BACKGROUND: Penile trauma is associated with debilitating complications. Apart from its sparse literature, contextually relevant evidence on aetiology and standardized severity grading, and its stratification by legal age are needed. This study aimed to describe the frequency, aetiology and injury severity grade of patients, and explore the association of specific factors by legal age.
METHODS: A single-centre retrospective cross-sectional study was conducted in our centre. Male patients with penile trauma managed by urologists were included. Data on age, year of presentation, aetiology, penile injury extent and co-existing genitourethral injuries were obtained. Descriptive and inferential statistics were undertaken using SPSS and MedCalc. Pvalue < 0.05 was considered significant.
RESULTS: Forty-two patient records were analyzed. The median age and interquartile range for legal minors and legal adults were 9.5 (5.0-14.8) years and 31.0 (22.5-41.0) years, and they constituted 28.6% (n=12) and 71.4% (n=30) of the study population respectively. Penile trauma was isolated in 26.2% (n=11) of the total population.Its annual frequency was below the median volume between 2001 and 2008 but shifted to a rate above the average level between 2017 and 2021. The rate of conveyor belt-related aetiology and high-grade trauma was 41.7% and 75.0% in legal minors while it was 26.1% and 53.3% respectively in legal adults.
CONCLUSIONS: Grade IV trauma was the most predominant while conveyor belt injury was the most common cause of the injury. Albeit limitations of statistical comparison, the rate of conveyor belt injury and high-grade trauma was numerically high in legal minors.
BACKGROUND: Les traumatismes du pénis sont associés à des complications débilitantes. Outre la rareté de la littérature, des preuves contextuel l ement per tinentes sur l \' étiol ogie et l a classification standardisée de la gravité, ainsi que leur stratification par âge légal, sont nécessaires. Cette étude visait à décrire la fréquence, l\'étiologie et le degré de gravité des blessures des patients, et à explorer l\'association de facteurs spécifiques par âge légal.
UNASSIGNED: Une étude rétrospective transversale monocentrique a été réalisée dans notre centre. Les patients masculins ayant subi un traumatisme pénien pris en charge par des urologues ont été inclus. Les données sur l\'âge, l\'année de présentation, l\'étiologie, l\'étendue de la blessure pénienne et les blessures génito-urétrales coexistantes ont été obtenues. Des statistiques descriptives et inférentielles ont été réalisées à l\'aide de SPSS et MedCalc. Une valeur de p < 0,05 a été considérée comme significative.
UNASSIGNED: Quarante-deux dossiers de patients ont été analysés. L\'âge médian et l\'intervalle interquartile pour les mineurs légaux et les adultes légaux étaient de 9,5 (5,0-14,8) ans et 31,0 (22,5-41,0) ans, représentant respectivement 28,6 % (n=12) et 71,4 % (n=30) de la population étudiée. Le traumatisme pénien était isolé chez 26,2 % (n=11) de la population totale. Sa fréquence annuelle était inférieure au volume médian entre 2001 et 2008, mais a dépassé le niveau moyen entre 2017 et 2021. Le taux d\'étiologie liée aux tapis roulants et de traumatismes graves était de 41,7 % et 75,0 % chez les mineurs légaux, contre 26,1 % et 53,3 % respectivement chez les adultes légaux.
CONCLUSIONS: Le traumatisme de grade IV était le plus prédominant, tandis que les blessures causées par les tapis roulants étaient la cause la plus courante de lésion. Bien que limitées par des comparaisons statistiques, les taux de blessures par tapis roulant et de traumatismes graves étaient numériquement élevés chez les mineurs légaux.
UNASSIGNED: Facteurs d\'âge, Étiologie, Score de gravité des blessures, Pénis.

BACKGROUND: Individuals with type 2 diabetes (T2D) face an increased mortality risk, not fully captured by canonical risk factors. Biological age estimation through DNA methylation (DNAm), i.e. the epigenetic clocks, is emerging as a possible tool to improve risk stratification for multiple outcomes. However, whether these tools predict mortality independently of canonical risk factors in subjects with T2D is unknown.
METHODS: Among a cohort of 568 T2D patients followed for 16.8 years, we selected a subgroup of 50 subjects, 27 survived and 23 deceased at present, passing the quality check and balanced for all risk factors after propensity score matching. We analyzed DNAm from peripheral blood leukocytes using the Infinium Human MethylationEPIC BeadChip (Illumina) to evaluate biological aging through previously validated epigenetic clocks and assess the DNAm-estimated levels of selected inflammatory proteins and blood cell counts. We tested the associations of these estimates with mortality using two-stage residual-outcome regression analysis, creating a reference model on data from the group of survived patients.
RESULTS: Deceased subjects had higher median epigenetic age expressed with DNAmPhenoAge algorithm (57.49 [54.72; 60.58] years. vs. 53.40 [49.73; 56.75] years; p = 0.012), and accelerated DunedinPoAm pace of aging (1.05 [1.02; 1.11] vs. 1.02 [0.98; 1.06]; p = 0.012). DNAm PhenoAge (HR 1.16, 95% CI 1.05-1.28; p = 0.004) and DunedinPoAm (HR 3.65, 95% CI 1.43-9.35; p = 0.007) showed an association with mortality independently of canonical risk factors. The epigenetic predictors of 3 chronic inflammation-related proteins, i.e. CXCL10, CXCL11 and enRAGE, C-reactive protein methylation risk score and DNAm-based estimates of exhausted CD8 + T cell counts were higher in deceased subjects when compared to survived.
CONCLUSIONS: These findings suggest that biological aging, as estimated through existing epigenetic tools, is associated with mortality risk in individuals with T2D, independently of common risk factors and that increased DNAm-surrogates of inflammatory protein levels characterize deceased T2D patients. Replication in larger cohorts is needed to assess the potential of this approach to refine mortality risk in T2D.

Microscopic colitis (MC) and coeliac disease (CD) are common associated gastrointestinal conditions. We present the largest study assessing hospitalisation in patients with MC and the effect of a concomitant diagnosis of CD. Data were retrospectively collected between January 2007 and December 2021 from all patients diagnosed with MC and compared to a database of patients with only CD. In total, 892 patients with MC (65% female, median age 65 years (IQR: 54-74 years) were identified, with 6.4% admitted to hospital due to a flare of MC. Patients admitted were older (76 vs. 65 years, p < 0.001) and presented with diarrhoea (87.7%), abdominal pain (26.3%), and acute kidney injury (17.5%). Treatment was given in 75.9% of patients, including intravenous fluids (39.5%), steroids (20.9%), and loperamide (16.3%). Concomitant CD was diagnosed in 3.3% of patients and diagnosed before MC (57 versus 64 years, p < 0.001). Patients with both conditions were diagnosed with CD later than patients with only CD (57 years versus 44 years, p < 0.001). In conclusion, older patients are at a higher risk of hospitalisation due to MC, and this is seen in patients with a concomitant diagnosis of CD too. Patients with MC are diagnosed with CD later than those without.

This work was inspired by the observation that a majority of MR-electrical properties tomography studies are based on direct comparisons with ex vivo measurements carried out on post-mortem samples in the 90\'s. As a result, the in vivo conductivity values obtained from MRI in the megahertz range in different types of tissues (brain, liver, tumors, muscles, etc.) found in the literature may not correspond to their ex vivo equivalent, which still serves as a reference for electromagnetic modelling. This study aims to pave the way for improving current databases since the definition of personalized electromagnetic models (e.g. for Specific Absorption Rate estimation) would benefit from better estimation. Seventeen healthy volunteers underwent MRI of both brain and thorax/abdomen using a three-dimensional ultrashort echo-time (UTE) sequence. We estimated conductivity (S/m) in several classes of macroscopic tissue using a customized reconstruction method from complex UTE images, and give general statistics for each of these regions (mean-median-standard deviation). These values are used to find possible correlations with biological parameters such as age, sex, body mass index and/or fat volume fraction, using linear regression analysis. In short, the collected in vivo values show significant deviations from the ex vivo values in conventional databases, and we show significant relationships with the latter parameters in certain organs for the first time, e.g. a decrease in brain conductivity with age.

To explore the effects of age and gender on the brain in children with autism spectrum disorder using magnetic resonance imaging. 185 patients with autism spectrum disorder and 110 typically developing children were enrolled. In terms of gender, boys with autism spectrum disorder had increased gray matter volumes in the insula and superior frontal gyrus and decreased gray matter volumes in the inferior frontal gyrus and thalamus. The brain regions with functional alterations are mainly distributed in the cerebellum, anterior cingulate gyrus, postcentral gyrus, and putamen. Girls with autism spectrum disorder only had increased gray matter volumes in the right cuneus and showed higher amplitude of low-frequency fluctuation in the paracentral lobule, higher regional homogeneity and degree centrality in the calcarine fissure, and greater right frontoparietal network-default mode network connectivity. In terms of age, preschool-aged children with autism spectrum disorder exhibited hypo-connectivity between and within auditory network, somatomotor network, and visual network. School-aged children with autism spectrum disorder showed increased gray matter volumes in the rectus gyrus, superior temporal gyrus, insula, and suboccipital gyrus, as well as increased amplitude of low-frequency fluctuation and regional homogeneity in the calcarine fissure and precentral gyrus and decreased in the cerebellum and anterior cingulate gyrus. The hyper-connectivity between somatomotor network and left frontoparietal network and within visual network was found. It is essential to consider the impact of age and gender on the neurophysiological alterations in autism spectrum disorder children when analyzing changes in brain structure and function.

BACKGROUND: Lumbar range of motion (ROM) is a critical component of spinal function and often affected by age and sex. This study aimed to evaluate the variations in lumbar ROM across different age groups in a healthy adult population and determine the influence of sex, height, weight, and body mass index.
METHODS: A total of 208 subjects (106 men, 102 women) were recruited and stratified into age groups from the 20s to 60s and older. Lumbar ROM was measured using the Wolfson modified Schober test. Data were analyzed for flexion, extension, and total ROM. Linear regression examined the predictors of lumbar ROM.
RESULTS: The study found a progressive decline in lumbar flexion and total ROM with age. Age was the only notable predictor of lumbar flexion, with no notable effect of weight and body mass index on ROM. Extension measurements were inconsistent and did not show a clear pattern across age groups.
CONCLUSIONS: Age-related changes in lumbar ROM were consistent with known physiological changes within the spine. Despite physical differences in height and weight, the lumbar spine ROM was similar between sexes, highlighting the influence of age over sex in lumbar motion. Lumbar ROM decreases with age, with flexion affected more than extension.

The objective of this study is to investigate the associated risk factors and their effects on cognitive impairment (CI) in patients undergoing peritoneal dialysis. A retrospective analysis was conducted on the basic information of 268 patients who underwent continuous ambulatory peritoneal dialysis (CAPD) at our hospital from January 2020 to September 2023. Cognitive function was assessed using the Montreal Cognitive Assessment Scale during their subsequent dialysis visits. Participants were categorized into a CI group and a cognitively normal group. Blood and other biological samples were collected for relevant biomarker analysis. Subsequently, we analyzed and compared the factors influencing CI between the 2 groups. The prevalence of CI among CAPD patients was 58.2%. Compared to the cognitively normal group, the CI group had a higher prevalence of alcohol consumption, lower levels of education, and reduced serum uric acid levels (P < .05). There was also a higher incidence of autoimmune diseases such as systemic lupus erythematosus in the CI group (P < .05). In terms of dialysis efficacy, the residual kidney Kt/V and residual kidney Ccr were significantly lower in the CI group compared to the cognitively normal group. In blood parameters, the CI group showed elevated total cholesterol levels and lower serum calcium concentrations (P < .05). Logistic regression analysis identified male gender, older age, lower educational attainment, hypercholesterolemia, and elevated high-sensitivity C-reactive protein levels as independent risk factors for CI in CAPD patients (P < .05). Additionally, in this patient cohort, dialysis duration and residual renal function were protective factors against CI (P < .05). CI is prevalent among PD patients. Elevated high-sensitivity C-reactive protein levels, male gender, older age, lower educational attainment, and hypercholesterolemia constitute an independent risk factor for CI in CAPD patients, whereas residual renal function acts as a protective element.

To compare the differences in clinical and morphological features between small ruptured intracranial aneurysms and large unruptured intracranial aneurysms to evaluate the risk factors for the rupture of IAs. The clinical data of 189 consecutive patients with 193 IAs were reviewed. The patients and IAs were divided into ruptured (<5 mm) and unruptured groups (>10 mm). The characteristics of the patients and the intracranial aneurysms (IAs) were compared between the 2 groups, and the risk factors for rupture of IAs were assessed using multiple logistic regression. Patient age (odds ratio [OR], 0.955), IA located at the internal carotid artery (ICA, OR, 0.202), irregular shape (OR, 0.083) and parent vessel diameter (OR, 0.426) were negatively correlated with the risk of IA rupture. IAs located at bifurcations (OR, 6.766) were positively correlated with the risk of IA rupture. In addition to the size of the IAs, regardless of IAs shape, other factors, such as younger age (<63.5 years), location at a bifurcation, IAs located at the ICA and a small parent vessel diameter (<3.25 mm), can influence the risk of IA rupture.

BACKGROUND: Estimates for cause-specific mortality for neonates are generally available for all countries for neonates overall (0 to 28 days). However, cause-specific mortality is generally not being estimated at higher age resolution for neonates, despite evidence of heterogeneity in the causes of deaths during this period. We aimed to use the adapted log quadratic model in a setting where verbal autopsy was the primary means of determining cause of death.
METHODS: We examined the timing and causes of death among a cohort of neonates in rural Nepal followed as part of the Nepal Oil Massage Study (NOMS). We adapted methods defined by Wilmoth et al (2012) and Guillot et al. (2022) to estimate age and cause-specific mortality among neonates. We used cross validation to estimate the accuracy of this model, holding out each three month period. We took the average cross validation across hold out as our measure of model performance and compared to a standard approach which did not account for the heterogeneity in cause-specific mortality rate within this age group.
RESULTS: There were 957 neonates in the NOMS cohort with known age and cause of death. We estimated an average cross-validation error of 0.9 per 1000 live births for mortality due to prematurity in the first week, and 1.1 for mortality due to birth asphyxia, compared to the standard approach, having error 7.4 and 7.8 per 1000 live births, respectively. Generally mortality rates for less common causes such as congenital malformations and pneumonia were estimated with higher cross-validation error.
CONCLUSIONS: The stability and precision of these estimates compare favorably with similar estimates developed with higher quality cause-specific mortality surveillance from China, demonstrating that reliably estimating causes of mortality at high resolution is possible for neonates in low resources areas.

Arterial stiffness is a non-traditional risk factor of cardiovascular disease and may explain part of the excess cardiovascular risk in chronic kidney disease patients. Successful renal transplantation (RT) may restore renal function and improve several metabolic abnormalities involved in arterial stiffness. This prospective study conducted non-invasive assessments of arterial stiffness indices [the augmentation index (AI) and pulse wave velocity (PWV)] in end-stage kidney disease (ESKD) patients before RT and 3 and 6 months after living-donor RT, alongside the effects of age and calcineurin inhibitors on arterial stiffness. The study included 26 ESKD patients (22 males and 4 females; mean age, 34.07 years; median duration of dialysis, 10 months) scheduled for RT and followed up for three visits (within 1 week before transplantation, and 3 and 6 months after transplantation). Six months after successful RT, the patients had nearly normal serum creatinine and significantly improved serum phosphate and intact parathyroid hormone levels. The pretransplant AI was 21.53% ± 13.61% which reduced significantly 6 months after RT to 16.19% ± 10.74% (P <0.05). Although there was a reduction in PWV 6 months after RT from the pre-transplant PWV, it was not significant. A significant correlation between age and the augmentation index was noted 3 and 6 months after RT. Patients on tacrolimus-based immunosuppression after RT showed significant improvements in the AI compared with patients on a cyclosporine-based regimen. RT helped to improve arterial stiffness indices, resulting in reduced cardiovascular risk.