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Chelating gels may initially assist in root canal preparations to help establish a glide path. While irrigation surveys have investigated liquid chelators and gels to a minor extent, no endodontic survey has focused on EDTA gels and why clinicians use them. All 395 members of the Australian Society of Endodontology (ASE) were emailed an 11-question survey concerning chelation gel usage via Qualtrics. Paper copies were also distributed at ASE events. Descriptive statistics were performed for practitioner and chelating gel data. Cross-tabulations of the practitioner type with the case percentage usage of gels were analyzed with the chi square test (adjusted p value < 0.0083). The overall response rate was 181/395 (46%). For 174 eligible responses, those who never/rarely used a gel were as follows: endodontic residents 12/14 (86%), endodontists 53/71 (75%), general dentists 39/86 (45%), and other members 0% (0/3). Most gel users said that gels helped establish a glide path. Those who never/rarely used chelating gels commented that they held no benefits over liquid EDTA. Endodontists were less likely to use a chelation gel than general dentists (p < 0.0083). Older clinicians had higher gel usage than younger ASE members (p < 0.0083), indicating a possible trend to diminished gel usage over time amongst ASE members. In conclusion, most ASE members find no need for a chelating gel, raising questions about their clinical effectiveness. Studies would therefore be warranted to investigate gel efficacy and improved clinical outcomes. [ABSTRACT FROM AUTHOR]

Recently, there is a new stream of mortality forecasting research using the vector autoregressive model with different sparse model specifications. They have been shown to be able to overcome some of the limitations of the more traditional factor models such as the Lee–Carter model. In this paper, we propose a more generalized systematic vector autoregressive framework for modeling and forecasting mortality. Under this framework, we progressively increase the sophistication of the diagonal parameters in the autoregressive matrix and formulate a range of model structures in a systematic fashion. They offer much flexibility for capturing the mortality patterns of different populations. The resulting models produce age coherent forecasts, and their parameters are reasonably interpretable for modelers, demographers, and industry practitioners. Using the mortality data of Australia, Japan, New Zealand, and Taiwan, we demonstrate that the proposed approach generates appropriate forecasts of mortality rates and life expectancies and produces very good performance in the fitting and out‐of‐sample analysis. [ABSTRACT FROM AUTHOR]

Background: Empirical evidence from European countries has shown that economic conditions in early life are associated with mortality risk. This study aims to assess the effects of economic conditions in early life, as well as their interaction with parental education, on the risk of adult mortality in the U.S. Methods: To capture exogenous variation of economic conditions early in life, we use the Gross Domestic Product (GDP) cyclical deviation during a respondent's birth year. Using the linked U.S. General Social Survey and National Death Index data (1979–2008), we employed parametric frailty survival models to examine the effects of economic conditions in early life on all-cause and cause-specific mortality. Results: We found that exposure to recession in the first year of life was associated with increased all-cause mortality only among women (hazard ratio = 1.54, 95% CI 1.03–2.31). This adverse effect was also found in women's mortality from cancers (hazard ratio = 2.24, 95% CI 1.18–4.28). We also found a significant interaction between economic conditions in infancy and paternal education on women's mortality risk—higher paternal education was protective against mortality under good economic conditions in infancy; however, higher paternal education was associated with greater mortality risk under poor economic conditions in infancy. We discuss how aspiration theory may explain these results. Conclusion: Our study concludes that worse macroeconomic conditions early in life heighten the risk of mortality among women, and paternal education moderates this relationship. [ABSTRACT FROM AUTHOR]

Objective: To elucidate the historical trends, underlying causes and future projections of esophageal cancer incidence in Hong Kong. Methods: Utilizing the Age-Period-Cohort (APC) model, we analyzed data from the Hong Kong Cancer Registry (1992-2021) and United Nations World Population Prospects 2022 Revision. Age-standardized incidence rates were computed, and APC models evaluated age, period, and cohort effects. Bayesian APC modeling, coupled with decomposition analysis, projected future trends and identified factors influencing incidence. Results: Between 1992 and 2021, both crude and age-standardized incidence rates of esophageal cancer witnessed significant declines. Net drifts exhibited pronounced downward trends for both sexes, with local drift diminishing across all age groups. Period and cohort rate ratios displayed a consistent monotonic decline for both sexes. Projections indicate a continued decline in esophageal cancer incidence. Population decomposition analysis revealed that epidemiological changes offset the increase in esophageal cancer cases due to population growth and aging. Conclusion: The declining trend of esophageal cancer in Hong Kong is influenced by a combination of age, period, and cohort. Sustaining and enhancing these positive trends requires continuous efforts in public health interventions. [ABSTRACT FROM AUTHOR]

Background Incidence of early-onset colorectal cancer (CRC) has increased globally in recent decades. We examined early-onset CRC incidence trends worldwide for potential cohort effects, defined as changes associated with time of birth (eg, early-life exposure to carcinogens), and period effects, defined as changes associated with calendar periods (eg, screening programs). Methods We obtained long-term incidence data for early-onset CRC diagnosed in patients aged 20 to 49 years through the year 2012 for 35 countries in the Cancer Incidence in Five Continents database. We used a smoothing method to help compare cohort and period trends of early-onset CRC and used an age-period-cohort model to estimate cohort and period effects. Results Cohort effects had a more dominant role than period effects in the early-onset CRC incidence in Shanghai (China), the United Kingdom, Australia, New Zealand, Canada, the United States, and Osaka (Japan). The smoothed trends show the specific birth cohorts when early-onset CRC began to increase: the 1940s-1950s birth cohorts in the United States; the 1950s-1960s birth cohorts in other Western countries; the 1960s birth cohorts in Osaka; and the 1970s-1980s birth cohorts in Shanghai. Such increases occurred earlier for early-onset cancers of the rectum than of the colon. For the other countries, the results were less clear. Conclusions Recent birth cohorts may have been exposed to risk factors different from earlier cohorts, contributing to increased early-onset CRC incidence in several developed countries or regions in the West and Asia. Such increases began in earlier birth cohorts in Western countries than in developed regions of Asia. [ABSTRACT FROM AUTHOR]

Chelating gels may initially assist in root canal preparations to help establish a glide path. While irrigation surveys have investigated liquid chelators and gels to a minor extent, no endodontic survey has focused on EDTA gels and why clinicians use them. All 395 members of the Australian Society of Endodontology (ASE) were emailed an 11-question survey concerning chelation gel usage via Qualtrics. Paper copies were also distributed at ASE events. Descriptive statistics were performed for practitioner and chelating gel data. Cross-tabulations of the practitioner type with the case percentage usage of gels were analyzed with the chi square test (adjusted p value < 0.0083). The overall response rate was 181/395 (46%). For 174 eligible responses, those who never/rarely used a gel were as follows: endodontic residents 12/14 (86%), endodontists 53/71 (75%), general dentists 39/86 (45%), and other members 0% (0/3). Most gel users said that gels helped establish a glide path. Those who never/rarely used chelating gels commented that they held no benefits over liquid EDTA. Endodontists were less likely to use a chelation gel than general dentists (p < 0.0083). Older clinicians had higher gel usage than younger ASE members (p < 0.0083), indicating a possible trend to diminished gel usage over time amongst ASE members. In conclusion, most ASE members find no need for a chelating gel, raising questions about their clinical effectiveness. Studies would therefore be warranted to investigate gel efficacy and improved clinical outcomes.

We aimed to investigate the developmental trajectories of the sense of community in South Korean children over time and explore potential variations in these changes among different cohort groups. For these purposes, we using latent growth curve modeling and performed multigroup analysis involving two separate cohorts (elementary 4th cohort, N = 2,092, female 47.4%, age 13–16; middle 1st cohort, N = 2,350, female 50.0%, age 13–16). The results showed that the recent generation demonstrated a stronger sense of community compared to the past generation. The differences between cohorts can be explained to several factors, such as South Korea's focus on public education, which promotes community unity, and the gradual diminishing of regional constraints associated with the notion of communities in the country. Gender, self-esteem, smartphone dependency, life satisfaction, parental affection and interference, income, social relationships, and various activities were found to be associated with the trajectory of sense of community changes. Based on these results, we discussed the implications. [ABSTRACT FROM AUTHOR]

Based on longitudinal data from four waves (2011, 2013, 2015, and 2018) of the China Health and Retirement Longitudinal Study, we examined savings and savings changes among older couples in China using hierarchical linear models, explored any cohort differences, and analyzed the effects of the accessibility of the employee pension and the number of children on parents' savings. The results indicate that the savings of older couples continued to increase in old age, but the growth slowed down with age. For the cohort born before 1940, savings declined in later years. The cohorts born after 1940 had higher savings, but their savings grew less in later years. Older adults with access to the employee pension saved more and faster. Older adults with more than two children had lower savings, while those from younger cohorts were less impacted. [ABSTRACT FROM AUTHOR]

In this paper, we propose a neural network (NN) architecture of mortality improvement model with cohort effect. We then extend the mortality improvement NN model to consider autoregressive effects, which allows mortality improvement to depend on the lagged mortality rates. The advantage of our NN model setup is that the parameters of period and cohort effects are implicitly estimated by the NN models, and hence, the mortality projection can be obtained without taking the extra steps of selecting and estimating the suitable time-series model for period and cohort effects. Our empirical results suggests that, based on 48 populations in the Human Mortality Database with complete sets of observations from 1950 with the age span of 55–90, the NN models with cohort and autoregressive effects improve the forecast accuracy of mortality rate projections and provide better prediction performance. [ABSTRACT FROM AUTHOR]

The purpose was to analyze age-standardized trends in diabetes mortality rates (DMR) from 1998 to 2022, stratified by sex and Mexican state, and the effects attributable to age, period, and cohort by sex. Joinpoint regression and age-period-cohort effect analysis. Based on the tenth revision of the International Classification of Diseases, E11, E12, E13, and E14 codes of the death certificate, a daily record of mortality was extracted from the death certificate attributable to diabetes as the main cause. From 1998 to 2022, sexes and ages (≥20 years) were used to calculate the crude mortality rates and standardized at the national and Mexican state levels. Additionally, the age-period-cohort model was used to examine age, period, and cohort effects. From 1998 to 2005, the age-adjusted DMR increased by 3.6% (95% confidence interval [CI]: 2.7, 4.5) for the total population, as shown by the joinpoint regression analysis at a national level; from 2017 to 2020, it increased by 7.4% (95% CI: 0.6, 14.8). The DMR with the highest increase during the study period came mainly from states in the country's southeastern region, 2.3% to 3.7% per year. The net age and period effects showed that mortality increased with advancing age and with going time, respectively; and the net cohort effect revealed that mortality increased in more recent birth cohorts, mainly in men Rate Ratio (RR) = 2.37 (95% CI: 2.29, 2.46) vs RR = 1.13 (95% CI: 1.09, 1.17). The DMR increased among older age groups. The period effect showed that mortality increased over time. Furthermore, the cohort effect showed that mortality increased in more recent birth cohorts, especially among men. [ABSTRACT FROM AUTHOR]

We examined in NORDCAN database how the annual age group-specific incidence rates (IR) of gastric cancer (GCA), and correspondingly the GCA risk, have declined in Finland during the twentieth century, and whether this decline corresponds to a decrease in the cohort-specific prevalence rate of Helicobacter pylori (Hp) gastritis that is considered an important precancerous risk condition for GCA. In modelling with partial least squares regression (PLSR), the logarithmically transformed IRs (ln(IR) of GCA were well explained with age and birth cohort as explanatory model variables. By considering the observed (actual) and the PLSR-modelled IRs, the IR of GCA (and the risk of GCA) has decreased gradually in Finland from 1900 onward, cohort by cohort. By prediction of the future with PLSR, the IRs of GCA will be markedly lower in all cohorts during the twenty-first century than in the twentieth century. By PLSR modelling, less than 10 GCA cases per 100,000 people are predicted to appear annually in cohorts (generations) born at the turn of the 20th and 21st centuries, even when these people will be 60–80 years old in the years 2060–2070. The IR of GCA and GCA risk progressively declined by cohort in Finland during the whole twentieth century. This decline corresponds in extent and time window to earlier observations in the decline of the prevalence rate of Hp gastritis in the same birth cohorts and supports the hypothesis of the role of Hp gastritis as an important risk condition of GCA. [ABSTRACT FROM AUTHOR]

Abstract Objectives This study examined the generational-gender distinctions in Diagnostic Criteria for Temporomandibular disorders (DC/TMD) subtypes among East Asian patients. Methods Consecutive “first-visit” TMD patients presenting at two university-based TMD/orofacial pain clinics in China and South Korea were enlisted. Demographic information along with symptom history was gathered and clinical examinations were performed according to the DC/TMD methodology. Axis I physical diagnoses were rendered with the DC/TMD algorithms and categorized into painful and non-painful TMDs. Patients were categorized into three birth cohorts, specifically Gen X, Y, and Z (born 1965–1980, 1981–1999, and 2000–2012 respectively) and the two genders. Data were evaluated using Chi-square/Kruskal-Wallis plus post-hoc tests and logistic regression analyses (α = 0.05). Results Gen X, Y, and Z formed 17.2%, 62.1%, and 20.7% of the 1717 eligible patients examined (mean age 29.7 ± 10.6 years; 75.7% women). Significant differences in prevalences of arthralgia, myalgia, headache (Gen X ≥ Y > Z), and disc displacements (Gen Z > Y > X) were observed among the three generations. Gen Z had substantially fewer pain-related and more intra-articular conditions than the other generations. Women presented a significantly greater frequency of degenerative joint disease and number of intra-articular conditions than men. After controlling for generation-gender interactions, multivariate analyses showed that “being Gen X” and female increased the risk of painful TMDs (OR = 2.20) and reduced the odds of non-painful TMDs (OR = 0.46). Conclusions Generational-gender diversities in DC/TMD subtypes exist and are important for guiding TMD care and future research endeavors.

Abstract Background Liver cancer remains a significant burden in Hong Kong. We sought to examine trends in liver cancer incidence using 30 years of cancer registry data in Hong Kong. Additionally, we aimed to assess the impact of age, period and birth cohort on liver cancer incidence, provided projections for liver cancer incidence until 2030, and examined the drivers of liver cancer incidence. Methods Data on liver cancer incidence were collected from the Hong Kong Cancer Registry (HKCaR). We assessed age, period, and birth cohort effects using age-period-cohort (APC) models. We employed Bayesian APC analysis with integrated nested Laplace approximations to project the future burden of liver cancer in Hong Kong. Furthermore, we attributed the changes in new liver cancer cases to population growth, population ageing, and epidemiological changes. Results The study included a total of 51,333 individuals, of whom 39,287 (76.53%) were male. From 1991 to 2020, the age-standardized liver cancer incidence rate in Hong Kong continued declining, while the number of new cases increased significantly, especially among males. The net drift, representing the overall annual percentage change of the age-adjusted rate, was − 3.06% (95% confidence interval [CI]: -3.31% to -2.80%) for males and − 3.85% (95% CI: -4.61% to -3.09%) for females. Local drift, which estimates the annual percentage change over time specific to age group, decreased in all age groups for both sexes, with a more pronounced decrease in younger age groups. The period and cohort risk of developing liver cancer also showed decreasing trends for both sexes. The study projected a decline in liver cancer cases for males but an increase for females in Hong Kong, with an estimated 1,083 cases in males and 710 cases in females by 2030. Demographic decomposition analysis revealed that while population growth and ageing were the main drivers of increased liver cancer cases, epidemiologic shifts mostly offset these factors. Conclusion The period and cohort risk of developing liver cancer in Hong Kong declined due to epidemiological changes. Although the age-standardized incidence rates of liver cancer have also declined, demographic and epidemiological factors have led to lower case expectations in males but a likely increase in females. Further research and epidemiological assessment of the disease are needed.

Abstract Background This study aims to evaluate the relationship between age, period, and birth cohort with the incidence trends of Nasopharyngeal Carcinoma (NPC) in Hong Kong, make projections through 2030 and parse the drivers of the incidence. Methods Using data from the Hong Kong Cancer Registry, we used an age-period-cohort model to uniquely estimate age, period, and cohort effects on NPC incidence trends and make projections. We further assessed the drivers of NPC incidence using a validated decomposition algorithm. Results From 1991 to 2020, crude and age-standardized incidence rates of NPC decreased significantly. The net drifts showed significant downward trends for both sexes, and local drift declined in all age groups. Period and cohort rate ratios revealed monotonic declining patterns for both sexes. Projections suggested that NPC incidence will continue to decline. Population decomposition showed that while population growth and ageing have led to an increase in NPC cases, epidemiologic changes offset these increases, resulting in an encouraging downward trend in the incidence and new NPC cases in Hong Kong. Conclusions The period and cohort risk of NPC in Hong Kong decreased, and epidemiologic changes offset the contribution of demographic factors, resulting in a continued decline in NPC incidence and cases.

Abstract Objective Estimate the effects of age, period, and birth cohort on suicide mortality in Brazil by major geographic region in the overall population and by sex. Methods This was a time trend ecological study. National and regional suicide mortality data from 1981 to 2020 were analyzed for the overall population and by sex. Age, period, and cohort effects were calculated with a Poisson regression model using estimable functions with the Epi package of the R statistical program, version 4.2.1. Results There were 272,716 suicides in individuals ranging from 20 to 79 years old. In the overall population, the age model-adjusted suicide mortality rates showed an upward pattern for Brazil. The most recent cohort showed the highest associated risk, 1.67 (95%CI 1.63; 1.71), while for the reference period, it was the highest risk among all the periods. Conclusions Suicide mortality rates have shown an upward trend with advancing age in both men and women in the Brazilian population. However, the behavior of the period effect and cohort depends on the population analyzed and regional distribution.

Abstract Background Literature concerning Temporomandibular disorders (TMDs) and the Covid-19 pandemic is limited and disparate findings related to TMD frequencies, psychological distress, and quality of life were presented. This study investigated the prevalence of painful Temporomandibular disorders (TMDs) and compared the psychological, sleep, and oral health-related quality of life profiles of patients seeking TMD care before and during the Covid-19 pandemic. Methods Data were accrued from consecutive adult patients 12 months before (BC; control) and during (DC; case group) the Covid-19 pandemic. The Diagnostic Criteria for TMDs (DC/TMD), Depression, Anxiety, Stress Scales (DASS)-21, Pittsburgh Sleep Quality Index (PSQI), and Oral Health Impact Profile (OHIP)-TMDs were utilized and statistical analysis was performed using Chi-square/non-parametric tests (α = 0.05). Results The prevalence of painful TMDs was 50.8% before and 46.3% during the pandemic. Significant differences in PSQI and OHIP component scores were discerned between the BC and DC groups contingent on TMD pain. Total-DASS was moderately correlated to total-PSQI/OHIP (r s = 0.41–0.63). Conclusion The covid-19 pandemic did not appear to exacerbate psychological distress but affected sleep and increased unease over TMD dysfunction.

Under the background of population aging, the rational use of resources for senior care services has more difficulty, leading to increasingly prominent conflicts between supply and demand. This paper uses the Gini coefficient, cohort effect, and other methods to build a matching supply and demand model for innovative senior care services based on the multi-source data of senior care services. The probabilistic linguistic term set is used for evaluation and a calculation method is proposed to match satisfaction. The model’s feasibility is demonstrated by analyzing arithmetic examples. Five types of senior care demand groups can be obtained through clustering analysis, with three kinds of intelligent senior care, namely, competent institutions, smart communities, and smart homes, in which the Gini coefficient value of community senior care facilities in X city is 0.4203, and there is an imbalance between supply and demand. The method proposed in this paper identifies five types of elderly groups, which can be matched with different innovative senior care services for elderly groups with distinct characteristics.

Objectives: This study examined the generational-gender distinctions in Diagnostic Criteria for Temporomandibular disorders (DC/TMD) subtypes among East Asian patients. Methods: Consecutive "first-visit" TMD patients presenting at two university-based TMD/orofacial pain clinics in China and South Korea were enlisted. Demographic information along with symptom history was gathered and clinical examinations were performed according to the DC/TMD methodology. Axis I physical diagnoses were rendered with the DC/TMD algorithms and categorized into painful and non-painful TMDs. Patients were categorized into three birth cohorts, specifically Gen X, Y, and Z (born 1965–1980, 1981–1999, and 2000–2012 respectively) and the two genders. Data were evaluated using Chi-square/Kruskal-Wallis plus post-hoc tests and logistic regression analyses (α = 0.05). Results: Gen X, Y, and Z formed 17.2%, 62.1%, and 20.7% of the 1717 eligible patients examined (mean age 29.7 ± 10.6 years; 75.7% women). Significant differences in prevalences of arthralgia, myalgia, headache (Gen X ≥ Y > Z), and disc displacements (Gen Z > Y > X) were observed among the three generations. Gen Z had substantially fewer pain-related and more intra-articular conditions than the other generations. Women presented a significantly greater frequency of degenerative joint disease and number of intra-articular conditions than men. After controlling for generation-gender interactions, multivariate analyses showed that "being Gen X" and female increased the risk of painful TMDs (OR = 2.20) and reduced the odds of non-painful TMDs (OR = 0.46). Conclusions: Generational-gender diversities in DC/TMD subtypes exist and are important for guiding TMD care and future research endeavors. [ABSTRACT FROM AUTHOR]

Background: Liver cancer remains a significant burden in Hong Kong. We sought to examine trends in liver cancer incidence using 30 years of cancer registry data in Hong Kong. Additionally, we aimed to assess the impact of age, period and birth cohort on liver cancer incidence, provided projections for liver cancer incidence until 2030, and examined the drivers of liver cancer incidence. Methods: Data on liver cancer incidence were collected from the Hong Kong Cancer Registry (HKCaR). We assessed age, period, and birth cohort effects using age-period-cohort (APC) models. We employed Bayesian APC analysis with integrated nested Laplace approximations to project the future burden of liver cancer in Hong Kong. Furthermore, we attributed the changes in new liver cancer cases to population growth, population ageing, and epidemiological changes. Results: The study included a total of 51,333 individuals, of whom 39,287 (76.53%) were male. From 1991 to 2020, the age-standardized liver cancer incidence rate in Hong Kong continued declining, while the number of new cases increased significantly, especially among males. The net drift, representing the overall annual percentage change of the age-adjusted rate, was − 3.06% (95% confidence interval [CI]: -3.31% to -2.80%) for males and − 3.85% (95% CI: -4.61% to -3.09%) for females. Local drift, which estimates the annual percentage change over time specific to age group, decreased in all age groups for both sexes, with a more pronounced decrease in younger age groups. The period and cohort risk of developing liver cancer also showed decreasing trends for both sexes. The study projected a decline in liver cancer cases for males but an increase for females in Hong Kong, with an estimated 1,083 cases in males and 710 cases in females by 2030. Demographic decomposition analysis revealed that while population growth and ageing were the main drivers of increased liver cancer cases, epidemiologic shifts mostly offset these factors. Conclusion: The period and cohort risk of developing liver cancer in Hong Kong declined due to epidemiological changes. Although the age-standardized incidence rates of liver cancer have also declined, demographic and epidemiological factors have led to lower case expectations in males but a likely increase in females. Further research and epidemiological assessment of the disease are needed. [ABSTRACT FROM AUTHOR]

How does psychological distress evolve over time? This study utilizes cross-sectional data from the China General Social Survey from 2010 to 2017 to explore the differences in psychological distress among Chinese residents at various ages, periods, and cohorts. The dummy variable method and random effects hierarchical age-period-cohort model were employed to isolate the age, period, and cohort effects that impacted the psychological distress of Chinese urban residents. First, in terms of the age effect, the psychological distress experienced by residents tends to increase initially and then decrease with age. Middle-aged individuals, around 40 years old, often face a particularly severe form of psychological distress known as the "midlife crisis." Additionally, middle-aged people who have larger families may experience more significant psychological distress due to increased family burdens. Second, in terms of the period effect, the psychological distress experienced by residents has been on the rise due to the continued development of society. Those who are at a disadvantage in market competition and work longer hours may be particularly vulnerable to increased psychological distress. Thirdly, the cohort effect refers to the different social behaviors and attitudes exhibited by individuals of different generations. In terms of this effect, psychological distress initially decreased and then increased among those born between 1945 and 1990. Individuals born in the 1980s and 1990s experienced higher levels of psychological distress, with internet use having a greater negative impact. Additionally, the positive effect of income on their psychological distress was reduced. The psychological distress of Chinese urban residents is affected by a variety of time-related factors, which are closely related to Chinese clan culture, market competition and social changes. The heavy family burden imposed by traditional clan culture, the different working conditions created by market competition, and the emergence of new lifestyles, such as internet use during social changes, have led to diverse psychological distress experiences among residents across different ages, time periods, and cohorts. In the future, longitudinal studies are needed to strengthen the robustness of the conclusions and consider the long-term impact of the COVID-19 pandemic. Mental health support should pay specific attention to the psychological distress of middle-aged individuals, long-time workers, and internet users. [ABSTRACT FROM AUTHOR]

Background: This study aims to evaluate the relationship between age, period, and birth cohort with the incidence trends of Nasopharyngeal Carcinoma (NPC) in Hong Kong, make projections through 2030 and parse the drivers of the incidence. Methods: Using data from the Hong Kong Cancer Registry, we used an age-period-cohort model to uniquely estimate age, period, and cohort effects on NPC incidence trends and make projections. We further assessed the drivers of NPC incidence using a validated decomposition algorithm. Results: From 1991 to 2020, crude and age-standardized incidence rates of NPC decreased significantly. The net drifts showed significant downward trends for both sexes, and local drift declined in all age groups. Period and cohort rate ratios revealed monotonic declining patterns for both sexes. Projections suggested that NPC incidence will continue to decline. Population decomposition showed that while population growth and ageing have led to an increase in NPC cases, epidemiologic changes offset these increases, resulting in an encouraging downward trend in the incidence and new NPC cases in Hong Kong. Conclusions: The period and cohort risk of NPC in Hong Kong decreased, and epidemiologic changes offset the contribution of demographic factors, resulting in a continued decline in NPC incidence and cases. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the long-term trends of incident end-stage kidney disease (ESKD) requiring renal replacement therapy (RRT) in Japan using age-period-cohort analysis and evaluated birth cohort effects for incident ESKD requiring RRT. Methods: The number of incident RRT patients aged between 20 and 84 years by sex from 1982 to 2021 was extracted from the Japanese Society of Dialysis Therapy registry data. Annual incidence rates of RRT were calculated using census population as denominators, and changes in the incidence rates were evaluated using an age-period-cohort model. The age and survey year period categories generated 20 birth cohorts with 5-year intervals (from 1902–1907 to 1997–2001). Results: The incidence rates of RRT in both sexes initially rose in the birth cohorts born in the early 1900s, and then decelerated and peaked during 1940–1960s in men and 1930–1940s in women, following a steady decline in both sexes. Compared with the reference 1947–1951 birth cohort, the highest cohort rate ratio was 1.14 (95% CI, 1.04–1.25) in the 1967–1971 birth cohort in men and 1.04 (95% CI, 0.98–1.10) in the 1937–1941 birth cohort in women. Conclusions: Significant cohort effects were identified in both sexes, but the peak of RRT was different for each sex. Our findings suggest that men born between 1940 and 1960s and women born between 1930 and 40 s may be important target populations to consider when decreasing incidence rates of RRT among the general Japanese population. [ABSTRACT FROM AUTHOR]

BACKGROUND:Variation in the relationship between education and health has been studied intensely over the past few decades. Although there is research on gender disparity and cohort variations in educational effect on health using samples from the U.S. and Europe, research about China's is limited. Given the specific social changes in China, our study is designed to analyze the gender and cohort patterns in the education-health gradient. METHOD:The latent growth-curve modeling was used to analyze the gender and cohort variations in the education gradient in self-rated health among Chinese respondents. The study employed longitudinal and nationally representative data from the Chinese Family Panel Studies from the years 2010 to 2016. Each cohort is specified according to their distinct periods of social change in China. Following the analysis, we used latent growth-curve model to illustrate gender and cohort differences in the age-graded education and health trajectories. RESULTS:Although Chinese men have reported to have better health than women in general, women reported 1.6 percentage points higher in self-reported health for each additional year of schooling compared to that of men (P

Objective: Estimate the effects of age, period, and birth cohort on suicide mortality in Brazil by major geographic region in the overall population and by sex. Methods: This was a time trend ecological study. National and regional suicide mortality data from 1981 to 2020 were analyzed for the overall population and by sex. Age, period, and cohort effects were calculated with a Poisson regression model using estimable functions with the Epi package of the R statistical program, version 4.2.1. Results: There were 272,716 suicides in individuals ranging from 20 to 79 years old. In the overall population, the age model-adjusted suicide mortality rates showed an upward pattern for Brazil. The most recent cohort showed the highest associated risk, 1.67 (95%CI 1.63; 1.71), while for the reference period, it was the highest risk among all the periods. Conclusions: Suicide mortality rates have shown an upward trend with advancing age in both men and women in the Brazilian population. However, the behavior of the period effect and cohort depends on the population analyzed and regional distribution. [ABSTRACT FROM AUTHOR]

Introduction: This study analyzed the incidence of ovarian cancer in Hong Kong and its association with age, calendar period and birth cohort, made projections through 2030, and attributed differences in new cancer cases to demographic and epidemiologic changes. Material and methods: Incidence data for ovarian cancer were obtained from the Hong Kong Cancer Registry. We employed the age‐period‐cohort modeling approach to investigate the association between ovarian cancer incidence and age in Hong Kong women, with particular emphasis on examining the changing trends of period and cohort effects on incidence. We projected the incidence of ovarian cancer in Hong Kong between 2018 and 2030 and attributed the rise in new cancer cases to epidemiologic and demographic shifts. Results: Between 1990 and 2017, a total of 11 182 women were diagnosed with ovarian cancer in Hong Kong. Crude and age‐standardized rates increased from 8.2 and 7.8 per 100 000 person‐years to 16.3 and 11.5 per 100 000 person‐years, respectively. New cases of ovarian cancer rose from 225 in 1990 to 645 in 2017. We observed an increased risk of ovarian cancer throughout the study period and in the post‐1940 birth cohort. The projected incidence rate and new cases of ovarian cancer are expected to continue growing due to demographic and epidemiologic changes such as fertility patterns and lifestyle factors, with an estimated 981 cases in 2030. Conclusions: The period risk and cohort risk of ovarian cancer among Hong Kong women is increasing. Demographic and epidemiologic changes may continue to increase ovarian cancer incidence and new cases in Hong Kong. [ABSTRACT FROM AUTHOR]

Background: Literature concerning Temporomandibular disorders (TMDs) and the Covid-19 pandemic is limited and disparate findings related to TMD frequencies, psychological distress, and quality of life were presented. This study investigated the prevalence of painful Temporomandibular disorders (TMDs) and compared the psychological, sleep, and oral health-related quality of life profiles of patients seeking TMD care before and during the Covid-19 pandemic. Methods: Data were accrued from consecutive adult patients 12 months before (BC; control) and during (DC; case group) the Covid-19 pandemic. The Diagnostic Criteria for TMDs (DC/TMD), Depression, Anxiety, Stress Scales (DASS)-21, Pittsburgh Sleep Quality Index (PSQI), and Oral Health Impact Profile (OHIP)-TMDs were utilized and statistical analysis was performed using Chi-square/non-parametric tests (α = 0.05). Results: The prevalence of painful TMDs was 50.8% before and 46.3% during the pandemic. Significant differences in PSQI and OHIP component scores were discerned between the BC and DC groups contingent on TMD pain. Total-DASS was moderately correlated to total-PSQI/OHIP (rs = 0.41–0.63). Conclusion: The covid-19 pandemic did not appear to exacerbate psychological distress but affected sleep and increased unease over TMD dysfunction. [ABSTRACT FROM AUTHOR]

Cohort effect refers to the social phenomenon that a certain event manifests differently depending on a group that is born in the same year or a similar time period. It is important to understand adolescents' depressive symptoms vary from generation to generation. We studied the changes of the depressive symptoms during the eighth to tenth grade and examined the difference between the 1997-birth cohort and 2000-birth cohort. The study included 2,070 students (2014–2016 of 2000-birth-cohort data, from 8th to 10th grade, mean age = 12.95–14.95 years) and 2,278 students (2011–2013 of 1997-birth-cohort data, from 8th to 10th grade, mean age = 12.90–14.90 years) who participated in the Korean Children and Youth Panel Survey. Latent growth curve modeling and multi-group analysis were used to compare depressive symptom trajectories between cohorts. The result of comparing the depression levels of the cohorts showed the initial values and change rates verifying the presence of a significant cohort effect—the depression level of the 2000-birth-cohort (initial value = 17.75) was significantly lower than the depression level of the 1997-birth-cohort (initial value = 19.49). This study has significance in that adolescents' depression has both age and cohort effects. It is speculated that the cohort effect may have been impacted by two major events: The Children Problem-Behavior Screening Questionare Test (mental health screening test), implemented nationwide in 2012, and the Sewol Ferry Disaster, which occurred in 2014. Based on the results, suggestions for future research were discussed. [ABSTRACT FROM AUTHOR]

The gut microbiota and associated metabolites have emerged as potential modulators of pathophysiological changes in obesity and related metabolic disorders. Butyrate, a product of bacterial fermentation, has been shown to have beneficial effects in obesity and rodent models of diet-induced obesity. Here, we aimed to determine the beneficial effects of butyrate (as glycerol ester of butyrate monobutyrin, MB) supplementation on metabolic phenotype, intestinal permeability and inflammation, feeding behavior, and the gut microbiota in low-fat (LF)- and high-fat (HF)-fed mice. Two cohorts (separated by 2 weeks) of male C57BL/6J mice (n = 24 in each cohort, 6/group/cohort; 6 weeks old) were separated into four weight-matched groups and fed either a LF (10 % fat/kcal) or HF (45% fat/kcal) with or without supplementation of MB (LF/MB or HF/MB) at 0.25% (w/v) in drinking water for 6 weeks. Metabolic phenotypes (body weight and adiposity), intestinal inflammation, feeding behavior, and fecal microbiome and metabolites were measured. Despite identical genetic and experimental conditions, we found marked differences between cohorts in the response (body weight gain, adiposity, and intestinal permeability) to HF-diet and MB. Notably, the composition of the gut microbiota was significantly different between cohorts, characterized by lower species richness and differential abundance of a large number of taxa, including subtaxa from five phyla, including increased abundance of the genera Bacteroides, Proteobacteria, and Parasutterella in cohort 2 compared to cohort 1. These differences may have contributed to the differential response in intestinal permeability to the HF diet in cohort 2. MB supplementation had no significant effect on metabolic phenotype, but there was a trend to protect from HF-induced impairments in intestinal barrier function in cohort 1 and in sensitivity to cholecystokinin (CCK) in both cohorts. These data support the concept that microbiota composition may have a crucial effect on metabolic responses of a host to dietary interventions and highlight the importance of taking steps to ensure reproducibility in rodent studies.

Since Voas and Crockett (2005), a consensus has emerged in the sociology of religions on the fact that secularization is largely due to a cohort effect. That is, each birth cohort is less religious than the previous one. We use data from the Swiss Household Panel (SHP), a multi-thematic survey based on a random sample representative of the general population since 1999, to understand what is the cohort effect in Switzerland on three indicators of religiosity: religious affiliation, frequency of religious service attendance, and personal prayer, taking into account the socio-demographic characteristics of individuals, which could interfere with cohort, period, or age effects. A first general observation can be drawn from the SHP: for the three religious indicators, a cohort effect is a key factor in explaining the decline of religiosity. Each birth cohort is less religious on all three indicators, that is, younger individuals are less affiliated, practice less often, and pray less than the older cohort. More subtly, we also observe an effect of age or life cycle, especially on the practice, and a period effect on the religious disaffiliation of individuals. Each birth cohort shows a more religious profile of individuals at the start of the cohort than at the end. There is, therefore, an initial movement of distancing from religion by birth cohorts, but this is further accentuated by a period effect for disaffiliation and sometimes accelerated and, at other times, slightly contained by a life-cycle effect. [ABSTRACT FROM AUTHOR]

Early life conditions, especially in long‐lived organisms, can have both immediate and long‐lasting effects in vital traits generating demographic structure across cohorts. Multiple non‐exclusive hypotheses have been proposed to explore this question. For instance, the silver spoon, the viability selection or the predictive adaptive response hypothesis, predict that long lasting effects resulting from harsh early conditions could be negative, positive or vary with current environmental conditions, respectively. We use an 18‐year capture–mark–recapture dataset on adult Audouin's gulls Ichthyaetus audouinii to test for these different hypotheses while accounting for age, breeding experience and large‐scale dispersal. Audouin's gull cohorts experiencing harsh conditions during early life (i.e. nestling period and first winter) are known to experience lower first year survival. Here, we show that early life conditions also explained a large proportion (54%) of adult survival variation among cohorts. However, adulthood cohorts experiencing poor early life conditions had higher adult survival, in accordance with the viability selection hypothesis. Our results also show that apparent inexperienced breeders showed lower survival than experienced ones. Moreover, adult survival decreased with age. These results could suggest an increased cost of reproduction for deferred breeders, individual quality differences or survival senescence in this population. Overall, our study highlights the importance of early development, age and breeding experience as potential factors generating heterogeneity of survival between cohorts. Understanding the mechanisms driving responses to early life conditions at different life stages is fundamental to understanding the long‐term dynamics of wild populations. [ABSTRACT FROM AUTHOR]

We describe changes in the comprehensiveness of services delivered by family physicians in 4 Canadian provinces (British Columbia, Manitoba, Ontario, Nova Scotia) during the periods 1999-2000 and 2017-2018 and explore if changes differ by years in practice. We measured comprehensiveness using province-wide billing data across 7 settings (home, long-term care, emergency department, hospital, obstetrics, surgical assistance, anesthesiology) and 7 service areas (pre/postnatal care, Papanicolaou [Pap] testing, mental health, substance use, cancer care, minor surgery, palliative home visits). Comprehensiveness declined in all provinces, with greater changes in number of service settings than service areas. Decreases were no greater among new-to-practice physicians. [ABSTRACT FROM AUTHOR]

BackgroundThe success of initiatives intended to increase the value of health care depends, in part, on the degree to which cost-conscious care is endorsed by current and future physicians. This study aimed to first analyze attitudes of U.S. physicians by age and then compare the attitudes of physicians and medical students.MethodsA paper survey was mailed in mid-2012 to 3897 practicing physicians randomly selected from the American Medical Association Masterfile. An electronic survey was sent in early 2015 to all 5,992 students at 10 U.S. medical schools. Survey items measured attitudes toward cost-conscious care and perceived responsibility for reducing healthcare costs. Physician responses were first compared across age groups (30-40 years, 41-50 years, 51-60 years, and > 60 years) and then compared to student responses using Chi square tests and logistic regression analyses (controlling for sex).ResultsA total of 2,556 physicians (65%) and 3395 students (57%) responded. Physician attitudes generally did not differ by age, but differed significantly from those of students. Specifically, students were more likely than physicians to agree that cost to society should be important in treatment decisions (p

Assessing change in campus interpersonal violence over time is an important step to understand the nature and prevalence of students' victimization experiences. Using a repeated cross-sectional campus survey of interpersonal violence from a large southern university, this article tracks the change of students' victimization experiences over a three-year period for two identified undergraduate student cohorts and offers empirical evidence to determine the best time in a college student's career to initially launch a campus interpersonal violence survey and how often such data should be collected. Controlling for demographic characteristics, the results indicate that both administration-year-effect and cohort-effect exist. The results further suggest that yearly campus interpersonal violence surveys would be most beneficial to track campus interpersonal violence change. [ABSTRACT FROM AUTHOR]

Introduction: Dementia prevalence in older women is higher than that in men. The purpose of the present study was to investigate whether there is a female disadvantage in cognitive functioning at adult age and/or whether a female disadvantage develops with age. Methods: Data of 5,135 women and 4,756 men from the Longitudinal Aging Study Amsterdam (LASA) and the Doetinchem Cohort Study (DCS) were used. In the LASA, memory, processing speed, fluid intelligence, and global cognitive function were measured every 3–4 years since 1992 in persons aged 55+ years for up to 23 years. In the DCS, memory, processing speed, cognitive flexibility, and global cognitive function were measured every 5 years since 1995 in persons aged 45+ years for up to 20 years. Sex differences in cognitive aging were analyzed using linear mixed models and also examined by the 10-year birth cohort or level of education. Results: Women had a better memory, processing speed, flexibility, and, in the DCS only, global cognitive function than men (p's < 0.01). However, women showed up to 10% faster decline in these cognitive domains, except for flexibility, where women showed 9% slower decline. In the LASA, women scored poorer on fluid intelligence (p < 0.01), but their decline was 10% slower than that in men. Female advantage was larger in later born cohorts; adjustment for the educational level increased the female advantage. Conclusion: Women have better memory and processing speed than men at middle age. This female advantage becomes smaller with aging and has increased in more recent birth cohorts. [ABSTRACT FROM AUTHOR]

Using comprehensive personnel data from a Chinese firm, we confirm significant cohort effect in our sample. Complementary to the existing literature, we have two new findings: First, cohort effect only exists among workers with low initial job levels and it disappears in senior managers. Second, the job position upon entering the firm accounts for half of the cohort effects, supporting the task-specific human capital theory. [ABSTRACT FROM AUTHOR]

Abstract Background Taiwan has gone through rapid industrialization, urbanization and economic growth in the 20th and early 21st centuries. Therefore, the population has experienced significant changes in the physical and social environment during the life course, which may affect the overall adiposity. Our aim was to examine the age trajectories of height, weight and body mass index (BMI) in the Taiwanese population and to explore the influences of sex, birth cohort and education. Methods The sample comprised 572,358 residents between 20 and 94 years of age in Taiwan who attended at least one health examination during 1996 to 2017 in a cohort study. Repeated measures of body weight and height were collected using an auto-anthropometer. We conducted a series of linear mixed-effects growth curve models to examine the trajectory of height, weight, and BMI across the life course with stratification by sex. Results Age-related trajectories of BMI differed between men and women and stronger cohort effects were observed among men, with younger cohorts having higher BMI. After holding cohort and age variables constant, men with junior high or lower education were shorter, thinner and had higher BMI than men with university or higher education (effect sizes: − 3.138 cm, p

Social scientists have frequently sought to understand the distinct effects of age, period, and cohort, but disaggregation of the three dimensions is difficult because cohort = period − age. We argue that this technical difficulty reflects a disconnection between how the cohort effect is conceptualized and how it is modeled in the traditional age-period-cohort framework. We propose a new method, called the age-period-cohort-interaction (APC-I) model, that is qualitatively different from previous methods in that it represents Ryder's theoretical account about the conditions under which cohort differentiation may arise. This APC-I model does not require problematic statistical assumptions and the interpretation is straightforward. It quantifies inter-cohort deviations from the age and period main effects and also permits hypothesis testing about intra-cohort life-course dynamics. We demonstrate how this new model can be used to examine age, period, and cohort patterns in women's labor force participation. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to examine age, period, and cohort effects contributing to the prevalence of diabetes and hypertension among older Koreans. Additionally, it sought to investigate how sociodemographic characteristics interact with period and cohort effects to influence the disease prevalence., Methods: Using the 2004-2020 data from the National Survey of Older Koreans, a nationally representative sample of older adults aged 65 or older, hierarchical age-period-cohort cross-classified random effects models (HAPC-CCREMs) were employed to estimate separate age, period, and cohort components of the recent trends in diabetes and hypertension. Sociodemographic characteristics were tested for their interactions with period and cohort effects., Results: Significant period effects were observed, indicating a steady increase in the likelihood of being diagnosed with diabetes and hypertension over time. Age effects revealed a quadratic trend, with disease risks generally increasing with age, but the rate of increase diminishing at older ages. Cohort effects exhibited an inverted U-shaped pattern, with higher risks observed in the 1930s and early 1940s cohorts compared to earlier and later cohorts. Gender and educational attainment emerged as significant moderators. Women than men born in the early 1930s exhibited higher risks of diabetes and hypertension, whereas individuals with lower educational attainment showed a steadily increasing risk of hypertension over time., Discussion: The results underscore the complex interplay of age, period, and cohort effects in shaping disease prevalence among older Koreans. Our findings highlight the importance of considering historical context and sociodemographic factors in understanding disease trends and designing targeted interventions to mitigate health disparities., (© The Author(s) 2024. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Colorectal cancer remains a major global public health challenge. Its incidence is shaped by a complex interplay of screening programmes and age, period and cohort factors., Methods: We introduce a novel Age-Period-Cohort-Screening (APCS) model to analyse trends in colorectal cancer incidence in Taiwan from 2000 to 2019., Results: In 2010, the incidence of colorectal cancer in Taiwan increased by 19.2% (95% CI: 13.5%, 25.3%) for men and 15.6% (95% CI: 9.2%, 22.4%) for women. This was followed by annual declines of 3.4% (95% CI: 2.8%, 4.1%) and 3.1% (95% CI: 2.4%, 3.9%), respectively. By 2015 for men and 2014 for women, the age-standardized incidence had fallen below the levels projected in a no-screening scenario. By 2019, the incidence had further declined by 12.4% (95% CI: 11.8%, 13.1%) for men and 11.6% (95% CI: 10.7%, 12.6%) for women, compared with the no-screening scenario. Cohort effects have shown a persistent rise from 1920 to 1980: incidence increased 5.8-fold for men and 3.1-fold for women. The trend began to plateau after 1980, with a noticeable decline in women., Conclusion: Through its screening programme, Taiwan has successfully reduced colorectal cancer incidence by 10% as of 2019. Furthermore, the incidence due to cohort effects has plateaued and even begun to decline. However, continued monitoring remains crucial. The advanced APCS model could serve as a robust analytical tool for other researchers and policy makers evaluating the impacts of cancer screening programmes on incidence trends., (© The Author(s) 2024; all rights reserved. Published by Oxford University Press on behalf of the International Epidemiological Association.)

Objective: To elucidate the historical trends, underlying causes and future projections of esophageal cancer incidence in Hong Kong., Methods: Utilizing the Age-Period-Cohort (APC) model, we analyzed data from the Hong Kong Cancer Registry (1992-2021) and United Nations World Population Prospects 2022 Revision. Age-standardized incidence rates were computed, and APC models evaluated age, period, and cohort effects. Bayesian APC modeling, coupled with decomposition analysis, projected future trends and identified factors influencing incidence., Results: Between 1992 and 2021, both crude and age-standardized incidence rates of esophageal cancer witnessed significant declines. Net drifts exhibited pronounced downward trends for both sexes, with local drift diminishing across all age groups. Period and cohort rate ratios displayed a consistent monotonic decline for both sexes. Projections indicate a continued decline in esophageal cancer incidence. Population decomposition analysis revealed that epidemiological changes offset the increase in esophageal cancer cases due to population growth and aging., Conclusion: The declining trend of esophageal cancer in Hong Kong is influenced by a combination of age, period, and cohort. Sustaining and enhancing these positive trends requires continuous efforts in public health interventions., Competing Interests: The authors declare that they do not have any conflicts of interest., (Copyright © 2024 Wang, Du and Sun.)

Objective: In the U.S., uterine cancer incidence is rising, with racial and ethnic minorities experiencing the largest increases. We performed age-period-cohort analyses using novel methods to examine the contribution of age at diagnosis (age), year of diagnosis (period), and birth cohort (cohort), to trends in uterine cancer incidence., Methods: We used uterine cancer incidence data from the Surveillance, Epidemiology, and End Result (SEER) 12 database (1992-2019), and performed hysterectomy-correction. We generated hexamaps to visualize age, period, and cohort effects, and used mutual information to estimate the percent contribution of age, period, and cohort effects, individually and combined, on uterine cancer incidence, overall and by race and ethnicity and histology., Results: Hexamaps showed an increase in uterine cancer in later time periods, and a cohort effect around 1933 showing a lower incidence compared with earlier and later cohorts. Age, period, and cohort effects combined contributed 86.6% (95% CI: 86.4%, 86.9%) to the incidence. Age effects had the greatest contribution (65.1%, 95% CI: 64.3%, 65.9), followed by cohort (20.7%, 95% CI: 20.1%, 21.3%) and period (14.2%, 95% CI: 13.7%, 14.8%) effects. Hexamaps showed higher incidence in recent years for non-Hispanic Blacks and non-endometrioid tumors., Conclusions: Age effects had the largest contribution to uterine cancer incidence, followed by cohort and period effects overall and across racial and ethnic groups and histologies., Impact: These findings can inform uterine cancer modeling studies on the effects of interventions that target risk factors which may vary across age, period, or cohort., Competing Interests: Declaration of competing interest Dr. Wright has received royalties from UpToDate and research support from Merck. Dr. Elkin has received research support from Pfizer. The other authors have no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)