Search Results (20,735)

Objectives: Due to variations in the standards for optimal protein intake and conflicting results across studies for Korean older adults, this study aimed to quantitatively integrate existing research on the association of protein intake with sarcopenia and related indicators in Koreans aged 65 and older through meta-analysis. Methods: A total of 23 studies were selected according to the study selection criteria (PICOS). Sixteen cross-sectional studies, 5 randomized controlled trials (RCTs), and 2 non-RCTs were included in the review, with 9 out of 23 studies included in the meta-analysis. We used fixed-effects models and performed subgroup and sensitivity analyses. Results: A meta-analysis found that the risk of sarcopenia was significantly higher in the <0.8 g/kg/day protein intake group compared to the 0.8–1.2 g/kg/day and ≥1.2 g/kg/day groups, with odds ratios (ORs) of 1.25 (95% confidence interval (CI), 1.10 to 1.42; I² = 55%) and 1.79 (95% CI, 1.53 to 2.10; I² = 71%), respectively. For low hand grip strength (HGS), the risk was higher in the <0.8 g/kg/day group compared to the 0.8–1.2 g/kg/day or ≥1.2 g/kg/day groups (OR 1.31; 95% CI, 1.03 to 1.65; I² = 28%). No significant associations were found with other sarcopenia indicators, such as skeletal muscle mass, short physical performance battery score, balance test, gait speed, and timed up-and-go test. Conclusions: Lower protein intake is associated with a higher risk of sarcopenia and low HGS in Korean older adults. To establish protein intake recommendations for the prevention and management of sarcopenia in this population, further well-designed RCTs incorporating both protein supplementation and resistance training are necessary. Full article

Background/Objectives: Age-related macular degeneration (AMD) is a significant cause of vision loss in older adults, often progressing without early noticeable symptoms. Deep learning (DL) models, particularly convolutional neural networks (CNNs), demonstrate potential in accurately diagnosing and classifying AMD using medical imaging technologies like optical coherence to-mography (OCT) scans. This study introduces a novel CNN-based DL method for AMD diagnosis, aiming to enhance computational efficiency and classification accuracy. Methods: The proposed method (PM) combines modified Inception modules, Depthwise Squeeze-and-Excitation Blocks, and ConvMixer architecture. Its effectiveness was evaluated on two datasets: a private dataset with 2316 images and the public Noor dataset. Key performance metrics, including accuracy, precision, recall, and F1 score, were calculated to assess the method’s diagnostic performance. Results: On the private dataset, the PM achieved outstanding performance: 97.98% accuracy, 97.95% precision, 97.77% recall, and 97.86% F1 score. When tested on the public Noor dataset, the method reached 100% across all evaluation metrics, outperforming existing DL approaches. Conclusions: These results highlight the promising role of AI-based systems in AMD diagnosis, of-fering advanced feature extraction capabilities that can potentially enable early detection and in-tervention, ultimately improving patient care and outcomes. While the proposed model demon-strates promising performance on the datasets tested, the study is limited by the size and diversity of the datasets. Future work will focus on external clinical validation to address these limita-tions. Full article

This paper introduces EIF-SlideWindow, a novel enhancement of the Extended Information Filter (EIF) algorithm for Simultaneous Localization and Mapping (SLAM). Traditional EIF-SLAM, while effective in many scenarios, struggles with inaccuracies in highly non-linear systems or environments characterized by significant non-Gaussian noise. Moreover, the computational complexity of EIF/EKF-SLAM scales with the size of the environment, often resulting in performance bottlenecks. Our proposed EIF-SlideWindow approach addresses these limitations by maintaining a fixed-size information matrix and vector, ensuring constant-time processing per robot step, regardless of trajectory length. This is achieved through a sliding window mechanism centered on the robot’s pose, where older landmarks are systematically replaced by newer ones. We assess the effectiveness of EIF-SlideWindow using simulated data and demonstrate that it outperforms standard EIF/EKF-SLAM in both accuracy and efficiency. Additionally, our implementation leverages PyTorch for matrix operations, enabling efficient execution on both CPU and GPU. Additionally, the code for this approach is made available for further exploration and development. Full article

Background: Vitamin D deficiency is increasingly recognized as a global health concern, with potential implications for cancer development and progression. This systematic review investigated the prevalence of vitamin D deficiency in pediatric cancer patients and its potential impact on clinical outcomes. Methods: A comprehensive literature search was conducted across multiple databases, including PubMed, Web of Science, and Cochrane Library, to identify the relevant studies published between 2009 and July 2024. Studies were included if they assessed vitamin D status in pediatric cancer patients and reported on the clinical outcomes. Data extraction and quality assessment were performed independently by two reviewers. Results: The review included 20 original articles encompassing a diverse pediatric population with various cancer types. A high prevalence of vitamin D deficiency was observed across the studies. Deficiency was associated with older age and lower socioeconomic status. Several studies reported associations between vitamin D deficiency and the increased risk of infection, poorer treatment response, and decreased survival. Conclusions: Vitamin D deficiency is highly prevalent in pediatric cancer patients and may negatively impact clinical outcomes. Routine screening for vitamin D deficiency and personalized supplementation strategies should be considered in this population. Further research is needed to establish optimal vitamin D management protocols and evaluate the long-term benefits of vitamin D repletion in pediatric oncology. Full article

The aim of this study was to determine the prevalence and association of EGUS in horses of different ages, breeds and occupations. Gastroscopies were performed on 395 horses, and gastric ulcers were graded on a scoring system from 0 to 4. The relationship between age, breed, and work, along with the prevalence of gastric ulcers and their influences, were evaluated. The prevalence rate of ulcers in this herd was 78%. Older horses were prone to ulcers in both the glandular and squamous mucosal areas. Across the different jobs surveyed, 60% of the horses had a score of 2 or above. For the horses participating in more intense jobs (group performances, pulling carts, etc.), the number of horses with an ulcer score of 2 or above exceeded 50% of the total number of horses in this job. The prevalence of gastric ulcers was high, and these ulcers were severe in the horses belonging to the examined club, with no association between age or breed and the prevalence of ulcers; however, there was a difference in the location of the ulcers between breeds, as well as differences in the incidence and severity of ulcers depending on work activity. This study provides data reference values for the control and prevention of gastric ulcers in horses in this horse farm. Full article

Objective: To explore the effect of time exposure to flat screen electronic devices with LED lighting and the Mediterranean diet on macular pigment optical density (MPOD). Methods: In this cross-sectional observational study, the MPOD was measured by heterochromatic flicker photometry in 164 eyes (47 of younger women aged 20–31 and 35 of older women aged 42–70). Exclusion criteria: evidence of macular degeneration and eyes with cataracts. Data on the use of electronic devices and Mediterranean diet adherence were collected through a survey. Nonparametric analysis of variance and independent sample t-tests were used to compare subjects. Results: Significant differences (p < 0.01) were found in total time of exposure to LEDs (hours per day) between both groups (9.31 ± 3.74 younger women vs. 6.33 ± 3.64 older women). The MPOD values for the younger and adult populations were significantly different: 0.38 ± 0.16 and 0.47 ± 0.15 (p < 0.01), respectively. When comparing both groups for the same time of exposure to LEDs, differences were obtained between MPOD values of both populations: For total exposures greater than 6 h per day, the MPOD values were lower in younger women than in adult ones (0.37 ± 0.14 vs. 0.50 ± 0.14, p < 0.01). On the other hand, a significantly higher adherence was found in the older women in comparison with the younger women (OW 9.23 ± 2.50 vs. YW 7.70 ± 2.08, p < 0.01), with higher MPOD values (OW (0.52 ± 0.14) vs. (YW (0.34 ± 0.18). Conclusions: Higher MPOD values are observed with decreasing exposure time to electronic devices with LED lighting screens and higher adherence to the Mediterranean diet. Full article

This retrospective, descriptive study, conducted in 2024, analysed Virtual Care Survey (2020–2022) data of patients’ self-reported reflections on use and experiences to investigate relationships between demographics, the number of chronic conditions, and virtual care use among older rural patients (≥65 years with at least one chronic condition) living in New South Wales, and their satisfaction with virtual care. Associations between categorical variables were assessed using chi-squared tests, and Kruskal–Wallis tests were used for continuous variables. Qualitative feedback was analysed thematically. The study included 264 patients (median age 74 years; 51.1% women). Most virtual care appointments (65.3%) were for consultations, check-ups, or review of test results. Over one-third (38.3%) of the patients had multimorbidity and were 1.8 times more likely to have five or more virtual care appointments compared to the patients with one chronic condition. The oldest age group (≥80 years) preferred telephone over online mediums (Skype or Zoom) (p < 0.05). Patient satisfaction was high (65.8%), with 60.9% finding virtual care comparable to in-person consultations. Technological issues correlated with more negative experiences (p < 0.05). Key themes were enhanced accessibility and convenience, quality and safety of virtual care, and recommendations for equitable access. Despite positive responses, addressing technological complexities is important for optimising virtual care models for older rural Australians with chronic conditions. Full article

Background: Hand dexterity is affected by normal aging and neuroinflammatory processes in the brain. Understanding the relationship between hand dexterity and brain structure in neurotypical older adults may be informative about prodromal pathological processes, thus providing an opportunity for earlier diagnosis and intervention to improve functional outcomes. Methods: this study investigates the associations between hand dexterity and brain measures in neurotypical older adults (≥65 years) using the Nine-Hole Peg Test (9HPT) and magnetic resonance imaging (MRI). Results: Elastic net regularized regression revealed that reduced hand dexterity in dominant and non-dominant hands was associated with an enlarged volume of the left choroid plexus, the region implicated in neuroinflammatory and altered myelination processes, and reduced myelin content in the left frontal operculum, the region implicated in motor imagery, action production, and higher-order motor functions. Distinct neural mechanisms underlying hand dexterity in dominant and non-dominant hands included the differences in caudate and thalamic volumes as well as altered cortical myelin patterns in frontal, temporal, parietal, and occipital regions supporting sensorimotor and visual processing and integration, attentional control, and eye movements. Although elastic net identified more predictive features for the dominant vs. non-dominant hand, the feature stability was higher for the latter, thus indicating higher generalizability for the non-dominant hand model. Conclusions: Our findings suggest that the 9HPT for hand dexterity might be a cost-effective screening tool for early detection of neuroinflammatory and neurodegenerative processes. Longitudinal studies are needed to validate our findings in a larger sample and explore the potential of hand dexterity as an early clinical marker. Full article

Background/Objectives: Troponin level elevation without an obstructive culprit lesion is caused by heterogenous entities. The effect of aging on this condition has been poorly investigated. Methods: After screening 24,775 patients between 2010 and 2021, this study included a total of 373 patients with elevated troponin levels without an obstructive culprit lesion or suspected myocardial infarction with non-obstructive coronary arteries (MINOCAs) categorized into four age groups containing 78 patients (<51 years), 72 patients (51–60 years), 81 patients (61–70 years), and 142 patients (>70 years). This study analyzed the baseline characteristics, the in-hospital complications, in-hospital mortality, and the long-term outcomes. Results: The older patients exhibited a higher rate of major adverse cardiovascular in-hospital events than those of the other age groups (15.4% in the <51-year-old group vs. 36.1% in the 51–60-year-old group vs. 33.3% in the 61–70-year-old group vs. 47.2% in the >70-year-old group; p < 0.001). However, the rate of non-sustained ventricular tachycardia (nsVT) was higher in the 51–60-year-old patients than those of the other age groups (5.6% in the 51–60-year-old group vs. 1.3% in the 61–70-year-old group vs. 0.7% in the >70-year-old group; p = 0.027). At the 11-year follow-up, cardiovascular mortality was higher among the older patients compared to that of the younger patients (3.9% in the 61–70-year-old group vs. 4.2% in the >70-year-old group, p = 0.042), while non-cardiovascular mortality was comparable between the age groups. Conclusions: The older patients with troponin level elevation without an obstructive culprit lesion experienced a higher incidence of major adverse cardiovascular events during hospitalization compared to that of the younger groups. Additionally, higher cardiovascular mortality rates were revealed in the older patients at a long-term follow-up. Full article

Background: Although the current literature has shown an increasing interest in surgical treatment of gastric cancer (GC) in older adults in recent years, there is still no consensus on proper management in this subgroup of patients. This study was designed with the objective of evaluating the current evidence that compares limited lymph node dissection with extended lymph node dissection in older adult patients (≥65 years) coursing with resectable GC. Methods: A systematic review of PubMed, Cochrane library, and ScienceDirect was performed according to PRISMA guidelines. All studies before 2018 were selected using a systematic review by Mogal et al. Studies were eligible for this meta-analysis if they were randomized controlled trials or non-randomized comparative studies comparing limited lymph node dissection versus extended lymph node dissection in patients with resectable GC taken to gastrectomy. Results: Seventeen studies and a total of 5056 patients were included. There were not any statistically significant differences in OS (HR = 1.04, CI95% = 0.72–1.51), RFS (HR = 0.92, CI95% = 0.62–1.38), or CSS (HR = 1.24, CI95% = 0.74–2.10) between older adult patients taken to limited and extended lymphadenectomy in addition to gastrectomy as the current surgical treatment for GC. Although a higher rate of major complications was observed in the extended lymphadenectomy group, this difference was not statistically significant in incidence between both groups of patients (OR = 1.92, CI95% = 0.75–4.91). Conclusions: Limited lymphadenectomy must be considered as the better recommendation for surgical treatment for GC in older adult patients, considering the oncological outcomes and lower rates of complications compared with more radical lymph node dissections. Full article

Background: The incidence of melanoma is increasing globally. The estimated worldwide incidence is projected to increase from 324,635 cases in 2020 to 510,000 in 2040. In the UK, melanoma accounts for 4% of all new cases of cancer. Melanomas occurring in the skin of the head and neck represent 13% and 23% of cases in women and men, respectively. Prognostic indicators include presence of nodal or distant metastasis, ulceration, and Breslow thickness, where >4 mm thickness predicts poorest overall survival rates. Giant melanomas, a term generally applied to melanomas larger than 5–10 cm, are rare and often have a very poor prognosis. Clinical case: An 82-year-old female presented acutely with a 2–3-day history of delirium and urinary retention in February 2022. In addition, she was noted to have a large fungating growth on her forehead that obscured the bridge of the nose and had been slowly increasing in size for the past year prior to admission. She had initially presented in primary care with a small growth on her forehead but declined further investigations for fear of contracting COVID-19. She consented to having further assessment and management of the forehead mass. A shave biopsy revealed giant nodular melanoma, specifically, the largest melanoma of the face reported in the literature. Remarkably, our patient underwent a successful complete excision and skin grafting, with no evidence of recurrence or distal metastasis after 2 years of follow up. Conclusions: This case highlights the anxieties people felt about contracting COVID-19 when national guidelines recommended shielding that had resulted in further morbidity. Despite poor prognostic factors, clinically and histologically, our patient did not need any systemic anticancer therapy nor radiotherapy. She was well after 2 years follow up without any signs of recurrence. Full article

(1) Background: Frailty is a multifactorial syndrome that significantly impacts the functional abilities of older adults, making them more vulnerable to falls, disabilities, and dependence. Exercise can serve as an effective intervention for pre-frail and frail older adults, improving muscle strength and reducing the risk of falls. This research aims to clarify the physical exercise protocols and their outcomes for this population. (2) Methods: A scoping review was conducted to summarize the evidence on physical activity parameters for frail and pre-frail older adults. The search included primary evidence sources published in PubMed, PEDro, Biomed, Scopus, and Springer, as well as search engines like Google Scholar and Dialnet. The keywords used were ([frailty] OR [frail] AND [exercise]). The PEDro and MINORS scales were used to assess the quality of the evidence and evaluate the risk of bias. (3) Results: Eighteen studies met the eligibility criteria. The most commonly reported exercise program was multicomponent, which included aerobic activities at 70% of the maximum effort and strength exercises at 20% to 80% of the participants’ maximum capacity. This approach proved effective for this population. (4) Conclusions: The studies suggest that exercise is a successful intervention strategy for addressing frailty. However, not all the articles provided adequate information regarding the dosing of their interventions. Full article

Background/Objectives: Bismuth quadruple therapy (BQT) is recommended as the best second-line regimen after failure of first-line clarithromycin triple therapy (CTT) for Helicobacter pylori eradication. However, there are some limitations to this approach, including the lack of an appropriate sequel regimen after failure of BQT and complicated administration. Metronidazole triple therapy (MTT) is simple to administer, but it is not widely recommended. This study was conducted to determine the efficacy of MTT as second-line regimen for H. pylori eradication after failure of CTT. Methods: We retrospectively reviewed the medical records of the Korean patients with H. pylori infection who underwent second-line treatment after failure of first-line CTT from October 2013 to October 2019. The efficacy of MTT and BQT for H. pylori eradication was compared. Results: The eradication rate in the BQT group tended to be higher than that in the MTT group; however, the difference was not statistically significant (208/233, 89.3% versus 244/284, 85.9%, p = 0.287). Among 40 patients with second-line MTT eradication failure, 21 received the third-line BQT, and 15 showed successful eradication (15/21, 71.4%). In the men 70 years or older, the eradication rate of MTT was lower than that of BQT without statistical significance (75.8% versus 94.1%, p = 0.141). Conclusions: These findings suggested that MTT could be a second-line treatment option, reserving BQT for Helicobacter pylori eradication after first line CTT failure, except in elderly men 70 years or older. Full article

Background: Ageism refers to the presence of stereotypes, prejudices, and discrimination against older adults based on their age. In healthcare settings it negatively impacts opportunities for treatment, rehabilitation, and cure opportunities. This study aims to assess the presence of ageism among healthcare workers toward older patients and to identify the associated sociodemographic, personal, and work-related factors. Methods: A systematic review of the literature was performed using PubMed, Embase, CINAHL, and Scopus. Studies that assessed the presence of ageism among healthcare professionals through a quantitative or mixed methodology and published between 2014 and 2024 were included. Results: Fifteen articles met the inclusion criteria. Healthcare workers generally exhibited low rates of ageism; however, results varied across studies. Although the available literature is limited, workers with less knowledge about aging and less experience, especially in geriatric units, showed higher ageism scores. Intergenerational contact and a wish to work with older people appeared to be important factors for promoting a positive relationship with older adults. Other sociodemographic and sociocultural factors, such as age and sex, were not related to ageism. Workload and work-related factors, such as stress or lack of personnel, might be associated with ageism, but few studies were found to be available to confirm these results. Conclusions: Ageism scores among professionals were low. Gerontological education and clinical and family experience could help reduce ageist attitudes toward older patients among health professionals. Full article

Background: Numerous studies have established a link between adverse childhood experiences (ACEs) and the development of depression in later life. However, the interactive relationships between ACEs, depression, and chronic diseases are still not well understood. In this study, the aim was to investigate the impact of ACEs on depressive trajectories among middle-aged and elderly individuals in China, as well as to examine the mediating roles of chronic diseases in this association. Methods: Data were drawn from 6921 participants aged 45 and older, using the China Health and Retirement Longitudinal Study (CHARLS) data from 2011, 2013, 2015, and 2018, combined with the 2014 life history survey. Depressive symptom scores were assessed using the widely recognized CES-D-10 scale. The trajectories of depressive symptoms were identified via group-based trajectory modeling (GBTM). The association between ACEs and depressive trajectories was analyzed using multinomial logistic regression, and the KHB method was employed to test the mediating effects of different chronic diseases. Results: The age of the 6921 participants was 57.2 ± 8.0 years, with females comprising 53.9% and males 46.1%. We found that approximately 70% of Chinese middle-aged and older adults had experienced at least one ACE, and 4.8% had experienced four or more ACEs. The following four distinct trajectories of depressive symptoms were identified: continuing-low (N = 1897, 27.4%), continuing-low-to-middle (N = 2937, 42.4%), continuing-middle-to-high (N = 1649, 23.8%), and continuing-high (N = 438, 6.3%). Compared to individuals without ACEs, those with four or more ACEs had a significantly higher likelihood of following the continuing-low-to-middle trajectory (OR = 2.407, 95%CI: 1.633–3.550), the continuing-middle-to-high trajectory (OR = 7.458, 95%CI: 4.999–11.127), and the continuing-high trajectory (OR = 20.219, 95%CI: 12.115–33.744), rather than the continuing-low trajectory. Exposure to a greater number of ACEs was associated with an increased risk of following an adverse trajectory of depressive symptoms. Multiple chronic diseases significantly mediated the relationship between ACEs and depressive trajectories, with arthritis or rheumatism exerting the largest mediating effect, followed by digestive and respiratory diseases. Conclusions: These findings indicated that ACEs were associated with a higher risk of worse depressive symptom trajectories, with different chronic diseases mediating this relationship. Therefore, developing public measures to prevent ACEs can reduce the risk of chronic diseases and depression in middle-aged and elderly people. Additionally, strengthening the prevention and management of chronic diseases in individuals exposed to ACEs may further reduce their subsequent risk of depression. Full article