Typical Age Research Articles

Atypical age of onset of the small bowel adenocarcinoma – case report

Background: Small bowel adenocarcinoma is a rare malignant tumor, with the typical age of diagnosis being 60 years old. In the field of risk factors, we can distinguish, between genetic disorders, inflammatory bowel diseases, smoking, and alcohol abuse. Guidelines for the screening methods are very wide, hence it may be difficult to make the right diagnosis at the early stages of cancer. Additional difficulties can be caused by similarities to inflammatory processes in the gastrointestinal tract.
 Case report: We present a case of a 22-year-old male patient, with the symptoms of weight loss, stool retention, abdominal pain, and vomiting. The patient was initially misdiagnosed with inflammatory bowel disease and received the first dose of anti-inflammatory treatment. At that point, the diagnostic process and the workflow of medical care were delayed due to the COVID-19 pandemic. After receiving the x-ray and computed tomography, the obstruction of the ileum was found, and an urgent operation was performed. Tissue samples obtained during surgery revealed the proper diagnosis, a low-differentiated adenocarcinoma (G3) of the small intestine, stage T4Nx.
 Conclusion: Taking into consideration the patient’s condition, age, and symptoms, we should always think about the probable malignant process. Inflammatory diseases are known for increasing cancer risk and should always be the indication of this disease. The age of onset of the disease is very unusual, however, we must be aware of such cases in our clinical practice.

A Family Cluster of Inherited Ataxia: Case Report and Clinical Review

The hereditary ataxias are a highly heterogeneous group of disorders phenotypically characterised by gait ataxia, incoordination of eye movements, speech, and hand movements, and usually associated with atrophy of the cerebellum. Friedreich's ataxia is a genetic, progressive, neurodegenerative movement disorder with a typical age of onset of between 10 and 15 years. Initial symptoms may include unsteady posture, frequent falling, and progressive difficulty in walking due to an impaired ability to coordinate voluntary movements (ataxia). A family of six members was diagnosed clinically, electro-physiologically, and radiologically with having this type of inherited ataxia from Basrah, southern Iraq. This article aims to describe the clinical presentation and diagnostic approach of cerebellar ataxia, with a focus on inherited forms of ataxia.

Poetic Resistance: Girls’ Autograph Albums during World War II in Norway

Poetic Resistance: Girls’ Autograph Albums during World War II in Norway

The chemical signature of the Galactic spiral arms revealed by Gaia DR3

Taking advantage of the recent Gaia Data Release 3 (DR3), we mapped chemical inhomogeneities in the Milky Way’s disc out to a distance of ∼4 kpc from the Sun, using different samples of bright giant stars. The samples were selected using effective temperatures and surface gravities from the GSP-Spec module, and they are expected to trace stellar populations of a different typical age. The cool (old) giants exhibit a relatively smooth radial metallicity gradient with an azimuthal dependence. Binning in Galactic azimuth ϕ, the slope gradually varies from d[M/H]/dR ∼ −0.054 dex kpc−1 at ϕ ∼ −20° to ∼ − 0.036 dex kpc−1 at ϕ ∼ 20°. On the other hand, the relatively hotter (and younger) stars present remarkable inhomogeneities, which are apparent as three (possibly four) metal-rich elongated features in correspondence with the spiral arms’ locations in the Galactic disc. When projected onto the Galactic radius, those features manifest themselves as statistically significant bumps on top of the observed radial metallicity gradients with amplitudes up to ∼0.05–0.1 dex, making the assumption of a linear radial decrease not applicable for this sample. The strong correlation between the spiral structure of the Galaxy and the observed chemical pattern in the young sample indicates that the spiral arms might be at the origin of the detected chemical inhomogeneities. In this scenario, the spiral arms would leave a strong signature in the younger stars which progressively disappears when cooler (and older) giants are considered.

Image Extraction of Lettuce Leaves using Fast Fourier Transform Method and Color Moments

Lettuce (Lactuca sativa L.) is a seasonal leaf vegetable with high nutritional content which is usually fresh for consumption. Typical harvest age for lettuce is 45 days. Lettuce which is harvested more than 45 days will affect the taste of the lettuce. In addition to the lettuce’s age, there are several things that can affect taste of the lettuce, including room temperature, harvest time, and thickness of the leaf color. In this study, Fast Fourier transform (FFT) was used as feature extraction by changing the spatial domain in frequency domain image of the lettuce leaves, while the color moment method was used as the extraction of lettuce leaves. With this digital image processing, it can automatically identify maturity level of lettuce leaves. The classification process uses the Naïve Bayes method with the Weka application. The obtained results of texture and color extraction using FFT method and the color moment using Naïve Bayes classification method in the Weka application work well. From the results of the age classification of lettuce based on its leaf color, the average percentage of total accuracy was 94.4%. The correlation of color and taste using the correlation test which performed by SPSS, and it was found that there are positive relationship between color and taste with sig. (1-tailed) 0.05.

Untangling the Galaxy. IV. Empirical Constraints on Angular Momentum Evolution and Gyrochronology for Young Stars in the Field

We present a catalog of ∼100,000 periodic variable stars in Transiting Exoplanet Survey Satellite (TESS) full-frame image data among members of widely distributed moving groups identified with Gaia in the previous papers in the series. By combining the periods from our catalog attributable to rotation with previously derived rotation periods for benchmark open clusters, we develop an empirical gyrochronology relation of angular momentum evolution that is valid for stars with ages 10–1000 Myr. Excluding stars rotating faster than 2 days, which we find are predominantly binaries, we achieve a typical age precision of ≈0.2–0.3 dex and improving at older ages. Importantly, these empirical relations apply to not only FGK-type stars but also M-type stars, due to the angular momentum distribution being much smoother, simpler, continuous, and monotonic as compared to the rotation period distribution. As a result, we are also able to begin tracing in fine detail the nature of angular momentum loss in low-mass stars as functions of mass and age. We characterize the stellar variability amplitudes of the cool stars as functions of mass and age, which may correlate with the starspot covering fractions. We also identify pulsating variables among the hotter stars in the catalog, including δ Scuti, γ Dor, and slowly pulsating B-type variables. These data represent an important step forward in being able to estimate precise ages of FGK- and M-type stars in the field, starting as early as the pre-main-sequence phase of evolution.

Therapies for lysosomal storage diseases: Principles, practice, and prospects for refinements based on evolving science.

Infantile nephropathic cystinosis, due to impaired transport of cystine out of lysosomes, occurs with an incidence of 1 in 100–200,000 live births. It is characterized by renal Fanconi syndrome in the first year of life and glomerular dysfunction progression to end-stage kidney disease by approximately 10 years of age. Treatment with oral cysteamine therapy helps preserve glomerular function, but affected individuals eventually require kidney replacement therapy. This is because glomerular damage had already occurred by the time a child is diagnosed with cystinosis, typically in the second year of life. We performed a retrospective multicenter study to investigate the impact of initiating cysteamine treatment within the first 2 months of life in some infants and comparing two different levels of adherence in patients diagnosed at the typical age. We collected 3983 data points from 55 patients born between 1997 and 2020; 52 patients with 1592 data points could be further evaluated. These data were first analyzed by dividing the patient cohort into three groups: (i) standard treatment start with good adherence, (ii) standard treatment start with less good adherence, and (iii) early treatment start. At every age, mean estimated glomerular filtration rate (eGFR) was higher in early-treated patients than in later-treated patients. Second, a generalized additive mixed model (GAMM) was applied showing that patients with initiation of treatment before 2 months of age are expected to have a 34 ml/min/1.73 m2 higher eGFR than patients with later treatment start while controlling for adherence and patients' age. These data strongly suggest that oral cysteamine treatment initiated within 2 months of birth preserves kidney function in infantile nephropathic cystinosis and provide evidence of the utility of newborn screening for this disease.

Provoked seizures at the onset of progressive disease contribute to diagnosis delay - A tertiary center experience in a cohort of 22 children with CLN2.

The evaluation of epilepsy features and factors with impact to diagnosis delay in children with CLN2. The study included children with CLN2 treated from 2000 to 2020. Diagnosis was confirmed by: TPP1 deficiency and/or TPP1 gene mutation or pathognomonic electron microscopy findings. The seizure features were evaluated: the age of onset, provocation, semiology and EEG. The disease severity was assessed by CLN2 Clinical Rating Scale (CLN2-CRS). Statistical analysis included T test, chi-square test, Wilcoxon-Mann-Whitney test, using SPSS statistics 25. The study included 22 children with CLN2. Seizures were experienced by all cases at the early stage of disease, preceded by language delay in 18, and behavior problems in 14pts. The first seizure was provoked in 9 children at mean age of 33.8±4.6 months, and unprovoked in 13at mean age of 34.6±2.7 months. In patients with provoked first seizure, the average period from the first seizure to diagnosis was longer (35.1 months), with lower CLN2-CRS, then in those with unprovoked (23.8 months) first seizures (p<0.008). Initial seizures were generalized tonic-clonic (Pampiglione and Harden, 1973 Feb) [8], atonic (Pampiglione and Harden, 1973 Feb) [8], and focal (Beltrán etal., 2018 Aug) [4], with recurrence within two months. With progression, the patients experienced multiple seizure types, and 1/3 suffered status epilepticus. Provoked seizures at the onset of CLN2 have impact to diagnosis delay. The red flags are: preceding language delay and behavior problems, later FS onset comparing to the typical age, atonic, focal and long-lasting seizure, and recurrence of seizures within two months.

Association of metallothionein 1A gene polymorphism rs8052394 with type 2 diabetes mellitus in Bangladeshi population

Overproduction of reactive oxygen species intervenes zinc metabolism and promotes the onset of diabetes and related complications. Metallothionein (MT) are proteins conferring protection to cells against the toxic effects of reactive oxygen species. Polymorphism in the MT1A gene particularly rs8052394 (+1245 A/G) was shown to be associated with Type 2 Diabetes Mellitus (T2DM) in several populations around the globe. Given the high frequency of T2DM in Bangladesh, the current case-control study (n = 300) explored the association of this polymorphism with the onset of T2DM in the Bangladeshi population. The genotyping of the samples was done by polymerase chain reaction (PCR) and followed by restriction fragment length polymorphism (RFLP). Before that, the deleterious effect of this non-synonymous single nucleotide polymorphism (SNP) was predicted through the bioinformatics approach. Upon analysis, homozygous polymorphic genotype was found absent in the studied population and overall allele frequency of A and G was observed as 86% and 14% respectively. Although the higher frequency of the heterozygous (AG) polymorphic genotype was observed in the cases compared to the control, the difference was not statistically significant (p = 0.059), which indicates this polymorphism is not associated with T2DM in the Bangladeshi population. However, significant (p = 0.024) typical T2DM age distribution of the heterozygous polymorphic genotype was observed in the studied population. Before making a conclusion regarding the association between this SNP and T2DM in the Bangladeshi population, a large-scale study of rs8052394 is necessary.

Relationship between age at initiation of cysteamine treatment, adherence with therapy, and glomerular kidney function in infantile nephropathic cystinosis.

Infantile nephropathic cystinosis, due to impaired transport of cystine out of lysosomes, occurs with an incidence of 1 in 100-200,000 live births. It is characterized by renal Fanconi syndrome in the first year of life and glomerular dysfunction progression to end-stage kidney disease by approximately 10 years of age. Treatment with oral cysteamine therapy helps preserve glomerular function, but affected individuals eventually require kidney replacement therapy. This is because glomerular damage had already occurred by the time a child is diagnosed with cystinosis, typically in the second year of life. We performed a retrospective multicenter study to investigate the impact of initiating cysteamine treatment within the first 2 months of life in some infants and comparing two different levels of adherence in patients diagnosed at the typical age. We collected 3983 data points from 55 patients born between 1997 and 2020; 52 patients with 1592 data points could be further evaluated. These data were first analyzed by dividing the patient cohort into three groups: (i) standard treatment start with good adherence, (ii) standard treatment start with less good adherence, and (iii) early treatment start. At every age, mean estimated glomerular filtration rate (eGFR) was higher in early-treated patients than in later-treated patients. Second, a generalized additive mixed model (GAMM) was applied showing that patients with initiation of treatment before 2 months of age are expected to have a 34 ml/min/1.73 m2 higher eGFR than patients with later treatment start while controlling for adherence and patients' age. These data strongly suggest that oral cysteamine treatment initiated within 2 months of birth preserves kidney function in infantile nephropathic cystinosis and provide evidence of the utility of newborn screening for this disease.

Fetal Disseminated Malignant Rhabdoid Tumor.

Fetal Disseminated Malignant Rhabdoid Tumor.

Clear cell sarcoma of the kidney with inferior vena cava thrombus: a case report

BackgroundClear cell sarcoma of the kidney is an uncommon pediatric renal malignant neoplasm that is typically characterized in 2–3-year-olds by aggressive behavior and late relapses. Our literature review revealed fewer than ten previously reported cases of CCSK with inferior vena cava thrombus, with only five in the pediatric age group.Case presentationWe report the case of a 14-year-old Syrian girl who complained of mild pain in the left lumbar region pain with hematuria. On physical examination, a mass was palpated in the left flank. Abdominal ultrasonography revealed a left renal mass (7 × 5 × 2 cm3), associated with dilatation of the left renal vein. Contrast abdominal computed tomography showed a mass measuring 7 × 5 × 3 cm3 with the presence of thrombus extending into the inferior cavity down to the right atrium that was initially diagnosed as Wilms’ tumor. Radical right nephrectomy with excision of the thrombus was undertaken. Histological immunostaining revealed a diagnosis of the tumor as clear cell sarcoma with vascular tumor thrombus extending to the inferior vena cava.ConclusionClear cell sarcoma and Wilms’ tumor are similar in terms of typical age of appearance, clinical features, and histopathology, but with different methods of treatment and prognosis. The differential diagnosis of such masses is thus very important. We present the case of a patient with clear cell sarcoma with unusual age, with complete removal of the thromboses in the inferior vena cava and the right atrium.

Association of Interleukin-33 with Recurrent Pregnancy Loss in Egyptian Women

A successful pregnancy requires a distinct and complex immunological state. Cytokines appear to be critical for the establishment of a tolerogenic environment towards the semi-allogenic foetus during the foeto-maternal interphase, and a shift from a Th1- to a Th2-cytokine profile may be crucial. An imbalance of cytokines can be a significant factor in recurrent pregnancy loss (RPL). Interleukin-33 (IL-33) is a member of the IL- 1 cytokine family, involved in both the innate and adaptive immune responses coordinating immune cell function for a broad range of physiological and pathological processes, including the regulation of pregnancy outcome. The aim of this study was to investigate a possible association between IL-33 and RPL in Egyptian women. The study was conducted on 66 Egyptian females recruited from Ain Shams University Specialized Hospital and 66 matched healthy non-pregnant females of typical childbearing age without a history of RPL. Serum IL-33 was measured in all subjects using a sandwich ELISA technique. Serum IL-33 levels were significantly higher in patients with RPL than in the healthy control group. In addition, in the patient group, there was a positive correlation between serum IL-33 level and both age and number of miscarriages and a negative correlation between serum IL-33 level and the number of deliveries. In Egyptian women, serum levels of IL-33 are associated with RPL, thus IL-33 level could be a predictive biomarker for RPL in early pregnancy.

Duchenne expert physician perspectives on Duchenne newborn screening and early Duchenne care.

Duchenne muscular dystrophy (DMD) is a progressive, fatal neuromuscular disorder typically diagnosed between 4 and 5 years of age. DMD currently has five FDA approved therapies, which has led to increased interest in newborn screening (NBS) for DMD. Our objective was to explore the perspectives and predicted practices of physicians (primarily neurologists) who will likely be responsible for the follow-up of infants identified with DMD through NBS. A short survey was developed and distributed to physicians who are responsible for providing care for patients with Duchenne at Certified Duchenne Care Centers across the USA. Twenty-seven physicians responded to statements about benefit and readiness for dystrophinopathy NBS, which care recommendations they would make at initial infant visits, and when they would recommend initiating approved therapies. Most DMD physicians indicated they see benefit in NBS (82%) and believe the DMD care community is ready for NBS in dystrophinopathies (74%). The majority of physicians would recommend multiple interventions, including genetic counseling, maternal carrier testing, referral to early intervention services, screening siblings, discussion of clinical trials, exon skipping therapies, and assessment of social and language development at initial visits. The majority of physicians also indicated they would recommend initiating approved therapies much earlier than the typical age of diagnosis.

Osteoarthritis of the Knee in Middle-age Athletes: Many Measures are Practiced, but Lack Sound Scientific Evidence.

Osteoarthritis of the knee generally affects individuals from the fifth decade, the typical age of middle-age athletes. In the early stages, management is conservative and multidisciplinary. It is advisable to avoid sports with high risk of trauma, but it is important that patients continue to be physically active. Conservative management offers several options; however, it is unclear which ones are really useful. This narrative review briefly reports the conservative options for which there is no evidence of effectiveness, or there is only evidence of short-term effectiveness.

Methodology for classification and definition of epilepsy syndromes with list of syndromes: Report of the ILAE Task Force on Nosology and Definitions.

Epilepsy syndromes have been recognized for >50years, as distinct electroclinical phenotypes with therapeutic and prognostic implications. Nonetheless, no formally accepted International League Against Epilepsy (ILAE) classification of epilepsy syndromes has existed. The ILAE Task Force on Nosology and Definitions was established to reach consensus regarding which entities fulfilled criteria for an epilepsy syndrome and to provide definitions for each syndrome. We defined an epilepsy syndrome as "a characteristic cluster of clinical and electroencephalographic features, often supported by specific etiological findings (structural, genetic, metabolic, immune, and infectious)." The diagnosis of a syndrome in an individual with epilepsy frequently carries prognostic and treatment implications. Syndromes often have age-dependent presentations and a range of specific comorbidities. This paper describes the guiding principles and process for syndrome identification in both children and adults, and the template of clinical data included for each syndrome. We divided syndromes into typical age at onset, and further characterized them based on seizure and epilepsy types and association with developmental and/or epileptic encephalopathy or progressive neurological deterioration. Definitions for each specific syndrome are contained within the corresponding position papers.

Corrective Adjustment Procedures as a strategy to remove Relative Age Effects: Validation across male and female age-group long jumping

ObjectivesTo validate the application of Corrective Adjustment Procedures for removing Relative Age Effects in youth athletic contexts, this study estimated the longitudinal relationships between decimal age (chronological and relative) and performance in male and female long jumpers. Using trendlines, Corrective Adjustment Procedures were applied, and Relative Age Effect distributions associated with performance attainment were re-examined. DesignRetrospective longitudinal design examining competitive long-jump data between 2005 and 2019. MethodsIn Part I, participants were 689 junior Italian long jumpers (age range = 11.01–17.99 years; 56.6% females) who participated in ≥three events. Longitudinal modelling and regression equations quantified the sex-specific relationships between decimal age and long jump performance. In Part II, equations were utilised to adjust individual performance within an independent sample (N = 13,639; 50.1% females) of age-matched jumpers. Relative Age Effect distributions within attainment levels (i.e., Top 25–10%) were examined based on raw and correctively adjusted performance. ResultsIrrespective of sex, Relative Age Effects were prevalent across all age-groups with medium-large effect sizes at 12–17 (males and females) and 12–17 years (females) of age (Cramer's V range = 0.07–0.28). Relative Age Effect bias magnitude also increased with attainment level (i.e., Top 25–10%). Following Corrective Adjustment Procedure application, typical Relative Age Effects were removed with non-significant deviations in relative age distributions regardless of sex or age-group or attainment level (Top 25 or 10%). ConclusionsFindings provide efficacy for Corrective Adjustment Procedure application to remove Relative Age Effects across youth long jumping events. Corrective Adjustment Procedures suggest potential in improving performance evaluation, identification of technically skilled performers, and sporting experiences.

Early Real-World Experience of Tofacitinib for Psoriatic Arthritis: Data from a United States Healthcare Claims Database

IntroductionThis study characterized real-world demographic and baseline clinical characteristics, as well as treatment persistence and adherence, in patients with psoriatic arthritis (PsA) who had newly initiated tofacitinib treatment.MethodsThis retrospective cohort study included patients aged 18 years or older in the IBM MarketScan™ US database with at least one tofacitinib claim (first = index) between December 14, 2017 and April 30, 2019; PsA diagnoses on/within 12 months pre-index; and no diagnoses of rheumatoid arthritis any time pre-index. Patients were continuously enrolled for 12 months pre-index and 6 months post-index, with no pre-index claims for tofacitinib. Patient demographic and clinical characteristics on the day of index, and history of advanced treatments (including tofacitinib monotherapy or combination therapy), were recorded. Outcomes at 6 months post-index included tofacitinib persistence (less than 60-day gap without tofacitinib treatment) and adherence (proportion of days covered [PDC] and medication possession ratio 80% or higher).ResultsOf the 10,354 patients with tofacitinib claims within the study period, 318 patients with PsA met the inclusion criteria. More than 60% of patients received tofacitinib monotherapy post-index, with a mean duration of PsA of 760.5 days at index. For patients who received tofacitinib combination therapy post-index, methotrexate was the most common concomitant conventional synthetic disease-modifying antirheumatic drug. At 6 months post-index, persistence was similar in patients receiving tofacitinib monotherapy (69.8%) versus combination therapy (73.1%); adherence (as measured by PDC ≥ 0.8) was numerically lower in patients receiving tofacitinib monotherapy (56.8%) versus combination therapy (65.5%).ConclusionsThis analysis of US-based claims data described patients who had newly initiated tofacitinib treatment an average of 2 years after PsA diagnosis, with approximately two-thirds of patients receiving tofacitinib monotherapy. Observed rates of tofacitinib persistence were similar across patients who received tofacitinib monotherapy and combination therapy 6 months after initiation; adherence rates were numerically lower in patients receiving monotherapy.Graphical

Motives of retirement-aged workers and the importance of doing, being, becoming, and belonging: A systematic review of qualitative studies

ABSTRACT Background: Although extended work activity is often associated with active and healthy ageing, it meets with a polarized response. Studying workers’ lived experience may provide important insights into their motives for working beyond typical retirement age. Objective: This systematic review aims to explore why people who could retire continue to work and applies the dimensions of doing, being, becoming, and belonging to describe prolonged participation in work. Methods: Our search strategy followed the guidelines of the Centre for Reviews and Dissemination (CRD, 2009). Original studies were identified from databases CINAHL, Web of Science, Business Source Premier, ERIC, and ProQuest. Data were analyzed from the perspective of doing, being, becoming, belonging. A thematic synthesis was applied to summarize key motives. Results: Eleven qualitative studies met the inclusion criteria and achieved the quality criteria of the The Qualitative Assessment Research Instrument. Eight motives were identified that were associated with extrinsic and intrinsic motivational factors. Health was a theme of salience and was both a prerequisite for work and an important motivator in itself. The dimensions of doing, being, becoming, belonging emerged in the description of workers’ motives and formed an interwoven selection of motives that included achievement, positive relationships, helping others, and enjoying work. Conclusion: Retirement-aged workers appear to be a poorly represented population in the scientific literature on work motives. The main findings indicate that workers who prolong labour activity experience work as much more than the act of ‘doing’ or acquiring additional financial resources. This urges us to include the dimensions of ‘being, becoming, belonging’ into contemporary age management.

Applying Machine Learning Methods and Models to Explore the Structure of Traffic Accident Data

The problem of reducing the increasing number of road traffic accidents has become more relevant in recent years. According to the United Nations plan this number has to be halved by 2030. A very effective way to handle it is to apply the machine learning paradigm to retrospective road traffic accident datasets. This case study applies machine learning techniques to form typical “portraits” of drivers violating road traffic rules by clustering available data into seven homogeneous groups. The obtained results can be used in forming effective marketing campaigns for different target groups. Another relevant problem under consideration is to use available retrospective statistics on mechanical road traffic accidents without victims to estimate the probable type of road traffic accident for the driver taking into account her/his personal features (such as social characteristics, typical road traffic rule violations, driving experience, and age group). For this purpose several machine learning models were applied and the results were discussed.