Binge drinking and progression of white matter hyperintensities of presumed vascular origin in older men.

BACKGROUND: Information on trajectories of diffuse subcortical brain damage of vascular origin associated with binge drinking in older adults is limited. We sought to evaluate the impact of this drinking pattern on the progression of white matter hyperintensities (WMH) of presumed vascular origin in individuals aged ≥60 years taken from the community. METHODS: Following a longitudinal prospective design, participants of the Atahualpa Project Cohort received interviews to assess patterns of alcohol intake as well as baseline and follow-up brain MRIs. Only men were included because alcohol consumption in women is negligible and tend not to engage in binge drinking in our studied population. Poisson regression models were fitted to assess the incidence rate ratio of WMH progression by patterns of alcohol use (binge drinking or not), after adjusting for demographics, level of education and cardiovascular risk factors. RESULTS: The study included 114 men aged ≥60 years (mean age: 65.1±5.4 years). Thirty-seven participants (32%) reported binge drinking for more than 30 years. Follow-up MRIs revealed WMH progression in 45 participants (39%) after a median of 7.2 years. In unadjusted analysis, the risk of WMH progression among individuals with binge drinking was 2.08 (95% C.I.: 1.16-3.73). After adjustment for age, education level and vascular risk factors, participants with this drinking pattern were 2.75 times (95% C.I.: 1.42-5.30) more likely to have WMH progression than those who did not. CONCLUSIONS: Study results show an independent association between binge drinking and WMH progression in community-dwelling older men.

Variations in healthcare costs by body mass index and obesity-related complications in a UK population: A retrospective open cohort study.

AIMS: To estimate healthcare resource utilization (HCRU) and healthcare costs by body mass index (BMI) in a UK cohort and to explore how this varied by defined BMI strata. MATERIALS AND METHODS: This retrospective open cohort study used Discover, a linked primary and secondary electronic health records database covering 2.7 million individuals. Adults were stratified by BMI as: overweight (25-<30 kg/m2); obesity class I (30-<35 kg/m2); obesity class II (35-<40 kg/m2); or obesity class III (≥40 kg/m2). Cost data, comprising primary care, secondary care (inpatient admissions, outpatient appointments and emergency room visits) and prescriptions, were reported for 2015-2019. RESULTS: Overall, 1 008 101 individuals were overweight, 278 782 had obesity class I; 80 621 had obesity class II, and 42 642 had obesity class III. Healthcare costs and HCRU events per person per year increased over time (2015: £851-£1321 and 10.6-13.4 events; 2019: £1143-£1871 and 11.4-14.9 events), and were higher for each successive BMI group. Groups with chronic kidney disease or cardiovascular disease incurred particularly high costs. In 270 493 individuals with obesity in 2019, more than 72% of total healthcare costs were incurred by the highest cost quintile, which had a higher mean age and more obesity-related complications (ORCs) than lower cost quintiles. CONCLUSIONS: The economic impact of obesity could be alleviated by weight management support based on unmet need, to limit the effects of BMI progression and ORC development.

Ten-year progression of obesity-related complications in a population with overweight and obesity in the UK: A retrospective open cohort study.

AIM: To assess the prevalence of individual obesity-related complications (ORCs) and multimorbidity (≥ 1, ≥ 2 and ≥ 3 ORCs), and multimorbidity-associated healthcare costs, over 10 years. METHODS: This retrospective open cohort study used Discover, a UK database of linked primary and secondary electronic health records. Adults were stratified by body mass index (BMI; overweight: 25-< 30 kg/m2; obesity class I: 30-< 35 kg/m2; obesity class II: 35-< 40 kg/m2; obesity class III: ≥ 40 kg/m2). Outcomes by year since baseline were assessed for serial cross sections across the study period (1 January 2004 to 31 December 2019; the index date was the date of first eligible BMI measurement). RESULTS: Across 1 410 146 individuals (overweight: 1 008 101; obesity class I: 278 782; obesity class II: 80 621; obesity class III: 42 642), ORC prevalence was higher in successive BMI groups, and increases over time were generally greater for obesity relative to overweight. In those with ORC multimorbidity, both higher BMI and the presence of more ORCs were associated with higher annual per-person healthcare costs. Costs increased over time in those individuals with obesity and one or more ORC, as well as in those with obesity and two or more ORCs. CONCLUSIONS: Higher BMI was associated with higher baseline ORC prevalence and a greater increase in ORC prevalence over time, and with higher healthcare costs in those with multimorbidity. To reduce the burden of overweight and obesity on patients and healthcare systems, the presence, number and type of ORCs should be considered in developing effective, targeted prevention and management care pathways.

Association between hospital-diagnosed tinnitus and suicide: A Nationwide Danish longitudinal study.

OBJECTIVES: Tinnitus is a source of significant distress among some people. Associations have been suggested between tinnitus and mental disorders, and with suicidal thoughts and attempts. However, whether this extends to suicide in the general population remains uncertain. METHODS: This is a retrospective cohort study including all individuals aged 15 years or older, using Danish nationwide, longitudinal, population-based register data from 1 January 1990 through 31 December 2021. The main outcome was death by suicide. Poisson regression models were used to estimate adjusted incidence rate ratios (IRR) with the 95% confidence intervals (CI). RESULTS: Among 7,438,007 individuals (49.8% males) observed over 144,050,344 person-years, 85,677 (57.7% males) were diagnosed with tinnitus. In all, 23,824 suicide deaths were identified, of which 225 had tinnitus. Suicide rates were 24.2 and 16.5 per 100,000 person-years for those with and without tinnitus, respectively, giving an adjusted IRR of 1.4 (95% CI 1.2-1.6). Suicide rates were adjusted for demographic characteristics, concomitant hearing loss, and co-existing mental disorders before tinnitus. Increased suicide rates were linked to a higher number of hospital contacts and to recent hospital contacts, suggesting dose-response and temporal associations. CONCLUSIONS: The findings reveal an association between tinnitus and suicide, particularly among individuals with co-existing mental disorders. Dose-response and temporal associations were found between tinnitus and suicide. Concurrent hearing loss had no influence on the tinnitus-suicide association. Attention towards patients experiencing tinnitus related distress is warranted, especially those with pre-existing mental disorders.

Population genetic data for 23 STR loci (PowerPlex Fusion 6C™ kit) genetic markers in the Lenca ethnic group in Honduras.

We have studied the allele frequencies for 23 STR autosomal loci (CSF1PO, FGA, TH01, vWA, D1S1656, D2S1338, D2S441, D3S1358, D5S818, D7S820, D8S1179, D10S1248, D12S391, D13S317, D16S539, D18S51, D19S433, D21S11; with the purpose to increase the power of discrimination, the markers Penta D, Penta E, D22S1045, TPOX and SE33 were included), from a sample of 100 unrelated individuals of Lenca ethnic group in Honduras, Central America.

A real-world analysis of pharmacotherapy adherence and the factors influencing it in Serbia: a nationwide, population-based, cross-sectional study.

Introduction: Monitoring the pharmacotherapy adherence in society is crucial for identifying occurance and causes of potential inadequate use of drugs and inform providers about the need for better customer counceling. It is necessary component of the strategic planning of the quality of healthcare services. This population- based study aimed to assess the medication intake adherence in the Republic of Serbia and the individual factors and health system variables influencing its pattern. Methods: We applied a cross-sectional approach to study medication intake adherence using a secondary analysis of the latest 2019 Serbian National Health Survey data. The statistical modeling of the pharmacotherapy adherence incorporated sociodemographic data, self-reported disease, and lifestyle behavior. Results: In 2019, in the representative sample of 12,066 adults in Serbia, requiring prescribed medicine, 49.8% did comply with the prescribed drugs, and 50.2% do not. Participants who adhered to prescribed medication were significantly (p < 0.001) older (62.4 ± 14 years), predominantly female (55.3%), had secondary education (48.5%), resided in southern and eastern parts of Serbia (55.5%), and belonged to the lowest income quintile (21.4%). The participants most often take prescribed drugs for hypertension (64.1%) and lower back pain (30.5%), while around 20% take medication for coronary disease, diabetes mellitus, and high blood cholesterol. About 85-92% of participants with financial or general difficulties using prescribed medication. Conclusion: There is poor medication intake adherence to prescribed medication in Serbia. Gender, age, and region determine the adherence. Also, health-related and healthcare system-related factors impact the use of prescribed medication. Study findings can inform planning the counceling interventions in the target groups where improving medication adherence is necessary, as well as to enhance training of healthcare providers about pharmacotherapy adherence.

Regions of Homozygocity size patterns among diverse ethnic groups in Israel: Toward tailored diagnostic reporting thresholds.

Long contiguous stretches of homozygosity or regions of homozygosity (ROH) are frequently detected via microarray and sequencing technologies. However, consensus on the establishment of specific size cutoffs for reporting ROH remains elusive. This study aims to assess the Total ROH Percentages (TRPS) and size of ROH segments across different ethnic origins, exploring potential disparities and proposing tailored diagnostic thresholds. This retrospective study included 13,035 microarray analyses conducted between 2017 to 2023. ROH segments on autosomal chromosomes were retrieved, and samples lacking ROH segments were excluded. The cohort was categorized based on reported ethnic origins, and TRPS and ROH segment size were analyzed for each origin. Distinct TRPS values were noted among different ethnic groups, ranging from median 0.36% in Ethiopian Jewish cohort and up to 6.42% in the Bedouin population. Wide range of 99th percentiles of ROH segment size for various origins was noted, ranging from 10.6 to 51.5 Mb. A significant correlation between ROH segment sizes and TRPS was noted in each origin. Statistically significant differences in ROH segment sizes were noted between the Jewish and the Israeli Arab/Druze origins in TRPS from 1% to 9.99%, whereas extremities of low (0.11%-0.99%) and high (over 10%) TRPS yielded no significant differences. In conclusion, as fixed absolute size thresholds may overlook pathogenic segments in certain populations while generating excessive reports in others, tailored approaches to define ROH reporting thresholds can be considered to facilitate the accuracy and clinical relevance of genomic analyses.

Racial and ethnic differences in comorbid psychosis: a population-based study.

Introduction: Differences in the prevalence of psychiatric conditions such as psychosis as well as patterns of comorbidity for psychosis have been reported between racial and ethnic groups. It is unclear whether those differences are consistent for comorbid psychosis. Methods: Self-reported diagnostic data from American adults ages 18-99 participating in the Collaborative Psychiatric Epidemiology Surveys (CPES) (N ~ 11,844) were used to test the association between four racial and ethnic group categories (White, Asian, Hispanic, Black) and comorbid psychosis. Comorbid psychosis was measured as a 4-level categorical variable (No mental illness nor psychosis, Mental Illness, Psychosis only, comorbid psychosis (i.e., Psychosis + Mental Illness). Chi-square tests were used to determine significant differences in the prevalence of comorbid psychosis by race and ethnicity. A multinomial logistic regression was used to test the association between racial and ethnic classifications and comorbid psychosis after adjusting for common demographic characteristics (i.e., education, sex, income, and age). Results: Relative to White participants, Hispanic and Asian participants were less likely to be affected with comorbid psychosis. (Adjusted Odds Ratio, AORAsian = 0.32, CI = 0.22 - 0.47, p <0.0001, AORHispanic = 0.66, CI = 0.48 - 0.92, p = 0.012). Relative to White participants there was not significant association for comorbid psychosis in Black participants (AORBlack = 0.91, CI = 0.70 - 1.20, p = 0.52) In contrast Hispanic and Black participants were more likely to report psychosis alone (AORHispanic = 1.94, CI = 1.27-2.98, p = 0.002, AORBlack = 1.86, 1.24-2.82, p = 0.003) compared to White participants. Conclusion: There were different patterns of associations by race and ethnicity for psychosis and comorbid psychosis. The lower prevalence of comorbid psychosis in non-White groups may be due to underdiagnosis or underreporting of other mental disorders.

Rising rates of anterior cruciate ligament reconstruction in Australian adults: An analysis of Australian Medicare Benefits Schedule database.

PURPOSE: Anterior cruciate ligament (ACL) reconstruction is an evolving field, though there remains sparse epidemiological data on the treatment of ACL ruptures. The objective of this study is to analyse the trends in the rate of ACL reconstruction (ACLR) in adult patients over the past two decades in the Australian population. METHODS: The incidence of ACLR between 2001 and 2020 in patients 15 years and over was analysed using the Australian Medicare Benefits Schedule (MBS) database. The data reflect patients with private health coverage (45% of the Australian population). An offset term was introduced using national population data to account for population changes over the study period. RESULTS: A total of 160,353 ACLRs were performed in Australia under the MBS in the 20-year period from 2001 to 2020. An annual increase in the total volume and per capita rate of ACLRs was found (p < 0.05). The annual volume of cases increased by 82%, from 5512 in 2001 to a peak of 10,011 in 2017. This increase was seen across all age groups (p < 0.05) and both sexes (p < 0.05), with a greater proportion of reconstructions performed on males (n = 102,357, 64%) than females (n = 57,996, 36%). In 2020, the rate of adult ACLRs decreased to a level last seen in 2004, likely due to the effects of COVID-19. CONCLUSIONS: The incidence of ACLR in adult patients has increased in Australia over the 20-year study period. The trends noted provide information that can be used to guide resource allocation and health provision in the future. LEVEL OF EVIDENCE: Level IV.

Persistent disparities in insulin pump uptake despite a universal pump programme for type 1 diabetes in Ontario, Canada.

AIM: To evaluate associations between social disadvantage and insulin pump use among adults with type 1 diabetes (T1D) in the context of a universal publicly funded insulin pump programme in Ontario, Canada, and to ascertain whether social disparities in insulin pump programme enrolment have decreased over time. METHODS: Population-based cross-sectional studies were conducted using administrative healthcare data in Ontario, Canada. First, among adults aged older than 18 years diagnosed with T1D before 31 March 2021, logistic regression was used to assess the association between neighbourhood social disadvantage (Ontario marginalization index quintiles) and insulin pump use. Second, among all paediatric and adult applicants to the insulin pump programme from 1 September 2006 to 31 March 2022, ordinal logistic regression was used to evaluate associations between year of insulin pump initiation and social disadvantage. RESULTS: Among 27 453 adults with T1D, 60% used insulin pumps. Greater social disadvantage was associated with lower odds of insulin pump use (adjusted odds ratio [OR] 0.44 [95% confidence interval {CI} 0.39-0.48] for greatest vs. lowest social disadvantage quintile). Among 21 002 paediatric and adult applicants to the insulin pump programme, social disparities in pump use decreased in the first 3 years of the programme, plateaued until 2020, then increased from 2020 to 2022, with no change in the odds of being in a higher social deprivation quintile for 2022 relative to 2007 (OR 1.09 [95% CI 0.83-1.44]). CONCLUSIONS: Despite a universal pump programme for individuals with T1D, disparities by social disadvantage persist. Residual financial and non-financial barriers must be addressed to promote equitable insulin pump uptake.

Exploring the impact of mental and work-related stress on sick leave among middle-aged women: observations from the population study of women in Gothenburg, Sweden.

OBJECTIVE: To investigate whether mental and work-related stress predicts a one-year incidence of sick leave in a cohort of middle-aged working women. DESIGN: The 2016/17 survey was part of the Population Study of Women in Gothenburg, Sweden, with registry data information on sick leave during one year pre- and post-baseline. SUBJECTS: A cohort of women aged 38 and 50 in 2016/17 (n = 573; 68% participation), of which 504 women were gainfully employed and not on sick leave ± 2 weeks around baseline examination; 493 women had complete data on stress exposure. METHODS: We studied associations between self-assessed mental and work-related stress and incident sick leave of >14 days during the year following the baseline examination. We used multiple logistic regression, adjusting for age and previous sick leave, and additionally for sleep quality, well-being, and physical activity. RESULTS: Overall, 75 women (16%) experienced at least one period of sick leave after baseline. Permanent stress during the last five years almost tripled the risk for incident sick leave, OR = 2.8 (95% CI 1.2-6.3), independent of previous sick leave, OR = 2.3 (95% CI 1.3-4.2). Among 21 specific work-related problems, conflicts at work, OR = 2.2 (95% CI 1.3-3.6), and low decision latitude, OR = 1.7 (95% CI 1.0-2.9), were associated with incident sick leave. The association with conflicts at work remained upon further covariate adjustment. CONCLUSION: Low decision latitude and conflicts at work are risk factors for incident sick leave among working women. The impact of conflicts at work, irrespective of own involvement, may indicate a specific vulnerability among women of interest for future interventions.

About 75% of around 500 middle-aged women reported mental stress in 2016/17. Low decision latitude and conflicts at work predicted incident sick leave independent of general mental stress and previous periods of sick leave. Efforts to improve the work environment may be essential for interventions aiming to reduce absenteeism among working women.

Survival trends among patients with metastatic non-small cell lung cancer before and after the approval of immunotherapy in the United States: A Surveillance, Epidemiology, and End Results database-based study.

BACKGROUND: In 2015, the US Food and Drug Administration approved nivolumab as the first immunotherapy for patients with advanced non-small cell lung cancer (NSCLC). However, population-based survival benefit studies after the introduction of immunotherapy in lung cancer are lacking. This study examined overall survival (OS) and cancer-specific survival in patients with NSCLC in the pre immunotherapy and immunotherapy eras. METHODS: This study used the Surveillance, Epidemiology, and End Results database, which spanned 17 registries from 2000 to 2020. Two cohorts were delineated: preimmunotherapy (2010-2014) and immunotherapy (2015-2020), which coincided with nivolumab's approval. RESULTS: This study included 191,802 patients, 90,807 in the preimmunotherapy era and 100,995 in the immunotherapy era. OS was significantly higher in the immunotherapy era, as shown by Kaplan-Meier curves (1-year OS, 40.1% vs. 33.5%; 3-year OS, 17.8% vs. 11.7%; 5-year OS, 10.7% vs. 6.8%; median OS, 8 vs. 7 months; p < .001 by log-rank test). Similarly, cancer-specific survival improved in the immunotherapy era (1-year survival, 44.0% vs. 36.8%; 3-year survival, 21.7% vs. 14.4%; 5-year survival, 14.3% vs. 9.0%; median OS, 10 vs. 8 months; p < .001 by log-rank test). Survival rates were significantly better in the immunotherapy era, as confirmed by multivariate analysis with a Cox proportional hazards model after adjusting for age, sex, race, income, and geographical area (adjusted hazard ratio, 0.830; 95% CI, 0.821-0.840; p < .001). CONCLUSIONS: In summary, the survival rate of patients with metastatic NSCLC has improved since the introduction of immunotherapy.

Physical Fitness as a Predictor of Disability Retirement: A 9-Year Register Linked Follow-Up Study.

BACKGROUND: To prospectively examine the association between physical fitness and risk of disability retirement in a large population-based cohort. METHODS: This study utilized data from Health 2011 survey Physical Activity subsample (n = 4898), combined with information on disability retirement derived from 2 national registers. In total, 2455 individuals aged 18-74 years underwent the physical fitness test protocol concerning measures of cardiorespiratory fitness, muscle strength, and balance. The outcome variable was disability retirement, during the follow-up period of 9 years. After excluding those not at risk of disability retirement (ie, age ≥63 y) or who had already been granted disability pension, and those who had not completed the fitness protocol, the analytical sample included 1381 participants. Data were analyzed using Cox regression model with SPSS (version 29). RESULTS: During the 9-year follow-up period, 61 individuals (4.4%) transitioned to a disability retirement. Cox regression analysis showed an association between the various physical fitness subdomains and the risk of disability retirement. In model 1, all fitness tests were associated with the risk of disability retirement, except the one-leg stand test with hazard ratios ranging from 1.69 (95% CI, 0.86-3.34) to 5.75 (95% CI, 1.84-17.90). Further adjustment for sociodemographic, health behavior, and health-related covariates attenuated the associations and statistical significance was lost, except for the vertical jump test (hazard ratio = 4.33; 95% CI, 1.32-14.10) and 6-minute walk test (hazard ratio = 3.81; 95% CI, 1.35-10.70). CONCLUSION: These findings highlight the importance of physical fitness for preventing work disability.

An Assessment of the Knowledge, Attitude, and Practice of Probiotics and Prebiotics among the Population of the United Arab Emirates.

Probiotics and prebiotics offer a range of advantageous effects on human health. The knowledge, attitudes, and practices (KAP) of individuals can impact their inclination to consume probiotics and prebiotics. The main objective of this study was to examine the KAP of the people in the United Arab Emirates (UAE) about probiotics and prebiotics consumption. Additionally, the study aimed to assess the impact of KAP and sociodemographic factors on the use of probiotics and prebiotics. In order to accomplish this objective, a verified online questionnaire was used with a five-point Likert scale and distributed using an online platform (Google Forms). A cross-sectional research, non-probability sampling was implemented, and G*Power statistical power analysis was used to estimate a sample size of 385 participants. A total of 408 replies were gathered. The population under study consisted of residents in the UAE between the ages of 18 to 64 years old, excluding populations under the age of 18 and those living outside the UAE. A total of 392 participants met the criteria for inclusion in this study. The research ethics committees of UAE University granted the study approval (ERSC_2024_4359), and the validity of the findings was confirmed through face-to-face interviews with around 50 individuals and a Cronbach's alpha test with result of 0.84. The statistical software SPSS version 29.0 for Mac OS was utilized to examine the relationships between KAP variables, including Chi-square tests and Pearson's correlation coefficients. The tests were selected based on their capacity to handle categorical and continuous data, respectively. The female population was 85.2% of the total, while the male population accounts for 14.8%. The age distribution of participants shows that the largest proportion, 68.4%, falls within the 18-24 age range. Out of the participants, 61.5% held a bachelor's degree. Most of the participants, 56.4%, were students, while 29.1% were employees. The average results indicate a significant inclination towards probiotics and prebiotics, as demonstrated by the scores above the midpoint for the six knowledge questions (M = 2.70), six attitude questions (M = 3.10), and six practice questions (M = 3.04). Several studies have examined this phenomenon; however, additional research comparing individuals in the UAE is necessary to fully comprehend the influence of KAP on the consumption of probiotics and prebiotics in the UAE.

Completion of Upper Secondary Mainstream School in Autistic Students in Sweden.

Higher education is an increasingly necessary achievement to attain employment. However, even in cases where a student has the academic skills to succeed, educational environments may not support students across all other domains necessary for education success, including social and communication needs. This is especially true for students with disabilities and autistic students, where the rate of completion of non-compulsory education is unknown. We used the Stockholm Youth Cohort (children aged 0-17 years from 2001 to 2011), a total population cohort (N = 736,180) including 3,918 autistic individuals, to investigate the association between autism without intellectual disability and completion of upper secondary education. We assessed the impact of sex and co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) on this association. By age 20 years (the expected age of completion), 68% of autistic students and 91% of non-autistic students admitted to upper secondary education had completed. In logistic regression models adjusted for student demographics, autistic students had almost five-fold higher odds of not completing secondary school (OR 4.90, 95% CI 4.56 5.26) compared to their non-autistic peers. Autistic students with ADHD had particularly high odds of non-completion of upper secondary school. Autistic students without intellectual disability attending mainstream education are substantially less likely to complete upper secondary education as compared to their peers. These findings have implications for the appraisal of how inclusive school policies serve autistic students' academic and social needs, ultimately addressing population health and independent living.

Mitochondrial Control Region Database of Hungarian Fallow Deer (Dama dama) Populations for Forensic Use.

The evidential value of an mtDNA match between biological remains and their potential donor is determined by the random match probability of the haplotype. This probability is based on the haplotype's population frequency estimate. Consequently, implementing a population study representative of the population relevant to a forensic case is vital to correctly evaluating the evidence. The emerging number of poaching cases and the limited availability of such data emphasizes the need for an improved fallow deer mtDNA population databank for forensic purposes, including targeting the entire mitochondrial control region. By sequencing a 945-base-pair-long segment of the mitochondrial control region in 138 animals from five populations in Hungary, we found four different haplotypes, including one which had not yet been described. Our results, supplemented with data already available from previous research, do not support the possibility of determining the population of origin, although some patterns of geographical separation can be distinguished. Estimates of molecular diversity indicate similarly low mtDNA diversity (Hd = 0.565 and π = 0.002) compared to data from other countries. The calculated random match probability of 0.547 shows a high probability of coincidence and, therefore, a limited capacity for exclusion. Our results indicate that despite the overall low genetic diversity of mtDNA within the Hungarian fallow deer samples, a pattern of differentiation among the regions is present, which can have relevance from a forensic point of view.

Biological and genetic determinants of glycolysis: Phosphofructokinase isoforms boost energy status of stored red blood cells and transfusion outcomes.

Mature red blood cells (RBCs) lack mitochondria and thus exclusively rely on glycolysis to generate adenosine triphosphate (ATP) during aging in vivo or storage in blood banks. Here, we leveraged 13,029 volunteers from the Recipient Epidemiology and Donor Evaluation Study to identify associations between end-of-storage levels of glycolytic metabolites and donor age, sex, and ancestry-specific genetic polymorphisms in regions encoding phosphofructokinase 1, platelet (detected in mature RBCs); hexokinase 1 (HK1); and ADP-ribosyl cyclase 1 and 2 (CD38/BST1). Gene-metabolite associations were validated in fresh and stored RBCs from 525 Diversity Outbred mice and via multi-omics characterization of 1,929 samples from 643 human RBC units during storage. ATP and hypoxanthine (HYPX) levels-and the genetic traits linked to them-were associated with hemolysis in vitro and in vivo, both in healthy autologous transfusion recipients and in 5,816 critically ill patients receiving heterologous transfusions, suggesting their potential as markers to improve transfusion outcomes.

In-hospital outcomes in people with autism and epilepsy - A population-based study.

Autism is a common comorbid diagnosis in those with epilepsy. Understanding the health needs and outcomes in patients with this dual diagnosis is important for optimizing healthcare outcomes. We compared hospital-level variables amongst patients with co-occurring autism and epilepsy, to those with epilepsy alone. Non-elective hospital admissions amongst patients with epilepsy alone and co-occurring autism and epilepsy were identified in the 2003-14 National Inpatient Sample (NIS) using previously validated ICD-9-CM case definitions. One patient with co-occurring epilepsy and autism was matched to three epilepsy patients for age and sex. Multinomial logistic regressions were performed to examine outcomes of interest. Compared to those with epilepsy alone (n = 27,762), patients with autism and epilepsy (n = 9254) had a higher odds of transfer to another facility (OR = 1.09, p = 0.048), in-hospital mortality (OR = 1.36, p = 0.011), longer mean length of stay (5.63 days vs. 5.12 days, p < 0.0001), and septicemia (4.21 % vs. 3.08 %, p < 0.0001). Distributions of demographics, insurance type, socioeconomic status, and comorbidities significantly differed between both groups. Our findings demonstrate that patients with comorbid autism and epilepsy are a unique population with health outcomes significantly differing from those with epilepsy alone. Given the effect that dual diagnosis has on hospital trajectory, focused treatment plans must be adopted to optimize care and hospital outcomes in these patients.

Validation of the Internet Addiction Test for Adolescents (IAT-A) in the Georgian language.

BACKGROUND: The internet has become an integral part of daily life, impacting various aspects, especially among children and adolescents. Internet overuse has been associated with numerous physical and mental health issues. Despite its significant implications, there is no universally accepted assessment tool for internet addiction. This study focuses on validating the Georgian version of the Internet Addiction Test (IAT) among pediatric patients aged 9 to 17, specifically the Internet Addiction Test - Adolescence (IAT - A). METHODS: The study, conducted in 2022-2023, involved pediatric patients from Givi Zhvania Pediatric Academic Clinic, generally healthy but with parental concerns about screen time. The IAT-A, a self-administered questionnaire, was adapted for cultural relevance. Translation-back-translation was employed for linguistic validation. Data was collected twice, with a 6-month interval. Statistical analyses included the Kappa coefficient, Kendall's tau test, paired t-test, and Bland-Altman plots. RESULTS: The translation process ensured linguistic accuracy and cultural relevance. The study included 100 participants (59 % boys, 41 % girls) with a mean age of 12 years. The mean IAT - A score remained consistently high over both testing periods. Kendall's tau correlation coefficient indicated a strong correlation (0.97), and Bland-Altman plots confirmed repeatability. The cut-off of 40 points identified 84 % as problematic internet users. Individual question analysis showed strong correlation and agreement. CONCLUSION: The Georgian version of the IAT - A demonstrated reliability and consistency in assessing internet addiction among pediatric patients. The prevalence of problematic internet use among children referred to a university hospital because parents were worried about their internet use was indeed high. The study contributes valuable insights into internet addiction research in Georgia and underscores the importance of a standardized assessment tool. The repeatability of the scores of each question was strong among both groups of problematic internet users and non-problematic internet users, confirming that the Georgian version of IAT - A has high level of accuracy and can be used in internet addiction research.

Sex-based differences in the association of resistance training levels with the risk of hypertension.

Introduction: Hypertension is a primary risk factor for cardiovascular disease and all-cause mortality. This study investigated sex-based differences in the association between the risk of hypertension and resistance training (RT) levels, including training frequency and period. Methods: We enrolled 162,102 participants from nationwide Korean cohorts. The training period (months) and frequency (per week) of RT were used to investigate the presence of an inverse dose-response relationship between RT levels and the risk of hypertension. Multiple logistic regression models were used to evaluate the risk of hypertension in relation to RT levels. Results: The prevalence of hypertension in the study population was 36.28% in men and 26.94% in women. Performing RT was associated with an 8% reduction in the risk of hypertension in women but not in men. In women, performing RT for 3-4 days/week, compared with not performing RT, reduced the risk of hypertension by 11%, even after adjusting for covariates, including RT time per week and period. However, in men, no significant association was observed between training frequency and the risk of hypertension. We also evaluated the risk of hypertension by simultaneously considering both the RT frequency and period. Performing RT for 3-4 days/week and ≥5 days/week were markedly related to 14 and 11% hypertension risk reduction, respectively, in women who had been performing RT for at least 6 months. Conclusion: Given that no inverse dose-response association was observed between RT frequency and hypertension risk, engaging in RT for 3-4 days/week for at least 6 months is recommended for women. Further longitudinal studies are needed to verify sex-based differences in the antihypertensive effects of regular RT.