Wilson disease (WD) primarily presents with hepatic and neurological symptoms. While hepatic symptoms typically precede the neurological manifestations, copper accumulates in the brain already in this patient group and leads to subclinical brain MRI abnormalities including T2 hyperintensities and atrophy. This study aimed to assess brain morphological changes in mild hepatic WD. WD patients without a history of neurologic symptoms and decompensated cirrhosis and control participants underwent brain MRI at 3T scanner including high-resolution T1-weighted images. A volumetric evaluation was conducted on the following brain regions: nucleus accumbens, caudate, pallidum, putamen, thalamus, amygdala, hippocampus, midbrain, pons, cerebellar gray matter, white matter (WM), and superior peduncle, using Freesurfer v7 software. Whole-brain analyses using voxel- and surface-based morphometry were performed using SPM12. Statistical comparisons utilized a general linear model adjusted for total intracranial volume, age, and sex. Twenty-six WD patients with mild hepatic form (30 ± 9 years [mean age ± SD]); 11 women; mean treatment duration 13 ± 12 (range 0-42) years and 28 healthy controls (33 ± 9 years; 15 women) were evaluated. Volumetric analysis revealed a significantly smaller pons volume and a trend for smaller midbrain and cerebellar WM in WD patients compared to controls. Whole-brain analysis revealed regions of reduced volume in the pons, cerebellar, and lobar WM in the WD group. No significant differences in gray matter density or cortical thickness were found. Myelin or WM in general seems vulnerable to low-level copper toxicity, with WM volume loss showing promise as a marker for assessing brain involvement in early WD stages.

• MeSH
• White Matter pathology   diagnostic imaging   MeSH
• Adult MeSH
• Hepatolenticular Degeneration * pathology   diagnostic imaging   MeSH
• Liver pathology   diagnostic imaging   MeSH
• Middle Aged MeSH
• Humans MeSH
• Magnetic Resonance Imaging * MeSH
• Young Adult MeSH
• Brain * pathology   diagnostic imaging   MeSH
• Gray Matter pathology   diagnostic imaging   MeSH
• Case-Control Studies MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Research Support, Non-U.S. Gov't MeSH

The aim of the present study was to examine gender and age-specific effects on subjective daytime sleepiness (as measured by the Epworth Sleepiness Scale), body weight and eating behaviour in patients with central disorders of hypersomnolence. Based on the European Narcolepsy Network database, we compared 1035 patients with narcolepsy type I and 505 patients with other central disorders of hypersomnolence ("narcoleptic borderland"), including narcolepsy type II (N = 308) and idiopathic hypersomnia (N = 174), using logistic regression and general linear models. In the entire study population, the Epworth Sleepiness Scale was higher in women (N = 735, mean age = 30 years, mean Epworth Sleepiness Scale = 16.6 ± SD 3.9) than in men (N = 805, mean age = 32 years, mean Epworth Sleepiness Scale = 15.8 ± SD 4.4). In women with narcolepsy type I (N = 475), both Epworth Sleepiness Scale and body mass index increased in parallel with age. In women of the narcoleptic borderland (N = 260), the Epworth Sleepiness Scale markedly peaked in their early 30s, while body mass index only started to rise at that age. This rise in body mass index following the Epworth Sleepiness Scale peak cannot be explained by sleepiness-induced uncontrolled eating, as self-reported uncontrolled eating was negatively associated with the Epworth Sleepiness Scale in this group. We propose that the narcoleptic borderland harbours a unique cluster of women in their fertile years with an unexplored aetiology requiring further investigation towards tailored interventions.

• MeSH
• Adult MeSH
• Body Mass Index * MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Narcolepsy * physiopathology   MeSH
• Disorders of Excessive Somnolence * physiopathology   epidemiology   MeSH
• Sex Factors MeSH
• Feeding Behavior MeSH
• Body Weight MeSH
• Age Factors MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

BACKGROUND: Exposure to benzophenone-1 (BP-1) and benzophenone-3 (BP-3), widely used as UV filters in personal care products, has been associated with adverse health effects. However, epidemiological evidence is limited and inconclusive, particularly in vulnerable populations such as teenagers. OBJECTIVE: To examine the relation between BP-1 and BP-3 concentrations and obesity, cardiometabolic biomarkers, and asthma/allergy outcomes in European teenagers, including possible sex-specific associations. METHODS: A multi-country cross-sectional study was conducted using pooled data from six aligned studies from the Human Biomonitoring for Europe Initiative (HBM4EU). Sociodemographic data, cardiometabolic biomarkers, and asthma/allergy outcomes were collected through questionnaires. Anthropometric data and BMI z-scores were calculated (n = 1339). Plasma/serum cardiometabolic biomarkers and asthma/allergy outcomes were available for a subsample (n = 173-594). Urinary BP-1 and BP-3 concentrations were adjusted for creatinine dilution using the traditional standardization (trad.) and the covariate-adjusted creatinine standardization (CAS) method. Generalized additive models, linear, logistic, and multinomial mixed models were applied, and sex-interaction terms were tested. RESULTS: Each natural log-unit increase in urinary BP-3 (CAS) concentrations was associated with higher odds of obesity in the whole population (OR: 1.20; 95%CI: 1.04-1.38). Sex-specific associations were also found with BP-1 (CAS) and BP-3 (CAS) concentrations, which were associated with higher odds of obesity in male teenagers (OR: 1.25; 95% CI: 1.01-1.55; OR: 1.34; 95%CI: 1.09-1.65, respectively). Linear mixed models showed consistent findings toward higher BMI z-scores. A negative association was found between BP-1 (CAS) concentration and serum adiponectin levels in females (% change per loge-unit increase: -3.73, 95%CI: -7.32, -0.10). BP-3 (CAS) concentrations were also associated with higher odds of non-food allergies in males (OR: 1.27; 95%CI: 1.00-1.63). Traditional creatinine adjustment showed similar or slightly attenuated estimates compared to the CAS method. CONCLUSIONS: BP-1 and BP-3 exposure was cross-sectionally associated with higher odds of obesity in European male teenagers, highlighting the need to update regulations and keep exposure levels as low as practically achievable. Longitudinal studies are needed to confirm these findings.

• MeSH
• Hypersensitivity * epidemiology   MeSH
• Benzophenones * toxicity   urine   adverse effects   MeSH
• Biomarkers blood   MeSH
• Biological Monitoring MeSH
• Asthma * epidemiology   chemically induced   MeSH
• Humans MeSH
• Adolescent MeSH
• Obesity * epidemiology   chemically induced   MeSH
• Sunscreening Agents * adverse effects   MeSH
• Cross-Sectional Studies MeSH
• Environmental Exposure * MeSH
• Check Tag
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe MeSH

OBJECTIVES: To assess the ability, as well as factors affecting the ability, of ultrasound examiners with different levels of ultrasound experience to detect correctly infiltration of ovarian cancer in predefined anatomical locations, and to evaluate the inter-rater agreement regarding the presence or absence of cancer infiltration, using preacquired ultrasound videoclips obtained in a selected patient sample with a high prevalence of cancer spread. METHODS: This study forms part of the Imaging Study in Advanced ovArian Cancer multicenter observational study (NCT03808792). Ultrasound videoclips showing assessment of infiltration of ovarian cancer were obtained by the principal investigator (an ultrasound expert, who did not participate in rating) at 19 predefined anatomical sites in the abdomen and pelvis, including five sites that, if infiltrated, would indicate tumor non-resectability. For each site, there were 10 videoclips showing cancer infiltration and 10 showing no cancer infiltration. The reference standard was either findings at surgery with histological confirmation or response to chemotherapy. For statistical analysis, the 19 sites were grouped into four anatomical regions: pelvis, middle abdomen, upper abdomen and lymph nodes. The videoclips were assessed by raters comprising both senior gynecologists (mainly self-trained expert ultrasound examiners who perform preoperative ultrasound assessment of ovarian cancer spread almost daily) and gynecologists who had undergone a minimum of 6 months' supervised training in the preoperative ultrasound assessment of ovarian cancer spread in a gynecological oncology center. The raters were classified as highly experienced or less experienced based on annual individual caseload and the number of years that they had been performing ultrasound evaluation of ovarian cancer spread. Raters were aware that for each site there would be 10 videoclips with and 10 without cancer infiltration. Each rater independently classified every videoclip as showing or not showing cancer infiltration and rated the image quality (on a scale from 0 to 10) and their diagnostic confidence (on a scale from 0 to 10). A generalized linear mixed model with random effects was used to estimate which factors (including level of experience, image quality, diagnostic confidence and anatomical region) affected the likelihood of a correct classification of cancer infiltration. We assessed the observed percentage of videoclips classified correctly, the expected percentage of videoclips classified correctly based on the generalized linear mixed model and inter-rater agreement (reliability) in classifying anatomical sites as being infiltrated by cancer. RESULTS: Twenty-five raters participated in the study, of whom 13 were highly experienced and 12 were less experienced. The observed percentage of correct classification of cancer infiltration ranged from 70% to 100% depending on rater and anatomical site, and the median percentage of correct classification for the 25 raters ranged from 90% to 100%. The probability of correct classification of all 380 videoclips ranged from 0.956 to 0.975 and was not affected by the rater's level of ultrasound experience. The likelihood of correct classification increased with increased image quality and diagnostic confidence and was affected by anatomical region. It was highest for sites in the pelvis, second highest for those in the middle abdomen, third highest for lymph nodes and lowest for sites in the upper abdomen. The inter-rater agreement of all 25 raters regarding the presence of cancer infiltration ranged from substantial (Fleiss kappa, 0.68 (95% CI, 0.66-0.71)) to very good (Fleiss kappa, 0.99 (95% CI, 0.97-1.00)) depending on the anatomical site. It was lowest for sites in the upper abdomen (Fleiss kappa, 0.68 (95% CI, 0.66-0.71) to 0.97 (95% CI, 0.94-0.99)) and highest for sites in the pelvis (Fleiss kappa, 0.94 (95% CI, 0.92-0.97) to 0.99 (95% CI, 0.97-1.00)). CONCLUSIONS: Ultrasound examiners with different levels of ultrasound experience can classify correctly predefined anatomical sites as being infiltrated or not infiltrated by ovarian cancer based on video recordings obtained by an experienced ultrasound examiner, and the inter-rater agreement is substantial. The likelihood of correct classification as well as the inter-rater agreement is highest for sites in the pelvis and lowest for sites in the upper abdomen. However, owing to the study design, our results regarding diagnostic accuracy and inter-rater agreement are likely to be overoptimistic. © 2025 The Author(s). Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology.

• MeSH
• Video Recording MeSH
• Abdomen diagnostic imaging   pathology   MeSH
• Neoplasm Invasiveness diagnostic imaging   MeSH
• Clinical Competence * MeSH
• Middle Aged MeSH
• Humans MeSH
• Ovarian Neoplasms * diagnostic imaging   pathology   MeSH
• Observer Variation MeSH
• Pelvis diagnostic imaging   pathology   MeSH
• Prevalence MeSH
• Aged MeSH
• Ultrasonography methods   MeSH
• Check Tag
• Middle Aged MeSH
• Humans MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH
• Research Support, Non-U.S. Gov't MeSH

AIMS: To explore all medication administration errors (MAEs) throughout the entire process of medication administration by nurses in the inpatient setting, to describe their prevalence, and to analyse associated factors, including deviation from the good practice standards. BACKGROUND: Worldwide, MAEs are very common and regarded as a serious risk factor to inpatient safety. Nurses assume an essential role in the hospital setting during the administration of medications. DESIGN: The prospective observational study was carried out in accordance with the STROBE guidance. METHODS: This study was conducted in four regional hospitals from June to August 2021. MAEs were collected when nurses administered medications to the adult inpatients during the morning, noon, and evening medication rounds at the internal, surgical, and follow-up care departments in each hospital over three consecutive days. Direct observation by the multidisciplinary team was employed. MAEs were classified as major MAEs (from the potentially most serious and common to all drug forms), specific MAEs (specific to a drug form), and procedural MAEs (e.g., patient identification, hygiene standards, or generic drug substitution). Predictors of either major MAE or specific MAE frequency were analysed using the generalised linear model and the decision tree model. RESULTS: Overall, 58 nurses administering medication to 331 inpatients at 12 departments were observed. In total, 6356 medication administrations were observed, of which 461 comprised major MAEs, 1497 specific MAEs, and 12,045 procedural MAEs. The predictors of the occurrence of major MAEs and specific MAEs were the specific hospital, the nurse's length of practice (less than 2 years), and two procedural MAEs (the unclear prescription and the wrong strength). CONCLUSIONS: Non-adherence to the standard processes in healthcare facilities for prescribing and administering drugs increased the prevalence of severe MAEs. Determinants of MAE occurrence such as incorrect prescriptions or limited experience of nurses should be considered. IMPLICATION FOR THE PROFESSION AND PATIENT CARE: The identified determinants of MAE should be considered by hospital stakeholders in their support programs to reduce the level of burden for nurses during medication administration. PATIENT OR PUBLIC CONTRIBUTION: Neither patients nor public was not involved in the design, data collection, or dissemination plans of this study. The researchers observed nurse care delivery at medical departments acting as passive participants.

• MeSH
• Adult MeSH
• Hospitalization * statistics & numerical data   MeSH
• Middle Aged MeSH
• Humans MeSH
• Medication Errors * nursing   statistics & numerical data   prevention & control   MeSH
• Nursing Staff, Hospital statistics & numerical data   MeSH
• Prospective Studies MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Multicenter Study MeSH
• Observational Study MeSH

BACKGROUND: Telomere length is a biomarker of cellular aging, influenced by various environmental and lifestyle factors. Air pollution is a known environmental stressor that may impact telomere dynamics. This study aimed to investigate the effect of age, lifetime exposure to air pollution, inflammatory parameters and selected lifestyle factors on telomere length. METHODS: The study included 356 participants aged 35-65 living in two regions with varying pollution. Telomere length was measured using qPCR. Individual lifetime exposures to PM10, PM2.5, NO2, benzo(a)pyrene and benzene were calculated based on historical air quality data. Statistical analysis of age, pollution exposure, inflammatory parameters, and lifestyle factors on telomere length was performed using logistic regression and generalized linear models, with odds ratios calculated. RESULTS: Unexpectedly, higher air pollutants lifetime exposures were associated with longer telomeres, particularly for PM10 51-55 μg/m3 (OR = 5.67, p < 0.001), PM2.5 42-45 μg/m3 (OR = 6.56, p < 0.001), B(a)P 6.9-8.3 ng/m3 (OR = 5.25, p = 0.002), NO2 26-27 μg/m3 (OR = 5.22, p = 0.001) and benzene 2.45-2.75 μg/m3 (OR = 6.13, p < 0.001). Age significantly affected telomere length, with older individuals having shorter telomeres. Socioeconomic factors such as college education were positively associated with longer telomeres, while lifestyle factors did not show significant associations. IL-8 was identified as a significant inflammatory marker negatively associated with very long telomeres. CONCLUSION: These baseline findings bring new perspective to the relationship between air pollution and telomere length. Contrary to traditional views, the results suggest potential adaptive responses, highlighting the need for further longitudinal research to explore telomere dynamics over time in conjunction with other factors.

• MeSH
• Benzene analysis   adverse effects   MeSH
• Benzo(a)pyrene analysis   MeSH
• Adult MeSH
• Telomere Homeostasis * MeSH
• Cohort Studies MeSH
• Air Pollutants * analysis   adverse effects   MeSH
• Middle Aged MeSH
• Humans MeSH
• Nitrogen Dioxide analysis   MeSH
• Particulate Matter analysis   adverse effects   MeSH
• Aged MeSH
• Telomere * drug effects   MeSH
• Environmental Exposure * analysis   adverse effects   MeSH
• Life Style MeSH
• Air Pollution * adverse effects   analysis   MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

INTRODUCTION: The aim was to analyse mortality and estimate the life expectancy among people hospitalised for alcohol use disorders (AUD) compared with the general Czech population aged ≥20 years. A temporal perspective on excess mortality was used, covering three recent calendar periods before and during the pandemic. METHODS: Three retrospective cohorts of the target population were constructed using registry-based data. The target population was defined as all adult patients (aged ≥20 years) admitted to the hospital for AUD (ICD-10 dg. of F10.x) between 2010 and 2021. Age-adjusted mortality rates and life expectancies were calculated for the comparative analysis. Official Czech mortality and vital statistics were used for the comparison. A Poisson log-linear regression model was used to test the effect of the pandemic period (2020-2021) on mortality in the AUD target population. RESULTS: At age 20, the estimated life expectancy of the AUD target was 21-27 years less than that of the Czech general population. Excess mortality was relatively highest in young people aged 20-34 years and in adults aged 35-49 years. During the pandemic period 2020-2021, mortality rates in the target AUD increased significantly. However, relative inequalities with the general Czech population did not change significantly. DISCUSSION AND CONCLUSIONS: People hospitalised for AUD have much higher mortality rates, resulting in markedly reduced life expectancy. During the pandemic, their mortality rates increased even more. However, the increase was no greater than in the general Czech population.

• MeSH
• Alcoholism * mortality   MeSH
• COVID-19 * epidemiology   MeSH
• Adult MeSH
• Hospitalization * trends   statistics & numerical data   MeSH
• Cohort Studies MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Life Expectancy * trends   MeSH
• Pandemics * MeSH
• Alcohol-Related Disorders * mortality   MeSH
• Registries MeSH
• Retrospective Studies MeSH
• Aged MeSH
• Check Tag
• Adult MeSH
• Middle Aged MeSH
• Humans MeSH
• Young Adult MeSH
• Male MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Czech Republic MeSH

OBJECTIVES: This study examined the association between childhood adversity and late-life cognitive outcomes among older Puerto Rican adults. METHODS: Data were from the Puerto Rican Elder: Health Conditions study, a population-based cohort of 3,713 older Puerto Rican adults (mean age 72.5 years; 60% female). Adverse childhood experiences were categorized into four factors: economic hardship, parental illiteracy, childhood illness, and neighborhood disadvantage. Cognition was assessed with the Mini-Mental Cabán (MMC). For our analyses, cognitive impairment was defined as scoring 1.5 standard deviations below the expected score, adjusted for age, sex, education, and reading ability. Ordinal logistic regression (baseline) and generalized linear mixed models (all 3 waves) analyzed MMC scores; generalized estimating equations assessed incident cognitive impairment (Waves 2 and 3). RESULTS: All four adversity factors were associated with poorer MMC scores at baseline. Parental illiteracy (β = -0.35, p < .001) and neighborhood disadvantage (β = -0.27, p < .001) showed stronger associations than economic hardship (β = -0.10, p = .003) and childhood illness (β = -0.21, p < .001). No factors were significantly related to changes in cognitive scores over time. Depressive symptoms and self-rated health partially mediated cross-sectional relationships, with depressive symptoms showing a stronger effect. All adversity factors except economic hardship were linked to baseline cognitive impairment (OR = 1.42 parent illiteracy, OR = 1.24 childhood illness, OR = 1.82 neighborhood disadvantage, p < .05). Only neighborhood disadvantage was associated with incident cognitive impairment (OR = 1.19, p = .003). DISCUSSION: This study highlights the lasting effect of childhood adversity on late-life cognitive health among older Puerto Ricans, suggesting that addressing early adversity may promote cognitive health later in life.

• MeSH
• Neighborhood Characteristics MeSH
• Poverty statistics & numerical data   psychology   MeSH
• Literacy statistics & numerical data   MeSH
• Cognitive Dysfunction * epidemiology   ethnology   etiology   MeSH
• Humans MeSH
• Adverse Childhood Experiences * statistics & numerical data   MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Check Tag
• Humans MeSH
• Male MeSH
• Aged, 80 and over MeSH
• Aged MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Puerto Rico MeSH

Offspring of parents with severe mental illness are at increased risk of developing psychopathology. Identifying endophenotypic markers in high-familial-risk individuals can aid in early detection and inform development of prevention strategies. Using generalized additive mixed models, we compared age trajectories of gyrification index (GI) and sulcal morphometric measures (i.e., sulcal depth, length and width) between individuals at familial risk for bipolar disorder or schizophrenia and controls. 300 T1-weighted MRI scans were obtained of 187 individuals (53 % female, age range: 8-23 years) at familial risk for bipolar disorder (n = 80, n families=55) or schizophrenia (n = 53, n families=36) and controls (n = 54, n families=33). 113 individuals underwent two scans. Globally, GI, sulcal depth and sulcal length decreased significantly with age, and sulcal width increased significantly with age in a (near-)linear manner. There were no differences between groups in age trajectories or mean values of gyrification or any of the sulcal measures. These findings suggest that, on average, young individuals at familial risk for bipolar disorder or schizophrenia have preserved developmental patterns of gyrification and sulcal morphometrics during childhood and adolescence.

• MeSH
• Bipolar Disorder * pathology   MeSH
• Child MeSH
• Adult MeSH
• Genetic Predisposition to Disease MeSH
• Humans MeSH
• Magnetic Resonance Imaging * MeSH
• Adolescent MeSH
• Young Adult MeSH
• Cerebral Cortex growth & development   diagnostic imaging   pathology   anatomy & histology   MeSH
• Schizophrenia * pathology   diagnostic imaging   genetics   MeSH
• Check Tag
• Child MeSH
• Adult MeSH
• Humans MeSH
• Adolescent MeSH
• Young Adult MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH

OBJECTIVES: To describe age and gender specific time trends in adolescent violence across 19 countries over 28 years. METHODS: The paper presents analysis of eight cycles of the Health Behaviour in School-aged Children (HBSC) Study from 1994-2022, involving 789,531 children aged 11, 13, and 15. Indicators of violence included physical fighting, school bullying and cyberbullying (from 2018). Log-binomial regression models were used to test for linear temporal trends, with Generalized Estimating Equations used to account for clustering by country. RESULTS: School bullying perpetration and victimization declined over time in each age/gender group in most countries. Similar declines were reported for frequent physical fighting among boys (all ages) and girls (age 15 only). The prevalence of violent behaviour was almost universally higher in boys in the early cycles than in girls, but this gender difference attenuated over time. For cyberbullying, significant increases were observed since 2018 in all groups except age 15 girls in most countries. CONCLUSION: This analysis of a large cross-national dataset suggests a decline in traditional forms of adolescent violence. However, the increases in cyberbullying warrant further monitoring.

• MeSH
• Adolescent Behavior MeSH
• Child MeSH
• Cyberbullying statistics & numerical data   MeSH
• Humans MeSH
• Adolescent MeSH
• Violence * statistics & numerical data   trends   MeSH
• Crime Victims statistics & numerical data   MeSH
• Prevalence MeSH
• Sex Factors MeSH
• Bullying * statistics & numerical data   MeSH
• Check Tag
• Child MeSH
• Humans MeSH
• Adolescent MeSH
• Male MeSH
• Female MeSH
• Publication type
• Journal Article MeSH
• Geographicals
• Europe MeSH
• North America MeSH