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Background: Loneliness is more common in older adults and those who face structural vulnerabilities, including homelessness. The homeless population is aging in the United States; now, 48% of single homeless adults are 50 and older. We know little about loneliness among older adults who have experienced homelessness. We aimed to describe the loneliness experience among homeless-experienced older adults with cognitive and functional impairments and the individual, social, and structural conditions that shaped these loneliness experiences. Methods: We purposively sampled 22 older adults from the HOPE HOME study, a longitudinal cohort study among adults aged 50 years or older experiencing homelessness in Oakland, California. We conducted in-depth interviews about participants perceived social support and social isolation. We conducted qualitative content analysis. Results: Twenty participants discussed loneliness experience, who had a median age of 57 and were mostly Black (80%) and men (65%). We developed a typology of participants’ loneliness experience and explored the individual, social, and structural conditions under which each loneliness experience occurred. We categorized the loneliness experience into four groups: (1) “lonely– distressed”, characterized by physical impairment and severe isolation; (2) “lonely– rather be isolated”, reflecting deliberate social isolation as a result of trauma, marginalization and aging-related resignation; (3) “lonely– transient”, as a result of aging, acceptance and grieving; and (4) “not lonely”– characterized by stability and connection despite having experienced homelessness. Conclusions: Loneliness is a complex and heterogenous social phenomenon, with homeless-experienced older adults with cognitive or functional impairments exhibiting diverse loneliness experiences based on their individual life circumstances and needs. While the most distressing loneliness experience occurred among those with physical impairment and mobility challenges, social and structural factors such as interpersonal and structural violence during homelessness shaped these experiences. [ABSTRACT FROM AUTHOR]

Objective: Despite increasing efforts to improve housing stability, research has largely defined housing stability in a narrow sense and heavily relied on objective measures, such as housing types and housing duration. The present study constructed a conceptual framework for a subjective housing stability definition from the perspectives of individuals with co-occurring mental health and substance use disorders and their behavioral health service providers. Methods: Following the principles of grounded theory, we collected and analyzed qualitative data through semistructured interviews with 24 individuals with serious mental illness and substance use problems and three focus groups with 22 behavioral health service providers. Results: We developed a conceptual framework with two domains of subjective housing stability: functional stability and experiential stability. The functional stability domain includes four theoretical concepts: meeting basic needs, housing quality, housing affordability, and housing permanence. The experiential stability domain includes four theoretical concepts: autonomy and independence, connectedness, safety, and supportiveness. Conclusions: The conceptual framework can inform future research, practices, and policies to move beyond focusing on merely providing housing to consider the diverse and underlying needs in improving housing stability and well-being among those experiencing or at risk of housing instability. [ABSTRACT FROM AUTHOR]

Backgrounds: This study aimed to determine whether the Mayo adhesive probability score (MAP), which evaluated adherent perinephric fat (APF), is useful in evaluating the difficulty of retroperitoneal laparoscopic adrenalectomy (RLA), and to analyse the correlation between MAP and perioperative parameters. Methods: Clinical data of 104 patients with adrenal adenoma who underwent RLA were collected for retrospective analysis. According to the CT images obtained before surgery, patients were divided into two groups: High MAP group (2–5 points) and Low MAP group (0–1 points). Comparison of the general clinical characteristics and the perioperative data between the two groups was made. Results: There were more male patients (73.7% versus 34.3%), more patients with a smoking history (24.3% versus 7.5%), higher BMI (25.7 versus 23.2, kg/m2), and bigger (23.8 versus 18.5, mm) neoplasm in the high MAP group (P < 0.05). Significant difference was observed in operative time (128.8 versus 102.3, min), estimated blood loss (47.2 versus 25.2, ml) and drainage tube removal time (4.0 versus 3.2, d) between the two groups (P < 0.05). A high MAP score (P < 0.001) and the size of tumour (P = 0.024) were independent risk factors for extended operative time. A higher BMI (OR = 1.525, P < 0.001) and larger tumour size (OR = 2.862, P = 0.004) were independent risk factors for a high MAP score. Conclusions: MAP score was associated with the perioperative outcomes of RLA. BMI and tumour size were better indicators of MAP score, which can influence the difficulty of RLA. [ABSTRACT FROM AUTHOR]

Accessible summary: What is known on the subject?: Understanding what strategies individuals use to cope with serious mental illness is vital for enhancing their quality of life, mental well‐being and recovery, and effective use of services;An episode of homelessness can be a profoundly disruptive event that often leads to chronic stress, social isolation, a negative belief about oneself and restricted access to care, among other adverse experiences; What the paper adds to existing knowledge?: In contrast to existing reviews of qualitative research focusing on escaping homelessness, managing problem substance use and growing resilience, the current review offers an in‐depth, interpretive account of coping with serious mental illness during an episode of homelessness;This paper integrates evidence showing the diverse and intricate processes via which homelessness can impede an individual's ability to successfully cope with life stressors and with chronic mental illness;Despite experiencing severe social disadvantage, many individuals demonstrate positive adaptation and coping, and even personal growth; What are the implications for practice?: It is important to be aware of the many ways in which coping with serious mental illness can be influenced by adverse environmental factors such as poverty, homelessness, traumatic life experiences and institutional discrimination;Nursing practice should recognize that coping efforts by individuals facing multiple forms of social disadvantage may be shaped by acute adverse life events and institutional interactions, as well as by the stresses and strains of living on the streets;Nursing practice should focus not only on reducing clients' mental illness symptoms and facilitating positive coping behaviours, but also on helping create the conditions that aid clients in leveraging inner resources for personal growth and constructive meaning‐making. Introduction: An evidence gap persists concerning the impact of extreme socio‐structural disadvantage, such as homelessness, on the nature and effectiveness of coping with severe mental illness (SMI). While existing reviews of qualitative research into homelessness have focused on processes such as escaping homelessness and managing concurrent problem substance use, as well as on the experiences of specific vulnerable groups such as women and youth, no analogical review has been dedicated to understanding the management of SMI during an episode of homelessness. Aim/Question: A qualitative metasynthesis of first‐person accounts was conducted to understand how individuals cope with SMI when experiencing homelessness. Method: The systematic search strategy yielded 481 potentially eligible sources. Following the team‐based full‐text screening and the two‐tiered quality appraisal, 14 studies involving 377 participants with lived experience were synthesized following Noblit and Hare's metaethnographic method. Results: Seven third‐order concepts were derived capturing the complex nature and processual character of coping, as well as the web of contextual influences upon coping strategies. The resultant line‐of‐argument synthesis reveals the dialectical relationship between the two higher‐order constructs—"the continuum of coping" and "the assemblage of disadvantage." Discussion: Despite the profoundly adverse impacts of biographical and socio‐structural conditions, many individuals mobilized internal and external resources to enable various coping processes. Coping in the context of multiple disadvantage is not a monolith but rather a multidimensional, contingent and fluid phenomenon. Implications for practice: Nursing practice should espouse a humanizing, structurally competent, and strength‐ and meaning‐oriented approach in order to meet the complex and multifaceted needs of such multiply disadvantaged persons. [ABSTRACT FROM AUTHOR]

• Peers' shared experience could uniquely benefit clients and service organizations. • Working in professional settings benefits peers' personal wellbeing and professional growth. • Peers experience multilevel challenges due to their unique peer identity. • Organizations should have a full organizational commitment to peers' unique values. • Future research is needed on context- and setting-specific peer work experiences. People with lived or living experiences of drug use and services have been increasingly incorporated into nonpeer-led mainstream organizational settings as a unique workforce. Despite the much discussed effectiveness of peer services in achieving measurable outcomes, limited attention has been given to the experiential aspects of peer work from the perspectives of peers, clients, or others involved. This systematic review synthesized qualitative evidence examining the experiences of peer work in nonpeer-led drug use service settings. It focused on the benefits of incorporating peers as a unique workforce, the challenges they face, and the organizational factors that influence their practices. A search of 15 databases identified 3,940 unique citations, 33 of which met inclusion criteria. Thematic analysis was utilized to synthesize their findings. Foregrounding the uniqueness of peers' shared experience, studies have shown that incorporating peers into nonpeer-led settings can provide benefits at the client, organizational, and societal levels while promoting peers' personal and professional growth. The unique shared experience of peers can also present multidimensional challenges, such as triggering, boundary negotiation, and feelings of being trapped by their peer identity. To fully integrate peers into the system, organizations need to work with them to reconstruct organizational mission, culture, and structures in a way that recognizes and genuine commits to peers' unique values. This review highlights the significance of understanding peer uniqueness for organizations to create nourishing conditions for peer services and calls for future research exploring context- and setting-specific peer roles and organizational enablers and barriers. [ABSTRACT FROM AUTHOR]

This report explores the nature and quality of social ties of formerly homeless individuals in recovery from serious mental illness and substance abuse and how these ties relate to experiences of community. Using grounded theory and cross-case analysis techniques, we analyzed 34 qualitative interviews conducted with predominantly racial/ethnic minority individuals receiving mental health services. Participants described a range of involvement and experiences in the mental health service and mainstream communities indicating a combination of weak or strong ties in these communities. Across participants, two broad themes emerged: ties that bind and obstacles that "get in the way" of forming social ties. Salient subthemes included those related to family, cultural spaces, employment, substance abuse, stigma and mental health service providers and peers. The current study integrates our understanding of positive and negative aspects of social ties and provides a theoretical framework highlighting the complexity of social ties within mainstream and mental health service communities. [ABSTRACT FROM AUTHOR]

Objective: Individuals with mental health and/or substance abuse problems experience disparities in health care utilization. While previous studies have focused on individual and social determinants of health care use in these populations, few have investigated the role of residential stability, especially in relation to different types of service use (i.e., inpatient vs. outpatient treatment). The present study examined the relationship between residential mobility, defined as the number of residential relocations in the past year, and past-year use of four types of behavioral services (i.e., inpatient and outpatient mental health services, inpatient and outpatient substance abuse services) among a national sample of adults with mental health and/or substance abuse problems. Methods: Data were drawn from the 2011–2014 National Survey of Drug Use and Health (unweighted N = 43,411). Based on prior literature and theory, we hypothesized that individuals who frequently relocate are more likely to use inpatient services and are less likely to use outpatient services. Logistic regression analyses were conducted and all models controlled for predisposing, need, and enabling factors. Results: Compared to individuals who did not move in the past year, those who moved three or more times were more likely to report using inpatient mental health and substance abuse services. The relationship between residential mobility and outpatient mental health and substance use service use is not significant. Conclusions: The findings highlight the importance of understanding housing stability as a predictor factor of service use and access. Future research is needed to shed light on the pathway through which residential mobility affects behavioral health service utilization. [ABSTRACT FROM AUTHOR]

Most research so far on hierarchical multi-task control with strict priority requires exact dynamic and kinematic models. However, when a robot picks up tools of unknown lengths, orientations and mass, its kinematics and dynamics are varying and unavailable. There are few controllers that can achieve asymptotic tracking of multi-task in the presence of kinematic and dynamic uncertainties. Thus, in this paper we present a passivity-based adaptive Jacobian hierarchical multi-task controller. New reference velocity and kinematic regressor matrix are defined for the multi-task case with strict priority to guarantee the asymptotic convergence of both tracking error and parameter estimation error. A novel natural adaption law is specially designed for this method to guarantee the correctness of estimated dynamic parameters and increase the rate of convergence. Experiment results are presented to illustrate the performance of the proposed controller. [ABSTRACT FROM AUTHOR]

This paper focuses on applying a new sign bit hiding method to improve the video coding efficiency. Sign bits account for a large proportion of the encoded stream conforming to the latest high efficiency video coding (HEVC) standard; hence, its hiding technique is of great significance. In this paper, an extra sign bit hiding algorithm is proposed. The parity of the sum of the first and last nonzero coefficients in a coefficient group is used to predict the sign bit, and one more bit could be hidden at the coefficient group level based on state-of-the-art algorithms. The proposed algorithm could recover transform coefficients with minor adjustment on multiple sign bit hiding technique in HEVC. Evaluation results on standard test sequences demonstrate -0.06% BD-rate gain compared to well-known multiple sign bit hiding method. Besides, either the quality loss or complexity increase is negligible with the proposed algorithm, which is applicable in real-time processing. [ABSTRACT FROM AUTHOR]

Although residential substance abuse treatment has been shown to improve substance use and other outcomes, relapse is common. This qualitative study explores factors that hinder and help individuals during the transition from long-term residential substance abuse treatment to the community. Semi-structured interviews were conducted with 32 individuals from residential substance abuse treatment. Based on the socio-ecological model, barriers and facilitators to transition were identified across five levels: individual, interpersonal, organizational, community, and policy. The major results indicate that primary areas of intervention needed to improve outcomes for these high-risk individuals include access to stable housing and employment, aftercare services and positive support networks; expanded discharge planning services and transitional assistance; and funding to address gaps in service delivery and to meet individuals' basic needs. This study contributes to the literature by identifying transition barriers and facilitators from the perspectives of individuals in residential treatment, and by using the socio-ecological model to understand the complexity of this transition at multiple levels. Findings identify potential targets for enhanced support post-discharge from residential treatment. [ABSTRACT FROM AUTHOR]

Background: Tumor glycolysis is a critical event for tumor progression. Docetaxel is widely used as a first-line drug for chemotherapy and shown to have a survival advantage. However, the role of docetaxel in tumor glycolysis remained poorly understood. Methods: The effect of Docetaxel in tumor glycolysis and proliferation were performed by CCK-8, Western blotting, real-time PCR, glucose, and lactate detection and IHC. ChIP and luciferase assay were used to analyze the mechanism of Docetaxel on Smad3-mediated HIF-1α transactivity. Results: In this study, we showed that docetaxel treatment led to a significant inhibition of cell proliferation in prostate cancer cells through PFKP-mediated glycolysis. Addition of lactate, a production of glycolysis, could reverse the inhibitory effect of docetaxel on cell proliferation. Further analysis has demonstrated that phosphorylation of Smad3 (Ser213) was drastically decreased in response to docetaxel stimulation, leading to reduce Smad3 nuclear translocation. Luciferase and Chromatin immunoprecipitation (ChIP) analysis revealed that docetaxel treatment inhibited the binding of Smad3 to the promoter of the HIF-1α gene, suppressing transcriptional activation of HIF-1α. Moreover, ectopic expression of Smad3 in prostate cancer cells could overcome the decreased HIF-1α expression and its target gene PFKP caused by docetaxel treatment. Most importantly, endogenous Smad3 regulated and interacted with HIF-1α, and this interaction was destroyed in response to docetaxel treatment. What's more, both HIF-1α and PFKP expression were significantly reduced in prostate cancer received docetaxel treatment in vivo. Conclusion: These findings extended the essential role of docetaxel and revealed that docetaxel inhibited cell proliferation by targeting Smad3/HIF-1α signaling-mediated tumor Warburg in prostate cancer cells. -FEhS87GPJvKiophzuvDRW Video Abstract [ABSTRACT FROM AUTHOR]

Osteocalcin is a bone-derived hormone that plays an important role in the crosstalk between bone and energy metabolism. Previous studies have found that treatment with uncarboxylated osteocalcin can protect mice from high-fat diet-induced nonalcoholic fatty liver disease (NAFLD). However, the potential mechanisms remain unclear. Although the G protein-coupled receptor family C group 6 subtype A (GPRC6A) is the putative receptor of osteocalcin, there is no direct evidence showing that GPRC6A mediates the effects of uncarboxylated osteocalcin in alleviating NAFLD in mice. We aimed to figure out this using liver-specific GPRC6A knockout (GPRC6ALKO) mice. Consistent with previous studies, uncarboxylated osteocalcin significantly protected high-fat diet-fed wild-type mice from obesity and NAFLD, while it did not protect high-fat diet-fed GPRC6ALKO mice from NAFLD. Differential mRNA expression of lipogenesis and lipolysis between GPRC6ALKO mice and control mice revealed that GPRC6A mediated the effects of osteocalcin in alleviating NAFLD through inhibiting lipid synthesis and promoting lipolysis. In conclusion, this study found that uncarboxylated osteocalcin alleviates NAFLD in mice through the GPRC6A signaling pathway. Our study suggests that liver GPRC6A may be a potential target for treating NAFLD. [ABSTRACT FROM AUTHOR]

Critical Time Intervention (CTI) is designed to reduce the risk of homelessness and other adverse outcomes by providing support to individuals during challenging life course transitions. While several narrative reviews suggest the benefit of CTI, the evidence on the model's effectiveness has not been systematically reviewed. This article systematically reviews studies of CTI applied to a variety of populations and transition types. Following the Preferred Reporting Items for Systematic Review and Meta-Analysis for protocols (PRISMA-P) guidelines, we reviewed 13 eligible experimental and quasi-experimental studies. Findings were summarized by individual outcome domains, including housing, service engagement use, hospitalization or emergency services, mental health, substance use, family and social support, and quality of life. CTI had a consistent positive impact on two primary outcomes—reduced homelessness and increased service engagement use—among different populations and contexts. Despite the effectiveness of CTI, the specific mechanisms of the model's positive impacts remain unclear. Implications for practice, policy and research are addressed. [ABSTRACT FROM AUTHOR]

The failure of ancient rock ruins is affected by freeze-thaw cycles is an important phenomenon in cold region. The degree of freeze-thaw damage be significantly influenced and show an obvious difference during the complex solution environments. However, few studies have been conducted to investigate the combined effects of complex solution environments and freeze-thaw (F-T) cycles to the crack propagation mechanism of loading freeze-thawed sandstones. To study the coupling effects of complex solution environments and freeze-thaw on argillaceous sandstone in ancient ruins, the physical and mechanical properties were investigated through weighing tests, ultrasonic tests, and uniaxial compression tests. The complete failure process of each sample was concurrently monitored using a combination of AE and MS techniques. The crack propagation mechanism at different scales was systematacially investigated through a comparative analysis of microseismic (MS) and acoustic emission (AE) signal characteristics. Additionally, the orthogonal test was designed to effectively analyse the sensitivity of the primary influencing factors to freeze-thawed damage. The findings indicate that:(1) NaCl concentration influences the frost heave force and salt crystallization pressure. While pH levels impact the integrity of the rock structure, leading to significant changes in volume expansion and frost heave force. These aspects are regarded as the main causes of sandstone softening. (2) Compared to the NaCl concentration, varying pH have a more pronounced effect on the freeze-thawed damage. (3) The micro-cracks propagation during loading process is classified into three stages: initial compaction, incubation, and rapid propagation. The macro-cracks propagation is divided into two stages: uniform propagation and rapid propagation. With the increase of NaCl concentration and acidity of solution, the relative duration of incubation in micro-cracks propagation decreased, while the relative duration of uniform propagation in macro-cracks increased. When NaCl concentration and acidity surpass a specific threshold, both the micro-cracks and macro-cracks rapidly propagate from the beginning of the loading process. • Analyse the combined effects of solution environments and freeze-thaw cycles. • Use orthogonal test to determine sensitivity of influencing factors in freeze-thaw. • Investigate multi-scales crack evolution through integrating AE and MS analysis. • Divide crack propagation process into stages based on characteristics of AE and MS. • Explore essence of diversity in multi-scale crack propagation by fracture mechanics. [ABSTRACT FROM AUTHOR]

Background: Schizophrenia is a leading cause of disability, and a shift from facility- to community-based care has been proposed to meet the resource challenges of mental healthcare in low- and middle-income countries. We hypothesized that the addition of mobile texting would improve schizophrenia care in a resource-poor community setting compared with a community-based free-medicine program alone.Methods and Findings: In this 2-arm randomized controlled trial, 278 community-dwelling villagers (patient participants) were randomly selected from people with schizophrenia from 9 townships of Hunan, China, and were randomized 1:1 into 2 groups. The program participants were recruited between May 1, 2015, and August 31, 2015, and the intervention and follow-up took place between December 15, 2015, and July 1, 2016. Baseline characteristics of the 2 groups were similar. The patients were on average 46 years of age, had 7 years of education, had a duration of schizophrenia of 18 years with minimal to mild symptoms and nearly one-fifth loss of functioning, and were mostly living with family (95%) and had low incomes. Both the intervention and the control groups received a nationwide community-based mental health program that provided free antipsychotic medications. The patient participants in the intervention group also received LEAN (Lay health supporters, E-platform, Award, and iNtegration), a program that featured recruitment of a lay health supporter and text messages for medication reminders, health education, monitoring of early signs of relapses, and facilitated linkage to primary healthcare. The primary outcome was medication adherence (proportion of dosages taken) assessed by 2 unannounced home-based pill counts 30 days apart at the 6-month endpoint. The secondary and other outcomes included patient symptoms, functioning, relapses, re-hospitalizations, death for any reason, wandering away without notifying anyone, violence against others, damaging goods, and suicide. Intent-to-treat analysis was used. Missing data were handled with multiple imputations. In total, 271 out of 278 patient participants were successfully followed up for outcome assessment. Medication adherence was 0.48 in the control group and 0.61 in the intervention group (adjusted mean difference [AMD] 0.12 [95% CI 0.03 to 0.22]; p = 0.013; effect size 0.38). Among secondary and other outcomes we noted substantial reduction in the risk of relapse (26 [21.7%] of 120 interventional participants versus 40 [34.2%] of 117 controls; relative risk 0.63 [95% CI 0.42 to 0.97]; number needed to treat [NNT] 8.0) and re-hospitalization (9 [7.3%] of 123 interventional participants versus 25 [20.5%] of 122 controls; relative risk 0.36 [95% CI 0.17 to 0.73]; NNT 7.6). The program showed no statistical difference in all other outcomes. During the course of the program, 2 participants in the intervention group and 1 in the control group died. The limitations of the study include its lack of a full economic analysis, lack of individual tailoring of the text messages, the relatively short 6-month follow-up, and the generalizability constraint of the Chinese context.Conclusions: The addition of texting to patients and their lay health supporters in a resource-poor community setting was more effective than a free-medicine program alone in improving medication adherence and reducing relapses and re-hospitalizations. Future studies may test the effectiveness of customization of the texting to individual patients.Trial Registration: Chinese Clinical Trial Registry ChiCTR-ICR-15006053. [ABSTRACT FROM AUTHOR]

Purpose:This observational study investigated the association between serum osteocalcin level and blood pressure in a Chinese population. Materials and methods:A total of 2241 subjects (909 men and 1,332 women; age, 24–78 years) from Shanghai communities were recruited. Subjects were divided into non-hypertensive and hypertensive groups according to diagnosis of hypertension based on the 1999 World Health Organization-International Society of Hypertension Guidelines. Serum osteocalcin levels were measured using an electrochemiluminescence immunoassay. Results:Men in the hypertensive group showed lower serum osteocalcin level compared with those in the non-hypertensive group, [16.37 (13.34–20.11) ng/mL versus 17.01 (14.23–20.79) ng/mL,p = .039]. No difference in serum osteocalcin level was found between the two groups of women (p = .675). An inverse association was observed between serum osteocalcin level and systolic blood pressure (SBP) in men (p = .004), but serum osteocalcin level was not associated with diastolic blood pressure (DBP) in men (p = .472). No associations were detected between serum osteocalcin level and SBP or DBP in women (SBP:p = .108; DBP:p = .575). A multiple stepwise regression analysis showed an inverse association between serum osteocalcin level and SBP in men after adjusting for age, smoking status, family history of hypertension, and lipid and C-reactive protein levels (standardized β = –0.074,p = .023), but the association disappeared after adjustment for body mass index, waist circumference, blood glucose, and homeostasis model assessment of insulin resistance (p = .327). Conclusions:Serum osteocalcin level was not independently associated with blood pressure in a Chinese population. [ABSTRACT FROM PUBLISHER]

Background: In order to efficiently determine genotypic differences in rooting patterns of crops, novel hardware and software are needed simultaneously to characterize dynamics of root development. Results: We describe a prototype robotic monitoring platform—the RhizoChamber-Monitor for analyzing growth patterns of plant roots automatically. The RhizoChamber-Monitor comprises an automatic imaging system for acquiring sequential images of roots which grow on a cloth substrate in custom rhizoboxes, an automatic irrigation system and a flexible shading arrangement. A customized image processing software was developed to analyze the spatio-temporal dynamics of root growth from time-course images of multiple plants. This software can quantify overall growth of roots and extract detailed growth traits (e.g. dynamics of length and diameter) of primary roots and of individual lateral roots automatically. It can also identify local growth traits of lateral roots (pseudo-mean-length and pseudo-maximum-length) semi-automatically. Two cotton genotypes were used to test both the physical platform and the analysis software. Conclusions: The combination of hardware and software is expected to facilitate quantification of root geometry and its spatio-temporal growth patterns, and therefore to provide opportunities for high-throughput root phenotyping in support of crop breeding to optimize root architecture. [ABSTRACT FROM AUTHOR]