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Along with the rapid increase in older adult population in South Korea, the management of dementia is becoming important. Higher dementia prevalence inevitably leads to an excessive burden on medical expenditure throughout one's life, so the catastrophic health expenditure for dementia should be protected in the aspect of both nation and family. Therefore, this study attempted to estimate the lifetime medical expenditures (LE) of older adults with dementia, and confirmed if the long-term care insurance (LTCI) is effective in reducing their medical expenses. The study analyzed LE of adults, aged over 70 years, using a cohort database and simulated the total LE per capita. In order to compare the differences in LE due to dementia, propensity score matching (PSM) was performed. As of 2015, the total LE per capita for older adults with dementia and without dementia was estimated to be 76,973 thousand won ($65,427) and 31,105 thousand won ($26,439). Older adults with dementia had 2.4 times more expenditure than those without dementia. In particular, the LE per capita for hospitalization of dementia patients was 63,945 thousand won ($54,353), which was about 5 times higher than LE per capita for outpatient treatment. In addition, as a result of confirming the political effectiveness of LTCI, the LE for older adults with dementia, who had not used the long-term care service (LTCS), was estimated to be about 85,769 thousand won ($72,904). Conversely, LTCS users were estimated to spend 70,487 thousand won ($59,914), which means that LTCS non-users spent about 22% more on total LE than LTCS users. Non-users spent about half of their LE after the age of 80. Based on these findings, this study confirmed that the LTCI system had the desired effect of reducing the total LE for older adults with dementia.

African-American mothers in the U.S. experience high rates of stress, placing them at risk for depression, anxiety, and preterm births, and their children at risk for poor social-emotional development later in childhood. Yet, few studies have developed and tested family-based interventions that target optimal management of stress in this population.

The current mixed methods study examined whether a six-week family-based intervention (e.g., cognitive behavioral stress management intervention component for mothers and mindfulness-based kindness curriculum for their children) was effective in improving psychosocial outcomes among low-income African-American mothers and increasing prosocial behaviors in their children.

Seventy-two mothers (28% pregnant, 72% postpartum) completed pre- and post-intervention assessments of stress, depression, anxiety, and self-efficacy for stress management. Prosocial behaviors for 38 of their children (3-10 years of age) were also assessed via mother's self-report and two observational child assessments of sharing and helping behaviors. Qualitative interviews at post-intervention and reunion focus groups (up to two years later) were also conducted.

Mothers showed significant reductions in perceived stress, depressive symptoms, and anxiety, as well as improved self-efficacy for stress management at post-intervention. Although observational assessments of children's sharing and helping behaviors did not change, mothers' qualitative responses indicated improvements in their child's prosocial behaviors at home. Qualitative responses also revealed unique stressors that mothers experienced, the short- and long-term impact of these interventions on mothers and their children, and program recommendations.

These results support the efficacy of family-based stress management interventions in this at-risk population.

These results support the efficacy of family-based stress management interventions in this at-risk population.

Stigma toward people with epilepsy (PWE) is common around the globe. Perceived stigma produced by mental or physical disorders may represent a significant risk factor for suicide.This study examines whether and how perceived stigma, unemployment and depression interact to influence suicidal risk in PWE.

A consecutive cohort of people with epilepsy (PWE) was recruited from the First Affiliated Hospital of Chongqing Medical University. read more Each patient completed the Stigma Scale for Epilepsy (SSE), the Neurological Disorders Depression Inventory for Epilepsy scale (NDDI-E) and the suicidality module of Mini-International Neuropsychiatric Interview(MINI) v.5.0.0. Spearman's correlation and moderated mediation analysis were used to examine the associations among perceived stigma, depression, unemployment and suicidal risk.

Perceived stigma was positively associated with depression severity and suicidal risk. Depression severity mediated the association between perceived stigma and suicidal risk. The indirect effect of perceived stigma on suicidal risk through depression severity was positively moderated by unemployment.

The effect of perceived stigma on suicidal risk can be explained by the mediation of depression severity, At the same time, getting out from the shadow of perceived stigma may help reducing suicidal risk in PWE. In addition, improving employment status of PWE may attenuate the indirect effect of perceived stigma on suicidal risk through depression severity.

The effect of perceived stigma on suicidal risk can be explained by the mediation of depression severity, At the same time, getting out from the shadow of perceived stigma may help reducing suicidal risk in PWE. In addition, improving employment status of PWE may attenuate the indirect effect of perceived stigma on suicidal risk through depression severity.In a 1-day old filly with a loud heart murmur, transthoracic echocardiography revealed right ventricular hypertrophy associated with severe pulmonary valvular stenosis and a transvalvular pressure gradient (between right ventricle and pulmonary artery) of 125 mmHg. Computed tomographic angiography confirmed the finding, with no evidence of other relevant concurrent abnormalities. Balloon valvuloplasty was performed using a single balloon technique. The foal recovered well from anaesthesia. Following the procedure, the right ventricle-pulmonary artery transvalvular gradient decreased to 38 mmHg. At follow up examinations after 1 month, 1 year and 2 years, the filly showed normal exercise capacity and echocardiography confirmed the persistent substantial improvement in the transvalvular outflow gradient.In grape cell cultures cv. Gamay Fréaux var. Teinturier, Ca was shown to decrease cell pigmentation through the inhibition of anthocyanin biosynthesis, while stimulating stilbenoids accumulation. Because methyl jasmonate (MeJA) is a well-known inducer of secondary metabolism in grape cells, and Ca antagonizes its stimulatory effect over several enzymes of core metabolic branches, in the present study we hypothesized that Ca and MeJA signaling pathways interact to regulate specific secondary metabolism routes. Grape cultured cells were elicited with MeJA or with MeJA + Ca and an UPLC-MS-based targeted metabolomic method was implemented to characterize their polyphenolic profiles. Results were compared with the profile of cells elicited with Ca only, previously reported. Data was complemented with gene expression analysis, allowing the assembly of a metabolic map that unraveled routes specifically regulated by both elicitors. MeJA + Ca specifically boosted E-resveratrol and E-ε-viniferin levels by 180% and 140%, respectively, in comparison to cells treated with MeJA only, while the stimulatory effect of MeJA over flavonoid synthesis was inhibited by Ca. In parallel, Ca downregulated most flavonoid pathway genes, including LAR1, ANS, BAN and ANR. Ca was able to mimic or potentiate the effect of MeJA on the expression of JA signaling genes, including JAR1, PIN and PR10. Transcript/metabolite correlation networks exposed the central influence of FLS1,STS,CDPK17 and COI1 in polyphenolic biosynthetic routes. This study highlights the potential of the MeJA-Ca combination for diverting polyphenolic metabolism towards the production of specific metabolites of interest, highly relevant in a biotechnological perspective.Non-invasive respiratory support (NRS) outside of the ICU has played an important role in the management of COVID-19 pneumonia. There is little data to guide selection of NRS modality. We present outcomes of NRS outside the ICU and discuss the effects of NRS on gas exchange with implications for management.

The ability to predict impending asthma exacerbations may allow better utilization of healthcare resources, prevention of hospitalization and improve patient outcomes. We aimed to develop models using machine learning to predict risk of exacerbations.

Data from 29,396 asthma patients was collected from electronic medical records and national registers covering clinical and epidemiological factors (e.g. comorbidities, health care contacts), between 2000 and 2013. Machine-learning classifiers were used to create models to predict exacerbations within the next 15 days. Model selection was done using the mean cross validation score of area under precision-recall curve (AUPRC).

The most important predictors of exacerbation were comorbidity burden and previous exacerbations. Model validation on test data yielded an AUPRC=0.007 (95% CI ± 0.0002), indicating that historic clinical information alone may not be sufficient to predict a near future risk of asthma exacerbation.

Supplementation with additional data on environmental triggers, (e.g. weather, pollen count, air quality) and from wearables, might be necessary to improve performance of the short-term predictive model to develop a more clinically useful tool.

Supplementation with additional data on environmental triggers, (e.g. weather, pollen count, air quality) and from wearables, might be necessary to improve performance of the short-term predictive model to develop a more clinically useful tool.

COVID-19 was first diagnosed in Kenya in March 2020 following which the government instituted control measures which could have affected people's sexual satisfaction and overall quality of life including restrictions in travels; ban on alcohol consumption and closure of bars; 9 pm to 5 am curfew; ban on political rallies, and closure of many workplaces with people being encouraged to work from home.

The objective of this study was to determine how perceived and experienced sexual satisfaction changed with the advent of COVID-19 among heterosexual married individuals in Kenya.

The study was a cross-sectional survey. Data was collected virtually using monkey survey from social groups. A total of 194 participants responded to the survey.

The difference in overall sexual satisfaction as well as satisfaction with sex frequency; sex process; and time, place and ambience around sexual intercourse before and during COVID-19.

Most of the participants (73.4%) reported that they were satisfied with their marit19 and Its Control Measures on Sexual Satisfaction Among Married Couples in Kenya. Sex Med 2021;9100354.

There was perceived increase in dissatisfaction with sex which could be a pointer to the falling quality of life during COVID-19 pandemic especially among the most sexually active men aged 31-50 years living in places where COVID-19 control measures are being stringently implemented. Osur J, Ireri EM, Esho T. The Effect of COVID-19 and Its Control Measures on Sexual Satisfaction Among Married Couples in Kenya. Sex Med 2021;9100354.