We investigated the dimensional structure of mental health among aging Korean Veterans using latent profile analysis (LPA) on posttraumatic stress disorder symptoms (PTSD), late onset stress symptomology (LOSS), and psychosocial well-being (PWB). The Korean Vietnam War Veterans Study consists of 367 men . LPA identified five classes of mental health as best fitting the data. Most men were in the normal (38%) and moderate distress (31%) groups, while smaller proportions were in the low affect (13%) and severe distress (7%) groups. The resilient group (12%) had low PTSD, medium LOSS, and high PWB, and were highest on optimism, positive appraisals of military service, and social support. Negative and positive aspects of mental health outcomes were on separate dimensions rather than on a single bipolar dimension. Service providers should attempt to both reduce Veterans’ negative psychological symptoms and increase psychosocial well-being. Part of a symposium sponsored by the Aging Veterans: Effects of Military Service across the Life Course Interest Group.


Hackman G The latest guideline suggest adjuvant radiotherapy or observation following prostatectomy with adverse pathological findings , 2. ThisThe authors founded a 74% benefit of BCRFs in the adjuvant group, and the number needed to treat was 4. There were no difference in the overall survival and in cancer-specific survival, with more grade 1 and 2 adverse events in the adjuvant group.The first results of the RADICALS trial (NCT 005541047) recently presented at ESMO Congress 2019 did not show any benefit in BCRFs (secondary endpoint), supporting the use of early salvage radiotherapy.


Bemisia tabaci poses a major threat to cassava production by small holder farmers in part due to their role as a vector of cassava mosaic begomoviruses (CMBs) and cassava brown streak ipomoviruses (CBSIs). In the present study untargeted metabolomics has been used as a tool to assess natural variation, similarities and attempts to identify trait differentiators among an East African cassava diversity panel that displayed tolerance/resistance to the effects of Bemisia tabaci infestation. The metabolome captured, was represented by 1529 unique chemical features per accession. Principal component analysis (PCA) identified a 23% variation across the panel, with geographical origin/adaption the most influential classification factors. Separation based on resistance and susceptible traits to Bemisia tabaci could also be observed within the data and was corroborated by genotyping data. Thus the metabolomics pipeline represented an effective metabotyping approach. Agglomerative Hierarchical Clustering Analysis (HCA) of both the metabolomics and genotyping data was performed and revealed a high level of similarity between accessions. Specific differentiating features/metabolites were identified, including those potentially conferring vigour to whitefly tolerance on a constitutive manner. The implications of using these cassava varieties as parental breeding material and the future potential of incorporating more exotic donor material is discussed.Cassava will have a vital role to play, if food security is to be achieved in Sub-Saharan Africa, especially Central and East Africa. The whitefly  Viral diseases like the cassava mosaic and cassava brown streak diseases (CMD and CBSD) constitute one of the major threats for cassava production in Sub-Saharan Africa (SSA)  of parent ions [M] were also excluded. The final data matrix contained 1530 unique chemical features . In order to reduce redundancy, chemical features corresponding to the isotopic species  and batch corrected contained 149 observations and 1529 variables  and was B. tabaci [To assess the overall biochemical variation of the Eastern African cassava elite varieties, unsupervised PCA was performed on the metabolite composition of leaf extracts. Score plot of components 1 and 2 explained 23% variation of the collection which was comprised of 26 varieties . Three m. tabaci  form a tGenetic similarity was evident when analysis of SNPs was carried out to assess the natural genetic variation of the diversity panel and compared to similarities found at chemical composition level. The Ward AHC dendrogram was constructed using the genetic similarities matrix obtained by running 96 highly informative SNP locus among the complete set of the 5CP collection, which includes 31 East African cassava genotypes . These AThe number of significant chemical features differentiating each sub-group of metabolome derived dendrogram  were calIn order to study whether the natural variation present in the collection can be utilised to define metabotypes representative of WF-R/WF-S phenotype and also to identify potential chemical markers linked to phenotype, a multivariate classification analysis was applied using the LC-MS untargeted data matrix as input.Supervised discriminant analysis like partial least squares (PLS) are often used for these purposes. In the present study an OPLS-DA model was chosen to incorporate both the orthogonal variation which is inherent of the metabolomics mass spectrometry data and the chemical variation of the different classes of phenotypes.Based on the whitefly abundance data available  OPLS-DA p-coumaric acid and caffeic acid and neochlorogenic acid  compared to the variation found in other cassavas’ collections including both African and South American cultivars  where >5orted by . In effeHistorical breeding efforts of African cassava, documented since in the 1930s , 11, 13 The variability introduced by environmental adaptation factors has likely to have an impact in defining the preference of whitefly adults for certain varieties or the symptoms developed under virus infection and therefore hindering/misleading the identification of true-to-type phenotype classes. This hypothesis/concern also arises when the list of potential biomarkers generated from the classification model (ultimately based on observed phenotype) is investigated further. Pair-wise comparison of the WF-R variety Nase 18 (UG4) and the susceptible Sagonja (MAL5) revealed higher similarity between them than comparison between Sagonja (MAL5) and Kalawe (MAL6), despite both Malawian lines being phenotyped as the most susceptible. Varieties UG4 (Nase 18) and MAL5 (Sagonja) presented a significant number of phenotypic biochemical markers displaying a similar pattern of accumulation in both lines.p-coumaric acid malate esters among other unknown features. Malate esters of p-coumaric and caffeic acid were the most influential in the S-plot and present at lower levels in the resistant varieties UG4, TZ3 and TZ6 whilst neochlorogenic acid accumulated in the Tanzanian varieties resistant to whitefly and viral diseases CMD and CBSD Click here for additional data file.S2 Fig(TIF)Click here for additional data file.S3 Figth and 25th quartiles respectively.(A) Table of calculated coefficient of variation (%) within biological replicates per each variety. Columns indicate median values of CV of all variables  and the minimum and maximum CV values of each cassava variety. (B) Violin plot showing within subject coefficient of variation  for each variety. Median values indicated as straight lines and top and bottom dashed lines indicate 75(TIF)Click here for additional data file.S4 FigScore plot of components 1 and 2 displaying all biological replicates of each cassava variety as small symbols and median values as large symbols. Geographical origin is denoted with different colouring: Kenya (KE) as green, Malawi (MAL) as light blue, Mozambique (MOZ) as blue, Tanzania (TZ) as orange and Uganda (UG) as purple; and number of variety indicated as different symbols: (circle) variety 1, (box) variety 2, (triangle) variety 3, (diamond) variety 4, (pentagon) variety 5, (hexagon) variety 6, (4-point star) variety 7 and (5-point star) variety 8.(TIF)Click here for additional data file.S5 Fig(PDF)Click here for additional data file.S1 File(XLSX)Click here for additional data file.S2 File(XLSX)Click here for additional data file.S3 File(PDF)Click here for additional data file.


Family caregivers play an important role in the healthcare of older adults, but their circumstances, needs, and risks are often unknown to medical professionals. Standardizing how caregivers’ needs are assessed in healthcare delivery can help clinicians design care plans that take caregivers’ capabilities into account and provide targeted recommendations for caregiver support. Despite the potential of caregiver assessment, little is known about its use in primary care practice. The present study surveyed a national random sample of 1,000 U.S. primary care clinicians  to characterize current practices, barriers, and facilitators of caregiver assessment. A total of 231 completed responses were received. A minority of respondents (11%) reported that their practice or clinic had a standardized procedure for caregiver assessment; one in ten (10%) reported that they had personally conducted a caregiver assessment using a standardized instrument in the past year. The most common barriers to caregiver assessment were lack of time (65%), inability to have private discussions with caregivers (36%), lack of access to referral options (30%), inadequate reimbursement (30%), and reluctance of caregivers to discuss their needs (30%). The most frequently endorsed facilitators to aid future implementation included better availability of referral options (77%), easier referral mechanisms (67%), co-location of mental health specialists, care managers, or social workers (65%), and training in how to address caregiver issues (61%). Findings are discussed within the context of emerging healthcare policies and practice initiatives designed to promote caregiver assessment in health care settings.


The University of New England College of Osteopathic Medicine (UNECOM) Geriatrics Education Mentor (GEM) Program is in its sixth year. It's a joint project between older community living adults and 2nd year medical students within the Osteopathic Clinical Skills course. The GEM program goal is to foster understanding and importance of the person/patient-provider relationship. Pairs of osteopathic medical students (N=87 +/- 5) were assigned to an older adult GEM (mentor) volunteer (N=87 +/-5) living within a 50 mile radius of UNECOM. Snowball sampling was used to recruit the GEMs; student participation is required. Four (4) home visits were conducted over 9 months with an assigned GEM; each visit included a new assignment. Students observed, summarized, and recorded experiences communicated by the GEM for each cumulative assignment. Data from assignments were “graded” and content analyses of open ended evaluation/summary questions were conducted. This program is UNE IRB approved. Student pairs completed all assignments. Assignments analysis on Blackboard revealed that students developed respect and awareness of life and medical experiences of the GEM; expressed understanding of the GEM’s life experiences and goals for what “matters most”. Relationships with older adults were established while students maintained professionalism and succeeded in competent and confident interactions. Documentation review from the 4 assignments aided in building students’ geriatrics knowledge, attitudes and skills. Pre-clinical medical education tends to be episodic; providing an opportunity to establish longitudinal assignments over the course of the academic year with the same older adult augments relationship skills and learning in geriatrics.


The exposure of male individual to environmental toxicant is regarded as a channel that results in reduced sperm counts and infertility.This study investigated the ameliorative response of Sulforaphane (SFN) on Aluminum trichloride  were divided into four groups (n = 8/each). Group A) received distilled water orally as placebo; Group B) received 100 mg/kgbw AlCl The sperm parameters showed a significant difference within the AlCl The present study revealed the ameliorative response of SFN on AlCl The exposure of male individual to environmental toxicant is regarded as a channel that results in reduced sperm counts and infertility . Aluminum is considered as the most common metallic element detectable in natural waters, animal, and plant tissues (3) leading to a significant upsurge in both gastrointestinal absorption and urinary elimination of aluminum in exposed individuals (4). The affinity of aluminum to other elements stimulates free radical-mediated reproductive cytotoxicity causing impairment of testicular tissues to both humans and animals (5). Aluminum compounds are widely used as by-products for the manufacture of several household cooking utensils andpharmaceutical drugs  (6). Increase in the level of exposure to aluminum-containing products will boost the concentration of this metallic element in different organs thereby causing harmful effects to the well-being of humans (7).In addition, elevated concentrations of Aluminum in human sperm and seminal plasma were observed to decrease sperm viability and motility (8). Testicular Aluminum accumulations cause spermatocyte necrosis and trigger other reproductive toxicity through several mechanisms such as oxidative stress, which ultimately interferes with spermatogenesis and steroidogenesis, bloodtestis barrier, and endocrine disruption (9). The application of nutritional antioxidant supplements has increased over the years to tackle oxidative stress-induced tissue damage since they act as defense regulators and scavengers of reactive oxygen species. Sulforaphane (SFN) is the most active natural products found in crucifers such as broccoli sprout, cabbage, and kale with the potential of lowering the risk of cancer, oxidative stress-induced tissue injury, and age-related diseases (10). SFN possess antiproliferative activities and can effectively halt the initiation and progression of chemically induced tissue damage in animals (11). In addition, SFN has been suggested to have antidiabetic properties for normalizing changes in blood glucose and insulin sensitivity (12-14), and is used in cardiovascular and antihypertensive protection . It has been reported that SFN can promote elimination and detoxification of aflatoxin (17), acetaldehyde (18), methylmercury (19), acrolein (20), benzene, crotonaldehyde (21), and free radicals (22) through the Nrf2-mediated mechanism. Furthermore, some clinical studies have demonstrated the effectiveness of SFN supplements in the prevention and/or improvement of skin erythema (23), autism (24), insulin resistance (13), Helicobacter pylori-infection (25), and liver abnormality (26). SNF also has the ability to cause programmed cell death(apoptosis) and cell cycle arrest linked to their ability to regulate several proteins such as Bcl-2 and Bax family proteins, caspases, p21, cyclins, and cyclin-dependent kinases (27).This study was therefore designed to investigate the ameliorative response of SFN on the histomorphometric and enzymatic antioxidants on Aluminum chloride  were obtained from the animal house, Department of Human Anatomy, Ladoke Akintola University of Technology, Ogbomosho. The rats were collected in an isolated cages in the experimental house of the Department of Human Anatomy, Federal University of Technology, Akure. They were maintained under constant 12 hr light/dark cycle.The rats were divided into four groups (n = 8/each) Group A) represent control and received water as placebo. Group B) were administered  with 100 mg/kgbw AlClAll animals were observed for any behavioral anomalies, illness, and physical anomalies. The experimental procedures were conducted in accordance with the provided recommendations in the “Guide for the Care and Use of Laboratory Animals” prepared by the National Academy of Sciences. The rats were fed with standard rat chow and drinking water was supplied ad libitum. The weight of the animals was recorded at procurement, during acclimatization, at commencement of the experiment, and weekly throughout the experimental period using a CAMRY electronic scale .“After the last administration, the rats were administered intraperitoneal pentobarbital sodium (40 mg/kg) and their abdominal region was opened and the testes of all the animals were immediately removed. The testicular weight of each rat were recorded. The rats were decapitated and blood samples were collected for analysis. The blood samples were centrifuged at 4°C for 10 min at 250“The spermatozoa from the cauda epididymis were obtained by cutting into 2 ml of medium (Hams F10) containing 0.5% bovine serum albumin (29). After 5 min of incubation at 37°C (with 5% COThe level of lipid peroxidation products were estimated in accordance with the method published by Adelakun and co-workers. (31). Nonenzymatic antioxidants such as reduced glutathione (GSH) and catalase (CAT) were estimated as described by Adelakun and co-workers. The SOD activity in the testes was also determined according to the method described by Adelakun and co-workers (31).“The hormonal levels of testosterone (TT), follicule-Stimulating Hormone (FSH), and Leutenizing Hormone (LH) were measured using available immunoassay (ELISA) kits  according to manufacturer's instructions”.“The testes of the rats were harvested and fixed in Bouin's fluid for 24 hr before being transferred to 70% alcohol for dehydration. The tissues passed through 90% and absolute alcohol and xylene for different durations before being transferred into molten paraffin wax for 1 hr each in an oven at 65°C for infiltration. The tissues were embedded and serial sections cut on a rotary microtome set at 5 microns were performed. The tissues were picked up with albumenized slides and allowed to dry on hot plates for 2 min. The slides were dewaxed with xylene and passed through absolute alcohol (two changes), 70% alcohol, 50% alcohol, (in that order), and then in water for 5 min. The slides were then stained with Hematoxylin and Eosin, mounted in DPX, and photomicrographs were taken at a magnification of 100 “Morphometric studies were carried out with modification of Akang and co-workers (32). Briefly, four sections per testis and six microscope fields per section were randomly chosen for analysis. Fields were sampled as images captured on a Leica DM750 bright field microscope (Germany) via LAZ software. Volume densities of testicular ingredients were determined by randomly superimposing a transparent grid comprising 35 test points arranged in a quadratic array. Test points falling on a given testis and its ingredients were summed over all fields from all sections. The total number of points hitting on a given ingredient (lumen (EL), epithelium (EE), interstitium (EI)), divided by the total number of points hitting on the testis sections (ET) multiplied by 100 provided an unbiased estimate of its percentage volume density/volume fraction. The estimation of the volumes of seminiferous tubule EE (seminiferous EE) and EI in the testes was done in accordance with Howard & Reed (33) and Baines and co-workers” (34).“This was carried out according to the method described by Adelakun and co-workers (31). Briefly, quantitative evaluation of spermatogonia, preleptotene, pachytene spermatocytes, and round spermatid cells was performed using 50 round tubules per group selected in stage VII/VIII of the seminiferous tubule cycle at All animal handling procedure and research activities was approved by the Ethics Committee of the College of Medicine, University of Lagos, Nigeria (CM/ HREC/07/19/120).Where applicable, data obtained were analyzed statistically using one-way ANOVA, followed by Dunnett's comparison test. Data were expressed as Mean In addition, there was a significant decline in the relative weight of the testes in the rat that received AlClThere was a significant decrease in the body weight in the rats administered with AlClThe spermatozoa concentration showed a significant difference within the AlClIn addition, there was a significant decrease in sperm motility in the group administered with AlClFurthermore, the spermatozoa viability was significantly decreased after AlClThe AlClThere was a significant decline in the levels of serum TT, FSH, and LH in rats treated with AlClThe rats administered with AlClThe testicular histoarchitecture of the AlClThe volume density of the germinal of the AlClConcerning the EI, the AlClThe testicular germ cell count such as spermatogonia, preleptotene and pachytene spermatocytes, and round spermatids count in the seminiferous tubules showed a significant decrease in the counts compared to the control . Although, the germ cell count after the administration of SFN and AlClAn emerging pandemic global public health issue after cancer and cardiovascular diseases is infertility due to increase in testicular cancer (35) and based on the analysis on semen parameters such as reduction in sperm counts and qualities in various countries . The exposure of male individual to environmental toxicant is regarded as the channel that results in reduced sperm counts and infertility . Aluminum is considered as the most common metallic element detectable in natural waters, animal, and plant tissues (3). Compounds of Al due to its reactivity with other elements such as Sulphur and chloride are widely used in many products such as storage utensils, household cookware, food additives, toothpaste,and pharmaceuticals  (3). The enormous rate of exposure to Al increases the chances of health-related issues to human due to increase metallic concentration in various organs thereby damaging various tissue of the body including testicular tissues of animals and humans (38). Testicular weight is crucial in the evaluation of male fertility test due to its important association in sperm production (39). In our study, the decrease in body and testicular weights observed after AlClThe seminal fluid analysis  were significantly declined in the AlClThe process of spermatogenesis has been implicated to be under the regulation of reproductive hormones such as TT, FSH, and LH. In this present study, our results showed a decrease in this reproductive hormone after AlClThe antioxidant defense system prevents the cells of the body against the injurious effect of Reactive Oxygen Species (ROS) produced due to exposure to environmental toxicants, ultimately inducing toxicity to the reproductive system by perturbing the pro-oxidant and thereby leading to oxidative stress (53). Our study showed that exposure to AlClThe histomorphological features of the testis are critical and usually refer to as the endpoint in the evaluation of male fertility assessment and reproductive toxicity (56). In our study, histological observation of animals that received AlClThe present study revealed the ameliorative response of SFN on AlClThe authors declare that there is no conflict of interests regarding the publication of this paper.


After this article  was publIn rnf-5(RNAi)) appear similar.In The authors noted that these panels were duplicated due to errors in figure preparation. An updated version of The following images have also been removed in the updated figure: the second panel in right column of As noted in the figure legend, the images shown in Raw data underlying all other results reported in the article are available.The authors apologize for the errors in the published article.S1 File(XLSX)Click here for additional data file.S2 File(XLSX)Click here for additional data file.S3 File(XLSX)Click here for additional data file.


Therefore, the serious ethical concerns regarding artificial intelligence are not related to the classification of massive photo data using simple/narrow artificial intelligence (ANI).Artificial intelligence (AI) is divided into 3 groups based on capability: 1) Weak/Narrow/Simple AI (ANI), 2) Strong/General AI (AGI), and 3) Artificial Super Intelligence (ASI).3Medicine is a prominent field that has witnessed a nanotechnological revolution. However, due to the current views in philosophy and ethics, this emerging technology can be considered inconsistent or conflicting with what most ethicists in the area of medicine hold to be true. Nanotechnology and neuroscience are raising unavoidable questions concerning the ethical justification of human enhancement and intervention.4The main ethical issues are related to the use of AI in general (AGI) and superintelligence (ASI) in particular. These two groups of AI need to be audited during their advancement, as they have the capacity to develop in a versatile and unpredictable direction. Providing safety measures to prevent any direct or indirect coercion can only be possible through continuous ethical evaluations and monitoring of technological development.


Data comprised last year gamblers of three merged cross sectional Icelandic gambling surveys of 2007, 2011, and 2017 (N = 4422). For each of 15 game types (12-month time frame), a parallel multiple mediation model was applied to disaggregate bivariate associations of last year game type participation and problem gambling (Problem Gambling Severity Index) by six mediating mechanisms: (1) demographic problem gambling propensity, (2) number of game types played, (3) gambling frequency within the type, (4) maximum gambling frequency across all types beyond, (5) usual spending within the type, (6) maximum usual spending across all types beyond. Games showed two distinct profiles via which mediator they mostly impacted problem gambling: Electronic gaming machines offline, scratch cards offline, live betting online, and poker offline as well as online impacted problem gambling mostly via gambling frequency within, whereas all other types mostly impacted via the number of game types played. The applied mediation models answer the question by which mechanism game types impact problem gambling in a more exhaustive way than previous research.Bivariate associations of problem gambling with participation in particular game types often decrease when adjusting for demographics or consumption behavior . A summary of 14 peer-reviewed studies showed inconsistencies as well as conceptual and methodological challenges. The aim of this study was to expand previous research by a combination of (1) sophisticated feature-engineering, which disaggregates gambling intensity into facets  In general, it is a well known fact that problem gamblers tend to invest more time and money into gambling and usually participate in a larger number of games than non-problem gamblers  were applied. However, all of them were based on vastly different samples, ranging from the general population of Australia to patrons of two Las Vegas resort casinos Table . In addiHowever, in spite of the methodological variations, the core idea of all data analyses was to examine the statistical association of participation in a specific game type and problem gambling. Therefore, participation in individual game types was applied as a predictor of problem gambling outcomes. This was done either in simultaneous model estimation with all game types and other covariates . They also underlined the importance of another construct of overall gambling intensity, the depth of involvement. Exemplary measures of depth of involvement include frequency of gambling across all game types during the last year combined . This further complicates the complex relationship between problem gambling, game types, context, individual predisposition, and behavior .In sum, the partially inconsistent empirical results of previous sophisticated regression-based studies document the complex relationship between gambling behavior and problem gambling as well as the challenges statistical modeling approaches of this relationship face. Hence, it is a major duty for further research (1) to disentangle the complexity of gambling problems and behavior as precisely as possible and (2) to provide a valid groundwork for evidence-based harm reduction measures referring to particular game types and overall gambling behavior in a given population. In a more practical sense, the inconsistent previous results also show that an unbiased evaluation of the impact of participating in particular game types on problem gambling behavior has to consider (1) demographic characteristics of the gambler and (2) his overall gambling behavior depth and breadth of involvement in regression-based models, however, not only results in the aforementioned empirical inconsistencies, but also in several methodological problems: First, the additionally inclusion of measures of overall gambling intensity (breadth or depth of involvement) in a bivariate model that predicts problem gambling by gambling participation in a specific game type only allows for indirect appraisals of the importance of the intensity measure. The extent of the decrease in statistical association of game type and outcome may be indicative for such an indirect appraisal  by which a predictor variable X  affects an outcome variable Y (problem gambling). In other words, mediation analyses answer the question how a predictor impacts an outcome and provide explicit point estimates and confidence intervals for specific mediating mechanisms of problem increasing gambling behaviors. Particularly this aspect qualifies parallel multiple mediation analysis to compare the importance of different plausible mechanisms within and beyond a game type, which may impact problem gambling.Against this background of empirical inconsistencies and methodological challenges, mediation analyses may solve some of the outlined problems. The core idea of mediation analyses Hayes  is to exIt is worth noting that the depicted previous linear-regression models in their current way of application are similar to an old-fashioned approach of mediation analyses, the so called “causal steps approach” Hayes . The criMoreover, percentile bootstrap estimation of indirect effects and their confidence intervals is able to cope adequately with some bias caused by strongly correlated mediators like in the case of measures of gambling intensity. Neglecting correlated mediators can affect the standard errors of the association of mediator and the outcome of interest . This in turn affects statistical inference with normal-theory-tests for indirect effects  no explicit statistical information about the importance and confidence of specific mechanisms probably impacting problem gambling, (2) multicollinearity of gambling behaviors, (3) lack of conceptual clarity]. The proposed gambling consumption mediation model (GCMM) in the following analyses provides a novel analytical framework that includes (1) last year participation in particular game types as dichotomous predictor variable , (2) different proxy measures of gambling involvement (within and beyond the type of interest) as parallel mediators, and (3) a formative index of socio-demographic covariates that commonly increase the risk of problem gambling as another mediator that may pose an additional way via which particular game types impact an (4) outcome of problem gambling. The presented analytical approach of parallel multiple mediator models for each individual game type in the GCMM generates precise information by which specific indirect effect participation in a particular game type increases gambling problems. These empirically confirmed mechanisms can be addressed precisely by evidence-based harm reduction measures. Moreover, the applied mechanisms of the model (demographics or gambling behavior) are (1) founded in current research (Table The aim of this study is to provide a new framework of  models  2012–2019 by Andrew F. Hayes), a syntax oriented supplementary tool for advanced mediation analyses in SPSS and SAS, based on ordinary least squares path analysis .A conceptual map of the applied parallel mediation models for each game type is illustrated in Fig. p-level of 5% most game types showed statistically significant changes across the years of the surveys. Only scratch cards offline and sport betting offline showed no significant changes. However, the majority of changes were based only on minuscule effect sizes with Cramer’s V values below 0.1.Table A small effect emerged for lotto offline with increasing participation from 2007 (75.6%) to 2011 (79.4%) and decreasing participation in 2017 (68.0%). A small effect also emerged for lotto online on an Icelandic website with an increasing participation from 8.7% in 2007 to 10.5% in 2011 and 19.5% in 2017. Moreover, participation in live betting online on Icelandic or foreign websites increased from 0.8% in 2007 to 4.6% in 2017. Also sport betting online on a foreign website increased from 0.2% in 2007 to 1.2% in 2011 and 5.3% in 2017. Poker offline increased from 7.4% in 2007 to 15.5% in 2011 and decreased again to 9.6% in 2017. Participation in bingo offline changed from 8.9% in 2007 to 15.2% in 2011 and 21.1% in 2017. Dividing participation rates of 2017 by rates of 2007 showed that the mean ratio for all 8 offline game types was 1.04 with largest growth values for bingo offline (2.36) and poker offline (1.29). In contrast, the ratio of 2017/2007 prevalence rates for the 7 online game types showed a mean growth rate of 7.06 with largest values for sport betting on foreign websites (24.89), poker online on a foreign website (7.15), live betting on an Icelandic or foreign website (5.85), and other online gambling on foreign websites (4.31).p ≤ 0.05) but minuscule effect sizes (Eta Square < 0.01) for the majority of inspected attributes . The only at least small effects (0.03 ≥ squared eta ≥ 0.01) emerged for the following attributes: The number of game types involved in increased from a mean of 1.660 in 2007 to 1.921 in 2011 and 1.944 in 2017. Frequency within bingo offline, lotto online on an Icelandic website, sport betting online on foreign websites, and live betting online on Icelandic or foreign websites increased from 2007 to 2017. Usual spending within bingo, lotto online on Icelandic websites, sport betting online on foreign websites, live betting online on Icelandic or foreign websites, and poker offline increased from 2007 to 2017. Usual spending beyond a given game type increased for every game type from 2007 to 2017.Kruskal–Wallis tests of the metric and ordinal variables across the years of the surveys also showed significant  within and beyond in many or even all game types. However, all relevant trends showed only small effect sizes between 2007 and 2017. Consequently, treating the entire dataset as one homogeneous population in the following analyses represents a justified step.Model estimates for unstandardized effects and 95%-percentile bootstrap confidence intervals of the parallel multiple mediation models are presented in Tables total effects on problem gambling  of last year participation in 11 of the 15 game types were of statistical relevance  and 10 types were of problem increasing impact . Lotto offline was the only game type with a statistically relevant problem decreasing impact . For several game types the total impact on problem gambling was not statistically relevant: Lotto online on an Icelandic website, sport betting online on a foreign website, bingo offline, and other online gambling on foreign websites (not poker or betting).The Direct effects of game type participation on gambling problems  became non significant for 8 of the 15 game types. Statistically relevant problem increasing direct effects of last year participation when simultaneously considering all other mediating impacts were left only for lotto offline, sport betting online on a foreign website, and other online gambling on foreign websites (not poker or betting). Problem decreasing direct effects occurred for sport betting online on an Icelandic website, EGMs offline, scratch cards offline, and poker offline.specific indirect effects (a*b-paths) which provides an effect size and confidence intervals for each mediator, while considering the direct path and all other mediators (indirect paths) within the model simultaneously. The metric of the unstandardized effects is determined by the scales of the X  and Y variables (winsorized sum score of gambling problems), which both were similar across all analyzed game types. Hence, the size of the indirect effects is comparable across the mediators.However, total and direct effects are only of minor interest in the parallel mediation analyses at hand that try to answer the following question: By which mediator (gambling behaviors or demographic propensity) is last year participation in game type X impacting gambling problems most severely? This aspect can explicitly be tackled by the quantification of breadth or (2) mostly via frequency within.A close look at the specific indirect effects revealed two distinct profiles of decisive mediators impacting gambling problems within the different game types: (1) mostly via breadth (number of game types involved in). Breadth was the strongest mediating mechanism of gambling behavior on gambling problems for participating in:lotto offline,lotto online on an Icelandic website,betting on sport pools offline,betting on sport pools on an Icelandic website,sport betting offline,sport betting online on an Icelandic website,sport betting online on a foreign website,betting on skill games offline,bingo offline andother online gambling on foreign websites (not poker or betting).Table frequency within. Frequency within was the strongest mediating mechanism of gambling behavior on gambling problems for participating in:EGMs offline,scratch cards offline,live betting online on an Icelandic or foreign website,poker offline andpoker online on a foreign website.Table The decision about the most important mediating gambling behavior was unequivocal in almost all game types. For several game types there was only one relevant positive indirect effect like breadth for lotto offline or lotto online on an Icelandic website (positive a*b-path). All other mediating mechanisms did not show statistically relevant effects for these two game types or even showed problem decreasing effects such as propensity for lotto offline or online on an Icelandic website (negative a*b-path).But these negative effect sizes did not mean that the mediating path propensity was not associated with gambling problems for individuals that participated in lotto (positive b-path). Rather, the negative effect was the consequence of a negative association of gambling lotto offline and demographic problem gambling propensity (negative a-path). In other words: Individuals who participated in lotto showed a reduced level of demographic propensity for gambling problems . Consequently, the product of a*b for the mediator propensity among individuals participating in lotto offline showed negative effect sizes. Hence, this mediator could not be an important problem increasing mechanism for lotto offline, even if it was positively associated with gambling problems in general.problem reducing impacts were not plausible from a theoretical position . However, in all five depicted situations with statistically relevant negative single b-paths the products of a*b-paths were not statistically relevant. Hayes  in the following situations: (1) betting on sport pools online on an Icelandic website via spending within; (2) live betting online on a foreign or Icelandic website via spending within; (3) sport betting online on foreign websites via spending within; (4) other games online (not betting or poker) on a foreign website via frequency within; (5) other games online via usual spending within. These t. Hayes , p. 520 breadth of involvement (10 game types) or (2) via frequency of gambling within that type of interest (5 game types).A simple descriptive rule of thumb to determine the most important mediator among a game type is to divide the largest statistically relevant and positive effect by the second largest relevant and positive effect within a game type . In almost all game types, this ratio was between values of 3.96 (betting on sport pools on an Icelandic website) and 2.20 (live betting online on an Icelandic or foreign website), indicating distinct orders of most important mediating mechanisms (effect size of the most important mediator outperforming the second by at least factor 2 in 14 of 15 game types). The only exception from this order was betting on skill games offline, with a ratio of only 1.64 between the mediators breadth and propensity, indicating a more equivocal profile of most important mediators among this game type. Participation in any other analyzed game type was unequivocally most strongly mediated either via (1) However, the remarkable positions of the two mediators breadth and frequency within for some game types did not disqualify the other mediators in the GCMM as redundant. On the contrary: Propensity and frequency beyond both showed statistically relevant specific indirect effects in 14 of 15 game types, spending beyond in 13 of 15 game types, and spending within in 3 of 15 game types.The presented GCMM provides, for the first time, an analytical frame work to disentangle the complex network of (1) last year participation  in particular game types, (2) an outcome of problem gambling and different proxy measures of (3) socio-demographic problem gambling propensity, (4) overall gambling involvement , and (5) game type-specific gambling involvement . The chosen approach of parallel multiple mediation analyses allowed for explicit quantification of the behavioral or interpersonal mechanisms, by which participation in specific game types impacts the outcome of problem gambling. Cohort analyses of the three merged Icelandic surveys warranted treating the empirical dataset as homogeneous population even though the number of used game types increased slightly and online game types showed continuously increasing levels of participation.p-levels within the parallel mediation analyses at hand were not adjusted for multiple testing, in order to uphold statistical power of the first time application of the GCMM. Further research may apply a more confirmative approach of model testing, including model-fit-statistics, but the aim of this study was rather exploratory.A short summary of 14 peer-reviewed regression-based studies outlined inconclusive results as well as methodological and conceptual challenges that can partially be resolved by the chosen approach of parallel multiple mediation analyses for each particular game type with the proposed mediating mechanisms characterizing gambling behavior and demographic problem gambling propensity. The state-of-the-art percentile bootstrap procedure to estimate effects and confidence intervals of mediators is able to cope adequately with unspecified correlated error terms (multicollinearity of mediators), providing robust estimates of indirect effects with adequate errors of type I and II. Inconsistent results of former research may be partially caused by a lack of such robustness and statistical power of very complex models with many highly correlated predictors. Consequently, statistical mediators appears to be conceptually more convincing than the commonly applied regression-based models with many covariates, because gambling behavior in terms of regularity, diversity, and spent money or time may be part of the etiological process of developing gambling-related harms and problems—not only a covariate one has to adjust for statistically.Treating different attributes of problem gambling behavior or propensity as Of course, mediation analyses are mathematically also regression-based, but the product-term a*b to quantify indirect effects provides additional information. Mediation analyses enabled us to quantify effects and confidence intervals to make precise evaluations of the most important mediating mechanisms by which behavior particular game types impact gambling problems. This information is of notable interest for testing competing models or theories Hayes  and for within and beyond as well as the number of game types a person was involved in. The applied maximum function to aggregate the beyond variables was chosen to curtail high correlations with the breadth variable, which occur by the alternative sum function across all game types. Further research is needed to make an informed choice about the most appropriate aggregation, because mean or median functions could also be useful proxies. However, the combination of (1) mediation analyses and (2) precise feature-engineering revealed explicit estimates and insights which were mostly concealed or at least only implicit in former research.The outlined analytical potential of mediation analyses was combined with a very elaborate process of feature-engineering for proxy measures of gambling behavior which distinguished mechanisms of demographic propensity, usual spending and frequency frequency within these types and not by the breadth of involvement or any other mediating variable of the model. Interestingly, results support findings of previous studies in which some of these types still showed explanatory power for gambling problems despite lots of other covariates in the models  see: Afifi et al. The empirical findings of the GCMM showed that last year participation in (1) EGMs offline, (2) scratch cards offline, (3) live betting online on Icelandic or foreign websites, (4) poker offline, or (5) poker online on foreign websites impacted gambling problems mostly via mechanisms of gambling To our knowledge, the GCMM represents the first analytical approach that provides explicit estimates of indirect effects and confidence intervals of the most important mediating mechanisms of a game type of interest impacting problem gambling. This data-driven information facilitates a valid evaluation of risk increasing mechanisms of game types and complements former evaluation tools  impacted gambling problems mostly in a qualitatively distinct way different from the breadth mechanism—namely via gambling frequency within the type of interest. Furthermore, type-specific measures of gambling frequency within EGMs and poker. Obviously, the GCMM has the potential to conceptually support, model and specify a promising line of research on gambling consumption that tries (1) to explicate the dose–response-relationship of gambling intensity and measures of gambling related harm and (2) to establish evidence based thresholds of low-risk gambling intensity by risk-curve- and receiver-operating-characteristic-curve-analyses , supply and access reductions may be effective due to the simple and convincing mechanisms of the total consumption model  of game type participation on gambling problems still showed stabile risk increasing or decreasing impacts. For instance, (1) lotto offline, (2) sport betting online on a foreign website, or (3) other online gambling (not betting or poker) on a foreign website showed direct problem increasing impacts. On the contrary, (4) sport betting online on an Icelandic website, (5) EGMs offline, or (6) scratch cards offline or (7) poker offline showed direct problem decreasing impacts (some kind of protective effect). Obviously, the applied mediators of the GCMM were not able to disentangle the complexity of gambling behavior exhaustively and other potential mediators may be at work that can additionally explain direct effects thoroughly. A mediation model which includes all relevant mechanisms will dissolve all direct effects (c′-paths) completely. Hence, future research on mediating mechanisms on problem gambling should include additional variables, for instance psychological or psychiatric attributes or other operationalizations of propensity that include comorbidities or attributes of personality. For example, the problem increasing direct effect of lotto may be attributable to demographics and health related behavior  demographic propensity, of which information is available in most monitoring datasets, and via which game type participation may positively impact ascending levels of problem gambling. Therefore, the result section was mainly narrowed to the problem increasing mechanisms, mostly disregarding problem decreasing mechanisms. Further research is needed to elaborate potential beneficial mechanisms or protective factors. Further research should also specify the applied descriptive rule of thumb (ratio of largest and second largest positive indirect effect) to discriminate both emerging mediating profiles (mostly via breadth or via frequency within) by inferential statistics. Moreover, structural equation models could be applied to explicitly include correlated mediators into the statistical model.The focus of the current GCMM was on mechanisms of (1) The aggregation of demographic information into a mediating propensity score allows for precise comparison of the indirect effect sizes of demographics and behavior. However, in other situations applying demographics as covariates or moderators may be more adequate.The analyses at hand treated gambling problems as a continuously ascending scale. Treating gambling problems as a nominal attribute with different estimates for qualitatively different groups of low, medium and high risk gamblers may be a fruitful extension of the GCMM. Additionally, modeling outcomes of gambling-related harms (Delfabbro and King mode of access and (2) certain access configurations  could have remarkable impacts on the GCMM, but are currently not considered adequately . Therefore, the proposed way to distinguish game types statistically by their most important risk increasing mechanism was obviously unaffected by cursory classification in online or offline game types. At the same time, particularly for Internet gambling, it is worth noting that (1) the way or In general, the GCMM is in line with other recent research that sheds light on relevant gambling issues by advanced methods of statistical modeling . Therefore, future secondary data analyses on such datasets with the proposed modeling procedure of this study have the potential to replicate and extend the suggested blueprint at hand in different countries with diverse gambling products, contexts, and regulations.This study addressed several limitations in previous research on the complex interactions of participating in different game types, problem gambling, and individual gambling behavior or vulnerabilities. Taken together, the proposed GCMM overcomes current methodological challenges by (1) a parallel multiple mediation approach in combination with (2) sophisticated feature engineering of gambling behavior and provides explicit information about the mechanisms by which participation in specific game types mostly impacts problem gambling—either mostly within or mostly beyond the type of interest.


While eHealth programs equip survivors with tools at where and when they need, their benefit to and engagement patterns among older adults are less known. Data come from the Springboard Beyond Cancer RCT, a cancer survivor self-management program  and the corresponding qualitative evaluation/user testing (N=40). Younger survivors, but not older, preferred socially interactive and personalized long-in features which enable greater tailoring of the program. However, the older survivors who did enroll in the RCT were equally as likely as their younger counterparts to engage with one or more aspects of program. Health self-efficacy improvement from baseline to 3 months was significant among younger participants in the intervention (p<.05) but not the control arm (p=.54) (d=.20) and marginally significant among older survivors (age 60+) in intervention (p=.06) but not the control arm (p=.58) (d=.28). Results suggest that the program may benefit survivors regardless of age. Part of a symposium sponsored by the Cancer and Aging Interest Group.


Esophageal cancer is the eighth most common cause of cancer mortality in Japan. More than 11,000 people had died from esophageal cancer in 2018. The Japan Esophageal Society has collected the data on patients' characteristics, performed treatment, and outcomes annually.We analyzed the data of patients who had first visited the participating hospitals in 2013. In 2019, the data collection method was changed from an electronic submission to a web-based data collection using the National Clinical Database (NCD). Japanese Classification of Esophageal Cancer 10th by the Japan Esophageal Society (JES) and UICC TNM Classification 7th were used for cancer stagingA total of 8019 cases were registered from 334 institutions in Japan. Squamous cell carcinoma and adenocarcinoma accounted for 87.8% and 6.3%, respectively. The 5-year survival rates of patients treated using endoscopic resection, concurrent chemoradiotherapy, radiotherapy alone, or esophagectomy were 88.3%, 32.4%, 24.4%, and 59.3%, respectively. Esophagectomy was performed in 4910 cases. The operative and the hospital mortality rates were 0.77% and 1.98%, respectively. The survival curves showed a good discriminatory ability both in the clinical and pathologic stages by the JES system. The 5-year survival rate of patients with pStage IV in the UICC classification that included patients with supraclavicular node metastasis was better than that of patients with pStage IVb in JES classification.We hope this report contributes to improving all aspects of the diagnosis and treatment of esophageal cancer in Japan. We deeply appreciate the great contributions of many physicians in the registry of esophageal cancer cases. The Comprehensive Registry of Esophageal Cancer in Japan, 2013, was published here. In 2019, the data collection method was changed from an electronic submission to a web-based data collection using the National Clinical Database (NCD). Personal information was replaced with individual management code inside each institute, and the NCD collected only anonymized information. The registry complies with the Act for the Protection of Personal Information.We briefly summarized the Comprehensive Registry of Esophageal Cancer in Japan, 2013. Japanese Classification of Esophageal Cancer 10th by the Japan Esophageal Society (JES) [We hope that this Comprehensive Registry of Esophageal Cancer in Japan for 2013 will help to improve all aspects of the diagnosis and treatment of esophageal cancer in Japan.I.Clinical factors of esophageal cancer patients treated in 2013Institution-registered cases in 2013Patient backgroundTableAge and genderTablePrimary treatmentTableTumor locationTableHistologic types of biopsy specimensTableDepth of tumor invasion, cT (UICC TNM 7th)TableLymph node metastasis, cN (UICC TNM 7th)TableDistant metastasis, cM (UICC TNM 7th)TableClinical stage (UICC TNM 7th)II.Results of endoscopically treated patients in 2013TableDetails of endoscopic treatment for curative intentTableComplications of EMR/ESDTablePathological depth of tumor invasion of EMR/ESD specimensFigureSurvival of patients treated with EMR/ESDFigureSurvival of patients treated with EMR/ESD according to the pathological depth of tumor invasion, pT (JES 10th)FigureSurvival of patients treated with EMR/ESD according to the lymphatic and venous invasionIII.Results in patients treated with chemotherapy and/or radiotherapy in 2013TableDose of irradiation TableDose of irradiation FigureSurvival of patients treated with chemotherapy and/or radiotherapyFigureSurvival of patients treated with definitive chemoradiotherapy according to clinical stage (UICC TNM 7th)FigureSurvival of patients underwent radiotherapy alone according to clinical stage (UICC TNM 7th)IV.Results in patients who underwent esophagectomy in 2013TableTreatment modalities of esophagectomyTableTumor locationTableApproaches to tumor resectionTableVideo-assisted surgeryTableFields of lymph node dissection according to the location of the tumorTableReconstruction routeTableOrgans used for reconstructionTableHistological classificationTableDepth of tumor invasion, pT (JES 10th)TablePathological grading of lymph node metastasis, pN (JES 10th)TablePathological findings of lymph node metastasis, pN (UICC TNM 7th)TablePathological findings of distant organ metastasis, pM (JES 10th)TableResidual tumorTableCauses of deathFigureSurvival of patients who underwent esophagectomyFigureSurvival of patients who underwent esophagectomy according to clinical stage (JES 10th)FigureSurvival of patients who underwent esophagectomy according to clinical stage (UICC TNM 7th)FigureSurvival of patients who underwent esophagectomy according to the depth of tumor invasion, pT (JES 10th)FigureSurvival of patients who underwent esophagectomy according to lymph node metastasis (JES 10th)FigureSurvival of patients who underwent esophagectomy according to lymph node metastasis (UICC TNM 7th)FigureSurvival of patients who underwent esophagectomy according to pathological stage (JES 10th)FigureSurvival of patients who underwent esophagectomy according to pathological stage (UICC TNM 7th)FigureSurvival of patients who underwent esophagectomy according to residual tumor (R)Institution-registered cases in 2013.Tables 8Tables Tables Tables 15


Bioscience Reports (2017) 37, https://doi.org/10.1042/BSR20170342) have realised that the vector-4 group image of The authors of the original article “Effects of RNA interference-mediated gene silencing of VEGF on the ultrafiltration failure in a rat model of peritoneal dialysis” (The correct The authors would like to express their apologies for any inconvenience caused to the readers of their published article by this error.


Sus scrofa domesticus) is one of the important farm animal contributing 7% of the country’s total animal protein sources in India. In the present study, random hexamer primer was used to amplify the complete mitochondrial genome of Central Indian domestic pig and resolved the complete mitochondrial sequence by shotgun sequencing followed by de novo assembly in MIRA version 4.0.5. The sequence assembly revealed to be 15,827 bp mitogenome of pig (accession no. KT965278). The mitogenome in the present study has 99% homology with previously reported mitogenome of pigs from different parts of the world. The present study is the first report of complete sequence of mitogenome of pig from Indian subcontinent. Mitogenome analysis by MITOS web server revealed similarity of gene order, organization with the other pig breeds and vertebrates, comprising of 13 protein-coding genes, 22 tRNAs, 2 rRNAs and a control region. It was concluded that modified random hexamer can be successfully used for whole mitogenome sequencing using NGS without designing mitogenome-specific primer, thereby reducing cost and labor.Domestic pig ( Sus scrofa domesticus) is domesticated since 8000 years, yet the origin and evolution of domestic pigs of India has not been established. The introgression of exotic genome under state sponsored programs to upgrade the local population using semen or live animals of exotic breeds has diluted the gene pool of local breeds, thus breed specification of the local domestic pig remains questionable. Most studies on Indian domestic pig mitochondrial DNA (MtDNA) are restricted to capillary electrophoresis (CE)-derived short sequence fragments analysis of cytocgrome b, 12S rRNA  as out group using MEGA 6 . The 16,827 bp length of the mitogenome of the CI domestic pig showed 99% homology with the available mitogenome sequences in the GenBank and genome annotation was performed using MITOS web server (Bernt et al. Pig (


Sterna paradisaea) a species notable for undertaking the longest migrations of any species as well as breeding in sub-polar habitats and capable of enduring extreme altitude. The complete mitogenome was 16,708 bp long and was typical of other avian mitogenomes in size and content. The phylogenetic position of the Arctic tern within Charadriiformes based on the coding region on the mtDNA corresponded closely to that based on nuclear loci. The sequence will provide a useful resource for investigations of metabolic adaptations of this remarkable species.The analysis of mitochondrial DNA (mtDNA) base composition, codon usage, and genome arrangement patterns can provide insight into metabolic pathways and evolutionary history. Here, we report on the complete mitochondrial genome (mitogenome) of Arctic tern ( Charadriiformes: Laridae: Sternini) are cosmopolitan core water birds closely related to the gulls, noddies, and skimmers. The life histories of 12 generally accepted genera of terns range from that of entirely sedentary to strongly migratory species (Cramp Sterna paradisaea) holds the record for the longest roundtrip animal migration ever recorded electronically  of Qiagen DNeasy  extracted DNA from mitochondrial-enriched DNA fraction obtained by differential centrifugation. The Illumina MiSeq run generated 8,468,804 paired-end reads that were mapped to complete Sterna hirundo genome . In total, 1.09% of the raw reads mapped to the Sterna hirundo mtDNA and yielded two ∼12kb and ∼3 kb contigs that covered 95.62% of the reference genome. Sanger sequencing was used, to add the missing control region (CR) sequence (1158 bp) and to confirm that no CR duplications  of Phylogenetic position of the newly assembled complete Arctic tern mitogenome coding sequence within the Charadriiformes was resolved in MEGA 7 (Kumar et al.


South Korea has included dementia care as part of their Long-Term Care (LTC) Insurance Program since 2014. Thus, LTC workers are increasingly engaged in dementia care. The purpose of this paper is to elucidate the role of the LTC workers’ occupational identity in their consciousness of human rights as well as their practice of human rights protection. Data were collected in 2018 from 303 LTC workers employed by 12 LTC facilities who completed questionnaires. Their mean age was 53.6 years. We measured occupational identity with a 15-item scale (a=.772), consciousness of human rights for persons living with dementia (PLWD) with a 27-item scale (a=.916), and practice of human rights for PLWD with a 26-item scale (a=.956). Results show that occupational identity was positively associated with consciousness of human rights  and practice of human rights . The findings have implications for protecting the human rights of PLWD. Part of a symposium sponsored by the Aging Among Asians Interest Group.


Does change in one lifestyle factor  help explain change in another factor or process ? The current modeling was a secondary analysis of a primary care feasibility study of individualized lifestyle (diet and exercise) treatment of metabolic syndrome  that achieved 19% reversal over one year. Diet quality was assessed by the Healthy Eating Index (HEI) (2005 Canada); while fitness was assessed by several measures . Three occasions  were examined using latent change score and latent growth curve models (in AMOS) to assess whether changes in one domain predicted changes in the remaining domains: (1) diet (measured by HEI or latent construct); (2) fitness (measured by VO2max percentiles or latent construct); and, (3) 10-year risk of cardiovascular disease (by Procam Risk score). Results showed significant improvement in all three domains separately during the intervention, with greater change between baseline and 3-month assessment and continued change between 3- and 12-months. Initial status variables on observed constructs were moderately positively correlated and change in dietary behavior was significantly related to change in fitness levels, but neither were significantly related to change in the 10-year risk of cardiovascular disease. In addition, the associations between change in diet and changes in fitness were inconsistent baseline to 3 months, and 3-12 months. These results offered new insight on relationships among interventions in a behavioural counselling program which can inform future programming.


Treponema pallidum in an infant or fetus, acquired during pregnancy from a mother with untreated or inadequately treated syphilis. Congenital syphilis can cause miscarriage, stillbirth, or early infant death, and infected infants can experience lifelong physical and neurologic problems. Although timely identification and treatment of maternal syphilis during pregnancy can prevent congenital syphilis  a condition affecting stillbirths and infants born to mothers with untreated or inadequately treated syphilis regardless of signs in the infant or 2) a condition affecting an infant with clinical evidence of congenital syphilis including direct detection of Demographic and clinical characteristics of infants and their mothers were analyzed using Stata statistical software . On the basis of CDC’s congenital syphilis prevention framework, each congenital syphilis case was assigned to one of four mutually exclusive missed opportunity categories based on the mother’s prenatal care, testing, and treatment history: 1) lack of timely prenatal care with no timely syphilis testing; 2) lack of timely syphilis testing despite timely prenatal care; 3) lack of adequate maternal treatment despite a timely syphilis diagnosis;Among 1,306 congenital syphilis cases reported during 2018, 685 (52.5%) occurred in the South, 465 (35.6%) in the West, 103 (7.9%) in the Midwest, and 53 (4.1%) in the Northeast Census regions . NationaNationally, the most commonly missed prevention opportunity was a lack of adequate maternal treatment despite the timely diagnosis of syphilis during pregnancy (30.7%), followed closely by a lack of timely prenatal care (28.2%) . This naRacial/ethnic disparities existed within the highest morbidity regions. In the South, the most commonly missed prevention opportunity among white mothers of infants with congenital syphilis was lack of timely prenatal care (31.6%), whereas among black and Hispanic mothers, lack of adequate maternal treatment (37.0%) was the most common . In the Nationally, the most commonly missed opportunity for preventing congenital syphilis was lack of adequate maternal treatment, likely driven by the high numbers of cases in the South, where this missed opportunity was most prevalent. The most common missed opportunities for preventing congenital syphilis differed by geographic region. In the West, a lack of timely prenatal care was the most commonly missed opportunity, and in the Northeast, late identification of seroconversion was the most common. Regional clinical and demographic differences in mothers of infants with congenital syphilis indicate that different populations are at increased risk and might require different interventions. The high proportion of mothers with early syphilis in certain regions signals recent heterosexual transmission and the potential for future increases in congenital syphilis cases if no intervention occurs. The high proportions of symptomatic and stillborn infants in certain regions might be related to early syphilis among their mothers, given that higher rates of vertical transmission and worse infant outcomes are associated with early syphilis during pregnancy  and a lack of timely prenatal care (28%), followed by late identification of seroconversions (11%); prevalences of these missed opportunities differ regionally and by race/ethnicity.Halting continued increases in congenital syphilis requires understanding the missed prevention opportunities and implementing tailored interventions based on local experience.


Dementia is arguably the most devastating condition of older adulthood with treatment options still elusive. Alzheimer’s is the most prevalent form of dementia where cognitive deficits relate strongly to underlying brain pathology. However, there exist cases in which cognitive performance does not match the corresponding level of neuropathology. Attempts to explain this phenomenon often include the concept of cognitive reserve (CR), whereby greater CR  presumably results in less impairment relative to the extent of pathology early in disease progression but also greater impairment once cognitive symptoms manifest. We examined the influence of CR proxy variables (education and occupation) on the relationship between hippocampal volume and cognitive performance on tests of executive control and memory using data from the Czech Brain Aging Study (CBAS). Participants were cognitively normal/with subjective cognitive decline but without actual impairment =66.43; M(education)=15.90; 37 men) or had amnestic mild cognitive impairment =71.37; M(education)=14.92; 85 men). We found that hippocampal volume was significantly related to executive control  and memory  for participants with aMCI, but only memory  for CN participants. Occupational position moderated the association between memory and hippocampal volume in aMCI, with the result approaching significance (p=.07), whereby a greater link between memory problems and hippocampal atrophy was present in those previously in high occupational positions. No other moderations for occupational position or education emerged (ps>.25). We found evidence for the concept of CR using occupational position as proxy.


Cognitive function is an important component of healthy aging and physical activities have been shown to support late life cognitive function. However, it is unclear whether non-traditional physical activities provide additional benefits for cognitive function above and beyond traditional leisure physical activities. This study examines the associations between movement therapy and cognitive function in the US population. We used data from the waves 1, 2 and 3 (1995-2014) of the Midlife in the United States (MIDUS) study. MIDUS included a national probability sample of community-living adults aged 25-75 years old in 1995 (wave 1) and added the wave 2 cognitive functioning tests of executive function and episodic memory. We applied multivariate linear regression models to estimate the effect of movement therapy (wave 2) on the cognitive episodic memory and executive function (wave 3) while controlling the covariates . A total of 2097 individuals aged 42-92 years  were included in the analysis. Movement therapy was independently associated with better episodic memory , but not with executive function , after including control variables. The results suggest that movement therapy may be an effective non-pharmacological intervention to attenuate age-related cognitive decline in middle-aged and older adults. Future research should test whether these findings can be replicated in similar populations and if confirmed, interventions should incorporate a wider range of physical activities in community-living older adults with the goal of maintaining and improving physical and cognitive health.


Using comparative analysis of the permeability and sorption performance of the obtained PAA cryogels and earlier developed polyethyleneimine (PEI) cryogels, we have demonstrated the advantages and disadvantages of these polymers as sorbents of heavy metal ions (Cu(II), Zn(II), Cd(II), and Ni(II)) in fixed-bed applications and as supermacroporous matrices for the fabrication of composite cryogels containing copper ferrocyanide (CuFCN) for cesium ion sorption. Applying the rate constant distribution (RCD) model to the kinetic curves of Cu(II) ion sorption on PAA and PEI cryogels, we have elucidated the difference in sorption/desorption rates and affinity constants of these materials and showed that physical sorption contributed to the Cu(II) uptake by PAA, but not to that by PEI cryogels. It was shown that PAA cryogels had significantly higher selectivity for Cu(II) sorption in the presence of Zn(II) and Cd(II) ions in comparison with that of PEI cryogels, while irreversible sorption of Co(II) ions by PEI can be used for the separation of Ni(II) and Co(II) ions. Using IR and Mössbauer spectroscopy, we have demonstrated that strong complexation of Cu(II) ions with PEI significantly affects the in situ formation of Cu(II) ferrocyanide nanosorbents leading to their inefficiency for Cs Taking into account the difference in affinities of PAA and PEI cryogels toward Cu(II) ions, we have investigated how a polymer matrix affects the efficiency of composite sorbents containing Cu(II) ferrocyanide for cesium ion removal. Transition metal ferrocyanides are the most efficient materials for selective uptake of cesium radionuclides from liquid radioactive wastes and natural waters; however, due to their small size and low mechanical strength, they cannot be used in columns without immobilization in organic or inorganic matrices, which can be realized under dynamic conditions ,45,46,474− anion ,50. We h4− anion , but PAAA composite formed in situ had homogeneous distribution of Cu and Fe on the surface, but CuFCN crystallites were not detectable with resolution of the SEM either on PEI or on PAA cryogels. XRD patterns of the composite formed in situ c did not6]4− complex due to the very high Lewis basicity of PEI. The latter possibility was demonstrated earlier for N-containing ligands and Fe(III) cyanide complexes [−1 typical for Fe(II) ferrocyanide (Fe-CN deformation mode) [6]4- complex ion in the CuFCN/PEI composite was also confirmed by the singlet in the Mössbauer spectrum (Taking into account a difference in the color of CuFCN/PAA (reddish brown) and CuFCN/PEI (dark blue) composites formed in situ, one can suggest that the PEI matrix had a significant effect on formation of Cu(II) ferrocyanide in situ. There are two possible reasons for this: (i) very strong binding of Cu(II) ions by PEI; and (ii) dissociation of  solution was added dropwise under constant stirring, the obtained colloid solution of reddish brown color was fed through the column with 1 mL of PAA cryogel at a flow rate of 122 BV/h using a peristaltic pump (the stirring was continued). The CuFCN colloids were distributed over the full length of the column; iron and copper in outlet solutions were not detected by AAS. The column with the composite material (CuFCN/PAA (precipitation) cryogel) was washed with distilled water and used to investigate the dynamics of Cs+ ion sorption and Cs+ uptake in a batch. In situ formation of composites containing CuFCN was performed as follows: PAA and PEI cryogels were saturated with Cu(II) ions under dynamic conditions and washed with distilled water; in a week, 10 mL of 0.01 M K4[Fe(CN)6] solution was fed through the column at a flow rate of 8 BV/h. Finally, the composites were washed with 150 mL of distilled water, removed from the column, and air-dried for investigation of Cs+ uptake in a batch.Composite cryogels containing CuFCN were fabricated by (i) precipitation of ex situ formed CuFCN colloids on PAA-DGEBD 1:8 cryogel, and (ii) in situ formation of CuFCN in PAA-DGEBD 1:6 and PEI-DGEBD 1:4 cryogels. The composite formed by precipitation method was obtained as follows: 0.5 mL of 0.1 M Cu(NO+ ion uptake in a batch was determined as follows: 5 mg of the composite cryogel was shaken for 24 h with 5 mL of CsCl solution containing 20 mgCs/L (pH~6). The equilibrium content of cesium was determined by AAS. Dynamics of Cs+ ions sorption on CuFCN/PAA (precipitation) cryogel was studied by feeding CsCl solution containing 20 mgCs/L (pH~6) through 1 mL of monolith in insulin syringe at the flow rate of 84 BV/h using a peristaltic pump, the filtrate was collected every 5 mL and analyzed for cesium, copper, and iron content by AAS.The efficiency of CsMorphology investigations and elemental analysis of the freeze-dried composite cryogels were performed using a Hitachi TM3000 scanning electron microscope (SEM) equipped with a Bruker Quantax 70 energy dispersive X-ray (EDX) spectrometer at an accelerating voltage of 15 kV.X-ray powder diffraction analysis (XRD) of composite cryogels was carried out on a Dron-3 multipurpose diffractometer .Here we have investigated the reactivity of affordable and commercially available polyamine PAA  in cross-linking reaction with diglycidyl ether of 1,4-butandiol and showed that PAA cryogels were formed at lower molar ratios of cross-linker to polymer and had better stability under the flow conditions than did PEI cryogels. Both PEI and PAA cryogels were efficient for the removal of Cu(II) and Zn(II) ions in batch and fixed bed applications to the level set by the WHO for drinking water.3 solution.Although PAA cryogels had worse chelating properties than PEI cryogels, they provided high selectivity of Cu(II) recovery over Zn(II) and Cd(II) ions, and Zn(II) ions over Cd(II) ions under equilibrium sorption conditions. PEI cryogels can be used for Co(II) and Ni(II) recovery from two component solutions in fixed-bed and selective elution of Ni(II) ions with 0.1 M HNOWe have also demonstrated that formation of stable Cu(II)–PEI complex hinders in situ formation of Cu(II) ferrocyanide that results in very poor sorption efficiency of this PEI-based composite in cesium ion uptake. In contrast, PAA cryogels are applicable for composite formation via loading of ex situ formed Cu(II) ferrocyanide colloids or the in situ formation of nanosorbent with preservation of the supermacroporous structure of the matrix.


Using the Conservation of Resources Theory, this study examined how caregiver strain was influenced by care recipients’ use of falls alert wearables. Online survey data from 486 unpaid caregivers for adults aged 50 and older were analyzed. Structural equation modeling was used to test the following hypotheses: (1) caregivers with fewer financial resources would engage in fewer resource conservation strategies ; (2) resource conservation strategy engagement would be associated less resource loss; and (3) the effect of resource conservation strategies on caregiver strain would be less salient than the effect of resources used on caregiving . The hypothesized model had a good model fit (CFI=.910), with SRMR (.060) and RMSEA (.062) being close to .05. All hypothesized paths were statistically-significant, except for the direct effect of using falls alert wearables on social support (p=.076) and caregiver strain (p=.135). As hypothesized, higher income was associated with greater likelihood of using falls alert wearables . Technology use was associated with less time spent on caregiving  and had statistically-significant indirect effects on caregiver strain . The total effect of using falls alert wearables  on caregiver strain was less powerful than the effect of time  or social support . Study findings suggest the benefits of using falls alert wearables to alleviate time-related burdens and downstream caregiver strain among unpaid caregivers. Future efforts should investigate the relative advantage of wearables for other caregiving purposes.


This paper describes data of earthworm abundance and functional group diversity regulate plant litter decay and soil organic carbon (SOC) level in global terrestrial ecosystems. The data also describes the potential effect of vegetation types, litter quality, litterbag mesh size, soil C/N, soil aggregate size, experimental types and length of experimental time on earthworm induced plant litter and SOC decay. The data were collected from 69 studies published between 1985 and 2018, covering 340 observations. This data article is related to the paper “Earthworm Abundance and Functional Group Diversity Regulate Plant Litter Decay and Soil Organic Carbon Level: A Global Meta-analysis” [1]. Totally 340 observations from 69 studies were included. Detailed data are listed in 2A data set was compiled using literature search of peer-reviewed publications about the effects of earthworms on litter decomposition or SOC from the ISI-Web of Science and Google Scholar research database. We used three different combinations of keywords: earthworm and litter decomposition; earthworm and forest floor; earthworm and soil carbon. A total of 69 studies published between 1985 and 2018 were found , Table 5For To be included in the meta-analysis, the paper had to report the means, standard deviation (SDs) and replicate numbers of litter percent mass loss or SOC for the control treatment  and the experimental treatment . For studies that did not report SD or standard error (SE), we conservatively estimated SD values as 150% of the average variance across the dataset . To eval


Adult protective services and other community-based agencies respond to hundreds of thousands of elder abuse cases annually in the United States; however, few studies include elder abuse victims’ voices. This study explored the most distressing aspects of elder abuse, as identified by victims themselves; to date, this is the first known study on this topic. Guided by a phenomenological qualitative methodology, this study conducted in-person, semi-structured interviews with a sample of elder abuse victims (n = 30) recruited from a community-based elder abuse social service program in New York City. To enhance trustworthiness, two researchers independently analyzed transcript data to identify key transcript codes/themes. Distressing aspects of elder abuse were identified across three key domains, related to feelings of loss (50% of codes), threats/negative consequences (55%), and client-needs/system incongruity (14%). Specifically, the first theme represented outcomes related to loss of relationships (19% of ‘loss’ codes), personhood (16%), credibility (19%), faith/trust in others (38%), and finances (8%). The second theme looked at threats to physical self (34% of ‘threat’ codes), psyche (39%), and others, including the perpetrator (27%). The third theme focused on mismatches in client/system goals (50% of ‘incongruity’ codes) and legal system involvement (50%). The findings in this study provide a comprehensive and conceptually organized range of aspects to serve as infrastructure for the development of meaningful interventions to address the needs of victims. This study represents one of the largest efforts to understand and integrate the perspectives and needs of victims into elder abuse intervention practice/research to date.


Pseudomonas sp. strains isolated from marine sponges have shown potential quorum sensing inhibition (QSI) activity. We sequenced the draft genomes of the three strains with the goal of determining which genes or gene cluster(s) could be potentially involved in the QSI activity. Average nucleotide identity (ANI) and phylogenetic analysis classified the three strains as belonging to the Pseudomonas fluorescens species.Three  Pseudomonas sp. strains isolated from marine sponges have shown potential quorum sensing inhibition (QSI) activity. We sequenced the draft genomes of the three strains with the goal of determining which genes or gene cluster(s) could be potentially involved in the QSI activity. Average nucleotide identity (ANI) and phylogenetic analysis classified the three strains as belonging to the Pseudomonas fluorescens species.Three  Pseudomonas is a Gram-negative bacterial genus belonging to the Gammaproteobacteria class, whose members are known to colonize and survive in a wide range of diverse environments, mainly due to inherent broad metabolic diversity (Pseudomonas sp. strains in the inhibition of quorum sensing (QS) signaling systems has been reported  were isolated from 2 different marine sponges, belonging to the Hexactinellida class, that were collected off the west coast of Ireland as part of a marine biodiscovery cruise in May 2010. The isolation of these Pseudomonas sp. strains and their QS inhibition (QSI) activities were described previously . DNA libraries were prepared using a TruSeq exome library preparation kit. The draft genome sequencing was performed by the Beijing Genomics Institute (China) using the Illumina HiSeq 2000 sequencing platform with paired-end reads and a read length of 90 bp for B98C39. The HiSeq 4000 platform, with paired-end reads and a read length of 150 bp, was used for B98SK52 and B98SM8. In order to obtain high-quality reads for assembly, the FASTA/Q file manipulation tool readfq.v5 quiP (pvdThe draft genome sequences discussed in this work have been deposited at DDBJ/ENA/GenBank and the Sequence Read Archive (SRA). The corresponding accession numbers are listed in


A 63-year-old man presented to our hospital with 2 days history of right-sided earache and numbness followed by the development of vesicular rash involving the right side of the face. There was no history of headache, tinnitus, giddiness or hearing impairment. Neurological examination revealed right-sided mild lower motor neuron type facial palsy (A) and vesicular rash in the distribution of maxillary and mandibular branch of trigeminal nerve without any sensorineural deafness . Routine all laboratory examinations including retroviral screening were normal. A clinical diagnosis of the Ramsay Hunt syndrome (RHS) was considered based on earache, facial paralysis and typical dermatomal distribution of rash. He was started with oral valaciclovir 1gm three times daily (TDS) for 7 days and Tab prednisolone 60mg daily for 5 days. Two days after initiation of the treatment vesicular lesions disappeared but neurological examination revealed right-sided grade IV facial nerve palsy. Ramsay Hunt syndrome or Herpes Zoster Oticus is characterized by reactivation of latent varicella zoster virus in the geniculate ganglion and subsequent spread to cranial nerve. The diagnosis is mainly clinical. The facial paralysis seen in Ramsay Hunt syndrome is often more severe with the increased rate of late neural denervation and decrease the chance of complete recovery.


This presentation reports an exploratory study evaluating the effect of Asian Care Training (ACT) Manual on Asian American (AA) caregivers’ care capacity and knowledge growth. A total of 65 AA caregivers were recruited from community-based organizations in Los Angeles and passed the screening questionnaire, in which 44  completed the evaluation process. Participants were given autonomy to choose topics they desired to learn out of 25 topics in ACT manual and completed one-month learning. The data were collected via structured questionnaires before and after the self-learning and were analyzed with paired t-test on 5 questions about care capacity and 4 about caregiving knowledge. One-month self-learning of ACT manual enhanced participants’ care capacity in 4 out of 5 sectors: confidence in caregiving ; ability to deal with emergency ; to solve concerns of the care recipients ; to communicate more smoothly . Improvements were found in 3 out of 4 sectors in knowledge: knowledge of Alzheimer’s disease ; appropriated approach to displacing care recipients ; and information about caregiver support resources . This self-learning method of ACT manual was feasible for AA caregivers to broaden knowledge and care capacity while adapting with their intensive workload. This study constitutes an important step towards establishing culturally tailored self-training programs for Asian American caregivers for frail older adults via multiple platforms such as online curriculums and mHealth app.


Control and treated animals (dams and offspring) were immunized ip with (0.5 ml) 20% sheep red blood cell (SRBC) suspension seven days before the end of experiments. At the end of exposure, ten dams and ten offspring from each group were used for assessment of cell-mediated immunity and a similar number of animals were sacrificed for evaluating the humoral immune response and serum protein profile. Aluminum chloride exposure of dams (G2 & G3) caused significant suppression of both cell mediated and humoral immune responses in the obtained offsprings compared to the control group (G1) without any significant effect on the immune responses of these dams. Moreover, the serum total globulins, albumin/ globulin (A/G) ratio and gamma globulin fraction were significantly decreased in the treated dam’s offsprings compared to the corresponding controls while the serum total protein and all serum protein fractions showed non significant difference between the control and treated dams and between the two treated dam groups themselves. There were no histopatho-logical changes observed in thymus, spleen and liver of the control and treated dams. Thymus of treated dam’s offsprings (G2) showed lymphoid depletion in both cortex and medulla. Their spleens showed lymphoid depletion in the white pulps and congestion with hemosiderosis in the red pulps. Liver of treated dam’s offsprings showed dilation and congestion of its central vein with degenerative changes in the hepatocytes. These histopathological changes were more severe in G2 than in G3 offsprings. It can be concluded that gestational and/ or lactation exposure of pregnant dams to AI chloride caused suppression of both cellular and humoral immune responses of their offsprings.The present study was designed to explore the immunotoxic effects of orally administered aluminum (AI) on pregnant rats (n = 60) and their growing fetuses and consequently on the animal wealth. The animals were randomly allocated into three equal groups of 20 rats each. The first group has no treatment and kept as a control (G1). The second and third groups of pregnant rats were treated orally with aluminum chloride at 345 mg/Kg b.wt. The second group (G2) received the tested compound from the 6


The University of Chicago GWEP, SHARE Network , is located on the South Side of Chicago, an urban medically underserved community. SHARE Network partners with a variety of community based organizations (CBOs) to support Age Friendly care through an Age Friendly Community Education Curriculum. In a one year period, 28 events were held in 13 CBO sites. Each of these events addressed the 4Ms of Age Friendly care with a specific content focus on Mentation (5 events), Mobility (5), Medications (4), and What Matters (10), and 4 events focused on multiple domains. There were 458 attendees, 290 completed surveys (63% response rate). Eighty-eight percent of participants planned to make a healthy behavior change after participation. Age Friendly Community Education can complement health system transformation to lead to health behavior change for community-dwelling older adults in medically underserved communities.


Research suggests that group music-making can improve well-being and cognitive function in people with dementia and their family carers. The importance of the music facilitator’s role is recognised. However, empirical studies rarely capture their experiences and perspectives. Semi-structured interviews were conducted with three music therapists and three community musicians with specialisms in dementia care. The interviews sought to gain a detailed understanding of their work with people with dementia. Interpretative Phenomenological Analysis revealed eight super-ordinate themes: (1) benefits of music-making for people with dementia; (2) challenges of working with people with dementia; (3) involving family carers; (4) musical content; (5) impact of the facilitator; (6) developing field of Arts and Health; (7) work as a privilege; and (8) potential for misuse of music. This study provides a useful basis from which to further develop concepts for the amelioration of people living with dementia and their families.


Korean immigrant older adults residing in areas without well-established Korean ethnic enclaves experience acculturative stress and depressive symptoms due to their lingual and cultural barriers. Expressive writing can be used as a culturally sensitive intervention to help those immigrants disclose their deepest thoughts and feelings related to their immigration and acculturation experiences. This study gathered qualitative data from the author’s experimental study using expressive writing for first-generation Korean immigrant adults 60 to 88 years of age residing in Midwestern cities. Participants were instructed to write for 15-20 minutes per day in three consecutive days at their convenience in a comfortable and private setting and asked to return their writings by mail. A total of 22 participants returned their writings: 14 wrote about their past and current stressful experiences related to their immigration and acculturation, while eight wrote about their daily lives. Eight themes emerged from thematic coding processes guided by the grounded theory approach: (1) survival, resilience, hardiness, tenacity, pride; (2) lingual barriers; (3) religious faith; (4) gender difference in roles and values; (5) racial discrimination; (6) traditional strategies of acculturation; (7) family and intergenerational gap; and (8) aging. The themes illustrate the participants’ lifelong efforts to shape their unique voices through heart-wrenching struggles, haunting wounds, and ethnic pride and resilience. The study findings suggest that culturally relevant programs and services are needed to facilitate social relationships and reduce lingual and cultural barriers for Korean immigrant older adults residing in non-ethnic enclaves.


Scientific Reports 10.1038/s41598-020-58408-6, published online 30 January 2020Correction to: The original version of this Article contained a typographical error in the Abstract.“We focused on anlyse the functional trait patterns and functional diversity components of two main assemblages that were collected with window traps (WTs) and hollow emergence traps (HETs) respectively, between three protected areas of the Iberian Peninsula.”now reads:“We focused on analysing the functional trait patterns and functional diversity components of two main assemblages that were collected with window traps (WTs) and hollow emergence traps (HETs) respectively, between three protected areas of the Iberian Peninsula.”This has now been corrected in the PDF and HTML versions of the Article.


We read with interest the recent article by Liao et al. who concluded that patients in the endovascular cooling (EC) group had shorter intensive care unit (ICU) hospitalization and a better neurological prognosis than those in the surface cooling (SC) group . In thei