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The study was to verify for older adults, the applicability of a recently developed measure of everyday problem solving, a performance-based observed assessment (the Chinese Version of Observed Tasks of Daily Living [OTDL-C]), by comparing with two other measures—a self-report questionnaire and a paper–pencil test. Totally 183 older adults (aged 60–84 years) completed demographic questionnaires and three everyday problem-solving assessments. All assessments measured the same instrumental domains of daily life (medication use, phone use, electric appliance use, and financial management). We observed significant differences in inter-individual variation, and found significant differences in the effects of age and education level on OTDL-C performance compared with self-report and paper–pencil measure performance. Additionally, the inter-individual variance was significantly greater for the OTDL-C and paper–pencil test than for the self-report questionnaire. Age remained a significant predictor of OTDL-C performance after controlling the scores of the self-report and the paper–pencil measures. Education level had more consistent effects on the total score and each domain score of the OTDL-C compared to the other two measures. Overall, our finding indicated that the OTDL-C had greater inter-individual variation, might be a more sensitive tool for examining age-related differences in the ability to solve everyday problem, and could be more applicable to older populations with diverse education levels compared to the self-report and the paper–pencil measures. In circumstances where a high sensitive assessment of everyday problem solving is needed to detect individual differences, the OTDL-C might be a more appropriate choice. [ABSTRACT FROM AUTHOR]

Meningiomas and their WHO histological diagnostic criteria is complex, especially for grade 2 tumors presenting a interobserver discordance as high as 12.2%. The 2016 edition of the WHO Classification of CNS tumors recommended brain invasion as a stand-alone grading criterion for diagnosing an atypical grade 2 meningioma (AM). To provide an overview of the classification of 2016 WHO impact on the natural history of atypical meningioma (AM) relative to previous classification. To achieve this goal, we selected articles from the period 2017–2024 in Medline search on atypical meningiomas and analyzed them after following the following criteria: 1) reports with confirmed histopathological diagnosis according to WHO 2016 and or 2021 criteria; 2) series and case reports; 3) detailed and individualized clinical outcomes for AM; and 4) papers written in English; after that a total of 3445 patients reported in 67 manuscripts from worldwide centers from 2017 to March 2024 were analyzed. The patient's age at the time of surgery ranged from 1 month to 97 years (mean 52.28 ± 18.7 years). The most common tumor site was the convexity, accounting for 67.8%, followed by the skull base in 30.6%, ventricle in 1%, and spine in 0.6%; Gross total resection (GTR) was performed in 71.25% and subtotal resection (STR) in 28.75%; 1021 patients (29.63%) underwent adjuvant radiotherapy, and 22 patients (0.6%) were treated with adjuvant chemotherapy; tumor recurrence was reported in 1221 patients (35.44%) and 859 deaths (24.93%). 1) AM prevalence in females; 2) AM age distribution similar to the distribution of meningiomas in general; 3) AM recurrence rate of 35.44%, despite the high rate of GTR, which was higher than previously reported; 4) deepening knowledge in molecular mechanism of tumor progression will provide alternative therapeutic approaches for AM. [ABSTRACT FROM AUTHOR]

Background: Bone age assessment assists physicians in evaluating the growth and development of children. However, deep learning methods for bone age estimation do not currently incorporate differential features obtained through comparisons with other bone atlases. Objective: To propose a more accurate method, Delta-Age-Sex-AdaIn (DASA-net), for bone age assessment, this paper combines age and sex distribution through adaptive instance normalization (AdaIN) and style transfer, simulating the process of visually comparing hand images with a standard bone atlas to determine bone age. Materials and methods: The proposed Delta-Age-Sex-AdaIn (DASA-net) consists of four modules: BoneEncoder, Binary code distribution, Delta-Age-Sex-AdaIn, and AgeDecoder. It is compared with state-of-the-art methods on both a public Radiological Society of North America (RSNA) pediatric bone age prediction dataset (14,236 hand radiographs, ranging from 1 to 228 months) and a private bone age prediction dataset from Zigong Fourth People's Hospital (474 hand radiographs, ranging from 12 to 218 months, 268 male). Ablation experiments were designed to demonstrate the necessity of incorporating age distribution and sex distribution. Results: The DASA-net model achieved a lower mean absolute deviation (MAD) of 3.52 months on the RSNA dataset, outperforming other methods such as BoneXpert, Deeplasia, BoNet, and other deep learning based methods. On the private dataset, the DASA-net model obtained a MAD of 3.82 months, which is also superior to other methods. Conclusion: The proposed DASA-net model aided the model's learning of the distinctive characteristics of hand bones of various ages and both sexes by integrating age and sex distribution into style transfer. [ABSTRACT FROM AUTHOR]

Human longevity leaders with remarkably long lifespan play a crucial role in the advancement of longevity research. In this paper, we propose a stochastic model to describe the evolution of the age of the oldest person in the world by a Markov process, in which we assume that the births of the individuals follow a Poisson process with increasing intensity, lifespans of individuals are independent and can be characterized by a gamma–Gompertz distribution with time-dependent parameters. We utilize a dataset of the world's oldest person title holders since 1955, and we compute the maximum likelihood estimate for the parameters iteratively by numerical integration. Based on our preliminary estimates, the model provides a good fit to the data and shows that the age of the oldest person alive increases over time in the future. The estimated parameters enable us to describe the distribution of the age of the record holder process at a future time point. [ABSTRACT FROM AUTHOR]

Finger flutings are channels drawn in soft sediments covering walls, floors and ceilings of some limestone caves in Europe and Australia and in some cases date as far back as 50,000 years ago. Initial research focused on why they were made, but more recently, as part of a growing interest in the individual in the past, researchers began asking questions about who made them. This shift in direction has led to claims that by measuring the width of flutings made with the three middle fingers of either hand, archaeologists can infer the ordinal age, sex and individuality of the 'fluter'. These claims rest on a single dataset created in 2006. In this paper, we undertake the first critical analysis of that dataset and its concomitant methodologies. We argue that sample size, uneven distribution of sex and age within the sample, non-standardised medium, human variability, the lack of comparability between an experimental context and real cave environments and assumptions about demographic modelling effectively negate all previous claims. To sum, we find no substantial evidence for the claims that an age, sex and individual tracing can be revealed by measuring finger flutings as described by Sharpe and Van Gelder (Antiquity 80: 937-947, 2006a; Cambridge Archaeological Journal 16: 281–95, 2006b; Rock Art Research 23: 179–98, 2006c). As a case study, we discuss Koonalda Cave in southern Australia. Koonalda has the largest and most intact display of finger flutings in the world and is also part of a cultural landscape maintained and curated by Mirning people. [ABSTRACT FROM AUTHOR]

Identifying major depression in children and adolescents is more challenging than in adults. Questionnaires are often used for screening or guiding clinical assessment. Several instruments of different lengths are used as equivalent measures in diagnostic decisions. In this paper, we explore to what extent 18 commonly used depression scales for children and adolescents explore depression clinical symptoms as established by standard DSM-5 diagnosis criteria. We analyzed scale content adequacy by examining the overlap between scale contents and consensus clinical symptoms, the diagnostic time frame for active symptom assessment, and readability for the target age group. The 18 scales encompassed 52 distinct symptoms. These scales included just 50% of clinical symptoms required for diagnosis. The content overlap was low; on average, 29% of symptoms coincide across scales. Half of the scales did not use the standard period for active symptom appraisal, and some did not include a period for assessment. The reading levels on six scales were inappropriate for the scale's target population age group. The substantial heterogeneity in defining the depressive syndrome, the low overlap among scales, different periods of a positive diagnosis, and mismatch of reading competence for detecting may lead to heterogeneity in clinical diagnoses when using different scales. Improving the content of self-report in terms of homogeneity of diagnostic criteria would lead to better diagnostic decisions and patient management. [ABSTRACT FROM AUTHOR]

This paper examined gender (N = 1406;77.7% women) patterns of religious coping and psychological impact following the devastating 2023 Syrian earthquakes. Measures in this nation-wide convenience sample study included positive religious coping (PRC) and negative religious coping (NRC) using the Brief Religious Coping Scale (RCOPE), and probable PTSD, depression, and anxiety, using the PCL-5, PHQ-9, and GAD-7, respectively. Women reported higher endorsement of PRC items while men higher endorsement of NRC items. Within the women only sample, lower education and lower income, education and younger age predicted PRC and NRC, respectively. NRC was strongly positively associated with PTSD, depression and anxiety; while, PRC was positively associated only with PTSD. These vulnerable women require targeted support to adopt more adaptive religious coping strategies. [ABSTRACT FROM AUTHOR]

This paper investigates the trends in erectile dysfunction research by integrating individual keywords such as COVID-19, mental health, psychiatry, and drug use. The study spans a six-year period from September 21, 2017, to September 21, 2023, and utilizes resources from the National Library of Medicine. For instance, the quantity of relevant documents is determined using the Google search engine. A custom date range can be set on the browser via tools, and the search is limited to the nih.gov site domain. The phrase-site search command used is executed with "erectile dysfunction" COVID-19 site:nih.gov. The result revealed that from Sept 2021 to 2022, research on COVID-19 and erectile dysfunction spiked. However, the previous year saw a rise in studies linking drugs or mental health with erectile dysfunction. Meanwhile, psychiatry-focused publications have consistently grown. The time-series trends of erectile dysfunction linked to COVID-19 are substantiated by a comprehensive literature review. [ABSTRACT FROM AUTHOR]

Oklahoma's medical cannabis is some of the least restrictive in the US. Previous research suggests that American Indian/Alaska Native (AIAN) have higher rates of cannabis use than other racial or ethnic groups. The goals of this paper are, first, to look at cannabis use among high school students living on the Cherokee Nation Reservation before (2017) and after (2019) medical cannabis because legal in Oklahoma (2018) utilizing the Cherokee Nation Youth Risk Behavior Survey (CNYRBS). Second, to describe the socio-demographic characteristics of youth using cannabis in the Cherokee Nation Reservation. Data were retrieved from the 2017 and 2019 CNYRBS. The data for this study included 1,216 high school students who completed the 2017 and 1,476 who completed the 2019 CNYRBS. After removal of incomplete records, there were 2,602 students whose data was analyzed in this study. Data were weighted to be representative of public-school students attending grades 9–12 within Cherokee Nation Reservation. Despite the legalization of medical cannabis in Oklahoma in 2018, there was no change in cannabis use among youth between 2017 and 2019. There were variations in cannabis use based on demographic factors and other substance uses. AIAN individuals had higher odds of current cannabis use compared to non-Hispanic White students, but there were no differences based on ethnicity. Additionally, the use of cigarettes, e-cigarettes, alcohol, and illegal drugs were associated with increased odds of cannabis use among both current and former users compared to those who had never used it. There was no spike in use among youth at least immediately after the legalization of cannabis in the Cherokee Nation Reservation. There were socio-demographic as well as substance use disparities in the use of cannabis. [ABSTRACT FROM AUTHOR]

Background: Adolescence is a critical period for social emotional development. The need to focus on social emotional competencies is exacerbated by the COVID 19 pandemic. Objective: This systematic review paper provides a collective account of mindfulness interventions conducted exclusively with adolescent students in an educational setting (mean age 11 to 18) with the sole focus on social emotional and behavioral competencies primarily as outlined by the Collaborative for Academic, Social, and Emotional Learning (Safe and sound: an educational leader's guide to evidence-based social and emotional learning programs, Author, Chicago, IL, 2003, 2011). Method: Mindfulness literature in the past 15 years, i.e., Jan 2008–Feb 2023 was reviewed. Additionally, the type of intervention implemented, dosage, delivery, measures used, and targets of intervention were examined. All the articles were also assessed for their methodological quality using the EPHPP quality assessment tool for quantitative studies (Effective Public Health Practice Project in Quality assessment tool for quantitative studies, Effective Public Health Practice Project, Hamilton, ON, 1998. https://merst.ca/ephpp/). Results: With less than one third of the 30 included studies rated as strong, there appears to be moderate evidence for the effectiveness of MBIs on adolescent social emotional competencies. Overall, there appears to be mixed evidence for the effectiveness of MBIs on adolescents' self-awareness, social awareness, social skills, with relatively more consistent evidence that MBIs positively impact their self-management (e.g., emotional regulation). We classify broader characteristics of the MBIs that could help explain some of the differences in effectiveness into three categories: intervention implementation related (e.g., dosage), method related (e.g., psychometric properties), and participant related (e.g., age and gender). Conclusion: Future work on MBIs in schools needs to consider the quality of and factors known to impact effective implementation and resultant social emotional outcomes. [ABSTRACT FROM AUTHOR]

The relationship between Serum Uric Acid (UA) and Cardiovascular (CV) diseases has already been extensively evaluated, and it was found to be an independent predictor of all-cause and cardiovascular mortality but also acute coronary syndrome, stroke and heart failure. Similarly, also many papers have been published on the association between UA and kidney function, while less is known on the role of UA in metabolic derangement and, particularly, in metabolic syndrome. Despite the substantial number of publications on the topic, there are still some elements of doubt: (1) the better cut-off to be used to refine CV risk (also called CV cut-off); (2) the needing for a correction of UA values for kidney function; and (3) the better definition of its role in metabolic syndrome: is UA simply a marker, a bystander or a key pathological element of metabolic dysregulation?. The Uric acid Right for heArt Health (URRAH) project was designed by the Working Group on uric acid and CV risk of the Italian Society of Hypertension to answer the first question. After the first papers that individuates specific cut-off for different CV disease, subsequent articles have been published responding to the other relevant questions. This review will summarise most of the results obtained so far from the URRAH research project. [ABSTRACT FROM AUTHOR]

Introduction: The goal of this research is to identify the factors that negatively impact the achievement of the minimum clinically significant change (MCID) for the American Shoulder and Elbow Surgeons (ASES) score within the realm of various orthopedic shoulder procedures. Methods: We conducted a comprehensive review of studies published from 2002 to 2023, utilizing OvidMedline and PubMed databases. Our search criteria included terms such as "minimal clinically important difference" or "MCID" along with associated MeSH terms, in addition to "American shoulder and elbow surgeon" or "ASES." We selectively included primary investigations that assessed factors linked to the failure to achieve MCID for the ASES score subsequent to orthopedic shoulder procedures, while excluding papers addressing anatomical, surgical, or injury-related aspects. Results: Our analysis identified 149 full-text articles, leading to the inclusion of 12 studies for detailed analysis. The selected studies investigated outcomes following various orthopedic shoulder procedures, encompassing biceps tenodesis, total shoulder arthroplasty, and rotator cuff repair. Notably, factors, such as gender, body mass index, diabetes, smoking habits, opioid usage, depression, anxiety, workers' compensation, occupational satisfaction, and the preoperative ASES score, were all associated with the inability to attain MCID. Conclusion: In summary, numerous factors exert a negative influence on the attainment of MCID following shoulder procedures, and these factors appear to be irrespective of the specific surgical technique employed. Patients presenting with these factors may perceive their surgical outcomes as less successful when compared to those without these factors. Identifying these factors can enable healthcare providers to provide more effective counseling to patients regarding their expected outcomes and rehabilitation course. Furthermore, these findings can aid in the development of a screening tool to better identify these risk factors and optimize them before surgery. [ABSTRACT FROM AUTHOR]

The lives of caregivers can be deeply impacted by having a child with a developmental disability (DD). To offset those impacts, caregivers may engage in accommodations, or strategies to bolster everyday functioning. The nature and extent of these accommodations can provide insight into how the family is doing and what supports are needed from a family-centered perspective. This paper presents the development and preliminary validation of the Accommodations & Impact Scale for Developmental Disabilities (AISDD). The AISDD is a rating scale that measures day-to-day accommodations and impacts of raising a child with a DD. A sample of 407 caregivers of youth with DDs (Mage = 11.7 years; 63% males) completed the AISDD, along with measures of caregiver strain, daily challenges, child adaptive behavior, and behavior and emotional regulation. The AISDD is a unidimensional, 19-item scale with excellent internal consistency (ordinal alpha =.93) and test–retest (ICC =.95) reliability. Scores were normally distributed and sensitive to age (r = −.19), diagnosis (ASD + ID > ASD > ID), adaptive functioning (r = −.35), and challenging behaviors (r =.57). Finally, the AISDD showed excellent convergent validity with similar measures of accommodations and impacts. These findings support the use of the AISDD as a valid and reliable tool for measuring accommodations among caregivers of individuals with DDs. This measure shows promise in its ability to identify which families may need additional support for their children. [ABSTRACT FROM AUTHOR]

The Electronic Personal Health Record (EPHR) provides an innovative service for citizens and professionals to manage health data, promoting patient-centred care. It enhances communication between patients and physicians and improves accessibility to documents for remote medical information management. The study aims to assess the prevalence of awareness and acceptance of the EPHR in northern Italy and define determinants and barriers to its implementation. In 2022, a region-wide cross-sectional study was carried out through a paper-based and online survey shared among adult citizens. Univariable and multivariable regression models analysed the association between the outcome variables (knowledge and attitudes toward the EPHR) and selected independent variables. Overall, 1634 people were surveyed, and two-thirds were aware of the EPHR. Among those unaware of the EPHR, a high prevalence of specific socio-demographic groups, such as foreign-born individuals and those with lower educational levels, was highlighted. Multivariable regression models showed a positive association between being aware of the EPHR and educational level, health literacy, and perceived poor health status, whereas age was negatively associated. A higher knowledge of the EPHR was associated with a higher attitude towards the EPHR. The current analysis confirms a lack of awareness regarding the existence of the EPHR, especially among certain disadvantaged demographic groups. This should serve as a driving force for a powerful campaign tailored to specific categories of citizens for enhancing knowledge and usage of the EPHR. Involving professionals in promoting this tool is crucial for helping patients and managing health data. [ABSTRACT FROM AUTHOR]

Summary: The purpose of this paper is to describe rates of forearm fractures in adults in Norway 2008–2019. Incidence rate of distal forearm fractures declined over time in both sexes. Forearm fracture constitute a significant health burden and prevention strategies are needed. Purpose: To assess age- and sex-specific incidence rates, and time trends for forearm fractures in Norway, and compare these with incidence rates in other Nordic countries. Methods: Data on all patients aged 20–107 years with forearm fractures treated in Norwegian hospitals from 2008 to 2019 was retrieved from the Norwegian Patient Registry. Fractures were identified based on International Classification of Disease 10th revision code S52. Age- and sex-specific incidence rates and changes in incidence rates were calculated. Results: We identified 181,784 forearm fractures in 45,628,418 person-years. Mean annual forearm fracture incidence rates per 100,000 person-years were 398 (95% CI 390–407) for all, 565 (95% CI 550–580) for women, and 231 (95% CI 228–234) for men above 20 years. Mean annual number of forearm fractures was 15,148 (95% CI 14,575–15,722). From 2008 to 2019, age-adjusted total incidence rates of forearm fractures S52 diagnoses declined by 3.5% (incidence rate ratio (IRR) of 0.997 (95% CI 0.994–0.999)) in men. The corresponding decline in women was not significant (IRR: 0.999 (95% CI 0.997–1.002)). In the same period, the age-adjusted incidence rates of distal forearm fractures declined by 7.0% in men (IRR = 0.930; 95% CI 0.886–0.965) and 4.7% in women (IRR = 0.953; 95% CI 0.919–0.976). The incidence rates of distal forearm fractures were similar to rates in Sweden and Finland. Conclusion: Age-adjusted incidence rates of distal forearm fractures in both sexes declined over time. [ABSTRACT FROM AUTHOR]

Infertility has massively disrupted social and marital life, resulting in stressful emotional well-being. Early diagnosis is the utmost need for faster adaption to respond to these changes, which makes possible via AI tools. Our main objective is to comprehend the role of AI in fertility detection since we have primarily worked to find biomarkers and related risk factors associated with infertility. This paper aims to vividly analyse the role of AI as an effective method in screening, predicting for infertility and related risk factors. Three scientific repositories: PubMed, Web of Science, and Scopus, are used to gather relevant articles via technical terms: (human infertility OR human fertility) AND risk factors AND (machine learning OR artificial intelligence OR intelligent system). In this way, we systematically reviewed 42 articles and performed a meta-analysis. The significant findings and recommendations are discussed. These include the rising importance of data augmentation, feature extraction, explainability, and the need to revisit the meaning of an effective system for fertility analysis. Additionally, the paper outlines various mitigation actions that can be employed to tackle infertility and its related risk factors. These insights contribute to a better understanding of the role of AI in fertility analysis and the potential for improving reproductive health outcomes. [ABSTRACT FROM AUTHOR]

In this paper, we contend that urban middle-class older Indians engaged in "serious leisure" as a way to reimagine and reconfigure the structure of everyday life during the pandemic-led epochal downtime. In particular, we heuristically show that leisure activity patterns and constraint negotiation strategies among older Indians followed conceptual semblances with the dominant leisure-based typology of Serious Leisure Perspective. By thematically analysing household surveys (n = 71), time-use diaries and in-depth interviews (n = 15) of middle to upper middle-class individuals (55–80 years), we show how both men and women distinguished between serious leisure that is marked by motivation, agency and perseverance with that of unstructured, routinized free-time (or causal leisure). Time-use diaries suggested that despite the changed realities of heightened domestic time available to both genders due to the pandemic, women recorded higher proportion of their daily hours in household management and caregiving. Although women were governed by moral-cultural self-descriptions in their engagement with leisure, it was often associated with an enhanced sense of self-actualisation, self-management and identity. Overall, we show how the social codes of age and gender were inextricably linked with the practice of leisure during the pandemic. [ABSTRACT FROM AUTHOR]

This study investigates the gender disparities and cohort differences in the health trajectories of older Chinese adults. Drawn on a nationally representative dataset from the 2008–2018 Chinese Longitudinal Healthy Longevity Survey, this paper uses a growth-curve model to identify the health trajectories of older adults in functional limitations, chronic diseases, depressive symptoms and cognitive skills. Older women are found to have slightly fewer functional limitations than older men at an earlier age; however, this gap is reversed later because of women's higher deterioration rate in physical function. Compared to men, older women have more chronic diseases at younger ages, but this trend is changed after age 90 years due to a faster decline rate in chronic diseases for women. The gender gap in the depressive symptom trajectories narrows with age, whereas the gap in the trajectories of cognitive skills widens. The cohort differences favouring later-born cohorts decrease with age in the trajectory of functional limitations. The latest cohort born in 1940 or after has the fastest increase in chronic diseases and depressive symptoms among all the cohorts. These results are further verified using the random-effect model and pooled ordinary least squares. Policymakers should promote gender equality and reduce cohort differences to achieve the national goal of "Healthy China". [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, focused protection strategies including selective lockdowns of the elderly were proposed as alternatives to general lockdowns. These selective restrictions would consist of isolating only those most at risk of COVID-19 hospitalization and subsequent use of healthcare resources. The proposal seems to have troubling implications, including the permissibility of selective lockdown on the basis of characteristics such as ethnicity, sex, disability, or BMI. Like age, these factors also correlated with an increased risk of hospitalization from COVID-19. In this paper, we argue that age has meaningful differences as a morally relevant characteristic in the justification for selective restrictions of liberty. Thus, it might justify selective freedom restrictions in a way in which other factors might not. We offer four moral domains that separate age from other proxies: empiricism, operationality, discrimination, and disparity. [ABSTRACT FROM AUTHOR]

In clinical practice, many drug therapies are associated with prolongation of the QT interval. In literature, estimation of the risk of prescribing drug-induced QT prolongation is mainly executed by means of logistic regression; only one paper reported the use of machine learning techniques. In this paper, we compare the performance of both techniques on the same dataset. High risk for QT prolongation was defined as having a corrected QT interval (QTc) ≥ 450 ms or ≥ 470 ms for respectively male and female patients. Both conventional statistical methods (CSM) and machine learning techniques (MLT) were used. All algorithms were validated internally and with a hold-out dataset of respectively 512 and 102 drug-drug interactions with possible drug-induced QTc prolongation. MLT outperformed the best CSM in both internal and hold-out validation. Random forest and Adaboost classification performed best in the hold-out set with an equal harmonic mean of sensitivity and specificity (HMSS) of 81.2% and an equal accuracy of 82.4% in a hold-out dataset. Sensitivity and specificity were both high (respectively 75.6% and 87.7%). The most important features were baseline QTc value, C-reactive protein level, heart rate at baseline, age, calcium level, renal function, serum potassium level and the atrial fibrillation status. All CSM performed similarly with HMSS varying between 60.3% and 66.3%. The overall performance of logistic regression was 62.0%. MLT (bagging and boosting) outperform CSM in predicting drug-induced QTc prolongation. Additionally, 19.2% was gained in terms of performance by random forest and Adaboost classification compared to logistic regression (the most used technique in literature in estimating the risk for QTc prolongation). Future research should focus on testing the classification on fully external data, further exploring potential of other (new) machine and deep learning models and on generating data pipelines to automatically feed the data to the classifier used. [ABSTRACT FROM AUTHOR]

Growing healthcare costs have been accompanied by increased policymakers' interest in the efficiency of healthcare systems. Network formation by hospitals as a vehicle for consolidation and achieving economies of scale has emerged as an important topic of conversation among academics and practitioners. Within networks, consolidation of particular specialties or entire campuses is expected and encouraged to take place. This paper describes the main findings of an effort to build gravity-type models to describe patient choices in inpatient and daycare hospital facilities. It analyzes the distance decay effects as a function of car travel times and great-circle distance, and it offers a method for inclusion of university hospitals. Additionally, it reviews the impact of driving and transit accessibility on hospital attraction and reviews the differences in distance decay for patient age groups and hospitalization types. In the described application, the best models achieve a Mean Absolute Percentage Error of around 10% in non-metropolitan areas, and 14.5% across different region types. Results in metropolitan areas suggest that latent factors unrelated to proximity and size have a significant role in determining hospital choices. Furthermore, the effects of relative driving and transit accessibility are found to be small or non-existent. [ABSTRACT FROM AUTHOR]

In this paper, we study a slotted Aloha cooperative network where a source node and a relay node send status updates of two underlying stochastic processes to a common destination. Additionally, the relay node cooperates with the source by accepting its packets for further re-transmissions using probabilistic acceptance and relaying. We obtain the exact steady state distributions of Age of Information (AoI) and Peak AoI sequences of both nodes using Quasi-Birth-Death Markov chains. The analytical model is first validated by simulations and then used to obtain optimal cooperation policies when transmission probabilities are fixed. Subsequently, we study the more general problem of joint optimization of the transmission probabilities and cooperation level between the source and relay, with detailed numerical examples. [ABSTRACT FROM AUTHOR]

Elder abuse is evil in human society. The present paper unveils this social issue from two major factors psychological and physical abuse. The study sensitizes the subject matter of study by examining the effects of demographic variables like gender and age on elders. For achieving the purpose of the study the research is a design by exploring and validating the factors of measuring elder abuse through the mix method approach, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA). To test the established hypotheses of the effects of the demographic variable on elders the two-way ANOVA was applied. The present study verdicts the development of a sound measurement scale with two influence factors. The separate and composite effect of aging and gender type on elder abuse was evidenced. These findings are crucial especially when the prevalence of elder abuse is higher during COVID-19. The limited novel understudied variable opens an avenue for further research in behavioral and demographic variables like marital status. The present study has practical insinuation for caring the elders in any human society like physical and psychological treatment of elders to avoid abusive situations. In addition, the study attempts to validate the novel issues like psychological and physical abuse of elders in the dimensions of demographic variables. Some rare studies in the Indian continent established the motivation of conducting the research on this dimension. [ABSTRACT FROM AUTHOR]

Facial age estimation is promising for a wide range of applications including security access control, biometrics, and human–computer interaction. Current label distribution learning-based age estimation methods usually assume a prior probability distribution to handle the correlation among adjacent ages, and Gaussian distribution is the most widely used one. However, the Gaussian distribution is symmetrical, it does not conform to the diversified characteristic of age processing. In this paper, we propose an age encoding method called ALD (asymmetrical label distribution) by fusing the apparent bimodal distributions and chronological single distribution so that much more robust age label distribution can be found. Then, a lightweight multi-task learning network is designed to perform label distribution learning and regression learning for both global estimation and stagewise estimation. Unlike traditional cascade networks of label distribution learning, the parallel structure of multi-task is able to reduce the error propagation from predictive distribution to regression. Extensive experimental analyses on four benchmark datasets demonstrate the superior performance of the proposed method. [ABSTRACT FROM AUTHOR]

When designing a message transmission system, from the point of view of making sure that the information transmitted is as fresh as possible, two rules of thumb seem reasonable: use small buffers and adopt a last-in-first-out policy. In this paper, the freshness of information is interpreted as the recently studied "age of information" performance measure. Considering it as a stochastic process operating in a stationary regime, we compute the whole marginal distribution of the age of information for some well-performing systems. We assume that the arrival process is Poisson and that the messages have independent service times with common distribution, i.e., the M/GI model. We demonstrate the usefulness of Palm and Markov-renewal theory to derive results for Laplace transforms. Our numerical studies address some aspects of open questions regarding the optimality of previously proposed scheduling policies, and a policy newly considered herein, for AoI management. [ABSTRACT FROM AUTHOR]

While it has long been understood that the human mind evolved to learn language, recent studies have begun to ask the inverted question: How has language evolved under the cognitive constraints of its users and become more learnable over time? In this paper, we explored how the semantic change of English words is shaped by the way humans acquire and process language. In Study 1, we quantified the extent of semantic change over the past 200 years and found that meaning change is more likely for words that are acquired later in life and are more difficult to process. We argue that it is human cognition that constrains the semantic evolution of words, rather than the other way around, because historical meanings of words were not easily accessible to people living today, and therefore could not have directly influenced how they learn and process language. In Study 2, we went further to show that semantic change, while bringing the benefit of meeting communicative needs, is cognitively costly for those who were born early enough to experience the change: Semantic change between 1970 and 2000 hindered processing speeds among middle-aged adults (ages 45–55) but not in younger adults (ages <25) in a semantic decision task. This hampering effect may have, in turn, curbed the rate of semantic change so that language does not change too fast for the human mind to catch up. Taken together, our research demonstrates that semantic change is shaped by processing and acquisition patterns across generations of language users. [ABSTRACT FROM AUTHOR]

This paper used Social Security Administration program data from 2005 to 2019 to examine national- and state-level changes in the number of new adult supplemental security income (SSI) awardees on the autism spectrum relative to awardees with intellectual disability and other mental health disorders. We identified three main findings: the number of autistic awards increased between 2005 and 2019 when awards for all other mental health disorders declined; roughly nine out of every 10 autistic adult awardees were between ages 18–25 years; there was variation in the growth of autistic awards across states. These findings support the need to consider geographic and age differences in SSI program participation among autistic adults and determine the underlying causes. [ABSTRACT FROM AUTHOR]

Current research in attitudes towards the sexuality of adults with intellectual disabilities yields heterogeneous results. The aim of the present paper was to systematically review current qualitative and quantitative evidence of attitudes towards the sexuality of adults with intellectual disabilities. A systematic review of current literature (2000–2020) was carried out in the ERIC, PsychINFO, SCOPUS, PUBMED, and WebOfScience databases. Thirty-three articles were included for review. The present review protocol is registered in the PROSPERO database. Included studies presented attitudes towards the sexuality of adults with intellectual disabilities in samples comprised of staff, family, members of the community, and adults with intellectual disability. Community samples held more positive attitudes, followed by staff and family. Adults with intellectual disabilities reported interest in intimate relationships but perceived barriers in others' attitudes. Factors such as familiarity, age, gender of the adult with a disability, and culture seemed to have clear relationships. Other factors such as gender or social status remain unclear. In general, attitudes were considered positive. However, a preference for low intimacy and friendship or Platonic relationships was found. Stereotypes towards intellectual disability may have a strong influence. These findings underline the need to investigate and address attitudinal changes to provide adequate support for adults with intellectual disabilities in regard to a healthy relational and sex life. Prospero registration number: CRD42021222918. [ABSTRACT FROM AUTHOR]

According to self-determination theory, individual well-being is universally dependent upon the satisfaction of three basic psychological needs: autonomy, competence and relatedness. This study set out to further elucidate the relationship between basic psychological need satisfaction (BPNS) and well-being across age by (i) more closely examining the age distribution of BPNS, and (ii) investigating whether BPNS is comparably associated with well-being across all ages, as predicted by the universality assumption, while taking into account variability in other demographic factors. A general population sample of Dutch speaking adults from The Netherlands and Belgium (N = 1709; Mage = 48.6 years, SD = 19.0, range 18–97) filled out a cross-sectional online or paper-and-pencil survey questionnaire, providing self-reports of BPNS and well-being, using the Basic Psychological Need Satisfaction and Frustration Scale and Mental Health Continuum-Short Form, respectively. Data analyses consisted of initial visual inspection using LOESS smoothed curve plotting, and subsequent model testing using multiple regression analyses. When correcting for other demographic factors, results showed a positive linear relationship between age and autonomy satisfaction, no significant relationship between age and competence satisfaction, and a slight positive cubic relationship between age and relatedness satisfaction (initial 'peak', followed by a slight decline and 'dip', and steady rise for later ages). All basic psychological needs factors were positively linked to well-being in all domains, with associations generally comparable between adults of different ages, thus lending support to the universality assumption of self-determination theory. Despite distinct age distributions, all three basic psychological needs seem important for maintaining a sense of well-being throughout life. [ABSTRACT FROM AUTHOR]

The increase in depression during the COVID-19 pandemic underscores the importance of systematic approaches to identify individuals with mental health concerns. Primary care is often underutilized for depression screening, and it is not clear how practices can successfully increase screening rates. This study describes a quality improvement initiative to increase depression screening in five Family Medicine clinics. The initiative included four Plan-Do-Study-Act cycles that resulted in implementing a standardized workflow for depression screening, collaborative efforts with health information technology to prompt providers to perform screening via the medical record, delivering educational materials for providers and clinic staff and conducting follow-up education. Between September 2020 and April 2021 there were 23,745 clinic encounters with adult patients that were analyzed to determine whether patients were up-to-date on depression screening following their visit. A multi-level logistic regression model was constructed to determine the changes in likelihood of a patient being up-to-date on screening over the study period, while controlling for patient demographics and comorbidities. The average proportion of up-to-date patients increased from 61.03% in September 2020 to 82.33% in April 2021. Patients aged 65+ and patients with comorbidities were more likely to be up-to-date on screening; patients with telemedicine visits had lower odds of being up-to-date on depression screening. Overall, this paper describes a feasible, effective intervention to increase depression screening in a primary care setting. Additionally, we discuss lessons learned and recommendations to inform the design of future interventions. [ABSTRACT FROM AUTHOR]

While research has found important links between religion and health, there is a gap in knowledge in sub-Saharan Africa. The purpose of this paper is to examine the relationship between religion and health in rural Malawi. After controlling for baseline health, results show that: (1) the relationship differs between younger (15–44 years) and older (45 + years) adults; (2) among younger adults, Muslims are relatively less healthy, whereas Muslims are healthier in older age; (3) religious activities have a stronger relationship with health than do other measures, especially for women; and (4) religious activities have a relationship with health only for two or more activities. These findings suggest that religion is tied to health in Malawi, especially for older women. This paper was originally presented at the European Conference on African Studies in June 2017. [ABSTRACT FROM AUTHOR]

Forensic age estimation generally involves considerable amounts of uncertainty. Forensic age indicators such as teeth or skeleton images predict age only approximately, and this is likely to remain true even for future forensic age indicators. Thus, forensic age assessment should aim to make the best possible decisions under uncertainty. In this paper, we apply mathematical theory to make statistically optimal decisions to age assessment. Such an application is fairly straightforward assuming there is a standardized procedure for obtaining age indicator information from individuals, assuming we have data from the application of this procedure to a group of persons with known ages, and assuming the starting point for each individual is a probability distribution describing prior knowledge about the persons age. The main problem is then to obtain such a prior. Our analysis indicates that individual priors rather than a common prior for all persons may be necessary. We suggest that caseworkers, based on individual case information, may select a prior from a menu of priors. We show how information may then be collected over time to gradually increase the robustness of the decision procedure. We also show how replacing individual prior distributions for age with individual prior odds for being above an age limit cannot be recommended as a general method. Our theoretical framework is applied to data where the maturity of the distal femur and the third molar is observed using MRI. As part of this analysis we observe a weak positive conditional correlation between maturity of the two body parts. [ABSTRACT FROM AUTHOR]

Studies on the association between population ageing and health spending are inconclusive. Though per capita health spending has a strong age gradient, evidence from the developed countries attributes increasing health expenditure to high spending in terminal year of life. In India, though studies have examined the level, trends and determinants of health care spending, no attempt has been made on association of population ageing and per capita health spending across the districts of India. The objective of this paper was to examine the spatial dependencies and heterogeneities of population ageing and per capita health spending across 640 districts of India. Data from the Census of India (2011) and the consumption expenditure rounds of the National Sample Survey Organisation (NSSO) (2009–10 and 2011–2012) were used in the analysis. Univariate and bivariate LISA analysis, ordinary least square regression, and spatial error model were used to decipher the spatial pattern of population ageing and health spending in the districts of India. Results suggest that per capita health expenditure is positively associated with the proportion of the older adults (aged 60 years and above) in the districts of India. Districts with less than 5% older adults have an annual per capita health expenditure of ₹629 compared to ₹2432 in districts with older adults 12% or more. Districts of India also exhibit large spatial heterogeneity in household health spending. Bivariate Moran's I statistic of proportion of older adults and per capita annual health expenditure was 0.48, suggesting spatially association of the share of the older adults and the per capita annual health expenditure in India. Results of the spatial error model confirmed that share of urban population, mean wealth score, and mean household size are significant predictors of per capita annual health expenditure in India. This study is important to monitor the progress of universal health coverage across the disadvantaged districts and to integrate age component in universal health coverage programmes. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this paper is to share the results of a systematic review on the state of inequalities in access to and utilization of maternal, newborn and child health (MNCH) services in the sub-Saharan African region. The focus of the review was on urban settings where growing needs and challenges have been registered over the past few years due to rapid increase in urban populations and urban slums. Methods: The review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies published in English between 2000 and 2019 were included. A narrative synthesis of both qualitative and quantitative data was undertaken. The record for registration in PROSPERO was CRD42019122066. Results: The review highlights a great variation in MNCH services utilization across urban sub-Saharan Africa (SSA). The main aspects of vulnerability to unequal and poor MNCH services utilization in urban settings of the region include poverty, low level of education, unemployment, lower socioeconomic status and poor livelihoods, younger maternal age, low social integration and social support, socio-cultural taboos, residing in slums, and being displaced, refugee, or migrant. At the health system level, persistent inequalities are associated with distance to health facility, availability of quality services and discriminating attitudes from health care personnel. Conclusion: Context-specific intervention programs that aim at resolving the identified barriers to access and use MNCH services, particularly for the most vulnerable segments of urban populations, are essential to improve the overall health of the region and universal health coverage (UHC) targets. [ABSTRACT FROM AUTHOR]

The coronavirus disease (COVID-19) pandemic has required health services to rapidly respond to the needs of people diagnosed with the virus. Over 80% of people diagnosed with COVID-19 experience a mild illness and there is a need for community management to support these people in their home. In this paper we present, a telephone based COVID-19 community monitoring service developed in an Australian public health network, and we describe the rapid implementation of the service and the demographic and clinical characteristics of those enrolled. A retrospective mixed methods evaluation of the COVID-19 community monitoring service using the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework. Eight hundred and fifty COVID-19 positive patients were enrolled, 54% female, 45% male, mean age 34 years SD 17. Four hundred and nine (48%) patients were born outside Australia. Among the 850 patients, 305 (36%) were classified as having a high risk of serious illness from COVID-19. The most prevalent risk factors were cardiovascular disease (37%), lung disease (30%) and age over 60 years (26%). The most common reported ongoing symptoms were fatigue (55%), breathing issues (26%) and mental health issues such as low mood (19%). There were no deaths in patients that participated in the service. The process of risk stratification undertaken with telephone triage was effective in determining risk of prolonged illness from COVID-19. Telephone monitoring by trained health professionals has a strong potential in the effective management of patients with a mild COVID-19 illness. [ABSTRACT FROM AUTHOR]

The paper contributes to unravelling the perceptions of urban commercial drivers regarding their vulnerability to catching the SARS-CoV-2 virus while at work. It further examines how the perception of vulnerability influences personal use of face masks by drivers, as well as on their insistence on appropriate masking behaviour by other persons on-board public transport. Overcrowding and unsanitary conditions in informal public transport in Africa could facilitate the spread of the corona virus. However, the use of face masks, among other enhanced mitigation measures significantly contain and minimize the spread of the virus. Primary data, obtained through surveys at five major public transport terminals in Accra, was analysed and interpreted using the Health Belief Model as an explanatory framework. Results indicate that most drivers have a high vulnerability perception to Covid-19. It further emerged that older drivers, in particular, consistently wore face masks and insisted on other persons in their commercial vehicles to follow suit. Socio-demographic factors, and the need to ensure one's personal safety and those of loved ones were critical determinants of face mask use among surveyed drivers. The study thus recommends that public awareness campaigns should strategically focus attention on the younger generation of drivers (i.e. 18–39 years) who perceived themselves to be immune to the SARS-CoV-2 virus. Also, the collaborative efforts of state and non-state actors, like the transport operator unions, must be further strengthened if the gains made so far against Covid-19 is to be sustained. [ABSTRACT FROM AUTHOR]

River capture is of great significance to landform evolution and hominine migration. In the Qinling-Daba Mountains, there is a viewpoint that Jialing River captured Hanjiang River, but this is still controversial. In this paper, we discuss the drainage evolution processes in intermountain basins at the Qinling-Daba Mountains based on a combination of detrital zircon U-Pb geochronology and geomorphic indexes. We suggest that the Hanjiang River gradually captured the Jialing River from east to west, accompanied by the evolution of the ancient Yangtze River. In terms of geomorphic evidences, wide valleys did not match with discharge, and a series of wind gaps developed in the Shiquan-Ankang basin. In addition, the valley shapes and width-to-height ratios (Vf) indicate two possible rapid incisions. The hypsometric integrals (HI) reflect that the landform gradually changes from the old stage to the youth stage from west to east. The χ values show that the drainage divide is moving to the side of the Yuehe River, and the Yuehe River is gradually shrinking. According to the sedimentary records, the zircon U-Pb age distributions indicate the provenance change. The high-altitude terraces show three age peaks (200–250, 400–505, and 700–900 Ma), with the dominant Indosinian age peak (200–250 Ma), while the modern fluvial sediments only show a single peak of Jinning (700–900 Ma). These data show that there are two major river captures: (1) The ancient Hanjiang River cut through the regional compression ridge, and then captured the Hanzhong Basin river system (a part of the ancient Jialing river system) from east to west, and (2) The southern tributary captured the trunk with the uplift of the divide in the Shiquan-Ankang Basin, forming the modern drainage pattern in the upper Hanjiang River. The activities of the regional strike-slip fault, and the associated compression uplift played a key role in the river captures, the drainage evolution, and related landforms in the Shiquan-Ankang basin. In addition, it is shown that the evolution of the upper tributary basins lagged behind the response of the trunk channel to the tectonic activities and river captures. The interconnected wide valleys caused by river capture may have provided convenient geomorphological conditions for human migration into the Qinling-Daba Mountains along those river valleys. [ABSTRACT FROM AUTHOR]

Using data from simulated and actual case studies, this paper assesses the accuracy and precision of Bayesian estimates for the constructional date of medieval masonry buildings, generated from the radiocarbon evidence returned by different assemblages of wood-charcoal mortar-entrapped relict limekiln fuel (MERLF). The results from two theoretical studies demonstrate how Bayesian model specifications can be varied to generate a chronologically continuous spectrum of distributions from radiocarbon datasets subject Inbuilt Age (IA). Further analysis suggests that the potential for these distributions to contain the date of the constructional event depends largely upon the accuracy of the latest radiocarbon determination within each dataset, while precision is predicated on dataset age range, dataset size and model specification. These theoretical studies inform revised approaches to the radiocarbon evidence emerging from six culturally important Scottish medieval masonry buildings, each of which is associated with a wood-charcoal MERLF assemblage of different botanical character. The Bayesian estimates generated from these radiocarbon datasets are remarkably consistent with the historical and archaeological evidence currently associated with these sites, while age range distributions suggest the IA of each MERLF assemblage has been constrained by the taxa-specific and environmentally contingent lifespans and post-mortem durabilities of the limekiln fuel source. These studies provide further evidence that Bayesian techniques can generate consistently accurate chronological estimates for the construction of medieval masonry buildings from MERLF radiocarbon data, whatever the ecological provenance of the limekiln fuel source. Estimate precision is contingent upon source ecology and craft technique but can be increased by a more informed approach to materials analysis and interpretation. [ABSTRACT FROM AUTHOR]

There is a growing international literature investigating the relationship between attention-deficit/hyperactivity disorder (ADHD) and younger relative age within the school year, but results have been mixed. There are no published systematic reviews on this topic. This study aimed to systematically review the published studies on the relative age effect in ADHD. Systematic database searches of: Medline, Embase, PsycINFO, Web of Science, ERIC, Psychology and Behavioral Sciences Collection and The Cochrane Library were conducted. Studies were selected which investigated the relative age effect in ADHD in children and adolescents. Twenty papers were included in the review. Sixteen (of 20) papers reported a significantly higher proportion of relatively younger children being diagnosed with ADHD and/or receiving medication for this. Meta-analyses involving 17 of these 20 papers revealed a modest relative age effect in countries with higher prescribing rates, risk ratio = 1.27 (95% CI 1.19–1.35) for receipt of medication. The relative age effect is well demonstrated in countries with known higher prescribing rates. Amongst other countries, there is also increasing evidence for the relative age effect, however, there is high heterogeneity amongst studies. Further research is needed to understand the possible reasons under-pinning the relative age effect and to inform attempts to reduce it. [ABSTRACT FROM AUTHOR]

This paper examines age of autism spectrum disorder (ASD) identification and related factors in a diverse urban sample, focusing on ASD identification in the East African Somali community. The overall average age of initial ASD identification was 4.8 years. Somali children received an initial clinical diagnosis of Autistic Disorder later than White children, and Somali children diagnosed with ASD born outside of Minnesota (MN) received their first comprehensive evaluation later than Somali children diagnosed with ASD born in MN. Most children had noted developmental concerns before age 3, with no significant racial or ethnic differences in those concerns. The current study contributes to a limited number of studies on early ASD identification in culturally and linguistically diverse populations. [ABSTRACT FROM AUTHOR]

Purpose: To aid prescribers in assessing a patient’s risk for statin-induced myopathy (SIM), we performed a comprehensive review of currently known risk factors and calculated aggregated odds ratios for each risk factor through a meta-analysis.Methods: This meta-analysis was done through four phases: (1) Identification of the relevant primary literature; (2) abstract screening using inclusion and exclusion criteria; (3) detailed review and data extraction; and (4) synthesis and statistical analysis.Results: Out of 44 papers analyzed from 836 papers searched from MEDLINE, 18 different potential risk factors were collected, divided into three categories: three demographics (11 papers), ten clinical factors (31 papers), and five pharmacogenetics/biomarkers (12 papers). Risk factors significant for myopathy and/or rhabdomyolysis included age, gender, diabetes, renal impairment, cardiovascular disease, certain interacting drugs, and mutations of the SLCO1B1 gene, which encodes a transporter protein in the liver. Several factors, such as gender, race, cardiovascular disease, and the GATM gene, which encodes a protein for creatine synthesis, appeared to be protective in terms of the outcomes of interest.Conclusions: This comprehensive assessment of risk factors can help support clinicians in reducing the incidence of SIM in their patient population on statins. [ABSTRACT FROM AUTHOR]

Background: This paper investigates the difference in survival of melanoma patients across stage and sex by utilising net survival measures. Metrics are presented at both the individual and population level.Methods: Flexible parametric models were fitted to estimate life-expectancy metrics to be applied to a group of 104,938 subjects with a melanoma skin cancer diagnosis from 2000 to 2017. Period analysis was used for better predictions for newly diagnosed patients, and missing-stage information was imputed for 9918 patients. Female relative survival was assigned to male subjects to demonstrate the survival discrepancies experienced between sexes.Results: At the age of 60, males diagnosed at the regional stage lose an average of 4.99 years of life compared to the general population, and females lose 4.79 years, demonstrating the sex variation in expected mortality. In 2017, males contributed 3545 more life years lost than females, and a potential 1931 life years could be preserved if sex differences in survival were eliminated.Conclusions: This study demonstrates the survival differences across population subgroups as a result of a melanoma cancer diagnosis. Females experience better prognosis across age and stage at diagnosis; however, further investigation is necessary to better understand the mechanisms behind this difference. [ABSTRACT FROM AUTHOR]

This paper presents a brief overview of the complex interaction between age, hypertension, the renin–angiotensin–aldosterone system (RAAS), inflammation, and severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) infection. Coronavirus disease 2019 (COVID-19) is more frequent and more severe in comorbid elderly patients, especially those with hypertension, diabetes, obesity, or cardiovascular diseases. There are concerns regarding the use of RAAS inhibitors in patients with COVID-19. Some physicians have considered the need for interrupting RAAS inhibition in order to reduce the possibility of SARS-CoV2 entering lung cells after binding to angiotensin-converting enzyme 2 (ACE2) receptors. We offer a different point of view in relation to the need for continuing to use RAAS inhibitors in patients with COVID-19. We focused our article on elderly patients because of the distinctive imbalance between the immune response, which is depressed, and the exacerbated inflammatory response, 'inflammaging', which makes the geriatric patient an appropriate candidate for therapeutic strategies aimed at modulating the inflammatory response. Indeed, COVID-19 is an inflammatory storm that starts and worsens during the course of the disease. During the COVID-19 pandemic, various therapeutic approaches have been tested, including antiviral drugs, interferon, anti-interleukins, hydroxychloroquine, anti-inflammatories, immunoglobulins from recovered patients, and heparins. Some of these therapeutic approaches did not prove to be beneficial, or even induced serious complications. Based on current evidence, in the early stages of the disease modulation of the inflammatory response through the inhibition of neprilysin and modulation of the RAAS could affect the course and outcome of COVID-19. [ABSTRACT FROM AUTHOR]

The use of MRI in forensic age estimation has been explored extensively during the last decade. The authors of this paper synthesized the available MRI data for forensic age estimation in living children and young adults to provide a comprehensive overview that can guide age estimation practice and future research. To do so, the authors searched MEDLINE, Embase and Web of Science, along with cited and citing articles and study registers. Two authors independently selected articles, conducted data extraction, and assessed risk of bias. They considered study populations including living subjects up to 30 years old. Fifty-five studies were included in qualitative analysis and 33 in quantitative analysis. Most studies had biases including use of relatively small European (Caucasian) populations, varying MR approaches and varying staging techniques. Therefore, it was not appropriate to pool the age distribution data. The authors found that reproducibility of staging was remarkably lower in clavicles than in any other anatomical structure. Age estimation performance was in line with the gold standard, radiography, with mean absolute errors ranging from 0.85 years to 2.0 years. The proportion of correctly classified minors ranged from 65% to 91%. Multifactorial age estimation performed better than that based on a single anatomical site. The authors found that more multifactorial age estimation studies are necessary, together with studies testing whether the MRI data can safely be pooled. The current review results can guide future studies, help medical professionals to decide on the preferred approach for specific cases, and help judicial professionals to interpret the evidential value of age estimation results. [ABSTRACT FROM AUTHOR]

Objectives: Children of injured or disabled veterans and service members may be at risk for mental health and adjustment problems due to household stress. Yet, there are few widely available interventions to address the needs of this population. Reducing distress and improving coping skills of the parent who cares for the injured or disabled adult may improve child outcomes. This paper examines whether changes in caregiver psychosocial outcomes after a caregiver coaching intervention are associated with decreases in child anxiety. Methods: Using programmatic data collected between 2015 and 2019 from participants in a family caregiver coaching intervention (170 caregivers, 294 children), we apply linear mixed models to assess associations between changes in family caregiver well-being, including problem solving, depressive symptoms, burden, health complaints and quality of life, and changes in parent-reported child anxiety. Results: The baseline median Spence Children's Anxiety Scale—Parent score was 17; children aged 6–11 had slightly higher scores. Child anxiety scores decreased on average 2.8 points (SD 8.4) between baseline and follow-up. In adjusted models, decreases in caregiver depressive symptoms and health complaints were associated with decreases in child anxiety. Caregiver problem-solving skills, quality of life, and subjective burden were not associated with changes in child anxiety. Conclusion: Family caregiver-focused interventions that decrease caregiver stress may positively affect children in the household. Few resources are directed at military children; therefore, practitioners should consider ways to leverage caregiver interventions to address child well-being, such as incorporating information on parenting strategies and addressing issues faced by military children. [ABSTRACT FROM AUTHOR]

This paper examines the relationship between hopelessness on chronic disease in a national sample of African Americans (3570) and Caribbean Blacks (1438) Using the National Survey of American Life. A multivariate negative binomial regression examined whether chronic disease is associated with hopelessness, controlling for sociodemographic characteristics. Overall, 13.14% of the sample reported they were highly hopeless, and 31.5% indicated they were moderately hopeless. About 19% of respondents experienced chronic disease. Bivariate associations showed that those who have ever had chronic disease significantly differed from those who did not in regard to age, gender and spirituality. Multivariate results showed that respondents who ever have had chronic disease reported significantly higher hopelessness scores than those with no chronic disease. The study findings contribute to the current body of literature by supporting findings from smaller studies on the relationship between depression and hopelessness in African Americans and Caribbean Blacks. [ABSTRACT FROM AUTHOR]

Homelessness is a chronic public health issue in the U.S. This paper reviews the endurance and evolution of individual, youth, and family homelessness over the past 40-plus years. Thematic findings detail research on predictors of homelessness among adolescents, runaway youth, veterans, older adults, sheltered families, and female-headed families. Results provide a summary of contributors to homelessness, including issues related to family instability, unemployment and poverty, mental illness, substance use, unstable living arrangements, child maltreatment, social support, crime, and violence. Findings highlight key and persistent predictors of homelessness found across decades, as well as more recently identified and nuanced precursors to individual or family displacement. The goal of this work was to summarize what is known about predictors of homelessness to inform targeted research, practice, and policies. [ABSTRACT FROM AUTHOR]

Purpose: Visual unilateral spatial neglect (VUSN) is a neuropsychological condition commonly experienced after stroke whereby patients are unable to attend to stimuli on the controlesional side of their space. VUSN can occur in the personal, peripersonal, and/or extrapersonal portion of patient's space. Traditional paper-and-pencil neuropsychological tests are widely used to evaluate VUSN, but they assess peripersonal VUSN. Instead, personal and extrapersonal neglect are less easily evaluated. The aim of this study was to present normative values for the Visual Scanning Test (VST), a new neuropsychological tool to quantitatively assess the extrapersonal VUSN.Methods: Eighty-six healthy subjects took part in the study (61 female), with a mean age of 52.8 years (SD = 17.0) and a mean of 14.0 years of education (SD = 5.2). The VST involved a visual search for a target between similar visual distractors, projected in the far space. The test was administered twice to each participant, with an interval of 2 weeks. From the recorded data, it was possible to obtain indexes related to the reaction times and to the accuracy of the performance on the VST.Results: Multiple linear regression analysis revealed that age and education significantly influenced VST-derived indexes. From the regression analysis, a correction grid for raw scores was built. Adjusted scores were then ranked, and by means of a non-parametric procedure, tolerance limits (both outer and inner one-sided) were defined.Conclusions: The present study provided normative data for the VST in an Italian population useful for both clinical and research purposes.Trial Registration: ClinicalTrials.gov ID: NCT03931798. [ABSTRACT FROM AUTHOR]

Objective: Media multitasking has been found to have a negative relationship with young people's psychological well-being. However, its relationship with self-esteem has only been examined among adults, and the mechanism underlying its association with adolescents' well-being has been unclear. The purpose of this study was to investigate the relationship between media multitasking and self-esteem and explore the effects of peer influence and family functioning as potential mediators of this association. Methods: A sample of 725 Chinese adolescents (55.6% girls; Mage = 14.71, SD = 1.41) completed a paper-based survey, which included questions on demographics, media multitasking, peer influence, family functioning, and self-esteem. Structural equation modeling and multi-group analyses were performed on the collected data. Results: Media multitasking (MM) showed a negative association with self-esteem (SE) (r = −0.17, p < 0.001); however, peer influence (PI) and family functioning (FF) entirely mediated this relationship, i.e., MM→FF→SE (β = −0.059, p < 0.05) and MM→PI→FF→SE (β = −0.025, p < 0.01). In addition, significant differences were found in specific mediation pathways among gender and age groups. Conclusions: Overall, these findings have important implications for understanding the relationship between media multitasking and self-esteem among adolescents, as well as the age and gender differences. [ABSTRACT FROM AUTHOR]

Transition-age youth (TAY, ages 14–26) diagnosed with serious mental health conditions are at high risk for vocational struggles. This paper examines the implementation and process evaluation of Individual Placement and Support (IPS) and Supported Employment enhanced to better meet developmental needs of TAY. Enhancements include the integration of a TAY development focus, engagement best-practices, Supported Education and Peer Support. Community mental health providers participated in a process evaluation to explore the feasibility of a larger scale implementation. Common organizational barriers were encountered across provider sites including: leadership support, agency structures and funding mechanisms; compounded by the complexity of bridging child and adult systems. Findings have implications for both child and adult community mental health providers as they adapt and integrate programming for TAY. [ABSTRACT FROM AUTHOR]