Miopatías RYR1 en la infancia: correlación fenotipo-genotipo e incidencia / RYR1 myopathies in childhood: phenotype-genotype correlation and incidence

Introducción: Las miopatías relacionadas con el receptor de rianodina de tipo 1 (RYR1-RM) constituyen la categoría más frecuente de miopatías congénitas. La introducción de técnicas genéticas ha cambiado el paradigma diagnóstico y sugiere la prioridad de estudios moleculares sobre biopsias. Este estudio busca explorar las características clinicoepidemiológicas de pacientes con variantes del gen RYR1 en un hospital pediátrico de tercer nivel con el objetivo de ampliar la comprensión de la correlación genotipo-fenotipo en las RYR1-RM. Pacientes y métodos: Estudio observacional, descriptivo y transversal, de pacientes menores de 14 años con síntomas miopáticos y variantes potencialmente patógenas del gen RYR1 entre enero de 2013 y diciembre de 2023, considerando variables como sexo, edad, desarrollo motor, variantes genéticas, patrón de herencia y otras manifestaciones. Todas las variables fueron tabuladas frente a la variante genética. Resultados: De los nueve pacientes incluidos, la incidencia estimada fue de aproximadamente 1/10.000 nacidos vivos. La mediana en el momento del diagnóstico fue de 6 años, con una variabilidad fenotípica significativa. Se observaron síntomas comunes, como debilidad y retraso del desarrollo motor. Las variantes genéticas afectaron al gen RYR1 de manera diversa, y hubo cinco variantes previamente no descritas. La biopsia muscular se realizó en cinco pacientes, en dos de ellos de tipo miopatía central core; en uno, multiminicore; en uno, desproporción congénita de fibras; y en otro, de patrón inespecífico. Conclusiones: Las RYR1-MR de nuestra serie ofrecieron variabilidad fenotípica y de afectación, con una incidencia en nuestra área de en torno a 1/10.000 recién nacidos. La mayoría de los casos fueron varones, de variantes missense dominantes. Aportamos cinco variantes genéticas no descritas con anterioridad.(AU)

Introduction: Ryanodine receptor type 1-related myopathies (RYR1-RM) represent the most prevalent category of congenital myopathies. The introduction of genetic techniques has shifted the diagnostic paradigm, suggesting the prioritization of molecular studies over biopsies. This study aims to explore the clinical and epidemiological characteristics of patients with RYR1 gene variants in a tertiary pediatric hospital, intending to enhance the understanding of the genotype-phenotype correlation in RYR1-RM. Patients and methods: An observational, descriptive, and cross-sectional study was conducted on patients under 14 years old with myopathic symptoms and potentially pathogenic RYR1 gene variants from January 2013 to December 2023. Variables such as gender, age, motor development, genetic variants, inheritance pattern, and other manifestations were considered. All variables were tabulated against the genetic variant. Results: Of the nine included patients, the estimated incidence was approximately 1 in 10,000 live births. The median age at diagnosis was six years, with significant phenotypic variability. Common symptoms such as weakness and delayed motor development were observed. Genetic variants affected the RYR1 gene diversely, including five previously undescribed variants. Muscle biopsy was performed in five patients, revealing central core myopathy in two, multiminicore in one, congenital fiber-type disproportion in one, and a nonspecific pattern in another.(AU)

Incidence of Diabetes Mellitus and Associated Factors in the Era of Antiretroviral Drugs With a Low Metabolic Toxicity Profile.

Objective: The incidence of type 2 diabetes mellitus (T2DM) has risen dramatically. Among people living with HIV (PLHIV), chronic disease (now >15 cases/1000 in the general population worldwide) and long-term exposure to antiretroviral therapy (ART) can alter metabolic processes early, favoring insulin resistance and T2DM. We retrospectively studied the incidence of T2DM and associated factors in the Cohort of the Spanish AIDS Research Network, a prospective cohort of PLHIV enrolled at diagnosis and before initiation of ART. Methods: PLHIV were aged >18 years and ART naive at inclusion. The incidence of new diagnoses of T2DM after initiation of ART (per 1000 person-years) was calculated. Predictors of a diagnosis of T2DM were identified by a Cox proportional hazards model adjusted for statistically significant and clinically relevant variables. Results: Cumulative incidence was 5.9 (95% CI, 5.1-6.7) per 1000 person-years, increasing significantly in persons aged >50 years to 14.4 (95% CI, 10.4-19.3). Median time to diagnosis of T2DM was 27 months. Only age and higher education were significant. Interestingly, higher education was associated with a 33% reduction in the incidence of T2DM. Having received tenofovir disoproxil fumarate + (lamivudine or emtricitabine) + rilpivirine was almost significant as a protective factor (hazard ratio, 0.49; 95% CI, .24-1.01; P = .05). Conclusions: The incidence of T2DM in PLHIV in Spain was high, especially in persons aged >50 years. Age was the factor most closely associated with onset, and educational level was the factor most associated with reduced risk. We highlight the lack of association between HIV-related factors and T2DM and show that, within nonnucleoside reverse transcriptase inhibitors, rilpivirine could prove more benign for metabolic comorbidities.

Type 2 Diabetes, the Epidemic: Trends in Prevalence and Incidence, 2004-2020.

Aims/Hypothesis: Only a few studies reported the incidence of type 2 diabetes (T2D). Understanding recent trends in diabetes is vital for planning future diabetes care. This study updated national trends in the prevalence and incidence of type 2 diabetes (T2D) in the Netherlands from 2004-2020. Methods: The DIAbetes, MANagement and Treatment (DIAMANT) cohort was used. A cross-sectional design with yearly measurements for the study period was used. The prevalence was calculated by dividing the total number of people with T2D by the total number of all residents. The incidence was calculated by dividing new cases of T2D by the resident population at risk during the calendar year of interest. Results: Among men, the prevalence of T2D in the Netherlands increased from 2.3% in 2004 to 6.3% in 2020. Women's prevalence increased from 2.3% in 2004 to 5.3% in 2020. During 2005-2009, the incidence rate for both men and women was relatively stable Between 2010 and 2020, the incidence rate fell about 1.5 per 1000 in both men and women. Conclusion: From 2004-2020, the prevalence of T2D in the Netherlands more than doubled, with a decreasing incidence from 2010 onwards.

Research in context What is already known about this subject? Many studies have reported the increasing prevalence of type 2 diabetes (T2D). However, only a few studies reported the incidence.In a recent systematic review of all these studies, the incidence fell in over a third of the most high-income populations and increased in a minority of populations. Data from the Netherlands were included, but they date back to 1996.Understanding recent trends in diabetes, the prevalence and incidence are vital for planning future diabetes care.What is the key question? To update national trends in the prevalence and incidence of T2D in the Netherlands for 2004-2020.What are the new findings? During 2004-2020, the prevalence of T2D in the Netherlands more than doubled, with a decreasing incidence from 2010 onwards.How might this impact on clinical practice in the foreseeable future? It demonstrates the effectiveness of preventive strategies, public health education and awareness campaigns contributing to this trend.

An ecological analysis of associations between ambient air pollution and cancer incidence rates in Taiwan.

Air pollution is deemed a human carcinogen and can be linked to certain types of cancer other than lung cancer. The present study aimed to investigate the pollutant-cancer associations in a population-level cohort. We obtained the annual age-standardized incidence rates of 28 different cancer types between 2015 to 2019 from the Taiwan Cancer Registry. Outdoor concentrations of particulate matter with a diameter of 10 µm or less (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), ground-level ozone (O3), and carbon monoxide (CO) between 2001 to 2010 were retrieved from the Taiwan Air Quality Monitoring Network. Weighted quantile sum (WQS) regression models were used to determine the combined effects of five air pollutants on the relationship to cancer incidence rates after controlling for sex ratio, age, average disposable income per household, overweight/obesity prevalence, current smoking rate, and drinking rate. Trend analyses showed that NO2 and CO concentrations tended to decrease, while SO2 concentrations increased in some counties. WQS regression analyses revealed significantly positive correlations between air pollutants and liver cancer, lung and tracheal cancer, colorectal cancer, thyroid cancer, kidney cancer, and small intestine cancer. Altogether, the results from this ecological study unravel that exposure to ambient air pollution is associated with the incidence of several non-lung cancer types.

Trends in the incidence of colorectal cancer in sub-Saharan Africa: A population-based registry study.

In sub-Saharan Africa, colorectal cancer (CRC) has historically been considered a rare disease, although some previous studies have suggested that the incidence is increasing. We examine time trends in the incidence of CRC using data from 12 population-based cancer registries in 11 countries of sub-Saharan Africa that were able to provide time series data for periods of 12 or more years, or with earlier data with which recent rates may be compared. Age-standardized incidence rates were highest in the higher-income countries, and were increasing in all of the populations studied, and these increases were statistically significant in all but three. Current evidence has suggested a link between the increased adoption of western lifestyle habits with colorectal cancer, and along with increasing urbanization of African populations, there is an increase in body weight, as well as evidence of increasing consumption of meat, sugars, and alcohol.

Changing trends in Japanese spotted fever epidemiology in Shimane, Japan: A two-decade retrospective study with emphasis on the COVID-19 pandemic era.

INTRODUCTION: The objective of this study is to evaluate the epidemiological characteristics of Japanese Spotted Fever (JSF) cases reported through the National Epidemiological Surveillance of Infectious Disease (NESID) system in Shimane Prefecture, Japan, from 2000 to 2022, encompassing the periods before and during the COVID-19 pandemic period. METHODS: A retrospective analysis was conducted on JSF cases reported to the NESID system in Shimane Prefecture between 2000 and 2022. Population data were obtained from the Statistical Information of Shimane. Poisson regression analysis was employed to examine the relationship between the annual prevalence rate of JSF and the COVID-19 pandemic. RESULTS: A total of 301 JSF cases were analyzed during the study period. Even the pre-COVID-19 pandemic period, a gradual and significant increase in the prevalence rate was observed (prevalence rate = 1.03, 95% CI: 1.01-1.05; p = 0.01), and a rapid increase was noted since 2020 (prevalence rate = 1.57, 95% CI: 1.39-1.78; p < 0.01). The slope during the pre-COVID-19 pandemic period was estimated to have significantly increased (p < 0.01). CONCLUSIONS: Our findings suggest that while the prevalence rate of JSF had exhibited a slight increase in the years preceding the COVID-19 pandemic, it demonstrated a more significant increase following the pandemic in Shimane Prefecture. JSF has increased since 2020 and may be linked to COVID-19 pandemic. The COVID-19 pandemic has had a substantial impact on global health, underscoring the importance of investigating the prevalence of specific infectious diseases and other health-related indicators to accurately assess the pandemic's impact.

Epidemiology and Anatomical Distribution of Primary Brain Tumors among Children in Palestine: A 6-Year National Referral Institution Study.

OBJECTIVE: The purpose of this research was to investigate the incidence rate of primary brain tumors (PBTs) among Palestinian children over a 6-year interval. Additionally, the study aimed to identify the predominant histopathological types identified in these children. METHODS: This retrospective epidemiologic study focused on PBTs in children (< 15 years) in Palestine. The data were collected from the registry system at Al-Makassed Hospital in Jerusalem, a prominent referral institution in Palestine and the largest center for PBTs in the region, over a 6 years period from 2018 to 2023. RESULTS: The incidence rate of PBTs in children (<15 years) was 1.33 per 100,000 person-years, with a 5% mortality rate. Pilocytic astrocytoma was the most common type (24%), followed by medulloblastoma (15.2%), and glioblastoma (6.3%). About half of the tumors in children were malignant. Headaches were the most common first sign or symptom. About 20% of brain tumors in children were situated within the ventricles, making it the most prevalent location of these tumors, followed by the cerebellum (15.19%), and frontal lobe (11.39%). CONCLUSION: This is the first national study in Palestine investigating PBTs in children. The crude incidence rate of primary brain tumors among Palestinian children was lower than the incidence rate in many countries around the world. It is recommended that more research be done on the epidemiology and distribution of PBTs in children in Palestine.

INSIGHT: in situ heuristic tool for the efficient reduction of grazing-incidence X-ray scattering data.

INSIGHT is a Python-based software tool for processing and reducing 2D grazing-incidence wide- and small-angle X-ray scattering (GIWAXS/GISAXS) data. It offers the geometric transformation of the 2D GIWAXS/GISAXS detector image to reciprocal space, including vectorized and parallelized pixel-wise intensity correction calculations. An explicit focus on efficient data management and batch processing enables full control of large time-resolved synchrotron and laboratory data sets for a detailed analysis of kinetic GIWAXS/GISAXS studies of thin films. It processes data acquired with arbitrarily rotated detectors and performs vertical, horizontal, azimuthal and radial cuts in reciprocal space. It further allows crystallographic indexing and GIWAXS pattern simulation, and provides various plotting and export functionalities. Customized scripting offers a one-step solution to reduce, process, analyze and export findings of large in situ and operando data sets.

X-ray standing wave characterization of the strong metal-support interaction in Co/TiOx model catalysts.

The strong metal-support interaction (SMSI) is a phenomenon observed in supported metal catalyst systems in which reducible metal oxide supports can form overlayers over the surface of active metal nanoparticles (NPs) under a hydrogen (H2) environment at elevated temperatures. SMSI has been shown to affect catalyst performance in many reactions by changing the type and number of active sites on the catalyst surface. Laboratory methods for the analysis of SMSI at the nanoparticle-ensemble level are lacking and mostly based on indirect evidence, such as gas chemisorption. Here, we demonstrate the possibility to detect and characterize SMSIs in Co/TiOx model catalysts using the laboratory X-ray standing wave (XSW) technique for a large ensemble of NPs at the bulk scale. We designed a thermally stable MoNx/SiNx periodic multilayer to retain XSW generation after reduction with H2 gas at 600°C. The model catalyst system was synthesized here by deposition of a thin TiOx layer on top of the periodic multilayer, followed by Co NP deposition via spare ablation. A partial encapsulation of Co NPs by TiOx was identified by analyzing the change in Ti atomic distribution. This novel methodological approach can be extended to observe surface restructuring of model catalysts in situ at high temperature (up to 1000°C) and pressure (≤3 mbar), and can also be relevant for fundamental studies in the thermal stability of membranes, as well as metallurgy.

Excessive androgen exposure and risk of malignancies: A cohort study.

BACKGROUND: A link between androgen use and the risk of cancers, especially prostate and breast cancer, has been suggested. The knowledge about a possible association is limited. OBJECTIVE: The study aimed to investigate cancer incidence rates, particularly those related to prostate and breast cancer, in male androgen users and compare them to a control group. METHODS: We included male androgen users identified through a nationwide anti-doping testing program in Danish fitness centers from 2006 to 2018. We paired each case with 50 male controls of the same age, selected randomly. The cohort was followed from baseline and until 2023. The outcome was the incidence of prostate cancer, breast cancer, or any cancer excluding non-melanoma skin cancer. RESULTS: The study included 1,189 androgen users and 59,450 controls, with a mean age of 27 years at enrolment. During the follow-up period with a mean length of 11 years, 13 androgen users, and 612 controls were diagnosed with cancer. This resulted in an incidence rate ratio of 1.05 (95% CI: 0.55-1.81). None of the androgen users were diagnosed with prostate or breast cancer. DISCUSSION AND CONCLUSION: Male androgen users did not face an increased short-term risk of cancer, neither overall nor related to prostate or breast cancer. Our study indicates that the absolute risk of malignancies in androgen users is comparable to that in the background population. However, we cannot exclude androgens as a cancer risk factor due to the limited sample size, relatively short follow-up period, and subject age.

Cumulative Incidence of Venous Thromboembolic Events In-Hospital, and at 1, 3, 6, and 12 Months After Metabolic and Bariatric Surgery: Systematic Review of 87 Studies and Meta-analysis of 2,731,797 Patients.

Systematic review/meta-analysis of cumulative incidences of venous thromboembolic events (VTE) after metabolic and bariatric surgery (MBS). Electronic databases were searched for original studies. Proportional meta-analysis assessed cumulative VTE incidences. (PROSPERO ID:CRD42020184529). A total of 3066 records, and 87 studies were included (N patients = 4,991,683). Pooled in-hospital VTE of mainly laparoscopic studies = 0.15% (95% CI = 0.13-0.18%); pooled cumulative incidence increased to 0.50% (95% CI = 0.33-0.70%); 0.51% (95% CI = 0.38-0.65%); 0.72% (95% CI = 0.13-1.52%); 0.78% (95% CI = 0-3.49%) at 30 days and 3, 6, and 12 months, respectively. Studies using predominantly open approach exhibited higher incidence than laparoscopic studies. Within the first month, 60% of VTE occurred after discharge. North American and earlier studies had higher incidence than non-North American and more recent studies. This study is the first to generate detailed estimates of the incidence and patterns of VTE after MBS over time. The incidence of VTE after MBS is low. Improved estimates and time variations of VTE require longer-term designs, non-aggregated reporting of characteristics, and must consider many factors and the use of data registries. Extended surveillance of VTE after MBS is required.

Incorporation of vasa previa screening into a routine anomaly scan: A single center cohort study.

INTRODUCTION: Vasa previa (VP), defined as unprotected fetal vessels traversing the membranes over the cervix, is associated with a high perinatal mortality when undiagnosed prenatally. Conversely, prenatal diagnosis with ultrasound and cesarean delivery before the membranes rupture is associated with excellent outcomes. However, controversy exists regarding screening for VP. In the UK, routine screening for VP is not recommended. The objective of this study was to report the incidence of VP and our experience in the detection of VP with a universal screening protocol at the time of the second-trimester fetal anomaly scan with third-trimester confirmation in an unselected population of pregnancies. MATERIAL AND METHODS: We performed a single-center historical cohort study of all pregnant women who underwent routine second-trimester anomaly screening scans at West Middlesex University Hospital, London, UK, between 2012 and 2016. Over 5 years, every patient undergoing routine anomaly screening was evaluated for VP using a systematic protocol during their 20-week anomaly scan. Suspected cases of VP were rescanned in the third trimester by specialist sonographers with an interest in VP. The primary outcomes were the incidence and detection of VP. RESULTS: During the study period, 24 690 anatomy scans were performed. A total of 64 patients were identified as having potential VP at the second-trimester anomaly screening scan, of which 19 were confirmed by the specialist sonographer in the third trimester and at delivery. The screen positive rate was 0.26% (95% confidence interval [CI] 0.20%-0.32%). VP at birth was found in 19/24690 births (1:1299 [95% CI: 1:832-1:2030] births). Universal screening for VP using our protocol had a sensitivity of 100% and a specificity of 99.78% (95% CI: 99.72%-99.84%). The false-positive rate of the second-trimester screen was 0.18% (95% CI: 0.13-0.24). There were no false positives or false negatives at delivery. Of the 19 patients with confirmed VP, 17 had scheduled cesarean deliveries, and two required emergency deliveries due to antepartum hemorrhage. One baby died, giving a perinatal mortality of 5%. CONCLUSIONS: VP complicates approximately 1:1300 pregnancies. Routine screening for VP yielded a 100% detection rate. We suggest the inclusion of structured VP assessment in standard fetal anomaly screening programs.

Factors associated with the progression of sagittal spinal deformity after total hip arthroplasty: a propensity score-matched cohort study.

PURPOSE: The functional interaction between the hip and spine in patients undergoing total hip arthroplasty (THA) is clinically significant, as it impacts post-operative outcomes. Therefore, this study aimed to identify factors associated with the progression of sagittal spinal deformity and assess the association with patient-reported outcomes. METHODS: This retrospective case-control study included 200 patients who underwent primary THA and completed a mean follow-up duration of 42.2 months (range, 24.0-78.0). We employed a multivariate logistic regression to identify variables predictive of a post-THA sagittal vertical axis (SVA) ≥ 50 mm, which was indicative of a spinal sagittal imbalance. Propensity score-matched cohorts for age, sex, body mass index, follow-up duration, hip flexion contracture, developmental dysplasia, pelvic incidence (PI), and SVA were created, and the outcomes were compared between the two groups. RESULTS: PI (odds ratio 1.39; 95% confidence interval 1.04-1.86, p = 0.033) was associated with an SVA ≥ 50 mm. After successfully matching patients with (n = 50) and without (n = 50) an SVA ≥ 50 mm, the minimum clinically important difference showed significant differences between the 50 matched pairs (p = 0.016 for EuroQol-5D, p = 0.003 for Hip Disability and Osteoarthritis Outcome Score Joint Replacement, and p < 0.001 for low back pain). CONCLUSION: PI is associated with the development of a positive sagittal spinal malalignment post-THA. This finding can assist surgeons in managing patient expectations and in optimising outcomes. Feasible strategies are warranted to minimise the risk of spinal deformity progression post-THA.

Association between hypotension during pancreatectomy and development of postoperative diabetes.

CONTEXT: With advancements in long-term survival after pancreatectomy, post-pancreatectomy diabetes has become a concern, and the risk factors are not established yet. Pancreatic islets are susceptible to ischemic damage, though there is a lack of clinical evidence regarding glycemic deterioration. OBJECTIVE: To investigate association between hypotension during pancreatectomy and development of post-pancreatectomy diabetes. DESIGN: In this retrospective, longitudinal cohort study, we enrolled patients without diabetes who underwent distal pancreatectomy or pancreaticoduodenectomy between January 2005 and December 2018, from two referral hospitals in Korea. MAIN OUTCOME MEASURES: Intraoperative hypotension [IOH] was defined as a 20% or greater reduction in systolic blood-pressure. The primary and secondary outcomes were incident diabetes and postoperative Homeostatic Model Assessment [HOMA] indices. RESULTS: We enrolled 1,129 patients (average age, 59 years; 49% men; 35% distal pancreatectomy). IOH occurred in 83% (median duration, 25 minutes; interquartile range [IQR], 5-65). During a median follow-up of 3.9 years, diabetes developed in 284 patients (25%). The cumulative incidence of diabetes was proportional to increases in the duration and depth of IOH (P < 0.001). For the median duration in an IOH when compared to a reference time of 0 minute, the hazard ratio [HR] was 1.48 (95% CI, 1.14-1.92). The effect was pronounced with distal pancreatectomy compared to pancreaticoduodenectomy. Furthermore, the duration of IOH was inversely correlated with 1-year HOMA beta-cell function (P < 0.002), but not with HOMA insulin resistance. CONCLUSIONS: These results support the hypothesis that IOH during pancreatectomy may elevate risk of diabetes by inducing beta cell insufficiency.

Occupational accidents in Slovak Military Forests and Estates: incidence, timing, and trends over 10 years.

Introduction: Forestry provides a wide range of employment opportunities worldwide and is seen as one of the high-risk industries in terms of occupational accidents. Objectives: The submitted study analyzed the injury rate in the Military Forests and Estates of the Slovak Republic (62.6 thousand ha) between 2013 and 2022. Methods: The data analyses included regression and correlation analyses, χ2 tests to analyze the relationships between studied variables, and incidence rates. Results: During the observed period, employees suffered 26 occupational accidents, of which 19.2% were light, 57.7% were registered, 23.1% were severe, and 0% were fatal. For every 1 million m3 of harvested timber, 7.7 accidents occurred. The incidence rate during the observed period was 672.1/100,000 employees. The highest proportion of accidents was in the age group 51-60 years and in employees with the lowest length of work experience <5 years. Regarding time, the highest proportion of occupational accidents occurred between 8:01 and 10:00 AM (53.8%) and day-wise on Thursdays (46.2%). The highest proportion of accidents occurred among forest workers (65.3%) during pruning and silviculture activities (42.3%). The most common injury site was forest stands (65.3%). Superficial injuries (34.6%) were the most common, mainly affecting the lower limbs (50%). The most frequent material agents causing the accidents were work and transport areas as sources of worker fall (38.5%), and the most frequent reason for an accident to occur was the lack of personal requirements for proper work performance (92.4%), whereas only (3.8%) of accidents occurred due to the use of forbidden or hazardous working procedures. Conclusion: The presented study identified the most vulnerable worker groups and provided an overview of the overall injury rate at the state forest company in Slovakia. The documentation can be incorporated into the safety strategies of forest enterprises.

An Intense Out-of-Season Rebound of Influenza Activity After the Relaxation of Coronavirus Disease 2019 Restrictions in Beijing, China.

Background: The aim of this study was to investigate the changes of epidemic characteristics of influenza activity pre- and post-coronavirus disease 2019 (COVID-19) in Beijing, China. Methods: Epidemiologic data were collected from the influenza surveillance system in Beijing. We compared epidemic intensity, epidemic onset and duration, and influenza transmissibility during the 2022-2023 season with pre-COVID-19 seasons from 2014 to 2020. Results: The overall incidence rate of influenza in the 2022-2023 season was significantly higher than that of the pre-COVID-19 period, with the record-high level of epidemic intensity in Beijing. The onset and duration of the influenza epidemic period in 2022-2023 season was notably later and shorter than that of the 2014-2020 seasons. Maximum daily instantaneous reproduction number (Rt) of the 2022-2023 season (Rt = 2.31) was much higher than that of the pre-COVID-19 period (Rt = 1.49). The incidence of influenza A(H1N1) and A(H3N2) were the highest among children aged 0-4 years and 5-14 years, respectively, in the 2022-2023 season. Conclusions: A late, intense, and short-term peak influenza activity was observed in the 2022-2023 season in Beijing. Children <15 years old were impacted the most by the interruption of influenza circulation during the COVID-19 pandemic. Maintaining continuous surveillance and developing targeted public health strategies of influenza is necessary.

Influence of diabetes and other risk factors on in-hospital mortality following kidney transplantation: an analysis of the Spanish National Hospital Discharge Database from 2016 to 2020.

INTRODUCTION: To assess time trends in incidence, clinical characteristics, complications, and hospital outcomes among patients with type 1 diabetes (T1D), with type 2 diabetes (T2D), and patients without diabetes who underwent kidney transplant (KT); to identify variables associated with in-hospital mortality (IHM); and to determine the impact of the COVID-19 pandemic. RESEARCH DESIGN AND METHODS: We used a nationwide discharge database to select KT recipients admitted to Spanish hospitals from 2016 to 2020. We stratified patients according to diabetes status. We used multivariable logistic regression to identify the variables associated with IHM. RESULTS: A total of 14 594 KTs were performed in Spain (T2D, 22.28%; T1D, 3.72%). The number of KTs rose between 2016 and 2019 and and decreased from 2019 to 2020 in all groups. In patients with T2D, the frequency of KT complications increased from 21.08% in 2016 to 34.17% in 2020 (p<0.001). Patients with T2D had significantly more comorbidity than patients with T1D and patients without diabetes (p<0.001). Patients with T1D experienced KT rejection significantly more frequently (8.09%) than patients with T2D (5.57%).COVID-19 was recorded in 26 out of the 2444 KTs performed in 2020, being found in 6 of the 39 patients deceased that year (15.38%) and in 0.83% of the survivors.The variables associated with IHM were comorbidity and complications of KT. The presence of T1D was associated with IHM (OR 2.6; 95% CI 1.36 to 5.16) when patients without diabetes were the reference category. However, T2D was not associated with a higher IHM (OR 0.86; 95% CI 0.61 to 1.2). CONCLUSIONS: The COVID-19 pandemic led to a decrease in the number of transplants. Patients with T1D have more rejection of the transplanted organ than patients with T2D. Fewer women with T2D undergo KT. The presence of T1D is a risk factor for IHM.

Harnessing a Dielectric/Plasma Photonic Crystal as an Optical Microwave Filter: Role of Defect Layers and External Magnetic Fields.

We investigate the transmittance spectrum of a multichannel filter composed of dielectric (A) and plasma (P) materials in the microwave region within the transfer matrix formalism. Two configurations of the proposed filter are studied under the influence of an applied magnetic field: (1) a periodic structure containing (A/P)N unit cells surrounded by air and (2) the introduction of a second dielectric material (D) acting as a defect layer to produce an (AP)N/2/D/(AP)N/2 structure. Our findings reveal that in the periodic case, the number of resonant states of the transmittance increases with number N; however, the observed blue and red shifts depend on the intensity and orientation of the applied magnetic field. We present contour plots of the transmission coefficients that show the effect of the incident angle on the shifts of the photonic band gaps. Furthermore, we find that the introduction of a defect layer generates additional resonant states and merges the central resonant peak into a miniband of resonances. Moreover, we show that the number of resonant peaks and their locations can be modulated by increasing the unit cell number, N, as well as increasing the width of the inserted defect layer. Our proposed structures enable the design of novel photonic filters using magnetized plasma materials operating in the microwave region.

Estimating the Effect of Engagement in Community-Based Going-Out Program on Incidence Disability in Older Adults.

OBJECTIVES: Although going out has been reported to be associated with the incidence of disability, few studies have investigated the effect of community-based programs to promote going out on the incidence of disability. This study aimed to estimate the effects of a program fostering going-out on the incidence of disability in community-dwelling older adults. DESIGN: Longitudinal, observational study. SETTING AND PARTICIPANTS: Nonengaged (n = 1086) and engaged older adults (n = 1086) enrolled in the National Center for Geriatrics and Gerontology Study of Geriatric Syndrome by using a one-to-one nearest neighbor propensity score-matching scheme. METHODS: After the baseline assessments, participants in the community-based going-out program received a specialized physical activity tracker, monitored their daily physical activity, and received personalized feedback on going out to community facilities with a system for reading the device for 12 months. Disability onset was defined as a new case of long-term care under the public insurance certification in Japan within 48 months of program completion. The absolute risk reduction and the number needed to treat for the incidence of disability were calculated for the nonengaged and engaged groups. Cox proportional hazard regression analysis, using inverse probability weighting was used to obtain the hazard ratio. RESULTS: Disabilities occurred in 112 individuals in the matched nonengaged group and 51 individuals in the engaged group. The absolute risk reduction was 5.67% (95% CI 3.46%-7.88%). The number needed to treat was 18 (95% CI 13-29). The hazard ratio, with the nonengaged group as the reference, was 0.49 (95% CI 0.36-0.67). CONCLUSIONS AND IMPLICATIONS: This longitudinal observational study suggested that a community-based program could prevent 1 disability in every 18 participants. This program does not require a professional instructor, only the distribution of devices and system installation, and it could be beneficial as a population-based approach to preventing disabilities.

Incidence of Facial Nerve Injury and Sialocele Formation Following Mandibular Condylar and Sub-condylar Fracture Fixation.

Purpose: To study the incidence of sialocele formation in the parotid gland and to study the incidence of facial nerve affliction following treatment of mandibular condylar and sub-condylar fractures. Materials and methods: The present study is a retrospective study conducted on a total of 82 patients with 107 sub-condylar and condylar fractures treated in this centre from August 2008 to August 2020. The surgical approaches used to treat the fractures were considered, and the occurrence of sialocele, salivary fistula and facial nerve paralysis was noted. The facial nerve function was analysed using House-Brackmann system of classification. Results: The incidence of sialocele formation was seen in 15.87% of cases, and the incidence was seen more commonly during a preauricular approach (52.94%) followed by retromandibular (41.17%) followed by anterior parotid transmassetric approach (11.76%). The incidence of facial nerve affliction was seen in 17.57% of cases with majority of them showing temporal branch involvement in 21.05% of cases. Conclusion: During the treatment of condylar and sub-condylar fractures, the facial nerve is at considerable risk of damage; however, understanding the anatomy of the nerve is of importance to avoid such complications. Sialocele formation is also an undesirable complication of such surgeries, a prompt diagnosis and early treatment is mandatory to overcome further unwanted sequel.