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For anthropologists, meat eating by primates like chimpanzees (Pan troglodytes) warrants examination given the emphasis on hunting in human evolutionary history. As referential models, apes provide insight into the evolution of hominin hunting, given their phylogenetic relatedness and challenges reconstructing extinct hominin behaviour from palaeoanthropological evidence. Among chimpanzees, adult males are usually the main hunters, capturing vertebrate prey by hand. Savannah chimpanzees (P. t. verus) at Fongoli, Sénégal are the only known non-human population that systematically hunts vertebrate prey with tools, making them an important source for hypotheses of early hominin behaviour based on analogy. Here, we test the hypothesis that sex and age patterns in tool-assisted hunting (n=308 cases) at Fongoli occur and differ from chimpanzees elsewhere, and we compare tool-assisted hunting to the overall hunting pattern. Males accounted for 70% of all captures but hunted with tools less than expected based on their representation on hunting days. Females accounted for most tool-assisted hunting. We propose that social tolerance at Fongoli, along with the tool-assisted hunting method, permits individuals other than adult males to capture and retain control of prey, which is uncommon for chimpanzees. We assert that tool-assisted hunting could have similarly been important for early hominins.

IntroductionThe COVID-19 pandemic prompted a surge in digital public health surveillance worldwide, with limited opportunities to consider the effectiveness or impact of digital surveillance. The news media shape public understanding of topics of importance, contributing to our perception of priority issues. This study investigated news media reports published during the first year of the pandemic to understand how the use and consequences of digital surveillance technologies were reported on.MethodsA media content analysis of 34 high- to low-income countries was completed. The terms “COVID-19,” “surveillance,” “technologies,” and “public health” were used to retrieve and inductively code media reports.ResultsOf the 1,001 reports, most were web-based or newspaper sources on the development and deployment of technologies directed at contact tracing, enforcing quarantine, predicting disease spread, and allocating resources. Technology types included mobile apps, wearable devices, “smart” thermometers, GPS/Bluetooth, facial recognition, and security cameras. Repurposed data from social media, travel cards/passports, and consumer purchases also provided surveillance insight. Media reports focused on factors impacting surveillance success (public participation and data validity) and the emerging consequences of digital surveillance on human rights, function creep, data security, and trust.DiscussionDiverse digital technologies were developed and used for public health surveillance during the first year of the COVID-19 pandemic. The use of these technologies and witnessed or anticipated consequences were reported by a variety of media sources worldwide. The news media are an important public health information resource, as media outlets contribute to directing public understanding and shaping priority public health surveillance issues. Our findings raise important questions around how journalists decide which aspects of public health crises to report on and how these issues are discussed.

Throughout the COVID-19 pandemic, a variety of digital technologies have been leveraged for public health surveillance worldwide. However, concerns remain around the rapid development and deployment of digital technologies, how these technologies have been used, and their efficacy in supporting public health goals. Following the five-stage scoping review framework, we conducted a scoping review of the peer-reviewed and grey literature to identify the types and nature of digital technologies used for surveillance during the COVID-19 pandemic and the success of these measures. We conducted a search of the peer-reviewed and grey literature published between 1 December 2019 and 31 December 2020 to provide a snapshot of questions, concerns, discussions, and findings emerging at this pivotal time. A total of 147 peer-reviewed and 79 grey literature publications reporting on digital technology use for surveillance across 90 countries and regions were retained for analysis. The most frequently used technologies included mobile phone devices and applications, location tracking technologies, drones, temperature scanning technologies, and wearable devices. The utility of digital technologies for public health surveillance was impacted by factors including uptake of digital technologies across targeted populations, technological capacity and errors, scope, validity and accuracy of data, guiding legal frameworks, and infrastructure to support technology use. Our findings raise important questions around the value of digital surveillance for public health and how to ensure successful use of technologies while mitigating potential harms not only in the context of the COVID-19 pandemic, but also during other infectious disease outbreaks, epidemics, and pandemics.

Attention to childhood trauma and the need for trauma-informed care has contributed to the emerging discourse in schools related to teaching practices, school climate, and the delivery of trauma-related in-service and preservice teacher education. However, though trauma-informed systems of care include schools, empirical work informing trauma-informed teaching and teacher education that is reflected back to those audiences is less established. This interdisciplinary overview and synthesis of literature examined interventions used in schools to determine the dominant framework used for promoting and practicing trauma-informed care in schools and the effectiveness of school-based supports for trauma-affected youth to identify implications for changing teaching practice. While multiple disciplines conduct research using different methodologies examining trauma-informed practices in schools, educators are underexamined in this work. Additionally, education researchers began engaging in research on trauma-informed practices in schools more recently, and as such, research emanating from education researchers comprises a small portion of this review. Drawing across the work, we offer recommendations for a more robust, interdisciplinary research agenda with the intentional purpose to change teacher practice.

In order to explore early childhood educators' cultural competence through a lens of racial identity development theory, a case study was conducted with four White Kindergarten teachers. Participants were surveyed and interviewed to understand their racial identity development as well as perspectives of teaching culturally diverse early childhood students. Findings suggest that representative characteristics of racial identities are evident among White early childhood educators, and that these characteristics influence their conceptualizations of teaching and understanding culturally diverse young students. Thus, authors recommend that racial identity development be considered as a crucial element of teacher professional developments in order to enhance their cultural competence. (Contains 1 table.)

Introduction Infectious diseases pose a risk to public health, requiring efficient strategies for disease prevention. Digital health surveillance technologies provide new opportunities to enhance disease prevention, detection, tracking, reporting and analysis. However, in addition to concerns regarding the effectiveness of these technologies in meeting public health goals, there are also concerns regarding the ethics, legality, safety and sustainability of digital surveillance technologies. This scoping review examines the literature on digital surveillance for public health purposes during the COVID-19 pandemic to identify health-related applications of digital surveillance technologies, and to highlight discussions of the implications of these technologies.Methods and analysis The scoping review will be guided by the framework proposed by Arksey and O’Malley and the guidelines outlined by Colquhoun et al and Levac et al. We will search Medline (Ovid), PsycInfo, PubMed, Scopus, CINAHL (EBSCOhost), ACM Digital Library, Google Scholar and IEEE Explore for relevant studies published between December 2019 and December 2020. The review will also include grey literature. Data will be managed and analysed through an extraction table and thematic analysis.Ethics and dissemination Findings will be disseminated through traditional academic channels, as well as social media channels and research briefs and infographics. We will target our dissemination to provincial and federal public health organisations, as well as technology companies and community-based organisations managing the public response to the COVID-19 pandemic.

As a result of rapid demographic changes in our society, more children from diverse racial/cultural backgrounds join our early childhood classrooms. The majority of early childhood teachers, on the other hand, are middle-class and of European-decent. This paper provides early childhood teachers with both theoretical and practical understandings about multicultural responsiveness, in order to understand and promote social competence of young children from diverse backgrounds. To accomplish this end, readers will be guided to consider actual classroom based examples and questions throughout the paper. First, the concept of social competence will be revisited from sociocultural perspectives. Next, we discuss advocacy for social competence of diverse children through the main themes of multicultural awareness, knowledge, and skills. Finally, we recommend several strategies to support teachers' professional growth and development for multicultural responsiveness.

This essay examines the Inclusive Teaching Circle (ITC) as a mechanism for faculty development in creating instructional tools that embrace an inclusive pedagogy reflecting diversity, cultural competence and social justice. We describe one group's year-long participation in an ITC at a large, metropolitan research university in the south. Next, we share several members' strategies for promoting more inclusive and equitable learning for students in our classrooms. Finally, we consider the implications of ITCs for its group participants and the professorate at large. [ABSTRACT FROM AUTHOR]

The article discusses the components that influence the responsive teaching strategies of social studies teachers. These elements determine the instructional decisions, standards, and cultural responsiveness used in instructional planning. They encourage students to examine critically the educational content and understand their cultures. Teachers emphasize the academic, social and cultural success including multicultural subject matter which is important for the students to become effective and active citizens.

To investigate the use of a novel surface coil for clinically utilized magnetic resonance imaging (MRI) scanners, in order to describe the microanatomic basis for hand osteoarthritis (OA) at all stages of disease.MRI of proximal or distal interphalangeal joints was performed in 58 subjects: 16 patients with early OA (symptom duration ≤12 months), 14 patients with chronic OA, 10 patients with clinically normal asymptomatic joints adjacent to arthritic joints, and 18 normal controls. High‐resolution images were obtained with displayed pixel dimensions of 80–100 μm using a 1.5T scanner and a 23‐mm–diameter surface coil. All joint structures were evaluated.The high‐resolution images of every joint structure showed comparable abnormalities in both early and chronic OA, including cartilage loss, bone edema, synovial enhancement, osteophytosis, and erosions. Heberden's and Bouchard's node formation occurred at regions where soft tissue bulged through the capsule between the dorsal tendons and collateral ligaments (CLs). Prominent CL thickening or disruption (100% of OA patients) was evident even in joints where cartilage was partially preserved. Clinically normal joints adjacent to OA hand joints showed thickening and enhancement of CLs which was the most common abnormality seen (80% of OA patients). Older normal subjects showed subtle changes within the CLs. Obtaining high‐resolution MR images from clinically utilized scanners represents a novel way for exploring the microanatomic basis of hand arthritis and may have considerable potential in the clinical setting. In the present evaluation in nodal OA, previously unappreciated CL abnormalities were especially common. [ABSTRACT FROM AUTHOR]

The U.S. is the last Western industrialized nation to execute criminals. While many societies are abolishing this practice, 3 in 4 American people continue to favor the death penalty. Studies have revealed that those favoring the death penalty often remain so when shown evidence that it discriminates against minorities and the poor; costs at least twice the price of keeping a convicted felon in prison for life; has no deterrent effect against murder; and that 25 innocent people have been executed in this century alone, indicating that more were simply not discovered. The resurgence of evangelical and fundamentalist Christianity in the last two decades is often viewed as a concomitant phenomenon with the rise of the Republican party. The reinstatement of the death penalty in 1976 may be related to these phenomena as a specific legislative consequence. Of particular interest and alarm are findings of significant increase in public support of the death penalty the highest. Thus ever been in the past fifty years. Conservatism in a broad sense implies an adherence to standing policy, a resistance to social and political change. Overwhelming evidence indicates the majority of death penalty advocates readily admit that information which contradicts the value and integrity of capital punishment will not and does not lessen the strength of their support.

This article describes the development and operation of a secondary prevention program designed to reduce recidivism in a rural community. Rural communities present unique aspects such as geographic isolation, cultural values divergent from those of urban society, and limited professional resources that impact upon consultation and program development and that must be considered if implemented programs are to be utilized. Parameters of work in rural areas are described and discussed. Fifty-five first offender participants in a community program that was developed through consultation to a rural juvenile court are compared with 177 cohort control subjects who appeared before the court prior to implementation of the program. Program participants had a recidivism rate one-fourth that of the cohort. Results are attributed to change in the court's approach to its task of dealing with juvenile delinquency in the community. [ABSTRACT FROM AUTHOR]

Nuclear masses and binding energies are some of the first nuclear properties met in high school physics, and can be used to introduce radioactive decays, fusion, and fission. With relatively little extension, they can also illustrate fundamental concepts in nuclear physics, such as shell structure and pairing, and to discuss how the elements around us were formed in stars. One way of visualising these nuclear properties is through the nuclide chart, which maps all nuclides as a function of their proton and neutron numbers. Here we use the nuclide chart to illustrate various aspects of nuclear physics, and present 3D visualisations of it produced as part of the binding blocks project. [ABSTRACT FROM AUTHOR]

We investigated the structure of the low density regions of the inner crust of neutron stars using the Hartree–Fock–Bogoliubov (HFB) model to predict the proton content Z of the nuclear clusters and, together with the lattice spacing, the proton content of the crust as a function of the total baryonic density . The exploration of the energy surface in the configuration space and the search for the local minima require thousands of calculations. Each of them implies a HFB calculation in a box with a large number of particles, thus making the whole process very demanding. In this work, we apply a statistical model called Gaussian process emulator that makes the exploration of the energy surface ten times faster. We also present a novel treatment of the HFB equations that leads to an uncertainty on the total energy of per particle. Such a high precision is necessary to distinguish neighbour configurations around the energy minima. [ABSTRACT FROM AUTHOR]

We present a new teaching and outreach activity based around the construction of a three-dimensional chart of isotopes using bricks5. The activity, binding blocks, demonstrates nuclear and astrophysical processes through a seven-meter chart of all nuclear isotopes, built from over 26 000 bricks. It integrates A-Level and GCSE curricula across areas of nuclear physics, astrophysics, and chemistry, including: nuclear decays (through the colours in the chart); nuclear binding energy (through tower heights); production of chemical elements in the cosmos; fusion processes in stars and fusion energy on Earth; as well as links to medical physics, particularly diagnostics and radiotherapy. [ABSTRACT FROM AUTHOR]

Provides a guide on understanding the signs of intracranial pressure. Ways of using the guide; Levels of consciousness; Changes in the motor and sensory functions of the extremities; Changes in the pupils and vital signs of the patient.

During a soil zoological expedition to São Tomé and Príncipe in 2010 by the California Academy of Sciences, millipedes of the genus Globanus were collected. Samples of G. marginescaber (Karsch, 1884) and G. integer (Karsch, 1884) were recovered in addition to those containing a new species. Globanus drewesi sp. nov. is described and additional records, illustrations, and descriptive notes are given for the other two species. A key to all three species of the genus is provided, and a distribution map is presented. The monotypic genus Lobogonus Demange, 1971, which includes L. trilobatus Demange, 1971, from Sierra Leone, mainland western Africa, is revalidated and removed from synonymy under Globanus. Lobogonus is illustrated from a type specimen.

A number of theoretical approaches suggest that gender inequity may give rise to health risks for men. This study undertook a multilevel analysis to ascertain if state-level measures of gender inequity are predictors of men's mortality in the United States. Data for the analysis were taken primarily from the National Longitudinal Mortality Study, which is based on a random sample of the non-institutionalised population. The full data set included 174,703 individuals nested within 50 states and had a six-year follow-up for mortality. Gender inequity was measured by nine variables: higher education, reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and per capita gross domestic product. The results of logistic multilevel modelling showed a number of measures of state-level gender inequity were significantly associated with men's mortality. In all of these cases greater gender inequity was associated with an increased mortality risk. In fully adjusted models for all-age adult men the elected office (OR 1.05 95% CI 1.01–1.09), business ownership (OR 1.04 95% CI 1.01–1.08), earnings (OR 1.04 95% CI 1.01–1.08) and relative poverty (OR 1.07 95% CI 1.03–1.10) measures all showed statistically significant effects for each 1 standard deviation increase in the gender inequity z-score. Similar effects were seen for working-age men. In older men (65+ years) only the earnings and relative poverty measures were statistically significant. This study provides evidence that gender inequity may increase men's health risks. The effect sizes while small are large enough across the range of gender inequity identified to have important population health implications.

Theoretical approaches suggest that gender inequity increases men's health risks. Previous findings from the United States support this contention, however only a small number of health outcomes have been explored. This study extends the range of health outcomes examined by using a cross-sectional, multilevel analysis to investigate whether measures of state-level gender inequity are predictors of men's self-rated health. Data were derived primarily from the Behavioral Risk Factor Surveillance System and the full-case data set included 116,594 individuals nested within 50 states. Gender inequity was measured with nine variables: higher education, women's reproductive rights, abortion provider access, elected office, management, business ownership, labour force participation, earnings and relative poverty. Covariates at the individual level were age, income, education, race/ethnicity, marital status and employment status. Covariates at the state level were income inequality and gross domestic product per capita. In fully adjusted models for all-age men the reproductive rights (OR 1.06 95% CI 1.01-1.11), abortion provider access (OR 1.11 95% CI 1.05-1.16) and earnings (OR 1.06 95% CI 1.02-1.12) measures all predicted an increased risk of men reporting poorer self-rated health for each 1 standard deviation increase in the gender inequity z-score. The most consistent effect was seen for the 65+ age group where the reproductive rights (OR 1.09 95% CI 1.03-1.16), abortion provider access (OR 1.15 95% CI 1.09-1.21), elected office (OR 1.06 95% CI 1.01-1.11) and earnings (OR 1.10 95% CI 1.04-1.16) measures all showed a significant effect. These findings provide evidence that some aspects of gender inequity increase the risk of poorer self-rated health in men. The study contributes to a growing body of literature implicating gender inequity in men's health patterns.

Abstract Objective: To assess the uptake of Medicare Benefit payments for non‐directive pregnancy support counselling which commenced in November 2006. Methods: Counts of services for pregnancy counselling from 1 July 2007 to 30 June 2012, where a Medicare rebate was paid, were used to calculate age‐, state‐ and provider‐specific rates per 100,000 women aged 15–44 years, and rates per 100,000 births for each study year. Results: Rates of Medicare rebates for pregnancy counselling were low, with a mean of 90.6 services per 100,000 women recorded over the study period. GP services were accessed most frequently, while services provided by allied health professionals averaged less than 5% of those for GPs. The overall rate of services fell in all jurisdictions except Victoria/Tasmania, although services provided by allied health professionals remained steady or rose in all jurisdictions over the study period. Conclusions: There has been a low uptake of pregnancy counselling covered by the Medicare Benefits Item numbers introduced in 2006, especially for services provided by allied health professionals. Due to a lack of available data, the impact on abortion rates is unknown. Implications: Provision of Medicare rebates for pregnancy counselling does not appear to be an effective way of assisting women with unintended pregnancies.

Abstract Objectives: To determine the proportion of women who have pregnancy terminations as private patients in Victoria who do not intend to claim a procedure fee rebate from Medicare, to compare characteristics of women who intend to submit a Medicare claim with those who do not and to compare the findings to the results from a similar study conducted in NSW in 1992. Design, setting and participants: This was a cross‐sectional observational study over a 12‐week period. Women having a pregnancy termination service in eight large Victorian private clinics were invited to complete a brief written questionnaire. Outcome measurer: The proportion of women who did not have a Medicare card or who had a Medicare card but did not intend to use it to claim from Medicare. Results: Of the 1,329 women who responded, 13.1% either did not have a Medicare card or did not intend to use their card to claim a Medicare rebate. A further 20.7% of respondents were not sure about whether they would submit a claim. Women who intended to claim a Medicare rebate were different from women who did not according to age, language spoken at home, residency, citizenship and distance travelled to the service. These results are very similar to the findings from the 1992 NSW study. Conclusion: Between 13.1% and 33.8% of private Victorian pregnancy terminations were estimated to not be recorded at the Health Insurance Commission. Health Insurance Commission records of Medicare rebate claims for pregnancy terminations are an incomplete and somewhat biased record of the services that are provided and are likely to have been so for some time.

The decades-long one-child policy in China has led to a growing number of older individuals with only one child. The Elderly Family Planning Subsidy (EFPS) policy was introduced to provide extra financial support to this group and was expanded nationwide in 2012. This study investigated the relationship between EFPS use and health among EFPS-eligible older Chinese using data from the China Health and Retirement Longitudinal Study. A total of 1,981 respondents were eligible for EFPS (i.e. aged 60 and above, had only one child, or were rural residents with two daughters). Respondents self-reported if they received EFPS in 2011, 2013, and 2015 and were followed up to 2018. Propensity score matching was used to match EFPS non-users with users based on their probability of using EFPS. Among the EFPS-eligible respondents, 256 (12.92%) used the benefit. Analysis revealed no significant differences between EFPS users and non-users with respect to mortality and other health outcomes (i.e. self-reported health, cognition, activities of daily living, chronic diseases, and depressive symptoms). Findings do not provide evidence that EFPS improved the short-term health of older Chinese with only one child.

Housing insecurity has been shown to be associated with worse mental health. However, previous studies mostly examined one aspect of housing insecurity (e.g., affordability), and few focused on older adults. This study examined the relationship between perceived housing problems and depressive symptoms among middle-aged and older Americans. Data from the Health and Retirement Study between 2006 and 2018 were used. A total of 7,119 respondents (aged 50+ at baseline in 2006) were followed up every 4 years. Respondents self-reported the status, severity, and duration of their housing problems. Depressive symptoms were assessed by the Center for Epidemiological Studies-Depression Scale. Mixed-effect models examined the association between perceived housing problems and depressive symptoms. Results show about 5%-7% of respondents had housing problems during every study visit and 5.73% of them experienced persistent housing problems over 12 years. Having housing problems was associated with a higher risk of depressive symptoms (incidence risk ratio = 1.29, 95% CI = 1.23, 1.36). A dose-response relationship was observed in the severity and duration of housing problems, with a greater increase of depressive symptoms risk among those experiencing more severe or prolonged housing problems. The dose-response pattern highlighted the importance of early intervention and persistent assistance to those experiencing housing problems.

Background: Previous research has examined how fruit and vegetable consumption may affect cognitive impairment among older adults. However, knowledge regarding the behavioral change in fruit and vegetable consumption remains limited in the Chinese older adult population. This research aimed to fill the literature gap., Methods: We used data from five waves of the Chinese Longitudinal Healthy Longevity Study (2005-2018, observations = 18,856 from 11,388 participants) and selected older adult participants (65 years old or above). A behavioral change was defined as a consumption change in the study sample. Cognitive impairment was measured based on the mini-mental state examination. We used the Cox multi-state model as the major statistical analysis., Results: Chinese older adults who transitioned from non-daily to daily consumption of vegetables had lower odds of reporting cognitive impairment deteriorating from normal cognitive function to severe, compared with those who did not change their consumption behavior (HR [hazard ratio] = 0.88, 95% CI 0.80, 0.97; p < 0.05). All transitions in fruit consumption were negatively associated with cognitive changes from normal cognitive function to mild-moderate cognitive impairment. In our additional stratified analysis examining rural-urban disparity, we observed similar significant findings among rural older adults (Vegetable consumption change: HR = 0.83, 95% CI 0.75, 0.93; p < 0.01) but not urban older adults., Conclusion: Behavioral change in consumption of vegetables may affect Chinese older adults' cognitive health. Future interventions should focus on the critical role of behavioral change in vegetable consumption in reducing older adults' cognitive impairment. However, the contradictory findings of fruit consumption warrant further investigation to draw a conclusive claim regarding its benefits for cognitive health., (© 2024. The Author(s), under exclusive licence to European Geriatric Medicine Society.)

The study compared care source typologies for older adults in China and the United States. Data from the 2014 U.S. Health and Retirement Study and the 2013 China Health and Retirement Longitudinal Study were used. The respondents included community-dwelling older adults aged 65 years or older with at least one limitation in activities of daily living (ADLs) or instrumental ADLs (IADLs) ( N China = 2476, N US = 2898). Respondents reported whether they received assistance from spouse, child/grandchild, relatives, others, and formal helpers. Latent class analysis and multinomial logistic regression were applied. Four classes were identified in China and the U.S, separately. In both countries, ADLs and IADLs were strong determinants of care source typologies. Care sources were more diverse and included formal assistance among older Americans. Older Chinese relied largely on their spouses and children/grandchildren for support. Policy efforts are needed to expand formal long-term services and supports, particularly in China., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Purpose: This study examined the relationship between sexual identities and perception of risks associated with illicit drug use among a nationally representative sample of US adults., Methods: We analyzed data from five waves of the National Survey on Drug Use and Health (NSDUH, 2015-2019), with 205,418 adult participants. Six survey questions assessing participants' perceptions of the risks associated with illicit drug use (LSD, heroin, and cocaine) were subjected to principal component analysis. Sex-stratified ordered logistic regressions were used to explore potential disparities in perceptions regarding the risk associated with illicit drug use among sexual minority identifiers., Results: Among male participants, approximately 11.3% and 1.8% of them perceived illicit drug use as moderate and low risks, respectively. About 6.0% of female participants perceived illicit drug use as moderate risk, and 1.1% of female participants perceived it as low risk. The sex-stratified regression models demonstrated that participants who identified as lesbian/gay or bisexual all had higher odds of reporting low perception of illicit drug use risks as compared to their heterosexual counterparts (all p < 0.01)., Conclusions: Illicit drug use prevention strategies should consider risk perception disparities by sexual minority populations., Competing Interests: Declaration of competing interest None., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Objectives: This study examined the long-term impact of spouse caregiving on insomnia symptoms, compared to propensity-score matched non-caregivers., Methods: Health and Retirement Study data between 2006 and 2018 were used. Caregivers ( n  = 403) were respondents (aged 50+) who assisted their heterosexual spouses in performing (instrumental) activities of daily living at baseline. Non-caregivers were matched using a propensity score matching procedure based on baseline characteristics. Insomnia symptoms were measured every 4 years for both groups. Poisson mixed-effect models estimated the association between caregiver status and insomnia symptoms., Results: Compared to matched non-caregivers, caregivers had similar severity of insomnia symptoms at baseline ( β caregiver  = 0.018, 95% CI = -0.089, 0.124) and reported a similar yearly change rate ( β caregiver × time  = -0.008, 95% CI = -0.017, 0.001). No moderation effects of care-recipients' dementia status and social support were significant., Conclusions: In this study sample, there is no evidence that spouse caregivers, specifically those who performed light duties, experience more severe insomnia symptoms than non-caregivers., Clinical Implications: Spouse caregiving, especially in a light-duty capacity, may not be detrimental to the caregivers' sleep health. More data are needed regarding insomnia in spouse caregivers with heavy duties of care to fully assess the health impact of the caregiving experience.

To combat ageism, the National Resource Center on Nutrition and Aging (NRCNA) launched two Ageism Webinars (AWs). The study's aims were to 1) assess the effectiveness of the AWs for increasing participants' perceived familiarity (FAM) and knowledge (KNOW) and producing high behavioral intent to implement recommended action steps and quality among participants, and 2) practice equitable evaluation by ascertaining whether outcomes were fairly achieved by participants regardless of race, age, and education. A convenience sample of mostly educated non-Hispanic females with an average age of 52 years ( n  = 193) completed a retrospective online survey post-webinar. A retrospective Likert scale noted an overall increase in perceived FAM and KNOW ( p  < 0.001). However, these changes were significantly smaller ( p  < 0.05) among those from historically marginalized races and ethnicities. The theory of planned behavior (TPB) items predicted high intention to complete the recommended action step following the webinars. High satisfaction for webinars was reported, with 98.7% wanting to attend future NRCNA training. This study provides evidence of an effective training modality for addressing ageist perspectives, and the demonstrated differences provide insight into how to improve the AWs and the evaluation of future webinars.

Health disparity by race/ethnicity or gender has been well-documented. However, few researchers have examined health outcomes based on the intersection of individuals' race, ethnicity, and gender or investigated various health dimensions. Guided by an intersectionality framework, this study explores racial/ethnic/gender-based differences in trajectories of multiple health outcomes over a ten-year period among American older adults. Longitudinal data from the Health and Retirement Study (2004-2014) were used ( N  = 16,654). Older adults (65+) were stratified into six mutually-exclusive groups based on their race, ethnicity, and gender: Non-Hispanic (NH) White Men, NH White Women, NH Black Men, NH Black Women, Hispanic Men, and Hispanic Women. Growth curve models examined the trajectories of three health measures, including cognitive function, physical function limitations (i.e. activities of daily living and instrumental activities of daily living), and depressive symptoms. NH White men and women reported significantly better outcomes in cognition and physical function trajectories than racial/ethnic minority groups. Women in all racial/ethnic groups had more depressive symptoms but better cognition than men. Hispanic women reported the most depressive symptoms. Hispanic women and NH Black women had the worst physical function limitations. NH Black men/women were the most disadvantaged in cognition. Racial/ethnic/gender-based differences were stable over time in all health trajectories. Study findings highlight the utility of an intersectional framework in understanding how multiple social identities intersect to generate protective and/or risk effects on cognitive, mental, and physical health. Multilevel intervention strategies are warranted to reduce the persistent health inequity gap.

High-quality predicted structures enable structure-based approaches to an expanding number of drug discovery programs. We propose that by utilizing free energy perturbation (FEP), predicted structures can be confidently employed to achieve drug design goals. We use structure-based modeling of hERG inhibition to illustrate this value of FEP., Competing Interests: Declaration of interests The authors declare no competing interests., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: There is limited research exploring the changing clinical practices among healthcare providers (HPs) care for patients with Emergency Department (ED)-initiated Medication for Opioid Use Disorder (MOUD)., Methods: This scoping review followed the methodological framework of Arksey and O'Malley to map relevant evidence and synthesize the findings. We searched PubMed, EMBASE, CINAHL, Web of Science, and Scopus for related studies from inception through October 12, 2022. Following the application of inclusion and exclusion criteria, 16 studies were included. Subsequently, they were charted and analyzed thematically based on ecological systems theory., Results: The main determinants in the four ecological systems were generated as follows: (1) microsystem: willingness and attitude, professional competence, readiness, and preference; (2) mesosystem: ED clinical practices, departmental factors; (3) exosystem: multidisciplinary approaches, discharge planning, and (4) macrosystem: stigma, health insurance, policy. The findings have implications for HPs and researchers, as insufficient adoption, implementation, and retention of MOUD in the ED affect clinical practices., Conclusions: Across the four ecological systems, ED-initiated MOUD is shaped by multifaceted determinants. The microsystem underscores pivotal patient-HP trust dynamics, while the mesosystem emphasizes interdepartmental synergies. Exosystemically, resource allocation and standardized training remain paramount. The macrosystem reveals profound effects of stigma, insurance disparities, and evolving policies on treatment access and efficacy. Addressing these interconnected barriers is crucial for optimizing patient outcomes in the context of MOUD.

Background : Medical marijuana legalization (MML) has been widely implemented in the past decade. However, the debates regarding the consequences of MML persist, especially criminal behaviors. Objectives : We examined the association between MML and criminal behaviors among adults in the United States. The criminal behaviors measured three past-year offenses: whether the adult (1) have sold illegal drugs, (2) have stolen anything worth > $50 USD, or (3) have attacked someone. Methods : Using the 2015-2020 National Survey of Drug Use and Health, we included 214,505 adults in our primary analysis for 2015-2019 and 27,170 adults in 2020 for supplemental analysis (age > = 18). Weighted multivariable logistic regression models were used to examine the association between MML and three criminal behaviors. Results : In our primary analysis, we observed no statistically significant association between MML and the three outcomes of criminal behavior. Nevertheless, our supplemental analysis of the 2020 data showed MML was associated with increasing odds of the three criminal behaviors (have sold illegal drugs: AOR [adjusted odds ratio] = 1.7; have stolen anything worth > $50 USD: AOR = 1.9; have attacked someone: AOR = 1.8; all p  < 0.05). Conclusion: Surveys from 2015 to 2019 did not suggest MML as a risk factor for higher incidence of criminal behaviors. However, 2020 data showed statistically significant association between MML and selected criminal behaviors. Issues related to the COVID-19 pandemic, such as the U.S. economic downturn, could potentially explain this discrepancy. Further research efforts may be warranted.

Finely tuned enzymatic pathways control cellular processes, and their dysregulation can lead to disease. Developing predictive and interpretable models for these pathways is challenging because of the complexity of the pathways and of the cellular and genomic contexts. Here we introduce Elektrum, a deep learning framework that addresses these challenges with data-driven and biophysically interpretable models for determining the kinetics of biochemical systems. First, it uses in vitro kinetic assays to rapidly hypothesize an ensemble of high-quality kinetically interpretable neural networks (KINNs) that predict reaction rates. It then employs a transfer learning step, where the KINNs are inserted as intermediary layers into deeper convolutional neural networks, fine-tuning the predictions for reaction-dependent in vivo outcomes. We apply Elektrum to predict CRISPR-Cas9 off-target editing probabilities and demonstrate that Elektrum achieves improved performance, regularizes neural network architectures and maintains physical interpretability., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)

Objectives: Studies on the interdependence of couples' health behaviors and subsequent cognitive outcomes remain limited. Methods: Longitudinal data from the China Health and Retirement Longitudinal Study (2011-2018) were used ( N = 1869 heterosexual couples). Latent class analysis identified the dyadic pattern of health behaviors in 2011 (i.e., alcohol consumption, smoking, and physical inactivity). Stratified Cox models examined the association of latent classes with risk of developing memory-related disorders in 2013-2018. Results: Three classes were identified: class 1 (21.25%, only husband smoke, and both active), class 2 (47.55%, both inactive, neither drink nor smoke), and class 3 (31.20%, both drink and smoke, and both active). Couples' sedentary lifestyle was associated with an increased risk of memory-related disorders among both husbands and wives. Conclusion: Couples were moderately concordant in their physical activity but weakly in smoking and drinking. Couple-based interventions, especially promoting physical activity, may reduce cognitive aging among middle-aged and older Chinese couples.

This study examines racial and ethnic disparities and prevalence in prescription drug misuse, illicit drug use, and the combination of both behaviors in the United States. Using five waves of the National Survey on Drug Use and Health (NSDUH, 2015-2019; n  = 276,884), a multinomial logistic regression model estimated the outcomes of prescription drug misuse, illicit drug use, and the combination of both behaviors. Participants' age was considered as an interaction effect. Approximately 5.4%, 2.9%, and 2.5% misused prescription drug, used illicit drug, or had both behaviors, respectively. Compared with White participants, Black (AOR = 0.69, 99.9 CI: 0.61, 0.79) and Asian (AOR = 0.60, 99.9% CI: 0.42, 0.87) participants had significantly lower odds of reporting prescription drug misuse. Individuals who were classified as others had higher odds of reporting illicit drug use (AOR = 1.31; 99.9% CI: 1.05, 1.64), compared with White participants. Black (AOR = 0.40, 99.9% CI: 0.29, 0.56) and Hispanic (AOR = 0.71, 99.9% CI: 0.55, 0.91) participants were significantly less likely to have both prescription drug misuse and illicit drug use behaviors. Interaction analysis showed that Black participants between 18 and 49 years old were less likely to participate in prescription drug misuse. However, Black participants who were 50 years of age or above were more likely to engage in illicit drug use and the combination of both prescription drug misuse and illicit drug use (all p  < 0.001). Hispanic adult participants between 18 and 49 years old were more likely to engage in illicit drug use. Successful intervention and cessation programs may consider the cultural and age disparities among different racial and ethnic groups., Competing Interests: Competing interestsThe authors declared no competing interests for this research., (© The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature 2023, Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.)

We aimed to determine if not using residual neuromuscular blockade (RNB) analysis to guide neuromuscular blockade reversal administration in the postsurgical ICU resulted in consequences related to residual weakness. This single-center, prospective study evaluated 104 patients arriving in a postcardiac surgical ICU. After demonstrating spontaneous movement and T > 35.5 °C, all patients underwent RNB evaluation, and neostigmine/glycopyrrolate was then administered. When patients later demonstrated an adequate Rapid Shallow Breathing Index, negative inspiratory force generation, and arterial blood gas values with minimal mechanical ventilatory support, RNB evaluation was repeated in 94 of the 104 patients, and all patients were extubated. Though RNB evaluation was performed, patients were extubated without considering these results. Eleven of one hundred four patients had not achieved a Train-of-Four (TOF) count of four prior to receiving neostigmine. Twenty of ninety-four patients demonstrated a TOF ratio ≤ 90% prior to extubation. Three patients received unplanned postextubation adjunct respiratory support-one for obvious respiratory weakness, one for pain-related splinting compounding baseline disordered breathing but without obvious benefit from BiPAP, and one for a new issue requiring surgery. Residual neuromuscular weakness may have been unrecognized before extubation in 1 of 104 patients administered neostigmine without RNB analysis. ICU-level care may mitigate consequences in such cases.

This cross-sectional study assessed the nutrition and physical activity (PA) needs, practices, and programming preferences of adults ages 40+ years from seven states ( n  = 1,250). Respondents were mostly educated, White, food-secure, adults ages 60+ years. Many were married, suburban-residing, and interested in health programming. By self-report most respondents were "at nutritional risk" (59.3%), in "somewhat good health" (32.3%), and sedentary (49.2%). One-third reported PA intention in the next two months. Desired programs were less than four weeks and under 4 h weekly. Respondents preferred to attend self-directed online lessons (41.2%). Program format preference varied by age ( P  < 0.05). More respondents aged 40-49 years and 70+ years reported a preference for online group sessions compared to those aged 50 to 69 years. Respondents ages 60 to 69 years reported the highest preference for interactive apps. More older respondents (60 years and older) preferred asynchronous online lessons compared to the younger respondents (age 59 years and younger). There were significant program participation interest differences by age, race, and location ( P < 0.05). These results revealed a need and preference for self-directed, online health programming for middle-aged and older adults.

Introduction: Black Americans encounter more barriers in the job market and earn less than White Americans. However, the extent to which racial disparities in employment and poverty histories impact health is not fully understood. This study characterized employment‒poverty histories for Black and White middle-aged adults and examined their association with health., Methods: Respondents born in 1948-1953 and enrolled in the 2004 Health and Retirement Study (N Black =555, N White =2,209) were included. Sequence analysis grouped respondents with similar employment‒poverty trajectories from 2004 to 2016, and confounder-adjusted regression analyses estimated the associations between these trajectories and health in 2018. Analyses were conducted in 2021-2022., Results: More than 23% of Black respondents experienced both employment and poverty fluctuations, including bouts of extreme poverty (<50% of the federal poverty threshold), whereas no trajectory for White respondents included extreme poverty. Adversities in employment‒poverty were associated with worse health. For example, among Black respondents, those who experienced both employment and poverty fluctuations had worse cognition than those employed and not poor (β= -0.55 standardized units, 95% CI= -0.81, -0.30). Similarly, among White respondents, those who experienced employment fluctuations had worse cognition than those employed (β= -0.35, 95% CI= -0.46, -0.24). Notably, the employed and not poor trajectory was associated with worse survival among Black respondents than among White respondents., Conclusions: Employment fluctuations were associated with worse health, especially cognitive function, where the association was stronger among Black Americans who experienced both employment fluctuations and poverty. Findings highlight the importance of enhancing employment stability and of antipoverty programs, especially for Black Americans., (Copyright © 2022 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.)

Virtual reality-delivered psychological therapies have recently been investigated as non-pharmacological management for acute and chronic pain. However, no virtual reality pain therapy software existed that met the needs of cancer patients with neuropathic pain. We created a bespoke virtual reality-delivered pain therapy software programme to help cancer patients manage neuropathic pain incorporating guided visualisation and progressive muscle relaxation techniques, whilst minimising the risk of cybersickness in this vulnerable patient population. This randomised controlled pilot study evaluated the feasibility, acceptability, recruitment rates and risk of cybersickness of this pain therapy software programme. Clinical outcomes including opioid consumption, pain severity, pain interference and global quality of life scores were secondary aims. Of 87 eligible cancer patients with neuropathic pain, 39 were recruited (47%), allocated to either the intervention (20 patients, virtual reality pain therapy software programme) or control (19 patients, viewing virtual reality videos). Four patients withdrew before the 3-month follow-up (all in the control group). Pre-existing dizziness (Spearman ρ 0.37, p = 0.02) and pre-existing nausea (Spearman ρ 0.81, p < 0.001) were significantly associated with risk of cybersickness in both groups. Patients in the intervention group reported less cybersickness, as well as tolerated and completed all therapy sessions. At 1- and 3-month follow-up, there were trends in the intervention group towards reductions in: oral morphine equivalent daily dose opioid consumption (-8 mg and -4 mg; vs. control: 0 mg and +15 mg respectively); modified Brief Pain Inventory pain severity (-0.4, -0.8; vs. control +0.4, -0.3); and pain interference (-0.9, -1.8; vs. control -0.2, -0.3) scores. The global quality of life subscale from the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire-C30 was not significantly changed between groups at 1 and 3 months (intervention: -5, -8; vs. control: +3, +4). This newly created virtual reality-delivered pain therapy software programme was shown to be feasible and acceptable to cancer patients with neuropathic pain. These results will aid the design of a definitive multicentre randomised controlled trial., (© 2023 The Authors. Anaesthesia published by John Wiley & Sons Ltd on behalf of Association of Anaesthetists.)

Objectives: This study examined whether trajectories of depressive symptoms of one spouse are associated with the other spouse's memory., Methods: Longitudinal data from the Health and Retirement Study (2004-2016) were used ( N = 5690 heterosexual couples). Latent-class growth analysis and structural equation models examined the actor and partner effects of depressive symptom trajectories on memory., Results: Four depressive symptom trajectories were identified (i.e., persistently low, increasing, decreasing, and persistently high). Compared to the low trajectory group, the increasing and persistently high trajectories were associated with worse memory for both men and women. While none of the wives' depressive symptom trajectories was significantly associated with husbands' memory ( p > .05), husbands' decreasing trajectory was linked to wives' better memory (β = 0.498, 95% CI = 0.106, 0.890)., Discussion: Older adults with increasing and persistently high depressive symptoms may experience worse memory. Psychosocial interventions targeting depressive symptoms among older men may be beneficial to their spouses' memory.

Objective: Explore the relevant evidence about stress-related cognitive appraisal and coping strategies among registered nurses in the emergency department (EDRNs) coping with the COVID-19 pandemic., Methods: This scoping review followed the methodological framework of Arksey and O'Malley to map relevant evidence and synthesize the findings. We searched PubMed, EMBASE, CINAHL, Web of Science, and Scopus electronic databases for related studies from inception through February 2, 2022. This review further conducted study selection based on the PRISMA flow diagram and applied Lazarus and Folkman's Psychological Stress and Coping Theory to systematically organize, summarize, and report the findings., Findings: Sixteen studies were included for synthesis. Most of the studies showed that the majority of EDRNs were overwhelmed by the COVID-19 pandemic. Depression, triaging distress, physical exhaustion, and intention to leave ED nursing were cited as major threats to their wellness. Additionally, comprehensive training, a modified triage system, a safe workplace, psychological support, promotion of resilience, and accepting responsibility may help EDRNs cope with pandemic-related challenges effectively., Conclusion: The long-lasting pandemic has affected the physical and mental health of EDRNs because they have increased their effort to respond to the outbreak with dynamically adjusted strategies. Future research should address a modified triage system, prolonged psychological issues, emergency healthcare quality, and solutions facing EDRNs during the COVID-19 or related future pandemics., Clinical Relevance: EDRNs have experienced physical and psychological challenges during the pandemic. The ED administrators need to take action to ensure EDRNs' safety in the workplace, an up-to-date triage system, and mental health of frontline nurses to provide high-quality emergency care for combating COVID-19., (© 2022 Sigma Theta Tau International.)

TYK2 is a member of the JAK family of kinases and a key mediator of IL-12, IL-23, and type I interferon signaling. These cytokines have been implicated in the pathogenesis of multiple inflammatory and autoimmune diseases such as psoriasis, rheumatoid arthritis, lupus, and inflammatory bowel diseases. Supported by compelling data from human genetic association studies, TYK2 inhibition is an attractive therapeutic strategy for these diseases. Herein, we report the discovery of a series of highly selective catalytic site TYK2 inhibitors designed using FEP+ and structurally enabled design starting from a virtual screen hit. We highlight the structure-based optimization to identify a lead candidate 30, a potent cellular TYK2 inhibitor with excellent selectivity, pharmacokinetic properties, and in vivo efficacy in a mouse psoriasis model., (Copyright © 2022 Elsevier Ltd. All rights reserved.)