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BACKGROUND: The incidence of breast and colorectal cancer (CRC) in younger-than-average-age patients is rising and poorly understood. This is the largest study on patients with both cancers who are less than 60 years old and aims to characterize demographic, clinicopathologic, and genetic features and describe therapeutic dilemmas and management strategies. MATERIALS AND METHODS: This is a retrospective medical records review of patients at the University of California San Francisco with both primary breast and CRC before age 60. RESULTS: Fifty-one patients were identified; 41 had detailed medical records. Median age of diagnosis with breast cancer was 43 (range 27-59) and CRC was 50 (28-59). Most were Caucasian (38, 74.5%) and never smokers (23, 56.1%); about half were current alcohol consumers (20, 48.8%) and about one-third had sedentary jobs (14, 34.1%). Average BMI was 25.8 (range: 14-49), and 30% were overweight or obese. Breast was the first cancer diagnosed in 36 patients (70.6%) and 44 (86.3%) had a metachronous CRC diagnosis. Breast cancer was early stage (0-2) in 32 (78.0%) patients whereas CRC was split between early stage (1-2) in 14 (34.1%) and later stage (3-4) in 19 (46.2%). Ten patients (24.3%) had a known germline mutation, although 23 (56.1%) had a family history of cancer in a first-degree relative. CONCLUSION: Younger patients with both breast and CRC are a unique cohort, often without known risk factors. Alcohol consumption and sedentary jobs were the most common risk factors, and about one-quarter had a known genetic predisposition. Comanagement of both cancers requires individualized, multidisciplinary care.

Introduction: We retrospectively studied young patients with head and neck squamous cell carcinoma (HNSCC) to identify factors associated with disease‐specific survival (DSS). Methods: Patient and tumor characteristics of patients aged ≤45 who received treatments for non‐metastatic HNSCC were collected to identify factors associated with DSS. Proportional hazards regression was applied separately for surgical and non‐surgical patients. Results: 230 patients were included. Surgical and non‐surgical patients had similar DSS. Higher pathologic stages, positive margins, perineural invasion (PNI), extranodal extension and negative HPV status were associated with worse DSS for surgical patients and negative HPV status for non‐surgical patients. In the multivariate analysis, pathologic stages, positive margins, and PNI were associated with worse DSS in surgical patients. Conclusion: Pathologic stages, positive margins, and PNI are independently associated with worse DSS in young surgical HNSCC patients. PNI is a uniquely strong prognostic factor for young patients. [ABSTRACT FROM AUTHOR]

Background: Archetypal ideas originate from the collective unconscious of humans and because they are embedded in the nature and institution of humans, and in everything that is the product of human thought, taste and feeling, they appear. From the point of view of the schema, excesses in the formation of psychological needs cause the formation of schemas. Literary works, including poetry, due to the fact that it comes from the human soul, are connected with archetypal ideas and poetry is considered as a collective unconscious medium of humans. Aims: The purpose of the current research is the psychological reflection of archetypal ideas (Yang) in the poems of modernist Kurdish poets (not selected poets). Methods: In this regard, in this article written in a library method, archetypal ideas in the poems of several modernist Kurdish poets have been investigated. Results: The results of the research show that these poets have used archetypal images and images abundantly in their poetry. Of course, this has several reasons; One is that most of these poets are in conflict with the manifestations of civilization and urbanization, and they present the elements of nature and countryside as an unattainable dream in their poetry, and this directly causes the elements of nature and archetypal images to enter their poetry. The second reason is that most of these poets have a political and social orientation and themes such as freedom and homeland are considered central themes of their poems, but due to the limitations, they are forced to turn to symbolic and ambiguous language. Conclusion: These poets turn to similes and metaphors to express the themes of freedom and homeland, and this causes natural and archetypal elements to enter their poems. [ABSTRACT FROM AUTHOR]

Objective: This paper systematically reviews the influencing factors of affective symptoms and psychological rehabilitation strategies of young breast cancer survivors (aged 50 years and under), so as to meet their psychological rehabilitation needs and provide evidence-based basis for medical staff to formulate precise psychological rehabilitation strategies. Methods. The databases PubMed, Embase, Web of Science, and Cochrane Library were searched for research questions from 2012 to 2022. The literature was screened and evaluated, and the content analysis method was used to conduct a descriptive analysis of the results. Results. A total of 20 studies were included, including 11 cross-sectional studies, 7 randomized controlled trials, and 2 cohort studies. The common affective symptoms of young breast cancer survivors are anxiety, depression and fear, and the influencing factors include personal factors, disease factors, family factors and socioeconomic factors. Conclusions. The influencing factors of affective symptoms in young breast cancer survivors are diverse, and the psychological rehabilitation needs have their unique characteristics, which have not been fully studied. There is an urgent need to conduct high-quality research in this field. According to its influencing factors, psychological rehabilitation strategies need to be developed to maintain their family role and social roles. [ABSTRACT FROM AUTHOR]

Background Objectives Materials and Methods Results Discussion and Conclusion The most prevalent sexually transmitted disease in the world has the human papillomavirus (HPV) as its etiological agent.To evaluate the prevalence of previous and actual HPV infection and the clinical manifestations in unselected males.A total of 718 males participating to a surveillance program were asked to complete a study visit at our unit, including semen collection, balanopreputial sulcus swab, and blood collection for total anti‐HPV immunoglobulin G (IgG). When HPV‐DNA was detected, we performed HPV fluorescence in situ hybridization, oral and anal swab, and penoscopy. Because previous studies demonstrated a very high risk for HPV infection in subjects with history of HPV‐induced lesions, with a partner with diagnosed HPV infection or reporting couple infertility or sexual promiscuity and an increase of the risk in males having sex with males, in subjects with unprotected sexual intercourses or in heavy smokers, patients were therefore stratified according to the presence of these known risk factors (RFs).Actual HPV infection was detected in 401/718 subjects (55.85%). Oral HPV‐DNA was reported in 80 subjects and anal HPV infection in 52 subjects. Anti‐HPV IgG antibodies have been detected in 288 subjects. The overall prevalence of HPV exposition, considering actual and/or previous infection was 77.99%. Among infected men, high‐risk HPV genotypes were detected in 66.08%.A total of 514 subjects were considered as the RF population, while 150 were classified in the non‐RF population. There was a significantly higher prevalence of condylomatosis (odds ratio [OR] 4.07) and of seminal infection (OR 6.22) in the RF group.These data represent an alert for the healthcare system to perform informative and screening campaigns for HPV infection in males and to promote HPV vaccination both in young people and for adult males with RF for HPV infections. [ABSTRACT FROM AUTHOR]

Purpose: Along with the progress of society, human life expectancy has been increasing, and late marriage and late childbearing are the current trend. Since reproductive aging affects fertility, ovarian aging in women has become a major reproductive health issue in the current society. During ovarian aging, DNA methylation levels may change. The ten-eleven translocation (TET) protein family proteins TET1, TET2, and TET3 are important DNA demethylation enzymes, and differential expression of TET1, TET2, and TET3 may affect the proliferation and apoptosis of aging ovarian cells. The aim of this study was to investigate the role of TET1 in the regulation of ovarian aging. Methods: The expression of 5-methylcytosine (5mC) and 5-hydroxymethylcytosine (5hmC) was analyzed by immunofluorescence (IF) in young and aging ovaries of six 6–8-week-old female mice and six 6–8-month-old female mice. Then, the expression pattern of the TET protein family in young and aging ovaries of mice was investigated. To determine the impact of TET1 on ovarian development, the aging of IOSE-80, KGN, and SKOV-3 cells was induced with D-galactosidase (D-gal). Cells were then transfected using the TET1 overexpression vector or si-TET1. We assessed the proliferation and apoptosis of aging cells after transfection and analyzed the regulatory effect of TET1 expression on aging cells. Additionally, we verified the Tet1 expression in Tet1-KO mice. Results: The 5mC to 5hmC transition, oocyte maturation, and blastocyst rate were reduced in aging mice compared to young mice. In aging mice ovaries, the expression levels of Tet1, Tet2, and Tet3 were reduced significantly, with Tet1 being particularly pronounced. The overexpression of TET1 promoted proliferation and inhibited apoptosis in aging human ovarian cells. Furthermore, Tet1 expression was very low in Tet1-KO C57BL/6 J mice ovaries. Conclusion: This study demonstrates that the expression levels of TET family proteins are low in aging ovaries, and the overexpression of TET1 can promote proliferation and inhibit apoptosis in aging ovarian cells. [ABSTRACT FROM AUTHOR]

Early, mild and young COPD concepts are not clearly defined and are often used interchangeably to refer to the onset of the disease. Objective: To describe and compare the characteristics of mild, young and early COPD in a large sample of COPD from primary and secondary care. Methods: Pooled analysis of individual data from four multicenter observational studies of patients with stable COPD (≥40 years, FEV1/FVC < 0.7, smoking ≥ 10 pack-years). Mild COPD was defined as FEV1% ≥ 65%; young COPD as <55 years; and early COPD as <55 years and smoking ≤ 20 pack-years. The relationship between FEV1(%), age and pack-years was analyzed with linear regression equations. Results: We included 5468 patients. Their mean age was 67 (SD: 9.6) years, and 85% were male. A total of 1158 (21.2%) patients had mild COPD; 636 (11.6%) had young COPD and 191 (3.5%) early COPD. The three groups shared common characteristics: they were more frequently female, younger and with less tobacco exposure compared with the remaining patients. Early COPD had fewer comorbidities and fewer COPD admissions, but no significant differences were found in ambulatory exacerbations. In linear regression analysis, the decline in FEV1(%) was more pronounced for the first 20 pack-years for all age groups and was even more important in younger patients. Conclusions: Mild, young and early COPD patients were more frequently women. The steepest decline in FEV1(%) was observed in individuals <55 years and smoking between 10 and 20 pack-years (early COPD), which highlights the importance of an early detection and implementation of preventive and therapeutic measures. [ABSTRACT FROM AUTHOR]

Although pulmonary adenomas have been reported in ICR mice, spontaneous adenomas have not been reported in mice aged ≤10 weeks. Here, we report a well-circumscribed nodule (1 mm × 1 mm) in the peripheral lesion of the left lateral lobe of a 10-week-old male ICR mouse. Histopathologic evaluation revealed a well-demarcated nodule compressing the surrounding tissue. The neoplastic cells were polygonal with indistinct cellular borders, round/oval nuclei and abundant cytoplasm. These characteristics led to the diagnosis of type II cell-derived bronchioloalveolar adenoma. Given that they are generally observed in aged laboratory animals, this case represents a rare manifestation of a spontaneous tumor in young laboratory mice before puberty. [ABSTRACT FROM AUTHOR]

Objective: Young Australian males 15-to-24-years-old have a high prevalence of mental health disorders and suicide but are least likely to seek professional mental health support. Most help-seeking studies fail to consider young males who are disengaged from mainstream education. This research aims to gain an enriched understanding about mental health literacy and help-seeking from the perspective of young rural males disengaged from mainstream education. Method: Participants included sixteen males aged 15-to-24-years. All participants had disengaged from mainstream education and had experienced disadvantage. Qualitative methodology was employed using reflexive thematic analysis to analyse interview transcripts and develop themes. Results: There were four major themes and three subthemes: 1) contextual influence, with subtheme of cultural influence; 2) a spectrum of knowledge with subtheme of subjective threshold; 3) battling stigma; and 4) genuine connection, with subtheme of redefining service models. Conclusions: This research provides the first known insight into the help-seeking perspectives of young rural males disengaged from education. Their narratives, highlight that help-seeking is valued yet action remains ambivalent and hindered by understandings of mental health literacy, stigma, and service models. For these young men, genuine connection that honours their context and experiences is more important than demonstrating clinical expertise. This research offers practical suggestions for tailoring mental health services to meet the needs of young rural men disengaged from education. Keypoints: What is already known about this topic: Young Australian, rural males aged 15–24 years old are at heightened risk of ill mental health and suicide. Young males who disengage from mainstream education face considerable challenges which require support, yet they are amongst the least likely to seek mental health support. Barriers and facilitators to mental health help-seeking for young people are well documented within the literature and youth participation contributes valuable information towards service design and policies for youth mental health services. What this topic adds: This qualitative research provides the first known insight into mental health help-seeking from the perspective of young rural males disengaged from education. Through participant voice, this research captures in depth understanding regarding mental health literacy and stigma for young rural males disengaged from education. This research contributes vital knowledge about how services and policies can improve equity of service provision and help-seeking for young rural males disengaged from education. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine the long-term consequences of trapeziectomy and ligament reconstruction and tendon interposition (LRTI) for trapeziometacarpal osteoarthritis in patients aged less than 56 years. A retrospective study was performed to investigate the outcome of trapeziectomy and LRTI with a follow-up period of greater than 5 years in patients aged less than 56 years at the time of surgery. Patients completed the Disabilities of Arm, Shoulder, and Hand (DASH), the Patient-Rated Wrist Evaluation (PRWE), and a 10-point visual analog score for pain (VAS). Objective assessments included thumb opposition, palmar and radial abduction angles, and grip, lateral key, and thumb tip pinch strengths. Radiographic assessments of the thumb carpometacarpal joint were performed in three planes, and the trapezial space and trapezial space to metacarpal height ratios were calculated. Between January 2005 and December 2017, 105 patients were treated. Forty-eight patients with 58 thumbs returned for review. The mean patient age at the time of surgery was 52.5 years, and 96% of the patients were women. The mean follow-up period from surgery was 11 years. The mean VAS score was 1. A significant association was found between younger age at the time of surgery and increased proximal migration of the metacarpal, between high VAS pain scores and high PRWE and DASH scores, weak grip, lateral key pinch and thumb tip pinch strength, and Kapandji score, and between the follow-up period and increasing VAS pain, PRWE, and DASH scores. Trapeziectomy and LRTI are effective procedures for patients aged less than 56 years. The benefits of surgery should be balanced against the deterioration in the outcome measures of DASH and PRWE and increasing VAS scores with increasing intervals from surgery. Therapeutic IV. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to investigate the effects of a school-based high-intensity interval training (HIIT) program on quality of life and physical fitness in adolescents. Methods: The study included 60 male adolescents (16.2 ± 0.6 years), randomly assigned to one of two groups: the HIIT group (n = 30) and the control group (CG, n = 30). Participants completed the KIDSCREEN-27 questionnaire to evaluate quality of life and physical fitness tests, including vertical jump, repetitive strength, agility, and flexibility. The experimental program consisted of a 12-week intervention integrated into the warm-up phase of regular physical education (PE) classes. Each PE class lasted 45 min, with the HIIT regimen occupying 10 min of the warm-up phase. The HIIT sessions followed a Tabata-style structure, performed twice weekly. A two-way ANOVA with repeated measures assessed group and time interaction effects. Results: The results revealed changes in physical well-being following the HIIT intervention (p = 0.01) compared to the control group (p = 0.42). The results of the two-way ANOVA with repeated measures revealed interaction effects between group and time for the various fitness tests, countermovement jump (p = 0.04), 4 × 10 m agility test (p = 0.02), medicine ball throw test (p = 0.04), and sit-ups (30 s) (p = 0.01). Conclusions: This study highlights the effectiveness of school-based HIIT in significantly enhancing physical well-being and physical fitness among adolescents. [ABSTRACT FROM AUTHOR]

Background and purpose Methods Results Conclusions Knowledge about the prevalence of atrial fibrillation (AF) in young stroke patients, as well as its associated factors and outcomes, is scarce. Our objective was to analyse it.A retrospective analysis of the Spain Nationwide Minimum Basic Data Set (MBDS) (2016–2020), including ischaemic stroke (IS) patients aged 18 and 50 years, was conducted. Multivariate analyses were conducted to identify factors related to AF diagnosis.Amongst 11,615 young IS patients, 426 (3.7%) had AF. Patients with AF were older (median age 45, interquartile range 42–48 vs. 44, interquartile range 40–47 years, p < 0.001) and displayed more incapacitating symptoms, higher in‐hospital complications and were less often discharged home (p < 0.001). Multivariate analyses showed that older age (odds ratio [OR] 1.053, 95% confidence interval [CI] 1.032–1.074), obstructive sleep apnoea (OR 1.508, 95% CI 1.018–2.233), hyperthyroidism (OR 3.741, 95% CI 1.798–7.783), valvular heart disease (OR 6.094, 95% CI 4.261–8.716), congenital (OR 2.386, 95% CI 1.146–4.969) and non‐congenital (OR 4.446, 95% CI 3.149–6.278) cardiopathies and heart failure (OR 3.098, 95% CI 1.905–5.037) were independently associated with higher probability of AF, whereas female gender (OR 0.647, 95% CI 0.516–0.812), diabetes mellitus (0.487, 95% CI 0.339–0.699), smoking (OR 0.617, 95% CI 0.501–0.759), patent foramen ovale (OR 0.210, 95% CI 0.111–0.396) and arterial dissection (OR 0.294, 95% CI 0.130–0.668) were associated with a lower probability.In young IS patients, AF is associated with more in‐hospital complications and disabling strokes. These findings emphasize the need to recognize AF in this demographic group, especially in patients with risk factors like hyperthyroidism and cardiomyopathies. Clinicians should assess these risk factors to ensure timely diagnosis and management of AF. [ABSTRACT FROM AUTHOR]

Background: The diagnosis of colorectal cancer (CRC) at early ages has become a challenging trend for oncology due to high rates of mortality worldwide. The correlation of clinical features with young-age prognosis in CRC remains unclear. Therefore, we aimed to describe the clinicopathological features and their impact on the overall survival of young Mexican adults diagnosed with CRC treated in the National Cancer Institute. Methods: This was a retrospective, observational study. The included patients were treated at the National Cancer Institute between 2004 and 2020. The statistical analyses comprised the X2 and t tests, Kaplan–Meier, log rank, and Cox regression. Statistical significances were assessed when p was bilaterally < 0.05. Results: A total of 3652 patients diagnosed with CRC attended the National Cancer Institute. Cases of early onset of CRC increased over the 16 years under study, with significant differences between the median age, from 57 in 2004 to 55 years old in 2020 (F = 5.49; gl: 12 p = 0.019). For this analysis, the population was divided in three groups: young (≤30 years), adults (31–70), and elderly (>70). The young population was mostly composed of men (62%; (n = 63), (p = 0.020), with high rates of metastatic disease (44%) (p = 0.001) and right-side tumors (57%), (p = 0.046), and with 44% with a moderate grade (p = 0.750). According to the overall survival (OS) analysis, the median OS was 29 months for young, versus 170 months for adult and 56 months for elderly patients (p <0.001, HR 1.53, 95% CI 1.11–2.10). A sub-analysis was performed considering only patients with metastatic disease. The median OS was 12 months for young, versus 17 and 9 months for adults and elderly (p = 0.08, HR 1.27, 95% CI 1.02–1.46). Conclusions: CRC diagnosis in the young population is increasing due unhealthy lifestyle habits and lack of screening. This population have clinical features of bad prognosis, such as left side, poor grade differentiation, and metastatic disease, precluding prognosis and OS. [ABSTRACT FROM AUTHOR]

Purpose: To understand the etiology, work-up, and secondary systemic and ocular events of retinal artery occlusion (RAO) in young patients (≤ 45 years old) without typical cardiovascular risk factors. Methods: Retrospective longitudinal case series of 18 young patients with RAO and without typical cardiovascular risk factors evaluated at the University of Michigan Medicine Health System between the year 2000 and 2022. Laboratory and imaging studies performed at the time of RAO diagnosis, along with systemic and ocular events during follow-up, were recorded. These data were combined with data from a literature review of 74 similar patients experiencing a RAO. Results: Fifteen (83%) of patients were female and 10 (56%) suffered a branch retinal artery occlusion (BRAO). 56% of patients had one risk factor associated with cryptogenic stroke, most commonly a migraine history (33%). The most frequent etiology of RAO was vasculitis (28%), followed by idiopathic (22%) and patent foramen ovale (PFO, 17%). Three out of four patients with idiopathic RAOs developed new migraines around the time of RAO diagnosis, whereas none of the patients with a clear etiology had new onset migraines (n = 14). No patients suffered a stroke or myocardial infarction (MI) in the follow-up period (average 3.6 years ± 3.2 years). Two patients (11%) suffered a repeat RAO, both of whom were diagnosed with a vasculitis. Patients with isolated retinal vasculitis required repeat fluorescein angiograms for up to 2 years after the initial event to definitively identify the vasculitic etiology of the RAO. When our data are pooled with similarly healthy patients from previously published RAO series, structural/functional cardiac abnormalities and vasculitides are the most common identifiable etiologies for RAOs in this group. Conclusion: The most common identifiable etiologies of RAO in young patients with low cardiovascular risk are structural/functional cardiac abnormalities and vasculitides, with a small range of additional causes/associations accounting for remaining cases. We suggest a focused work-up algorithm to rapidly identify etiologies in this group while minimizing unnecessary testing. The long-term risk of systemic or ocular secondary events in these patients is low regardless of the etiology of their RAO. Key message: What was Known: • Retinal artery occlusions (RAOs) in young, healthy individuals are rare, making a data-driven work-up for these patients difficult. What is new: • The most common identifiable etiologies for RAO in young, low cardiovascular risk individuals are functional/structural cardiac abnormalities and vasculitides. • Several repeat fluorescein angiographic studies may be required to diagnose an occult retinal vasculitis. • The long-term risk of secondary systemic or ocular events in young, otherwise healthy individuals is low regardless of the etiology of their RAO. [ABSTRACT FROM AUTHOR]

Background: Atrioventricular block (AVB) is common in the elderly and therefore considered to be a degenerative disease of the cardiac conduction system. However, there exist other etiologies contributing to AVB in young patients. This study aimed to determine the etiologies in patients aged before 60 years receiving their first pacemaker implantation for AVB in China. Methods and Results: Medical records and diagnostic tests of AVB patients were reviewed to identify the etiologies between 2010 and 2021 at Guangdong Provincial People's Hospital. Eight hundred and twenty‐six patients (median age 47 years; 47.9% males) were included. The etiologies were identified in 336 (40.7%) cases, including complications to cardiac surgery (n = 190 [23.0%]), myocarditis (n = 57 [6.9%]), myocardial infarction (n = 25 [3.0%]), complications to catheter‐based interventional procedures (n = 21 [2.5%]) and others (n = 43 [5.2%]). AVB caused by myocardial infarction was more common in men (5.8% vs. 0.5%, p <.001), while women received pacing treatment earlier (48 vs. 46 years, p =.019). Men were more likely to suffer from dilated cardiomyopathy (6.6% vs. 2.1%, p =.001) and atrial fibrillation/flutter (23.0% vs. 12.8%, p <.001). The number of first pacemaker implantation increased with age especially among patients with unclear etiologies. Conclusion: The etiology of AVB was only determined in approximately 40% of patients receiving their first pacemaker implantation aged before 60 years. The predominance of AVB with unknown etiology and potential gender differences warrants further studies. [ABSTRACT FROM AUTHOR]

Background: Colorectal cancer (CRC) is a major global health concern, with a rising incidence in young individuals. Early-onset CRC displays unique clinicopathological and molecular characteristics, necessitating a closer examination of prognosis, particularly in the context of adjuvant chemotherapy. This study aimed to investigate the prognosis of early-onset CRC patients (< 50 years) diagnosed at stage II/III compared to older counterparts, utilizing propensity score matching to minimize heterogeneity. Methods: A retrospective analysis of 3324 stage II/III CRC patients aged < 70 years was conducted, focusing on age-based subgroups (< 50 vs. ≥ 50 years). Propensity score matching balanced clinical characteristics. Relapse-free survival (RFS) and overall survival (OS) were analyzed. Results: In stage II CRC, age of onset did not impact prognosis after adjuvant chemotherapy, with no significant differences in RFS (5-year RFS rates: 80% in both groups, p = 0.98) and OS (5-year OS rates: 96% vs. 92%, p = 0.17). In stage III, a trend suggested slightly poorer OS in patients aged < 50 years than those ≥ 50 years (5-year OS rates: 85% vs. 88%, p = 0.077). However, in a propensity score-matched cohort, age-dependent differences were attenuated (5-year OS rates: 85% vs. 88%, p = 0.32). Conclusion: In the context of stage II/III CRC patients receiving adjuvant chemotherapy, age was not an independent predictor of prognosis. Age alone should not be the sole factor guiding treatment decisions. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has had an enormous impact on mental health, especially among young people. A cross-sectional study was carried out (N = 450, mean age = 24) using an online questionnaire from march to may 2022 collecting different sociodemographic and clinical variables. The 42.2% of the sample presented symptoms of depression, 41.6% of anxiety, and 21.1% of stress. 8.9% of the young people reported suicide attempts, while 39.1% declared having had suicidal ideation. Youth with lower socioeconomic status reported worse symptomatology and higher rates of suicidal ideation and behaviour. The main predictor of suicide was depression, along with lower socioeconomic status and being male in more severe cases. Depression and anxiety were associated variables in cases with a history of suicide attempts. More attention needs to be paid to the mental health of young people, especially those with worse socioeconomic status and depressive symptoms. Possible measures to address the problem are proposed. [ABSTRACT FROM AUTHOR]

This study aims to organize an intergenerational program to provide unemployed young people with operational skills related to gerontechnology and the experience required to deliver digital outreach rehabilitation services to community-dwelling older people. A quasi-experimental research design was adopted. The young participants received a 12-session training program on the management of common chronic diseases, communication with older people, the functions and use of interactive games, and techniques to teach and match interactive games with older people. The perception of elderly outcomes (i.e., knowledge and attitude toward elderly care, willingness to care for the elderly), personal outcomes (i.e., life satisfaction, self-efficacy), and desired vocational outcomes (i.e., hours worked in the nongovernmental organization's center, hours spent with older people) were evaluated preprogram and postprogram. Fifty-one young people joined the program. A statistically significant improvement was seen from preprogram to postprogram in their willingness to care for the elderly (p =.016) and life satisfaction (p =.005), as well as in the number of hours that they spent in the community center volunteering or engaged in social services for older people. The findings proved that the program could improve the willingness of young people to care for older people, as well as improve their own life satisfaction. Using gerontechnology can serve to bridge the intergenerational gap and bring benefits to both young adults and older people. It may provide policy makers with a way to address the manpower shortage in elderly care services and help frail older people to age in place. [ABSTRACT FROM AUTHOR]

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Hereditary aortopathies are a group of rare genetic diseases affecting the aorta and its major branches, and they represent a cause of sudden cardiac death. These pathologies are classified into syndromic hereditary aortopathies and non-syndromic hereditary aortopathies. The epidemiology of hereditary aortopathies varies according to the specific genetic condition involved; however, these disorders are believed to account for a significant proportion of sudden cardiac death in young individuals with a family history of inherited cardiovascular conditions. The causes of hereditary aortopathies are primarily genetic, with pathogenic variants in various genes encoding structural proteins of the vascular wall, leading to dissection, aneurysms, rupture, and ultimately sudden cardiac death. When the cause of death remains unknown after an autopsy, it is referred to as sudden unexplained death, and post-mortem genetic testing, known as a molecular autopsy, is crucial to confirm hereditary aortopathies and assess the genetic risk in the patient's relatives. This helps to facilitate diagnostic and therapeutic pathways and/or implement monitoring strategies to prevent sudden cardiac death. In this state-of-the-art review, we focus on syndromic and non-syndromic hereditary aortopathies causing sudden cardiac death in the young and explore preventive strategies for affected family members. [ABSTRACT FROM AUTHOR]

BackgroundSmartphone apps may provide an opportunity to deliver mental health resources and interventions in a scalable and cost-effective manner. However, young people from marginalized and underserved groups face numerous and unique challenges to accessing, engaging with, and benefiting from these apps.ObjectiveThis study aims to better understand the acceptability (ie, perceived usefulness and satisfaction with an app) and feasibility (ie, the extent to which an app was successfully used) of mental health apps for underserved young people. A secondary aim was to establish whether adaptations can be made to increase the accessibility and inclusivity of apps for these groups.MethodsWe conducted 2 sequential studies, consisting of a systematic literature review of mental health apps for underserved populations followed by a qualitative study with underserved young male participants (n=20; age: mean 19). Following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, an electronic search of 5 databases was conducted in 2021. The search yielded 18,687 results, of which 14 articles met the eligibility criteria.ResultsThe included studies comprised a range of groups, including those affected by homelessness, having physical health conditions, living in low- and middle-income countries, and those with sexual and gender minority identities. Establishing and maintaining user engagement was a pervasive challenge across mental health apps and populations, and dropout was a reported problem among nearly all the included studies. Positive subjective reports of usability, satisfaction, and acceptability were insufficient to determine users' objective engagement.ConclusionsDespite the significant amount of funding directed to the development of mental health apps, juxtaposed with only limited empirical evidence to support their effectiveness, few apps have been deliberately developed or adapted to meet the heterogeneous needs of marginalized and underserved young people. Before mental health apps are scaled up, a greater understanding is needed of the types of services that more at-risk young people and those in limited-resource settings prefer (eg, standard vs digital) followed by more rigorous and consistent demonstrations of acceptability, effectiveness, and cost-effectiveness. Adopting an iterative participatory approach by involving young people in the development and evaluation process is an essential step in enhancing the adoption of any intervention, including apps, in "real-world" settings and will support future implementation and sustainability efforts to ensure that marginalized and underserved groups are reached.Trial registrationPROSPERO CRD42021254241; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=254241.

The proportion of young individuals that present with acute myocardial infarction is a major problem that keeps increasing. The specific characteristics of premature coronary artery disease and its differences between young and older individuals need to be elucidated. Although risk factors are similar in different age categories, there is a great difference in their prevalence. The vast majority of young patients are males and there is a higher prevalence of cigarette smoking, family history of premature coronary artery disease, lipid disorders, and illicit drug use, while the prevalence of hypertension and diabetes mellitus is lower. Young individuals with acute coronary syndrome usually present either with ST-segment elevation or non-ST-segment elevation myocardial infarction. It is not unusual for young patients to present with atypical symptoms to the office of primary care physicians, leading occasionally to incorrect or delayed diagnosis. Therefore, prompt and correct diagnosis is necessary to implement the specific management as quickly as possible. A literature research of studies was conducted for the last 10 years, regarding the risk factors and prevention of premature myocardial infarction. As databases, we used PubMed and peer reviewed journals. The aim of this review is to raise awareness among family medicine and primary care physicians, regarding the clinical presentation of young patients with acute myocardial infarction, to provide optimal medical attention.

Introduction: Chemonucleolysis with condoliase is a minimally invasive treatment option for lumbar disk herniation (LDH). However, studies reporting the efficacy of condoliase in patients aged

It has been observed that married women refrain from utilizing contraceptive methods owing to a variety of reasons, including postpartum-amenorrhea, side-effects-worries, rarely or never having sex, no contraception while breastfeeding, or frustration with a particular method. The current study sought to investigate the sociodemographic disparities and contributing factors related to married women who are young (15–24 years old) and non-young (25–49 years old) and who do not utilize contemporary contraceptive methods. The research utilized cross-sectional data obtained from the fifth round of the National Family Health Survey (NFHS-5) to explore the determinants of contraceptive non-utilization among 175,652 married women in India. Multiple logistic regression analysis was utilized for the examination. The study found that non-young married females (25-49) had a higher prevalence of not using contemporary contraceptives (72%) compared to young married females (45.8%). The majority of non-users were from the central region (24.4%), followed by the east (17.4%), north-east (17.2%), north (15.9%), south (15.2%), and west region (9.9%). The majority of non-users were non-working and had male and female household heads. Most non-users knew about modern contraceptives but were unaware of family planning on radio and TV. Higher odds ratios in the non-use among married females were found significant among central-region females (OR=2.189, CI: 1.815-2.641), East-region (OR=1.324, CI: 1.148-1.527), South-region (OR=1.262, CI: 1.063-1.497), females who don’t know caste (OR=1.898, CI: 1.176-3.062), females having primary (OR=3.466, CI: 2.889-4.157) and secondary education (OR=2.281, CI: 1.890-2.753), females who used since last birth (OR=1.851, CI: 1.658-2.068) and never used (OR=1.632, CI: 1.474-1.806). The study found that economically disadvantaged females, household heads, and those with multiple children are less likely to avoid birth control methods, while marital status, religion, caste, education, and birth order did not have a significant impact on non-usage. The study highlights sociodemographic disparities in contraceptive use, emphasizing the need to address issues like low education, media exposure, and ignorance towards birth-control practices, and recommends immediate actions to reduce non-use among married females.

Background and objectives: COVID-19 vaccination program has become a global priority to combat the worldwide pandemic. Studies claimed that severity and case fatality could be minimized by vaccination. The durability of antibodies developed after vaccination is crucial for preventing COVID-19. The purpose of this study was to investigate the dynamics of antibody responses to an inactivated SARS-CoV-2 virus vaccine over time. Materials and method: The study was conducted from November 2021 to November 2022 among young adults. A pre-tested structured questionnaire was used to record the socio-demographic and clinical data of all the participants. All the participants were vaccinated with two doses of Sinopharm COVID-19 vaccine. Blood samples were collected for estimation of IgG antibodies to SARS-CoV-2 spike S1 protein by indirect ELISA. Biochemical parameters namely random blood sugar (RBS), lipid profile, total protein, thyroid stimulating hormone (TSH), FT4 (free thyroxin) and vitamin D levels were determined in baseline samples by standard methods. Result: Total 348 adults, aged 18-28 years, were enrolled and of which 35.3% and 64.7% were male and female respectively. Out of 348 participants, 51.7% was seropositive for anti- SARS-CoV-2 antibodies before receiving vaccination. Seropositivity was not significantly (p >0.05) different in male and female participants before and after vaccination. Seropositivity at 1 month after 1st dose and 4 and 7 months after 2nd dose of vaccination increased significantly (p 0.05) different before and after vaccination in participants having adequate and insufficient/deficient vitamin D levels. Conclusion: The study revealed that a good proportion of young adults possessed anti- SARS-CoV-2 antibody before vaccination and the seropositivity increased to over 90% following vaccination with Sinopharm COVID-19 vaccine. High level of anti- SARS-CoV-2 antibody persisted 7 months after 2nd dose of vaccine. July 2024; Vol. 18(2):012. DOI:https://doi.org/10.55010/imcjms.18.024 *Correspondence: Nehlin Tomalika, Department of Community Medicine & Public Health, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh. Email: nehlintomalika@gmail.com

Objective: There is a paucity of studies investigating the outcomes among Asian stroke patients. Identifying subgroups of stroke patients at risk of poorer outcomes could identify patients who would benefit from targeted interventions. Therefore, the aim of this study was to identify which ischemic stroke patients at high risk of recurrent events and mortality. Methods: This cohort study adhered to STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) guidelines. We obtained data from the Singapore Stroke Registry (SSR) from 2005 to 2016 and cross referenced to the Death Registry and the Myocardial Infarction Registry. Outcome measures included recurrent stroke, acute myocardial infarction (AMI), and all-cause and stroke-related deaths. Multivariable Cox proportional hazards regression models were performed to determine risk factors for recurrent stroke, AMI, and all-cause and stroke-related deaths. Results: A total of 64,915 patients (6705 young, and 58,210 older) were included in our analysis. Older stroke patients were found to have an increased risk of recurrent stroke (hazard ratio (HR) = 1.21, 95% confidence interval (CI) = 1.12–1.30), AMI (HR = 1.73, 95% CI = 1.54–1.95), all-cause death (HR = 2.49, 95% CI = 2.34–2.64), and stroke-related death (HR = 176, 95% CI = 1.61–1.92). Among young stroke patients, males were at increased risk for recurrent stroke (HR = 1.18, 95% CI = 1.01–1.39) and AMI (HR = 1.41, 95% CI = 1.08–1.83), but at reduced risk for all-cause (HR = 0.78, 95% CI = 0.69–0.89) and stroke-related deaths (HR = 0.79, 95% CI = 0.67–0.94). Ethnicity appeared to influence outcomes, with Malay patients at increased risk of recurrent stroke (HR = 1.37, 95% CI = 1.14–1.65), AMI (HR = 2.45, 95% CI = 1.87–3.22), and all-cause (HR = 1.43, 95% CI = 1.24–1.66) and stroke-related deaths (HR = 1.34, 95% CI = 1.09–1.64). Indian patients were also at increased risk of AMI (HR = 1.96, 95% CI = 1.41–2.72). Similar findings were seen among the older stroke patients. Conclusion: This study found that older stroke patients are at risk of poorer outcomes. Within the young stroke population specifically, males were predisposed to recurrent stroke and AMI but were protected against all-cause and stroke-related deaths. Males were also at reduced risk of all-cause and stroke-related deaths in the older stroke population. In addition, Malay and Indian patients experience poorer outcomes after first stroke. Further optimization of risk factors targeting these high-priority populations are needed to achieve high-quality care. [ABSTRACT FROM AUTHOR]

Background: Breast cancer (BC) in adolescents and young adults (AYAs, aged 15--39 years), remains inadequately understood. The incidence of BC in AYAs has been steadily increasing, making it the second leading cause of cancer-related mortality among females aged 0--39 globally. This study aimed to elucidate the clinical characteristics and long-term outcomes of AYAs and older adults (OAs, aged > 39 years) with BC who underwent surgery. Methods: From January 2011 to June 2017, BC patients who underwent surgery were enrolled in this study and divided into AYA group and OA group. Clinical characteristics, recurrence-free survival (RFS), and overall survival (OS) were compared between these two groups, both before and after propensity score matching (PSM). Univariate and multivariate Cox proportional hazard regression analyses were performed to assess the influence of age on OS and RFS. Results: Compared to the OA group, the AYA group exhibited a younger age at menarche (p < 0.001), a lower prevalence of menopausal status (p < 0.001), a reduced occurrence of comorbid conditions (p < 0.001), fewer instances of undergoing mastectomy (p = 0.031), a higher incidence of Triple-Negative Breast Cancer (TNBC) (p = 0.046), and elevated Ki-67 levels (p = 0.036). In terms of prognostic outcomes, within the study cohort, AYAs had a higher mortality rate and poorer long-term survival compared to OAs, both before and after PSM. In the PSM cohort, AYAs experienced a significantly shorter mean OS (p < 0.001) and RFS (p < 0.001). Young age (15--39 years) emerged as an independent risk factor for OS (HR 2.659, 95% CI 1.385--5.106, p = 0.003) and RFS (HR 3.235, 95% CI 2.085--5.022, p < 0.001) in BC patients following surgery. Conclusion: Significant differences were identified in the clinicopathological characteristics between AYA and OA patients with BC. In comparison to OA patients, AYA patients exhibited a less favorable long-term prognosis, with young age emerging as an independent prognostic risk factor for both OS and RFS in BC patients following surgery. Further investigations are warranted to develop agespecific therapeutic approaches for AYA BC patients. [ABSTRACT FROM AUTHOR]

The aim of the study was to determine whether there is a significant relationship between Emotional Intelligence and Loneliness among young adults and older retired population. It was hypothesized that there would be a difference in feelings of loneliness in both populations. The sample size consisted of 80 participants in which 40 participants were young adults (18-25 years), selected from a private university, 40 participants were older retired (60+years), each set consisted 20 male and 20 female participants. Emotional Intelligence was tested through Schulte Self-Report Emotional Intelligence Test, while Loneliness was assessed using Revised UCLA Loneliness scale. The result showed a difference (p = 0.040) between the feelings of loneliness of young adults and older retired population, they indicate negative correlation (r = -0.348) between Emotional Intelligence and Loneliness, depicting that lower levels of Loneliness in individual with high Emotional Intelligence. The research carries implications for further intervention focusing on coping strategies to counter the negative effects of Loneliness and enhancement of Emotional Intelligence from a younger age. [ABSTRACT FROM AUTHOR]

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We present a real-life case of a very young man with multiple risk factors who progressed rapidly from minimally obstructive non-calcified plaque on computed tomography angiography (CCTA) to severe three-vessel coronary disease presenting with STEMI. It questions the reliability of zero coronary calcium in high-risk subgroups like familial hypercholesterolemia, high Lp(a), and the young. While CCTA can accurately visualize non-calcified plaque, its interpretation requires expertise and clinical judgment should consider both imaging and clinical risk factors for management. Advanced plaque quantification, peri-coronary (PCAT), and epicardial (EAT) adipose tissue could help better-stratified patients but the evidence-based clinical application remains unknown. [ABSTRACT FROM AUTHOR]

Background: Type 1 diabetes is a chronic disease especially affecting young people. Mindfulness-based psychological interventions might reduce emotional symptoms post-diagnosis, but the evidence is limited. Objectives: This systematic review aimed to evaluate the effectiveness of mindfulness interventions on psychological well-being and biomedical variables in young people with type 1 diabetes. Methods: A systematic review of trials was conducted that involved a bibliographic search in electronic databases (Web of Science, MEDLINE, SciELO, Scopus, PsycINFO, and Cochrane Library) considering studies published between 2013 and 2024. Results: A total of 434 records were identified, of which 252 underwent selection according to title and abstract, leaving 32 that were evaluated for eligibility and 7 included in this review. From Google Scholar, six more studies were identified and evaluated, and two were selected. Finally, nine studies were subjected to full reading and a detailed analysis of the inclusion criteria. A total of 66.6% of the studies were evaluated as having a methodological quality of moderate or optimal, but the samples analysed tended to be small, and only two articles carried out short-term follow-up evaluations. Conclusions: Mindfulness-based interventions, upon reviewing the preliminary results, may be posited as a viable strategy to enhance psychological (anxiety, diabetes distress, perceived stress, depression, self-efficacy, psychological well-being, and quality of life) and biomedical outcomes (glycaemic control, blood glucose levels, and diastolic blood pressure) for type 1 diabetes in young people. Although promising, further research is required to improve the quality, methodology, and design of studies. [ABSTRACT FROM AUTHOR]

AbstractPurposeMaterials and methodsResultsConclusion\nIMPLICATIONS FOR REHABILITATIONAdolescents with cerebral palsy (CP) may experience limitations in self-care and household tasks. The aim of the study was to understand the process of building independence in self-care and household tasks from the perspective of adolescents and their caregivers.We conducted a qualitative study with a phenomenological approach with 10 adolescents (15–17 years old) and 11 caregivers from a transition service in Brazil. Semistructured, remote interviews were conducted with each participant. The interviews were recorded for transcription and content analysis.Two thematic categories emerged: (1) “Thinking about independence” and (2) “Possible ways to foster independence.” The first category was divided into three subcategories: “Expectations and the desire to be independent,” “Obstacles to independence,” “Concerns about the future.” The second category was divided into four subcategories: “People and places,” “Opportunities for practice,” “Personal attitude” and “Adaptations that facilitate.”Adolescents’ independence in several everyday activities involves physical, socioemotional and environmental aspects. Enabling opportunities for practice, an adapted environment, support from rehabilitation services and developing collaborative relationships with caregivers are elements that may favor the independence of adolescents with CP.The relationship between adolescents and their caregivers is important in building independence.Interventions centered on educational practices for caregivers of adolescents with cerebral palsy should be encouraged.Environmental facilitators include support from families, friends and therapists.Collaborations among therapists, caregivers and adolescents may promote autonomy. [ABSTRACT FROM AUTHOR]

Young (<18 years of age) patients with Brugada syndrome (BrS) are often under-represented in BrS studies and their management, especially related to syncopal episodes, remains unclear. This study sought to describe the arrhythmia prevalence among young patients with BrS undergoing continuous rhythm monitoring by implantable loop recorder (ILR) and to assess the etiology behind syncope of undetermined origin. A total of 147 patients with BrS with ILR were enrolled in 12 international centers and divided into pediatric (age <12 years; n = 77, 52%) and adolescents (age 13-18 years; n = 70, 48%). Mean age was 11.3 years, 53 patients (36.1%) were female, and 31 (21.1%) had spontaneous type 1 electrocardiograms. Over a median follow-up of 3.6 years (Q1-Q3: 1.6-4.8 years), an arrhythmic event was recorded in 33 patients (22.4%), mainly of nonventricular origin: 15 atrial (10.2%) and 16 bradyarrhythmic events (10.9%). Ventricular arrhythmias occurred in 4 patients, all with spontaneous BrS, and were fever-related in one-half. Among all patients with recurrence of syncope during follow-up, true arrhythmic syncope was documented in 5 (17.8%), and it was due to bradyarrhythmias or atrial arrhythmias in 3 cases (60%). Continuous rhythm monitoring with ILRs in young patients with BrS detects a broad range of arrhythmias. Ventricular arrhythmias occur predominantly in patients with spontaneous type 1 electrocardiograms and during fever. Despite the young age, bradyarrhythmias and atrial arrhythmias are frequent and represent the cause of arrhythmic syncope in 60% of patients. Young patients with BrS with syncope of undetermined origin may benefit from ILR implant. [ABSTRACT FROM AUTHOR]

ABSTRACT: The proportion of young individuals that present with acute myocardial infarction is a major problem that keeps increasing. The specific characteristics of premature coronary artery disease and its differences between young and older individuals need to be elucidated. Although risk factors are similar in different age categories, there is a great difference in their prevalence. The vast majority of young patients are males and there is a higher prevalence of cigarette smoking, family history of premature coronary artery disease, lipid disorders, and illicit drug use, while the prevalence of hypertension and diabetes mellitus is lower. Young individuals with acute coronary syndrome usually present either with ST-segment elevation or non-ST-segment elevation myocardial infarction. It is not unusual for young patients to present with atypical symptoms to the office of primary care physicians, leading occasionally to incorrect or delayed diagnosis. Therefore, prompt and correct diagnosis is necessary to implement the specific management as quickly as possible. A literature research of studies was conducted for the last 10 years, regarding the risk factors and prevention of premature myocardial infarction. As databases, we used PubMed and peer reviewed journals. The aim of this review is to raise awareness among family medicine and primary care physicians, regarding the clinical presentation of young patients with acute myocardial infarction, to provide optimal medical attention. [ABSTRACT FROM AUTHOR]

In the quotidian, people perform voluntary whole-body movements requiring dynamic body balance. However, the literature is scarce of dynamic balance evaluations employing standardized voluntary movements. In this investigation, we aimed to analyze the sensitivity of balance evaluation between gymnasts and athletes from other sports in the performance of balance tasks. Participants were evaluated in upright quiet standing and the performance of cyclic dynamic tasks of hip flexion-extension and squat-lift movements. Movements were individually standardized in amplitude, while the rhythm was externally paced at the frequency of 0.5 Hz. Tasks were performed on a force plate, with dynamic balance measured through the center of pressure displacement. Results showed that in quiet standing and the dynamic hip flexion-extension task, no significant differences were found between the groups. Conversely, results for the squat-lift task revealed a better balance of the gymnasts over controls, as indicated by the reduced amplitude and velocity of the center of pressure displacement during the task execution. The superior balance performance of gymnasts in the squat-lift task was also observed when vision was suppressed. These findings suggest the employed squat-lift task protocol is a potentially sensitive procedure for the evaluation of voluntary dynamic balance. [ABSTRACT FROM AUTHOR]

Purpose: Total hip arthroplasty (THA) has demonstrated excellent results in elderly patients, however, the indications, outcomes, and long-term results in adolescent patients are less understood. This study aims to assess the outcomes of THA in patients under 21, providing insights for clinical decision-making in this exceptional population. Methods: A systematic review in PubMed, Ovid MEDLINE, and Embase database was performed. We included studies reporting clinical, radiological, and functional outcomes of THA in patients younger than 21 years, for any cause, with a with a minimum follow-up of one year. The ten year survivorship estimate was pooled using a meta-analysis methodology and each study was weighted according to its standard error, calculated from published confidence intervals. Results: We included 25 studies involving 1166 hips. Median age was 17 years old, 60% were females, and the average follow-up was 8.1 years. Juvenile inflammatory arthritis was the main indication for total hip arthroplasty (THA). The all-cause revision rate was 14.4% and aseptic loosening was the most common cause. Only eight studies reported ten year survival rates and form the pooled analysis an 84.91% survival rate (95% CI 70.56 – 99.27) was obtained. An average score of 88.08 in the Harris Hip Score (HHS) was observed. We found a 3.43% complication rate. Conclusions: Hip arthroplasty is an acceptable option for adolescents with end-stage arthritis. However, the altered hip anatomy, the elevated revision rate, and the long-term implant survival must be considered before performing a THA in adolescent patients. [ABSTRACT FROM AUTHOR]

It is quite consensual that the younger citizens exhibit higher – although objectively modest – scepticism about democracy and openness to undemocratic forms of government. Despite the ongoing debate about whether a process of deconsolidation is underway in liberal democracies, as well as about the role of young citizens in it, research has so far given little attention to finding out why younger people are more likely to turn away from democracy. Seeking to contribute to filling this gap, we focus on exploring the determinants of young Europeans' support for democracy and non-democratic forms of government, and the extent to which these determinants differ from that of older citizens. Our claim is that young people's detachment from mainstream politics and political polarization are crucial factors underlying that tendency. The findings generally support our expectations. [ABSTRACT FROM AUTHOR]

The Philadelphia-negative chronic myeloproliferative neoplasms (MPNs) are clonal hematopoietic stem cell disorders predominantly occurring in elderly, whereas in children and young adults are quite infrequent. Therefore, less is known about clinical presentation, genetic abnormalities, prognosis and best management strategies for this groups of patients. Currently, more cases of younger MPN patients are diagnosed. Nevertheless, diagnosis of MPNs, especially in childhood, may be difficult due to lower incidence of JAK2V617F and CALR mutations and differences in peripheral blood counts between adults and children. Challenges for younger MPN patients are longer life expectances, specific psychosocial need, fertility and pregnancy need and a long term therapy side effect (including second cancers). The most severe MPNs complication is transformation to secondary myelofibrosis (MF) or acute myeloid leukemia (AML). Optimal management of young MPNs remains a challenge as the classical risk scores fail in young MPNs. Moreover, the main objective of young MPNs therapy should be the disease outcome modification. Therefore, international collaborative work between pediatricians and "adult hematologists" is required to measure outcomes and generate protocol of management of young MPNs. [ABSTRACT FROM AUTHOR]

Highly cross-linked polyethylene (HXLPE) has been an excellent bearing for total hip arthroplasty (THA) due to improved wear characteristics compared to conventional materials. Patients 50 years of age or younger are at high risk for wear-related complications of their THA, and few studies have followed these patients who have HXPLE into the third decade. In a retrospective review of 88 consecutive THAs performed in 77 patients aged 50 years and younger (mean 41; range, 20 to 50), in which HXLPE was utilized, they were evaluated for their clinical and radiographic results at an average of 20-year follow-up (range, 18 to 24). The current study reports on longer-term follow-up from our previously published series at shorter follow-up times. Patients were categorized by femoral head material: cobalt chrome (n = 14), ceramic (n = 30), and oxidized zirconium (n = 22) and by femoral head size: 26 mm (n = 12), 28 mm (n = 46), and 32 mm (n = 8). Harris Hip Scores were collected preoperatively and at the most recent follow-up. Radiographs were evaluated for linear and volumetric wear, radiolucent lines, and osteolysis. Mean Harris Hip Scores improved from 47.1 (standard deviation [SD] 8.8) preoperatively to 92.0 (SD 7.7) (P <.0001) at 20-year follow-up. There was one hip that was revised for recurrent instability, and no hip demonstrated radiographic evidence of loosening or osteolysis. The mean polyethylene linear wear rate was 0.017 (SD 0.012) mm/y, and the mean polyethylene volumetric wear rate was 3.15 (SD 2.8) mm3/year, with no significant differences based on articulation type or head size. Total hip arthroplasty with HXLPE in patients ≤ 50 years of age continues to demonstrate excellent long-term clinical and radiographic outcomes with low wear characteristics at 20-year follow-up, regardless of femoral head material or size. [ABSTRACT FROM AUTHOR]

First-generation trabecular metal (TM) backed glenoids reported poor implant survival and were recalled from the market. Second generation TM glenoids have demonstrated promising findings at short- and mid-term follow-up. In our study, we report on clinical and radiographic outcomes of TM glenoids with an average of 10 years of clinical and radiographic follow-up. The charts of 14 TM glenoid patients with minimum 5 years follow-up were retrospectively analyzed. The primary end points included implant survival, range of motion, and patient-reported outcomes. Additionally, radiographic data (metal debris, lateral humeral offset (LHO), acromiohumeral interval (AHI)) were studied. The mean age at surgery was 52 ± 11 years and the mean follow-up time was 10 ± 3 years. Implant survivorship was 100%. Range of motion improved significantly following surgery. Forward elevation changed from 120 ± 22º preoperatively to 155 ± 13º postoperatively (P <.01). The mean external rotation showed a statistically significant increase from 19 ± 30º preoperatively to 54 ± 13º postoperatively (P <.01). Internal rotation improved six vertebral levels on average (P <.01). Pain levels decreased significantly from 7 ± 1 to 2 ± 2 (P <.01) while American Shoulder and Elbow Surgeons Shoulder scores increased from 35 ± 10 to 83 ± 21 (P <.01). Simple Shoulder Test scores demonstrated an improvement from 5 ± 3 to 10 ± 3 (P <.01). No patients had glenoid loosening, metal debris, or radioluency on radiographic imaging. The immediate LHO was 18 (standard deviation [SD] ± 9) and final LHO of 16 (SD ± 8) (P value =.01). The immediate AHI was 12 (SD ± 3) and final AHI was 11 (SD ± 3) (P value =.01). TM backed glenoids should remain in the modern orthopedic surgeon's armamentarium of procedures. This particular glenoid design showed 100% implant survival at a decade following surgery, and provided sustained improvements in range of motion and shoulder function in osteoarthritic patients. [ABSTRACT FROM AUTHOR]

How do privileged young people engage in artistic fields? Are the arts classified and classifying for educational paths? To examine these questions, I propose observations and reflections from a study of secondary art schools in Italy. Artistic education has received focused but limited attention from sociology, as part of an increasing interest towards cultural labour. However, Italian artistic schools remain a neglected research theme. The proposed study on secondary art schools aims to examine certain early dynamics of creative fields in Milan. This article interrogates the educational experiences of privileged students at art schools. The research is based on discursive interviews and focus groups with these students. Students' class culture is investigated focusing on diverse scholastic dispositions and different outlooks on the future. The Bourdieusian notions of cultural capital and habitus allow certain dynamics of the aspiring young creatives' process of self-formation to be examined. The analysis reveals privileged individuals who are ambitious, self-confident and with great forward-thinking skills, but who are also academically negligent. The trust in individual enterprise and success is deeply interiorised by interviewees. These neoliberal and entrepreneurial ideas are infused with moral, and often tacit, considerations on class boundaries. The analysis reveals some aspects of the symbolic boundary-making; dynamics in which a meritocratic ethos plays a key role in legitimating social divisions. [ABSTRACT FROM AUTHOR]

The incidence and prevalence of type 2 diabetes mellitus (T2DM) in young individuals (aged <40 years) have significantly increased in recent years, approximating two to threefold increase in the respective rates. Numerous risk factors including severe obesity, family history, ethnicity, maternal diabetes or gestational diabetes, and female sex contribute to a younger age of onset. In terms of pathogenesis, impaired insulin secretion is the key operating mechanism, alongside with ectopic adiposity-related insulin resistance. T2DM diagnosis in a young adult requires the exclusion of type 1 diabetes mellitus (T1DM), latent autoimmune diabetes of adults (LADA) and maturity-onset diabetes of the young (MODY). The establishment of such diagnosis is critical for prognosis, because early-onset T2DM is associated with rapid deterioration in pancreatic β-cell secretory function leading to earlier initiation of insulin therapy. Furthermore, mortality and lifetime risk of developing complications, especially microvascular, is increased in these patients compared to both later-onset T2DM and T1DM patients; also, the latter are often developed earlier in the course of disease. The management of early-onset T2DM follows the same guidelines as in later-onset T2DM; yet patients aged 18–39 years are underrepresented in the big clinical trials on which the development of guidelines is based. Finally, young people with T2DM face significant challenges associated with social determinants, which compromise their adherence to therapy and induce diabetes distress. Future research focusing on the pathogenesis of β-cell decline and complications, as well as on specific treatment shall lead to better understanding and management of early-onset T2DM. [ABSTRACT FROM AUTHOR]

The evidence on bladder cancer in the young population remains fragmented due to lack of literature and conflicting results from the existing studies. We aim to elucidate such conflicting data and define the clinicopathologic characteristics, management trends, and outcomes of urothelial bladder carcinoma in young adults as compared to their older counterparts. This was a retrospective, single-center study involving patients with primary urothelial bladder cancer who underwent treatment at our center from March 2017 to March 2022. For analysis, patients were stratified into three subgroups based on age: group A, 18–40 years; group B, > 40 years; and group C, > 60 years. Group A with younger patients was compared with groups B and C. A total of 471 eligible patients (422 males and 49 females) were included in the study with a median age of 44 years. Group A had significantly lower recurrence and progression rates as compared to group B (31% vs 57.1%, p = 0.002 and 9.5% vs 19.2%, p = 0.04, respectively). Group A had significantly more recurrence-free survival (RFS) than group B (5-year-RFS = 68.03% vs 32.58%, p = 0.01). Similarly, group A also had lower recurrence (31% vs 62.6%, p < 0.001) and progression (9.5% vs 28.6%, p = 0.015) rates as compared to group C as well as better RFS (5-year-RFS = 68.03% vs 19.00%, p = 0.04) and progression-free survival (5-year-PFS = 83.1% vs 62.8%, p = 0.03) in comparison to group C. Age and tumor grade were found to be independent predictors of recurrence-free and progression-free survival. We concluded that high-grade disease is more common than low-grade disease both in younger and older patients. Younger patients fare better in terms of recurrence and progression when compared to their older counterparts. [ABSTRACT FROM AUTHOR]

Background: Suicide attempts and anxiety are common commodities in patients with major depressive disorder (MDD), and suicide attempts are often associated with anxiety symptoms. Studies have found gender differences in several aspects of MDD; however, gender differences in suicide attempts in young first-episode and drug-naive (FEDN) MDD patients with anxiety remain unknown. This study aimed to investigate potential gender differences in the prevalence of suicide attempts and associated risk factors among young FEDN MDD patients with anxiety in a Chinese Han population. Methods: A cross-sectional study was conducted on 1289 young patients with FEDN MDD. Demographics, clinical characteristics, and biochemical parameters of patients were collected. Results: Suicide attempters accounted for 23.80% and 26.12% of male and female FEDN MDD patients with anxiety, respectively, with no significant gender differences. Binary logistic regression analyses showed that anxiety, clinical global impression severity, and thyroid peroxidase antibody significantly predicted suicide attempts in both male and female FEDN MDD patients with anxiety, while body mass index significantly predicted suicide attempts only in males, and psychotic symptoms predicted suicide attempts only in females. Conclusion: The present study represents the first large-scale investigation of gender differences in the prevalence of suicide attempts and related risk factors among young FEND MDD patients with anxiety in the Chinese Han population. The results indicate that risk factors associated with suicide attempts vary by gender among young FEND MDD patients with anxiety, although a comparable rate of suicide attempts was observed in both female and male patients. [ABSTRACT FROM AUTHOR]

Background: Although most young people successfully manage the transition from childhood to adulthood, the speed and magnitude of these changes can cause stress that can exceed the coping abilities of many young people. Previous studies have suggested that adolescence is a vulnerable period for the development of psychiatric disorders; therefore, an adequate coping repertoire must be developed. Aims: Our aims were to develop and implement a coping skills training for young people and to evaluate the results of the training. Therefore, the components of the coping skills training programs in the existing literature were used. Methods: Young people from Turkey participated in this cluster randomised controlled trial (n = 89; mean age, 20.06 ± 1.44 years). Ten sessions of the coping skills training were applied in the study group (SG; n = 33), and one session was applied in the control group (CG; n = 56). To assess the effects of the coping skills training, all participants completed several psychological questionnaires (for stress, anxiety, coping and social problem-solving evaluations) at the beginning and end of the training. We performed an analysis of covariance (ANCOVA). In cases where ANCOVA assumptions could not be met, the efficacy of the intervention was determined using the mixed design/split-plot analysis of variance. Results: Compared with the CG, the SG had significantly reduced stress and anxiety levels and increased adaptive coping skills. Social problem-solving skills remained relatively similar between the groups. Conclusion: Complete and correct implementation of coping skills training among the youth may contribute positively to the development of adaptive coping skills by reducing their stress and anxiety levels. This online coping skills training program allowed young people to directly experience their response to stress and offered opportunities to try and develop different coping strategies. Coping skills should be considered for successful stress and anxiety management in everyday life. [ABSTRACT FROM AUTHOR]

This essay explores Wollstonecraft's experimental first novel, Mary: A Fiction (1788) in the context of Dissenting preoccupation with prejudice. It shows how Wollstonecraft shared the Dissenters' analysis that prejudice was the source of political and social oppression, and how she extended that insight into her account of the situation of women. She shared with Dissent a belief in education and in print culture as tools to combat prejudice, but her experimental textual strategies differ significantly from, for instance, that of Dissenter Anna Laetitia Barbauld, in her "Address to the Opposers of the Repeal of the Corporation and Test Acts" (1790). Where Barbauld replicates in print the rhetorical strategies of public and political discourse, Wollstonecraft, in key moments in Mary, draws on the model, from Edward Young, of authentic, persuasive enthusiasm, to "steal into the soul" of her readers. Early in her writing career, she can thus be seen seeking to turn affective transport to political effect, and experimenting with the resources and registers of print culture to combat prejudice, and enact dissent. [ABSTRACT FROM AUTHOR]