Small Increase Research Articles

Impact of Substituting Meats with Plant-Based Analogues on Health-Related Markers: A Systematic Review of Human Intervention Studies

The growing drive towards more sustainable dietary patterns has led to an increased demand for and availability of plant-based meat analogues (PBMAs). This systematic review aims to summarize the currently available evidence from human intervention studies investigating the impact of substituting animal meat (AM) with PBMAs in adults. A total of 19 studies were included. Overall, an increase in satiety following PBMA intake was reported, albeit to different extents and not always accompanied by changes in leptin and ghrelin. PBMAs generally resulted in lower protein bioavailability and a smaller increase in plasma essential amino acids in comparison to AM. However, muscle protein synthesis and physical performance were not affected. Finally, conflicting results have been reported for other outcomes, such as pancreatic and gastrointestinal hormones, oxidative stress and inflammation, vascular function, and microbiota composition. In conclusion, we documented that the impact of substituting AM with PBMA products has been scarcely investigated. In addition, the heterogeneity found in terms of study design, population, outcomes, and findings suggests the need for additional high-quality intervention trials, particularly long-term ones, to better clarify the advantages and potential critical issues of such substitutions within sustainable healthy diets.

Numerical Study on the Effect of Geometrical Changes on the Deformation Behaviour of Recycled Aluminium Alloy AA6061 undergoing High Velocity Impact using Hyperworks-Radioss

Numerical analysis is important to predict material behaviour without require an experimental implementation. This manuscript focuses on a numerical prediction establishment of a direct recycled aluminium alloys AA6061 undergoing Taylor Cylinder Impact test using Johnson-Cook model in HyperWorks Radioss. The numerical setup was first validated against the experimental data at the velocity range of 179 to 212 m/s. Good agreement between simulation and experimental data was obtained within the range that exhibits a mushrooming shape fracture mode. A parametric study was then conducted to study the deformation behaviour of the selected recycled aluminum alloys within the validated range at various geometrical settings. The analysis was made by focusing on the post-impact configuration of the projectile at different impact velocities in terms of residual length, deformed diameter, and the final length-to-diameter ratio. It was found that a broader projectile experienced a less significant reduction in its final length (Lf/Lo goes from 0.87 to 0.9 for projectile diameter 9mm to 34mm) and a smaller increase in the deformed diameter compared to a thinner projectile (Df/Do goes from 1.18 to 1.12 for projectile diameter 9mm to 34mm). It was found that a thinner projectile experienced more diameter expansion than length reduction post impact. In addition, a longer projectile experienced more residual length reduction (Lf/Lo goes from 0.92 to 0.87 for projectile length 2mm to 14mm) and more radial deformation compared to the one with a smaller initial length (Df/Do goes from 1.06 to 1.18 for projectile length 2mm to 14mm). All projectiles showed more significant changes on the deformed diameter compared to the changes in residual length post-impact. The results helped the understanding of a critical aspect of the deformation behaviour of recycled aluminum alloy AA6061 more effectively compared to experimental work implementation.

Global burden of stroke in adolescents and young adults (aged 15–39 years) from 1990 to 2019: a comprehensive trend analysis based on the global burden of disease study 2019

SummaryIntroductionThe incidence of stroke is rising among individuals aged 15–39. Insufficient research targeting this age group hampers the development of effective strategies. This study analyzes data from the Global Burden of Disease Study 2019 (GBD 2019) to examine trends from 1990 to 2019 and propose future interventions.MethodsData on ischemic strokes, intracerebral hemorrhage, and subarachnoid hemorrhage from 1990 to 2019 was collected from the Global Health Data Exchange (GHDx) platform. We used the Annual Average Percentage Change (AAPC) to assess global trends in incidence, prevalence, Disability-Adjusted Life Years (DALYs), and mortality rates across various stroke categories. Joinpoint models identified significant years of trend inflection. Trend analyses were segmented by age, gender, and Sociodemographic Index (SDI).FindingsFrom 1990 to 2019, the global incidence of ischemic stroke within the adolescents and young adults (AYAs) cohort declined from 1990 to 1999, further decreased from 2000 to 2009, and then increased from 2010 to 2019. The overall AAPC p-value showed no significant difference. Mortality rates for ischemic strokes were consistently reduced during this period. The overall incidence rate of intracerebral hemorrhage has exhibited a downward trend. Meanwhile, the incidence rate of subarachnoid hemorrhage decreased from 1990 to 2009, yet saw a resurgence from 2010 to 2019. Male ischemic stroke incidence grew more than female incidence, but both absolute incidence and rates were higher for females. Differences in SDI levels were observed, with the fastest increase in incidence occurring in low-middle SDI regions, followed by high SDI regions, and the smallest increase in low SDI regions. Conversely, the most rapid decline was noted in high-middle SDI regions, with no significant change observed in middle SDI regions.ConclusionA concerning trend of increasing ischemic stroke incidence, DALYs, and prevalence rates has emerged in the global 15–39 age group, especially among those aged 30–39. This increase is evident across regions with varying SDI classifications. To combat this alarming trend among adolescents and young adults, enhancing preventive efforts, promoting healthier lifestyles, strengthening the healthcare system’s responsiveness, and maintaining vigilant epidemiological monitoring is essential.

The Effect of Traditional Strength Training on Sprint and Jump Performance in 12- to 15-Year-Old Elite Soccer Players: A 12-Month Controlled Trial.

Skratek, J, Kadlubowski, B, and Keiner, M. The effect of traditional strength training on sprint and jump performance in 12- to 15-year-old elite soccer players: a 12-month controlled trial. J Strength Cond Res XX(X): 000-000, 2024-The aim of the study was to evaluate the effect of traditional strength training on maximum strength (1 repetition maximum in front squat [FS] and back squat [BS]), jump (squat and countermovement jump), and linear sprint (LS) performance (5, 10, and 30 m) in elite young soccer players. A 12-month longitudinal design was chosen, and 48 elite male youth soccer players (age: 12-15 years) were included. The subjects were divided in 2 groups (a strength training group [STG] and a control group [CG]). The intervention group trained for 1 year over a competitive soccer season with additional sessions to their regular soccer practice (4 sessions per week), while the CG did not complete any additional sessions to the regular soccer training (4 sessions per week). The additional strength training (2 sessions per week [each approximately 30 minutes]) consisted of either parallel FS or BS. The squat variants switched in each session. Data were analyzed using a 2 × 3 (group × time) repeated-measures analysis of variance. The main findings of this study were that the STG resulted in significant pretest and post-test improvements in maximum strength (d = 3.75-5.58), jump (d = 0.84-1.14), and LS performance (d = -0.25 to 0.44), while for the CG, smaller increases or performance decreases were measured (maximum strength: d = 1.64-2.7; jump: d = 0.12-0.31; sprint: d = 0.00-025). A significant interaction effect in all variables indicated significant (p < 0.05) stronger performance improvements compared with the CG. Traditional strength training in elite youth soccer players is recommended to increase strength and speed-strength (jump and sprint performance) and should be considered in long-term athletic development programs.

Performance of Aromatic Amine-Modified Metallocene Polyalphaolefin Lubricant Base Oil

With the continuous advancement of industrial technology, higher demands have been placed on the properties of gear oils, such as oxidation stability and shear resistance. Herein, the oxidation stability of high-viscosity metallocene poly-α-olefins (mPAOs) was improved by chemical modification via aromatic amine alkylation. The modified mPAO base oils were synthesized separately with diphenylamine (mPAO-DPA) and N-phenyl-α-naphthylamine (mPAO-NPA), and their applicability in industrial gear oil formulations was evaluated. The composition and physicochemical properties of the obtained samples were assessed using 1H NMR spectroscopy, Fourier transform infrared spectroscopy, gel permeation chromatography, and the American Society for Testing and Materials standards (ASTM D445, ASTM D2270, ASTM D92, etc.) confirming the successful completion of the alkylation reaction. The oxidation stability of the samples was also evaluated using pressurized differential scanning calorimetry. The initial oxidation temperature of mPAO-NPA (230 °C) was 53 °C higher than that of mPAO, and the oxidation induction period of mPAO-DPA was nearly twice that of mPAO-NPA. Thermogravimetric analysis in air revealed the increased thermal decomposition temperature and improved thermal stability of modified mPAO. ISO VG 320 industrial gear oils were formulated using mPAO alkylated with N-phenyl-α-naphthylamine(Lub-2) and commercially purchased PAO100 (Lub-1) as base oil components. The antioxidant performance of two industrial gear oils was evaluated through oven oxidation and rotating oxygen bomb tests. The oxidation induction period of Lub-2 was 30% higher than that of Lub-1, with the latter having a lower acid number and a smaller increase in viscosity at 40 °C. Finally, the friction performance of the samples was assessed on a four-ball friction tester, revealing the synergistic effect of the mPAO-NPA base oil with the HiTEC 3339 additive, forming a more stable oil film with a smaller wear scar diameter.

Методологічні основи визначення і контролю витрат біопалив у процесі руху автомобіля

The paper proposes a methodological approach to determine and control fuel consumption (biofuels) of a car that has known design parameters and moves in known conditions at known modes. It is noted that at this stage it is more attractive to use mixed fuels based on gasoline or diesel fuel with the addition of various impurities of biological origin. For gasoline-based fuels, impurities can be methyl or ethyl alcohol, for diesel fuel – vegetable oils, as well as their methyl and ethyl esters of these oils. A structural and logical scheme has been developed, which explains the main provisions of the proposed determining method and controlling the biofuels consumption. In the structural and logical scheme, the following groups of parameters that take place during the car movement are highlighted: parameters of the conditions, the driving mode design. The mutual influence of parameters among themselves and between groups, the influence of the biological component concentration on its consumption, which must be taken into account to determine and control the consumption of biofuels during the movement of the car, was analyzed. It is shown that when switching to the use of biofuel, there is a change in the indicator coefficient of the internal combustion engine, which also affects the change in consumption.It has been proven that in the process of using biofuel, important factors affecting its consumption are density, lower heat of combustion, and the theoretically required amount of air for kg of biofuel combustion, which depends on the volumetric a specific biological component concentration in it. It has been proven that in the biofuel use process, important factors affecting its consumption are density, lower heat of combustion and the theoretically necessary amount of air for combustion in 1 kg of biofuel, which depends on the volumetric a specific biological component concentration. Taking into account the relative indicators of the «main» fuel (lower combustion heat, density and theoretically necessary air amount for the combustion of 1 kg impurities), it was established that the smallest increase in fuel consumption by the car engine during operation occurs when rapeseed oil is added to diesel fuel.

Surgical Stone Trends from 2013 to 2021 in the US Medicare Population: Before and after the COVID-19 Pandemic.

Introduction and Objective: In early 2020, as the SARS-Cov-2 (COVID-19) pandemic progressed, many institutions limited nonurgent surgical care. This coincided with a decade-long trend of increasing percutaneous nephrolithotomy (PCNL) and ureteroscopy (URS) and decreasing shock wave lithotripsy (SWL) for surgical management of urolithiasis. Herein, we evaluate temporal stone surgery rates and surgeon volumes in the Medicare population and suggest how COVID-19 contributed to them. Methods: Retrospective analysis was conducted using the "Medicare Physician & Other Practitioners" database containing data from January 2013 to December 2021. Adult patients who underwent stone surgery were included. We evaluated surgeon characteristics and changes in case volumes over time adjusted for population. Results: In 2013, urologists performed 68,910 stone surgeries: SWL 42,903 (62%); URS 25,321 (37%); PCNL 686 (1%). Over the next 8 years, there was an average annual increase in URS (+13%) and PCNL (+13%) and decrease in SWL (-2%). In 2020, there was a 14% reduction in all stone cases: SWL (-25%); URS (-6%); PCNL (-8%). By 2021, case volumes recovered to pre-2020 levels, though SWL remained low: SWL 33,974 (34%); URS 64,541 (64%); PCNL 1764 (2%). From 2013 to 2021, the number of urologists performing SWL decreased (1718 to 1361) while URS and PCNL providers doubled (1,347 to 2,914 and 28 to 76, respectively). Conclusions: From 2013 to 2021, there was an increase in URS and PCNL and a decrease in SWL in the US Medicare population. The COVID-19 pandemic was associated with a decline in stone surgeries, particularly SWL. By 2021, PCNL and URS case numbers increased significantly with a smaller increase in SWL.

Particulate Matter Exposure and Default Mode Network Equilibrium During Early Adolescence.

Background: Air pollution exposure has been associated with adverse cognitive and mental health outcomes in children, adolescents, and adults, although youth may be particularly susceptible given ongoing brain development. However, the neurodevelopmental mechanisms underlying the associations among air pollution, cognition, and mental health remain unclear. We examined the impact of particulate matter (PM2.5) on resting-state functional connectivity (rsFC) of the default mode network (DMN) and three key attention networks: dorsal attention, ventral attention, and cingulo-opercular. Methods: Longitudinal changes in rsFC within/between networks were assessed from baseline (9-10 years) to the 2-year follow-up (11-12 years) in 10,072 youth (M ± SD = 9.93 + 0.63 years; 49% female) from the Adolescent Brain Cognitive Development (ABCD®) study. Annual ambient PM2.5 concentrations from the 2016 calendar year were estimated using hybrid ensemble spatiotemporal models. RsFC was estimated using functional neuroimaging. Linear mixed models were used to test associations between PM2.5 and change in rsFC over time while adjusting for relevant covariates (e.g., age, sex, race/ethnicity, parental education, and family income) and other air pollutants (O3, NO2). Results: A PM2.5 × time interaction was significant for within-network rsFC of the DMN such that higher PM2.5 concentrations were associated with a smaller increase in rsFC over time. Further, significant PM2.5 × time interactions were observed for between-network rsFC of the DMN and all three attention networks, with varied directionality. Conclusion: PM2.5 exposure was associated with alterations in the development and equilibrium of the DMN-a network implicated in self-referential processing-and anticorrelated attention networks, which may impact trajectories of cognitive and mental health symptoms across adolescence.

Rancidity development in oat during industrial processing

To improve the shelf-life of food products rich in lipids, it is important to minimize the lipid oxidation that occurs during processing, since this oxidation not only decreases shelf-life but also induces off-flavors. To evaluate the oxidation of lipids in the production of one β-glucan-rich and one protein-rich food supplement made from oats (Avena sativa), the neutral and polar lipid profile, hexanal content, peroxide value, avenanthramides and lipase activity were measured at all production steps. The concentration of antioxidants in the form of avenanthramides was also investigated. This study shows that oat lipases were fully inactivated in the wet processing part of the processing line, and the total lipid content per dry weight increased with the progression of steps toward the oat protein product. Processing had no apparent effect on avenanthramide levels. Lipid oxidation markers increased in certain processing steps. The most significant increase in hexanal and peroxide values could be seen in the spray-drying step of the process, while a much smaller increase was seen for the drum-drying. The main conclusion is that the most important factor to prolong the shelf-life of the product is to minimize the oxidation in the drying step.

Arrhythmogenic effects of acute electronic cigarette compared to tobacco cigarette smoking in people living with HIV.

The leading cause of death in people living with HIV (PLWH) is cardiovascular disease, and the high prevalence of tobacco cigarette (TC) smoking is a major contributor. Switching to electronic cigarettes (ECs) has been promoted as a harm reduction strategy. We sought to determine if acute EC compared to TC smoking had less harmful effects on arrhythmogenic risk factors including acute changes in hemodynamics, heart rate variability (HRV), and ventricular repolarization (VR). In PLWH who smoke, changes in hemodynamics, HRV, and VR were compared pre/post acutely using an EC, TC, or puffing on an empty straw on different days in random order, in a crossover study. Thirty-seven PLWH (36 males, mean age 40.5 ± 9.1 years) participated. Plasma nicotine was greater after TC versus EC use (10.12 ± 0.96 vs. 6.18 ± 0.99 ng/mL, respectively, p = 0.004). HR increased significantly, and similarly, after acute EC and TC smoking compared to control. Changes in HRV that confer increased cardiac risk (LF/HF ratio) were significantly smaller after acute EC versus TC use, consistent with a harm reduction effect. In a post-hoc analysis of PLWH with and without positive concurrent recreational drug use as indicated by point of care urine toxicology testing, this differential effect was only seen in PLWH not currently using recreational drugs. Changes in VR were not different among the three exposures. In PLWH who smoke, EC compared to TC smoking resulted in smaller adverse changes in HRV. This differential effect was accompanied by a smaller increase in plasma nicotine, and was negated by concurrent recreational drug use. Additional studies are warranted in this vulnerable population disproportionately affected by tobacco-related health disparities.

Trunk Instability in the Pitch, Yaw, and Roll Planes during Clinical Balance Tests: Axis Differences and Correlations to vHIT Asymmetries Following Acute Unilateral Vestibular Loss.

Clinical dynamic posturography concentrates on the pitch and roll but not on the yaw plane instability measures. This emphasis may not represent the axis instability observed in clinical stance and gait tasks for patients with balance deficits in comparison to healthy control (HC) subjects, nor the expected instability based on correlations with vestibulo-ocular reflex (VOR) deficits. To examine the axis stability changes with vestibular loss, we measured trunk sway in all three directions (pitch, roll, and yaw) during the stance and gait tasks of patients with acute unilateral vestibular neuritis (aUVN) and compared the results with those of HC. Concurrent changes in VORs were also examined and correlated with trunk balance deficits. The results of 11 patients (mean age of 61 years) recorded within 6 days of aUVN onset were compared within those of 8 age-matched healthy controls (HCs). All subjects performed a two-legged stance task-standing with eyes closed on foam (s2ecf), a semi-gait task-walking eight tandem steps (tan8), and four gait tasks-walking 3 m with head rotating laterally, pitching, or eyes closed (w3hr, w3hp, w3ec), and walking over four barriers 24 cm high, spaced 1 m apart (barr). The tasks' peak-to-peak yaw, pitch and roll angles, and angular velocities were measured with a gyroscope system (SwayStarTM) mounted at L1-3 and combined into three, axis-specific, balance control indexes (BCI), using angles (a) for the tandem gait and barriers task, and angular velocities (v) for all other tasks, as follows: axis BCI = (2 × 2ecf)v + 1.5 × (w3hr + w3hp + w3ec)v + (tan8 + 12 × barr)a. Yaw and pitch BCIs were significantly (p ≤ 0.004) greater (88 and 30%, respectively) than roll BCIs for aUVN patients. For HCs, only yaw but not pitch BCIs were greater (p = 0.002) than those of roll (72%). The order of BCI aUVN vs. HC differences was pitch, yaw, and roll at 55, 44, and 31%, respectively (p ≤ 0.002). This difference with respect to roll corresponded to the known greater yaw plane than roll plane asymmetry (40 vs. 22%) following aUVN based on VOR responses. However, the lower pitch plane asymmetry (3.5%) in VOR responses did not correspond with the pitch plane instability observed in the balance control tests. The increases in pitch plane instability in UVL subjects were, however, highly correlated with those of roll and yaw. These results indicate that greater yaw than pitch and roll trunk motion during clinical balance tasks is common for aUVN patients and HCs. However, aUVN leads to a larger increase in pitch than yaw plane instability and a smaller increase in roll plane instability. This difference with respect to roll corresponds to the known greater yaw plane than roll plane asymmetry (40 vs. 22%) following aUVN observed in VOR responses. However, the lower pitch plane asymmetry (3.5%) in VOR responses does not correspond with the enhanced movements in the pitch plane, observed in balance control tasks. Whether asymmetries in vestibular-evoked myogenic potentials (Vemps) are better correlated with the deficits in pitch plane balance control remains to be investigated. The current results provide a strong rationale for the clinical testing of directional specific balance responses, especially yaw and pitch, and the linking of balance results for yaw and roll to VOR asymmetries.

Long term remineralizing effect of casein phosphopeptide amorphous calcium phosphate in white spot lesions: A systematic review and meta-analysis.

White spot lesions (WSLs) appear as white, opaque areas on the teeth and are caused by a demineralization of the enamel. The purpose of this systematic review and meta-analysis was to determine whether casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) has beneficial effects on WSLs and provides remineralizing benefits that are superior to those of placebo or no treatment. Following a thorough analysis of the literature across major online sources, 103 papers - 54 of which underwent in-depth evaluation- were found. We used inclusion and exclusion criteria to choose research articles that were appropriate for our review. 10 papers met this review's requirements and were subsequently included. As compared to the controls, CPP-ACP demonstrated increased efficacy in treatment of WSLs in terms of remineralisation and other parameters which included microhardness tests and enamel surface roughness. The forest plots present the results of meta-analyses comparing the effect of CPP-ACP versus control/other agents on white spot lesions (WSLs). In terms of odds ratios (OR), CPP-ACP showed a small increase in the odds of WSLs compared to control/other agents. In-vitro studies showed no significant difference in relative risk (RR) between CPP-ACP and control/other agents. Randomized control trials indicated a small increase in the risk of WSLs with CPP-ACP treatment, but the overall effect was not statistically significant. There was evidence to support the use of CPP-ACP over other agents for WSL prevention or treatment, but further research is needed to confirm these findings.

Spatio-temporal dynamics of vegetation over cloudy areas in Southwest China retrieved from four NDVI products

The Normalized Difference Vegetation Index (NDVI) is the most commonly used index for assessing vegetation. However, significant differences among various satellite datasets, complex terrain, and the impact of clouds on optical sensors limit vegetation change assessment based on NDVI. To address these issues, this study utilizes multi-source satellite data (GIMMS3g NDVI, CDR AVHRR NDVI, SPOT NDVI, and MODIS NDVI) to monitor vegetation dynamics at different time scales from 1990 to 2020 in Sichuan Province, China. The results indicate that over time, NDVI values from the four NDVI products in Sichuan Province have shown an upward trend. There are certain differences in the spatial distribution and spatial heterogeneity of the change rate of NDVI values among the four NDVI products at different time scales, and the differences are mainly concentrated in the Sichuan Basin (SB) and the Western Sichuan alpine plateau region (WS). Compared with the other three NDVI products, GIMMS NDVI has the highest value but the smallest increase during the study period. The SPOT NDVI value is the smallest, but the increase is relatively large. However, within the overlapping period of the four NDVI datasets, only the annual average of CDR AVHRR NDVI showed a downward trend (slope2000–2013 = −0.0001·a−1). The annual fluctuation of CDR AVHRR NDVI is the smallest, and compared to other NDVI datasets, its correlation with climate factors shows significantly weaker spatial variability. Moreover, the ability of CDR AVHRR NDVI to distinguish different vegetation land cover types is significantly poor (STD = 0.045). The findings of this study will provide a reference for further research on vegetation changes in Sichuan Province and NDVI reconstruction in cloudy areas.

Adult attachment assessed via the ASA and AAI: Empirical convergence and links with autonomic physiological responding during attachment assessments

ABSTRACT This study examined the empirical convergence of Attachment Script Assessment (ASA) deactivation, hyperactivation, and anomalous scripts with conceptually corresponding attachment patterns assessed via the Adult Attachment Interview (AAI), and the significance of ASA dimensions for autonomic physiological reactivity during adult attachment assessments. Young adults’ (50% male; Mage = 19 years; 80% White/European American) ASA deactivation, hyperactivation, and anomalous content were significantly associated with AAI dismissing (r = .26-.38), preoccupied (r = .31-.35), and unresolved (r = .37) states of mind, respectively. ASA hyperactivation and anomalous content were associated with heightened RSA reactivity to the AAI and ASA, aligning with expectations that these attachment patterns capture the tendency to heighten expressions of negative, traumatic experiences. ASA deactivation was associated with smaller increases in electrodermal activity to the ASA—indicative of less sympathetic arousal—converging with the tendency of individuals higher in deactivation to avoid discussing attachment themes in the ASA.

The effect of heavy metal lead (Pb) removal by Hydrilla verticillata, Hygrophila polysperma, and Rotala rotundifolia plants on the height and dry weight of plants

Heavy metal lead is widely used in the industrial world, such as in the manufacture of batteries and cable coatings. Behind its benefits, heavy metal lead has become a pollutant waste that is dangerous for the survival of organisms because it is accumulative and difficult to degrade. This study aims to analyze the effect of aquascape plants removing lead heavy metal concentrations on plant height and dry weight. The experimental design used in this study was a factorial complete randomized design with two factors. The results showed that the plants in all types of treatment had a bioconcentration factor (BCF) value > 1 so the three aquascape plants were categorized as accumulators. This study’s removal of lead and heavy metals influenced aquascape plants’ height and dry weight. The highest increase in height occurred in Hygrophila polysperma (A2B0), while the smallest increase in height occurred in Rotala rotundifolia (A3B0). Measurement of plant dry weight at the end of the study showed that Hydrilla verticillata had the highest dry weight of 1.26 g while the lowest dry weight was owned by Rotala rotundifolia plants at 0.34 g.

Changes in well-being among socially isolated older people during the COVID-19 pandemic: An outcome-wide analysis

Older adults experienced major changes during the COVID-19 pandemic and ensuing restrictions, and it might be expected that those who were already socially isolated before the pandemic were particularly vulnerable. We apply an outcome-wide longitudinal design on 4,636 participants (mean age 66.8 y) from the English Longitudinal Study of Ageing, observed in 2018/19 and early (June/July 2020) and later (November/December 2020) in the pandemic. Social isolation is defined using an index including marital status, social contact, and social participation in 2018/19. Using mixed models, we compare changes in well-being, health, health behaviors, financial well-being, and Internet use, between isolated and nonisolated participants. From before to during the pandemic, isolated participants (29%) experienced smaller declines in life satisfaction and quality of life and a smaller increase in loneliness. They showed greater declines in smoking and physical activity and were more likely to remain worried about their future financial situation. They also did not change in their likelihood of regular Internet use, contrasting with nonisolated participants who increased in this regard. The groups followed a similar trend for general health and sleep quality (no change), depression and anxiety (increase), and expectations of future financial difficulties (decrease). Although isolated older adults generally show poorer outcomes than their socially connected counterparts, they were somewhat protected during the pandemic on some fronts. Our findings highlight the need to continually care for isolated older adults but also to be attentive in times of unexpected crises to those experiencing extreme changes related to necessary policy responses.

Exploring the impact of antenatal micronutrients used as a treatment for maternal depression on infant temperament in the first year of life.

Antenatal depression and maternal nutrition can influence infant temperament. Although broad-spectrum-micronutrients (BSM: vitamins and minerals) given above Recommended Dietary Allowances during pregnancy can mitigate symptoms of antenatal depression, their associated effects on infant temperament are unknown. One hundred and fourteen New Zealand mother-infant dyads (45 infants exposed to BSM during pregnancy (range of exposure during pregnancy: 12-182 days) to treat antenatal depressive symptoms (measured by Edinburgh Postnatal Depression Scale) and 69 non-exposed infants) were followed antenatally and for 12 months postpartum to determine the influence of in utero BSM exposure on infant temperament. The Infant Behavior Questionnaire-Revised: Very Short-Form assessed temperament at 4 (T1), 6 (T2) and 12 (T3) months postpartum via online questionnaire. Latent growth curve modeling showed BSM exposure, antenatal depression and infant sex did not statistically significantly predict initial levels or longitudinal changes in orienting/regulatory capacity (ORC), positive affectivity/surgency (PAS) or negative affectivity (NEG). Higher gestational age was positively associated with initial PAS, and smaller increases between T1 and T3. Breastfeeding occurrence was positively associated with initial NEG. Although not significant, BSM exposure exerted small, positive effects on initial NEG (β = -0.116) and longitudinal changes in ORC (β = 0.266) and NEG (β = -0.235). While BSM exposure did not significantly predict infant temperament, it may mitigate risks associated with antenatal depression. BSM-exposed infants displayed temperamental characteristics on par with typical pregnancies, supporting the safety of BSM treatment for antenatal depression.

Characterising smoking and nicotine use behaviours among women of reproductive age: a 10-year population study in England

BackgroundTobacco smoking affects women’s fertility and is associated with substantial risks of adverse pregnancy outcomes. This study explored trends by socioeconomic position in patterns of smoking, use of non-combustible nicotine products, and quitting activity among women of reproductive age in England.MethodsData come from a nationally representative monthly cross-sectional survey. Between October 2013 and October 2023, 197,266 adults (≥ 18 years) were surveyed, of whom 44,052 were women of reproductive age (18–45 years). Main outcome measures were current smoking, vaping, and use of nicotine replacement therapy (NRT), heated tobacco products (HTPs), and nicotine pouches; mainly/exclusively smoking hand-rolled cigarettes and level of dependence among current smokers; past-year quit attempts among past-year smokers; and success of quit attempts among those who tried to quit. We modelled time trends in these outcomes, overall and by occupational social grade (ABC1 = more advantaged/C2DE = less advantaged).ResultsSmoking prevalence among women of reproductive age fell from 28.7% [95%CI = 26.3–31.2%] to 22.4% [19.6–25.5%] in social grades C2DE but there was an uncertain increase from 11.7% [10.2–13.5%] to 14.9% [13.4–16.6%] in ABC1. By contrast, among all adults and among men of the same age, smoking prevalence remained relatively stable in ABC1. Vaping prevalence among women of reproductive age more than tripled, from 5.1% [4.3–6.0%] to 19.7% [18.0–21.5%], with the absolute increase more pronounced among those in social grades C2DE (reaching 26.7%; 23.3–30.3%); these changes were larger than those observed among all adults but similar to those among men of the same age. The proportion of smokers mainly/exclusively smoking hand-rolled cigarettes increased from 40.5% [36.3–44.9%] to 61.4% [56.5–66.1%] among women of reproductive age; smaller increases were observed among all adults and among men of the same age. Patterns on other outcomes were largely similar between groups.ConclusionsAmong women of reproductive age, there appears to have been a rise in smoking prevalence in the more advantaged social grades over the past decade. Across social grades, there have been substantial increases in the proportion of women of reproductive age who vape and shifts from use of manufactured to hand-rolled cigarettes among those who smoke. These changes have been more pronounced than those observed in the general adult population over the same period.

Atrial Shunt Device Effects on Cardiac Structure and Function in Heart Failure With Preserved Ejection Fraction

Although the results of A Study to Evaluate the Corvia Medical Inc IASD System II to Reduce Elevated Left Atrial Pressure in Patients with Heart Failure (REDUCE LAP-HF II) trial were neutral overall, atrial shunt therapy demonstrated potential efficacy in responders (no latent pulmonary vascular disease and no cardiac rhythm management device). Post hoc analyses were conducted to evaluate the effect of shunt vs sham stratified by responder status. To evaluate the effect of atrial shunt vs sham control on cardiac structure/function in the overall study and stratified by responder status. This was a sham-controlled randomized clinical trial of an atrial shunt device in heart failure with preserved ejection fraction (HFpEF)/HF with mildly reduced EF (HFmrEF). Trial participants with evaluable echocardiography scans were recruited from 89 international medical centers. Data were analyzed from April 2023 to January 2024. Atrial shunt device or sham control. Changes in echocardiographic measures from baseline to 1, 6, 12, and 24 months after index procedure. The modified intention-to-treat analysis of the REDUCE LAP-HF II trial included 621 randomized patients (median [IQR] age, 72.0 [66.0-77.0] years; 382 female [61.5%]; shunt arm, 309 [49.8%]; sham control arm, 312 [50.2%]). Through 24 months, 212 of 217 patients (98%) in the shunt arm with evaluable echocardiograms had patent shunts. In the overall trial population, the shunt reduced left ventricular (LV) end-diastolic volume (mean difference, -5.65 mL; P <.001), left atrial (LA) minimal volume (mean difference, -2.8 mL; P =.01), and improved LV systolic tissue Doppler velocity (mean difference, 0.69 cm/s; P <.001) and LA emptying fraction (mean difference, 1.88 percentage units; P =.02) compared with sham. Shunt treatment also increased right ventricular (RV; mean difference, 9.58 mL; P <.001) and right atrial (RA; mean difference, 9.71 mL; P <.001) volumes but had no effect on RV systolic function, pulmonary artery pressure, or RA pressure compared with sham. In the shunt arm, responders had smaller increases in RV end-diastolic volume (mean difference, 5.71 mL vs 15.18 mL; interaction P =.01), RV end-systolic volume (mean difference, 1.58 mL vs 7.89 mL; interaction P =.002), and RV/LV ratio (mean difference, 0.07 vs 0.20; interaction P <.001) and larger increases in transmitral A wave velocity (mean difference, 5.08 cm/s vs -1.97 cm/s; interaction P =.02) compared with nonresponders randomized to the shunt, suggesting greater ability to accommodate shunted blood through the pulmonary circulation enabling LA unloading. In this post hoc analysis of the REDUCE LAP-HF II trial, over 2 years of follow-up, atrial shunting led to reverse remodeling of left-sided chambers and increases in volume of right-sided chambers consistent with the shunt flow but no change in RV systolic function compared with sham. Changes in cardiac structure/function were more favorable in responders compared with nonresponders treated with the shunt, supporting the previously identified responder group hypothesis and mechanism, although further evaluation with longer follow-up is needed. ClinicalTrials.gov Identifier: NCT03088033.

Long-term effects of abatacept on atherosclerosis and arthritis in older vs. younger patients with rheumatoid arthritis: 3-year results of a prospective, multicenter, observational study

BackgroundWe aimed to reveal the effect of abatacept (ABT) on atherosclerosis in rheumatoid arthritis (RA) patients, 3-year efficacy for arthritis, and safety in a population of older vs. younger patients.MethodsIn this open-label, prospective, observational study, patients were stratified into four groups: younger (20–64 years old) and older (≥ 65 years) patients taking ABT (AY and AO) and conventional synthetic disease-modifying antirheumatic drugs (csDMARDs) (CY and CO). Primary endpoints were change from baseline in mean intima-media thickness (IMT) of the common carotid artery, IMT max (bulbus, bifurcation, and internal and common carotid artery), and plaque score at Week 156. Disease activity, retention rate, and adverse effects were also evaluated.ResultsThe ABT group (AY + AO) tended to have smaller increases in mean IMT, max IMT, and plaque score than the csDMARD group (CY + CO) at Week 156, although the differences between groups were not statistically significant. Multivariate analysis showed significantly lower increases in plaque score with ABT than with csDMARDs, only when considering disease activity at 156 weeks (p = 0.0303). Proportions of patients with good or good/moderate European League Against Rheumatism response were higher in the ABT group, without significant difference between older and younger patients. No significant differences were observed in ABT retention rates between older and younger patients. Serious adverse effects, especially infection, tended to be more frequent with ABT than with csDMARDs, although no significant differences were found.ConclusionsABT may decelerate atherosclerosis progression and may be useful for patients with high risk of cardiovascular disease, such as older patients.Trial registration number:UMIN000014913.