Exposición a temperaturas extremas y su efecto en la gestación en un departamento de Colombia / Exposure to extreme temperatures and its effect on pregnancy in a department of Colombia

Introducción: Diversas investigaciones han establecido la relación entre temperatura y duración del embarazo, la exposición a temperaturas altas durante el embarazo plantea interrogantes en especial el papel que esta juega frente a los partos prematuros y partos de bajo peso, es indispensable determinar si las temperaturas altas o bajas tienen un comportamiento protector o de riesgo sobre el feto durante la gestación en regiones tropicales. Objetivo: describir la relación entre la exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos del departamento del Guaviare-Colombia. Metodología: Estudio tipo observacional, analítico, retrospectivo de corte transversal que busco determinar la relación entre exposición a temperaturas altas y bajas durante el embarazo y su efecto en la edad gestacional y peso al momento del parto en los recién nacidos, el universo estuvo conformado por 10.137 nacidos vivos, de los cuales 9.932 cumplieron los criterios de inclusión. Se determinó Odds Ratio para estimar la asociación entre las variables. Resultados: Dentro de la semana de retraso 3 el estar expuesto a temperaturas máximas percentil 90 es un factor protector para la ganancia ponderal de peso OR < 1, la exposición a temperaturas mínimas percentil 10 se asoció como factor protector para el parto prematuro en la semana de retraso 1 y 2 OR < 1.Conclusión: A pesar del beneficio de las altas y bajas temperaturas durante el embarazo en la ganancia ponderal de peso y disminución del parto prematuro, es recomendable prevenir la exposición a temperaturas extremas durante el periodo de gestación[AU]

Introduction: Various investigations have established the relationship between temperature and duration of pregnancy. Exposure to high temperatures during pregnancy raises questions, especially the role it plays in premature births and low-weight births. It is essential to determine whether high temperatures or low have a protective or risky behavior on the fetus during pregnancy in tropical regions.Objective: to describe the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns in the department of Guaviare-Colombia.Methodology:Observational, analytical, retrospective cross-sectional study that sought to determine the relationship between exposure to high and low temperatures during pregnancy and its effect on gestational age and weight at the time of delivery in newborns. The universe was made up of 10,137 births. alive, of which 9,932 met the inclusion criteria. Odds Ratio was determined to estimate the association between the variables.Results:Within the 3rd week of delay, being exposed to maximum temperatures at the 90th percentile is a protective factor for weight gain OR < 1, exposure to minimum temperatures at the 10th percentile was associated as a protective factor for premature birth in the week. of delay 1 and 2 OR < 1. Conclusion: Despite the benefit of high and low temperatures during pregnancy in weight gain and reduction in premature birth, it is advisable to prevent exposure to extreme temperatures during the gestation period[AU]

Introdução: Várias investigações estabeleceram a relação entre temperatura e duração da gravidez. A exposição a altas temperaturas durante a gravidez levanta questões, especialmente o papel que desempenha nos partos prematuros e nos nascimentos de baixo peso. É essencial determinar se as temperaturas altas ou baixas têm um comportamento protetor ou de risco para o feto durante a gravidez em regiões tropicais. Objetivo:descrever a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos no departamento de Guaviare-Colômbia. Metodologia: Estudo observacional, analítico, retrospectivo e transversal que buscou determinar a relação entre a exposição a altas e baixas temperaturas durante a gravidez e seu efeito na idade gestacional e no peso no momento do parto em recém-nascidos. O universo foi composto por 10.137 nascimentos. vivos, dos quais 9.932 preencheram os critérios de inclusão. O Odds Ratio foi determinado para estimar a associação entre as variáveis. Resultados:Na 3ª semana de atraso, a exposição a temperaturas máximas no percentil 90 é fator de proteção para ganho de peso OR < 1, a exposição a temperaturas mínimas no percentil 10 foi associada como fator de proteção para parto prematuro na semana. de atraso 1 e 2 OR < 1.Conclusão:Apesar do benefício das altas e baixas temperaturas durante a gravidez no ganho de peso e redução do parto prematuro, é aconselhável evitar a exposição a temperaturas extremas durante o período de gestação[AU]

Red and green defocus curves and duochrome test in different age groups / Curvas de desenfoque rojo y verde y prueba de duocromo en diferentes grupos de edad

Purpose: To compare the eye defocus curves (DCs) obtained with stimuli on red, green, and white backgrounds and to investigate the applicability of the duochrome test (DT) in different age groups. Methods: 12 elderly (ELD: 59.3 ± 3.9 years) and 8 young (YG: 22.1 ± 1.1 years) subjects were recruited. An optometric assessment with the DT was carried out to obtain the subjective refraction at distance. DCs at distance on green, white, and red backgrounds were measured and the following parameters were deduced: dioptric difference between red-green, green-white, red-white focal positions (minima of the DCs), best corrected visual acuity (BCVA), and widths of the DCs for red, green, and white. Results: The DC difference between the green-white focal positions (mean ± standard deviation) was -0.12±0.17 diopters (D) (ELD, p = 0.012) and -0.11±0.12 D (YG, p = 0.039), while the red-white difference was not statistically significant. The DC red-green difference was 0.20±0.16 D (ELD, p = 0.002) and 0.18±0.18 D (YG, p = 0.008). The ELD BCVA with green background was significantly worse than BCVA with red (p = 0.007) and white (p = 0.007). The mean value of the DC's width in ELD for green (1.01±0.36 D) was higher than for red (0.77±0.21 D) and for white (0.84±0.35 D), but with no statistical significance. Conclusion: Both age groups showed a slight focusing preference for red when using white light. Moreover, ELD showed a worse BCVA with a green compared to a red background. Despite these results deduced by DC analyses, these aspects do not compromise the possibility of using the DT in clinical practice both in the young and in the elderly. Furthermore, the difference of about 0.20 D between red-green DC in both groups confirms the clinical appropriateness of the widespread use of 0.25 D step as the standard minimum difference in power between correcting lenses.(AU)

A retrospective analysis of factors affecting speech production in school-aged children with cleft palate (+- cleft lip).

OBJECTIVE: The present investigation examined how factors such as cleft type, age of primary palatal surgery, diagnosed syndromes, hearing problems, and malocclusions could predict persistent speech difficulties and the need for speech services in school-aged children with cleft palate. METHODS: Participants included 100 school-aged children with cleft palate. Americleft speech protocol was used to assess the perceptual aspects of speech production. The logistic regression was performed to evaluate the impact of independent variables (IV) on the dependent variables (DV): intelligibility, posterior oral CSCs, audible nasal emission, hypernasality, anterior oral CSCs, and speech therapy required. RESULTS: Sixty-five percent of the children were enrolled in (or had received) speech therapy. The logistic regression model shows a good fit to the data for the need for speech therapy (Hosmer and Lemeshow's χ2(8)=9.647,p=.291). No IVs were found to have a significant impact on the need for speech therapy. A diagnosed syndrome was associated with poorer intelligibility (Pulkstenis-Robinson's χ2(11)=7.120,p=.789). Children with diagnosed syndromes have about six times the odds of a higher hypernasality rating (Odds Ratio = 5.703) than others. The cleft type was significantly associated with audible nasal emission (Fisher'sexactp=.006). At the same time, malocclusion had a significant association with anterior oral CSCs (Fisher'sexactp=.005). CONCLUSIONS: According to the latest data in the Cleft Registry and Audit Network Annual Report for the UK, the majority of children with cleft palate attain typical speech by age five. However, it is crucial to delve into the factors that may influence the continuation of speech disorders beyond this age. This understanding is vital for formulating intervention strategies aimed at mitigating the long-term effects of speech disorders as individuals grow older.

Map of epigenetic age acceleration: A worldwide analysis.

We present a systematic analysis of epigenetic age acceleration based on by far the largest collection of publicly available DNA methylation data for healthy samples (93 datasets, 23 K samples), focusing on the geographic (25 countries) and ethnic (31 ethnicities) aspects around the world. We employed the most popular epigenetic tools for assessing age acceleration and examined their quality metrics and ability to extrapolate to epigenetic data from different tissue types and age ranges different from the training data of these models. In most cases, the models proved to be inconsistent with each other and showed different signs of age acceleration, with the PhenoAge model tending to systematically underestimate and different versions of the GrimAge model tending to systematically overestimate the age prediction of healthy subjects. Referring to data availability and consistency, most countries and populations are still not represented in GEO, moreover, different datasets use different criteria for determining healthy controls. Because of this, it is difficult to fully isolate the contribution of "geography/environment", "ethnicity" and "healthiness" to epigenetic age acceleration. Among the explored metrics, only the DunedinPACE, which measures aging rate, appears to adequately reflect the standard of living and socioeconomic indicators in countries, although it has a limited application to blood methylation data only. Invariably, by epigenetic age acceleration, males age faster than females in most of the studied countries and populations.

Multifactorial Memory Questionnaire: a comparison of young and older adults.

The Multifactorial Memory Questionnaire (MMQ; Troyer & Rich, [2002]. Psychometric properties of a new metamemory questionnaire for older adults. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 57(1), P19-P27) is a widely used measure of subjective memory consisting of three scales: Satisfaction, Ability, and Strategies. Although subjective memory complaints are prevalent across different age groups, the factor structure and psychometric properties of the MMQ have yet to be examined in young adults. Here, we independently replicated the original MMQ factor structure in N = 408 young adults (YA) recruited from undergraduate courses and N = 327 older adults (OA) and, for the first time, assessed the age-invariance of the scale using measurement invariance testing. YAs made significantly higher ratings than OAs on MMQ-Satisfaction and MMQ-Strategies, indicating greater satisfaction with their memory and greater use of strategies, but the groups were similar on MMQ-Ability. The original MMQ factor structure was replicated in OAs but not in YAs, and age invariance was not supported. Future studies seeking to compare young and older adults could therefore consider either requesting modification of the MMQ for use with young adults or using a different scale.

Neurocognitive outcomes in young adults with cochlear implants: The role of early language access and crossmodal plasticity.

Many children with profound hearing loss have received cochlear implants (CI) to help restore some sense of hearing. There is, however, limited research on long-term neurocognitive outcomes in young adults who have grown up hearing through a CI. This study compared the cognitive outcomes of early-implanted (n = 20) and late-implanted (n = 21) young adult CI users, and typically hearing (TH) controls (n=56), all of whom were enrolled in college. Cognitive fluidity, nonverbal intelligence, and American Sign Language (ASL) comprehension were assessed, revealing no significant differences in cognition and nonverbal intelligence between the early and late-implanted groups. However, there was a difference in ASL comprehension, with the late-implanted group having significantly higher ASL comprehension. Although young adult CI users showed significantly lower scores in a working memory and processing speed task than TH age-matched controls, there were no significant differences in tasks involving executive function shifting, inhibitory control, and episodic memory between young adult CI and young adult TH participants. In an exploratory analysis of a subset of CI participants (n = 17) in whom we were able to examine crossmodal plasticity, we saw greater evidence of crossmodal recruitment from the visual system in late-implanted compared with early-implanted CI young adults. However, cortical visual evoked potential latency biomarkers of crossmodal plasticity were not correlated with cognitive measures or ASL comprehension. The results suggest that in the late-implanted CI users, early access to sign language may have served as a scaffold for appropriate cognitive development, while in the early-implanted group early access to oral language benefited cognitive development. Furthermore, our results suggest that the persistence of crossmodal neuroplasticity into adulthood does not necessarily impact cognitive development. In conclusion, early access to language - spoken or signed - may be important for cognitive development, with no observable effect of crossmodal plasticity on cognitive outcomes.

Stand age diversity (and more than climate change) affects forests' resilience and stability, although unevenly.

Stand age significantly influences the functioning of forest ecosystems by shaping structural and physiological plant traits, affecting water and carbon budgets. Forest age distribution is determined by the interplay of tree mortality and regeneration, influenced by both natural and anthropogenic disturbances. Unfortunately, human-driven alteration of tree age distribution presents an underexplored avenue for enhancing forest stability and resilience. In our study, we investigated how age impacts the stability and resilience of the forest carbon budget under both current and future climate conditions. We employed a state-of-the-science biogeochemical, biophysical, validated process-based model on historically managed forest stands, projecting their future as undisturbed systems, i.e., left at their natural evolution with no management interventions (i.e., forests are left to develop undisturbed). Such a model, forced by climate data from five Earth System Models under four representative climate scenarios and one baseline scenario to disentangle the effect of climate change, spanned several age classes as representative of the current European forests' context, for each stand. Our findings indicate that Net Primary Production (NPP) peaks in the young and middle-aged classes (16- to 50-year-old), aligning with longstanding ecological theories, regardless of the climate scenario. Under climate change, the beech forest exhibited an increase in NPP and maintained stability across all age classes, while resilience remained constant with rising atmospheric CO2 and temperatures. However, NPP declined under climate change scenarios for the Norway spruce and Scots pine sites. In these coniferous forests, stability and resilience were more influenced. These results underscore the necessity of accounting for age class diversity -lacking in most, if not all, the current Global Vegetation Models - for reliable and robust assessments of the impacts of climate change on future forests' stability and resilience capacity. We, therefore, advocate for customized management strategies that enhance the adaptability of forests to changing climatic conditions, taking into account the diverse responses of different species and age groups to climate.

Evaluation of urban-rural difference in breast cancer mortality among Chinese women during 1987-2021: A hierarchical age-period-cohort analysis.

BACKGROUND: Breast cancer mortality varies in urban and rural areas in China. Studies have reported urban-rural difference across time period, however, the evaluation on urban-rural differences in age and birth cohort effects is limited. Our aim was to quantitatively assess urban-rural disparities in age, period and cohort effects in breast cancer mortality in China. METHODS: We collected age-specific breast cancer mortality rates for urban and rural females aged 20-84 years from 1987 to 2021. Hierarchical age-period-cohort (HAPC) models were used to evaluate the effect of area (urban, rural) on breast cancer mortality and investigate urban-rural differences in age, time period and birth cohort effects. RESULTS: We found a significant area (urban, rural) effect on breast cancer mortality in that rural females had a lower mortality risk than urban females [-0.25 (95 % confidence interval (CI): -0.32, -0.17)]. Age trajectories of mortality based on the HAPC model showed nonlinear trends with adjustment for area variable. The urban-rural difference in age effect appeared to be divergent with age, and urban women had higher mortality risk in the senior age group. The urban-rural difference in birth cohort effect indicated a reversal around the birth cohort group of 1962-1966, after which rural females had a higher mortality risk than urban females. CONCLUSION: The area (urban, rural) could affect breast cancer mortality among women, and the effect of urban-rural difference varies with age and birth cohort. To promote the health of urban and rural females, the gap between urban and rural areas should be shorten.

Sestrin2 plays a protective role in Age-related hearing loss by inhibiting NLRP3-inflammasome activity.

Age-related hearing loss (ARHL) is an auditory disease characterized by gradual loss of high-frequency hearing sensitivity. Excessive reactive oxygen species trigger NLRP3-inflammasome activation that may be crucial for ARHL pathogenesis. The antioxidant factor Sestrin2 (SESN2) has been reported to be involved in the remission of oxidative stress and ARHL. However, the mechanism by which SESN2 protects auditory cells in the aging mouse cochlea remains unknown. Here, we observed that ectopic overexpression of SESN2 delayed ARHL, whereas SESN2 knockdown accelerated it. Importantly, we elucidated that SESN2 exerts a hearing-protective effect by inhibiting the production of NLRP3 by acting as a mitophagy agonist. Our study proposes a new theoretical basis for SESN2 prevention of ARHL and provides a novel therapeutic strategy for maintaining SESN2 activity in the aging cochlea.

The effect of sparkling water on the systemic pharmacokinetics of paracetamol in older adults.

Paracetamol absorption kinetics show considerable variability in older adults, complicating the development of effective dosing regimens in the advanced-age population. In previous research, sparkling water has been shown to influence absorption-related processes. This study aimed to apply these findings to older adults and investigate the impact of sparkling water on absorption-related variability and early exposure. To this end, fourteen volunteers, with a median age of 72.5, were enrolled in a small-scale, randomised, controlled clinical trial with a cross-over design. A single immediate-release 500 mg paracetamol tablet was administered with sparkling or still water. Venous blood samples were collected regularly over 8 hours and analysed using HPLC-UV. Reduced variability of absorption-related parameters and a trend towards higher early exposure were observed in the sparkling water group, as demonstrated by a 1.6-fold increased AUC0-30min, a 2-fold reduced geometric coefficient of variation (GCV) for AUC0-30min, and a reduced median [interquartile range] Tmax of 25.0 [20.0-30.0] min compared to 30.0 [25.0-45.0] min. Based on our findings, sparkling water as a real-life dosing condition might improve paracetamol absorption kinetics and early exposure in the advanced-age population.

Social vs. individual age-dependent costs of imperfect vaccination.

In diseases with long-term immunity, vaccination is known to increase the average age at infection as a result of the decrease in the pathogen circulation. This implies that a vaccination campaign can have negative effects when a disease is more costly (financial or health-related costs) for higher ages. This work considers an age-structured population transmission model with imperfect vaccination. We aim to compare the social and individual costs of vaccination, assuming that disease costs are age-dependent, while the disease's dynamic is age-independent. A model coupling pathogen deterministic dynamics for a population consisting of juveniles and adults, assumed to be rational agents, is introduced. The parameter region for which vaccination has a positive social impact is fully characterized and the Nash equilibrium of the vaccination game is obtained. Finally, collective strategies designed to promote voluntary vaccination, without compromising social welfare, are discussed.

Triptonide protects retinal cells from oxidative damage via activation of Nrf2 signaling.

Age­related macular degeneration (AMD) is an ocular disease that threatens the visual function of older adults worldwide. Key pathological processes involved in AMD include oxidative stress, inflammation and choroidal vascular dysfunction. Retinal pigment epithelial cells and Müller cells are most susceptible to oxidative stress. Traditional herbal medicines are increasingly being investigated in the field of personalized medicine in ophthalmology. Triptonide (Tn) is a diterpene tricyclic oxide, the main active ingredient in the extract from the Chinese herbal medicinal plant Tripterygium wilfordii, and is considered an effective immunosuppressant and anti­inflammatory drug. The present study investigated the potential beneficial role of Tn in retinal oxidative damage in order to achieve personalized treatment for early AMD. An oxidative stress model of retinal cells induced by H2O2 and a retinal injury model of mice induced by light and N­Methyl­D­aspartic acid were constructed. In vitro, JC­1 staining, flow cytometry and apoptosis assay confirmed that low concentrations of Tn effectively protected retinal cells from oxidative damage, and reverse transcription­quantitative PCR and western blotting analyses revealed that Tn reduced the expression of retinal oxidative stress­related genes and inflammatory factors, which may depend on the PI3K/AKT/mTOR­induced Nrf2 signaling pathway. In vivo, by retinal immunohistochemistry, hematoxylin and eosin staining and electroretinogram assay, it was found that retinal function and structure improved and choroidal neovascularization was significantly inhibited after Tn pretreatment. These results suggested that Tn is an efficient Nrf2 activator, which can be expected to become a new intervention for diseases such as AMD, to inhibit retinal oxidative stress damage and pathological neovascularization.

Interpregnancy weight change and neonatal and infant outcomes: A systematic review and meta-analysis.

PURPOSE: To synthesize evidence regarding the association between interpregnancy weight change (IPWC) in consecutive pregnancies and neonatal or infant outcomes in the subsequent pregnancy. METHODS: Search strategy was implemented in MEDLINE, EMBASE, Web of Science, Scopus and Cochrane Library from their inception to 13 November 2023. The most adjusted odds ratio (OR) or risk ratio estimates provided by original studies were used to calculate pooled risk ratios and their corresponding 95 % confidence intervals (CI) with the DerSimonian and Laird random effects method. Publication bias was assessed by funnel plots and Egger's method, and risk of bias was assessed with The NewcastleOttawa Quality Assessment Scale. RESULTS: Thirty-seven observational studies were included. Interpregnancy weight loss or gain were associated with large for gestational age (OR: 0.89; 95 % CI: 0.84-0.94; I2 = 83.6 % and OR: 1.33; 95 % CI:1.26-1.40; I2 = 98.9 %), and stillbirth risk (OR: 1.10; 95 % CI: 1.01-1.18; I2 = 0.0 % and OR: 1.21; 95 % CI: 1.09-1.33; I2 = 60.2 %,). CONCLUSIONS: Findings highlight the importance of managing weight between interpregnancy periods, although these findings should be interpreted cautiously because of the possible influence of social determinants of health and other factors.

Aryl hydrocarbon receptor (AhR)-mediated immune responses to degeneration of the retinal pigment epithelium.

Injuries to the retinal pigment epithelium (RPE) trigger immune responses, orchestrating interactions within the innate and adaptive immune systems in the outer retina and choroid. We previously reported that interleukin 17 (IL-17) is a pivotal signaling molecule originating from choroidal γδ T cells, exerting protective effects by mediating functional connections between the RPE and subretinal microglia. In this current study, we generated mice with aryl hydrocarbon receptor (AhR) knockout specifically in IL-17-producing cells. These animals had deficiency in IL-17 production from γδ T cells, and exhibited increased sensitivity to both acute and chronic insults targeting the RPE. These findings imply that IL-17 plays a crucial role as a signaling cytokine in preserving the homeostasis of the outer retina and choroid.

All-cause and cause-specific mortality risk and loss in life expectancy associated with incident type 2 diabetes onset age and duration.

BACKGROUND: Evidence on type 2 diabetes onset age and duration on mortality risk has been limited by short follow-up, inadequate control for confounding, missing repeated measurements, and inability to cover the full range of onset age, duration, and major causes of death. Moreover, scarce data dissect how type 2 diabetes onset age and duration shape life expectancy. METHODS: We evaluate prospectively these topics based on 270,075 eligible participants in the Nurses' Health Studies and Health Professionals Follow-up Study, leveraging repeated measurements throughout up to 40 years of follow-up. Cox models were used to estimate hazard ratios (HRs) and 95% confidence intervals (CIs). RESULTS: In fully adjusted analyses, incident early onset type 2 diabetes (diagnosed <40 years of age) was associated with significantly higher mortality from all-causes (HR, 95% CI was 3.16, 2.64-3.79; vs. individuals without type 2 diabetes), cardiovascular disease (6.56, 4.27-10.1), respiratory disease (3.43, 1.38-8.51), neurodegenerative disease (5.13, 2.09-12.6), and kidney disease (8.55, 1.98-36.9). The relative risk elevations declined dramatically with each higher decade of age at diagnosis for deaths from most of these causes, though the absolute risk difference increased continuously. A substantially higher cumulative incidence of mortality and a greater loss in life expectancy were associated with younger age at type 2 diabetes diagnosis. Longer disease duration was associated with generally higher relative and absolute risk of mortality. CONCLUSION: Early onset of type 2 diabetes and longer disease duration are associated with substantially increased risk of all-cause and cause-specific mortality and greater loss in life expectancy.

Preconception underweight and the risk of offspring congenital heart diseases in young pregnant women: Evidence from the China Birth Cohort Study.

OBJECTIVE: Maternal obesity is a highly suggestive risk factor of offspring congenital heart diseases (CHD). However, the risk of offspring CHD associated with maternal underweight has rarely been mentioned. Therefore, this study aimed to explore the effect of preconception underweight on offspring CHD. METHODS: From November 2017 to August 2021, 132 386 pregnant women were enrolled in a birth cohort study in China in early pregnancy, and completed follow-up until delivery (or miscarriage/termination). Offspring CHD was diagnosed by prenatal ultrasound examination in both live births and stillbirths. Log-binomial regression and restricted cubic spline were used to estimate the risk of offspring CHD associated with preconception body mass index (BMI). A generalized additive model was used to explore the modification effect of maternal age on the association between preconception BMI and offspring CHD. RESULTS: A total of 129 096 pregnant women were included in the analysis. The incidence of CHD in the underweight, normal weight, overweight, and obesity groups were 117/17 313 (0.68%), 556/85 695 (0.65%), 128/19 936 (0.64%), 47/6152 (0.76%), respectively. Both underweight and obesity before pregnancy marginally increased the risk of offspring CHD. The association between preconception BMI and offspring CHD varied by maternal age, with low preconception BMI associated with a significantly higher risk of offspring CHD in women <24 years (RR 2.32, 95% CI: 1.07-5.01 for 17 vs 21 kg/m2). CONCLUSION: Preconception underweight was associated with an increased risk of offspring CHD in young pregnant women. Therefore, weight gain is important to prevent offspring CHD, especially for young women with low preconception BMI.

[Temporal Variations in Community Structure and Function of Root-associated Fungi Associated with Pinus sylvestris var. mongholica Plantations in the Mu Us Sandy Land].

To illuminate the temporal variations in the structure and functional groups of the root-associated fungal community associated with Mongolian pine Pinus sylvestris var. mongholica plantations in the Mu Us Sandy Land, P. sylvestris var. mongholica plantations with different stand ages （23, 33, and 44 a） were targeted. The community compositions and main drivers of root-associated fungi at different months and stand ages were identified using the Illumina high-throughput sequencing method. The results indicated that： ① There was a distinct temporal distribution in the root-associated fungal community, the sampling month had a significant effect on the diversity of root-associated fungi （P<0.05）, and the values were higher in May and July. The stand age had no significant effect on the diversity of root-associated fungi （P>0.05） and decreased gradually with increasing stand age. ② The dominant phylum of the root-associated fungal community was Ascomycota. The relative abundance of fungal function groups was different within each month and stand age, and the dominant groups were saprotroph-symbiotroph, undefined saprotroph, and ectomycorrhizal fungi. The indicator genera of ectomycorrhizal fungi in May, July, and September were Melanoleuca, Amphinema, and Tricholoma, respectively. ③ The temporal distribution of the root-associated fungal community was significantly affected by annual relative humidity, annual precipitation, soil porosity, ammonia nitrogen, annual sunshine duration, annual temperature, and soil water content （P<0.05）. Soil organic carbon content, soil porosity, annual precipitation, and annual relative humidity were the main factors that significantly affected the indicator genus of the root-associated fungal community. Our results demonstrated that the temporal distribution of the root-associated fungal community was shaped by climate and soil properties, whereas stand age contributed less. This improved information will provide a theoretical basis for the sustainable management of P. sylvestris var mongholica plantations.

Estimated Pulse-Wave Velocity and Magnetic Resonance Imaging Markers of Cerebral Small-Vessel Disease in the NOMAS.

BACKGROUND: Pulse-wave velocity is a measure of arterial stiffness and a risk factor for cardiovascular disease. Recently, an estimated pulse-wave velocity (ePWV) was introduced that was predictive of increased risk of cardiovascular disease. Our objective was to determine whether ePWV was associated with cerebral small-vessel disease on magnetic resonance imaging. METHODS AND RESULTS: We included 1257 participants from the NOMAS (Northern Manhattan Study). The ePWV values were calculated using a nonlinear function of age and mean arterial blood pressure. The association between ePWV and white matter hyperintensity volume was assessed. Modification by race and ethnicity was evaluated. Associations between ePWV and other cerebral small-vessel disease markers, covert brain infarcts, cerebral microbleeds, and enlarged perivascular spaces, were explored as secondary outcomes. Mean±SD age of the cohort was 64±8 years; 61% were women; 18% self-identified as non-Hispanic Black, 67% as Hispanic, and 15% as non-Hispanic White individuals. Mean±SD ePWV was 11±2 m/s in the total NOMAS population and was similar across race and ethnic groups. The ePWV was significantly associated with white matter hyperintensity volume (ß=0.23 [95% CI, 0.20-0.26]) after adjustment. Race and ethnicity modified the association between ePWV and white matter hyperintensity volume, with stronger associations in Hispanic and non-Hispanic Black individuals. Significant associations were found between ePWV and covert brain infarcts, cerebral microbleeds, and perivascular spaces after adjustment. CONCLUSIONS: The ePWV function may provide a vascular mechanism for deleterious cerebrovascular outcomes in individuals with cerebral small-vessel disease and is particularly apparent in the racial and ethnic minorities represented in the NOMAS cohort.

Home-monitoring for neovascular age-related macular degeneration in older adults within the UK: the MONARCH diagnostic accuracy study.

Background: Most neovascular age-related macular degeneration treatments involve long-term follow-up of disease activity. Home monitoring would reduce the burden on patients and those they depend on for transport, and release clinic appointments for other patients. The study aimed to evaluate three home-monitoring tests for patients to use to detect active neovascular age-related macular degeneration compared with diagnosing active neovascular age-related macular degeneration by hospital follow-up. Objectives: There were five objectives: Estimate the accuracy of three home-monitoring tests to detect active neovascular age-related macular degeneration. Determine the acceptability of home monitoring to patients and carers and adherence to home monitoring. Explore whether inequalities exist in recruitment, participants' ability to self-test and their adherence to weekly testing during follow-up. Provide pilot data about the accuracy of home monitoring to detect conversion to neovascular age-related macular degeneration in fellow eyes of patients with unilateral neovascular age-related macular degeneration. Describe challenges experienced when implementing home-monitoring tests. Design: Diagnostic test accuracy cohort study, stratified by time since starting treatment. Setting: Six United Kingdom Hospital Eye Service macular clinics (Belfast, Liverpool, Moorfields, James Paget, Southampton, Gloucester). Participants: Patients with at least one study eye being monitored by hospital follow-up. Reference standard: Detection of active neovascular age-related macular degeneration by an ophthalmologist at hospital follow-up. Index tests: KeepSight Journal: paper-based near-vision tests presented as word puzzles. MyVisionTrack®: electronic test, viewed on a tablet device. MultiBit: electronic test, viewed on a tablet device. Participants provided test scores weekly. Raw scores between hospital follow-ups were summarised as averages. Results: Two hundred and ninety-seven patients (mean age 74.9 years) took part. At least one hospital follow-up was available for 317 study eyes, including 9 second eyes that became eligible during follow-up, in 261 participants (1549 complete visits). Median testing frequency was three times/month. Estimated areas under receiver operating curves were < 0.6 for all index tests, and only KeepSight Journal summary score was significantly associated with the lesion activity (odds ratio = 3.48, 95% confidence interval 1.09 to 11.13, p = 0.036). Older age and worse deprivation for home address were associated with lower participation (χ2 = 50.5 and 24.3, respectively, p < 0.001) but not ability or adherence to self-testing. Areas under receiver operating curves appeared higher for conversion of fellow eyes to neovascular age-related macular degeneration (0.85 for KeepSight Journal) but were estimated with less precision. Almost half of participants called a study helpline, most often due to inability to test electronically. Limitations: Pre-specified sample size not met; participants' difficulties using the devices; electronic tests not always available. Conclusions: No index test provided adequate test accuracy to identify lesion diagnosed as active in follow-up clinics. If used to detect conversion, patients would still need to be monitored at hospital. Associations of older age and worse deprivation with study participation highlight the potential for inequities with such interventions. Provision of reliable electronic testing was challenging. Future work: Future studies evaluating similar technologies should consider: Independent monitoring with clear stopping rules based on test performance. Deployment of apps on patients' own devices since providing devices did not reduce inequalities in participation and complicated home testing. Alternative methods to summarise multiple scores over the period preceding a follow-up. Trial registration: This trial is registered as ISRCTN79058224. Funding: This award was funded by the National Institute of Health and Care Research (NIHR) Health Technology Assessment programme (NIHR award ref: 15/97/02) and is published in full in Health Technology Assessment; Vol. 28, No. 32. See the NIHR Funding and Awards website for further award information.

Treatment for neovascular age-related macular degeneration, the most common cause of sight loss in those over 50 years, involves regular eye injections and frequent follow-up appointments. This is inconvenient for patients and causes capacity issues in the hospital eye service. Finding tests that could be undertaken at home that could detect if a further injection and hospital appointment was required or not would increase capacity to see those at highest risk of sight loss and also reduce the burden on patients and their carers. We investigated three different visual function tests, one paper-based and two applications on an iPod Touch_TM tablet (Apple, Cupertino, CA, USA). We wanted to see if they could detect an increase in disease activity that would require treatment, compared to the decision by a retinal specialist at a traditional hospital eye outpatient visit based on clinical examination and retinal imaging. To encourage those without a smartphone or home internet to participate, we provided both an iPod Touch and Mobile Wireless-Fidelity device with a mobile contract. None of the tests performed well enough to safely monitor patients at home. Those who were willing to participate tended to be younger, had previous experience of using smartphones, sending e-mail and internet access and were more well-off than those who chose not to participate. Some participants also experienced difficulties with the devices provided and successfully uploading the data which were not related to the extent of previous information technology experience. There were also significant technical challenges for the research team. The study helpline was used heavily, considerably more than we anticipated. These tests are not ready to be used in this context. Future studies involving mobile health technology need to carefully consider how to reach those unlikely to participate and provide sufficient technical support to support long-term follow-up.

Detecting the veracity of children's experiences through drawings.

Research is lacking regarding adults' ability to determine whether children's drawings are based on an experience or not. Drawings are useful in professional settings to alleviate linguistic demands, facilitate memory, and have been used as evidence. Determining the accuracy of veracity assessments of children's drawings would inform professionals regarding their use as evidence of experiences. Twenty-eight children (14 younger, Mage = 7.53 years, SDage = 1.19; 14 older, Mage = 11.67 years, SD = 1.27) produced drawings of two events: one staged experienced, and one narrative-based not experienced event. Fifty (Study 1, Mage = 23.72 years, SDage = 9.70) and 63 (Study 2, Mage = 25.92, SDage = 12.79) adults indicated whether each drawing was based on experience and their confidence in each assessment. In Study 2, additional drawing quality assessments were collected. Results indicated that adults were more accurate at distinguishing experienced than not experienced drawings for older artists. An inverse relationship was observed between confidence and accuracy-participants were more confident when they were inaccurate, especially for younger artists. Drawing quality improved with age and for drawings of experienced events. Adults tended to rate drawings of higher quality as resulting from experience leading to the highest accuracy for drawings from older artists that were based on experience. Overall, results suggest that there may be some features of drawings that allow for above chance levels of accuracy (up to 75%). However, rates are not high enough across assessments (M = 53.93%, range: 39%-75%) to reliably use them as indicators of experience.