r = -0.19) and significant correlations between white matter hyperintensity and the ALPS index (r = -0.46 for periventricular white matter, r = -0.38 for deep white matter). It was concluded that the ALPS method using DWI with orthogonal MPGs suggest alteration in interstitial fluid dynamics in patients after whole-brain radiotherapy. Further systematic prospective studies are required to investigate their association with cognitive symptoms.

Maximal and Submaximal Intensity Isometric Knee Extensions Induce an Underestimation of Time Estimates with Both Younger And Older Adults: A Randomized Crossover Trial

Our perception of time plays a critical role in nearly all daily activities and especially in sports. There are no studies that have investigated and compared time perception during exercise in young and older adults. Thus, this study aimed to compare the effects of exercise on time perception between younger and older adult populations. Thirty-three recreationally active participants were recruited and assigned to either the younger (university students, 9 males and 10 females) or older adults (&gt;60 years, 8 males and 6 females). All participants completed four exercise conditions over two sessions on separate days: approximately 30-seconds of knee extensors 100%, 60% and 10% of maximum voluntary isometric contraction (MVIC), and control (no contractions). Prospective time perception was estimated (at 5-, 10-, 20-, and 30-seconds) at the beginning of each session and while performing the exercise. A main effect for condition (p &lt; 0.001, d = 1.06) with subsequent post-hoc tests indicated participants significantly underestimated (estimated time was shorter than chronological time) time in all three exercise conditions compared to the control. There were no significant age group differences. In conclusion, exercise underestimated time estimates regardless of intensity or age. This questions the postulated intensity-dependent relationship between exercise and time perception. While older adults were expected to be less accurate in their time estimates, they may have been able to adopt alternative strategies for age-related changes in their internal clock, resulting in no significant age group differences.

Receptors expressions on peripheral lymphocytes and CD4+ CD183+ as a diagnostics biomarker for rheumatoid arthritis: A case-control study in Ghana.

T cell receptors play important roles in the development and progression of rheumatoid arthritis (RA).Their involvement has been reported in inflammatory autoimmune diseases. However, their role in predicting RA is still under exploration. This study evaluated the expression of CD183 (CXCR3)receptors on T-cells and other relevant biomarkers for detecting RA and determine their relationship with disease activity. This unmatched case-control study included 48 newly diagnosed RA patients and 30 apparent healthy controls from the orthopedic units of Komfo Anokye Teaching Hospital (KATH),Kumasi and Korle-Bu Teaching Hospital (KBTH),Accra, Ghana. Sociodemographic data was obtained, and blood samples were also collected and processed for flow cytometric analysis. Statistical analyses were done using SPSS version 26.0 and R programming language. p < .05 was considered statistically significant. This study found a significant difference in age group (p < .0001), marital status (p = .0210), occupation (p = .0140), educational level (p = .0210) and religion (p = .0100) between RA patients and healthy controls. Moreover, hemoglobin level (p = .0010), waist circumference (p < .0001) and hip circumference (p = .0040) were significantly different between RA patients and controls. RA patients had significantly lower levels of CD4+ CD183+ compared with the control group (p < .001), and was positively correlated with DAS score (r = .0397, p = .789). In Receiver Operator Characteristics analysis, CD4+ CD183+ could significantly detect RA with a high area under the curve (AUC = 0.687, p = .018). At a cut-off of 0.082, CD4+ CD183+ was the best receptor biomarker for detecting RA with a sensitivity of 90.0%, specificity of 25.9%, a positive predictive value of 69.2%, and a negative predictive value of 58.3%. CD4+ CD183+ best predict RA and is positively correlated with disease activity. CD4+ CD183+ could serve as diagnostics and disease-monitoring biomarker for RA; however, it demonstrates low specificity. Future studies should be directed on CD4+ CD183+ and other biomarkers to augment their diagnostics performances and routine management in RA.

Assessment of the Cardiothoracic Ratio and Its Association with Gender and Age: A Nigerian Study

Cardiothoracic ratio (CTR) evaluation is a useful screening method used to detect cardiomegaly. It varies in different populations due to genetic, geographical and environmental factors that influence body morphology. This study aimed at assessing the CTR and determining its association with gender and age among adult Nigerians. This retrospective cross-sectional study was conducted in the Radiology Department of a Teaching Hospital in Delta State after obtaining ethical clearance. Postero-anterior chest radiographs of 200 adults (108 males and 92 females) were used to measure the transverse cardiac diameter (TCD) and transverse thoracic diameter (TTD) in centimeters (cm). These were used to compute the CTR (TCD/TTD*100). Statistical Package for Social Sciences version 22.0 was used to analyze the data. Independent t-test and analysis of variance (ANOVA) were used to determine the differences in the measurements with regards to gender and age-groups respectively. The correlation that exists between the variables and their association with age were assessed using Pearson’s correlation. P value was set at &lt; 0.05. The TTD and TCD were significantly larger in males than in females (p=0.001 each) while the CTR was significantly larger in females than in males (p=0.016). The TTD and CTR showed significant differences in the various age groups (p=0.002, 0.031) (p=0.195). The two diameters showed a significant positive correlation with age (0&lt;r&lt;0.5). The study provides the normal mean CTR values for the studied population based on age and gender which will help clinicians in the screening for heart conditions. This will enhance early diagnosis and intervention. Keywords: cardiomegaly, thoracic diameter, cardiac diameter, chest radiographs, diagnosis, cardiothoracic ratio