Search

This paper introduces a novel one-dimensional convolutional neural network that utilizes clinical data to accurately detect choledocholithiasis, where gallstones obstruct the common bile duct. Swift and precise detection of this condition is critical to preventing severe complications, such as biliary colic, jaundice, and pancreatitis. This cutting-edge model was rigorously compared with other machine learning methods commonly used in similar problems, such as logistic regression, linear discriminant analysis, and a state-of-the-art random forest, using a dataset derived from endoscopic retrograde cholangiopancreatography scans performed at Olive View–University of California, Los Angeles Medical Center. The one-dimensional convolutional neural network model demonstrated exceptional performance, achieving 90.77% accuracy and 92.86% specificity, with an area under the curve of 0.9270. While the paper acknowledges potential areas for improvement, it emphasizes the effectiveness of the one-dimensional convolutional neural network architecture. The results suggest that this one-dimensional convolutional neural network approach could serve as a plausible alternative to endoscopic retrograde cholangiopancreatography, considering its disadvantages, such as the need for specialized equipment and skilled personnel and the risk of postoperative complications. The potential of the one-dimensional convolutional neural network model to significantly advance the clinical diagnosis of this gallstone-related condition is notable, offering a less invasive, potentially safer, and more accessible alternative. [ABSTRACT FROM AUTHOR]

Background: The problems of students' social interaction and psychological well-being associated with online learning dependent on self-directed learning have become an important topic of research in recent years worldwide due to the COVID-19 pandemic, affecting their Social Emotional Learning. This paper aimed to compare the students' loneliness, social anxiety, social interaction, and general psychological well-being at different stages of online learning (at the beginning and the height of the pandemic), considering their criteria (presence/absence of a job and own family). Methods: For this, the researchers conducted an electronic survey of students (n = 320) twice, in February and May 2020, using four questionnaires: UCLA loneliness scale-3, Social Anxiety Scale for E-Learning Environments, Social Interaction Scale, and Brief Adjustment Scale. The responses at different stages of online learning were compared using Student's t-test. Differences between employed and unemployed students with or without their own families were determined using the analysis of variance (ANOVA). Results: The findings showed that unemployed students without their families suffered the most from loneliness. Social interaction online was rated higher by students with their own families; psychological well-being at the beginning of the distance period and social anxiety at the height of the distance period were higher among unemployed students. Conclusions: This research can become a theoretical basis for a phase-by-phase study of social predictors for the psychological well-being of higher education students and is of practical value for teachers and administrators of online learning aimed at students' socialization. In addition, it provides education officials with information about how students perceive psychological well-being, anxiety, social interaction, and loneliness during distance learning, which can help officials direct their decisions and reforms to improve interaction in the online environment. [ABSTRACT FROM AUTHOR]

This paper examines potential associations of loneliness with laboratory data and specific psychosocial and behavioral attitudes. The sample collection took place in an urban Primary Health Care unit between May and July 2023, consecutively, and once exclusion criteria were implemented. Participants were aged between 40 and 75 years. Routine laboratory test results upon study initiation and six months before were used. The University of California, Los Angeles (UCLA), Loneliness Scale (Version 3), blood glucose, serum lipids, Fibrosis-4 index, and Creatinine Clearance (CrCl) were assessed through hierarchical multiple logistic regression analysis. Based on full model (3rd) analysis, those who were engaged in an individual sport or activity or had contacts with more friends presented significantly lower odds for increased loneliness levels (odds ratio (OR): 0.28 [95% confidence interval (CI) 0.09–0.91], p = 0.034 and OR: 0.76 [95%CI 0.66–0.88], p < 0.001, respectively). The consumption of alcohol was associated with increased loneliness (OR: 5.55 [95%CI 1.42–21.63], p = 0.014). Elevated triglyceride levels were linked with moderate or no loneliness (OR: 0.20 [95%CI 0.05–0.83], p = 0.026), while an increased LDL/HDL atherosclerotic index was related to increased subjective loneliness (OR: 4.50 [95%CI 1.12–18.13], p = 0.035). The need for holistic approaches—involving primary care personnel—in understanding and addressing loneliness, recognizing its multifaceted nature as well as the diverse factors that contribute to this issue, is considered challenging. [ABSTRACT FROM AUTHOR]

aimed to analyze research on epilepsy in autism and autism in epilepsy using VOSviewer and CiteSpace to identify research hotspots and future directions. Methods: We searched the Web of Science Core Collection (WoSCC) for relevant studies about epilepsy in autism and autism in epilepsy published from inception to 31 May 2022. VOSviewer and CiteSpace were used to analyze the authors, institutions, countries, publishing journals, reference co-citation patterns, keyword co-occurrence, keyword clustering, keywords with citation bursts, and other aspects to construct a knowledge atlas. Results: A total of 473 publications related to epilepsy/autism were retrieved. The number of publications about epilepsy/ASD has generally increased over time, with some fluctuations. The USA (202 papers) and University of California-Los Angeles (15 papers) were the leading country and institution, respectively, in this field. Frye, Richard E. was the most published author (9 papers). Notably, collaboration between institutions, countries, and authors does not appear to be active. Hot topics and research frontiers include intellectual disability and exploring the mechanism of epilepsy/ASD from a genetics perspective. Conclusion: This analysis identified the most influential publications, authors, journals, institutions, and countries in the field of epilepsy/ASD research. Using co-occurrence and evolution analyses, the status of the field was identified and future trends were predicted. [ABSTRACT FROM AUTHOR]

Background: Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with a significant impact on the quality of life of affected patients. This study aimed to correlate serum inflammatory markers with specific tools assessing quality of life, emotional well-being, and loneliness, such as the Dermatology Life Quality Index (DLQI), Hospital Anxiety and Depression Scale (HADS), and the UCLA Loneliness Scale. Methods: A pilot observational study including 37 patients with HS was conducted. Inflammatory serum markers, including C-reactive protein (CRP) and Erythrocyte Sedimentation Rate (ESR), were evaluated at baseline, 3 months, and 6 months later. Psychometric scores were also evaluated at the same study intervals. Results: DLQI was correlated with ESR at baseline (Spearman's rho = 0.35, p = 0.03), indicating that poorer quality of life is associated with changes in this serum marker. Disease activity, as reflected by inflammatory markers, was associated with significant psychological burden. Specifically, a worse DLQI score was associated with higher ESR (estimate β = 0.14, 95% confidence interval [CI]: 0.05–0.22; p = 0.001) and higher CRP level (estimate β = 0.25, 95% CI: 0.02–0.48; p = 0.02). Similarly, a worse UCLA score was associated with higher ESR (estimate β = 0.11, 95% CI: 0.02–0.20, p = 0.01). Conclusions: Our study results underline the close relation between systemic inflammatory markers and clinical severity together with psychological burden in HS patients, as indicated by the significant association that was revealed between ESR/CRP and poorer psychometric scores. However, further research is warranted to validate these findings. [ABSTRACT FROM AUTHOR]

While lumbar spinal fusion using rigid rods is a prevalent surgical technique, it can lead to complications such as adjacent segment disease (ASDis). Dynamic stabilization devices serve to maintain physiological spinal motion and alleviate painful stress, yet they are accompanied by a substantial incidence of construct failure and subsequent reoperation. Compared to traditional rigid devices, Isobar TTL semi-rigid stabilization devices demonstrate equivalent stiffness and effective stabilization capabilities. Furthermore, when contrasted with dynamic stabilization techniques, semi-rigid stabilization offers improved load distribution, a broader range of motion within the fixed segment, and reduced mechanical failure rates. This paper will review and evaluate the clinical and biomechanical performance of Isobar TTL semi-rigid stabilization devices. A literature search using the PubMed, EMBASE, CNKI, Wanfang, VIP, and Cochrane Library databases identified studies that met the eligibility criteria. Twenty-eight clinical studies and nine biomechanical studies were included in this systematic review. The VAS, the ODI, and Japanese Orthopedic Association scoring improved significantly in most studies. UCLA grading scale, Pfirrmann grading, and modified Pfirrmann grading of the upper adjacent segments improved significantly in most studies. The occurrence rate of ASD was low. In biomechanical studies, Isobar TTL demonstrated a superior load sharing distribution, a larger fixed segment range of motion, and reduced stress at the rod–screw/screw–bone interfaces compared with titanium rods. While findings from mechanical studies provided promising results, the clinical studies exhibited low methodological quality. As a result, the available evidence does not possess sufficient strength to substantiate superior outcomes with Isobar semi-rigid system in comparison to titanium rods. To establish more conclusive conclusions, further investigations incorporating improved protocols, larger sample sizes, and extended follow-up durations are warranted. [ABSTRACT FROM AUTHOR]

Background: Chronic ankle instability is a common condition that develops after lateral ankle sprains. Many surgical techniques have been described in case of failure of conservative treatment. The purpose of this paper is to present the results in terms of clinical outcomes, return to sport and recurrence rate after reconstruction of the lateral ligament complex of the ankle with a minimally invasive approach at a minimum follow up of five years. Methods: This retrospective study involved forty-seven patients treated for chronic ankle instability from January 2013 to November 2017. The clinical outcomes were evaluated with the American Orthopedic Foot and Ankle Society ankle and hindfoot score (AOFAS score), the University of California–Los Angeles Rating Scale (UCLA Rating Scale), the Karlsson–Peterson ankle instability score and the Halasi scale at a mean follow up time of 80 months. Results: The mean age of the patients was 42 years (23–63). The mean VAS pain score decreased from 5.6 (2–9) pre-operatively to 0.7 (0–7) post-operatively. The mean UCLA Rating Scale score improved from 7.7 (4–8) before surgical treatment to 9.2 (6–10) afterwards. The AOFAS score increased from a pre-operative mean value of 66.5 (40–95) to a post-operative mean value of 94 (88–100) and the Halasi scale from a pre-injury mean value of 4.3 (2–8) to 4.5 post-operatively (2–8). The mean Karlsson–Peterson ankle instability score increased from 71 (40–90) pre-operatively to 87.9 (70–90) post-operatively. During this period of follow up, the procedure survival rate was 95.7%, with two cases of recurrence of ankle sprain post-operatively after twelve months in one case and forty months in the other case. Conclusions: The described technique of reconstruction of the anterior talofibular and calcaneofibular ligament with a minimally invasive approach with a semitendinosus autograft is a viable treatment option for chronic ankle instability and enables the majority of patients to regain their activity and sport level with a low recurrence rate at a mid-term follow up. [ABSTRACT FROM AUTHOR]

Background: Colon capsule endoscopy (CCE) has gained momentum as an alternative modality for the investigation of the lower gastrointestinal tract. Of the few challenges that remain, the comparison and – eventually – matching of polyps at different timestamps leads to the potential for double reporting and can contribute to false-positive findings and inaccuracies. With the impending artificial intelligence integration, the risk of double reporting the same polyp due to the lack of information on spatial orientation underscores the necessity for establishing criteria for polyp matching. Objectives: This RAND/University of California, Los Angeles (modified Delphi) process aims to identify the key factors or components used to match polyps within a CCE video. This involves exploring the attributes of each factor to create comprehensive polyp-matching criteria based on international expert consensus. Design: A systematic qualitative study using surveys. Methods: A panel of 11 international CCE experts convened to assess a survey comprised of 60 statements. Participants anonymously rated statement appropriateness on a 1–9 scale (1–3: inappropriate, 4–6: uncertain and 7–9: appropriate). Following a virtual group discussion of the Round 1 results, a Round 2 survey was developed and completed before the final analysis. Results: The factors that were agreed to be essential for polyp matching include (1) timestamp, (2) polyp localization, (3) polyp vascular pattern, (4) polyp size, (5) time interval of the polyp appearance between the green and yellow camera, (6) surrounding tissue, (7) polyp morphology and (8) polyp surface and contour. When five or more factors are satisfied, it was agreed that the comparing polyps are likely the same polyp. Conclusion: This study has established the first complete criteria for polyp matching in CCE. While it might not provide a definitive solution for matching difficult, small and common polyps, these criteria serve as a framework to guide and facilitate the process of polyp-matching. Plain language summary: Creating criteria and standards for matching polyps (abnormal growth in the bowels) on colon capsule video analysis: an international expert agreement using the RAND (modified Delphi process) process Background: Doctors often use colon capsule endoscopy (CCE), a high-tech capsule with two cameras, to record and check for diseases in the small and large bowels as the capsule travels through the intestines. One of the most common conditions in the large bowel is polyps, which are abnormal growths in the lining of the bowel. Comparing and matching polyps in the same video from the capsule can be tricky as they look very similar, leading to the possibility of incorrectly reporting the same polyp twice or more. This can lead to wrong results and inaccuracies. The literature did not have any criteria or standards for matching polyps in CCE before. Aim: Using the RAND/UCLA (modified Delphi) process, this study aims to identify the key factors or components used to match polyps within a CCE video. The goal is to explore each factor and create complete criteria for polyp matching based on the agreement from international experts. Method: A group of 11 international CCE experts came together to evaluate a survey with 60 statements. They anonymously rated each statement on a scale from 1 to 9 (1-3: inappropriate, 4-6: uncertain, and 7-9: appropriate). After discussing the Round 1 results virtually, a Round 2 survey with the same but revised questions was created and completed before the final analysis of their agreement. Results: The main factors for matching polyps are 1) the timing when the polyp was seen, 2) where it is in the bowel, 3) its blood vessel pattern, 4) size, 5) the timing of its appearance between cameras, 6) surrounding tissue features, 7) its shape, and 8) surface features. If five or more of these factors match, the compared polyps are likely the same. Conclusion: This study establishes the first complete criteria for matching polyps in CCE. While it may not provide a definitive solution for matching challenging and small polyps, these criteria serve as a guide to help and make the process of polyp matching easier. [ABSTRACT FROM AUTHOR]

In South Korea, the proportion of adults experiencing severe loneliness has been increasing rapidly. Accordingly, this study examines the elements of loneliness experienced by Korean adults and investigates their structural relevance using concept mapping. Korean adults (47) were recruited for individual in-depth interviews based on their scores on the UCLA Loneliness Scale. The interviews yielded 80 unique statements, which were then evaluated using multidimensional scaling and a hierarchical cluster analysis. A cluster map of loneliness was derived, with three clusters: (1) emotional distress due to the actual or anticipated absence of connection in relationships, (2) emotional distance from oneself or from others in a relationship, and (3) powerlessness and emptiness due to being directionless. Two dimensions distinguished these clusters: the lack of a sense of connection or self-assurance, and an inward or outward focus. These findings reveal that loneliness encompasses more than unmet relational needs; it also involves self-attentional focus, indicating a need to reconceptualize the notion of loneliness. The study's implications extend to counseling theory and practices by highlighting the importance of addressing both relational connections and self-perceptions in interventions for loneliness. By expanding the understanding of loneliness through empirical data, this research provides a more comprehensive framework for addressing loneliness. [ABSTRACT FROM AUTHOR]

Introduction: Loneliness in Japan, accentuated by demographic challenges and the hikikomori phenomenon (extreme social withdrawal), has raised concerns. This study critically examines loneliness dynamics, questioning assumptions embedded in hikikomori classifications. The term "hikikomori," originally signifying prolonged home stay, requires nuanced exploration, especially regarding outgoing behaviors' relationship with loneliness. Objectives: Investigating the intricate connection between outgoing behaviors and loneliness, this study questions the effectiveness of existing hikikomori classifications. Aiming to understand if these classifications accurately represent the loneliness spectrum across age groups, the research emphasizes the significance of comprehending loneliness dynamics amid societal challenges. The study explores an array of factors influencing loneliness, including demographics, mental health, and outgoing behaviors, advocating for a reassessment of assumptions linked to hikikomori classifications. Methods: This secondary analysis employed data from a nationwide Internet addiction survey conducted in July 2012. A sample of 623 participants, representative of Japanese internet users aged 16 and above, was included for analysis. Loneliness was assessed using the UCLA Loneliness Scale, and exposure variables included demographic, mental health, outgoing behaviors, and lifestyle factors. Statistical analyses encompassed descriptive statistics, one-way ANOVA, chi-square tests, and logistic regression. Results: Significant differences were observed in loneliness scores based on sex, age, marital status, employment, and outgoing behaviors. Mental health factors, including dissatisfaction with life and romance, life stress, and psychological distress, emerged as strong contributors to loneliness. The study challenges existing hikikomori classifications, suggesting they may not fully encapsulate the loneliness experiences of individuals engaged in routine school or work activities. Conclusion: Findings underscore the need for a reevaluation of hikikomori, emphasizing loneliness as a complex and multifaceted issue in Japan. The study advocates for nuanced strategies to address loneliness, considering diverse demographic vulnerabilities. Limitations include the pre-pandemic sample and potential unmeasured confounding factors. [ABSTRACT FROM AUTHOR]

Background: In cases of adolescent and early adulthood eating disorders, despite the importance of the patients' relationship with their parents, conflict and confusion frequently occur among them. Interpersonal psychotherapy (IPT) is a present-focused psychotherapy that emphasizes the interpersonal context of symptoms. We developed a remote family education and support program exclusively for parents of patients with eating disorders, based on the principle of IPT. The use of IPT is expected to reduce conflicts in the patient-parent relationship. Consequently, parents will be better able to listen to patients, and patients will be better able to express their thoughts and desires. In this study, we describe the protocol for a randomized controlled trial designed to examine the effectiveness of this program in promoting effective communication in their home based on active listening skills of parents of patients with adolescent and early adulthood eating disorders. Methods: Participants will be parents of patients aged 12–29 years with adolescent and early adulthood eating disorders. Individually randomized, parallel-group trial design will be employed. Seventy participants will be allocated to one of two treatment conditions: (1) remote family education and support program (four, 150 min weekly group sessions) for parents plus treatment-as-usual for patients (consultation by physicians or no treatment), or (2) waiting for the control condition (parents will wait to start the program for 8 weeks) plus treatment-as-usual for patients. The primary outcome measure will be parents' active listening ability as measured by the Active Listening Attitude Scale at 8 weeks after randomization. Additionally, perception of social support (Social Provision Scale-10 item), loneliness (UCLA Loneliness Scale), mental health status (K6), family function (Family Assessment Device), and parent-evaluated eating disorder symptoms (Anorectic Behavior Observation Scale) will be assessed. Data from the intention-to-treat sample will be analyzed 8 weeks after randomization. Discussion: This is the first study to evaluate the effectiveness of a family education and support program for parents of patients with adolescent and early adulthood eating disorders based on IPT. If this type of intervention is effective, although indirect, it could be a new support method for this patient population. Trial registration: Clinical Trials. gov ID NCT05840614. Plain English summary: For patients with adolescent and early adulthood eating disorders, although the relationship with their parents is an important interpersonal dynamic, conflicts and confusion often arise between patients and their parents. On the other hand, parents who live with individuals with eating disorders are frequently involved in interpersonal disputes, leading to a heavy psychological burden and elevated levels of depression and anxiety. It has been found that highly depressed or anxious parents tend to have difficulty listening carefully to their patients. Additionally, parental anxiety often promotes an overprotective response. Interpersonal psychotherapy (IPT) is a present-focused psychotherapy that emphasizes the interpersonal context of symptoms. In IPT, the patient and therapist work within interpersonal therapeutic domains, such as interpersonal role disputes with different expectations and role transitions. We developed a remote family education and support program exclusively for parents of patients with eating disorders based on IPT principles. In the present study, we describe the protocol for a randomized controlled trial designed to examine the effectiveness of this program in promoting effective communication within their homes, focusing on the active listening skills of parents of patients with adolescent and early adulthood eating disorders. [ABSTRACT FROM AUTHOR]

Background: Rotator cuff injury (RCI) is a common musculoskeletal ailment and a major cause of shoulder pain and limited functionality. The ensuing pain and restricted movement significantly impact overall quality of life. This study aims to systematically review the effects of extracorporeal shock wave therapy (ESWT) on RCI. Methods: This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols. A literature search, spanning inception to November 1, 2023, will include databases such as PubMed, Web of Science, the Cochrane Library, Scopus, MEDLINE, EMBASE, EBSCO, and China National Knowledge Infrastructure (CNKI) to identify ESWT studies for RCI treatment. Excluding retrospectives, bias risk will be assessed with the Cochrane tool. Two researchers will independently screen, extract data, and evaluate bias risk. Revman 5.3 software will be used for data analysis. Results: This study aims to objectively and comprehensively evaluate the effectiveness and safety of randomized controlled trials of ESWT in the treatment of RCI, and analyze in detail the effect of ESWT in the treatment of RCI. Results will be analyzed using the Pain Visual Analogue Scale (VAS), Constant-Murley score, University of California Los Angeles score (UCLA), and American Shoulder and Elbow Surgeons form (ASES). If applicable, subgroup analysis will also be performed to divide patients into groups according to the energy level of ESWT, the time of intervention, and the degree of tearing of RCI. Finally, the results are submitted for publication in a peer-reviewed journal. Discussion and conclusion: There is existing evidence suggesting that ESWT may contribute to the amelioration of pain and functional limitations associated with Rotator Cuff Injury (RCI). This systematic review aims to update, consolidate, and critically evaluate relevant evidence on the effects of ESWT for RCI. The anticipated outcomes may serve as a valuable reference for clinical ESWT practices, covering treatment methods, timing, and intensity. Moreover, this review aspires to provide high-quality evidence addressing the impact of ESWT on RCI-related pain. Simultaneously, the findings of this systematic review are poised to offer guidance to clinicians and rehabilitation therapists. This guidance is intended to enhance the management of pain and functional impairments experienced by individuals with RCI, ultimately leading to improvements in their physical well-being. Trial registration: Protocol registration numberCRD42023441407. https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023441407. [ABSTRACT FROM AUTHOR]

Objective: To compare the clinical outcomes of a modified arthroscopic triple‐row (TR) repair technique with the suture bridge (SB) repair technique in treating L‐shaped delaminated rotator cuff tears. Various surgical techniques for L‐shaped delaminated rotator cuff tears have been reported, many of which aid in increasing the contact area and pressure of the rotator cuff. However, there is still debate over which technique yields superior results. Methods: From January 2017 to March 2020, 61 cases of L‐shaped delaminated rotator cuff tears were included in this study. Of these, 34 cases underwent the modified arthroscopic triple‐row repair technique, while 27 cases were addressed with the suture bridge repair technique. Functional assessment was conducted using the American Shoulder and Elbow Surgeons (ASES) score, the University of California Los Angeles (UCLA) shoulder score, the Constant score (CS), and the visual analogue scale (VAS) score. Magnetic Resonance Imaging (MRI) assessments for rotator cuff healing were performed at the 24‐month postoperative mark. Statistical evaluations were conducted using SPSS for Windows (Version 25.0, IBM, Armonk, NY, USA), employing the Wilcoxon signed‐rank test to compare preoperative and postoperative data and ROM differences, and the Mann–Whitney U test for statistical differences in clinical outcome scores between the two groups. A p‐value of less than 0.05 was considered statistically significant. Results: Comparative analysis of the preoperative and final follow‐up scores revealed a substantial enhancement in shoulder function, as indicated by the ASES, UCLA, CS, and VAS scores, with statistical significance (p < 0.001). At both the preoperative stage and final follow‐up, no notable differences were observed in ASES, UCLA, CS, and VAS scores between the two groups. However, the TR repair group exhibited lower VAS scores than the SB group at 1 and 3 months postoperatively. Active range of motion (ROM) showed significant improvement in both groups. No significant differences in ROM were noted between the two groups either before the surgery or at the final follow‐up. Conclusion: The study demonstrates that both the modified arthroscopic TR and SB techniques for L‐shaped delaminated cuff tears yield satisfactory outcomes, with no significant differences in overall clinical performance. Notably, early postoperative pain management appears more effective with the modified TR technique, suggesting its potential for enhanced early recovery experiences. This technique's design, promoting securer fixation and optimal contact conditions, is implied to facilitate superior long‐term healing, warranting further investigation into its long‐term benefits. [ABSTRACT FROM AUTHOR]

Purpose: Adolescence is a period of transition from childhood to adulthood where people are vulnerable to stress. The COVID-19 pandemic continues to cause sustained stress in the population. Since the COVID-19 pandemic, social isolation and loneliness have increased. Loneliness is associated with increased stress, psychological distress, and a higher risk of mental illnesses, such as depression. This study examined the association between loneliness, premenstrual symptoms, and other factors in the era of the COVID-19 pandemic among adolescent females in Japan. Patients and Methods: A school-based cross-sectional survey of 1450 adolescent female students in Japan was conducted in mid-December of 2021. Specifically, paper-based questionnaires were distributed in class, and the responses were collected. The Premenstrual Symptoms Questionnaire (PSQ), 6-item Kessler Psychological Distress Scale, 3-item Revised UCLA Loneliness Scale (R-UCLA), and Fear of COVID-19 Scale were used as measurement tools. The prevalence of loneliness was defined as a total R-UCLA score ≥ 6. Results: The prevalence of loneliness was 29.0%. The prevalence of serious psychological distress was also high (8.2%), especially in the lonely group (16.0%). Multivariable regression analysis identified the following factors associated with loneliness: second year (odds ratio [OR] 1.53; 95% confidence interval [CI] 1.09– 2.14), longer internet use (OR, 1.11; 95% CI, 1.02– 1.20), total PSQ score (OR 1.08; 95% CI 1.06– 1.11), and psychological distress (OR 1.05; 95% CI 1.01– 1.08). Conclusion: Adolescent females in Japan showed a high prevalence of loneliness. School year (2nd year), longer periods of internet use, premenstrual symptom severity, and psychological distress were independently associated with loneliness. For clinicians and school health professionals, special concern should be given to the psychological health of adolescent females during the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Content-sharing social network platforms rely heavily on user-generated content to attract users and advertisers, but they have limited authority over content provision. We develop an intervention that leverages social interactions between users to stimulate content production. We study social nudges, whereby users connected with a content provider on a platform encourage that provider to supply more content. We conducted a randomized field experiment (N = 993 , 676) on a video-sharing social network platform where treatment providers could receive messages from other users encouraging them to produce more, but control providers could not. We find that social nudges not only immediately boosted video supply by 13.21% without changing video quality but also, increased the number of nudges providers sent to others by 15.57%. Such production-boosting and diffusion effects, although declining over time, lasted beyond the day of receiving nudges and were amplified when nudge senders and recipients had stronger ties. We replicate these results in a second experiment. To estimate the overall production boost over the entire network and guide platforms to utilize social nudges, we combine the experimental data with a social network model that captures the diffusion and over-time effects of social nudges. We showcase the importance of considering the network effects when estimating the impact of social nudges and optimizing platform operations regarding social nudges. Our research highlights the value of leveraging co-user influence for platforms and provides guidance for future research to incorporate the diffusion of an intervention into the estimation of its impacts within a social network. This paper was accepted by Victor Martínez-de-Albéniz, operations management. Funding: H. Dai thanks the University of California, Los Angeles (UCLA) [Hellman Fellowship and Faculty Development Award] for funding support. R. Zhang is grateful for financial support from the Hong Kong Research Grants Council [Grant 16505418]. Supplemental Material: The data files and online appendix are available at https://doi.org/10.1287/mnsc.2022.4622. [ABSTRACT FROM AUTHOR]

The 2022 John Bates Clark Medal of the American Economic Association was awarded to Oleg Itskhoki, Professor of Economics at the University of California, Los Angeles for his path breaking contributions in international economics. This article summarizes Oleg Itskhoki's work and places it in the context of the broader literature and emphasizes how it has shed new light on a number of long-standing puzzles regarding the behavior of exchange rates and international relative prices more generally and their connection to macroeconomic fluctuations and government's choices of monetary and fiscal policies. [ABSTRACT FROM AUTHOR]

Purpose: In order to control the corona virus disease-2019 (COVID-19) pandemic, many countries have adopted social quarantine policies, with older adults in Wuhan suffering the longest and most severe conditions. But few studies have explored the impact of this on the mental health of older adults in Wuhan. The purpose of this paper is to examine changes in the residential status and mental health of this group when 1 year after the social isolation policies in Wuhan.Method: A cross-sectional study with convenience sampling was conducted to assess the questionnaire of older adults in a total of 21 streets in 5 central and 2 distant urban districts of Wuhan. Using a self-compiled living status questionnaire, the Patient Health Questionnaire-9, the General Anxiety Disorder-7, the PTSD Checklist-Civilian Version, the UCLA Loneliness Scale and the Social Support Rating Scale, our survey evaluated the living status, depression, anxiety, post-traumatic stress symptoms, loneliness and social support of all the participants.Results: A total of 400 valid samples were obtained. One year after experiencing social isolation, older adults had not changed much from their pre-epidemic living status and mostly lived with their partners. They had satisfactory social support (33.86 ± 6.92) and low levels of depression (3.12 ± 4.30), anxiety (1.52 ± 3.19) and post-traumatic stress symptoms (21.41 ± 7.39), but there were moderate levels of loneliness (38.27 ± 9.31). Among them, depression, anxiety and post-traumatic stress symptoms were significantly higher (ps < 0.05) in older adults who were COVID-19 close contacts while experiencing social isolation.Conclusion: One year after experiencing Wuhan's harsh social isolation, older adults in the Wuhan community did not experience significant symptoms of depression, anxiety or post-traumatic stress, but loneliness has increased and the mental health of older adults who were COVID-19 close contacts needs attention. [ABSTRACT FROM AUTHOR]

Spectrogram analysis is a vital skill for learning speech acoustics. Spectrograms are necessary for visualizing cause-effect relationships between speech articulator movements and the resulting sound produced. However, many interpretation techniques needed to read spectrograms are counterintuitive to engineering students who have been taught to use more rigid mathematical formulas. As a result, spectrogram reading is often challenging for these students who do not have prior background in acoustic phonetics. In this paper, a structured, inclusive framework for teaching spectrogram reading to students of engineering backgrounds is presented. Findings from the implementation of these teaching methods in undergraduate and graduate engineering courses at University of California, Los Angeles are also unveiled. [ABSTRACT FROM AUTHOR]

Skeleton-based action recognition is a research hotspot in the field of computer vision. Currently, the mainstream method is based on Graph Convolutional Networks (GCNs). Although there are many advantages of GCNs, GCNs mainly rely on graph topologies to draw dependencies between the joints, which are limited in capturing long-distance dependencies. Meanwhile, Transformer-based methods have been applied to skeleton-based action recognition because they effectively capture long-distance dependencies. However, existing Transformer-based methods lose the inherent connection information of human skeleton joints because they do not yet focus on initial graph structure information. This paper aims to improve the accuracy of skeleton-based action recognition. Therefore, a Graph Skeleton Transformer network (GSTN) for action recognition is proposed, which is based on Transformer architecture to extract global features, while using undirected graph information represented by the symmetric matrix to extract local features. Two encodings are utilized in feature processing to improve joints' semantic and centrality features. In the process of multi-stream fusion strategies, a grid-search-based method is used to assign weights to each input stream to optimize the fusion results. We tested our method using three action recognition datasets: NTU RGB+D 60, NTU RGB+D 120, and NW-UCLA. The experimental results show that our model's accuracy is comparable to state-of-the-art approaches. [ABSTRACT FROM AUTHOR]

Objectives: This study aimed to investigate the utility of the RAND/UCLA appropriateness method (RAM) in validating expert consensus-based multiple-choice questions (MCQs) on electrocardiogram (ECG). Methods: According to the RAM user's manual, nine panelists comprising various experts who routinely handle ECGs were asked to reach a consensus in three phases: a preparatory phase (round 0), an online test phase (round 1), and a face-to-face expert panel meeting (round 2). In round 0, the objectives and future timeline of the study were elucidated to the nine expert panelists with a summary of relevant literature. In round 1, 100 ECG questions prepared by two skilled cardiologists were answered, and the success rate was calculated by dividing the number of correct answers by 9. Furthermore, the questions were stratified into "Appropriate," "Discussion," or "Inappropriate" according to the median score and interquartile range (IQR) of appropriateness rating by nine panelists. In round 2, the validity of the 100 ECG questions was discussed in an expert panel meeting according to the results of round 1 and finally reassessed as "Appropriate," "Candidate," "Revision," and "Defer." Results: In round 1 results, the average success rate of the nine experts was 0.89. Using the median score and IQR, 54 questions were classified as " Discussion." In the expert panel meeting in round 2, 23% of the original 100 questions was ultimately deemed inappropriate, although they had been prepared by two skilled cardiologists. Most of the 46 questions categorized as "Appropriate" using the median score and IQR in round 1 were considered "Appropriate" even after round 2 (44/46, 95.7%). Conclusions: The use of the median score and IQR allowed for a more objective determination of question validity. The RAM may help select appropriate questions, contributing to the preparation of higher-quality tests. [ABSTRACT FROM AUTHOR]

Objective: This study aims to elucidate the complex relationship among social isolation, loneliness, and perception of social isolation and its influence on depressive symptoms by evaluating a hypothetical model. This understanding is essential for the formulation of effective intervention strategies. Methods: We conducted an online survey on Japanese adults (N = 3,315) and used the six-item Lubben Social Network Scale to assess the size of their social networks. We employed a single question to gauge their perception of social isolation. Loneliness was assessed using the three-item UCLA Loneliness Scale, and depressive symptoms were examined using the Patient Health Questionnaire-9. Structural equation modeling was employed to test the hypothesized model. Results: The final model demonstrated satisfactory fit with data (χ2 (1) = 3.73; not significant; RMSEA = 0.03; CFI = 1.00; TLI = 1.00). The size of social network demonstrated a weak negative path to loneliness and depressive symptoms (β = −.13 to −.04). Notably, a strong positive association existed between perception of social isolation and loneliness (β =.66) and depressive symptoms (β =.27). Additionally, a significant positive relationship was found between loneliness and depressive symptoms (β =.40). Mediation analysis indicated that perception of social isolation and loneliness significantly intensified the relationships between social networks and depressive symptoms. Conclusions: Results indicate that interventions of psychological approaches, such as cognitive–behavioral therapy, are effective in reducing the perception of social isolation and loneliness, which may lead to the prevention of depressive symptoms. Future longitudinal studies are expected to refine and strengthen the proposed model. [ABSTRACT FROM AUTHOR]

Background: Older people with hip fracture are often medically frail, and many do not regain their walking ability and level of physical activity. The aim of this study was to examine the relationship between pre-fracture recalled mobility, fear of falling, physical activity, walking habits and walking speed one year after hip fracture. Methods: The study had a longitudinal design. Measurements were performed 3–5 days postoperatively (baseline) and at one year after the hip fracture. The measurements at baseline were all subjective outcome measures recalled from pre-fracture: The New Mobility Scale (NMS), the 'Walking Habits' questionnaire, The University of California, Los Angeles (UCLA) Activity Scale, Fear of Falling International (FES-I) and demographic variables. At one year 4-meter walking speed, which was a part of the Short Physical Performance Battery (SPPB) was assessed. Results: At baseline 207 participants were included and 151 were assessed after one year. Their age was mean (SD) 82.7 (8.3) years (range 65–99 years). Those with the fastest walking speed at one year had a pre-fracture habit of regular walks with a duration of ≥ 30 min and/or a frequency of regular walks of 5–7 days a week. Age (p =.020), number of comorbidities (p <.001), recalled NMS (p <.001), and recalled UCLA Activity Scale (p =.007) were identified as predictors of walking speed at one year. The total model explained 54% of the variance in walking speed. Conclusions: Duration and frequency of regular walks before the hip fracture play a role in walking speed recovery one year following the fracture. Subjective outcome measures of mobility and physical activity, recalled from pre-fracture can predict walking speed at one year. They are gentle on the old and medically frail patients in the acute phase after hip fracture, as well as clinically less time consuming. [ABSTRACT FROM AUTHOR]

Tropical-tropopause-layer cirrus clouds and their radiative effects represent a major uncertainty in the evaluation of Earth's energy budget. High-altitude aircraft offer an opportunity to provide observations at cirrus cloud altitudes, most commonly using in situ measurements of ice particle optical properties and composition. In particular, remote sensing of scattering properties and near-IR ice water absorption in the limb can provide unique insights into thin and sub-visible cirrus clouds. Here we present novel spectroscopic observations of path-averaged ice water absorptions on board NASA's Global Hawk aircraft during the Airborne Tropical TRopopause Experiment (ATTREX), which took place in 2011, 2013, and 2014. The University of California Los Angeles and University of Heidelberg mini-differential optical absorption spectroscopy (mini-DOAS) instrument provided multi-angle limb-scanning observations of scattered solar radiation in the near-IR (900–1726 nm), allowing the identification of ice and liquid water, O 2 , CO 2 , and H 2 O. The VLIDORT-QS radiative transfer (RT) code was specifically developed for this study and used to simulate high-altitude limb observations for varied cloud scenarios. We performed a comprehensive sensitivity study, developing a fundamental understanding of airborne near-IR limb observations of cirrus clouds. We identified two general distinct cases: a linear regime for optically thin clouds, where the ice absorption is proportional to ice water content (IWC), and a regime for optically thick cirrus clouds, where ice absorption is in saturation and independent of IWC. Results also demonstrate how molecular oxygen absorption can be used to infer information on optical properties of ice particles in the second regime only, with minimal information for thin cirrus clouds. We also explored the feasibility of retrieving IWC from mini-DOAS path-averaged ice water absorption (SIWP) measurements. This innovative interpolation-based approach requires a small number of RT calculations per observation to determine the sensitivity of SIWP to IWC. Spectral retrievals were applied for a particularly interesting case during Science Flight 2 over Guam in February 2014, during which the aircraft flew in circles in the same general area for an extended period of time. Retrieved IWC results are consistent with independent in situ measurements from other instruments on board. The measurements of ice particle scattering and absorption at different azimuths relative to the sun and at different altitudes represent a unique opportunity to test our approach and to infer properties of the ice particles, together with information on cirrus cloud radiative transfer. [ABSTRACT FROM AUTHOR]

Background: The suicide rate in bipolar disorder (BD) is among the highest across all psychiatric disorders. Identifying modifiable variables that relate to suicidal thoughts and behaviors (STBs) in BD may inform prevention strategies. Social connectedness is a modifiable variable found to relate to STBs in the general population, but differences exist across subgroups of the general population and findings specifically in BD have been equivocal. We aimed to clarify how perceived social connectedness relates to STBs in BD. Method: 146 adults (86 BD, 60 healthy controls) completed clinical interviews (Hamilton Depression Rating Scale; Structured Clinical Interview for DSM-5) and self-report measures of loneliness (UCLA Loneliness Scale) and social support (Interpersonal Support Evaluation List). Analyses explored differences in indicators of social connectedness (loneliness and social support) between BD participants and healthy controls, and explored relationships between STBs (lifetime suicide attempts and current suicidal ideation) and indicators of social connectedness in BD participants. Results: BD participants reported significantly higher loneliness and lower social support than healthy controls. In BD participants, perceived social support was significantly related to both ever having attempted suicide and number of lifetime attempts. Interestingly, perceived loneliness, but not social support, was significantly associated with current suicidal ideation. Conclusions: Findings expand the evidence base supporting a relationship between perceived social connectedness and STBs in BD. They suggest that this modifiable variable could be a fruitful treatment target for preventing STBs in BD. [ABSTRACT FROM AUTHOR]

The article explores the historical exclusion and discrimination faced by Black and Chinese individuals in the United States, focusing on court cases and legal opinions. It discusses the concept of whiteness being used to exclude and otherize these groups, as well as the ongoing struggles faced by Black Americans. The text highlights the need for cross-racial solidarity and anti-racist action, emphasizing the importance of dismantling and rebuilding the legal system to be truly inclusive. It concludes by acknowledging recent events and the potential for change when people demand government protection. [Extracted from the article]

Background: A cancer diagnosis and its treatment may be an especially isolating experience. Despite evidence that positive health behaviours can improve outcomes for people living with and beyond cancer (LWBC), no studies have examined associations between loneliness and different health behaviours in this population. This study aimed to describe the prevalence of loneliness in a large sample of UK adults LWBC and to explore whether loneliness was associated with multiple health behaviours. Methods: Participants were adults (aged ≥ 18 years) diagnosed with breast, prostate or colorectal cancer who completed the Health and Lifestyle After Cancer Survey. Loneliness was reported using the UCLA loneliness score, dichotomised into higher (≥ 6) versus lower (< 6) loneliness. Engagement in moderate-to-vigorous physical activity, dietary intake, smoking status, alcohol use, and self-reported height and weight were recorded. Behaviours were coded to reflect meeting or not meeting the World Cancer Research Fund recommendations for people LWBC. Logistic regression analyses explored associations between loneliness and health behaviours. Covariates were age, sex, ethnicity, education, marital status, living situation, cancer type, spread and treatment, time since treatment, time since diagnosis and number of comorbid conditions. Multiple imputation was used to account for missing data. Results: 5835 participants, mean age 67.4 (standard deviation = 11.8) years, completed the survey. 56% were female (n = 3266) and 44% (n = 2553) male, and 48% (n = 2786) were living with or beyond breast cancer, 32% (n = 1839) prostate, and 21% (n = 1210) colorectal. Of 5485 who completed the loneliness scale, 81% (n = 4423) of participants reported lower and 19% (n = 1035) higher loneliness. After adjustment for confounders, those reporting higher levels of loneliness had lower odds of meeting the WCRF recommendations for moderate-to-vigorous physical activity (Odds Ratio [OR] 0.78, 95% Confidence Internal [CI], 0.67, 0.97, p =.028), fruit and vegetable intake (OR 0.81, CI 0.67, 1.00, p =.046), and smoking (OR 0.62, 0.46, 0.84, p =.003). No association was observed between loneliness and the other dietary behaviours, alcohol, or body mass index. Conclusions: Loneliness is relatively common in people LWBC and may represent an unmet need. People LWBC who experience higher levels of loneliness may need additional support to improve their health behaviours. [ABSTRACT FROM AUTHOR]

Introduction: Loneliness in Japan, accentuated by demographic challenges and the hikikomori phenomenon (extreme social withdrawal), has raised concerns. This study critically examines loneliness dynamics, questioning assumptions embedded in hikikomori classifications. The term "hikikomori," originally signifying prolonged home stay, requires nuanced exploration, especially regarding outgoing behaviors' relationship with loneliness. Objectives: Investigating the intricate connection between outgoing behaviors and loneliness, this study questions the effectiveness of existing hikikomori classifications. Aiming to understand if these classifications accurately represent the loneliness spectrum across age groups, the research emphasizes the significance of comprehending loneliness dynamics amid societal challenges. The study explores an array of factors influencing loneliness, including demographics, mental health, and outgoing behaviors, advocating for a reassessment of assumptions linked to hikikomori classifications. Methods: This secondary analysis employed data from a nationwide Internet addiction survey conducted in July 2012. A sample of 623 participants, representative of Japanese internet users aged 16 and above, underwent factor analysis. Loneliness was assessed using the UCLA Loneliness Scale, and exposure variables included demographic, mental health, outgoing behaviors, and lifestyle factors. Statistical analyses encompassed descriptive statistics, one-way ANOVA, chi-square tests, and logistic regression. Results: Significant differences were observed in loneliness scores based on sex, age, marital status, employment, and outgoing behaviors. Mental health factors, including dissatisfaction with life and romance, life stress, and psychological distress, emerged as strong contributors to loneliness. The study challenges existing hikikomori classifications, suggesting they may not fully encapsulate the loneliness experiences of individuals engaged in routine school or work activities. Conclusion: Findings underscore the need for a reevaluation of hikikomori, emphasizing loneliness as a complex and multifaceted issue in Japan. The study advocates for nuanced strategies to address loneliness, considering diverse demographic vulnerabilities. Limitations include the pre-pandemic sample and potential unmeasured confounding factors. [ABSTRACT FROM AUTHOR]

Background: Research into men and masculinities suggests men may be more reluctant than women to state they are lonely, more reliant on partners/spouses and/or alcohol to tackle it, and that this may be a result of poorer social relationships. Ageing is often associated with loneliness, and research has indicated gendered results in older people, but existing evidence lacks generalisability and cultural context. This study tests hypotheses on sex differences in loneliness in older England-based men and women. Methods: We conducted a cross-sectional study using a sample of 6936 respondents aged 50 + from the English Longitudinal Study of Ageing (wave 8). Multiple imputation with chained equations was conducted to handle missing data. Multivariate regression was used to investigate the impact of sex on a direct question on loneliness whilst controlling for the University of California loneliness (UCLA) scale. Multivariate regression with interaction terms were used to examine sex differences in loneliness and alcohol consumption, partner status, and social relationships. Results: Older men were less likely than older women to state they are lonely even when controlling for UCLA score. Older men showed a greater association between loneliness and alcohol consumption, but only when measuring the number of units consumed in the last week, and not using a less precise measure of the past year. Older men who cohabited with a partner were less lonely than cohabiting older women, whereas previously married but not cohabiting older men were lonelier than their female counterparts. However, never married older men were less lonely than never married older women. Evidence was found to suggests older men's worse friendships mediated this association, but social isolation and number of close relationships did not. Severe isolation predicted greater loneliness in older women, but not older men. Conclusions: Cultural ideals of masculinity and older men's poorer quality friendships may explain their reluctance to directly state loneliness, greater dependency on partners/spouses, and use of alcohol. Severely isolated older men may under-report loneliness on the UCLA scale as well as a direct question. [ABSTRACT FROM AUTHOR]

Skeleton-based action recognition is widely used in varied areas, e.g., surveillance and human-machine interaction. Existing models are mainly learned in a supervised manner, thus heavily depending on large-scale labeled data, which could be infeasible when labels are prohibitively expensive. In this paper, we propose a novel Contrast-Reconstruction Representation Learning network (CRRL) that simultaneously captures postures and motion dynamics for unsupervised skeleton-based action recognition. It consists of three parts: Sequence Reconstructor (SER), Contrastive Motion Learner (CML), and Information Fuser (INF). SER learns representation from skeleton coordinate sequence via reconstruction. However the learned representation tends to focus on trivial postural coordinates and be hesitant in motion learning. To enhance the learning of motions, CML performs contrastive learning between the representation learned from coordinate sequences and additional velocity sequences, respectively. Finally, in the INF module, we explore varied strategies to combine SER and CML, and propose to couple postures and motions via a knowledge-distillation based fusion strategy which transfers the motion learning from CML to SER. Experimental results on several benchmarks, i.e., NTU RGB+D 60/120, PKU-MMD, CMU, and NW-UCLA, demonstrate the promise of the our method by outperforming state-of-the-art approaches. [ABSTRACT FROM AUTHOR]

Loneliness and social isolation are subjective measures associated with the feeling of discomfort and distress. Various factors associated with the feeling of loneliness or social isolation are: the built environment, long-term illnesses, the presence of disabilities or health problems, etc. One of the most important aspect which could impact feelings of loneliness is mobility. In this paper, we present a machine-learning based approach to classify the user loneliness levels using their indoor and outdoor mobility patterns. User mobility data has been collected based on indoor and outdoor sensors carried on by volunteers frequenting an elderly nursing house in Tampere region, Finland. The data was collected using Pozyx sensor for indoor data and Pico minifinder sensor for outdoor data. Mobility patterns such as the distance traveled indoors and outdoors, indoor and outdoor estimated speed, and frequently visited clusters were the most relevant features for classifying the user's perceived loneliness levels.Three types of data used for classification task were indoor data, outdoor data and combined indoor-outdoor data. Indoor data consisted of indoor mobility data and statistical features from accelerometer data, outdoor data consisted of outdoor mobility data and other parameters such as speed recorded from sensors and course of a person whereas combined indoor-outdoor data had common mobility features from both indoor and outdoor data. We found that the machine-learning model based on XGBoost algorithm achieved the highest performance with accuracy between 90 % and 98 % for indoor, outdoor, and combined indoor-outdoor data. We also found that Lubben-scale based labelling of perceived loneliness works better for both indoor and outdoor data, whereas UCLA scale-based labelling works better with combined indoor-outdoor data. [ABSTRACT FROM AUTHOR]

We established consensus on practice-based metrics that characterize quality of care for older primary care patients and can be examined using secondary health administrative data. We conducted a two-round RAND/UCLA Appropriateness Method (RAM) study and recruited 10 Canadian clinicians and researchers with expertise relevant to the primary care of elderly patients. Informed by a literature review, the first RAM round evaluated the appropriateness and importance of candidate quality measures in an online questionnaire. Technical definitions were developed for each endorsed indicator to specify how the indicator could be operationalized using health administrative data. In a virtual synchronous meeting, the expert panel offered feedback on the technical specifications for the endorsed indicators. Panelists then completed a second (final) questionnaire to rate each indicator and corresponding technical definition on the same criteria (appropriateness and importance). We used statistical integration to combine technical expert panelists' judgements and content analysis of open-ended survey responses. Our literature search and internal screening resulted in 61 practice-based quality indicators for rating. We developed technical definitions for indicators endorsed in the first questionnaire (n = 55). Following the virtual synchronous meeting and second questionnaire, we achieved consensus on 12 practice-based quality measures across four Priority Topics in Care of the Elderly. The endorsed indicators provide a framework to characterize practice- and population-level encounters of family physicians delivering care to older patients and will offer insights into the outcomes of their care provision. This study presented a case of soliciting expert feedback to develop measurable practice-based quality indicators that can be examined using administrative data to understand quality of care within population-based data holdings. Future work will refine and operationalize the technical definitions established through this process to examine primary care provision for older adults in a particular context (Ontario, Canada). [ABSTRACT FROM AUTHOR]

Background: Social frailty (SF) is associated with multiple adverse health outcomes, yet there has been an inadequate focus on social frailty. The convoy model portrays the social networks through the perspective of the life course, thus providing a framework to explain the occurrence of social frailty. This study aimd to figure out the prevalence of social frailty and loneliness among community-dwelling older adults and to explore their correlations based on convoy model. Methods: This was a cross-sectional study, and 295 older adults from 10 communities of Zhengzhou in Henan Province participated in the study. Social frailty and loneliness were assessed separately with the Social Frailty Scale and University of California at Los Angeles-Loneliness Scale. The scores of social frailty of the older adults in different characteristic communities were compared by independent sample t-test and single factor analysis of variance. The influencing factors of social frailty were analysed by multiple stepwise linear regression and the structural equation model. The correlation between social frailty and loneliness was analysed by Pearson correlation analysis. Results: The total scores of social frailty and loneliness of the older adults in the community were (2.09 ± 1.53) and (43.19 ± 8.91), respectively. There was a moderate positive correlation between social frailty and loneliness (r = 0.621, P < 0.01). The results of multiple stepwise linear regression analysis showed that age, living styles, balance of payments, and loneliness were the main influencing factors of the social frailty of older adults in the community (F = 27.180, P < 0.001). The structural equation model of social frailty fitted well (χ2 = 47.292, df = 26, χ2/df = 1.819, P = 0.007; RMSEA = 0.053, 95%CI (0.028, 0.076), P = 0.359; GFI = 0.971; AGFI = 0.939; NFI = 0.904; IFI = 0.955; TLI = 0.918; CFI = 0.953; SRMR = 0.0466). Conclusions: The convoy model had certain applicability in explanation of the relationship between loneliness and social frailty among older adults in community. The incidence of social frailty among the older adults in the community was high, and loneliness was at a medium level. It is necessary to strengthen the intervention of social frailty and loneliness of the older adults in the community, improve the quality of life of the older adults, and promote the development of healthy aging. [ABSTRACT FROM AUTHOR]

Purpose -- Using a panel of over 433,000 college students from over 600 institutions of higher education in the USA, we investigate students' opinions of leadership skill development during their undergraduate tenure. Design/methodology/approach -- The data used in this analysis come from the Higher Education Research Institute, which runs the Cooperative Institutional Research Program (CIRP) housed at the University of California, Los Angeles. Among others, the CIRP administers two surveys known as The Freshman Survey (TFS) and the College Senior Survey (CSS). Findings -- The present research supports the extant literature and conventional wisdom of academic and student affairs professionals with regards to engagement in leadership classes or training where students have an opportunity to increase their knowledge bases through course content, and when there are opportunities for them to apply leadership principles, the students are more likely to report an increase in leadership capacity upon completion of their collegiate degree. Originality/value -- If colleges and universities are serious about fulfilling their espoused visions, then it is essential that awareness of leadership courses and applied opportunities be heightened and made a strategic priority to ensure resources are allocated in appropriate places to support these key efforts. It also suggests greater collaboration between academic and student affairs, as well as other departments (e.g. athletics and centers), is needed, as well as prioritizing experiential learning. [ABSTRACT FROM AUTHOR]

Objectives: Hemimegalencephaly (HME) is a rare congenital brain malformation presenting predominantly with drug‐resistant epilepsy. Hemispheric disconnective surgery is the mainstay of treatment; however, little is known about how postoperative outcomes compare across techniques. Thus we present the largest single‐center cohort of patients with HME who underwent epilepsy surgery and characterize outcomes. Methods: This observational study included patients with HME at University of California Los Angeles (UCLA) from 1984 to 2021. Patients were stratified by surgical intervention: anatomic hemispherectomy (AH), functional hemispherectomy (FH), or less‐than‐hemispheric resection (LTH). Seizure freedom, functional outcomes, and operative complications were compared across surgical approaches. Regression analysis identified clinical and intraoperative variables that predict seizure outcomes. Results: Of 56 patients, 43 (77%) underwent FH, 8 (14%) underwent AH, 2 (4%) underwent LTH, 1 (2%) underwent unknown hemispherectomy type, and 2 (4%) were managed non‐operatively. At median last follow‐up of 55 months (interquartile range [IQR] 20–92 months), 24 patients (49%) were seizure‐free, 17 (30%) required cerebrospinal fluid (CSF) shunting for hydrocephalus, 9 of 43 (21%) had severe developmental delay, 8 of 38 (21%) were non‐verbal, and 15 of 38 (39%) were non‐ambulatory. There was one (2%) intraoperative mortality due to exsanguination earlier in this cohort. Of 12 patients (29%) requiring revision surgery, 6 (50%) were seizure‐free postoperatively. AH, compared to FH, was not associated with statistically significant improved seizure freedom (hazard ratio [HR] =.48, p =.328), although initial AH trended toward greater odds of seizure freedom (75% vs 46%, p =.272). Younger age at seizure onset (HR =.29, p =.029), lack of epilepsia partialis continua (EPC) (HR =.30, p =.022), and no contralateral seizures on electroencephalography (EEG) (HR =.33, p =.039) independently predicted longer duration of seizure freedom. Significance: This study helps inform physicians and parents of children who are undergoing surgery for HME by demonstrating that earlier age at seizure onset, absence of EPC, and no contralateral EEG seizures were associated with longer postoperative seizure freedom. At our center, initial AH for HME may provide greater odds of seizure freedom with complications and functional outcomes comparable to those of FH. [ABSTRACT FROM AUTHOR]

Background: There is conclusive evidence of a multifaceted and bidirectional relationship between loneliness and depression and anxiety. Nonetheless, more extensive research is needed to examine their relationships at a more granular level. This study employed a network analysis approach to identify the pathological mechanisms underpinning those relationships and to identify important bridge nodes as potential targets for intervention. Methods: 941 University students were included in this study. The ULS-6 (the short-form UCLA Loneliness Scale) was used to assess loneliness, the PHQ-9 (Patient Health questionnaire-9) and GAD-7 (Generalized anxiety disorder 7-item) scales were used to assess the symptoms of depression and anxiety. We constructed two network structures of loneliness-anxiety and loneliness-depression and computed bridge expected influence for each symptom. In addition, we showed a flow network of "Suicide" containing symptoms of depression and loneliness. Results: All edges were positive in both networks constructed and the strongest edges were present within disorder communities. The overall connection between loneliness and depression was stronger compared to anxiety. The results demonstrated that the loneliness item "People are around me but not with me" was identified as bridge symptom in both networks. Furthermore, "Suicide" was directly connected to five symptoms of depression and four items of loneliness, with the strongest connections being between it and "Feeling of worthlessness" and "Psychomotor agitation/retardation". Conclusions: Our findings provide a more nuanced explanation of the link between loneliness and depression and anxiety. The results identified the bridge symptom "People are around me but not with me", which had the strongest effect on enhancing symptoms of depression and anxiety. Clinical improvements based on the findings of this study and the impact of the intervention are discussed. [ABSTRACT FROM AUTHOR]

Purpose: The objective of the study was to qualitatively assess the micro-gap dimensions, connecting fitting surface profile, and bacterial leakage of cast high-gold-alloy UCLA abutments, with or without electrodeposited gold coatings attached to external hexagon implants. Materials and methods: Sixteen plastic UCLAs (PUCLAs) were cast with a high-gold-content alloy. Eight were electrolytically gold plated. Five machined cast-to-UCLA (GUCLA) control abutments were cast with the same alloy. All abutments were attached to external hexagon implants, giving 21 implant-abutment combinations (IACs). External perimeter micro-gaps measured with SEM under shadow eliminating silhouette illumination and 2000× magnification were averaged over three regions. The IACs were examined for E. coli leakage following an initial sterility test. Disassembled combinations were examined with SEM, and surface profiles were qualitatively assessed. Results: External micro-gap measurements did not reflect the variable connecting surface profiles, but average values < 5.0 μm were observed for all IACs measured under the shadow eliminating silhouette illumination for both cast and pre-machined external hexagon abutments with and without Au plating. E. coli transfer was observed in 3 of 5 PUCLA-plated and 2 of 5 PUCLA-non-plated IACs. No transfer occurred in the 3 GUCLA-non-plated or 2 GUCLA-plated control IACs. Abutment connecting surfaces, both Au-plated and not Au-plated, showed plastic deformation (smearing) in variable mosaic patterns across the micro-gap. Conclusions: Micro-gap dimensions < 5μm were obtained with both the high noble metal cast and pre-machined control external hexagon abutments with and without Au electrodeposited on the abutment connecting surface. Regions of intimate contact due to plastic deformation (smearing) of these surfaces were observed. A continuous smeared region around the circumference of the surfaces can provide an effective barrier to the egress of E. coli bacteria from the internal regions of the implant under static loading. The sample size was insufficient to determine if the gold coating resulted in a superior bacterial barrier. [ABSTRACT FROM AUTHOR]

Evidence shows that the Covid-19 pandemic caused increased loneliness, anxiety and greater social isolation due to social distancing policies. Virtual reality (VR) provides users with an easy way to become engaged in social activities without leaving the house. This study focused on adults, who were socialising in Altspace VR, a social VR platform, during the Covid-19 pandemic and it explored whether social VR could alleviate feelings of loneliness and social anxiety. A mixed-methods research design was applied. Participants (n = 74), aged 18–75, completed a questionnaire inside the social VR platform to measure levels of loneliness (UCLA 20-item scale) and social anxiety (17-item SPIN scale) in the social VR platform (online condition) and real world (offline condition). Subsequently, a focus group (n = 9) was conducted to gather insights into how and why participants were using the social VR platform. Findings from the questionnaire revealed significantly lower levels of loneliness and social anxiety when in the social VR platform. Lower levels of loneliness and social anxiety were also associated with participants who socialised with a regular group of friends. In addition, findings from the focus group suggested that being part of an online group facilitates stronger feelings of belonging. Social VR can be used as a valuable intervention to reduce feelings of loneliness and social anxiety. Future studies should continue to establish whether social VR can help to encourage group formation and provide people with enhanced social opportunities beyond the COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Background: Reverse shoulder arthroplasty (RSA) was initially developed for rotator cuff arthropathy but has been expanded to treat comminuted proximal humerus fractures. Few studies have compared RSA for traumatic and degenerative indications. We present the first report of mid-term outcomes of RSA comparing both indications in an Asian population. Methods: 113 degenerative and 20 fracture patients underwent RSA from 2010 to 2019. Patients with degenerative indications were 4:1 propensity-score matched to fractures and adjusted for age and sex. Patients were assessed for range of motion (ROM), strength, pain, Constant-Murley score (CMS), University of California Los Angeles Shoulder Score (UCLA) and Oxford shoulder score (OSS) preoperatively, at 6-months and 1-year. Patients' satisfaction, expectation fulfilment and minimal clinically important difference (MCID) were analysed. Results: Degenerative patients had better ROM, isometric strength and CMS at 6-months, although at 1-year only abduction was superior (104.8 ± 17.3° vs 86.7 ± 19.8°). No significant differences in pain, UCLA and OSS were observed. Most improvements occurred within 6 months. Similar proportions of patients were satisfied (83.3% vs 73.3%, p = 0.460) and attained MCID (85.0% vs 86.7%, p = 1.000) at 1-year. Discussion: Although initially exhibiting slower recovery, patients with proximal humerus fractures can expect similar functional recovery and satisfaction at 1-year compared to those who received RSA for degenerative indications. [ABSTRACT FROM AUTHOR]

Introduction: Massive rotator cuff tears (MRCTs) have long posed a complex problem for both patients and surgeons. If not treated promptly, tendon retraction, fatty infiltration and muscle atrophy of the rotator cuff muscles occur. These lead to irreparable RCTs with poor functional outcomes. We describe our technique of superior capsular reconstruction (SCR) augmented with partial cuff repair and report on our short term outcomes Method: Seven consecutive patients who underwent the procedure were recruited at our institution from January 2019 to December 2019. Medical records of these patients were reviewed looking at pre-operative symptoms and examination findings, imaging studies, intra-operative findings, the surgical technique employed, post-operative progress in terms of pain, affected shoulder range of movement and outcome scores. Results: All patients showed complete tears of at least two tendons and were deemed irreparable intra-operatively. All patients exhibited Goutalier grade 2–4 wasting of the affected tendons on MRI and Patte grade 3 intra-operatively. At 12 months, the mean improvement shown in Constant score is 12.1 points, in University of California Los Angeles (UCLA) score is 9.4 points and in Oxford Shoulder Score is 17 points. Active forward flexion improved in all patients with a mean improvement of 40 degrees. Numerical Pain Rating Scale improved in all patients with a mean of 5.1 points. Conclusion: Our case series shows good short-term outcomes can be achieved with SCR augmented with partial cuff repair. Notably, our SCR results showed encouraging results even for challenging revision rotator cuff repairs. [ABSTRACT FROM AUTHOR]

This is the story of six books looted by Nazis from the Jewish Religious Community Library in Prague (JRCLP) that were discovered recently in the University of California Los Angeles (UCLA) Library. No scholarly literature describing similar experiences of North American academic libraries was found, nor were any professional guidelines for repatriating library materials. We describe our repatriation process, explore the historical contexts of the Nazi confiscation of millions of books and describe the Allies’ post-war restitution efforts. As the digitization of academic library holdings worldwide progresses, the probability of uncovering more material of questionable provenance increases. This case study can open a dialog on the issue. [ABSTRACT FROM AUTHOR]

Clinical outcome data for the novel minced cartilage procedure are sparse. While good results have been shown for the knee joint, this is the first report in the current literature regarding this increasingly important procedure in the glenohumeral joint.Case Description: A 33-year-old handyman with a cartilage defect in the humeral head underwent an all arthroscopic one-stage cartilage repair with the AutoCartTM procedure (Arthrex GmbH, Munich, Germany). A senior specialist examined the patient before surgery, five-, 12-and 24-weeks post-surgery. Outcome parameters (Constant-Murley Score, UCLA Shoulder Score and ASES Score) and radiographic imaging were recorded.Results: At six months, follow-up the outcome parameter showed excellent results, the joint pain decreased to numeric rating scale (NRS) 0. The postoperative magnetic resonance imaging (MRI) revealed a thin cartilage layer in the treated area with sufficient integration to the surrounding tissue. The cartilage in the former defect zone presented a homogeneous signal, which was comparable to the intact cartilage.Conclusion: This case report underlines the growing interest in single-stage arthroscopic minced cartilage procedures and shows promising results in the glenohumeral joint. Yet, larger investigations with long-term follow-up are necessary to provide reliable clinical data to determine if comparable results can be achieved over time. [ABSTRACT FROM AUTHOR]

Aim/Goal/Purpose: Population surveys underrepresent people with severe mental ill health. This paper aims to use multiple regression analyses to explore perceived social support, loneliness and factor associations from self-report survey data collected during the Covid-19 pandemic in a sample of individuals with severe mental ill health. Design/Methodology/Approach: We sampled an already existing cohort of people with severe mental ill health. Researchers contacted participants by phone or by post to invite them to take part in a survey about how the pandemic restrictions had impacted health, Covid-19 experiences, perceived social support, employment and loneliness. Loneliness was measured by the three item UCLA loneliness scale. Findings: In the pandemic sub-cohort, 367 adults with a severe mental ill health diagnosis completed a remote survey. 29–34% of participants reported being lonely. Loneliness was associated with being younger in age (adjusted OR = -.98, p =.02), living alone (adjusted OR = 2.04, p =.01), high levels of social and economic deprivation (adjusted OR = 2.49, p =.04), and lower perceived social support (B = -5.86, p <.001). Living alone was associated with lower perceived social support. Being lonely was associated with a self-reported deterioration in mental health during the pandemic (adjusted OR = 3.46, 95%CI 2.03–5.91). Practical implications: Intervention strategies to tackle loneliness in the severe mental ill health population are needed. Further research is needed to follow-up the severe mental ill health population after pandemic restrictions are lifted to understand perceived social support and loneliness trends. Originality: Loneliness was a substantial problem for the severe mental ill health population before the Covid-19 pandemic but there is limited evidence to understand perceived social support and loneliness trends during the pandemic. [ABSTRACT FROM AUTHOR]

Numerous students suffer from academic procrastination; it is a common problem and phenomenon in academic settings. Many previous researchers have analyzed its relationships with other factors, such as self-regulation and academic success. This paper aims to provide a full outline of academic procrastination and explore the current hot spots and trends. Bibliometrix and VOSviewer were used to conduct quantitative analysis. The data was collected from the Web of Science core collection database, which contains 1,240 articles from the years 1938 to 2021. The analysis shows that the publication of articles on academic procrastination has been rapidly increasing since 1993. In terms of the most influential countries and institutions, the United states took a prominent lead among all countries, and the most productive institutions in this area were the University of Washington and University of California, Los Angeles. By analyzing the authors, we see that most authors like working with a few collaborators, leading to main groups of authors, such as Murat Balkis and June J. Pilcher. The most frequently cited author was Esther D. Rothblum. Based on the co-citation journals network, Personality and Individual Differences was the prolific and influential journal referring to the number of citations and articles it received. The VOSviewer tool identified the hot spots of academic procrastination, which were mainly distributed as follows: (a) procrastination, (b) academic procrastination, (c) self-regulation, (d) academic performance, and (e) motivation. Therefore, this paper is helpful for scholars and practitioners to know the trend of academic procrastination research comprehensively. [ABSTRACT FROM AUTHOR]

Background: Quality indicators are crucial in evaluating and comparing the quality of healthcare services. In the case of congenital heart disease, transition programmes for adolescents have been recommended to ensure uninterrupted healthcare and lifelong care. It is necessary to establish quality indicators in order to facilitate the evaluation of programme quality and to allow comparison between different centres. The objective of this study is therefore to develop a set of quality indicators for the transition of adolescents with congenital heart disease. Methods: The RAND/UCLA appropriateness method was employed in a four-step process to develop a set of quality indicators. First, a literature search was conducted on the dimensions of transitional care, based on which a preliminary set of quality indicators was developed. Second, experts were contacted, and an expert panel was established. Third, the panel members were asked to rate the appropriateness of the quality indicators in a two-round process. Finally, in the fourth step, we evaluated the data by measuring the median and Disagreement Index. Results: The expert panel consisted of 16 members, congenital cardiologists, nurses, transition experts, patients and research experts. The preliminary set of quality indicators comprised 16 items, categorized in process and structure criteria. Based on the panel's feedback, the set was refined to 12 quality indicators, which were rated as relevant and feasible. Conclusions: This study represents the first attempt to develop quality indicators for transitional care services for adolescents with congenital heart disease. The set of 12 quality indicators was developed based on existing evidence and expert opinion. Further testing is needed to assess the feasibility of these quality indicators in daily practice. If successfully implemented, these quality indicators could allow comparison and facilitate benchmarking of transitional care services for adolescents with congenital heart disease. [ABSTRACT FROM AUTHOR]

Background: Social isolation and loneliness can be detrimental to the overall functioning of the older adults. The study examines the impact of social isolation and loneliness on the psychological well-being of older adults residing in various old-age homes in India and investigates the mediating role of gender, marital status, and education level in the way social isolation and loneliness affect psychological well-being. Methods: Data has been collected from 320 individuals aged sixty years or above. Data were collected using standardized measures like Lubben Social Network Scale- 6, revised UCLA Loneliness Scale, and shortened version of psychological well-being scale by Ryff & Keyes (1995). Multivariate and mediation analysis were performed to understand the associations of social isolation and loneliness with psychological well-being. Results: A statistically significant MANOVA effect was obtained for social isolation (F = 3.836, p <.01), and loneliness (F = 3.782, p <.01). Gender and education as independent factors were significantly associated with the psychological well-being of individuals. However, both gender and education did not mediate the impact of social isolation and loneliness on the psychological well-being of older adults. Further, marital status had a partial mediating effect on the relationship between social isolation, loneliness, and psychological well-being. Conclusions: The findings of the study can be incorporated into measures aiming at alleviation of feelings of social isolation and loneliness among the elderly. Further, the findings can be used to design various intervention strategies aimed at the reduction of social isolation and loneliness among older adults and the restoration of their psychological well-being. [ABSTRACT FROM AUTHOR]

The goal of a Consensus in clinical practice is to provide daily practitioners with evidence- based recommendations on data from the literature, clinical expertise and expectations of professionals and patients. In this context, a consensus aligns with the principles of evidence-based medicine in clinical practice and is consequently regarded as a scientific work of a certain level of evidence (LOE). It is expected that such a project may contribute to filling the gap observed between scientific evidence and reality of the daily practice. A Clinical Consensus is particularly needed for those topics that are of interest to daily practice but controversial due to lack of evidence, and for which expert agreement can provide valuable support in reaching conclusions. A Consensus requires a strict methodology, based on two principles: an iterative process with independence of the involved groups and pluralism (geographical and professional representation). These processes guarantee the scientific quality of the recommendations. Among the various consensus modalities, ESSKA has adopted the Formal Consensus derived from the Delphi method, and the RAND/UCLA appropriateness method. These two methods are complementary. The first one, based on questions-answers sets, is particularly suitable for questions of terminology, diagnosis, planning, strategy. The second one is based on the concept of scenarios, particularly adapted to treatment indications. These two methods can also be used within the same consensus. The aim of this article is to define what is a consensus initiative, to detail the methodology ESSKA has chosen, and to point out the key role of the dissemination. [ABSTRACT FROM AUTHOR]