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In the digital age, social media has emerged as a significant platform, generating a vast amount of raw data daily. This data reflects the opinions of individuals from diverse backgrounds, races, cultures, and age groups, spanning a wide range of topics. Businesses can leverage this data to extract valuable insights, improve their services, and effectively reach a broader audience based on users' expressed opinions on social media platforms. To harness the potential of this extensive and unstructured data, a deep understanding of Natural Language Processing (NLP) is crucial. Existing approaches for sentiment analysis (SA) often rely on word co-occurrence frequencies, which prove inefficient in practical scenarios. Identifying this research gap, this paper presents a framework for concept-level sentiment analysis, aiming to enhance the accuracy of sentiment analysis (SA). A comprehensive Urdu language dataset was constructed by collecting data from YouTube, consisting of various talks and reviews on topics such as movies, politics, and commercial products. The dataset was further enriched by incorporating language rules and Deep Neural Networks (DNN) to optimize polarity detection. For sentiment analysis, the proposed framework employs predefined rules to trigger sentiment flow from words to concepts, leveraging the dependency relations among different words in a sentence based on Urdu language grammatical rules. In cases where predefined patterns are not triggered, the framework seamlessly switches to its sub-symbolic counterpart, passing the data to the DNN for sentence classification. Experimental results demonstrate that the proposed framework surpasses state-of-the-art approaches, including LSTM, CNN, SVM, LR, and MLP, achieving an improvement of 6–7% on Urdu dataset. In conclusion, this research paper introduces a novel framework for concept-level sentiment analysis of Urdu language data sourced from social media platforms. By combining language rules and DNN, the proposed framework demonstrates superior performance compared to existing methodologies, showcasing its effectiveness in accurately analyzing sentiment in Urdu text data. [ABSTRACT FROM AUTHOR]

A diet high in sodium contributes to a significant proportion of Disability Adjusted Life Years (DALYs) due to cardiovascular diseases. This paper describes the awareness, behaviour and determinants related to dietary salt intake in an adult population of 18–69 years that were assessed as part of the National NCD Monitoring Survey (NNMS) in India. A sub-sample of 3000 adults selected through simple random sampling from 150 nationally representative Primary Sampling Units (PSUs) was included. Data regarding awareness and behaviour related to dietary salt intake were collected. Urinary sodium excretion in spot urine samples was estimated and used to calculate dietary salt intake. The dietary salt intake's sociodemographic, behavioural and metabolic determinants were also analysed. Less than one-third of the adults of both genders in all age groups in rural and urban areas were aware that daily high salt intake could affect health. The estimated mean daily salt intake was 8.0 g (8.9 g/day for men and 7.1 g/day for women). The salt intake was significantly higher in men [Adjusted OR = 17.66 (5.24–59.46)], rural areas [Adjusted OR = 6.14 (1.83–20.60)], overweight and obese respondents [Adjusted OR = 17.62 (3.17–98.07)]. The perception of the harmful effects of high salt intake and practices to limit salt intake was low in the study population. The mean daily salt intake was higher than the WHO recommendation of up to 5 g daily. The mean dietary salt intake is high in the Indian population, which calls for planning and implementing control of dietary salt consumption measures. [ABSTRACT FROM AUTHOR]

Recently, well-being of older people measure (WOOP) was developed and validated in a Dutch population. Although WOOP was developed targeting the older people, it has the potential for use in a wider population. In this study, we aimed to examine the relationship between WOOP and EQ-5D-5L and compared their psychometric properties in a sample of patients, carers and healthy general public covering a wider age group. We conducted a cross-sectional study in Guizhou Province, China between July and August 2022. Data was collected using paper and pencil. We analysed and reported the acceptability, item response distribution, the Spearman correlation coefficients of all items, the Exploratory Factor Analysis (EFA) of all items, the known-group validity and the convergent validity of EQ-5D-5L utility and WOOP utility. A total of 322 participants completed the survey with 105 patients, 101 carers and 116 healthy general public. 9% of participants had at least one missing response. Three items of WOOP did not have any level 5 responses and EQ-5D-5L had more level 1 responses. The correlations were low between EQ-5D-5L and WOOP items and the three-factor EFA showed these two instruments had only one shared factor and the other two factors were only related to WOOP items. Younger people had lower missing response rate and a different response distribution for three items. WOOP measures a broader construct beyond health while EQ-5D-5L is a more sensitive instrument when health is considered alone. There is a potential of using WOOP in a wider population. [ABSTRACT FROM AUTHOR]

The emergence of SARS-CoV-2 in China in December 2019 has posed a major challenge to health systems in all countries around the world. One of the most relevant epidemiological measures to consider during the course of a pandemic is the proportion of cases that eventually die from the disease (case fatality ratio, CFR). Monitoring the evolution of this indicator is of paramount importance because it allows for the assessment of both variations in the lethality of the virus and the effectiveness of the control measures implemented by health authorities. One of the problems with estimating the CFR in practice is that the available data only show daily or weekly counts of new cases and deaths; there is no information on when each deceased patient was infected and therefore it is not possible to know exactly how many cases there were at the time the patient became infected. Various approaches have been proposed for calculating the CFR by correcting for the time lag between infection and death. In this paper, we present a novel methodology to perform a non-parametric estimation of the evolution of the CFR by initially identifying an optimal time lag between infections and deaths. The goodness of this procedure is assessed by means of a simulation study and the method is applied to the estimation of the CFR in Spain in the period from July 2020 to March 2022. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 (COVID-19) pandemic devastated countries worldwide, and resulted in a global shutdown. Not all infections are symptomatic and hence the extent of SARS-CoV-2 infection in the community is unknown. The paper presents the dynamics of the SARS-CoV-2 epidemic in the Greater Accra Metropolis, describing the evolution of seroprevalence through time and by age group. Three repeated independent population-based surveys at 6-week intervals were conducted in from November 2020 to July 2021. The global and by age-groups weighted seroprevalences were estimated and the risk factors for SARS-CoV-2 antibody seropositivity were assessed using logistic regression. The overall age-standardized SARS-CoV-2 antibody seroprevalence for both spike and nucleocapsid increased from 13.8% (95% CI 11.9, 16.1) in November 2020 to 39.6% (95% CI 34.8, 44.6) in July 2021. After controlling for gender, marital status, education level, and occupation, the older age group over 40 years had a higher odds of seropositivity than the younger age group (OR 3.0 [95% CI 1.1–8.5]) in the final survey. Pupils or students had 3.3-fold increased odds of seropositivity (OR 3.2 [95% CI 1.1–8.5]) compared to the unemployed. This study reinforces that, SARS-CoV-2 infections have been significantly higher than reported. [ABSTRACT FROM AUTHOR]

Females on average live longer but with higher rates of functional impairment and lower physical and economic activities than men. However, research linking retirement to functional impairment and the modifying role of gender and physical activity (PA) is limited especially in low- and middle-income countries. This paper examines the association between retirement and functional impairment in Ghana and evaluates the effect modification of the association by gender and PA. The sample included 1201 adults aged ≥ 50 years from a population-based study. Functional impairment was assessed with the activities of daily living scale. Ordinary least squares regression models adjusted for confounding variables and estimated gender-wise and PA heterogeneity effect of retirement on functional impairment. Regressions showed that retirement predicted an increase in functional impairment score in the full sample (β =.76, p <.001) and in men (β = 1.96, p <.001), but not in women. Interestingly, retirement significantly increased functional impairment in ≥ 65 age cohort (full sample: β =.71, p <.005; men: β = 1.86, p <.001) although not in women. However, the effect was significantly moderated by PA such that retirement × PA predicted a decrease in functional impairment in the full sample (β = −.81, p <.005) and the ≥ 65 age group (β = −.43, p <.005). Functional impairment risk of retirement is gender-specific, but PA buffers the relationship. Retirement is generally commonplace, but these findings imply that promoting PA may hold promise for addressing functional impairment in old age. Attending to the physical health needs of men during retirement should be a social policy priority. [ABSTRACT FROM AUTHOR]

Social distancing measures are effective in reducing overall community transmission but much remains unknown about how they have impacted finer-scale dynamics. In particular, much is unknown about how changes of contact patterns and other behaviors including adherence to social distancing, induced by these measures, may have impacted finer-scale transmission dynamics among different age groups. In this paper, we build a stochastic age-specific transmission model to systematically characterize the degree and variation of age-specific transmission dynamics, before and after lifting the lockdown in Georgia, USA. We perform Bayesian (missing-)data-augmentation model inference, leveraging reported age-specific case, seroprevalence and mortality data. We estimate that overall population-level transmissibility was reduced to 41.2% with 95% CI [39%, 43.8%] of the pre-lockdown level in about a week of the announcement of the shelter-in-place order. Although it subsequently increased after the lockdown was lifted, it only bounced back to 62% [58%, 67.2%] of the pre-lockdown level after about a month. We also find that during the lockdown susceptibility to infection increases with age. Specifically, relative to the oldest age group (> 65+), susceptibility for the youngest age group (0–17 years) is 0.13 [0.09, 0.18], and it increases to 0.53 [0.49, 0.59] for 18–44 and 0.75 [0.68, 0.82] for 45–64. More importantly, our results reveal clear changes of age-specific susceptibility (defined as average risk of getting infected during an infectious contact incorporating age-dependent behavioral factors) after the lockdown was lifted, with a trend largely consistent with reported age-specific adherence levels to social distancing and preventive measures. Specifically, the older groups (> 45) (with the highest levels of adherence) appear to have the most significant reductions of susceptibility (e.g., post-lockdown susceptibility reduced to 31.6% [29.3%, 34%] of the estimate before lifting the lockdown for the 6+ group). Finally, we find heterogeneity in case reporting among different age groups, with the lowest rate occurring among the 0–17 group (9.7% [6.4%, 19%]). Our results provide a more fundamental understanding of the impacts of stringent lockdown measures, and finer evidence that other social distancing and preventive measures may be effective in reducing SARS-CoV-2 transmission. These results may be exploited to guide more effective implementations of these measures in many current settings (with low vaccination rate globally and emerging variants) and in future potential outbreaks of novel pathogens. [ABSTRACT FROM AUTHOR]

The distribution of lip, oral cavity, and pharynx (LOCP) cancer mortality rates in small domains (defined as the combination of province, age group, and gender) remains unknown in Spain. As many of the LOCP risk factors are preventable, specific prevention programmes could be implemented but this requires a clear specification of the target population. This paper provides an in-depth description of LOCP mortality rates by province, age group and gender, giving a complete overview of the disease. This study also presents a methodological challenge. As the number of LOCP cancer cases in small domains (province, age groups and gender) is scarce, univariate spatial models do not provide reliable results or are even impossible to fit. In view of the close link between LOCP and lung cancer, we consider analyzing them jointly by using shared component models. These models allow information-borrowing among diseases, ultimately providing the analysis of cancer sites with few cases at a very disaggregated level. Results show that males have higher mortality rates than females and these rates increase with age. Regions located in the north of Spain show the highest LOCP cancer mortality rates. [ABSTRACT FROM AUTHOR]

Tourism is an emotional sphere, and researchers focus on emotions to optimize tourism experiences. Tourism studies on emotions mostly ignore differences in emotions across demographic tourist groups by gender and age, thus limiting the understanding of emotions to the explicit characteristics of tourists' emotions. On the basis of geotagged facial expressions on social media platforms, this study aims to visualize the emotions of groups in scenic spots and then reveal the variations between groups' emotions within theme parks. By employing a facial recognition algorithm, an emotion distribution graph was proposed to represent groups' emotions in detail. Some analytical methods were combined to characterize of the emotion distribution of each group. Through a comprehensive comparison, the results suggest that there are unique characteristics of emotion distribution for each group and considerable variations between them. This study helps researchers achieve a deeper understanding of tourists' emotional differences and enhances the theorization of emotions. This research also highlights the advantages and significant practical implications of our method framework. [ABSTRACT FROM AUTHOR]

Hodgkin lymphoma (HL) is a rare malignancy affecting the lymphatic system. Our study examined the incidence rates of adult HL based on sex, race/ethnicity, age, and histological subgroups in the United States (US) from 2000 to 2020. Data for this study were extracted from the Surveillance, Epidemiology, and End Results 22 database. HL patients were identified utilizing the International Classification of Diseases for Oncology version 3 and categorized as classical HL, lymphocyte-rich/mixed cell/lymphocyte depleted, nodular sclerosis, classical HL, not otherwise specified, and nodular lymphocyte-predominant HL. The study reported average annual percent change (AAPC). All estimates were presented as counts and age-standardized incidence rates (ASIRs) per 100,000 individuals. Between 2000 and 2019, a total of 70,924 cases of HL were reported in the US. Classical HL was the predominant subtype (94.27%), and most incident cases were among non-Hispanic Whites (66.92%) and those aged 20–29 years (24.86%). The ASIR per 100,000 population was 3.83 for men and 2.92 for women. Both sexes showed declines in the AAPCs between 2000 and 2019 (− 0.64% [− 0.99, − 0.28] and − 0.40% [− 0.77, − 0.03] for men and women, respectively). There was a significant decrease in ASIRs after COVID-19 among both sexes (percent change: − 7.49% [− 11.58, − 3.40]). Throughout all age groups, men had a higher incidence rate compared to women, except for those aged 20–29 years. Although the overall HL incidence rate was lowered in the study period from 2000 to 2019, a dramatic decrease in ASIRs of HL patients following COVID-19 pandemic was observed. [ABSTRACT FROM AUTHOR]

Persons with disabilities in LMICs facing numerous challenges in accessing essential healthcare services. However, this understanding is lacking so far in LMICs and Bangladesh. This study aimed to explore the pattern and determinants of healthcare services access among persons with disabilities in Bangladesh. We analysed data from 4293 persons with disabilities extracted from the 2021 National Survey on Persons with Disabilities. The outcome variable was healthcare services access within three months of the survey, categorized as either "yes" or "no" based on perceived needs. Several individual, household, and community-level factors were considered as explanatory variables. We utilized a multilevel mixed-effect logistic regression model to explore the association of the outcome variable with explanatory variables. The analysis included stratification by age groups: 0–17 years and 18–95 years. One out of every four persons with disabilities in Bangladesh reported that they could not access healthcare services based on their needs within three months of the survey. The main reasons for not accessing services were healthcare costs (52.10%), followed by lack of family support (27.0%), and absence of healthcare facilities in their areas of residence (10.10%). Among those who did receive healthcare services, the majority reported accessing them from governmental hospitals (26.49%), followed by village practitioner (20.52%), and private healthcare centres (19.87%). There was a higher likelihood of accessing healthcare services among persons with disabilities residing in households with higher wealth quintiles and living in the Chattogram and Sylhet divisions. Unmarried or divorced/widowed/separated persons with disabilities reported lower likelihoods of accessing healthcare services. The findings of this study emphasize the need for policies and programs to ensure healthcare services for persons with disabilities in Bangladesh. This entails raising awareness about the importance of providing healthcare services for this demographic, as well as considering healthcare services as part of social safety net programs. [ABSTRACT FROM AUTHOR]

Mnemonic discrimination of highly similar memory traces is affected in healthy aging via changes in hippocampal pattern separation—i.e., the ability of the hippocampus to orthogonalize highly similar neural inputs. The decline of this process leads to a loss of episodic specificity. Because previous studies have almost exclusively tested mnemonic discrimination of visuospatial stimuli (e.g., objects or scenes), less is known about age-related effects on the episodic specificity of semantically similar traces. To address this gap, we designed a task to assess mnemonic discrimination of verbal stimuli as a function of semantic similarity based on word embeddings. Forty young (Mage = 21.7 years) and 40 old adults (Mage = 69.8 years) first incidentally encoded adjective-noun phrases, then performed a surprise recognition test involving exactly repeated and highly similar lure phrases. We found that increasing semantic similarity negatively affected mnemonic discrimination in both age groups, and that compared to young adults, older adults showed worse discrimination at medium levels of semantic similarity. These results indicate that episodic specificity of semantically similar memory traces is affected in aging via less efficient mnemonic operations and strengthen the notion that mnemonic discrimination is a modality-independent process supporting memory specificity across representational domains. [ABSTRACT FROM AUTHOR]

Large language models (LLMs) are becoming a significant source of content generation in social networks, which is a typical complex adaptive system (CAS). However, due to their hallucinatory nature, LLMs produce false information that can spread through social networks, which will impact the stability of the whole society. The uncertainty of LLMs false information spread within social networks is attributable to the diversity of individual behaviors, intricate interconnectivity, and dynamic network structures. Quantifying the uncertainty of false information spread by LLMs in social networks is beneficial for preemptively devising strategies to defend against threats. To address these challenges, we propose an LLMs hallucination-aware dynamic modeling method via agent-based probability distributions, spread popularity and community affiliation, to quantify the uncertain spreading of LLMs hallucination in social networks. We set up the node attributes and behaviors in the model based on real-world data. For evaluation, we consider the spreaders, informed people, discerning and unwilling non-spreaders as indicators, and quantified the spreading under different LLMs task situations, such as QA, dialogue, and summarization, as well as LLMs versions. Furthermore, we conduct experiments using real-world LLM hallucination data combined with social network features to ensure the validity of the proposed quantifying scheme. [ABSTRACT FROM AUTHOR]

Hepatitis B virus (HBV) infection is highly prevalent in Guangzhou, China. This study aimed to examine the long-term trend of HB incidence from 2008 to 2022 and the independent impacts of age, period, and cohort on the trends. HBV data were collected from the China Information System for Disease Control and Prevention. Joinpoint regression was utilized to examine temporal trends, and an age-period-cohort model was employed to estimate the effects of age, period, and cohort. A total of 327,585 HBV cases were included in this study. The incidence of chronic and acute HB showed a decreasing trend in Guangzhou over the past 15 years, with an average annual percent change of − 4.31% and − 16.87%, respectively. Age, period, and cohort all exerted significant effects. The incidence of HB was higher in males than in females and non-central areas compared to central areas. Age groups of 0–4 years and 15–24 years were identified as high-risk groups. The period relative risks for chronic HB incidence decreased initially and then stabilized. Cohorts born later had lower risks. Chronic HB incidences remain high in Guangzhou, especially among males, younger individuals, and residents of non-central areas. More efforts are still needed to achieve hepatitis elimination targets. [ABSTRACT FROM AUTHOR]

We aimed to evaluate the association of unmet health-related need with suicidal behaviors among Korean adults. We included 26,219 adults (13,937 men and 17,788 women) aged ≥ 19 years from the Korea National Health and Nutrition Examination Survey (2015–2020). Suicidal behavior included suicidal plan and attempt. We analyzed the odds ratios and 95% confidence intervals of suicidal behaviors according to unmet health-related need via multivariable logistic regression analysis and performed stratified analyses according to sex, age, income, education, and type of insurance. Of the participants, 9.6% had unmet health-related need. Suicidal plans and attempts had 1.3% and 0.5% of the participants, respectively. The prevalence of suicidal plans and attempts was 0.9% and 0.4% among participants without unmet health-related need and 3.1% and 1.0% among those with such need, respectively. The odd ratios of suicidal plans and attempts increased significantly among participants with unmet health-related need compared to those without. In subgroup analysis, most subgroups showed similar results, except for suicidal plan and attempt in the 45–64 age group, high education, and medical care and suicidal attempt in 19–44 age group, low-income, and unmarried. Unmet health-related need was independently associated with suicidal plan and attempt. A policy alternative is needed for these associations. [ABSTRACT FROM AUTHOR]

The study aimed to examine the association of expanded adverse childhood experiences (ACEs) with psychological distress in adulthood. The data from nation-wide online cohort was used for analysis. Community dwelling adults in Japan were included. The ACEs was assessed by 15 items of ACE-J, including childhood poverty and school bullying. Severe psychological distress was determined as the score of Kessler 6 over 13. Multivariable logistic regression analysis was conducted, by using sample weighting. A total of 28,617 participants were analyzed. About 75% of Japanese people had one or more ACEs. The prevalence of those with ACEs over 4 was 14.7%. Those with ACEs over 4 showed adjusted odds ratio = 8.18 [95% CI 7.14–9.38] for severe psychological distress. The prevalence of childhood poverty was 29% for 50–64 year old participants and 40% of 65 or older participants. The impact of childhood poverty on psychological distress was less than other ACEs in these age cohorts. Bullying was experienced 21–27% in young generations, but 10% in 65 or older participants. However, the impact on psychological distress in adulthood was relatively high in all age groups. ACEs have impacted mental health for a long time. Future research and practice to reduce ACEs are encouraged. [ABSTRACT FROM AUTHOR]

Regional population mortality correlates with regional socioeconomic development. This study aimed to identify the key socioeconomic factors influencing mortality patterns in Chinese provinces. Using data from the Seventh Population Census, we analyzed mortality patterns by gender and urban‒rural division in 31 provinces. Using a functional regression model, we assessed the influence of fourteen indicators on mortality patterns. Main findings: (1) China shows notable gender and urban‒rural mortality variations across age groups. Males generally have higher mortality than females, and rural areas experience elevated mortality rates compared to urban areas. Mortality in individuals younger than 40 years is influenced mainly by urban‒rural factors, with gender becoming more noticeable in the 40–84 age group. (2) The substantial marginal impact of socioeconomic factors on mortality patterns generally becomes evident after the age of 45, with less pronounced differences in their impact on early-life mortality patterns. (3) Various factors have age-specific impacts on mortality. Education has a negative effect on mortality in individuals aged 0–29, extending to those aged 30–59 and diminishing in older age groups. Urbanization positively influences the probability of death in individuals aged 45–54 years, while the impact of traffic accidents increases with age. Among elderly people, the effect of socioeconomic variables is smaller, highlighting the intricate and heterogeneous nature of these influences and acknowledging certain limitations. [ABSTRACT FROM AUTHOR]

The advanced stage at diagnosis of colorectal cancer (CRC) may be related to individual factors, socioeconomic conditions, and healthcare service availability. The objective of the study was to analyze the prevalence of advanced stage CRC at the time of diagnosis and its association with individual, contextual, socioeconomic, and healthcare service indicators. An observational, cross-sectional study was conducted, analyzing cases of malignant neoplasms of the colon and rectum in individuals of both sexes, aged between 18 and 99 years, diagnosed between 2010 and 2019 in Brazil (n = 69,047). Data were collected from the Hospital Cancer Registry (HCR), Atlas of Human Development in Brazil, and from the National Registry of Health Institutions (NRHI). A Multilevel Poisson Regression model with random intercept was used. The prevalence of advanced stage CRC at diagnosis was 65.6%. Advanced stage was associated with older age groups prevalence ratio (PR) 4.40 and younger age groups (PR 1.84), low Human Development Index (HDI) (PR 1.22), and low density of family health strategy teams (PR 1.10). The study highlights the unequal distribution of social determinants of health in the diagnosis CRC in Brazil, revealing the need to evaluate and redirect public policies aimed at improving early detection and prevention of CRC in the country. [ABSTRACT FROM AUTHOR]

This study aimed to conduct a cross-sectional data analysis of the alveolar bone mineral density (al-BMD) in 225 patients of various ages and different sexes. The al-BMD value in the mandibular incisor region was calculated using a computer-aided measurement system (DentalSCOPE) for intraoral radiography. All participants with intact teeth (101 males and 124 females; age range, 25–89 years) were divided into three age-segregated groups (25–49, 50–74, and > 75 years). Statistical differences were evaluated using the Mann–Whitney U or Kruskal–Wallis test. Males exhibited significantly greater al-BMD than females (p < 0.001). The highest means were observed in the 25–49 age group, regardless of sex (1007.90 mg/cm2 in males, 910.90 mg/cm2 in females). A 9.8% decrease in al-BMD was observed with the increase in age in males (25–49 to 50–74 years; p = 0.004); however, no further changes were seen thereafter. In females, a decreasing trend was seen throughout the lifespan, with values reaching up to 76.0% of the initial peak value (p < 0.001). Similar to other skeletal sites, the alveolar bone exhibits sex differences and undergoes a reduction in BMD via the normal aging process. [ABSTRACT FROM AUTHOR]

The impact of common environmental exposures in combinations with socioeconomic and lifestyle factors on cancer development, particularly for young adults, remains understudied. Here, we leveraged environmental and cancer incidence data collected in New York State at the county level to examine the association between 31 exposures and 10 common cancers (i.e., lung and bronchus, thyroid, colorectal, kidney and renal pelvis, melanoma, non-Hodgkin lymphoma, and leukemia for both sexes; corpus uteri and female breast cancer; prostate cancer), for three age groups (25–49, 50–69, and 70–84 year-olds). For each cancer, we stratified by age group and sex, and applied regression models to examine the associations with multiple exposures simultaneously. The models included 642,013 incident cancer cases during 2010–2018 and found risk factors consistent with previous reports (e.g., smoking and physical inactivity). Models also found positive associations between ambient air pollutants (ozone and PM2.5) and prostate cancer, female breast cancer, and melanoma of the skin across multiple population strata. Additionally, the models were able to better explain the variation in cancer incidence data among 25–49 year-olds than the two older age groups. These findings support the impact of common environmental exposures on cancer development, particularly for younger age groups. [ABSTRACT FROM AUTHOR]

Liver cancer, a chronic non-communicable disease, represents a serious public health problem. Long-term trends in the burden of liver cancer disease are heterogeneous across regions. Incidence and mortality of liver cancer, based on the Global Burden of Disease, were collected from the Chinese Centre for Disease Control and Prevention. Age–period–cohort model was utilized to reveal the secular trends and estimate the age, period and cohort effects on primary liver cancer due to specific etiologies. Both the age-standardized incidence and mortality rate of liver cancer in Hubei province were on the rise, although there were discrepancies between gender groups. From age–period–cohort analysis, both incidence and mortality of liver cancer due to Hepatitis B virus were the highest in all age groups. The incidence of all liver cancer groups increased with time period in males, while this upward trend was observed in females only in liver cancer due to alcohol use group. Cohort effects indicated the disease burden of liver cancer decreased with birth cohorts. Local drifts showed that the incidence of liver cancer due to specific etiologies was increasing in the age group of males between 40 and 75 years old. The impact of an aging population will continue in Hubei Province. the disease burden of liver cancer will continue to increase, and personalized prevention policies must be adopted to address these changes. [ABSTRACT FROM AUTHOR]

Mechanisms through which most known Alzheimer's disease (AD) loci operate to increase AD risk remain unclear. Although Apolipoprotein E (APOE) is known to regulate lipid homeostasis, the effects of broader AD genetic liability on non-lipid metabolites remain unknown, and the earliest ages at which metabolic perturbations occur and how these change over time are yet to be elucidated. We examined the effects of AD genetic liability on the plasma metabolome across the life course. Using a reverse Mendelian randomization framework in two population-based cohorts [Avon Longitudinal Study of Parents and Children (ALSPAC, n = 5648) and UK Biobank (n ≤ 118,466)], we estimated the effects of genetic liability to AD on 229 plasma metabolites, at seven different life stages, spanning 8 to 73 years. We also compared the specific effects of APOE ε4 and APOE ε2 carriage on metabolites. In ALSPAC, AD genetic liability demonstrated the strongest positive associations with cholesterol-related traits, with similar magnitudes of association observed across all age groups including in childhood. In UK Biobank, the effect of AD liability on several lipid traits decreased with age. Fatty acid metabolites demonstrated positive associations with AD liability in both cohorts, though with smaller magnitudes than lipid traits. Sensitivity analyses indicated that observed effects are largely driven by the strongest AD instrument, APOE, with many contrasting effects observed on lipids and fatty acids for both ε4 and ε2 carriage. Our findings indicate pronounced effects of the ε4 and ε2 genetic variants on both pro- and anti-atherogenic lipid traits and sphingomyelins, which begin in childhood and either persist into later life or appear to change dynamically. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the impact of ocular demodicosis on dry eye disease (DED) and meibomian gland dysfunction (MGD) across different age populations: young (20 to < 40), middle-aged (40 to < 60), and elderly (≥ 60), based on the retrospective medical chart review. In each age subgroup, Demodex infestation and its count were correlated with clinical parameters of DED and MGD. Among the total of 351 subjects, 52.7% had ocular demodicosis, with a mean of 2.31 ± 1.39 mites per four eyelashes (0.58 per lash) in a unilateral eye. In the age subgroup 1 (age < 40; N = 44), subjects with Demodex had significantly higher meibum quality grades. In subgroup 2 (40 ≤ age < 60; N = 122), subjects with Demodex had higher ocular surface disease index scores and higher MG expressibility grades. However, in subgroup 3 (age ≥ 60; N = 185), demographics and all parameters did not differ according to Demodex infestation. Moreover, the number of mites did not correlate with MGD severity in any of the subgroups. In conclusion, age may act as a significant confounding factor in the relationship between ocular Demodex infestation and clinical features of DED and MGD, despite older patients aged 60 years and above being at a higher risk of Demodex infestation and experiencing more severe MGD. [ABSTRACT FROM AUTHOR]

Brain disorders are leading causes of disability worldwide. Gene expression studies provide promising opportunities to better understand their etiology but it is critical that expression is studied on a cell-type level. Cell-type specific association studies can be performed with bulk expression data using statistical methods that capitalize on cell-type proportions estimated with the help of a reference panel. To create a fine-grained reference panel for the human prefrontal cortex, we performed an integrated analysis of the seven largest single nucleus RNA-seq studies. Our panel included 17 cell-types that were robustly detected across all studies, subregions of the prefrontal cortex, and sex and age groups. To estimate the cell-type proportions, we used an empirical Bayes estimator that substantially outperformed three estimators recommended previously after a comprehensive evaluation of methods to estimate cell-type proportions from brain transcriptome data. This is important as being able to precisely estimate the cell-type proportions may avoid unreliable results in downstream analyses particularly for the multiple cell-types that had low abundances. Transcriptome-wide association studies performed with permuted bulk expression data showed that it is possible to perform transcriptome-wide association studies for even the rarest cell-types without an increased risk of false positives. [ABSTRACT FROM AUTHOR]

We evaluated the association between gestational age at threatened preterm birth (TPTB) diagnosis and preterm birth (PTB) incidence using a nationwide birth cohort. Data of 94,236 women with singleton deliveries from the Japan Environment and Children's Study (enrolled between 2011 and 2014) were analysed. Participants were divided based on parity and gestational age at TPTB diagnosis (22–24, 25–27, 28–30, 31–33, and 34–36 weeks). Multivariable logistic regression models were used to calculate the odds ratios (ORs) for PTB before 37 and 34 weeks in women from all groups, using participants without TPTB as the reference. The adjusted ORs for PTB before 37 weeks were the highest in the latest gestational age group in nulliparous and multiparous women without previous PTB, while those before 34 weeks were the highest in the earliest and latest gestational age group in multiparous women without previous PTB and in the earliest gestational age group in multiparous women with previous PTB. The association between gestational age at TPTB diagnosis and PTB incidence varies based on maternal parity and PTB before 37 or 34 weeks. Further studies with detailed clinical data and a unified TPTB diagnosis protocol are necessary to clarify this association. [ABSTRACT FROM AUTHOR]

Globally, over 200 million women and girls have been subjected to Female Genital Mutilation (FGM). This practice, illegal in most countries, often happens in unsanitary conditions and without clinical supervision with consequent bleeding and infection. However, little is known about its contribution to the global epidemiology of child mortality. We matched data on the proportion of girls of a given age group subject to FGM to age-gender-year specific mortality rates during 1990–2020 in 15 countries where FGM is practised. We used fixed-effects regressions to separate the effect of FGM on mortality-rates from variation in mortality in that country in that year. Using our estimated effect, we calculated total annual excess mortality due to FGM. Our estimates imply that a 50% increase in the number of girls subject to FGM increases their 5-year mortality rate by 0.075 percentage point (95% CI 0 · 065 – 0 · 085 ). This increased mortality rate translates into an estimated 44,320 excess deaths per year across countries where FGM is practised. These estimates imply that FGM is a leading cause of the death of girls and young women in those countries where it is practised accounting for more deaths than any cause other than Enteric Infections, Respiratory Infections, or Malaria. [ABSTRACT FROM AUTHOR]

Pyogenic spondylodiscitis presents significant diagnostic and therapeutic challenges. In Germany, a comprehensive understanding of its epidemiology and inpatient management outcomes is limited, hindering the optimisation of therapeutic strategies. This study aimed to characterise the evolving epidemiological trends of pyogenic spondylodiscitis in Germany, and concurrently evaluate inpatient management strategies and outcomes. We performed a retrospective population-based study of spondylodiscitis cases in Germany from 2005 to 2021, utilising data from the German Federal Statistical Office database. The parameters assessed were incidence trends, demographic characteristics, inpatient management strategies, and inpatient mortality. The study found a significant rise in the population-adjusted incidence of spondylodiscitis in Germany from 2005 to 2021, increasing by 104% from 5.4 to 11.0 cases per 100,000 individuals (p < 0.001). The highest number of diagnoses was recorded in 2019. Age group-adjusted data revealed the largest relative changes in the "90 + " age group, followed by the "80–89" and "70–79" age groups. These increases were not solely attributable to population changes but were also confirmed after calculating the age-group-adjusted incidence rates. Additionally, our statistical analysis demonstrated that both age and year significantly influenced the incidence of spondylodiscitis. Over the same period, inpatient mortality also surged significantly by 347% (p < 0.001), with the highest increase recorded in the 90 + age group, observing a 2450% rise (p < 0.001). The mean length of inpatient stay decreased by 15% (p < 0.05). Concurrently, there was a significant increase in surgical interventions using spinal stabilisation procedures (p < 0.001), which might suggest a shift in the treatment paradigm for spondylodiscitis. The results underscore a concerning rise in spondylodiscitis incidence and mortality in Germany, particularly affecting the ageing population. A notable shift towards surgical intervention was observed. The data highlights the urgent necessity for high-level evidence studies comparing surgical versus conservative treatment, thereby guiding optimised therapeutic strategies. [ABSTRACT FROM AUTHOR]

Before vaccines were introduced, mobility restriction was one of the primary control measures in the early stage of the coronavirus disease 2019 (COVID-19) pandemic. Because different age groups face disproportionate health risks, differences in their mobility changes affect the effectiveness of pandemic control measures. This study aimed to investigate the relationship between multiscale mobility patterns in different age groups and COVID-19 transmission before and after control measures implementation. Data on daily confirmed case numbers, anonymized mobile phone data, and 38 socioeconomic factors were used to construct negative binomial regression models of these relationships in the Taipei metropolitan area in May 2021. To avoid overfitting, the socioeconomic factor dimensions were reduced by principal component analysis. The results showed that inter-district mobility was a greater promoter of COVID-19 transmission than was intra-district mobility (coefficients: pre-alert, 0.52 and 0.43; post-alert, 0.41 and 0.36, respectively). Moreover, both the inter-district mobility of people aged 15–59 and ≥ 60 years were significantly related to the number of confirmed cases (coefficients: pre-alert, 0.82 and 1.05; post-alert, 0.48 and 0.66, respectively). The results can help agencies worldwide formulate public health responses to emerging infectious diseases. [ABSTRACT FROM AUTHOR]

Word retrieval during language production slows down with age. However, bilinguals also require language control to manage language competition, in particular when switching languages to cues. The current study examined how this bilingual language control differs between younger and older adults. It also compared bilingual control, and age-group differences, to control that might be applied when alternating between responses within one language. In Experiment 1, 40 younger and 40 older monolingual adults completed a task alternating between noun and verb responses to pictures. The task showed costs associated with language control but these did not differ between age groups. Experiment 2 was completed by 50 older and 50 younger bilingual adults. Older adults showed larger switching costs than younger adults when switching between and within languages, suggesting they experienced more difficulty with reactive control. However, while older adults showed larger mixing costs than younger adults when using two languages in the dual-language environment relative to the single-language environment, they surprisingly showed smaller mixing costs than younger adults in the noun-verb within-language naming task. These findings show that language control, and the way it differs between older and younger adults, is not the same across within- and bilingual-language competition. [ABSTRACT FROM AUTHOR]

The link between cardiovascular (CV) risk factors or diseases and dementia is documented. There is conflicting evidence whether age moderates the association. We need to study this gap so that research and clinical initiatives target appropriate age groups. A cohort of 320,630 adult patients without dementia was built using Quebec healthcare databases (1998–2010). The CV risk factors were hypertension, diabetes and dyslipidemia, while diseases included stroke, myocardial infarction (MI), chronic heart failure (HF), and atrial fibrillation (AF). Dementia risk and CV risk factors or diseases were assessed using incidence rate ratios and Cox regression across age groups. The cohort presented by mainly female sex (67.7%) and mean age of 74.1 years. Incident rate of dementia increased with age, ranging from 4.1 to 93.5 per 1000 person-years. Diabetes, stroke, HF and AF were significantly associated with dementia risk, hazard ratios ranged from 1.08 to 3.54. The strength of association decreased in advanced age for diabetes, stroke and HF. The results suggest that prevention of diabetes, stroke, HF and AF are crucial to mitigate dementia risk. The pathophysiology of dementia in younger and older populations seems to differ, with less impact of CV risk factors in advanced age. [ABSTRACT FROM AUTHOR]

Self-harm among adolescents has increased in many countries, but few studies have examined possible explanations. One explanation could be the changes in the way adolescents socialize and use of social media. We explored the relationship between past year self-harm and time spent on social media, employing data from a nationwide cross-sectional survey among students in grades 8 through 11 in Norway (N = 37,268). The association was estimated in logistic regression models and we adjusted for identified confounders and stratified on gender, age group and depressive symptoms. A total of 16.1% of the study population reported to have self-harmed in the past year. This proportion was elevated among those spending more than 3 h daily on social media (unadjusted OR = 2.74 (CI 2.58.–2.90)). Adjustment for confounders modified the association (OR = 1.49 (CI 1.39–1.60)). In stratified analyses, adjusted OR did not differ significantly by gender or age The association between time spent on social media and self-harm was weaker among adolescents with severe depressive symptoms (adjusted OR = 1.38 (CI 1.22–1.55)), than among those with mild or no symptoms (adjusted OR = 1.70 (CI 1.56–1.86)). Risk of self-harm was elevated among those who spent 3 or more hours daily on social media, also after controlling for other factors. Further studies are needed to explore the nature and underlying mechanisms of this association. Strengthening the evidence will help informing the development of adequate measures to prevent self-harm. [ABSTRACT FROM AUTHOR]

Health literacy is an asset for and indicator of adolescents' health and wellbeing, and should therefore be monitored and addressed across countries. This study aimed to develop and validate a shorter version of the original 10-item health literacy for school-aged children instrument in a cross-national context, using data from the health behaviour in school-aged children 2017/18 survey. The data were obtained from 25 425 adolescents (aged 13 and 15 years) from seven European countries. Determination was made of the best item combination to form a shorter version of the health literacy instrument. Thereafter, the structural validity, reliability, measurement invariance, and criterion validity of the new 5-item instrument were examined. Confirmatory factor analysis showed a good model fit to the data across countries and in the total sample, confirming the structural validity (CFI = 0.995, TLI = 0.989, SRMR = 0.011, RMSEA = 0.031). The internal consistency of the instrument was at a good level across countries (α = 0.87–0.98), indicating that the instrument provided reliable scores. Configural and metric invariance was established across genders, ages, and countries. Scalar invariance was achieved for age and gender groups, but not between countries. This indicated that the factor structure of the scale was similar, but that there were differences between the countries in health literacy levels. Regarding criterion validity, structural equation modelling showed a positive association between health literacy and self-rated health in all the participating countries. The new instrument was found to be valid and reliable for the purposes of measuring health literacy among adolescents in a cross-national context. [ABSTRACT FROM AUTHOR]

The older adult is an influential group experiencing acute myocardial infarction, delaying treatment and causing a high mortality rate. Factors related to their delay differ from other age groups, and their specific characteristics are barriers to recognizing their symptoms and learning new information. Therefore, specific innovative methods related to their limitations and needs should be considered when developing interventions promoting on-time treatment. This study aims to review intervention details and their effects on knowledge, belief, decision-making, rate of calling 911, and mortality among community-dwelling older adults at risk or after a first myocardial infarction compared to receiving usual care or no intervention. The 12 databases were searched unlimitedly until July 30, 2022. The two researchers independently reviewed the articles, and the third reviewer broke the tight when disagreement was found. Data were extracted, kinds of interventions were grouped, and intervention details were summarized narratively. Finally, the selected outcomes were analyzed by meta-analysis using a fixed and a random-effects model. Eleven articles were for final review. Interventions were categorized into eight groups: direct mail, community-based, multi-group health education, innovation methods, tailored education, structured education, tricked intervention promoting memory and concern, and nurse-based case management. Finally, the meta-analysis found that only innovative methods could increase the rate of calling 911 and taking aspirin (Odd ratio = 2.55; 95% CI = 1.01-6.44). In contrast, there were no statistically significant differences in the rate of affecting time to first unplanned readmission or death and time delay to the emergency room. Results recommended that effective and specific interventions must be developed and strengthened to promote older adults surviving acute myocardial infarction. Clinical Trial Registration Number: PROSPERO CRD42021247136. [ABSTRACT FROM AUTHOR]

Organ donation is vital to saving lives, but its success depends on people's willingness to donate organs. This descriptive cross-sectional survey aimed to investigate attitudes towards organ donation in Damascus, Syria. Understanding attitudes is crucial for the success of organ donation programs, especially in countries with similar settings. This study was a descriptive cross-sectional survey aimed at understanding patients' attitudes towards organ donation in Damascus, Syria. Data was collected through a carefully constructed validated survey through face-to-face interviews. 600 participants were randomly interviewed, 62.8% agreed to donate their organs after death, with helping others being the primary reason. Religious beliefs were the primary reason for organ refusal in males, while for females, it was lack of knowledge and religious beliefs. However, there were no significant differences between genders or educational level and age groups in the acceptance of organ donation. The percentage of those who agree to donate their organs after death encourages taking an effective step to build an integrated donation system, not just a center. Bearing in mind that there is no correlation with age, gender or even educational level, which means that the system may include different groups of society. [ABSTRACT FROM AUTHOR]

The human body is encompassed by a thin layer of tissue, the skin, which is heterogenous and highly specialized to protect the body and encode interactions with the external world. There is a fundamental scientific drive to understand its function, coupled with the need to preserve skin as we age, which impacts on our physiological and psychological well-being. In the present study, we aimed to define differences in touch perception between age groups and with skin cream application. We investigated touch on the finger, the forearm and cheek in younger (20–28 years, n = 22) and older (65–75 years, n = 22) females. We measured skin hydration, touch detection, finger spatial discrimination, forearm tactile pleasantness together with electrodermal activity, and perceptual ratings about cream use, skin dryness, and cosmetic habits. Glabrous finger skin became drier and touch performance was impaired with age, but these aspects were preserved in hairy skin. Skin moisturization immediately increased hydration levels, but did not significantly change touch perception. We also found that touch appreciation increased with age. We conclude that reduced finger capacity may impact self-evaluation of the skin and that long-term skin care strategies should focus on hydrating the hand to preserve touch capacities. [ABSTRACT FROM AUTHOR]

The presented study focuses on assessing the effect of caponization on the densitometric, osteometric, geometric and biomechanical parameters of tibial bones in crossbred chickens. The study was carried out on 96 hybrids between Yellowleg Partridge hens (Ż-33) and Rhode Island Red cockerels (R-11) aged 16 weeks, 20 weeks and 24 weeks. Birds were randomly assigned to 2 groups-the control group (n = 48; which consisted of intact roosters) and the experimental group (n = 48, which consisted of individuals subjected to caponization at the age of 8 weeks). The caponization had no effect on the densitometric, osteometric and geometric parameters (except the horizontal internal diameter of 16-week-old individuals) of tibia bone, as well as the content of calcium (Ca), phosphorus (P) and the Ca/P ratio in the bone mineral fraction in all analyzed age groups of animals. However, it contributes to a lower percentage of ash in the bones of capons at 20 and 24 weeks of age compared to cockerels. On the contrary, some mechanical and material parameters show the negative effect of caponization. Ultimate load and bending moment decreased in capons in all of the analyzed age groups of animals and yield load, stiffness and ultimate stress also decreased but only in the group of 20-week-old and 24-week-old individuals. This can contribute to the weakening of the capon bones, and in the perspective of prolonged maintenance to their deformation and even fracture. [ABSTRACT FROM AUTHOR]

Without feature selection, the time-series of vaccine dose counts remained statistically significant and positive (IRR: 1.92, 95% CI [1.34-2.76]) and the time-series of new COVID-19 infection counts did not have statistical significance. Graph: Figure 1Weekly counts of cardiac arrest calls (five-week centered moving-average), COVID-19 cases (three-week centered moving-average), and vaccination doses (three-week centered moving-average) for those between 16 and 39 during: (A) the study period (January 1st, 2019, to June 20th, 2021) and (B) the third COVID-19 wave and vaccination distribution period (October 18th, 2020, to June 20th, 2021). Without feature selection, the time-series of vaccine dose counts remained statistically significant and positive (IRR: 1.94, 95% CI [1.36-2.76]) and the time-series of new COVID-19 infection counts did not have statistical significance. [Extracted from the article]

The aim was to investigate the attitude towards and perceived stress from emergency remote teaching (ERT) among teachers during the COVID-19 pandemic. A Germany-wide online survey was conducted among teachers from all school types in March 2021. Data from 31,089 teachers entered analysis. ANOVAs or Welch's t-tests with post-hoc analyses were performed to determine sociodemographic and work-related group differences in teachers' attitude towards and perceived stress from ERT. The mean attitude towards ERT was 3.47 (±.84) out of 5 and the mean perceived stress was 5.03 (±.62) out of 6. Regarding the attitude towards ERT, we revealed significant differences for gender, age groups, number of children, occupational group, school management membership, and employment status (p <.05). Regarding perceived stress, significant differences were obtained for gender, age groups, and employment status (p <.05). A more positive attitude towards ERT seems to be associated with lower stress levels. Being female, a higher age, a higher number of children living in the own household as well as working full-time might hinder an effective implementation of remote teaching in school settings in Germany. Policy-makers and schools should think of strategies to improve the attitude towards and decrease perceived stress from remote teaching. This could include subgroup-specific training on the use of digital media, adapted to the work environment. [ABSTRACT FROM AUTHOR]

Community-acquired pneumonia (CAP) is one of the main reasons of mortality and morbidity in elderly population, causing substantial clinical and economic impacts. However, clinically available score systems have been shown to demonstrate poor prediction of mortality for patients aged over 65. Especially, no existing clinical model can predict morbidity and mortality for CAP patients among different age stages. Here, we aimed to understand the impact of age variable on the establishment of assessment model and explored prognostic factors and new biomarkers in predicting mortality. We retrospectively analyzed elderly patients with CAP in Minhang Hospital, Fudan University. We used univariate and multiple logistic regression analyses to study the prognostic factors of mortality in each age-based subgroup. The prediction accuracy of the prognostic factors was determined by the Receiver Operating Characteristic curves and the area under the curves. Combination models were established using several logistic regressions to save the predicted probabilities. Four factors with independently prognostic significance were shared among all the groups, namely Albumin, BUN, NLR and Pulse, using univariate analysis and multiple logistic regression analysis. Then we built a model with these 4 variables (as ABNP model) to predict the in-hospital mortality in all three groups. The AUC value of the ABNP model were 0.888 (95% CI 0.854–0.917, p < 0.000), 0.912 (95% CI 0.880–0.938, p < 0.000) and 0.872 (95% CI 0.833–0.905, p < 0.000) in group 1, 2 and 3, respectively. We established a predictive model for mortality based on an age variable -specific study of elderly patients with CAP, with higher AUC value than PSI, CURB-65 and qSOFA in predicting mortality in different age groups (66–75/ 76–85/ over 85 years). [ABSTRACT FROM AUTHOR]

Sleep quality is an important indicator of treatment outcome for patients with traffic accident injuries. In Vietnam, the impacts of injury on sleep status are usually amplified in urban areas due to disproportionate distribution of mental care services between the city and less developed settings. Our study investigated deterioration in sleep quality and identified associated demographic factors among traffic injury patients in an small urban setting of Vietnam. A cross-sectional study was conducted among 408 patients in one provincial hospital and five district hospitals in Thai Binh, Vietnam from October to December 2018. A structured questionnaire was designed based on 3 standardized scales: Health-related Quality of Life, the Pittsburgh Sleep Quality Index and the Kessler Scale. Face-to-face interviews and medical records were conducted by trained health professionals on patients hospitalized in the Trauma—Orthopedic/Burn Department and Surgery and General Department. About 16.9% of respondents had sleep disturbances, and there was a statistically significant difference between age group (p < 0.01), education level (p < 0.01), and monthly household income (p < 0.01) between participants who with and without sleep disturbances. Furthermore, more than half (50.7%) of respondents sleep less than 5 h per day, while 18.7% of the sampled also reported that the habitual sleep efficiency was below 85%. Current results indicated that people being female, suffering from traumatic brain injury, being comatose at hospitalization, and having higher psychological distress scores were more likely to suffer from sleep problems. Our study is one of the first evidence in Vietnam to assess sleep disturbances in road traffic injury patients and their correlated factors. It is important to identify patients who are at risk of sleep disturbances based on socio-demographic and clinical characteristics, as well as psychological distress status. Therefore, a holistic approach should be taken to include sleep quality and psychological state in the treatment process and outcome assessment for road traffic injury patients. [ABSTRACT FROM AUTHOR]

Cytomegalovirus (CMV) is known to alter circulating effector memory or re-expressing CD45RA+ (TemRA) T-cell numbers, but whether Epstein–Barr virus (EBV) does the same or this is amplified during a CMV and EBV co-infection is unclear. Immune cell numbers in blood of children and young, middle-aged, and senior adults (n = 336) were determined with flow cytometry, and additional multivariate linear regression, intra-group correlation, and cluster analyses were performed. Compared to non-infected controls, CMV-seropositive individuals from all age groups had more immune cell variance, and CMV+ EBV− senior adults had more late-differentiated CD4+ and CD8+ TemRA and CD4+ effector memory T-cells. EBV-seropositive children and young adults had a more equal immune cell composition than non-infected controls, and CMV− EBV+ senior adults had more intermediate/late-differentiated CD4+ TemRA and effector memory T-cells than non-infected controls. CMV and EBV co-infected young and middle-aged adults with an elevated BMI and anti-CMV antibody levels had a similar immune cell composition as senior adults, and CMV+ EBV+ middle-aged adults had more late-differentiated CD8+ TemRA, effector memory, and HLA-DR+ CD38− T-cells than CMV+ EBV− controls. This study identified changes in T-cell numbers in CMV- or EBV-seropositive individuals and that some CMV and EBV co-infected young and middle-aged adults had an aging-related T-cell phenotype. [ABSTRACT FROM AUTHOR]

Chronic obstructive pulmonary disease (COPD) is a common disease and among the top causes of mortality worldwide but can be prevented and treated. This study aims to estimate the awareness of COPD among the Syrian population. A cross-sectional anonymous self-administered online survey was conducted by using Google Forms on Social Media platforms. The questionnaire included demographic, smoke-related and COPD-related questions. This study included 1607 participants with 930 (57.8%) females, 40% aging 21–25 years old, more than 90% being university students/graduates and 67.8% living in cities. Around half were either active smokers or had second-hand smoke exposure. After excluding participants in health-related fields who were 950 participants, only 25.4% of the remaining had ever heard of the term COPD. Knowing about COPD was not associated with reported smoking habits. No significant differences in awareness were seen between city and countryside dwellers, governate groups, genders, or age groups. Being in a health-related field was a major factor of being aware of COPD. COPD awareness in Syria is low, even amongst the well-educated group. Moreover, COPD risk factors of smoking and exposure to indoor and outdoor pollutants are common. Raising awareness is crucial in the Syrian community as COPD is highly prevalence. [ABSTRACT FROM AUTHOR]

In view of a conspicuous absence of any cross-country study linking obesity and COVID-19 mortality, we conduct an empirical analysis of plausible associations between COVID-19 mortality and the proportion of obese in the adult population distributed across 142 countries around the globe. We observe a statistically significant positive association between COVID-19 mortality and the proportion of obese in adult populations spanning 142 countries. This association holds across countries belonging to different income groups and is not sensitive to a population's median age, proportion of the elderly, and/or proportion of females. The estimated elasticity of COVID-19 mortality, with respect to the proportion of obese in adult populations, is the highest for the sub-sample of countries that belong to the high-income group. While limits of confidence intervals around the point estimates of these elasticities range between 0.7 and 2.1, on an average, every percentage point increment in the proportion of obese in adult populations contributes to an additional 1.5% points to COVID-19 mortality for high income countries. A positive association, observed between COVID-19 mortality and the proportion of the obese in a country's adult population, is robust subject to alterations in the conditioning information set on age, gender, and income. [ABSTRACT FROM AUTHOR]

In low-and-middle-income countries, people develop chronic diseases at a younger age, leading to health-and-economic loss. Estimates of the age of onset of chronic disease provide evidence for policy intervention, but in the Indian context, evidence is limited. The present study aims to explore the onset of seven chronic diseases across adults and the elderly, along with the prognostic factors of chronic disease onset. Using Wave 1 data of the Longitudinal Ageing Study in India (LASI), we estimated the statistical distributions, the median age at onset, and Loglogistic and Weibull accelerated failure time model to understand the onset of seven medically diagnosed self-reported chronic diseases across age groups. We also obtained the sub-distribution hazard ratio (SHR) from the Fine-Gray model to determine the risk of contracting selected chronic diseases in a competing risk setup. The seven chronic diseases– hypertension, diabetes, lung disease, heart disease/stroke, arthritis, neurological disease, and cancer– were developing early, especially in individuals aged 45–54 and 55–64. Arthritis risk was higher in rural areas, and physically active adults and elderly were 1.32 times (95% CI 1.12–1.56) more likely to develop heart disease/stroke. The emerging evidence of the early onset of neurological diseases in middle-aged adults (i.e., among the 45–54 age group) reminds us of the need to reinforce a balance between the physical and mental life of individuals. The early onset of chronic diseases in the independent and working-age category (45–54 years) can have many social and economic implications. For instance, it can create a greater healthcare burden when these individuals grow older with these diseases. Further, disease-specific interventions would be helpful in reducing future chronic disease burden. [ABSTRACT FROM AUTHOR]

The worldwide inequitable access to vaccination claims for a re-assessment of policies that could minimize the COVID-19 burden in low-income countries. Nine months after the launch of the national vaccination program in March 2021, only 3.4% of the Ethiopian population received two doses of COVID-19 vaccine. We used a SARS-CoV-2 transmission model to estimate the level of immunity accrued before the launch of vaccination in the Southwest Shewa Zone (SWSZ) and to evaluate the impact of alternative age priority vaccination targets in a context of limited vaccine supply. The model was informed with available epidemiological evidence and detailed contact data collected across different geographical settings (urban, rural, or remote). We found that, during the first year of the pandemic, the mean proportion of critical cases occurred in SWSZ attributable to infectors under 30 years of age would range between 24.9 and 48.0%, depending on the geographical setting. During the Delta wave, the contribution of this age group in causing critical cases was estimated to increase on average to 66.7–70.6%. Our findings suggest that, when considering the vaccine product available at the time (ChAdOx1 nCoV-19; 65% efficacy against infection after 2 doses), prioritizing the elderly for vaccination remained the best strategy to minimize the disease burden caused by Delta, irrespectively of the number of available doses. Vaccination of all individuals aged ≥ 50 years would have averted 40 (95%PI: 18–60), 90 (95%PI: 61–111), and 62 (95%PI: 21–108) critical cases per 100,000 residents in urban, rural, and remote areas, respectively. Vaccination of all individuals aged ≥ 30 years would have averted an average of 86–152 critical cases per 100,000 individuals, depending on the setting considered. Despite infections among children and young adults likely caused 70% of critical cases during the Delta wave in SWSZ, most vulnerable ages should remain a key priority target for vaccination against COVID-19. [ABSTRACT FROM AUTHOR]

The objective of the study was to determine if using the hypothermia-detecting bracelet (named BEMPU) improves the duration of Kangaroo Mother Care (KMC) at home by one hour. This parallel-group randomized controlled trial was conducted at a step-down nursery of a teaching hospital. Neonates between 1000 and 2000 g were randomized to BEMPU and control groups at the time of discharge. BEMPU was applied at the wrist of each newborn in the BEMPU (intervention) group. Parents were advised to keep the BEMPU in place till 4 weeks post-discharge. The BEMPU generates a beep sound as an alarm when a newborn's temperature drops below 36.5 °C. Parents in both groups were trained to provide KMC at home. Parents in the BEMPU group received the "KMC chart" and "BEMPU beep chart," while the control group received the "KMC chart" only. In the "KMC chart," parents entered information about KMC hours on a real-time basis, and in the "BEMPU beep chart," they entered information about alarm beeps from BEMPU on a real-time basis till 4 weeks post-discharge. Independent samples t-test was used to compare mean KMC hours between the two groups. A total of 128 neonates participated in the study (64 in BEMPU and 64 in Control groups). The mean(SD) gestational age for the BEMPU group was 34.04(2.84) weeks vs 34.75(2.70) weeks for the control group. In BEMPU group, mean(SD) daily time spent doing KMC was significantly higher in 1st week [4.78(2.93) vs. 3.22(2.44) h, p = 0.003], in 2nd week [4.52(3.43) vs. 2.84(2.95) h, p = 0.008], in 3rd week [4.23(3.71) vs. 2.30(2.70) h, p = 0.003], in 4th week [3.72(3.30) vs. 1.95(2.65) h, p = 0.003] as compared to control group. BEMPU improved the daily duration of KMC hours at home compared to the control group over four weeks. Clinical Trial Registration: This trial is registered at Clinical Trials Registry India with registration number: CTRI/2018/08/015154 and accessible at http://ctri.nic.in/Clinicaltrials/pdf%5fgenerate.php?trialid=27600&EncHid=&modid=&compid=%27,%2727600det%27 Registered on 01/08/2018. [ABSTRACT FROM AUTHOR]

The rapid growth of online social media usage in our daily lives has increased the importance of analyzing the dynamics of online social networks. However, the dynamic data of existing online social media platforms are not readily accessible. Hence, there is a necessity to synthesize networks emulating those of online social media for further study. In this work, we propose an epidemiology-inspired and community-based, time-evolving online social network generation algorithm (EpiCNet), to generate a time-evolving sequence of random networks that closely mirror the characteristics of real-world online social networks. Variants of the algorithm can produce both undirected and directed networks to accommodate different user interaction paradigms. EpiCNet utilizes compartmental models inspired by mathematical epidemiology to simulate the flow of individuals into and out of the online social network. It also employs an overlapping community structure to enable more realistic connections between individuals in the network. Furthermore, EpiCNet evolves the community structure and connections in the simulated online social network as a function of time and with an emphasis on the behavior of individuals. EpiCNet is capable of simulating a variety of online social networks by adjusting a set of tunable parameters that specify the individual behavior and the evolution of communities over time. The experimental results show that the network properties of the synthetic time-evolving online social network generated by EpiCNet, such as clustering coefficient, node degree, and diameter, match those of typical real-world online social networks such as Facebook and Twitter. [ABSTRACT FROM AUTHOR]

Trauma-induced coagulopathy (TIC) is a risk factor for death and is associated with deviations in thrombin generation. TIC prevalence and thrombin levels increase with age. We assayed in vivo and ex vivo thrombin generation in injured patients (n = 418) to specifically investigate how age impacts thrombin generation in trauma and to address the prognostic ability of thrombin generation. Biomarkers of thrombin generation were elevated in young (< 40 years) and older (≥ 40 years) trauma patients. In vivo thrombin generation was associated with Injury Severity Score (ISS) and this association was stronger in young than older patients. In vivo thrombin generation decreased faster after trauma in the young than the older patients. Across age groups, in vivo thrombin generation separated patients dying/surviving within 30 days at a level comparable to the ISS score (AUC 0.80 vs. 0.82, p > 0.76). In vivo and ex vivo thrombin generation also predicted development of thromboembolic events within the first 30 days after the trauma (AUC 0.70–0.84). In conclusion, younger trauma patients mount a stronger and more dynamic in vivo thrombin response than older patients. Across age groups, in vivo thrombin generation has a strong ability to predict death and/or thromboembolic events 30 days after injury. [ABSTRACT FROM AUTHOR]

Investigating secular trends of ocular cancer registration in Iran. After acquiring Iranian national population-based cancer registry data, trends of age-standardised incidence rates (ASIR) of ocular cancers and annual percent changes (APC) between 2004 and 2016 were analysed in age groups, gender, topography and morphology types with joinpoint regression analysis. Age, period, and cohort effects on incidence rates were estimated by age–period–cohort model. Geographic distribution of ASIR was assessed using GIS. Overall ASIR of ocular cancers was 16.04/100,000 (95% CI 15.77–16.32). Joinpoint regression analysis showed a significant increase of ASIR between 2004 and 2009 for males (APC = 5.5, 95% CI 0.9–10.2), ages over 50 years (APC = 5.2, 1.2–9.4), skin/canthus/adnexal cancers (APC = 4.2, 0.8–7.7), and carcinomas/adenocarcinomas (APC = 4.3, 0.6–8.1); however, between 2009 and 2016 a declining trend was observed in all investigated variables. ASIR of retinoblastoma was significantly increased (averaged APC = 20.7, 9–33.7) between 2004 and 2016. age–period–cohort analyses showed that incidence rates of ocular cancers significantly increased with aging, time periods, and birth cohort effects (p < 0.001). ASIR varied from 6.7/100,000 to 21.7/100,000 in Iran. Excepting retinoblastoma, all ocular cancer incidence trends were downward over a 13-year period; however, it was increasing between 2004 and 2009 cancer. ASIR was significant aging in Iran. [ABSTRACT FROM AUTHOR]

In many low-mortality countries, life expectancy at birth increased steadily over the last century. In particular, both Italian females and males benefited from faster improvements in mortality compared to other high-income countries, especially from the 1960s, leading to an exceptional increase in life expectancy. However, Italy has not become the leader in longevity. Here, we investigate life expectancy trends in Italy during the period 1960–2015 for both sexes. Additionally, we contribute to the existing literature by complementing life expectancy with an indicator of dispersion in ages at death, also known as lifespan inequality. Lifespan inequality underlies heterogeneity over age in populating health improvements and is a marker of uncertainty in the timing of death. We further quantify the contributions of different age groups and causes of death to recent trends in life expectancy and lifespan inequality. Our findings highlight the contributions of cardiovascular diseases and neoplasms to the recent increase in life expectancy but not necessarily to the decrease in lifespan inequality. Our results also uncover a more recent challenge across Italy: worsening mortality from infectious diseases and mortality at older age. [ABSTRACT FROM AUTHOR]