YA Group Research Articles

A comparative analysis of IDH-mutant glioma in pediatric, young adult, and older adult patients.

The frequency and significance of IDH mutations in glioma across age groups is incompletely understood. We performed a multi-center retrospective age-stratified comparison of patients with IDH-mutant gliomas to identify age-specific differences in clinico-genomic features, treatments, and outcomes. Clinical, histologic, and sequencing data from patients with IDH-mutant, grade 2-4 gliomas, were collected from collaborating institutions between 2013-2019. Patients were categorized as pediatric (<19y), YA (19-39y) or older adult (≥40y). Clinical presentation, treatment, histologic, and molecular features were compared across age categories using Fisher's exact test or analysis-of-variance. Cox proportional-hazards regression was used to determine association of age and other covariates with overall (OS) and progression-free survival (PFS). We identified a cohort of 379 patients (204 YA) with IDH-mutant glioma with clinical data. There were 155 (41%) oligodendrogliomas and 224 (59%) astrocytomas. YA showed significantly shorter PFS and shorter median time-to-malignant transformation (MT) compared to pediatric and adult groups, but no significant OS difference. Adjusting for pathology type, extent of resection, and upfront therapy in multivariable analysis, the YA group was independently prognostic of shorter PFS than pediatric and adult groups. Among astrocytomas, CDK4/6 copy number amplifications were associated with both shorter PFS and shorter OS. Among oligodendrogliomas, PIK3CA and CDKN2A/2B alterations were associated with shorter OS. IDH-mutant glioma YA patients had significantly shorter PFS and time to MT but did not differ in OS compared to pediatric and adult groups. Treatment approach varied significantly by patient age and warrant further study as addressable age-associated outcome drivers.

Near-infrared spectroscopy (NIRS) in vivo assessment of skeletal muscle oxidative capacity: a comparison of results from short versus long exercise protocols and reproducibility in non-athletic adults.

Near-infrared spectroscopy (NIRS) provides a non-invasive, cost-effective method for assessing skeletal muscle oxidative capacity when combined with a short exercise protocol and arterial occlusions. However, the impact of different exercise protocols and reproducibility of the method in non-athletic adults have not previously been assessed. Young, non-athletic adults (YA) were invited to perform a short duration, fast frequency contraction (SF) exercise protocol and a long duration slow frequency (LS) contraction protocol, combined with NIRS measurements and arterial occlusions to assess skeletal muscle oxidative capacity. YA and older non-athletic adults (OA; >65years old) were invited to perform the SF exercise protocol twice to assess the reproducibility of this oxidative capacity measurement. We included 25 participants (14 male (56%), age range: 18-86 years) in the analyses. There was a strong positive correlation and good agreement between time constants derived following the SF and LS exercise protocols (Lin's concordance correlation coefficient: 0.69, p-value < 0.001 mean bias [LoA]: -3.2 [-31.0, 24.4] seconds. There was a strong positive correlation and good agreement between time constants derived from the SF exercise protocol in the YA & OA group (Lin's concordance correlation coefficient: 0.63, p-value < 0.001; mean bias [LoA] -6.4 [-34.0, 21.3] seconds). These data provide evidence to suggest that NIRS is a reliable in vivo method for the assessment of skeletal muscle oxidative capacity irrespective of exercise protocol duration or muscle contraction frequency. NIRS-measured oxidative capacity via the SF exercise protocol was reproducible in non-athletic adults with a wide range in age.

Associations Between Music and Dance Relationships, Rhythmic Proficiency, and Spatiotemporal Movement Modulation Ability in Adults with and without Mild Cognitive Impairment.

Personalized dance-based movement therapies may improve cognitive and motor function in individuals with mild cognitive impairment (MCI), a precursor to Alzheimer's disease. While age- and MCI-related deficits reduce individuals' abilities to perform dance-like rhythmic movement sequences (RMS)-spatial and temporal modifications to movement-it remains unclear how individuals' relationships to dance and music affect their ability to perform RMS. Characterize associations between RMS performance and music or dance relationships, as well as the ability to perceive rhythm and meter (rhythmic proficiency) in adults with and without MCI. We used wearable inertial sensors to evaluate the ability of 12 young adults (YA; age = 23.9±4.2 years; 9F), 26 older adults without MCI (OA; age = 68.1±8.5 years; 16F), and 18 adults with MCI (MCI; age = 70.8±6.2 years; 10F) to accurately perform spatial, temporal, and spatiotemporal RMS. To quantify self-reported music and dance relationships and rhythmic proficiency, we developed Music (MRQ) and Dance Relationship Questionnaires (DRQ), and a rhythm assessment (RA), respectively. We correlated MRQ, DRQ, and RA scores against RMS performance for each group separately. The OA and YA groups exhibited better MRQ and RA scores than the MCI group (p < 0.006). Better MRQ and RA scores were associated with better temporal RMS performance for only the YA and OA groups (r2 = 0.18-0.41; p < 0.045). DRQ scores were not associated with RMS performance in any group. Cognitive deficits in adults with MCI likely limit the extent to which music relationships or rhythmic proficiency improve the ability to perform temporal aspects of movements performed during dance-based therapies.

Associations between music and dance relationships, rhythmic proficiency, and spatiotemporal movement modulation ability in adults with and without mild cognitive impairment.

Personalized dance-based movement therapies may improve cognitive and motor function in individuals with mild cognitive impairment (MCI), a precursor to Alzheimer's disease. While age- and MCI-related deficits reduce individuals' abilities to perform dance-like rhythmic movement sequences (RMS)-spatial and temporal modifications to movement-it remains unclear how individuals' relationships to dance and music affect their ability to perform RMS. Characterize associations between RMS performance and music or dance relationships, as well as the ability to perceive rhythm and meter (rhythmic proficiency) in adults with and without MCI. We used wearable inertial sensors to evaluate the ability of 12 young adults (YA; age=23.9±4.2 yrs; 9F), 26 older adults without MCI (OA; age=68.1±8.5 yrs; 16F), and 18 adults with MCI (MCI; age=70.8±6.2 yrs; 10F) to accurately perform spatial, temporal, and spatiotemporal RMS. To quantify self-reported music and dance relationships and rhythmic proficiency, we developed Music (MRQ) and Dance Relationship Questionnaires (DRQ), and a rhythm assessment (RA), respectively. We correlated MRQ, DRQ, and RA scores against RMS performance for each group separately. The OA and YA groups exhibited better MRQ and RA scores than the MCI group (p<0.006). Better MRQ and RA scores were associated with better temporal RMS performance for only the YA and OA groups (r2=0.18-0.41; p<0.045). DRQ scores were not associated with RMS performance in any group. Cognitive deficits in adults with MCI likely limit the extent to which music relationships or rhythmic proficiency improve the ability to perform temporal aspects of movements performed during dance-based therapies.

Changes in brain structure and function during early aging in patients with chronic low back pain.

To explore the structural and functional changes in cognition-related brain regions in patients with chronic low back pain (CLBP) at earlier ages, and explore the impact of the interaction between CLBP and age on the brain. Seventy-six patients with CLBP were recruited and divided into "younger" age group (20-29 years, YA), "middle" age group (30-39 years, MA), and "older" age group (40-49 years, OA). All patients underwent functional magnetic resonance imaging (fMRI) as well as clinical psychological and pain-related symptoms assessments. Structural analysis showed that patients in OA group had lower gray matter (GM) volumes in the orbitofrontal cortex (OFC) bilaterally and the right superior frontal gyrus (SFG) compared to YA group. The resting-state brain activity analysis showed that amplitude of low-frequency fluctuation (ALFF) values in the bilateral postcentral gyrus and left ventral medial prefrontal cortex (mPFC) were significantly different in the OA group. The functional connectivity (FC) in the right ventral dorsolateral prefrontal cortex (DLPFC) and the right insula was significantly decreased in the OA group compared to the YA and MA groups. Likewise, the FC in the left caudal parahippocampal gyrus (PHG) and left inferior parietal lobule (IPL) were significantly lower in the MA and OA groups compared to the YA group. In addition, both the structural properties and the FC values of these brain regions were significantly correlated with age. This preliminary study concludes that CLBP affects the aging process. The synergistic effects of CLBP and aging accelerate the functional and structural decline of certain areas of the brain, which not only affects pain processing, but are also may be associated with cognitive declines.

Comparison of Dentin Microstructure and Its Correlation to the Direction of Fracture Line in Mandibular Molars of Young and Older Individuals: In Vitro Study

IntroductionThe aim of the study was to assess the presence and extent of sclerotic dentin and to study its impact on the direction of fracture lines in extracted mandibular first molars of young (20–44 years) and older age groups (45 and older). MethodsExtracted permanent mandibular first molars were collected along with the related demographic details. A total of 40 teeth were included in this study, 20 each from young age group (YA group) (20–44 years) and older age group (OA group) (45–70 years). All molars were decoronated, and the sectioned mesial roots were embedded in acrylic blocks. They were subjected to vertical force in a universal testing machine. Fractured roots were then examined under the stereomicroscope at ×8 magnification to determine the direction and pattern of the fracture line. The roots were then sectioned and evaluated at ×10 and ×20 magnification to assess the dentin microstructure and its correlation with the direction of the fracture line. Statistical analysis was done by using χ2 test (P < .05). ResultsA greater incidence and degree of sclerotic dentin were found in the OA group as compared with the YA group, which was statistically significant. The sclerotic dentin was distributed predominantly mesiodistally and the fracture line propagated buccolingually in both young and older groups, which was statistically significant (P < .05). ConclusionsThe presence of sclerotic dentin mesiodistally may impede crack propagation in this direction for both young and older age groups, causing the fracture line to extend buccolingually in coronal third of the root.

Role of Dentofacial Harmony among Young and Old Adult Females in Smile Perception of Dental Specialists and Laypeople: A Cross-Sectional Study.

The purpose of this study was to determine whether balance and harmony of the face, when seen as a whole, alter the smile perception as compared to a lone standing smile in female subjects of two age groups and to identify parameters of dental composition and dentofacial harmony associated with the smile perception of dental specialists (DS) and laypeople (LP). A cross-sectional study. Twenty-nine DS and 29 LP scored the smile attractiveness of 84 full-face images (FFIs) and corresponding smile images (SIs) of young adults (YA: 20-29 years) and old adults (OA: 50-59 years), using the Visual Analogue Scale. Smile analysis software (Planmeca Romexis®Smile-Design) was used to measure 10 parameters of dental composition and dentofacial harmony in FFI. Independent t-test and Pearson's correlation coefficient (r) were used to analyze the data. A significant difference was not seen between the smile attractiveness scores of FFI and SI in both raters and age groups. Significant differences were observed between DS and LP in the YA group. The OA group was rated significantly higher than the YA group. The correlation between smile attractiveness scores and each of the nine dentofacial parameters was not significant (P < 0.05). Framing of images did not significantly alter smile perception. FFI received higher scores than SI, and raters were more critical of the YA group. Professional training of raters and an interplay of smile and facial attractiveness of the female subjects contributed to the smile perception of raters. No parameters of dental composition or dentofacial harmony significantly associated with smile attractiveness were identified.

Detecting age‐dependent deterioration of spatial working memory with a virtual water maze paradigm in human subjects

AbstractBackgroundVirtual‐Morris Water Maze (V‐MWM) has been developed to assess potential hippocampal‐dependent memory decline. Previous attempts showed the V‐MWM was sensitive in detecting age‐related reference memory decline, but our pilot study indicated that elderly often could not complete the tasks within 60s. Therefore, we have investigated further the use of a spatial working memory paradigm to evaluate one‐trial learning task allowing for up to 120s per trial.MethodsThree age groups were recruited from the community with a cross‐sectional design. The Young Adult (YA,n = 22), Young Elderly (YE,n = 30) and older elderly (OE,n = 19) groups defined according to the subjects’ age in years: 18‐45, 60‐69, and 70 or above, respectively. The V‐MWM was programmed using MazeWaker. Subjects navigated in a 3D circular arena, defined by uniform walls and presented on a 14‐inch screen using an arrow key. Eight distal 3D‐cues located outside the arena. A total of 8 possible locations assigned randomly to every two consecutive trials. The two trials were separated by 5s or interspersed by a comic strip for 15s. The target become visible after 120s. Working memory was indexed by more efficient navigation from trial‐1 to trial‐2 in terms of latency or path‐length, indexed by the ratio: T2/(T1+T2) and subjected to a 3×2×3 (AgexInterference typesxLocations) ANOVAs. Two 60s‐nonrevealing probe tests were conducted on trials 8th and 16th. Percent path‐length near the 8 possible target‐zones using separate 2×2×8 (Age groupsxInterference typesxTarget‐zones) ANOVAs.ResultsThe YA group outperformed both the YE and OE groups (F(2,68) = 8.17, p = .001), but no significant group by interference interaction was revealed. However, the 15s‐interference tended to increase the latency in both YA and YE groups (F(1,68) = 9.05, p&lt;.005). An overall preference for the target zone was identified in both percent time and path‐length (F(7,62) = 6.03 and 8.71, respectively, p&lt;.001), together with a significant Age x Zones interaction (F(14,126) = 8.71, p&lt;.001) indicative of reduce target zone preference in the OE relative to YA, with YE performing at an intermediate level.Conclusionsur V‐MWM working test was sensitive to detect age‐related visual‐spatial working memory deterioration, but our interference procedures were insufficient to reduce working memory performance in all groups. Alternative interference may be considered in the future.

Effect of Age on the Patterns of Traumatic Femoral Fractures: Seven Years of Experience at a Regional Tertiary Hospital

ObjectiveFemoral fractures are a common cause of mortality and functional loss, mainly among older people, and there are few studies about the age in relation to traumatic femoral fractures. The aim of this study was to investigate the effect of age on the patterns of traumatic femoral fractures in patients presenting to our regional tertiary hospital.MethodsThe records of 2020 patients who presented with traumatic femoral fractures between 2013 and 2019 were retrospectively reviewed. The patients' clinical and radiographic records were reviewed. Univariate and multivariable logistic regression were used to identify independent risk factors for associated injuries and complications.ResultsThe patients were divided into a child group (CH group, n = 342) aged under 18 years, a young adult group (YA group, n = 484) aged 18–60 years, and an older people group (OP group, n = 1194) aged 60 years and over. There were significant differences among the three groups in several indexes, such as sex ratio (χ 2 = 301.699, p < 0.001), osteoporosis (χ 2 = 375.463, p < 0.001), injury time of day (χ 2 = 114.913, p < 0.001), injury cause (χ 2 = 748.187, p < 0.001), injury location (χ 2 = 490.153, p < 0.001), fracture side (χ 2 = 57.000, p < 0.001), fracture site (χ 2 = 806.650, p < 0.001), associated injuries (χ 2 = 322.921, p < 0.001), coma after injury (χ 2 = 147.814, p < 0.001), non‐surgery‐related complications (χ 2 = 7.895, p = 0.019), and surgery‐related complications (χ 2 = 82.186, p < 0.001). The YA group had a significantly higher percentage of patients with surgery‐related complications than the OP group. The OP group had a higher frequency of non‐surgery‐related complications than the YA group and CH group. The most common non‐surgery‐related complications were pneumonia (7.1%) in the OP group and deep venous thrombosis (6.4%) in the YA group. Multivariable logistic regression showed that young adults, high‐energy injury, outdoors, coma after injury, and fracture sites except for the proximal region were independent risk factors for associated injuries. Older age, male, and fracture site except for the proximal region were independent risk factors for complications.ConclusionsTraumatic femoral fractures are mostly the result of low‐energy trauma and predominantly affect the proximal site of the femur among older people. A higher rate of shaft fractures, fractures occurring outdoors, and associated injuries were observed among young adults and children than among older people.

The effect of aging on context use and reliance on context in speech: A behavioral experiment with Repeat-Recall Test.

PurposeTo elucidate how aging would affect the extent of semantic context use and the reliance on semantic context measured with the Repeat–Recall Test (RRT).MethodsA younger adult group (YA) aged between 18 and 25 and an older adult group (OA) aged between 50 and 65 were recruited. Participants from both the groups performed RRT: sentence repeat and delayed recall tasks, and subjective listening effort and noise tolerable time, under two noise types and seven signal-to-noise ratios (SNR). Performance–Intensity curves were fitted. The performance in SRT50 and SRT75 was predicted.ResultsFor the repeat task, the OA group used more semantic context and relied more on semantic context than the YA group. For the recall task, OA used less semantic context but relied more on context than the YA group. Age did not affect the subjective listening effort but significantly affected noise tolerable time. Participants in both age groups could use more context in SRT75 than SRT50 on four tasks of RRT. Under the same SRT, however, the YA group could use more context in repeat and recall tasks than the OA group.ConclusionAge affected the use and reliance of semantic context. Even though the OA group used more context in speech recognition, they failed in speech information maintenance (recall) even with the help of semantic context. The OA group relied more on context while performing repeat and recall tasks. The amount of context used was also influenced by SRT.

Impact of Rearing Strategies on the Metabolizable Energy and SID Lysine Partitioning in Pigs Growing from 90 to 200 kg in Body Weight.

Simple SummaryThe nutritional recommendations for pigs largely focus on pigs with lean genotypes fed ad libitum until reaching up to 140 kg in body weight (BW). Under different rearing conditions, it is still unclear whether existing recommendations apply to pigs that weigh more than 140 kg in BW, especially in heavy pig production systems. In the current study, pigs growing from 90 to 200 kg in BW were raised with different feeding strategies. We observed that energy restriction had a negligible effect on pigs’ estimated metabolizable energy requirements at heavier BW under different feeding conditions. Under energy and protein restrictions, a value of 0.73 could be assumed as the maximum marginal efficiency of standardized ileal digestible lysine (SID lysine) utilization for protein deposition irrespective of BW, which corresponds to 9.8 g of SID lysine per 100 g of protein deposition as a minimum requirement.The current nutrient recommendations focus on pigs fed ad libitum up to 140 kg in body weight (BW). It remains unclear whether this applies to pigs weighing above 140 kg in BW under different rearing conditions. This study aimed to estimate protein (Pd) and lipid (Ld) depositions and the metabolizable energy (ME), standardized ileal digestible lysine (SID lysine) requirement and partitioning in 224 C21 Goland pigs (90–200 kg in BW). The control pigs (C) received diets limiting ME up to 170 kg in slaughter weight (SW) at 9 months of age (SA); older (OA) pigs had restricted diets limiting ME and SID lysine up to 170 kg in SW at >9 months SA; younger (YA) pigs were fed nonlimited amounts of ME and SID lysine up to 170 kg in SW at <9 months SA; and greater weight (GW) pigs were fed as the YA group, with 9 months SA at >170 kg in SW. The estimated MEm averaged 1.03 MJ/kg0.60. An 11% increase in MEm was observed in OA pigs compared to the controls. Energy restriction had negligible effects on the estimated MEm. The marginal efficiency of SID lysine utilization for Pd averaged 0.725, corresponding to a SID lysine requirement of 9.8 g/100 g Pd.

Survival analysis of young adults from a Brazilian cohort of non-small cell lung cancer patients.

BackgroundThe influence of age at diagnosis in non-small cell lung cancer (NSCLC) prognosis is unclear.ObjectivesTo compare in a Brazilian cohort of NSCLC patients of different age groups: 1) The overall survival; 2) Clinical features and treatment options.MethodsThis is a retrospective cohort study using a hospital-based registry, for NSCLC patients registered in years 2000–2009. Patients were grouped into three age groups: Young adults (YA: < 40 years), middle-aged (MA: 40–64 years) and elderly (E: ≥ 65 years). Kaplan–Meier was used to estimate overall survival and Cox regression for hazard ratios (HRs) and 95% confidence intervals.Results17,422 NSCLC patients were included: 370 YA (2.1%), 8,697 MA (49.9%) and 8,355 E (48.0%). Compared with older age groups, the YA group had a higher proportion of females, patients diagnosed with adenocarcinoma and metastatic disease (63.2%). Overall survival was longer in YA in the entire cohort and in all clinical stages (CSs) (p < 0.001). For YA, higher education level was a good prognosis factor (compared with illiterate and incomplete elementary); advanced or metastatic disease (compared with early-stage disease) and treatment based in radiotherapy or chemotherapy (CT) (without surgery), compared with treatment combinations with surgery, were poor prognostic factors. Young men (but not women) had lower HR of death compared with older groups; YA had lower HR of death in all CSs compared with patients from older groups. A higher percentage of YA were treated with surgery or CT in early-stage disease compared with older groups. Besides that, YA and MA patients treated with surgery or CT had a better prognosis than elderlies. Conclusions: In this Brazilian cohort of NSCLC patients, most young individuals were diagnosed with metastatic disease. YA presented longer survival than older age groups in all CSs, but mainly in CS I/II and III, where some patients may achieve long remissions or cure.

95 Growing Up with Burn Injuries - Has the Experience Changed Over Time?

Abstract Introduction Growing up with disfigurement and functional limitations resulting from childhood burns can be challenging. Initial stages of care involve painful surgeries/dressing changes, strenuous physical &amp; occupational therapy, pressure garments and time away from family/school activities. Few studies have examined the voiced issues faced by youth while maturing with burns. This study’s purpose was to determine if experiences in the post-injury phase differed between currently burn-injured youth vs. young adults burned as children. Methods A prior study asked Child Burn Survivors (CBS -10–16 yrs.) and Young Adults (YAs -17-25yrs.) to answer the statement: “The hardest thing about being burned is…” The most common issues included: People Staring, Getting Unwanted Questions, Being Bullied, Remembering When I Was Burned, Having Additional Surgeries and My Scars. The current study asked participants to rate items on a 4-point scale from (1) Not at all to (4) Really a lot. The YAs were asked to consider issues they encountered maturing with burns. Results Child Survivors (CBS, n=147) mean age 13.4 years, male (n=46%) female (n=54%), and YA Survivors (YA, n = 81) male(n=39%) female (n=61%) mean age =19.1 yrs. and were predominately racial/ethnic minorities (CBS=67%; YA = 58%). No differences existed for age burned (CBS=6 yrs. vs. YA = 6.4 yrs.) hidden &amp; visible scars (CBS=55% vs. YA=68%) and TBSA &amp;gt; 50% (CBS=19% vs. YA =20%). Top mean scores for CBS’s included: Remembering the Burn (2.05) &amp; Getting Unwanted Questions (2.0). The YA group’s top mean scores included Being Bullied (2.10) &amp; People Staring (2.0). The CBS group reported that Getting Unwanted Questions was more problematic than the YA Group (p =003). YAs shared that Being Bullied was their biggest problem vs. CVS, significantly more so (p=.01). Conclusions Bullying appears to be less of a problem for current child burn survivors than those previously burned. The difference may be due to a recent emphasis placed on anti-bullying in US schools. Findings highlight an ongoing need to address the psycho/social issues related to burns. Teaching interventions like the Phoenix Society’s Rehearse Your Response can help youth address unwanted questions and staring. Providing children an opportunity to process the injury event may also improve their ability to cope with burn stressors.

Effect of electroacupuncture combined with aerobic exercise on IGF-I /Akt pathway in skeletal muscle of aging rats

To explore the effects of low-frequency electroacupuncture combined with aerobic exercise on sarocopenia, and the effects of IGF-I /Akt and its downstream signaling pathway-related protein. Naturally aging SD rats were used as research objects. Thirty-two 6-month-old male SD rats weighing 400 to 450 g were bred to 12-month-old and randomly divided into 4 groups according to body weight:Control group(YC, only grasp, fix, put back, without other intervention), electroacupuncture group (YA, electroacupuncture intervention), exercise group (YE, exercise intervention) and electroacupuncture+exercise group (YEA, electroacupuncture combined with exercise intervention). SD rats were continuously intervened from 12 months to 18 months of age. At the end of the experiment, the conditions of naturally aging rats in each group were observed:skeletal muscle wet weight / weight ratio;HE staining morphology of soleus muscle under light microscope; qPCR was used to detect the expression level of IGF-I mRNA in skeletal muscle;the expression of AKT, mTOR, p70S6K and p-p70S6K proteins in rat gastrocnemius was determined by Western blot. In 18-month-old rats, the intervention period was 6 months. (1) Compared with YC group, YA group and YEA group significantly increased the wet weight / body weight ratio of gastrocnemius muscle in 18 months old rats. YEA group could significantly increase the wet weight / body weight ratio of soleus muscle compared with YC group YC group and YA group (P<0.05). (2) Compared with YC group, the increase of the expression of IGF-I mRNA in YEA group was more obvious(P=0.051). (3)The expression of p-Akt and p-mTOR in YA group was significantly higher than that in YC group (P<0.05), and the expressionof p-mTOR, p-p70S6K also showed an increasing trend in YEA group (P>0.05). Electroacupuncture combined with aerobic exercise can attenuate sarocopenia in 18-month-old naturally aging rats. The molecular mechanism may be related to the promotion of protein synthesis by activating the IGF-I / Akt pathway.

Age-related differences in diagnostic categories, psychological states and oral health-related quality of life of adult temporomandibular disorder patients.

The peak prevalence of temporomandibular disorders (TMDs) may occur in middle age. This study determined the proportion of matured adults seeking TMD treatment and compared their diagnostic, psychological and oral health-related quality-of-life (OHRQoL) profiles to younger patients. Adult subjects were recruited from a tertiary TMD centre and assigned to three age groups, namely 18-44years (young adults [YA]), 45-64 (middle-aged adults [MA]) and ≥65 (old adults [OA]). TMD diagnoses were established with the Diagnostic Criteria for TMDs and categorised as pain-related (PT), intra-articular (IT) and combined (CT) TMDs. Psychological states and OHRQoL were assessed with the Depression, Anxiety, and Stress Scale-21 (DASS-21) and Oral Health Impact Profile-TMDs (OHIP-TMDs). Demographic, DASS-21, and OHIP-TMDs data were analysed using chi-square test, one-way ANOVA and Pearson's correlation (P<.05). Middle-aged (19.7%; 136/692) and old (4.0%; 28/692) adults comprised about a quarter of the TMD patients. Although gender distribution was comparable, significant differences in TMD categories were observed (P<.001). Pain-related TMDs were more prevalent in the MA/OA groups while intra-articular TMDs were more frequent in the YA group. No significant difference in DASS-21 and total OHIP scores was noted among three groups. However, the MA and OA groups had significantly lower OHRQoL in the physical pain domain. Correlations between DASS-21 and OHIP-TMDs scores varied with age and ranged from rs =0.47-0.92. Matured patients constituted a quarter of TMD cohort and presented higher frequencies of painful TMDs. They have similar psychological profiles to younger patients but experienced lower OHRQoL in physical pain domain.

767 Growing up with Burn Injuries - Has the Experience Changed over Time?

Abstract Introduction Growing up with disfigurement and functional limitations resulting from childhood burns can be challenging. Initial stages of care involve painful surgeries/dressing changes, strenuous physical &amp; occupational therapy, pressure garments and time away from family/school activities. Few studies have examined the voiced issues faced by youth while maturing with burns. This study’s purpose was to determine if experiences in the post-injury phase differed between currently burn-injured youth vs. young adults burned as children. Methods A prior study asked Child Burn Survivors (CBS -10–16 yrs.) and Young Adults (YAs -17-25yrs.) to answer the statement: “The hardest thing about being burned is…” The most common issues included: People Staring, Getting Unwanted Questions, Being Bullied, Remembering When I Was Burned, Having Additional Surgeries and My Scars. The current study asked participants to rate items on a 4-point scale from (1) Not at all to (4) Really a lot. The YAs were asked to consider issues they encountered maturing with burns. Results Child Survivors (CBS, n=147) mean age 13.4 years, male (n=46%) female (n=54%), and YA Survivors (YA, n = 81) male(n=39%) female (n=61%) mean age =19.1 yrs., and were predominately racial/ethnic minorities (CBS=67%; YA = 58%). No differences existed for age burned (CBS=6 yrs. vs. YA = 6.4 yrs.) hidden &amp; visible scars (CBS=55% vs. YA=68%) and TBSA ≥ 50% (CBS=19% vs. YA =20%). Top mean scores for CBS’s included: Remembering the Burn (2.05) &amp; Getting Unwanted Questions (2.0). The YA group’s top mean scores included Being Bullied (2.10) &amp; People Staring (2.0). The CBS group reported that Getting Unwanted Questions was more problematic than the YA Group (p =003). YAs shared that Being Bullied was their biggest problem vs. CVS, significantly more so (p=.01). Conclusions Bullying appears to be less of a problem for current child burn survivors than those previously burned. The difference may be due to a recent emphasis placed on anti-bullying in US schools. Findings highlight an ongoing need to address the psycho/social issues related to burns. Teaching interventions like the Phoenix Society’s Rehearse Your Response can help youth address unwanted questions and staring. Providing children an opportunity to process the injury event may also improve their ability to cope with burn stressors. Applicability of Research to Practice This research has clinical implications as issues shared by participants can be addressed by burn healthcare providers and therapists. Results endorse the delivery of supportive strategies which complement surgical/medical treatment and should help improve their social interactions/quality of life.

Feasibility and Pilot Efficacy Testing of Integrated Yoga and Shirodhara (Ayurvedic Oil-Dripping) Intervention on Clinical Symptoms, Cognitive Functions and Sleep Quality of Adults with Anxiety Disorder.

Background:Beneficial effects of yoga therapy in anxiety disorders (ADs) are known. Traditional texts describe usefulness of Ayurvedic oil-dripping, Shirodhara technique, in relieving anxiety. Thus, present study was planned to assess the feasibility and synergistic value of Shirodhara as an add-on to yoga therapy in adults with AD.Materials and Methods:Thirty adults (males = 14, females = 16) admitted in a residential holistic health care center with an age range of 29.66 ± 6.63 years and diagnosis of one of the ADs (generalized AD, n = 18; social phobia, n = 8; and panic AD, n = 4) as per mini-international neuropsychiatric interview (M. I. N. I. English version 5.0) by a psychiatrist were randomly divided into two groups: (1) integrated yoga-based lifestyle program (YT; n = 15) and (2) YT + Ayurveda (YA; n = 15). Both groups continued to receive conventional treatment and were on stable medications throughout the study period except in cases of emergency. Assessments were done by an independent assessor at baseline and after 2 weeks of intervention for clinical symptoms (HAM-A, State and Trait Anxiety Inventory, and Brief Psychiatric Rating Scale), sleep quality (sleep rating questionnaire), and cognition (Stroop test and digit letter substitution test) using standard validated tools. Parametric tests were applied using SPSS 10.0 to analyze the data.Results:Twelve subjects in yoga group and thirteen subjects in YA group completed the trial. No side effects were reported in any of the groups. Within-group comparisons showed a significant improvement in clinical symptoms, cognition and sleep quality in both the groups. Between-group comparisons showed significantly better scores in Stroop word task for YA group as compared to YT group. Furthermore, there was a trend toward better improvement in sleep quality for YA group.Conclusion:Adding of Shirodhara technique to YT was feasible and may be useful in improving executive memory and sleep quality in adults with ADs.

Epidemiology of diabetes phenotypes and prevalent cardiovascular risk factors and diabetes complications in the National Health and Nutrition Examination Survey 2003–2014

AimsTo characterize unique diabetes phenotypes among National Health and Nutrition Examination Survey (NHANES) participants and assess associations with race/ethnicity, cardiovascular disease (CVD) risk factors, and prevalent complications. MethodsWe included participants (age ≥ 20 years) from NHANES exams 2003–04 through 2013–14 with diabetes (self-report of diabetes diagnosis or medication use, fasting glucose ≥7.0 mmol/L, random glucose ≥11.1 mmol/L, and glycated hemoglobin (HbA1c) ≥ 48 mmol/mol). We used k-means clustering to characterize unique diabetes subgroups based on data for age of diabetes diagnosis, body mass index (BMI), waist circumference, HbA1c, and years of insulin use. We estimated subgroup prevalence of CVD risk factors and microvascular complications, accounting for demographics and survey sampling. ResultsAmong 4300 adults with diabetes, we identified four unique subgroups of diabetes related to aging (AR, 51.3%), severe obesity (SO, 30.3%), severe hyperglycemia (SH, 12.5%), and young adulthood-onset (YA, 5.9%). We observed differences in subgroup proportion by race/ethnicity. Compared to the AR phenotype, all groups had higher HbA1c and BMI, the YA and SO groups had greater blood pressure, and the YA group had greater prevalence of renal, eye, and neuropathy complications. ConclusionsWhether consideration of diabetes phenotypes with treatment strategies reduce diabetes incidence, morbidity, and mortality merits evaluation.

Anodal Transcranial Direct Current Stimulation Over S1 Differentially Modulates Proprioceptive Accuracy in Young and Old Adults.

BackgroundProprioception is a prerequisite for successful motor control but declines throughout the lifespan. Brain stimulation techniques such as anodal transcranial direct current stimulation (a-tDCS) are capable of enhancing sensorimotor performance across different tasks and age groups. Despite such growing evidence for a restorative potential of tDCS, its impact on proprioceptive accuracy has not been studied in detail yet.ObjectiveThis study investigated online effects of a-tDCS over S1 on proprioceptive accuracy in young (YA) and old healthy adults (OA).MethodsThe effect of 15 min of a-tDCS vs. sham on proprioceptive accuracy was assessed in a cross-over, double blind experiment in both age groups. Performance changes were tested using an arm position matching task in a robotic environment. Electrical field (EF) strengths in the target area S1 and control areas were assessed based on individualized simulations.Resultsa-tDCS elicited differential changes in proprioceptive accuracy and EF strengths in the two groups: while YA showed a slight improvement, OA exhibited a decrease in performance during a-tDCS. Stronger EF were induced in target S1 and control areas in the YA group. However, no relationship between EF strength and performance change was found.Conclusiona-tDCS over S1 elicits opposing effects on proprioceptive accuracy as a function of age, a result that is important for future studies investigating the restorative potential of a-tDCS in healthy aging and in the rehabilitation of neurological diseases that occur at advanced age. Modeling approaches could help elucidate the relationship between tDCS protocols, brain structure and performance modulation.

Low levels of dehydroepiandrosterone sulfate are associated with the risk of developing cardiac autonomic dysfunction in elderly subjects.

To assess the relationships between serum dehydroepiandrosterone sulfate (DHEA-S) levels and heart rate variability (HRV) among different age groups. Forty-five healthy men were divided into 3 groups: young age (YA; 20-39 yrs; n = 15), middle age (MA; 40-59 yrs; n = 15) and old age (OA; ≥ 60 yrs; n = 15). Hemodynamic parameters, linear analyses of HRV and concentrations of cortisol and DHEA-S were measured at rest. The OA group presented a higher resting heart rate (84.3 ± 4.6 bpm) than the YA group (72.0 ± 4.4 bpm; p < 0.05). The YA group showed an attenuated variance of HRV (2235.1 ± 417.9 ms2) compared to the MA (1014.3 ± 265.2 ms2; p < 0.05) and OA (896.3 ± 274.1 ms2; p < 0.05) groups, respectively. The parasympathetic modulation of HRV was lower in both the MA (244.2 ± 58.0 ms2) and OA (172.8 ± 37.9 ms2) groups in comparison with the YA group (996.0 ± 255.4 ms2; p < 0.05), while serum DHEA-S levels were significantly lower in both the MA (91.2 ± 19.6 mg/dL) and OA (54.2 ± 17.7 mg/dL) groups compared to the YA group (240.0 ± 50.8 mg/dL; p < 0.05). A positive correlation between lower serum concentrations of DHEA-S and attenuated variance of HRV (r = 0.47, p = 0.031), as well as lower serum concentrations of DHEA-S and decreased parasympathetic modulation of HRV (r = 0.54, p = 0.010), were found. The present study demonstrated that the decline of plasma DHEA-S is associated with reduced cardiac autonomic modulation during the aging process.