Exploring the effects of birth order on human lifespan in Polish historical populations, 1738–1968

While the relationships between birth order and later outcomes in life, including health and wealth, have been the subject of investigation for several decades, little or no data exist regarding the relationship between birth order and life expectancy in the Polish population. The aim of this study was to explore the link between birth order and lifespan in Polish historical populations. We obtained 8523 records from a historical dataset that was established for parishioners from the borough of Bejsce, including 4463 males and 4060 females. These data pertain to the populations that lived over a long period in a group of localities for which parish registers were well preserved. The Mann-Whitney U test, the Kruskal-Wallis ANOVA and ANCOVA were run. The results strongly suggest that birth order affects male longevity. However, no such association was found for females. On balance, the hypothesis that first-born boys live longer because they are born to relatively younger parents has received some empirical support and deserves further study. We hypothesise that the effects of birth order on human health and lifespan might be overshadowed by other factors, including educational attainment, socioeconomic status and lifestyle.

Comparative Perspectives on Geriatrics-Surgery Co-Management Program by Specialty and Staff Role

Co-management programs between geriatrics and surgical specialties have gained popularity in the last few years. Little is known about how these programs are perceived across surgical specialties and staff roles. We conducted a mixed methods study to assess perspectives on a geriatrics-surgery co-management program (GSCP) at a hospital where geriatricians co-manage patients 65 or older admitted to Orthopedic Trauma, General Trauma, and Neurosurgery. We used semi-structured interviews (n=13) and online surveys (n=45) to explore program value, facilitators, use, understanding, and impact by specialty and staff roles (physicians, advanced practice providers, nurses, case managers, social workers). Interview transcripts were analyzed using qualitative thematic analysis, and survey data were analyzed using Kruskal-Wallis, ANOVA, and Fisher’s exact tests. Interviews revealed three themes: 1) GSCP is valued because of geriatricians’ expertise in older adults, relationship with patients and families, and skill in addressing social determinants of health; 2) GSCP facilitators include consistent availability of geriatricians, clear communication, and collaboration via shared data-driven goals; and 3) GSCP use varies by surgical specialty and role depending on expertise and patient complexity. Survey data analysis affirmed interview themes and showed significant differences (p-values<0.05) between perspectives of surgical specialties and roles on GSCP use, understanding, impact, and which specialty should manage specific clinical issues. Findings suggest that while there are similarities across surgical specialties and roles regarding the value of, and facilitators for, a GSCP, specialties and roles differ in use, understanding, and perceived program impact on care. These findings suggest strategies for optimizing this intervention across groups.

The influence of different morphological units on the turbulent flow characteristics in step-pool mountain streams

The morphology of step-pools is often implemented for ecological restoration and for the creation of close-to-nature fish passes. Step-pools display spatio-temporal variations in bed and flow characteristics due to meso-scale units such as step, tread, base of step, and pool. Exclusive research on the effects of bed variations in step-pools on the flow dynamics is limited. Here, we conducted laboratory experiments on a physical model downscaled from a field site in the Western Ghats, Kerala, India. The results of Kruskal–Wallis ANOVA show significant differences in the velocity and turbulent intensities for the morphological units. A regression equation of the form Power-Allometric1 has been proposed to relate the normalized turbulent kinetic energy with the velocity magnitude. The present study also estimated the range of Reynolds shear stress and energy dissipation factor existent in the step-pool systems. The normalized values of Reynolds shear stress in the x–z plane ranged from − 19.477 to 13.729, and energy dissipation factors obtained for the three step-pool systems are 321, 207, and 123 W/m3; both the results reveal insufficient pool volume for adequate energy dissipation. The study concludes that while designing close-to-nature step-pool fish passes, pool dimensions should be finalized with respect to the target aquatic species.

Cerebral Microbleeds May Be Less Detectable by Susceptibility Weighted Imaging MRI From 24 to 72 Hours After Traumatic Brain Injury

Purpose: A former rodent study showed that cerebral traumatic microbleeds (TMBs) may temporarily become invisible shortly after injury when detected by susceptibility weighted imaging (SWI). The present study aims to validate this phenomenon in human SWI.Methods: In this retrospective study, 46 traumatic brain injury (TBI) patients in various forms of severity were included and willingly complied with our strict selection criteria. Clinical parameters potentially affecting TMB count, Rotterdam and Marshall CT score, Mayo Clinic Classification, contusion number, and total volume were registered. The precise time between trauma and MRI [5 h 19 min to 141 h 54 min, including SWI and fluid-attenuated inversion recovery (FLAIR)] was individually recorded; TMB and FLAIR lesion counts were assessed. Four groups were created based on elapsed time between the trauma and MRI: 0–24, 24–48, 48–72, and >72 h. Kruskal–Wallis, ANOVA, Chi-square, and Fisher’s exact tests were used to reveal differences among the groups within clinical and imaging parameters; statistical power was calculated retrospectively for each comparison.Results: The Kruskal–Wallis ANOVA with Conover post hoc analysis showed significant (p = 0.01; 1−β > 0.9) median TMB number differences in the subacute period: 0–24 h = 4.00 (n = 11); 24–48 h = 1 (n = 14); 48–72 h = 1 (n = 11); and 72 h ≤ 7.5 (n = 10). Neither clinical parameters nor FLAIR lesions depicted significant differences among the groups.Conclusion: Our results demonstrate that TMBs on SWI MRI may temporarily become less detectable at 24–72 h following TBI.

EVALUACIÓN DE LA RUGOSIDAD SUPERFICIAL Y EL COLOR DE LA RESINA BULK FILL CUANDO ES SOMETIDA A DISTINTOS PH SALIVALES

Objetivo: determinar el efecto en la rugosidad superficial y el color de una resina Bulk Fill, sometida a los diferentes pH salivales. Materiales y métodos: Se planteó un estudio de tipo experimental y comparativo utilizando 45 discos de 10 mm de diámetro y 1 mm de espesor, construidos a partir de una resina Bulk Fill, pulidos, tras revisión de su integridad, distribuidos de forma aleatoria en tres grupos (n=15). Ejecutada la primera medición de rugosidad y color fueron sumergidos en frascos conteniendo saliva artificial cada uno con un pH diferente, 5, 6 y 7, durante 336 horas a una temperatura de 37° C, para realizarse una nueva evaluación de rugosidad superficial y color, siguiendo a un nuevo contacto con las mismas sustancias hasta completar las 504 horas. Los datos obtenidos de las tres evaluaciones fueron recolectados en tablas de Excel, y analizados estadísticamente mediante pruebas de Kruskal Wallis, Anova y Tukey Resultados: fue evidenciado una variación de la rugosidad de la resina estudiada proporcional al tiempo de contacto con las sustancias, de forma mas evidente cuando la sustancia alcanzó un pH 5 y 6. En cuanto al color, los datos obtenidos no permitieron ser analizados. Conclusión: Se evidencia un aumento en la rugosidad superficial directamente proporcional entre el tiempo de contacto y la acidez de la sustancia.

Comparative evaluation to determine the efficacy of conventional radiography, digital radiography and ultrasound imaging in the diagnosis of periapical lesions

In recent time several imaging modalities have been implicated for diagnosing periapical lesion. The present study is carried out to determine and compare the nature and extent of periapical lesions using conventional radiography, digital radiography and ultrasound imaging and to confirm the diagnosis with histopathological examination. Thirty patients aged between 15 and 45 years with well-defined periapical radiolucency associated with anterior maxillary or mandibular teeth requiring endodontic surgery or extraction were selected. The pre-operative intraoral periapical radiographs and digital images and were diagnosed by three observers. Ultrasound examination was performed and the images were assessed by an ultrasonographer. The periapical tissues were obtained to enable histopathological investigation. The data was statistically analysed using the kappa procedure, Kruskal Wallis Anova & Mann-Whitney U test. Results showed that the percentage accuracy of diagnosing periapical lesions using conventional radiography, digital radiography and ultrasound was – 86.67%, 93.33% & 93.33% respectively. Thus, we conclude that ultrasound helps in distinguishing between periapical granuloma and cyst which is of importance in predicting the treatment outcome. So, ultrasound can be used as an adjunct to conventional or digital radiography in diagnosing periapical lesions.

Análisis tomográfico de la alineación del retropié en pacientes con coaliciones tarsianas

Introducción: El objetivo de este estudio es describir la morfología del retropié mediante cortes coronales con tomografía computarizada en pacientes con coaliciones tarsianas. Materiales y Métodos: Se incluyeron 85 pies de 78 pacientes de entre 9 y 17 años. Fueron divididos en 3 grupos: 1) grupo de control (n = 29), 2) con coaliciones calcáneo-escafoideas (CCE) (n = 31) y 3) con coaliciones astrágalo-calcáneas (CAC) (n = 25). Dos observadores valoraron cinco medidas: Inftal-Suptal, Inftal-Hor, Inftal-Supcal, Suptal-Infcal y el ángulo astrágalo-calcáneo (AAC). Resultados: Los grupos no presentaron diferencias en la distribución por edad y sexo. Los pacientes con coaliciones tarsianas tuvieron valores significativamente superiores en todas las mediciones comparados con el grupo de control (p <0,05 Kruskall-Wallis/ANOVA). Las mediciones del AAC en los pacientes con CCE y CAC fueron significativamente superiores a las del grupo de control (10,09 ± 4,60; 17,77 ± 11,28 y 28,66 ± 8,89, respectivamente, p <0,0001). La distribución del AAC fue muy variable en los pacientes con CCE, mientras que, en la mayoría del grupo CAC, tuvo un patrón de alineación en valgo. No hubo una correlación directa entre los valores del AAC e Inftal-Hor (Spearman 0,27013; p = 0,1916). Conclusiones: En los pacientes con coaliciones tarsianas, la orientación del valgo del retropié suele estar aumentada. La magnitud de esta deformidad es mayor en pacientes con coaliciones CAC, mientras que, en aquellos con CCE pueden manifestarse con una gran variabilidad. El aumento del valgo del retropié no implica necesariamente un aumento de la inclinación de la articulación subastragalina, por lo que esta última debe evaluarse por separado en la planificación preoperatoria. Nivel de Evidencia: III

Az új koronavírus okozta járvány első hullámának jellemzői és esetleges kapcsolata a tuberkulózis elleni oltottsággal

Összefoglaló. Bevezetés: A COVID–19-járvány az egész világon elterjedt. A járvány Európában való első megjelenése során megfigyelhető volt, hogy a terjedés mértéke kisebb azokban az országokban, ahol a tuberkulózis elleni védekezésül kiterjedt BCG-vakcinációt végeznek. Célkitűzés: A jelen munkában olyan összefüggéseket igyekeztünk feltárni, amelyek befolyásolták a járványterjedés paramétereit, különös figyelemmel a BCG-vakcinációs gyakorlatra. Módszerek: A világ összes olyan országára vonatkozóan, ahol megfelelő minőségű statisztikai adatok álltak rendelkezésünkre, vizsgáltuk a járvány terjedésének első hullámát. A mozgóátlagolt járványgörbéken elemeztük a járvány időtartamát, a tetőzés mértékét, a fertőzöttek és a halálesetek egymillió lakosra vetített számát. Figyelembe vettük az országok gazdasági mutatóit (GDP, légi forgalom, a tengeri hajózás mértéke). Statisztikai analízis: A vizsgált paraméterek nem mutattak normális eloszlást, így nemparaméteres próbákkal (rangkorreláció, Kruskal–Wallis ANOVA) statisztikai kapcsolatot kerestünk a járványterjedés mértéke, a BCG-vakcináció és más paraméterek között. Eredmények: A járvány gyorsan elterjedt a világon, de mégis, február első három hetében a terjedésben egy szünet volt megfigyelhető. A járványhullám Európában nagyjából egyszerre ért véget. A járvány által leginkább azok az országok érintettek, ahol nem alkalmaztak rendszeres BCG-vakcinációt, bár a képet bonyolítja, hogy ezek az országok gazdaságilag többnyire fejlettek. A halálozási rátában nem mutatkozott ilyen különbség. Következtetés: Statisztikailag igazolható tény, hogy a vakcinációt végző országokból az első hullám alatt kevesebb fertőzöttet jelentettek; az ok-okozati összefüggés bizonytalan, hiszen az országok múltja, szokásai, társadalmi berendezkedése, gazdasági fejlettsége nem azonos. Eredményeink alátámasztják az összehasonlító kontaktkutatás fontosságát annak tisztázására, hogy a BCG-oltás hogyan befolyásolja az emberek vírussal szembeni érzékenységét, valamint a vírus terjesztésének, továbbadásának képességét. Orv Hetil. 2021; 162(4): 123–134. Summary. Introduction: The new type of coronavirus (SARS-CoV-2) epidemic is widespread throughout the world. During the outbreak of the pandemic in Europe it was revealed that the rate of spread was lower in countries where extensive BCG vaccination is used to protect against tuberculosis. Objective: In the present work, we sought to explore relationships that influenced epidemic spreading parameters, with particular reference to BCG vaccination practice. Methods: We examined the first wave of the spread of the epidemic for all countries in the world where adequate quality statistics were available. We analyzed the duration of the epidemic, the extent of the peak, the number of infected people, and the number of deaths per million inhabitants with the moving average of epidemic curves. We took into account the economic indicators of the countries (GDP, air traffic and extent of maritime shipping). Statistical analysis: The examined parameters did not show a normal distribution, so we looked for a statistical relationship with non-parametric tests (rank correlation, Kruskal–Wallis ANOVA) between the extents of epidemic spread, BCG vaccination and other parameters. Results: The epidemic spread rapidly around the world, but still, in the first three weeks of February, there was a pause in the spread. The first wave of epidemics ended roughly at the same time in Europe. Those countries are the most affected by the epidemic where regular BCG vaccination has not been used, although the picture is complicated by the fact that these countries are mostly economically developed. There was no such difference observable in the mortality rate. Conclusion: Although this work clearly demonstrates that during the first wave of the pandemic, fewer infections were reported worldwide in countries where BCG vaccination is obligatory, however, the causal relationship is uncertain, as the countries’ past, customs, social organization and economic development are different. Our results support the necessity of comparative contact tracing to clarify how BCG vaccination affects people’s susceptibility to this new type of coronavirus as well as their ability to spread and transmit the virus. Orv Hetil. 2021; 162(4): 123–134.

Abstract 131: Chest Molding in Extended Cardiopulmonary Resuscitation

Introduction: Cardiopulmonary resuscitation (CPR) is a forceful procedure that may change characteristics of the subject. Little clinical data has been published relating applied forces and depth responses, particularly in increasingly prevalent extended sessions of CPR. We analyzed synchronous force and depth records to investigate how chests mold during the course of extended CPR. Hypothesis: Chest molding, characterized as decrease in stiffness from its initial value, will increase as CPR proceeds. Methods: Force and acceleration signals were extracted from CPR monitors used in adult cases of continuous compression CPR in out-of-hospital resuscitations attended by a single EMS agency (TVFR, Tigard, Oregon) during 2013 through 2017. We computed depth and velocity from acceleration, and identified chest compressions automatically where downward velocity crossed 25mm/s and force subsequently exceeded 5 kg-f. Series were defined as sequences without pauses exceeding 2 minutes. We analyzed initial series lasting at least 10 minutes. We calculated stiffness as force/depth at peak compression velocity. We calculated molding in 5 minute blocks of CPR as 100*(1- stiffnessblock/stiffnessminute 1), using medians as stiffness was not normally distributed. Dependence of molding on CPR duration was analyzed with Kruskal-Wallis ANOVA. Results and Conclusions: Of 616 available cases, 478 had initial CPR series >= 10 minutes duration, including 997,254 compressions. Initial CPR series duration were >= 30 minutes in 152 cases, and >= 40 minutes in 48 cases. The longest initial series was 61 minutes. Chest molding increased steadily through the first 25 minutes of CPR, and plateaued thereafter (p < 0.001). Median molding at >= 25 minutes was 20%. The implications of declining stiffness warrant further investigation.

Effect of a Modified Irrigation Protocol on the Cleanliness of Moderately Curved Canals

Objectives This study tested the hypothesis that modifying the sequence of sodium hypochlorite (NaOCl)/ethylene diamine tetra-acetic acid (EDTA) irrigation during root canal shaping would improve apical cleanliness in moderately curved canals. Materials and Methods Forty-five root canals were prepared using Protaper Gold with three irrigation protocols. Standard irrigation (SI) used 0.5 mL 3% NaOCl between each instrument, followed by 5 mL 17% EDTA manually agitated for 30 seconds. Reverse irrigation (RI) used 0.5 mL of 17% EDTA between each instrument, then 5 mL of 3% NaOCl, manually agitated for 30 seconds. Reverse irrigation plus (RI+) was similar to RI, except NaOCl (5 mL), used as a final rinse, (5 mL), used as a final rinse, was allowed to interact for 3 minutes with dentin before manual agitation (30 seconds).Root canal cleanliness was evaluated under the scanning electron microscope (SEM) (Hulsmann score); the chemical composition of dentin after irrigation was analyzed by energy dispersive X-ray (EDX). Statistical Analysis Results were compared using Kruskal–Wallis ANOVA by ranks and Wilcoxon matched paired posthoc tests. A Chi-square test assessed whether the best cleanliness would demonstrate a significant association with one irrigation protocol; odds ratio calculation was performed using score “1” versus score “2 or more” (2+) (p < 0.05). Results In the apical region, cleanliness was better in RI+ than SI and both significantly better than RI. Odd ratios indicate that the cleanliness in RI+ was significantly better than RI and SI groups (p < 0.000 and 0.003, respectively). Independently of the irrigation protocol, EDX analyses showed no chemical alteration of root dentin. Conclusions Using 17% EDTA during shaping, followed by 3% NaOCl rinse for 3 minutes, improved apical cleanliness without inducing erosion of dentin.