Adaptation of Postural Sway in a Standing Position during Tilted Video Viewing Using Virtual Reality: A Comparison between Younger and Older Adults

This study aimed to investigate the effects of wearing virtual reality (VR) with a head-mounted display (HMD) on body sway in younger and older adults. A standing posture with eyes open without an HMD constituted the control condition. Wearing an HMD and viewing a 30°-tilt image and a 60°-tilt image in a resting standing position were the experimental conditions. Measurements were made using a force plate. All conditions were performed three times each and included the X-axis trajectory length (mm), Y-axis trajectory length (mm), total trajectory length (mm), trajectory length per unit time (mm/s), outer peripheral area (mm2), and rectangular area (mm2). The results showed a significant interaction between generation and condition in Y-axis trajectory length (mm) and total trajectory length (mm), with an increased body center-of-gravity sway during the viewing of tilted VR images in older adults than in younger adults in both sexes. The results of this study show that body sway can be induced by visual stimulation alone with VR without movement, suggesting the possibility of providing safe and simple balance training to older adults.

Differential trends and patterns of sociodemographic disparities in burden of mental disorders, substance use disorder and self-harm across age groups: ecological study in 204 countries using the Global Burden of Disease Study 2019

BACKGROUND

It is well-known that socioeconomic status is associated with mental illness at both the individual and population levels, but there is a less clear understanding of whether socioeconomic development is related to poor mental health at the country level.

AIMS

We aimed to investigate sociodemographic disparities in burden of mental disorders, substance use disorders and self-harm by age group.

METHOD

Estimates of age-specific disability-adjusted life years (DALY) rates for mental disorders, substance use disorders and self-harm from 1990 to 2019 for 204 countries were obtained. The sociodemographic index (SDI) was used to assess sociodemographic development. Associations between burden of mental health and sociodemographic development in 1990 and 2019 were investigated, and sociodemographic inequalities in burden of mental health from 1990 to 2019 by age were estimated using the concentration index.

RESULTS

Differential trends in sociodemographic disparities in diseases across age groups were observed. For mental disorders, particularly depressive disorder and substance use disorders, DALY rates in high SDI countries were higher and increased more than those in countries with other SDI levels among individuals aged 10-24 and 25-49 years. By contrast, DALY rates for those over 50 years were lower in high SDI countries than in countries with other SDI levels between 1990 and 2019. A higher DALY rate among younger individuals accompanied a higher SDI at the country level. However, increased sociodemographic development was associated with decreased disease burden for adults aged ≥70 years.

CONCLUSIONS

Strategies for improving mental health and strengthening mental health system should consider a broader sociocultural context.

Effect of gender and age on bDMARD efficacy for axial spondyloathritis patients: a meta-analysis of randomized controlled trials

OBJECTIVE

To study the therapeutic variations of biological and targeted synthetic disease-modifying antirheumatic drugs(b/tsDMARDs) between genders and across age stages in axial spondyloarthritis (axSpA) patients through meta-analysis.

METHODS

Randomized controlled trials (RCTs), published by Pubmed, Scopus, and Embase before August 10, 2023, testing the efficiency of b/tsDMARDs in axSpA, were searched and systematically reviewed. The Assessment of Spondyloarthritis International Society ≥40% improvement (ASAS40) response was used as the primary outcome of treatment response.

RESULTS

: Only one study meet the inclusion criteria was related to tsDMARD, which was excluded from further data combination. Nine studies of bDMARDs, with the involvement of 4127 patients, were included for final analysis. When compared with placebo, both males (OR = 3.14; 95%CI, 2.66-3.70) and females (2.32; 1.82-2.82), younger (4.00; 2.50-6.40) and older (2.21; 1.15-4.22) patients, presented significantly better responses to bDMARDs. Besides, the efficacies were more evident in males (1.89; 1.56-2.30) and younger patients (2.07; 1.42-3.02). Subgroup analysis revealed that gender difference in efficacy was more obvious in non-radiographic-axSpA (nr-axSpA) patients (Pheterogeneity=0.03, I2=78.1%). Moreover, males with radiographic-axSpA (r-axSpA) and nr-axSpA shared similar responses to bDMARDs (Pheterogeneity=0.87, I2=0%), while females with r-axSpA showed greater response than those with nr-axSpA (Pheterogeneity=0.005, I2=87.4%).

CONCLUSIONS

BioDMARDs were efficient in all axSpA patients regardless of gender or age stage. However, the treatment responses were more evident in male and younger patients. Besides, females with r-axSpA had greater responses than those with nr-axSpA, whereas no relevant difference was observed in males, indicating that the gender difference on efficacy was larger in nr-axSpA patients.

Emotional involvement matters, too: Associations among parental involvement, time management and academic engagement vary with Youth's developmental phase

BACKGROUND

Prior studies have emphasized the importance of parents' educational involvement (a type of cognitive involvement) to academic engagement, although little is known about emotional involvement.

AIMS

This study investigated whether and how different facets of involvement (cognitive vs. emotional, paternal vs. maternal) are differentially related to academic engagement and whether and how the associations among parental involvement, time management and academic engagement vary by adolescents' developmental phases.

SAMPLES

The participants of this large national survey were students in elementary, middle and high school across different regions of mainland China. A total of 2687 adolescents (52.7% females, Mage  = 14.07 ± 2.47) participated in this study.

METHODS

Structural equation models and multigroup analysis were conducted.

RESULTS

We found that the total effect of paternal and maternal emotional involvement on academic engagement was positive in elementary-, middle- and high school students, and an indirect effect of time management underlying the above paths was found in all three groups. In contrast, the positive effect of maternal cognitive involvement on academic engagement as well as the indirect effects underlying the above pathways was established only in high school students.

CONCLUSIONS

The findings highlight the necessity of parents' emotional involvement and the consideration of adolescent developmental characteristics in the design of interventions.

Risk Factor Analysis for Long-Term Graft Survival Following Pediatric Kidney Transplantation: The Importance of Pretransplantation Time on Dialysis and Donor/Recipient Age Difference

Recognizing risk factors that may negatively affect long-term graft survival following pediatric kidney transplantation is a key element in the decision-making process during organ allocation. We retrospectively reassessed all cases of pediatric kidney transplantation performed in our center in the last 20 years with the aim of determining baseline characteristics that could be identified as prognostic risk factors for long-term graft survival. Between 2001 and 2020, a total of 91 kidney transplantations in children under the age of 18 years were undertaken in our center. Early graft failure was observed in six of the 91 patients (7%). The median follow-up of the remaining 85 children was 100 months, and the overall kidney graft survival rates at 5, 10, 15 and 20 years were 85.2%, 71.4%, 46.0% and 30.6%, respectively. Small children with a body surface area of <1 m2 were significantly associated with better long-term graft survival outcomes, while adolescents aged more than twelve years showed poorer graft survival rates than younger children. Body surface area of the recipient of ≥1 m2, pretransplantation duration of the recipient on dialysis ≥18 months, hemodialysis prior to transplantation and donor/recipient age difference of ≥25 years were significantly associated with poorer long-term graft survival.

Sex differences in serum pigment epithelium-derived factor in healthy individuals

To investigate sexual dimorphism of serum pigment epithelium-derived factor (PEDF) and its influencing factors in healthy individuals. A total of 162 healthy people (69 males, 93 females) who underwent health examinations in our department were selected. Serum PEDF, estradiol and other metabolic indices were measured, and homeostasis model assessment of insulin resistance (HOMA-IR) and homeostasis model assessment of β-cell function (HOMA-β) were calculated to evaluate insulin resistance and β-cell function, respectively. Subjects were divided into < 50 years and ≥ 50 years groups to explore the sexual dimorphism of serum PEDF in different age groups. We found no statistically significant difference in serum PEDF levels between men and women in total. However, in the group of subjects under 50 years old, men had significantly higher PEDF levels than women (9.32 ± 2.07 μg/mL vs 8.24 ± 2.29 μg/mL, P < .05), and no sex difference was found in the ≥ 50 years group. In women, serum PEDF levels were significantly higher in subjects aged 50 years and over than in those younger than 50 years of age (9.56 ± 3.05 μg/mL vs 8.25 ± 2.30 μg/mL, P < .05). In men, there was no significant difference in serum PEDF levels between the 2 age groups. In women, correlation analysis showed that serum PEDF levels were significantly correlated with body mass index, waist circumference, diastolic blood pressure (DBP), 2-h postprandial glucose, fasting and 2-h postprandial insulin, HOMA-β, HOMA-IR, aminotransferase, triacylglycerol, and estradiol. Elevated triacylglycerol and aminotransferase and decreased estradiol were significant predictors of increased PEDF concentrations in women. There is sexual dimorphism in circulating PEDF levels, which may be related to estrogen status.

Age Differences in Core Symptoms and Symptom Relationships in Patients With Irritable Bowel Syndrome: A Network Analysis

INTRODUCTION

Irritable bowel syndrome (IBS) is a common disorder of gut-brain interaction, characterized by symptoms of abdominal pain and changes in bowel habits. It often co-occurs with extraintestinal somatic and psychological symptoms. However, the nature of the interrelationships among these symptoms is unclear. Although previous studies have noted age differences in IBS prevalence and specific symptom severity, it remains unknown whether specific symptoms and symptom relationships may differ by age.

METHODS

Symptom data were collected in 355 adults with IBS (mean age 41.4 years, 86.2% female). Network analysis was used to examine the interrelationships among 28 symptoms and to identify the core symptoms driving the symptom structure between young (≤45 years) vs older (>45 years) adults with IBS. We evaluated 3 network properties between the 2 age groups: network structure, edge (connection) strength, and global strength.

RESULTS

In both age groups, fatigue was the top core symptom. Anxiety was a second core symptom in the younger age group, but not the older age group. Intestinal gas and/or bloating symptoms also exerted considerable influences in both age groups. The overall symptom structure and connectivity were found to be similar regardless of age.

DISCUSSION

Network analysis suggests fatigue is a critical target for symptom management in adults with IBS, regardless of age. Comorbid anxiety is likely an important treatment focus for young adults with IBS. Rome V criteria update could consider the importance of intestinal gas and bloating symptoms. Additional replication with larger diverse IBS cohorts is warranted to verify our results.

Maternal age differences in cognitive regulation: examination of associations and interactions between RSA and EEG frontoparietal alpha power coherence

Strong cognitive regulation is advantageous for flexible, responsive parenting. Optimal cognitive regulation is reliant on associations between physiological mechanisms of central and peripheral nervous system functioning. Across middle adulthood there may be shifts in how cognitive regulation functions, reflecting changes in the associations and interactions between these physiological mechanisms. Two physiological indicators of cognitive regulation are autonomic regulation of the heart (e.g., respiratory sinus arrhythmia, RSA) and activity of the brain's frontoparietal network (e.g., frontoparietal EEG alpha power coherence, FPc). In the current study we examined maternal age differences (N = 90, age M = 32.35 years, SD = 5.86 years) in correlations and interactions between RSA and FPc in the statistical prediction of cognitive regulation [i.e., executive function (EF), effortful control (EC), cognitive reappraisal (CR)]. Age-related patterns involving interaction between RSA and FPc were found, pointing to a potential shift from optimization to compensation for changes with aging or alternately, the effects of age-based decrements in functioning. Findings are discussed in the context of adult developmental changes in maternal caregiving.

Effectiveness of sublingual immunotherapy with house dust mite drops in asthmatic children at different ages

Background

Respiratory allergies in children, such as asthma and rhinitis, are becoming progressively common every year. Recent studies found that pediatric patients with asthma receiving regular medication and specific immunotherapy (SIT) had improved therapeutic outcomes in a wide age range. However, there are few studies that have examined the effectiveness of SIT treatment in children with allergic asthma at different ages in terms of the degree of asthma control, improvements in lung function, and changes in exhaled nitric oxide (FeNO).

Method

A total of 200 asthmatic pediatric patients who had been receiving regular treatment for at least a year were split into the observation and the control groups, which depended on whether sublingual immunotherapy was added based on conventional treatment medicines. The children who were divided by an age cut-off of 6 years old in these two groups were compared before and after therapy based on the exhaled levels of FeNO, pulmonary function, visual analog scale, medication scores, daytime and nighttime ratings of asthma symptom, and rhinitis symptom scores.

Results

Before treatment, there was no significant difference between the observation group and the control group in various indicators of the patients under 6 years old; and in the older children (6-16 years old) group, the scores of FVC, FEV1, and FEF25 in the observation group were significantly lower than those in the control group (P < 0.05). The FEF75, FEF50, FEF25, and MMEF75/MMEF25 indexes in the observation group were significantly higher than those in the control group after treatment (P < 0.05), but there was no statistical significance in other indexes (P > 0.05). The scores of ACT, FEF75, FEF50, MMEF72/MMEF25, and FeNO in the observation group were all higher than those in the control group after treatment (P < 0.05), and the differences in other indexes were not statistically significant (P > 0.05). Between the young-age group and the elder group, there was no significant difference in all indexes in the observation group before and after treatment (P > 0.05).

Conclusion

Children with asthma of all ages can considerably benefit from sublingual immunotherapy. Specifically, younger patients showed greater tendency on the improvement of small airway resistance, whereas school-age children with asthma significantly improved their small airway resistance as well as their asthma control and inflammation alleviation.

Social support and cognitive function in Chinese older adults who experienced depressive symptoms: is there an age difference?

Objective

This study examined the moderating effect of overall social support and the different types of social support on cognitive functioning in depressed older adults. We also investigated whether the moderating effect varied according to age.

Methods

A total of 2,500 older adults (≥60 years old) from Shanghai, China were enrolled using a multistage cluster sampling method. Weighted linear regression and multiple linear regression was utilized to analyze the moderating effect of social support on the relationship between depressive symptoms and cognitive function and to explore its differences in those aged 60-69, 70-79, and 80 years and above.

Results

After adjusting for covariates, the results indicated that overall social support (β = 0.091, p = 0.043) and support utilization (β = 0.213, p < 0.001) moderated the relationship between depressive symptoms and cognitive function. Support utilization reduced the possibility of the cognitive decline in depressed older adults aged 60-69 years (β = 0.310, p  < 0.001) and 80 years and above (β = 0.199, p  < 0.001), while objective support increased the possibility of cognitive decline in depressed older people aged 70-79 years (β = -0.189, p  < 0.001).

Conclusion

Our findings highlight the buffering effects of support utilization on cognitive decline in depressed older adults. We suggest that age-specific measures should be taken when providing social support to depressed older adults in order to reduce the deterioration of cognitive function.

Age and gender differences in expressive flexibility and the association with depressive symptoms in adolescents

Objective

This study investigated age and gender differences in the ability to flexibly enhance and suppress facial expressions according to situational demands, known as expressive flexibility (EF), as well as its relationship with depressive symptoms in adolescents.

Methods

The participants included 766 Chinese high school students aged between 12 and 18 years (mean age = 14.96 years, standard deviation = 2.04; 52.2% female). Data on EF and depressive symptoms were collected using self-report questionnaires.

Results

Girls scored higher on enhancement abilities than boys, but with no significant gender difference in suppression abilities. There were also no significant age-related differences in enhancement and suppression abilities. Only enhancement ability was negatively associated with depressive symptoms.

Conclusion

The development of EF abilities was stable among adolescents, with varying effects in terms of gender, and the importance of EF and enhancement abilities in reducing depressive symptoms in adolescents was highlighted.

Perceived emotional states mediate willingness to buy from advertising speech

Previous studies have shown that stimulus-organism-response (SOR) theory can well explain the willingness to buy from stores, products, and advertising-related stimuli. However, few studies have investigated advertising speech stimulus that is not influenced by visual design. We examined whether SOR theory using emotional states can explain the willingness to buy from advertising speech stimulus. Participants listened to speech with modified speech features (mean F0, speech rate, and standard deviation of F0) and rated their willingness to buy the advertised products and their perceived emotional states (pleasure, arousal, dominance). We found that emotional states partially mediate the influence of speech features on the willingness to buy. We further analyzed the moderating effects of listeners' attributes and found that listeners' gender and age group moderated the relationship between speech features, emotional states, and willingness to buy. These results indicate that perceived emotional states mediate the willingness to buy from advertising speech.

Risk-taking in the human brain: An activation likelihood estimation meta-analysis of the balloon analog risk task (BART)

The Balloon Analog Risk Task (BART) is increasingly used to assess risk-taking behavior and brain function. However, the brain networks underlying risk-taking during the BART and its reliability remain controversial. Here, we combined the activation likelihood estimation (ALE) meta-analysis with both task-based and task-free functional connectivity (FC) analysis to quantitatively synthesize brain networks involved in risk-taking during the BART, and compared the differences between adults and adolescents studies. Based on 22 pooled publications, the ALE meta-analysis revealed multiple brain regions in the reward network, salience network, and executive control network underlying risk-taking during the BART. Compared with adult risk-taking, adolescent risk-taking showed greater activation in the insula, putamen, and prefrontal regions. The combination of meta-analytic connectivity modeling with task-free FC analysis further confirmed the involvement of the reward, salience, and cognitive control networks in the BART. These findings demonstrate the core brain networks for risk-taking during the BART and support the utility of the BART for future neuroimaging and developmental research.

Comparison of Younger and Older medical student performance outcomes: A retrospective analysis in Japan

The present study examined the impact of age on medical student repeat-year experience and performance outcomes on the objective structured clinical examination (OSCE), Clinical Clerkship (CC), and other relevant examinations in the Japanese medical school system. This retrospective analysis examined the number of students with repeat-years and the years required to graduate, stratifying students by the age they entered medical school (Younger: within 4 years of high school graduation; Older: 5 or more years after high school graduation). Scores of the Pre-CC OSCE, Computer-based testing (CBT), CC performance, CC integrative test, and graduation exams were compared among those graduating from our medical school between 2018 and 2020, and examined correlations between student age and performance outcomes. From 2018 to 2020, 328 medical students graduated. Of these, 283 had entered within 4 years of high school graduation (Younger), while 45 did so 5 or more years after high school graduation (Older). The number of repeat-years did not differ significantly between groups. The average number of years required to graduate was slightly higher for the Older group and the Younger group scored significantly higher on the CC integrative test. No significant differences were found for the remaining tests. These results suggest that older medical students in general show no significant inferiority in their performance of most clinical skills and competencies relative to younger students in Japan.

Suicide among young-old and old-old adults in rural China: A case-control psychological autopsy study

OBJECTIVE

Late-life suicide is a vital public health concern. Though gerontological research suggested the young-old and old-old phases were heterogeneous, age differences in the elderly suicide have not been well studied due to the lack of comparable control groups and small samples. The study aimed to examine the age-specific suicidal characteristics and risk factors among the young-old (60-79) and old-old (over 80) elderly.

METHODS

Two hundred and forty two suicide decedents and 242 living comparisons were enrolled in a 1:1 matched case-control psychological autopsy study in rural China: 173 young-old and 69 old-old in each group. Suicidal characteristics, demographic characteristics, living arrangements, physical health, mental disorder, and psychosocial factors were collected. We used logistic regression models to assess risk factors of suicide and test for interactions between age and each risk factor.

RESULTS

Pesticide suicide was more prevalent among young-old suicides than old-old suicides (56.07% vs. 40.58%, p = 0.029). Non-currently married, unemployment, mental disorder, higher disability in physical activities of daily living, higher hopelessness and higher depressive symptom were significantly associated with suicide among older adults. The effect of poor function in physical activities of daily living on suicide was significantly greater during younger ages (p for interaction = 0.038).

CONCLUSIONS

Findings indicated that most suicidal characteristics and risk factors for completed suicide were generally similar among young-old and old-old adults. But poor function in physical activities of daily living predicted increase suicide risk only at younger ages. In addition to common risk factors, age-specific factors should also be noted in suicide prevention.

CLINICAL TRIAL REGISTRATION

According to the ICMJE, purely observational studies (those in which the assignment of the medical intervention is not at the discretion of the investigator) will not require registration. Our study was not registered because this is a case-control study. But all procedures of the study were carried out in accordance with the latest version of the Declaration of Helsinki. The study were approved by the Institutional Review Boards of the Central South University, Shandong University, and Guangxi Medical University.

The Association Between Spicy Food Intake and Risk of Hyperuricemia Among Chinese Adults

Hyperuricemia is associated with substantial health and economic burden all over the world. Dietary habits are an important influencing factor of hyperuricemia. This study aimed to investigate the relationship between spicy food intake and hyperuricemia based on a large population. A total of 22,125 individuals aged 30-79 were enrolled in China Multi-Ethnic Cohort (CMEC), Chongqing region. Spicy food intake information was collected by a standardized questionnaire. The association between spicy food intake and hyperuricemia was estimated by multivariable logistic regression models and multiple linear regression models. Additionally, we explored these relations in subgroups stratified by sex and age. Furthermore, sensitivity analyses were conducted to verify the stability of current findings. After controlling for potential confounders, compared with participants who never consumed spicy food and consumed less hot, participants who ate 3-5 days per week and very hot had the highest risk of hyperuricemia; the ORs (95% CIs) were 1.28 (1.09, 1.5) and 1.22 (0.92, 1.63), respectively. Additionally, the corresponding ORs (95% CIs) for each level increment in the frequency and degree of pungency in spicy food intake were 1.04 (1.01, 1.07) (P trend = 0.009) and 1.15 (1.04, 1.26) (P trend = 0.004). Further in sex-stratified and age-stratified analysis, similar positive associations were observed among men and those aged 30-59, but no significant association was found among women and those aged 60-79. In the linear regression models, 3-5 days per week and moderate pungency in spicy food intake were associated with 5.21 μmol/L (95% CI: 1.72, 8.70) and 4.69 μmol/L (95% CI: 1.93, 7.45) higher serum urate level. Results in further subgroup analysis were generally consistent with the logistic regression models. This study suggests that spicy food intake may be a risk factor for hyperuricemia, especially in men and younger people, and more studies are warranted to verify the causal associations.

The Impact of Gender and Age Differences and Infectious Disease Symptoms on Psychological Distress in Quarantined Asymptomatic or Mildly Ill COVID-19 Patients in Japan

Quarantine imposed due to COVID-19 infection can exacerbate psychological distress, and it is important for a public mental health agency to identify factors that are predictive of high psychological distress in such situation. The aim of this study was to investigate whether gender, age, and the presence or absence of infectious disease symptoms affected psychological distress among asymptomatic or mildly ill COVID-19 patients who were quarantined. Participants were 436 asymptomatic or mildly symptomatic COVID-19-infected patients who were quarantined in a treatment facility between 1 May 2020 and 30 September 2021. We used Quantification Theory I analysis to investigate the effects of gender, age, and the nature of infectious disease symptoms on psychological distress. The results of the analysis showed that the contribution rate was 0.06. Among gender, age, presence of symptoms, and the nature of symptoms, age had the greatest effect on psychological distress, and being in one’s teens to thirties was considered to exacerbate psychological distress the most. According to the results, the psychological distress of asymptomatic and mildly symptomatic COVID-19 patients isolated was affected by gender, age, and symptomology, especially due to age differences. However, the impact of these items on psychological distress was not considered significant.

Early-Life Exposure to the Chinese Famine of 1959-1961 and Type 2 Diabetes in Adulthood: A Systematic Review and Meta-Analysis

BACKGROUND

The fast-growing literature suggests that the Chinese famine of 1959-1961 drives current and future type 2 diabetes (T2D) epidemics in China. This conclusion may be premature, as many Chinese famine studies have major methodological problems. We examine these problems, demonstrate how they bias the study results, and formulate recommendations to improve the quality of future studies.

METHODS

We searched English and Chinese databases for studies that examined the relationship between prenatal exposure to the Chinese famine and adult T2D from inception to 8 February 2022. We extracted information on T2D cases and study populations of individuals born during the famine (famine births), before the famine (prefamine births), and after the famine (postfamine births). We used random-effects models to compare the odds of T2D in famine births to several control groups, including postfamine births, combined pre- and postfamine births, and prefamine births. We used meta-regressions to examine the impacts of age differences between comparison groups on famine effect estimates and the role of other characteristics, including participant sex, age, and T2D assessments; famine intensity; residence; and publication language. Potential sources of heterogeneity and study quality were also evaluated.

RESULTS

Twenty-three studies met our inclusion criteria. The sample sizes ranged from less than 300 to more than 360,000 participants. All studies defined the famine exposure based on the participants' dates of birth, and 18 studies compared famine births and postfamine births to estimate famine effects on T2D. The famine and postfamine births had an age difference of three years or more in all studies. The estimates of the famine effect varied by the selection of controls. Using postfamine births as controls, the OR for T2D among famine births was 1.50 (95% CI 1.34-1.68); using combined pre- and postfamine births as controls, the OR was 1.12 (95% CI 1.02-1.24); using prefamine births as controls, the OR was 0.89 (95% CI 0.79-1.00). The meta-regressions further showed that the famine effect estimates increased by over 1.05 times with each one-year increase in ignored age differences between famine births and controls. Other newly identified methodological problems included the poorly assessed famine intensity, unsuitable study settings for famine research, and poor confounding adjustment.

INTERPRETATION

The current estimates of a positive relationship between prenatal exposure to the Chinese famine and adult T2D are mainly driven by uncontrolled age differences between famine births and postfamine births. Studies with more rigorous methods, including age-balanced controls and robust famine intensity measures, are needed to quantify to what extent the famine exposure is related to current T2D patterns in China.

The Difference of Sagittal Correction of Adult Subaxial Cervical Spine Surgery According to Age: A Retrospective Study

Objective

At present, the true sagittal alignment of the cervical spine is uncertain, resulting in no standard reference for subaxial cervical surgery. So, we aimed to explore the age difference of normal cervical sagittal alignment and to further investigate the mid‐and long‐term changes of sagittal alignment after subaxial cervical spine surgery.

Materials and Methods

This was a retrospective study and 1223 asymptomatic volunteers and 79 patients undergoing subaxial cervical spine surgery were retrospectively reviewed in total. Asymptomatic volunteers and patients were divided into six subgroups: 20–29, 30–39, 40–49, 50–59, 60–69 and ≥70 groups. The age difference and trend with age of cervical sagittal parameters of asymptomatic volunteers were assessed by cervical lateral radiography and analyzed by ANOVA test, and the regression equation of C2‐7 Cobb was established via multiple linear regression. Based on the C2‐7 Cobb regression equations of different ages, the theoretical value, deviation value, loss value of the C2‐7 Cobb, and JOA recovery rate of patients were calculated, and the correlation among the loss value, deviation value of the C2‐7 Cobb, and JOA recovery rate of the 79 patients was evaluated by Pearson correlation analysis.

Results

For the asymptomatic volunteers, the C0‐2 Cobb decreased gradually with increasing age. The C2‐7 Cobb, C2‐7 SVA, T1S, NT, and TIA increased gradually with increasing age. The CBVA fluctuated with increasing age. T1S demonstrated a moderate correlation with C2‐7 Cobb (r = 0.60, p < 0.01); C0‐2 Cobb, C2‐7 SVA, CBVA, and TIA demonstrated a fair correlation with C2‐7 Cobb (r = −0.30, −0.33, 0.41, 0.40, p < 0.01); age demonstrated a poor correlation with C2‐7 Cobb (r = 0.19, p < 0.01). The regression equations of C2‐7 Cobb were established using C0‐2 Cobb, C2‐7 SVA, CBVA, and T1S. For the patients with subaxial cervical spine surgery, the loss of C2‐7 Cobb was moderately correlated with the deviation of C2‐7 Cobb (r = 0.33, p < 0.01).

Conclusion

The age difference of cervical sagittal alignment was obvious, and the C2‐7 Cobb increased with age especially. The closer the postoperative C2‐7 Cobb was to the theoretical value of corresponding age, the smaller the loss of correction angle was, and the better the mid‐ and long‐term outcomes. The personalized sagittal reconstruction should be performed according to age difference for subaxial cervical spine surgery.

Using age difference and sex similarity to detect evidence of sibling influence on criminal offending

BACKGROUND

Sibling resemblance in crime may be due to genetic relatedness, shared environment, and/or the interpersonal influence of siblings on each other. This latter process can be understood as a type of 'peer effect' in that it is based on social learning between individuals occupying the same status in the social system (family). Building on prior research, we hypothesized that sibling pairs that resemble peer relationships the most, i.e., same-sex siblings close in age, exhibit the most sibling resemblance in crime.

METHODS

Drawing on administrative microdata covering Finnish children born in 1985-97, we examined 213 911 sibling pairs, observing the recorded criminality of each sibling between ages 11 and 20. We estimated multivariate regression models controlling for individual and family characteristics, and employed fixed-effects models to analyze the temporal co-occurrence of sibling delinquency.

RESULTS

Among younger siblings with a criminal older sibling, the adjusted prevalence estimates of criminal offending decreased from 32 to 25% as the age differences increased from less than 13 months to 25-28 months. The prevalence leveled off at 23% when age difference reached 37-40 months or more. These effects were statistically significant only among same-sex sibling pairs (p < 0.001), with clear evidence of contemporaneous offending among siblings with minimal age difference.

CONCLUSIONS

Same-sex siblings very close in age stand out as having the highest sibling resemblance in crime. This finding suggests that a meaningful share of sibling similarity in criminal offending is due to a process akin to peer influence, typically flowing from the older to the younger sibling.

The Association between Trajectories of Loneliness and Physical Frailty in Chinese Older Adults: Does Age Matter?

Background: The present study aimed to examine age differences in the relationship between trajectories of loneliness and physical frailty among Chinese older adults. Methods: A total of 4618 participants aged ≥60 years old were taken from pooled data created from the 2011−2015 China Health and Retirement Longitudinal Study (CHARLS). Loneliness was assessed by a single question from the Centre for Epidemiological Studies scale, whereas physical frailty (PF) was examined by the physical frailty phenotype scale. We characterized trajectories of loneliness and PF using transition types and changes within the survey period. Results: Logistic regression models revealed that baseline loneliness was significantly related to remaining robust PF (OR = 0.55, 95% CI = 0.49−0.63, p < 0.001) and worsening in PF (OR = 1.17, 95% CI = 1.05−1.30, p < 0.01) at follow-up. Baseline PF status was also significantly related to the transitions in loneliness (worsen: OR = 1.41, 95% CI = 1.11−1.78, p < 0.01; improve: OR = 0.65, 95% CI = 0.47−0.91, p < 0.05). The cross-lagged panel model found that baseline PF or loneliness had a significant predictive effect on the changes in each other. The associations between trajectories of loneliness and PF were weakened with age and clustered in the under 75 age groups. Conclusions: Bidirectional associations may exist between trajectories of loneliness and PF among Chinese older adults. Interventions should mainly target the young-old to reduce the adverse reciprocal effects of loneliness and PF.

The Relationship Between Obesity and Depression Is Partly Dependent on Metabolic Health Status: A Nationwide Inpatient Sample Database Study

OBJECTIVE

Some studies have demonstrated a bidirectional association between obesity and depression, whereas others have not. This discordance might be due to the metabolic health status. We aimed to determine whether the relationship between obesity and depression is dependent on metabolic health status.

METHODS

In total, 9,022,089 participants were enrolled and classified as one of four obesity phenotypes: metabolically healthy nonobesity (MHNO), metabolically unhealthy nonobesity (MUNO), metabolically healthy obesity (MHO), and metabolically unhealthy obesity (MUO). We then divided the population into eight phenotypes based on obesity and the number of metabolic risk factors. Furthermore, the associations of eight phenotypes, based on obesity and specific metabolic risk factors, with depression were assessed.

RESULT

Among all participants, a higher risk of depression was observed for MUNO, MHO and MUO than for MHNO. The risk was highest for MUO (OR = 1.442; 95% CI = 1.432, 1.451). However, the association between MHO and depression was different for men and women (OR = 0.941, men; OR = 1.132, women). The risk of depression increased as the number of metabolic risk factors increased. Dyslipidemia was the strongest metabolic risk factor. These relationships were consistent among patients ≥ 45 years of age.

CONCLUSIONS

The increased risk of obesity-related depression appears to partly depend on metabolic health status. The results highlight the importance of a favorable metabolic status, and even nonobese populations should be screened for metabolic disorders.

Parental age gaps among immigrants and their descendants: Adaptation across time and generations?

Age gaps between partners have undergone dramatic changes in high-income countries over the past century. Yet, there has been little focus on age gaps for immigrants and their descendants. This is an important omission because age gaps can be interpreted as a macro-level indicator of intergenerational adaptation. We examine the age gaps of biological parents (childbearing partners) among immigrants and their descendants in Sweden, a country with high gender equality and a stable mean age gap. Using longitudinal, whole-population data, we examine changes in age gaps for cohorts born 1950-86. Cohort trends in age gaps often follow very different patterns for male and female immigrants, with limited evidence of adaptation across cohorts. However, there is considerable evidence of adaptation towards the Swedish norm among the second generation, including from direct comparison between immigrants and their children. The largest differences between women and men are seen among the first generation with a Swedish-born partner.

How Institutional Evaluation Bridges Uncertainty and Happiness: A Study of Young Chinese People

Uncertainty triggers negative psychological responses, while positive institutional evaluations elevate the sense of control in individuals and satisfy their need for structure and order. Data from the 2015 Chinese Social Survey (CSS) (N = 4,605) demonstrated that objective uncertainty negatively predicted the happiness of young people (aged 18–45 years). However, this negative relationship was attenuated among those who evaluated the institutional system (e.g., social security, local government effectiveness, and trust in government) positively; in other words, positive institutional evaluation may have protected people's happiness from the threat of uncertainty. In addition, participants from different age groups evaluated the institutional system differently. The first generation born after the Chinese economic reform, which includes young people born in the 1980s (aged 26–35 years), had unique experiences compared to the preceding (aged 36–45 years, born in the 1970s) and succeeding (aged 18–25 years, born in the 1990s) generations. Among the three age groups, young people born in the 1980s held the least positive evaluation of the institutional system. The institutional evaluation also showed the weakest moderating effect on this group's happiness.

Age and Cultural Differences in Recognitions of Emotions from Masked Faces among Koreans and Americans

This study investigates age and cultural differences in the negative effects of senders’ wearing masks on receivers’ readabilities of senders’ facially expressed emotions in interpersonal interactions. An online experiment was thus conducted with Koreans and Americans aged over 20 years. Based on sampling quotas by nationality, age group and gender, Korean (n = 240) and American (n = 273) participants were recruited from panel members of a Korean research company and Amazon’s Mechanical Turk via email and the website, respectively. The participants played receiver roles to infer senders’ facially expressed emotions presented in photos in the experiment. They judged emotions facially expressed by the senders without masks and with masks are shown in photos. The results revealed that the senders’ wearing masks reduced the readabilities of the senders’ facially expressed anger among participants aged 30–49 years more than among participants aged 20–29 years. The senders’ wearing masks decreased the readabilities of the senders’ facially expressed fear for participants in their 50’s more than for participants in their 20’s. When the senders wore masks, the readabilities of the senders’ facially expressed happiness dropped among participants aged over 60 years more than among participants aged 20–49 years. When senders wore masks, American participants’ readabilities of disgust, fear, sadness and happiness expressed in the senders’ faces declined more than Korean participants’ readabilities of those emotions. The implications and limitations of these findings are discussed.

Religious Affiliation, Daily Spirituals, and Private Religious Factors Promote Marital Commitment Among Married Couples: Does Religiosity Help People Amid the COVID-19 Crisis?

Religious studies are a vital branch of social science that seeks to explain the beliefs of human society and deals with the practices and beliefs of individuals. This distinctive study focuses on such influential aspects of a healthy life, which could play a vital role in the marital quality and matrimonial commitment of individuals. The study principally focused on inspecting the role of religiosity in healthy marital commitment among individuals. It is a distinctive and central value in regulating a healthy social life. This research designed a conceptual model for assessing marital commitment, and the study model comprised two primary variables. The study received datasets through a survey questionnaire based on participants from five private and public sectors. The research study conducted an empirical analysis to test the proposed conceptual framework. The findings exhibited that the value of the R 2 model was 0.484, meaning the level of religiosity had a substantial impression on healthy and lasting marital commitment. According to the final outline of the model factors associated with building religious support factors (β = 0.491), the marital commitment had a better and healthier impact. The goodness-of-fit of the measurement of the conceptual model showed a value of 0.51, which indicated that the theoretical model had sufficient consistency and rationality, and accurately fitted the data. Such an advanced statistical model is missing from the previous literature. The study results provide helpful insight to elucidate the social dynamics of marital commitment. The findings designate that religious practices strengthen and promote nuptial commitment. The study is novel in the context of religiosity impact on martial commitment with a cultural background of Pakistan. The generalizability of the study does not apply to the entire population or other regions. Future studies can investigate other religious variables to explore further research findings. The findings are helpful for decision-makers and policymakers to concentrate on marital issues and challenges confronted by couples worldwide.

The Moderating Role of Deviant Peer Affiliation in the Relation between Cyber-Victimization, Tobacco and Alcohol Use, and Age Differences

Cyber-victimization, tobacco and alcohol use are all prominent public health problems among adolescents throughout the world. Against this background, this study examined the association between cyber-victimization and tobacco and alcohol use, as well as the moderating role of deviant peer affiliation and the potential age differences among elementary, middle, and high school students. A survey conducted among 1488 school students (aged 9-19 years, consisting of 702 elementary school students, 318 middle school students, and 468 high school students) found that cyber-victimization was positively correlated with tobacco and alcohol use among students of all stages. However, the moderating mechanism was different. Among elementary school students, deviant peer affiliation played a positive moderating role. For individuals with high deviant peer affiliation, this association was stronger. Among middle school students, the moderating role of deviant peer affiliation was insignificant. Among high school students, deviant peer affiliation played a negative moderating role; this association was significant for individuals with low deviant peer affiliation. The results of this study clarify the relationship between cyber-victimization and tobacco and alcohol use by examining the moderating role of deviant peer affiliation and age differences, providing intervention guidance for reducing the negative influences of cyber-victimization on children and adolescents with respect their use of tobacco and alcohol.

Gut microbiota are associated with sex and age of host: Evidence from semi-provisioned rhesus macaques in southwest Guangxi, China

Host characteristics, such as sex and age, are closely associated with the structure and function of gut microbiota; however, less is known about the effects of age and sex on the gut microbiota of nonhuman primates, and therefore, our knowledge of interindividual variability in host gut microbiota is limited. In this study, 153 fecal samples from rhesus macaques (Macaca mulatta) were analyzed using high-throughput 16S rRNA sequencing in order to explore associations between age and sex of the host and their gut microbiota. The results indicated that female macaques had higher alpha diversity and a more unique gut microbiota than did males. The proportion of Proteobacteria, Tenericutes, Cyanobacteria, unclassified bacteria, and Verrucomicrobia was higher in females than that in males. We also found that adults of both sexes had a higher alpha diversity, a higher proportion of norank Ruminococcaceae, Oscillospira, norank Lachnospiraceae, norank Clostridiales, and Succinivibrio, and a lower proportion of Enterococcus than immatures. Functional analyses revealed that the richness of metabolic pathways was higher in females than males and in adults compared with immatures. These results could be attributed to differences in the nutritional requirements and hormone levels of macaques of different sex and age classes. We conclude that variation in the gut microbiota of different sex and age classes of rhesus macaques may be linked to age- and sex-specific differences in nutrient requirements and hormone levels. These results highlight the importance of host age and sex on the structure and function of the gut microbiota and the need to consider physiological traits when conducting studies on the gut microbiota.

Older adults with colon cancer are not different from younger ones, but treated differently: Retrospective analysis from single centre

AIM

Decision- making of the treatment of colon cancer for the older patients becomes more complicated in consequence of comorbidities and geriatric syndromes, most importantly frailty. In the present study, we aimed to investigate whether there is a difference between tumour characteristics, treatment choices, and outcomes between the younger and older adults.

METHOD

The patients who were diagnosed with colorectal carcinoma in our centre between 2010 and 2015 included. Clinicopathological features of tumour, treatment choices and survivals of the patients were recorded. Patients were separated into two groups according to their chronological age.

RESULTS

The present study included 465 patients, there were 173 patients aged 65 years and older. Clinicopathological features were similar in both groups. Adjuvant chemotherapy was given in similar rates. Whereas combination chemotherapies were preferred in younger patients as first-line therapy, single agents were given to the older group(p-value < 0.001). No significant differences were observed between combination therapy and monotherapy as progression-free and overall survival in older adults(p value > 0.05). It was observed that 53.2% of the older patients was not treated with any biological treatment (p-value < 0.001).

DISCUSSION

Geriatric people are underrepresented in clinical trials,because of the presence of the limitations in the older patients. The results of our study revealed older patients with colon cancer patients underwent surgery less than the younger ones, they recieved monotherapy more frequently as first-line chemotherapy, and less frequently targeted therapy. Their mortality was higher. It was shown that decision-making of colon cancer therapy is influenced by age according to our results.

Age differences in the relationship between threatening and coping mechanisms and preventive behaviors in the time of COVID-19 in the United States: Protection Motivation Theory

It is important to understand the factors motivating people to adopt recommended behavioral changes in response to the coronavirus disease 2019 (COVID-19) pandemic, and how they differ for younger and older adults. Using a nationally representative sample from the Understanding America Study (3/10-3/31/2020), we assessed how four cognitive mediators affected uptake of protective activities for younger (aged 18-34) and older adults (aged 65+) during the beginning of the COVID-19 pandemic. Confirmatory factor analysis based on Protective Motivation Theory demonstrated associations between our observed variables and the latent constructs: perceived severity and susceptibility, and response efficacy and self-efficacy. Among younger adults, coping appraisal such as perceptions of effectiveness of behaviors in protecting them from coronavirus and belief in their ability to perform recommended changes led them to adopt preventive behaviors; for older people, threat appraisal such as perception of severity was associated with behavioral responses. Younger people may rely more on their assessment of coping resources and effectiveness in their response to COVID-19; while older people base their behavioral responses on their perception of the severity of the situation, which they appraise using information from media and the severity of the epidemic in their state of residence. Different strategies are required to motivate older and younger people to adopt behavioral modifications, which are critical in reducing further spread of COVID-19.

The Developmental Trajectory of Self-Esteem Across the Life Span in Japan: Age Differences in Scores on the Rosenberg Self-Esteem Scale From Adolescence to Old Age

We examined age differences in global self-esteem in Japan from adolescents aged 16 to the elderly aged 88. Previous research has shown that levels of self-liking (one component of self-esteem) are high for elementary school students, low among middle and high school students, but then continues to become higher among adults by the 60s. However, it did not measure both aspects of self-esteem (self-competence and self-liking) or examine the elderly over the age of 70. To fully understand the developmental trajectory of self-esteem in Japan, we analyzed six independent cross-sectional surveys. These surveys administered the Rosenberg Self-Esteem Scale, which measured both self-competence and self-liking, on a large and diverse sample (N = 6,113) that included the elderly in the 70s and 80s. Results indicated that, consistent with previous research, for both self-competence and self-liking, the average level of self-esteem was low in adolescence, but continued to become higher from adulthood to old age. However, a drop of self-esteem was not found over the age of 50, which was inconsistent with prior research in European American cultures. Our research demonstrated that the developmental trajectory of self-esteem may differ across cultures.

Intraspecific Variation in the External and Skeletal Morphology of Hynobius setouchi Matsui, Okawa, Tanabe et Misawa, 2019 (Amphibia: Urodela: Hynobiidae)

The hynobiid salamander genus Hynobius is a basal taxon in the urodeles that plays a key role in understanding the evolution of sexual dimorphism in urodeles. We examined the age (juveniles vs. adults) and sexual differences in the external and skeletal morphology of a Japanese lentic breeding salamander, Hynobius setouchi. We found that juveniles had larger heads than those of adults, and most characters were larger in adult males than in females, except for trunk size. This was also observed in skeletal morphology, although some tail characters differed only in the skeleton. We suggest that intra- and interspecific comparisons of the external and skeletal characters of salamanders should consider age, sexual, and seasonal differences.

Adult and juvenile bearded capuchin monkeys handle stone hammers differently during nut-cracking

Wild bearded capuchin monkeys (Sapajus libidinosus) habitually use stone hammers to crack open palm nuts and seeds on anvils. This activity requires strength, balance, and precise movement of a large stone with respect to the item placed on an anvil. We explored how well young monkeys cope with these challenges by examining their behavior and the behavior of adults while they cracked palm nuts using a stone. Using video records, we compared actions of six juvenile (2-5 years) and six adult (7+ years) wild monkeys during their first 20 strikes with one unfamiliar ellipsoid, quartzite stone (540 g), and the outcomes of these strikes. Compared with adults, juveniles cracked fewer nuts, performed a more diverse set of exploratory actions, and less frequently placed one or both hands on top of the stone on the downward motion. Adults and juveniles displayed similar low frequencies of striking with a slanted trajectory, missing the nut, and losing control over the nut or stone after striking. These findings indicate that young monkeys control the trajectory of a stone adequately but that is not sufficient to crack nuts as effectively as adults do. Compared with juveniles, adults more quickly perceive how to grip the stone efficiently, and they are able to adjust their grip dynamically during the strike. Young monkeys develop expertise in the latter aspects of cracking nuts over the course of several years of regular practice, indicating that perceptual learning about these aspects of percussion occurs slowly. Juvenile and adult humans learning to use stones to crack nuts also master these features of cracking nuts very slowly.

Opposite Roles of BAP1 in Overall Survival of Uveal Melanoma and Cutaneous Melanoma

Background: BRCA1-Associated Protein 1 (BAP1) germline mutations predispose individuals to cancers, including uveal melanoma (UM) and cutaneous melanoma (CM). BAP1 loss is common in UM and is associated with a worse prognosis. BAP1 loss is rare in CM and the outcome is unclear. Methods: UM and CM data was retrieved from The Cancer Genome Atlas (TCGA) database. Cox regression model was performed to examine whether BAP1 mRNA levels or copy number variations were associated with overall survival (OS). Results: BAP1-low mRNA predicted a poor OS in UM (HR = 9.57, 95% CI: 2.82, 32.5) but a contrasting better OS in CM (HR = 0.73, 95% CI: 0.56, 0.95). These results remained unchanged after adjusting for sex, age, and stage in UM and CM, or after adjusting for ulceration or Breslow depth in CM. Additionally, low BAP1 mRNA predicted a better OS in CM patients older than 50 years but not in younger patients. Co-expression and enrichment analysis revealed differential genes and mutations that were correlated with BAP1 expression levels in UM and CM tumors. Conclusions: Low BAP1 mRNA was significantly associated with a better OS in CM patients, in sharp contrast to UM. High BAP1 expression in CM was significantly associated with over-expressed CDK1, BCL2, and KIT at the protein level which may explain the poor OS in this sub-group of patients. Function of BAP1 was largely different in CM and UM despite of a small subset of shared co-expressed genes.

Illness Perceptions, Self-Care Management, and Clinical Outcomes According to Age-Group in Korean Hemodialysis Patients

Illness perception, formed in social-cultural contexts, is the driving force for health behavior. Age difference can affect health outcomes due to its association with socioeconomic status. The purpose of this study is to determine the relationship between illness perception, self-care management, and clinical outcomes according to the age group in hemodialysis patients. A cross-sectional study was conducted. Using the Brief Illness Perception Questionnaire (BIPQ) and Patient Activation Measure (PAM) 13, clinical outcomes, such as serum phosphorus, potassium, hemoglobin, and albumin were investigated in maintenance hemodialysis patients. Illness perception, self-care management, and clinical outcomes in 189 hemodialysis patients were different according to age group. Younger hemodialysis patients had the lowest illness perception and the highest serum phosphorus. Illness perception was associated with self-care management and clinical outcomes. After the adjusted age, the association between illness perception and self-care management and the association between illness perception and phosphorus were reduced, while the association between illness perception and potassium increased. Uncontrolled phosphorus in younger hemodialysis patients can increase the risk of cardiovascular complications and mortality. To improve self-care management and clinical outcomes in hemodialysis patients, reconstruction, or expansion of illness perception needs to be differentiated according to age group.

Age Differences in the Relationship between Secondhand Smoke Exposure and Risk of Metabolic Syndrome: A Meta-Analysis

Secondhand smoke (SHS), a common environmental exposure factor, has become a serious public health problem. Metabolic syndrome is another worldwide clinical challenge. Our study tried to determine the age differences in the relationship between SHS and the risk of metabolic syndrome. Studies were searched in PubMed and Web of Science from 11 November to 30 November 2018. Eighteen studies were finally included based on inclusion and exclusion criteria. The relationship between SHS and the risk indicators of metabolic syndrome was analyzed. The weighted mean difference (WMD) of fasting plasma glucose (FPG), insulin, body mass index (BMI), and waist circumference (WC), and the standard mean difference (SMD) of total cholesterol, triglycerides, and low- and high-density lipoprotein-cholesterol (LDL-C, HDL-C) were calculated in a meta-analysis. SHS was positively associated with the level of insulin and WC. According to the subgroup analysis based on age difference, SHS was positively associated with FPG in the upper age group, and positively associated with LDL-C and negatively associated with HDL-C in the lower age group. BMI showed a more obvious positive correlation in the adults group than in the children and the teenagers group. In conclusion, the association of metabolic syndrome with SHS varies with age. When exposed to SHS, older people may be more susceptible to glucose metabolic disorder, but younger people may be more susceptible to lipid metabolic disorder.

The Association Between Education and Smoking Prevalence, Independent of Occupation: A Nationally Representative Survey in Japan

Background

Higher smoking prevalence in less educated persons and manual workers is well known. This study examines the independent relationship of education and occupation with tobacco use.

Methods

We used anonymized data from a nationwide population survey (30,617 men and 33,934 women). Education was divided into junior high school, high school, or university attainment. Occupation was grouped into upper non-manual, lower non-manual, and manual. Poisson regression models stratified by age and gender were used to estimate adjusted prevalence ratio (PR) and 95% confidence interval (CI) for current smoking.

Results

After adjustment for covariates, education, and occupation, education was significantly related to current smoking in both genders; compared to university graduates, PRs of junior high school graduates aged 20–39, 40–64, and ≥65 were 1.74 (95% CI, 1.53–1.98), 1.50 (95% CI, 1.36–1.65), and 1.28 (95% CI, 1.08–1.50) among men, and 3.54 (95% CI, 2.92–4.30), 2.72 (95% CI, 2.29–3.23), and 1.74 (95% CI, 1.14–2.66) among women, respectively. However, significantly higher smoking prevalence in manual than in upper non-manual was found only in men aged 20–64; compared to upper non-manual, the PRs of manual workers aged 20–39, 40–64, and ≥65 were 1.11 (95% CI, 1.02–1.22), 1.18 (95% CI, 1.10–1.27), and 1.10 (95% CI, 0.89–1.37) among men, and 0.95 (95% CI, 0.75–1.20), 0.92 (95% CI, 0.75–1.12), and 0.46 (95% CI, 0.22–0.95) among women, respectively.

Conclusions

Independent of occupation, educational disparities in smoking existed, regardless of age and gender. Occupation-smoking relationship varied with age and gender. Our study suggests that we should pay attention to social inequality in smoking as well as national smoking prevalence.

Age Differences in Work Stress, Exhaustion, Well-Being, and Related Factors From an Ecological Perspective

The aim of this study was to examine the association of work stress, exhaustion, well-being, and related individual, organizational, and social factors, focusing especially on age differences in Taiwan. The data were from the 2015 Taiwan Social Change Survey. The participants were community-based adults, aged 18 years or older, selected via stratified multistage proportional probability sampling from the Taiwanese population. Well-being was measured by self-rated health and psychological health. Descriptive analysis, one-way analysis of variance, and linear regression analysis were used. Work stresses were related to three types of exhaustion, and exhaustion was related to well-being. Individual working style (being creative and using new methods), organizational factors (job satisfaction, work-family conflict, discrimination against women), and social factors (difficult finding a good job than older cohorts) were related to well-being. Older age was related to worse self-rated health, and age showed a reverse-U-shaped relation with psychological health. The resilience of older workers could be an opportunity for the global active aging trend, and interventions to support older workers in organizations would be beneficial.

The impact of donor/recipient age difference and HLA mismatch on graft outcome in pediatric kidney transplantation

BACKGROUND

Understanding the relationship between the factors that influence long-term kidney transplant survival remains a key priority for pediatric nephrologists. We assessed the relative impact of donor/recipient age difference and HLA matching on long-term graft outcomes.

METHODS

We conducted a retrospective cohort study of pediatric and adolescent recipients who received a primary kidney transplant in Australia and New Zealand between January 1, 1990, and December 31, 2015. The primary outcome was graft survival analyzed by Kaplan-Meier method.

RESULTS

During the 26-year period, 1134 primary (395 DD and 739 LD) kidney transplants were performed in recipients less than 20 years of age. The median follow-up time was 10.2 years. Overall, 405 patients (35.7%) lost their transplant with graft survival 93.8% at 1 year, 82.5% at 5 years, 65.8% at 10 years, and 49.9% at 15 years post-transplant. There was consistently higher graft loss of DD kidneys as compared to LD kidneys at each time point. Both increasing donor/recipient age difference (aHR 1.11 per 10 years; 95% CI, 1.02-1.20; P = 0.009) and increasing HLA mismatch (aHR 1.20 per mismatch; 95% CI, 1.10-1.30; P < 0.001) were associated with decreased graft survival.

CONCLUSIONS

Donor/recipient age difference and HLA matching are important factors influencing long-term graft outcomes in pediatric kidney transplantation. HLA mismatch remains a strong predictor of graft loss. For patients without the option of a LD, we suggest that the degree of HLA mismatch should not be discounted as part of the decision-making process of organ allocation.

Age-Dependent Anti-migraine Effects of Valproic Acid and Topiramate in Rats

Background: Valproic acid (VPA) and topiramate (TPM), initially developed as antiepileptics, are approved for migraine prophylaxis in adults but not children. The differences in their antimigraine mechanism(s) by age remain unclear.

Methods: A migraine model induced by intra-cisternal (i.c.) capsaicin instillation in pediatric (4–5 weeks) and adult (8–9 weeks) rats was pretreated with VPA (30, 100 mg/kg) or TPM (10, 30, 100 mg/kg). Noxious meningeal stimulation by the irritant capsaicin triggered trigeminovascular system (TGVS) activation mimicking migraine condition, which were assessed peripherally by the depletion of calcitonin gene-related peptide (CGRP) in sensory nerve fibers of the dura mater, the increased CGRP immunoreactivity at trigeminal ganglia (TG) and centrally by the number of c-Fos-immunoreactive (c-Fos-ir) neurons in the trigeminocervical complex (TCC). Peripherally, CGRP released from dural sensory nerve terminals of TG triggered pain signal transmission in the primary afferent of trigeminal nerve, which in turn caused central sensitization of the TGVS due to TCC activation and hence contributed to migraine.

Results: In the VPA-treated group, the central responsiveness expressed by reducing the number of c-Fos-ir neurons, which had been increased by i.c. capsaicin, was significant in pediatric, but not adult, rats. Inversely, VPA was effective in peripheral inhibition of elevated CGRP immunoreactivity in the TG and CGRP depletion in the dura mater of adult, but not pediatric, rats. In TPM group, the central responsiveness was significant in both adult and pediatric groups. Peripherally, TPM significantly inhibited capsaicin-induced CGRP expression of TG in adult, but not pediatric, rats. Interestingly, the capsaicin-induced depletion of CGRP in dura was significantly rescued by TPM at high doses in adults, but at low dose in pediatric group.

Conclusion: These results suggest VPA exerted peripheral inhibition in adult, but central suppression in pediatric migraine-rats. In contrast, TPM involves both central and peripheral inhibition of migraine with an optimal therapeutic window in both ages. These findings may clarify the age-dependent anti-migraine mechanism of VPA and TPM, which may guide the development of new pediatric anti-migraine drugs in the future.

Spontaneous recovery of fear differs among early - late adolescent and adult male mice

Adolescence is a vulnerable period for developing anxiety-related mental disorders such as post-traumatic stress disorder (PTSD), which requires a long-term course of therapy when a traumatic event has been experienced during childhood. However, the biological mechanism underlying these age-dependent characteristics remains unclear. In the present study, we used early adolescent, late adolescent and adult (4-, 8-, and 15-week old) male mice to examine age differences in fear memory, fear extinction, and spontaneous recovery of fear. We also measured the activation of extracellular signal-regulated kinase (ERK) 2 in the dorsal hippocampus (dHip) and the basolateral amygdala (BLA) following a spontaneous recovery test. Our major findings were as follows: (1) early adolescent and adult mice did not recover the fear response; only late adolescent mice recovered the fear response. (2) The ERK2 in the dHip was more activated after the spontaneous recovery test in late adolescent mice than in adult mice, and the ERK2 in the BLA was more activated after the spontaneous recovery test in adult mice than in late adolescent mice. These results suggest that there exists a unique period in which spontaneous recovery occurs and that these late adolescent behavioral signatures may be related to alteration in the ERK2 phosphorylation in the dHip and BLA.

Effects of age on effect-site concentration of remifentanil for suppressing anesthetic emergence cough in male patients undergoing laparoscopic cholecystectomy

Background

Remifentanil infusion during emergence lowers cough. Effect-site concentration (Ce) of remifentanil using target-controlled infusion (TCI) has been evaluated in previous studies. Recent studies revealed the existence of sex-related differences in remifentanil Ce in young and elderly patients. Thus, there was the need to re-evaluate the effect of age in single sex. We investigated the remifentanil Ce for suppressing emergence cough in young and elderly male patients and evaluated the age-related differences.

Patients and methods

In total, 25 young (ages between 20 and 50 years) and 24 elderly (ages between 65 and 75 years) male patients undergoing laparoscopic cholecystectomy were enrolled. Anesthesia was implemented with remifentanil using TCI and sevoflurane. The remifentanil Ce for suppressing emergence cough was estimated for each group using Dixon’s up-and-down method and isotonic regression method with a bootstrapping approach.

Results

The remifentanil Ce for suppressing emergence cough in 50% (EC₅₀) and 95% (EC₉₅) of the patients was comparable between the young and elderly patients. Isotonic regression demonstrated that the EC₅₀ (83% confidence interval [CI]) of remifentanil was 2.56 (2.39−2.75) ng/mL in the young patients and 2.15 (1.92−2.5) ng/mL in the elderly patients. The EC₉₅ (95% CI) of remifentanil was 3.33 (2.94−3.46) ng/mL in the young patients and 3.41 (3.18−3.48) ng/mL in the elderly patients. Dixon’s up-and-down method also demonstrated that the EC₅₀ was comparable between the two groups (2.69±0.32 ng/mL vs 2.39±0.38 ng/mL, P=0.132).

Conclusion

The remifentanil Ce for suppressing emergence cough following extubation during general anesthesia was comparable between young and elderly male patients. It indicates that age-related differences in remifentanil requirement for suppressing emergence cough did not exist in male sex.

Sex and age differences in risk factors of marijuana involvement during adolescence

Objectives

We aimed to examine whether there are sex and age differences in psychosocial risk factors of marijuana use during adolescence.

Methods

Data were drawn from 57,767 adolescents (8^th and 10^th graders) from the 2012-2013 Monitoring the Future study. We examined the association between socio-demographic and behavioral correlates with different frequencies of past-year marijuana use (non-use, occasional use: <10 time, frequent use: 10-39 times, and regular use: 40+ times). We further investigated whether these associations were similar for boys and girls of different ages.

Results

Overall, 20.6% of the adolescents reported past-year marijuana use: 12.1% occasional use, 4.3% frequent use, and 3.8% regular use. Girls were less likely to be frequent and regular marijuana users (frequent use: OR=0.83 [0.75, 0.93]; regular use: OR=0.41 [0.36, 0.48]) while no sex difference was noted for occasional use. Also, the odds of deviant behaviors were higher as the frequencies of marijuana use were higher. Compared to younger girls, older boys and girls had higher association between all levels of marijuana use and low self-esteem, low perceived harm, peer influence and perceived easy access. Besides, younger boys were more likely than younger girls to report an association between regular marijuana use with low self-esteem, peer influence, and perceived easy access but not with perceived low harm.

Conclusions/Importance

Findings suggest the relationship between these psychosocial correlates and frequency of marijuana involvement varies across sex and age groups. These variations ask for a nuanced approach to prevention of marijuana involvement in different groups of youth.

Age differences in sexual risk behaviors and related factors among people living with HIV in Guangxi, China

Sexual risk behaviors by people living with HIV (PLHIV) can result in secondary HIV transmission and other health problems. Given the dearth of research on age differences in sexual behaviors among PLHIV, the objective of the study is to compare sexual risk behaviors and related factors among PLHIV by age groups. Data used in the current study were derived from a cross-sectional survey conducted from 2012 to 2013 in Guangxi, China. PLHIV were selected randomly from 12 sites with the largest number of HIV/AIDS cases. The 2,987 PLHIV completing the survey were included in the study. Participants were asked about key sociodemographic characteristics, health condition, same-sex behavior, and sexual risk behaviors (number of sex partners, condom use consistency, and change in condom use after HIV diagnosis). Univariate logistic regression analyses were conducted to evaluate associations of sexual risk behaviors with age and other factors. Those variables with a p-value of less than 0.2 were entered into multivariate logistic regression models. All statistical analyses were conducted using SAS 9.4. Differences in sexual risk behaviors across age groups were observed. Compared with their younger counterparts, who were ≥ 50 years of age were more likely to have multiple partners, use condoms inconsistently, and use condoms less than before HIV diagnosis. Moreover, lower education attainment, being in the lowest or highest category of income, having a sero-concordant or sero-unknown steady partner or no steady partner, and having contracted HIV from steady or casual/commercial partners, or through injection drug use appeared to be predictive of at least one of the sexual risk behaviors examined in the study. The findings call for HIV prevention interventions to be tailored to different age groups. The interventions that can help reduce unprotected sex among older PLHIV are urgently needed.

Quantitative sensory testing (QST) in the orofacial region of healthy Chinese: influence of site, gender and age

OBJECTIVE

To establish a preliminary thermal and mechanical somatosensory profile using a standardized quantitative sensory testing (QST) to investigate site, gender and age differences in healthy Chinese.

MATERIALS AND METHODS

Twenty younger (age: 20-40 years, 10 men, 10 women) and twenty older (age: 41-61 years, 10 men, 10 women) healthy participants completed the study. Cold detection threshold (CDT), warm detection threshold (WDT), cold pain threshold (CPT), heat pain threshold (HPT), mechanical detection threshold (MDT) and mechanical pain threshold (MPT) were measured at five sites: Left hand, bilaterally at the mental area, tip of tongue and the lower lip mucosa. Mixed model ANOVAs with repeated measures were used to analyze the data.

RESULTS

MDT(p < .001) and MPT (p < .05) were significantly higher on the hand compared to the mental areas. The CDT ( p = .006) was significantly higher and WDT (p < .001) was significantly lower at the tongue compared to lip mucosa and CDT (p < .001) was higher at the tongue mucosa than at the mental areas. WDT (p < .001) and HPT (p < .05) were significantly higher at the tip of the tongue and the lower lip mucosa compared to the mental areas. Significantly lower sensitivity for WDT (p < .001) and CDT (p = .004) were found in the older group compared to the younger group. Significant gender differences were found with less sensitivity for WDT (p = .024) and MDT (p = .003) in men compared to women.

CONCLUSIONS

Application of standardized QST can provide valuable information of orofacial somatosensory phenotypes in a Chinese population. Age, gender and site are mandatory to control for.

Gingival Pigmentation Affected by Smoking among Different Age Groups: A Quantitative Analysis of Gingival Pigmentation Using Clinical Oral Photographs

The presence of any age-related differences in gingival pigmentation associated with smoking, particularly in a young population, remains to be fully investigated. The purpose of this study was to determine the age-related differences in smoking gingival pigmentation. Gingival pigmentation was analyzed using the gingival melanosis record (GMR) and Hedin’s classification with frontal oral photographs taken at 16 dental offices in Japan. Participants were categorized into 10-year age groups, and their baseline photographs were compared. In addition, to evaluate the effect of smoking cessation on gingival pigmentation, subjects were divided into a former smoker group (stopped smoking) and current smoker group. A total of 259 patients 19 to 79 years of age were analyzed. People in their 30s showed the most widespread gingival pigmentation. In addition, subjects in their 20s showed a weak effect of smoking cessation on gingival pigmentation. These findings suggested that the gingival pigmentation induced by smoking was more remarkable in young people than in middle-aged people. This information may be useful for anti-smoking education, especially among young populations with a high affinity for smoking.

Impact of Age on Pain Perception for Typical Painful Diagnoses in the Emergency Department

BACKGROUND

Age-related differences in pain perception have been demonstrated in experimental settings but have been investigated scarcely and without valid scale in the clinical framework.

OBJECTIVES

To examine the effect of age on pain perception for recognized painful diagnoses encountered in the emergency department (ED).

METHODS

A post-hoc analysis of real-time archived data was performed in a tertiary urban and a secondary regional ED. We included all consecutive adult patients (≥18 years) with the following diagnosis at discharge: renal colic, pancreatitis, appendicitis, headache/migraine, dislocation and extremities fractures, and a pain evaluation of ≥1 (0-10, verbal numerical scale) at triage. The primary outcome was to compare for each of these diagnoses the level of pain intensity between four age groups (18-44; 45-64; 65-74; 75+ years).

RESULTS

A total of 15,670 patients (48% women) were triaged with a mean pain intensity of 7.7 (SD=2.0). Women exhibited greater pain scores than men for pancreatitis, headache/migraine, and extremity fracture. Renal colic, pancreatitis, appendicitis, and headache/migraine showed a linear decrease in pain scores with age whereas dislocation and extremity fractures did not present age differences. Mean differences in pain intensity scores between young adults (18-44 years) and patients aged ≥75 years were 0.79 (95% confidence interval [95% CI] 0.5-1.1) for renal colic, 1.1 (95% CI 0.7-1.4) for pancreatitis, 0.70 (95% CI 0.2-1.2) for appendicitis, and 0.86 (95% CI 0.6-1.1) for headache/migraine.

CONCLUSION

Older patients perceive similar pain for dislocation and extremity fractures and less for visceral and headache/migraine pain; however, these age differences may not be clinically important.

Sporadic contraceptive use and nonuse: age-specific prevalence and associated factors

OBJECTIVE

The purpose of this study was to characterize age-group specific patterns in the stability of contraceptive use and to evaluate whether factors that are associated with nonuse and sporadic use, compared with stable use, differ by age among women who are at risk for unintended pregnancy.

STUDY DESIGN

We used data from the 2006-2010 National Survey of Family Growth to characterize the prevalence of stable and sporadic contraceptive use and nonuse by age over a 1-year period. We used polytomous logistic regression models to assess the odds of contraceptive nonuse and sporadic use vs stable use. Age-stratified models were used to show age-group differences in associated characteristics.

RESULTS

Over a 1-year period, stable contraceptive use decreased across age groups from 80% for teens 15-19 years old to 74% for women 20-24 years old, and 70-71% for women 25-34 and 35-44 years old. Contraceptive nonuse increased across age groups from 5% for teens 15-19 years old to 9-20% for older women. By contrast, sporadic use was least common for women 35-44 years old (10% compared with 16-17% for younger women). Among teens 15-19 years old, a history of method discontinuation because of dissatisfaction was associated with nonuse. Among older women, intentions to have children in the future and reported difficulty achieving pregnancy were associated with nonuse and sporadic use.

CONCLUSION

Because the stability of contraceptive use and associated factors differ by age, providers may need to consider these differences when talking to women about contraception. To address nonuse, helping teens identify a method that they are comfortable using may be especially important; for older women, discussing the potential for continuing fertility may be more important. To address sporadic use, discussing the benefits of user-independent methods may be helpful, with a particular emphasis on long-acting reversible contraceptives for younger women and teens who are less likely to have completed their desired childbearing and who have tended to rely on methods that are more difficult to use consistently.

Intermittent hypoxia in childhood: the harmful consequences versus potential benefits of therapeutic uses

Intermittent hypoxia (IH) often occurs in early infancy in both preterm and term infants and especially at 36-44 weeks postmenstrual age. These episodes of IH could result from sleep-disordered breathing or may be temporally unrelated to apnea or bradycardia events. There are numerous reports indicating adverse effects of IH on development, behavior, academic achievement, and cognition in children with sleep apnea syndrome. It remains uncertain about the exact causative relationship between the neurocognitive and behavioral morbidities and IH and/or its associated sleep fragmentation. On the other hand, well-controlled and moderate IH conditioning/training has been used in sick children for treating their various forms of bronchial asthma, allergic dermatoses, autoimmune thyroiditis, cerebral palsy, and obesity. This review article provides an updated and impartial analysis on the currently available evidence in supporting either side of the seemingly contradictory scenarios. We wish to stimulate a comprehensive understanding of such a complex physiological phenomenon as intermittent hypoxia, which may be accompanied by other confounding factors (e.g., hypercapnia, polycythemia), in order to prevent or reduce its harmful consequences, while maximizing its potential utility as an effective therapeutic tool in pediatric patients.

Age-related and sex-related changes in perfusion index in response to noxious electrical stimulation in healthy subjects

Background

Even though pain is a subjective phenomenon, its objective evaluation in humans is important because subjects requiring pain evaluation may be unable to describe their pain intensity because of decreased awareness or impaired cognitive function. Previous reports indicate that the perfusion index (PI), which is calculated from pulse oximeter waveforms, has some utility in assessing pain. However, age-associated and sex-associated differences in change of PI have hitherto not been evaluated for assessment of pain. Therefore, we aimed to estimate the utility of age-related differences in PI change among healthy volunteers subjected to electrical stimulation.

Methods

We measured PI and pulse rate in 70 healthy volunteers exposed to gradually increasing electrical stimulation. The subjects were classified into four groups, ie, young men, young women, aged men, and aged women. Stimulation was stopped when subjects reached their pain tolerance threshold. The average PI and pulse rate were calculated 10 seconds before and after electrical stimulation and compared across the four groups. Changes in PI and pulse rate were analyzed using the paired t-test.

Results

The PI was significantly decreased in response to pain stimulation in young men (P<0.0001), young women (P=0.0002), and aged men (P=0.0158). However, aged women failed to show significant changes in PI before or after stimulation. The pulse rate was not significantly altered in any of the groups.

Conclusion

PI may be an independent parameter reflecting the perception of noxious stimuli and could be used for objective evaluation of pain perception in healthy volunteers, except when it is used for pain evaluation in elderly women.