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Purpose: To compare the outcomes of decompression alone and fusion for L4-5 DLS in different age cohorts (< 70 years, ≥ 70 years). Methods: This retrospective cohort study included patients who underwent minimally invasive decompression or fusion for L4-5 DLS and had a minimum of 1-year follow-up. Outcome measures were: (1) patient-reported outcome measures (PROMs) (Oswestry Disability Index, ODI; Visual Analog Scale back and leg, VAS; 12-Item Short Form Survey Physical Component Score, SF-12 PCS), (2) minimal clinically important difference (MCID), (3) patient acceptable symptom state (PASS), (4) response on the global rating change (GRC) scale, and (5) complication rates. The decompression and fusion groups were compared for outcomes separately in the < 70-year and ≥ 70-year age cohorts. Results: 233 patients were included, out of which 52% were < 70 years. Patients < 70 years showed non-significant improvement in SF-12 PCS and significantly lower MCID achievement rates for VAS back after decompression compared to fusion. Analysis of the ≥ 70-year age cohort showed no significant differences between the decompression and fusion groups in the improvement in PROMs, MCID/PASS achievement rates, and responses on GRC. Patients ≥ 70 years undergoing fusion had significantly higher in-hospital complication rates. When analyzed irrespective of the surgery type, both < 70-year and ≥ 70-year age cohorts showed significant improvement in PROMs with no significant difference. Conclusions: Patients < 70 years undergoing decompression alone did not show significant improvement in physical function and had significantly less MCID achievement rate for back pain compared to fusion. Patients ≥ 70 years showed no difference in outcomes between decompression alone and fusion. [ABSTRACT FROM AUTHOR]

Background: Arterial stiffness is a crucial factor in the pathogenesis of cardiovascular disease, often associated with aging. However, the impact of smoking on arterial stiffness is frequently underestimated. This study aims to investigate the intricate relationship between smoking and arterial stiffness to advance our understanding of and therapeutic approaches to cardiovascular health. Methods: A prospective analysis was conducted from January to July 2024, focusing on arterial stiffness parameters in a cohort of students from the Carol Davila University of Medicine and Pharmacy. Participants were categorized as smokers or non-smokers based on self-reported smoking status. The study endpoints included correlations between high pulse wave velocity, elevated peripheral and central systolic blood pressure, increased peripheral and central pulse pressure, and smoking status. These markers were assessed using an arteriograph device measuring the time difference between the initial forward pulse wave and the reflected pulse wave in the brachial artery to indirectly estimate the PWV using oscillometric pulsations. Results: Our investigation, involving 102 young individuals aged 20 to 26 (69 females, 33 males), revealed that smokers exhibited significantly higher average values of arterial stiffness indicators compared to non-smokers. Current smokers had higher mean systolic blood pressure (130.65 vs. 123.05 mmHg), higher mean peripheral pulse pressure (53.19 vs. 45.64 mmHg), higher mean central pulse pressure (33.66 vs. 29.69 mmHg), and higher mean pulse wave velocity (5.27 vs. 5.03 m/s). Conclusions: The utilization of arterial stiffness markers as predictive tools offers opportunities for personalized treatment strategies, potentially enhancing cardiovascular health outcomes. [ABSTRACT FROM AUTHOR]

Abstract Background The surgical outcomes for younger patients with non‐small cell lung cancer (NSCLC) remain uncertain. The aim of this study was to investigate the clinical features long‐term survival outcomes in younger individuals with NSCLC following surgery. Methods We queried the Surveillance, Epidemiology, and End Results database from 2010 to 2017, selecting all pathologically confirmed NSCLC cases that underwent cancer‐directed surgery. Younger patients were defined as those aged 18–50 years, while older patients were 51–80 years. Propensity score matching (PSM) was implemented to mitigate selection bias. Overall survival (OS) and lung cancer‐specific survival (LCSS) were compared using the Kaplan–Meier method. Results Among the 33 586 treated surgically patients, 2223 (6.6%) were young. Compared to the older group, younger patients had a higher frequency of female gender, non‐white ethnicity, carcinoid tumors, stage IV disease, pneumonectomy, and postoperative adjuvant therapies. The 5‐year OS rates were significantly higher for younger patients (79.3% vs. 62.0%; p

Background: The surgical outcomes for younger patients with non‐small cell lung cancer (NSCLC) remain uncertain. The aim of this study was to investigate the clinical features long‐term survival outcomes in younger individuals with NSCLC following surgery. Methods: We queried the Surveillance, Epidemiology, and End Results database from 2010 to 2017, selecting all pathologically confirmed NSCLC cases that underwent cancer‐directed surgery. Younger patients were defined as those aged 18–50 years, while older patients were 51–80 years. Propensity score matching (PSM) was implemented to mitigate selection bias. Overall survival (OS) and lung cancer‐specific survival (LCSS) were compared using the Kaplan–Meier method. Results: Among the 33 586 treated surgically patients, 2223 (6.6%) were young. Compared to the older group, younger patients had a higher frequency of female gender, non‐white ethnicity, carcinoid tumors, stage IV disease, pneumonectomy, and postoperative adjuvant therapies. The 5‐year OS rates were significantly higher for younger patients (79.3% vs. 62.0%; p < 0.001), as were the 5‐year LCSS rates (82.4% vs. 71.8%; p < 0.001). Post‐PSM, younger patients consistently demonstrated significantly better OS and LCSS. Further stage‐specific analysis revealed significantly improved 5‐year OS rates at each stage and superior 5‐year LCSS for stages I–II among younger patients. However, there was no statistically significant difference in LCSS for stages III–IV. Conclusions: Overall, younger patients with NSCLC treated surgically exhibit superior OS and LCSS compared to their older counterparts, although no statistically significant difference in LCSS for stages III–IV was observed between the two age groups. [ABSTRACT FROM AUTHOR]

To identify inter-limb asymmetries through the knee's muscular and lower limb functional performance in young male soccer athletes. Twenty male soccer athletes aged 17 to 19 from an under-20 team performed isokinetic tests at 60°/s., 120°/s., 180°/s., and 240°/s. To assess the knee extensors and flexors muscles and functional tests (hop tests and Y-balance test). There were no significant differences between the dominant limb (DL) and non-dominant limb (NDL) in the knee extensors and flexors peak torque and hamstrings (H)/quadriceps(Q) conventional ratio. Moreover, no angular velocities observed inter-limb asymmetries seen by values higher than 10% in the isokinetic parameters. However, the H/Q conventional ratio shows borderline values in low angular velocities (60°/s. and 120°/s.). No significant changes were observed in the functional test performance between the DL and NDL. Furthermore, we did not see inter-limb asymmetries in both hop and Y-balance tests. On the contrary, the anterior distance reached was lower than found in the literature, and the composite score of the Y-balance test demonstrated values below the normative (>94%). The data demonstrated that soccer athletes have muscular and functional inter-limb symmetry. However, they tend to have knee muscle imbalance in low velocities and dynamic balance deficits that might increase the risk of musculoskeletal injury. [ABSTRACT FROM AUTHOR]

Abstract Background The relationship between postoperative long-term prognosis and age in colorectal cancer patients remains controversial. The purpose of this study based on a Chinese CRC cohort is to determine the disparity in long-term survival outcomes between younger and older colorectal cancer (CRC) patients after surgery using a propensity score matching (PSM). Methods Data for this study was derived from the CRC cohort of the Database from Colorectal Cancer (DACCA) at West China Hospital of Sichuan University from January 2007 to September 2022. The long‑term prognoses were compared between younger and older groups. Results A total of 2374 CRC patients were evaluated in this study, including 1039 older patients and 1335 younger ones. After 1:1 ratio PSM, each group contained 784 CRC patients. There was no significant difference in baseline information after PSM (p

Background: Arterial stiffness is a crucial factor in the pathogenesis of cardiovascular disease, often associated with aging. However, the impact of smoking on arterial stiffness is frequently underestimated. This study aims to investigate the intricate relationship between smoking and arterial stiffness to advance our understanding of and therapeutic approaches to cardiovascular health. Methods: A prospective analysis was conducted from January to July 2024, focusing on arterial stiffness parameters in a cohort of students from the Carol Davila University of Medicine and Pharmacy. Participants were categorized as smokers or non-smokers based on self-reported smoking status. The study endpoints included correlations between high pulse wave velocity, elevated peripheral and central systolic blood pressure, increased peripheral and central pulse pressure, and smoking status. These markers were assessed using an arteriograph device measuring the time difference between the initial forward pulse wave and the reflected pulse wave in the brachial artery to indirectly estimate the PWV using oscillometric pulsations. Results: Our investigation, involving 102 young individuals aged 20 to 26 (69 females, 33 males), revealed that smokers exhibited significantly higher average values of arterial stiffness indicators compared to non-smokers. Current smokers had higher mean systolic blood pressure (130.65 vs. 123.05 mmHg), higher mean peripheral pulse pressure (53.19 vs. 45.64 mmHg), higher mean central pulse pressure (33.66 vs. 29.69 mmHg), and higher mean pulse wave velocity (5.27 vs. 5.03 m/s). Conclusions: The utilization of arterial stiffness markers as predictive tools offers opportunities for personalized treatment strategies, potentially enhancing cardiovascular health outcomes.

Background: The relationship between postoperative long-term prognosis and age in colorectal cancer patients remains controversial. The purpose of this study based on a Chinese CRC cohort is to determine the disparity in long-term survival outcomes between younger and older colorectal cancer (CRC) patients after surgery using a propensity score matching (PSM). Methods: Data for this study was derived from the CRC cohort of the Database from Colorectal Cancer (DACCA) at West China Hospital of Sichuan University from January 2007 to September 2022. The long‑term prognoses were compared between younger and older groups. Results: A total of 2374 CRC patients were evaluated in this study, including 1039 older patients and 1335 younger ones. After 1:1 ratio PSM, each group contained 784 CRC patients. There was no significant difference in baseline information after PSM (p < 0.05). Multivariate analysis showed that younger age was an independent predictor of better overall survival (OS) (p < 0.001, HR = 1.750, 95% CI = 1.407–2.177) and disease-specific survival (DSS) (p < 0.001, HR = 1.718, 95% CI = 1.369–2.157). In terms of different tumor pathological stages after PSM, in comparison to older group, younger group had better OS in stage II (p < 0.001), stage III (p = 0.0085), and stage IV (p = 0.0014) and better DSS in stage II (p = 0.0035), stage III (p = 0.0081), and stage IV (p < 0.001). Conclusion: Younger CRC patients have better prognosis than older CRC patients after surgery, especially, and have better OS and DSS in stages II, III, and IV CRC. Younger CRC patient may gain greater benefit from CRC resection and combined therapy. As for the cut-off age, it may be determined by a specific model suitable for local patients. [ABSTRACT FROM AUTHOR]

Background: The risk of lung cancer (LC) increases with an older age and is most frequently diagnosed among patients aged 65–74 years with an increasing women ratio over the years in the United States (US). Aim: This study aimed to demonstrate the age and gender distribution of Turkish LC patients at diagnosis over the past 10 years. Material and Methods: A total of 5,201 LC patients who had been admitted to the Institute of Oncology, a tertiary referral center, from January 2011 to December 2020 were included in the study. Results: The median age at diagnosis was 62 years. This was 9 years younger than that of the US patients according to surveillance, epidemiology, and end results program data from 2015 to 2019, showing that the median age at diagnosis was 71 years. The distribution curve of the age-specific incidence ratios significantly shifted to the left compared to the American data. The majority of the patients were men (79.2%); women were 20.8%. These values were quite different from the US patients; the distribution of gender was nearly identical, with 51.8% for men and 48.2% for women according to American Cancer Society data from 2011 to 2020. The changes in the ratios of Turkish and US LC patients by sex were identical over the years; although the proportion of men has been in a downtrend, the proportion of women has been in an uptrend in both countries. Conclusion: Turkish LC patients are diagnosed at younger ages and male-dominant compared to LC patients from the US, and this portends a significant health problem. Therefore, efforts to quit smoking must be increased. [ABSTRACT FROM AUTHOR]

This article argues that, based on a close reading of the ancient textual, documentary and epigraphic evidence, the expression ὁ μικρός in Mark 15.40 is most likely a nickname regarding this James' particular height or potentially an affectionate indication that he is a child. The expression ὁ μικρός is not an indication of comparative age to another person ('younger'). The evidence from ancient epigraphy and the LXX, initially provided by Adolf Deissmann to support a longstanding reading of ὁ μικρός as 'the younger' in Mark 15.40, proves to be less than reliable. [ABSTRACT FROM AUTHOR]

Simple Summary: The impact of age on gastric cancer (GC) features is controversial, and most studies have been conducted in Asian countries. Clarifying this issue can enhance our disease understanding, refine risk stratification models, and aid in the development of personalized therapeutic approaches for GC. This study aimed to evaluate the influence of age at diagnosis on the clinicopathological features, prognosis, and management of a specific cohort of Spanish patients with resected GC. Younger patients showed a higher prevalence of flat, diffuse, high-grade tumors, signet-ring cells, perineural infiltration, D2 lymphadenectomies, and adjuvant therapy. However, we did not detect prognostic differences between age groups. Our results suggest that younger patients may require more aggressive treatment due to adverse clinicopathologic features, but the lack of prognostic differences observed indicates the need for further investigation into the complex interplay between age, clinicopathologic factors, and long-term outcomes in GC. The impact of age on various aspects of gastric cancer (GC) remains controversial. Clarifying this issue can improve our understanding of the disease, refine risk stratification models, and aid in personalized therapeutic approaches. This study aimed to evaluate the influence of age at diagnosis on the clinicopathological features, prognosis, and management of a specific cohort of Spanish patients with resected GC. The study encompassed 315 patients treated at a single tertiary hospital in Spain, divided into two age-based subgroups: ≤65 years and >65 years. The mean and median ages at diagnosis were 72 and 76 years. Most tumors were diagnosed at pT3 stage (49.2%), and 59.6% of patients had lymph node metastases. 21.3% of cases were diagnosed with GC at age ≤ 65 years. Younger patients showed a significantly higher prevalence of flat, diffuse, high-grade tumors, signet-ring cells, perineural infiltration, D2 lymphadenectomies, and adjuvant therapy. They also exhibited a higher rate of recurrences, but had a significantly longer follow-up. Kaplan-Meier curves indicated no significant prognostic differences based on age. Finally, age did not independently predict overall survival or disease-free survival. Our results suggest that younger patients may require more aggressive treatment due to adverse clinicopathologic features, but the lack of prognostic differences among age groups in our cohort indicates the need for further investigation into the complex interplay between age, clinicopathologic factors, and long-term outcomes in GC. [ABSTRACT FROM AUTHOR]

ABL1-tyrosine kinase inhibitors (TKIs) are an established treatment choice for patients with chronic myeloid leukemia in the chronic phase (CML-CP). However, effects of TKI dose modification have not been well investigated. In this study, we retrospectively analyzed 178 patients with newly diagnosed CML-CP who were treated with dasatinib or nilotinib, focusing on age and dose effects. Efficacy as measured by cumulative major molecular response (MMR) and molecular response 4.5 rates did not differ significantly between the younger group and elderly group. Elderly patients who started nilotinib at a reduced dose had similar or better efficacy outcomes (including cumulative MMR and continuation ratios) than other groups, and elderly patients who started dasatinib at a reduced dose had the lowest MMR ratio and longest MMR duration. Effects of dose modification based on age and TKI selection can be attributed to flexible management of TKI therapy in real-world practice, but further studies are required to validate the findings of this study. [ABSTRACT FROM AUTHOR]

Background We compare the differences in the efficacy of percutaneous transforaminal endoscopic diskectomy (PTED) between the younger (age <60 years) and older (age ≥60 years) patients with lumbar disk herniation (LDH). Methods From December 2016 to December 2017, 128 patients with symptomatic LDH underwent PTED and were followed up. Forty-four 60 years old and above, including 19 males and 25 females with an average age of 68.7 (61–82) years, were classified as the elderly age group. Eighty-four patients younger than 60 years were classified as the young age group, which included 48 males and 36 females with an average age of 44.7 (16–58) years. The visual analog scale (VAS) scores, Japanese Orthopaedic Association (JOA) scores, and satisfaction rates of the two groups before and after surgery were compared. Results The operation was completed successfully in both groups. The average follow-up times of the elderly and young age groups were 18.47 ± 2.62 (12–23) and 17.90 ± 3.27 (12–23) months, respectively. One patient in the young age group had recurrence 7 months after surgery, and the symptoms were relieved after PTED was performed again. Two patients with nerve root injury after surgery in the young age group completely recovered after 2 months of conservative treatment. There were no significant surgical complications in the elderly age group. There was no significant difference in postoperative VAS, JOA, and MacNab scores between the two groups. The MacNab scores in the elderly age group were excellent for 28 patients, good for 10 patients, and fair for 6 patients; the satisfaction rate was 86.3%. In the young age group, scores were excellent for 63 patients, good for 14 patients, fair for 5 patients, and poor for 2 patients; the satisfaction rate was 91.7%. Conclusion The clinical effectiveness of PTED for treatment of LDH in both elderly and young patients is satisfactory. Age is not a predictor of poor outcomes of PTED. [ABSTRACT FROM AUTHOR]

This study aimed to determine the characteristics of occlusal force, lip strength, and tongue pressure in older and young females. We included 16 healthy young female university students and 16 community-dwelling females aged >65 years. Age, occlusal force, lip strength, tongue pressure, and grip strength were confirmed using Spearman's rank correlation coefficient. Differences in these functions between young and older females were analyzed using the Mann–Whitney U test. The occlusal force was associated with grip strength (ρ = 0.64) and tongue pressure (ρ = 0.59). Tongue pressure and occlusal force showed significant differences between older and young women. However, there was no significant difference in lip-closing strength. The results of this study suggest that occlusal force, lip strength, and tongue pressure should be measured, respectively, in order to evaluate oral function in female. [ABSTRACT FROM AUTHOR]

Abstract Purpose The purpose of the current study is to analyze the difference of short-term and oncologic outcomes between younger and older colorectal cancer (CRC) patients who underwent primary CRC surgery using a propensity score matching (PSM) analysis. Methods We retrospectively collected CRC patients who underwent primary surgery in a single clinical database from Jan 2011 to Jan 2020. The short-term and oncologic outcomes were compared between younger aged group and older aged group. Results A total of 4599 patients were included in this study, and there were 4196 patients in older aged group and 403 patients in younger aged group. After 1:1 ratio PSM, there were 401 patients in each group. No significant difference was found in terms of baseline information after PSM (p>0.05). Younger aged group had larger retrieved lymph nodes before (p

Abstract Background The number of young patients with hepatocellular carcinoma (HCC) is increasing, but whether patients of different ages have a survival advantage is unclear. This study was conducted to investigate whether age differences in the Barcelona Clinic Liver Cancer (BCLC) classification system contribute to the long-term survival outcomes of patients with HCC. Methods A total of 1602 patients with HCC admitted to the Beijing Ditan Hospital was included in this study. Patients were divided into younger (≤45 years) and older (> 45 years) groups. Factors determining overall survival and progression-free survival were analyzed using univariate and multivariate analyses with the Kaplan-Meier method and Cox proportional hazard regression model. We calculated the cumulative incidence function using the Fine-Gray model. The effect of mortality on age was also estimated using a restricted cubic spline. Results After matching, overall survival and progression-free survival were significantly better in younger patients than in older patients with BCLC stage 0-B (p = 0.015 and p = 0.017, respectively). In BCLC stage 0-B, all-cause mortality increased with age and increased rapidly around the age of 40 years (non-linear, p

Background: The incidence of breast cancer (BC) has been on the rise over the last decades in the USA, and it is most frequently diagnosed among women aged 65–74 years. Aims: The aim of this study was to demonstrate the median age of BC at diagnosis and the age-specific incidence ratios of Turkish BC patients over the last 10 years. Methods: A total of 6009 Turkish BC patients who had been admitted to the Institute of Oncology, a tertiary referral center, from January 2011 to December 2020 were included in the study. Results: The median age at diagnosis was 49 years. This was 14 years younger than that of the US patients according to SEER data from 2014 to 2018 showing that the median age at diagnosis was 63 years. The distribution curve of the age-specific incidence ratios significantly shifted to the left compared to the American data. Conclusions: Turkish BC patients are diagnosed at younger ages than BC patients in developed countries, and this portends a significant health problem. Therefore, it is important and vital that society be educated about the disease without any further delay and screening programs should be instated effectively and extensively from the age of forties. [ABSTRACT FROM AUTHOR]

Background: Patients with total hip arthroplasty (THA) under the age of 35 represent a small and heterogeneous group of 1% of all THA performed. This systematic review aims to analyse the diagnosis, implant type, complications, and long-term results in these patients., Methods: A search was performed on PubMed, Scopus, and Cochrane Library up to 31 July 2023. We included observational prospective and retrospective studies published in the last 20 years, which evaluated diagnosis, implant types, long-term results, and return to sports in patients ⩽35 years who underwent THA. We excluded case reports, case series, and studies with <35 patients. We extracted age, diagnosis, surgical information, follow-up, complications, revision rate, implant survival, and clinical outcomes for each study. The methodology of the included studies was evaluated using the MINORS score., Results: 18 studies with 1955 patients and 2383 THAs were included. Osteonecrosis (40.6%), posterior approach (81%), the uncemented press-fit implants (73.4%), metal-polyethylene bearings (31.3%) were the most frequently found items. All the clinical outcomes reported improvement from the preoperative to postoperative. The most frequent complication was aseptic loosening (4.3%). The survival rate was 92.4% at a mean follow-up of 10 years., Conclusions: THA is a good option for specific hip diseases in the young, but aseptic loosening still is the major point of concern., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Aims: The prevalence of chronic mental and physical diseases is increasing globally. In addition, the changing demographics towards an ageing population pose a challenge to healthcare systems, as ageing is associated with a decrease in physical and mental capacity and an increased risk of developing disease. The review aims to explore primary studies that investigated the effect of museum and art gallery-based heritage activities and programmes on the wellbeing of (1) individuals recovering from drug addiction or patients with dementia and (2) younger and older adults., Methods: We conducted a search using specific keywords, and inclusion and exclusion criteria, in databases for the period 2013-2023. Following a detailed examination of numerous articles, 15 original studies were included in this review., Results: 15 original studies investigated the effects of museum and art gallery-based heritage activities or programmes on (1) patients with chronic diagnoses associated with mental health and/or physical impairment, such as drug addiction and dementia and (2) the wellbeing of younger and older populations. The interactive environment of museums had positive health outcomes for patients with chronic mental (addiction recovery, dementia) and physical diseases (cancer) as well as hospitalized patients. In addition, it improved the physical and mental wellbeing of younger and older individuals., Conclusion: Museum art-based interventions may be integrated as part of the non-pharmacological management of patients experiencing mental disorders as well as for improving the wellbeing of younger and older populations., Competing Interests: Conflict Of InterestThe author(s) declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article.

Objectives: Studies on coronavirus disease 2019 (COVID-19) usually focus on middle-aged and older adults. However, younger patients may present with severe COVID-19 with potentially fatal outcomes. For optimized, more specialized therapeutic regimens in this particular patient group, a better understanding of the underlying pathomechanisms is of utmost importance. Methods: Our study investigated relevant, pre-existing medical conditions, clinical histories, and autopsy findings, together with SARS-CoV-2-RNA, determined by qPCR, and laboratory data in six COVID-19 decedents aged 50 years or younger, who were autopsied at the Charité University Hospital. Results: From a total of 76 COVID-19 patients who underwent an autopsy at our institution, six (7.9%) were 50 years old or younger. Most of these younger COVID-19 decedents presented with pre-existing medical conditions prior to SARS-CoV-2 infection. These included overweight and obesity, arterial hypertension, asthma, and obstructive sleep apnea, as well as graft-versus-host disease following cancer and bone marrow transplantation. Furthermore, clinical histories and autopsy results revealed a disproportionally high prevalence of thromboembolism and ischemic organ damage in this patient cohort. Histopathology and laboratory results indicated coagulopathies, signs of immune dysregulation, and liver damage. Conclusions: In conclusion, pre-existing health conditions may increase the risk of severe and fatal COVID-19 in younger patients, who may be especially prone to developing thromboembolic complications, immune dysregulation, and liver damage.

Despite the significant contribution of the tourist growth to the economics, besides the concern of its impact on the environment has gained much attention. This integrated green image in the theory of planned behavior to determine the factor influencing Younger tourist environmentally responsible intention behavior particularly recycling behavior intention. The study identified the factors influencing tourist environmentally responsible behavior within the lens of the theory Of Planned Beha vior (TPB). The framework was tested with regression analysis with data collected from 229 younger traveler visiting in Bali, Indonesia. The result showed that environmental attitude, subjective norm have a positive impact on younger tourist environmentally responsible intention (recycling intention). Whereas, perceived behavior control does not influence intention. Further, Destination Green Image has a positive impact on environmental attitude. This finding provide an additional knowledge and understanding to the existing body literature of tourist behavior particularly in context of tourism environmentally responsible behavior. Practical and theoretical implication for sustainable tourism are proposed on this study.

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Background: The number of young patients with hepatocellular carcinoma (HCC) is increasing, but whether patients of different ages have a survival advantage is unclear. This study was conducted to investigate whether age differences in the Barcelona Clinic Liver Cancer (BCLC) classification system contribute to the long-term survival outcomes of patients with HCC.Methods: A total of 1602 patients with HCC admitted to the Beijing Ditan Hospital was included in this study. Patients were divided into younger (≤45 years) and older (> 45 years) groups. Factors determining overall survival and progression-free survival were analyzed using univariate and multivariate analyses with the Kaplan-Meier method and Cox proportional hazard regression model. We calculated the cumulative incidence function using the Fine-Gray model. The effect of mortality on age was also estimated using a restricted cubic spline.Results: After matching, overall survival and progression-free survival were significantly better in younger patients than in older patients with BCLC stage 0-B (p = 0.015 and p = 0.017, respectively). In BCLC stage 0-B, all-cause mortality increased with age and increased rapidly around the age of 40 years (non-linear, p < 0.05). In BCLC stages 0-B, HCC-related and non-HCC-related deaths significantly differed between younger and older individuals (p = 0.0019).Conclusion: In stage BCLC 0-B, age affects the long-term prognosis of patients. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of the current study is to analyze the difference of short-term and oncologic outcomes between younger and older colorectal cancer (CRC) patients who underwent primary CRC surgery using a propensity score matching (PSM) analysis.Methods: We retrospectively collected CRC patients who underwent primary surgery in a single clinical database from Jan 2011 to Jan 2020. The short-term and oncologic outcomes were compared between younger aged group and older aged group.Results: A total of 4599 patients were included in this study, and there were 4196 patients in older aged group and 403 patients in younger aged group. After 1:1 ratio PSM, there were 401 patients in each group. No significant difference was found in terms of baseline information after PSM (p>0.05). Younger aged group had larger retrieved lymph nodes before (p<0.001) and after PSM (p=0.001) than older aged group. In multivariate analysis, younger age was an independent predictor of better overall survival (OS) (p<0.001, HR=2.303, 95% CI=1.658-3.199) and disease-free survival (DFS) (p=0.008, HR=1.425, 95% CI=1.098-1.850). In terms of different tumor stage after PSM, younger aged group had better OS than older group in stage II (p<0.001) and stage IV (p=0.028) CRC, and younger aged group had better DFS than older group in stage II (p=0.016) CRC.Conclusion: Younger CRC patients had larger retrieved lymph nodes and better prognosis than older CRC patients after primary CRC surgery. [ABSTRACT FROM AUTHOR]

Objective: To determine and compare the clinical features and endoscopic findings of gastro-esophageal reflux disease (GERD) in elderly and younger age groups.Materials and Methods: The clinical and endoscopic features were evaluated for all patients with GERD between January 2017 and September 2020. The criteria for inclusion were being aged over 65 and under 50 years and having an upper gastrointestinal endoscopy with reflux symptoms resistant to ppi theraphy. The exclusion criteria included prior surgery, age under 18 years, and pregnancy. The diagnosis of GERD was made according to the patients' symptoms. The SPSS 11.0 for Windows pocket program was used for statistical analysis.Results: Two hundred eighty-six patients aged over 65 years and 261 patients aged below 50 years were enrolled in this study. The mean age of the older group was 68.2 ± 4.5 years and the mean age of the young group was 38 ± 7.2 years. The male/female ratio was 5/3 and 2/1 in the young and older groups, respectively. The older patients had less severe and rare typical symptoms than the young patients. However, significantly more serious endoscopic findings were noted in the older patients compared with the younger patients.Conclusion: The older and young patients with GERD were predominantly male and typical reflux problems were less common in older patients with GERD. Older patients had more important endoscopic findings such as hernia, esophagitis, and cancer.

• Pre-existing medical conditions increase the risk of fatal COVID-19 in younger adults. • Younger and healthy COVID-19 patients may develop serious health conditions. • Younger COVID-19 patients are prone to thromboembolic complications. Studies on coronavirus disease 2019 (COVID-19) usually focus on middle-aged and older adults. However, younger patients may present with severe COVID-19 with potentially fatal outcomes. For optimized, more specialized therapeutic regimens in this particular patient group, a better understanding of the underlying pathomechanisms is of utmost importance. Our study investigated relevant, pre-existing medical conditions, clinical histories, and autopsy findings, together with SARS-CoV-2-RNA, determined by qPCR, and laboratory data in six COVID-19 decedents aged 50 years or younger, who were autopsied at the Charité University Hospital. From a total of 76 COVID-19 patients who underwent an autopsy at our institution, six (7.9%) were 50 years old or younger. Most of these younger COVID-19 decedents presented with pre-existing medical conditions prior to SARS-CoV-2 infection. These included overweight and obesity, arterial hypertension, asthma, and obstructive sleep apnea, as well as graft-versus-host disease following cancer and bone marrow transplantation. Furthermore, clinical histories and autopsy results revealed a disproportionally high prevalence of thromboembolism and ischemic organ damage in this patient cohort. Histopathology and laboratory results indicated coagulopathies, signs of immune dysregulation, and liver damage. In conclusion, pre-existing health conditions may increase the risk of severe and fatal COVID-19 in younger patients, who may be especially prone to developing thromboembolic complications, immune dysregulation, and liver damage. [ABSTRACT FROM AUTHOR]

Abstract Background Prolonged static postures (PSPs) may predispose dentists to develop cervical herniated intervertebral disc (C-HIVD); however, there is limited evidence supporting this in the literature thus far. We conducted this study to fit the data gap. Methods We conducted a retrospective nationwide population-based study using the Taiwan National Health Insurance Research Database to identify 10,930 dentists, an identical number of age- and sex-matched participants from the general population, and 73,718 other health care providers (HCPs, non-dentists). Comparisons for the risk of developing C-HIVD between dentists and the general population, and between dentists and other HCPs were performed by tracing their medical histories between 2007 and 2011. Results Dentists had a cumulative incidence rate of 1.1% for C-HIVD during the 5-year follow-up period. Overall, there was no difference of the risk for C-HIVD between dentists and the general population after adjusting for hypertension, hyperlipidemia, liver disease, mental disorders, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, malignancy, stroke, and renal disease (adjusted odds ratio [AOR]: 1.2, 95% confidence interval [CI]: 0.9–1.6). However, stratified analysis showed that younger dentists (≤ 34 years) had a trend of higher risk for C-HIVD than members of the younger general population (AOR: 1.9, 95% CI: 0.9–4.1). There was no difference found between dentists and other HCPs (AOR: 0.9, 95% CI: 0.8–1.1). Conclusion Younger dentists had a trend of higher risk of developing C-HIVD than members of the general population.

Despite the significant contribution of the tourist growth to the economics, besides the concern of its impact on the environment has gained much attention. This integrated green image in the theory of planned behavior to determine the factor influencing Younger tourist environmentally responsible intention behavior particularly recycling behavior intention. The study identified the factors influencing tourist environmentally responsible behavior within the lens of the theory Of Planned Beha vior (TPB). The framework was tested with regression analysis with data collected from 229 younger traveler visiting in Bali, Indonesia. The result showed that environmental attitude, subjective norm have a positive impact on younger tourist environmentally responsible intention (recycling intention). Whereas, perceived behavior control does not influence intention. Further, Destination Green Image has a positive impact on environmental attitude. This finding provide an additional knowledge and understanding to the existing body literature of tourist behavior particularly in context of tourism environmentally responsible behavior. Practical and theoretical implication for sustainable tourism are proposed on this study. [ABSTRACT FROM AUTHOR]

Biological motherhood plays an important role in the lives of many young women facing breast cancer and threats to reproduction may be disruptive. In this study, we explored the indirect effects of the importance of parenthood and childlessness on depression and health-related quality of life (HRQoL) among cancer patients 18–40 years of age (n = 104) through reported reproductive concerns. These specific concerns fully mediated the relationship between the importance of parenthood in women's lives and HRQoL. Greater importance of parenthood was directly associated with higher depression symptoms. Interventions should address the reproductive needs and concerns of patients to improve their HRQoL. [ABSTRACT FROM AUTHOR]

Introduction: Pituitary adenomas (PA) are common intracranial tumors. In the context of the aging of the population, the question is whether postsurgical outcomes are comparable to the younger ones. The primary objective of the present study was to review published resection and recurrence rates after transsphenoidal resection. The secondary aim was to evaluate visual improvement and complication rates. Methods: The authors searched PubMed and Medline databases, of published English series, with no time frame limit, evaluating outcomes of transsphenoidal resection in populations aged more or less than 65, 70, and 80 years. We performed a systematic review and meta-analysis. Results: Median overall resection rates for younger population was 70.7% (range 54–76.8) and for elderly one was 65.7% (range 16.6–78.2) (two-sample t test, p = 0.35). The only statistically significant difference for gross total resection rates (GTR) favored patients aged less than 80 (p = 0.01). There was no statistically significant difference among recurrence rates. There was a statistically significant difference for visual improvement favoring patients aged more than 80 (p = 0.03). For the age groups of less versus more than 70, there was a statistically significant difference for overall complication rate favoring younger groups (p < 0.05). Conclusion: Present data shows GTR rates favoring younger patients. Recurrence rates remain similar over the mean follow-up period. Moreover, visual improvement favors patients aged more than 80. Overall complication rates favor patients younger than 70, which might be also related to additional comorbidities, frequently present in seniors. Transsphenoidal surgery is safe and effective even for older patients. [ABSTRACT FROM AUTHOR]

Indications for reverse total shoulder arthroplasty (RTSA) are expanding, and more young patients are undergoing RTSA. Younger patients are expected to place increased functional demands on their shoulder, which may affect implant performance and longevity. Reports on longer-term outcomes in young patients remain limited. This study evaluates the minimum 5-year functional outcomes of RTSA in patients younger than 65 years. A retrospective review was performed using a multinational prospective shoulder arthroplasty database of a single implant system, Exactech Equinoxe (Gainesville, FL, USA). All RTSAs performed between 2007 and 2014 in patients younger than 65 years with minimum 5-year follow-up were included. Shoulder function was assessed preoperatively and at last follow-up via range-of-motion measurements and multiple patient-reported outcome measures. Fifty-two shoulders were evaluated at an average follow-up of 6.3 years. Abduction, forward flexion, internal rotation, and Simple Shoulder Test, Constant, American Shoulder and Elbow Surgeons, University of California–Los Angeles, Shoulder Pain and Disability Index, and visual analog scale scores all showed statistically significant improvements greater than the minimum clinically important difference at the time of last follow-up. Three patients (5.8%) required revision surgery after a mean of 7.5 years and 1 more suffered an acromial stress fracture, bringing the total complication rate to 7.7%. Five patients (9.6%) demonstrated scapular notching, one of whom required revision arthroplasty. RTSA provides clinically significant improvement in nearly all functional measures at a mean follow-up of 6.3 years in patients younger than 65 years. The implants appear to have good midterm survivorship; only 5.8% of patients required revision. [ABSTRACT FROM AUTHOR]

Background: The annual volume of patients requiring revision total hip arthroplasty prior to age 60 is projected to increase considerably. Despite this, outcome data for revision THA in these younger patients remain limited. The purpose of this study was to define implant survivorship, identify risk factors for re-revision, and determine clinical outcomes of revision THA in patients aged ≤60 years., Methods: We identified 191 revision THAs performed in patients aged ≤60 years. Minimum 4-year follow-up was obtained in 141 (73.8%) hips (mean 10.3 years [range, 4-20]). Mean age was 48 years (range, 20-60). Forty-five hips (32%) had previously been revised. Indications for index revision included aseptic loosening (28%), polyethylene wear (26%), dislocation (20%), and infection (14%). Outcome measures were Kaplan-Meier survival free from re-revision and patient-reported outcome scores (mHHS, UCLA)., Results: Survivorship free from re-revision for any cause was 78% [95% CI=70-85] at five years and 71% [62-78] at ten years. The most common indication for re-revision at both five and ten years was dislocation (12% [8-19], 16% [10-23]), followed by infection (6% [3-12], 10% [5-18]) and aseptic loosening (2% [1-7], 4% [1-11]). Mean scores were improved from baseline at six (mHHS +21.4, UCLA +0.9) and twelve years (mHHS +13.4, UCLA +0.5)., Conclusion: Revision THA in patients less than 60 years of age was associated with considerably lower rates of early loosening-related failure than historically reported. Recurrent dislocation and infection appear to remain challenges in this population. Despite improvements in survivorship from earlier studies, patient-reported functional improvements remained relatively unchanged. Level of Evidence: IV ., Competing Interests: Disclosures: No direct conflicts of interest related to the work however, a full list of conflicts of interest are listed: AAOS: board or committee member (CPH); American Association of Hip and Knee Surgeons: board or committee member (CPH), Stryker: research support (CPH); GlaxoSmithKline: stock or stock options (GEP); Department of Defense grant: research support (JCC); Hip Society: board of committee member (JCC); International Hip Society: board or committee member (JCC); International Society for Hip Arthroscopy: board or committee member (JCC); Microport: IP royalties (JCC); Microport Orthopedics, Inc: paid consultant (JCC); Wolters Kluwer Health-Lippincott Williams & Wilkins: publishing royalties, financial or material support (JCC); Zimmer: paid consultant, research support (JCC)., (Copyright © The Iowa Orthopaedic Journal 2023.)

Aim and methods: A single-centre retrospective study was conducted using electronic medical records (EMR) of inpatients and outpatients with the diagnosis of "scleroderma" or "systemic sclerosis" visiting our clinic over the preceding 5 years. Results: A total of 327 patients' charts met our selection criteria; 301 were females. The median (IQR (inter quartile range)) age at onset of first non-Raynaud's symptom was 34.67 (27–43) years and median (IQR) disease duration prior to presentation to our department was 2.5 (1–5) years. Of these, 310 (94.8%) belonged to diffuse systemic sclerosis variety, 13 (4%) had limited systemic sclerosis, and 4 (1.2%) were of sine scleroderma type. A total of 289/302 (95.7%) patients were positive for ANA; of them, 245/327 (74.9%) were Scl-70 antibody-positive and 4% were CENP antibody-positive. Interstitial lung disease (ILD) was present in 288/327 (88.1%) patients. Among patients with available baseline forced vital capacity (FVC) data, 20% had a normal lung function and 28.4% had severe restriction. Pulmonary hypertension as assessed by echocardiography was present in 8.1% of patients. A significant association of Scl-70 antibody positivity with the presence of interstitial lung disease (ILD) (p = 0.000) and pulmonary hypertension (p = 0.035) was seen. On the other hand, presence of CENP antibody showed a protective trend against muscle weakness and/or muscle enzyme elevation (p = 0.052). Presence of arthritis was protective against development of digital ulceration (p = 0.021) and PAH (0.004). Patients younger than 40 years of age had significantly higher frequency of Scl-70 positivity (p = 0.038), whereas CENP antibody positivity was more likely in those aged > 40 years (p = 0.002). Conclusion: Younger age of onset and high prevalence of Scl-70 antibody are unique South Asian features common with large Indian, Thai, and Chinese series. High prevalence of ILD is a feature common to Indian and Chinese series. Strong correlation of Scl-70 antibody with younger age and pulmonary hypertension were unique features of our cohort. Key Points: • Asian Indian scleroderma patients are younger by 2 decades compared to Caucasian series. • Higher prevalence of Scl-70 antibody, its association with young age, interstitial lung disease and pulmonary hypertension are features of our cohort. • High prevalence of interstitial lung disease (88.1%) was noted ; among those with baseline spirometry data (141/327), two thirds(66%) had moderate to severe restriction. • Younger age at onset, higher prevalence of Scl-70 antibody are features common to other Indian, Thai and Chinese series. [ABSTRACT FROM AUTHOR]

Increasing evidence suggests that statins may have antitumor effects but their role in rectal cancer appears inconclusive. The aim of this study was to investigate whether statins may have an impact on survival of older and younger patients with rectal cancer. This study included 238 patients ≥70 years and 227 patients <70 years old, from the Southeast Health Care Region of Sweden, who were diagnosed with rectal adenocarcinoma between 2004 and 2013. In the older group (n = 238), statin use at the time of diagnosis was related to better cancer-specific survival (CSS) and overall survival (OS), compared to non-use (CSS: Hazard Ratio (HR), 0.37; 95% CI, 0.19–0.72; P =.003; OS: HR, 0.62; 95% CI, 0.39–0.96; P =.032). In the older group with stages I-III disease (n = 199), statin use was associated with better disease-free survival (DFS) compared to non use (HR, 0.18; 95% CI, 0.06–0.59; P =.005). The improvement of CSS, OS and DFS remained significant after adjusting for potential confounders. In the older group with stage III disease, statin users had better CSS and DFS compared to non-users (log rank P =.043; log-rank P =.028, respectively). In the older group with short course radiotherapy, statin use was related to better CSS (log-rank P =.032). No such association was present in the younger group. Statin use was related to improved survival in older patients with rectal cancer. This observation is important given the low cost and safety of statins as a drug. [ABSTRACT FROM AUTHOR]

Background: Prolonged static postures (PSPs) may predispose dentists to develop cervical herniated intervertebral disc (C-HIVD); however, there is limited evidence supporting this in the literature thus far. We conducted this study to fit the data gap.Methods: We conducted a retrospective nationwide population-based study using the Taiwan National Health Insurance Research Database to identify 10,930 dentists, an identical number of age- and sex-matched participants from the general population, and 73,718 other health care providers (HCPs, non-dentists). Comparisons for the risk of developing C-HIVD between dentists and the general population, and between dentists and other HCPs were performed by tracing their medical histories between 2007 and 2011.Results: Dentists had a cumulative incidence rate of 1.1% for C-HIVD during the 5-year follow-up period. Overall, there was no difference of the risk for C-HIVD between dentists and the general population after adjusting for hypertension, hyperlipidemia, liver disease, mental disorders, diabetes mellitus, coronary artery disease, chronic obstructive pulmonary disease, malignancy, stroke, and renal disease (adjusted odds ratio [AOR]: 1.2, 95% confidence interval [CI]: 0.9-1.6). However, stratified analysis showed that younger dentists (≤ 34 years) had a trend of higher risk for C-HIVD than members of the younger general population (AOR: 1.9, 95% CI: 0.9-4.1). There was no difference found between dentists and other HCPs (AOR: 0.9, 95% CI: 0.8-1.1).Conclusion: Younger dentists had a trend of higher risk of developing C-HIVD than members of the general population. [ABSTRACT FROM AUTHOR]

Background: The revised 2017 European LeukemiaNet (ELN) classification (ELN-2017) of acute myeloid leukemia (AML) divides patients into 3 prognostic risk categories, with additional factors such as the fms-like tyrosine kinase 3 (FLT3)-internal tandem duplication (ITD) allele ratio (AR) considered for risk stratification. To the best of the authors' knowledge, the prognostic usefulness of ELN-2017 in comparison with ELN-2010 in younger patients with AML has not been validated to date.Methods: The authors performed a retrospective study on patients aged <60 years who received idarubicin plus cytarabine (IA)-based induction chemotherapy for newly diagnosed AML.Results: According to ELN-2017 criteria, the number of patients in the favorable (Fav), intermediate (Int), and adverse (Adv) risk categories was 192 patients (27%), 331 patients (46%), and 192 patients (27%), respectively. Overall survival probabilities at 5 years in the Fav, Int, and Adv groups were 57%, 37%, and 18%, respectively. In comparison, the 5-year overall survival probabilities in the Fav (169 patients), intermediate (IR)-1 (80 patients), IR-2 (306 patients), and Adv (160 patients) ELN-2010 categories were 59%, 32%, 40%, and 14%, respectively. Although ELN-2010 historically distinguishes prognosis into IR-1 and IR-2 categories in younger patients, this difference was nullified in the current study cohort. When comparing patients with a low FLT3-ITD AR with those with a high FLT3-ITD AR, no significant differences in survival were noted among patients with nucleophosmin 1 (NPM1)-mutated AML (P = .28) or wild-type NPM1 (P = .35), and in those treated with IA alone (P = .79) or those treated with IA and a FLT3 inhibitor (P = .10).Conclusions: The ELN-2017 more accurately distinguishes prognosis in patients with newly diagnosed AML. The lack of prognostic significance for the FLT3-ITD AR needs further evaluation in different treatment settings. [ABSTRACT FROM AUTHOR]

[Purpose] The purpose of this study was to verify whether Timed Up and Go (TUG) test measurements differed according to the seat height of the chair, presence or absence of armrests, and measurement location in young healthy adults, and to clarify the flexibility of the TUG settings. [Participants and Methods] Fifty-nine young healthy males and females participated in this study. The TUG test was performed under several conditions. Eight measurements were obtained at both the usual walking speed and the individual's fastest walking speed. [Results] There were no significant differences in TUG test measurements according to variation in seat height, different measurement locations, with and without the use of armrests, or at the usual walking speed or the fastest walking speed. [Conclusion] In young healthy adults, TUG test measurements were unaffected by differences in chair height, use of armrests, or the location of the measurement. If TUG measurements are found to differ according to these variables, it is necessary to consider the influence of the individual's ability rather than the measurement method., Competing Interests: The authors have no conflicts of interest to declare., (2023©by the Society of Physical Therapy Science. Published by IPEC Inc.)

Background and Purpose: The recommended treatment of displaced femoral neck fractures (FNF) in patients younger than 70 years of age is fracture reduction and internal fixation (IF). The incidence of re-operation due to nonunion (NU) or avascular necrosis (AVN) has been reported to be between 20-30%. Knowledge of possible predisposing factors needs to be elucidated. The primary aim of this study was to identify factors associated with a major re-operation due to NU or AVN in patients <70 years with a displaced FNF treated with IF.Patients and Methods: 128 patients, 20-69 years with a FNF treated with IF. Follow up included radiographic and clinical examination at 4, 12 and 24 months. Logistic regression analysis was used to identify factors associated with re-operation due to NU or AVN.Results: The re-operation rate due to NU or AVN was 6%, 16% and 28% at 4, 12 and 24 months respectively. Patients with low BMD was more likely to be re-operated than those with normal BMD, OR 5.5, CI (95%) 1.15-26.8, and those with a high alcohol consumption had 3.2 times higher odds to be re-operated due to NU or AVN, CI (95%) 1.16-8.76.Interpretation: In more than two thirds (83/120) of the patients the fracture healed after one operation. Moreover, a low BMD and high alcohol consumption were related to a major re-operation. These results suggest that only age as a sole variable for choosing the type of surgical treatment may not be rational. [ABSTRACT FROM AUTHOR]

Zhen Wang, Junbo GeDepartment of Cardiology, Zhongshan Hospital, Shanghai, People's Republic of ChinaAbstract: Coronary heart disease (CHD) is the leading cause of death worldwide. The efficacy and safety of statins in primary and secondary prevention of CHD is confirmed in several large studies, and rosuvastatin is the latest statin on market. We review the published literature on rosuvastatin in Chinese people. The pharmacokinetics of rosuvastatin in Chinese is somewhat different from that in Caucasians, but this does not influence the linear relationship between dosage and efficacy and with no drug accumulation. Rosuvastatin 5–20 mg/day is effective and safe in decreasing low-density lipoprotein cholesterol in both younger and elderly patients with hypercholesterolemia, even in very elderly patients. Rosuvastatin also shows anti-inflammatory and antiatherosclerosis features, such as reducing carotid intima-media thickness and plaque area. Rosuvastatin can also improve the prognosis of Chinese CHD patients, such as in the case of acute myocardial infarction. Its adverse-event rate is low and comparable to other statins. In conclusion, rosuvastatin is effective and safe for younger or elderly Chinese patients.Keywords: rosuvastatin, Chinese, younger, elderly