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Adhesive Capsulitis of the shoulder is a painful pathology limiting shoulder movements, commonly known as "Frozen Shoulder". Since this pathology limits movement, it is important to make an early diagnosis. Diagnosing capsulitis relies on clinical assessment, although diagnostic imaging, such as Magnetic Resonance Imaging, can provide predictive or supportive information for specific characteristic signs. However, its diagnosis is not so simple nor so immediate, indeed it remains a difficult topic for many general radiologists and expert musculoskeletal radiologists. This study aims to investigate whether it is possible to use disease signs within a medical image to automatically diagnose Adhesive Capsulitis. To this purpose, we propose an automatic Model Checking-based approach to quickly diagnose the Adhesive Capsulitis taking as input the radiomic feature values from the medical images. Furthermore, we compare the performance achieved by our method with diagnostic results obtained by professional radiologists with different levels of experience. To the best of our knowledge, this is the first method for the automatic diagnosis of Adhesive Capsulitis of the Shoulder.
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Bursitis , Diagnóstico Precoz , Imagen por Resonancia Magnética , Bursitis/diagnóstico por imagen , Bursitis/diagnóstico , Humanos , Imagen por Resonancia Magnética/métodos , Femenino , Masculino , Persona de Mediana Edad , Articulación del Hombro/diagnóstico por imagen , Articulación del Hombro/patología , Anciano , RadiómicaRESUMEN
As health impairment increases, older adults utilize care from different types of caregivers, but little is known about changes in the composition of care networks. We mapped the transitions between different care networks to gain insight into which people develop care networks that include informal, privately and publicly paid care. We used three waves (2012-2015-2018) of the Longitudinal Aging Study Amsterdam with 1413 Dutch community-dwelling adults, aged 64-100. Network types were identified using six types of caregivers: (1) co-resident, (2) non-co-resident children, (3) other kin, (4) neighbours/friends/acquaintances, (5) publicly paid, (6) privately paid, in a latent transition analysis with mortality and moving to a care facility as missing states. Five types of care networks were identified: (1) no care, (2) privately paid, (3) mixed informal, (4) mixed publicly paid, (5) co-resident. The co-resident network was the most unstable and had a high transition rate to nursing homes. Participants from the privately paid care network often transitioned to a mixed informal network and rarely transitioned to a mixed publicly paid network. Transitions out of the no-care network were mostly to the privately paid network. The two mixed care networks were the most stable. Transitions appeared to be most triggered by deteriorating health. Transitions to institutional care were most likely in the mixed informal, mixed publicly paid and the co-resident network. Thus, these networks appear to require additional support to facilitate ageing in place.
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This study examined the mediating effect of social adaptation on the associations between sources of social support and depressive symptoms among Chinese older adults, and explored how filial piety moderated these associations in different ways. Data were drawn from the China Longitudinal Aging Social Survey in 2018 (N = 6617). Regression analysis and bootstrap test were used to assess the mechanisms underlying the inconsistency between different sources of social support and depressive symptoms. We found that social support, except for pension, significantly affected depressive symptoms through social adaptation. Moreover, filial piety positively moderated the mediating effect of social adaptation on the association between social support inside the family and depressive symptoms, while negatively moderating it in regard to social support outside the family, except for pension, and depressive symptoms. The results showed filial piety may affect the extent to which older adults convert different sources of social support into personal subjective welfare.
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The lack of awareness and accessibility about the support organizations for preventing sexual violence and assisting victims hampers the effectiveness of the social safety net. A mobile application based on a connection to support agencies was developed and evaluated for usability. A group of 15 experts and a group of 30 users evaluated usability. The developed mobile application focused on "Emergency Report," "Support Agencies and Services," and "Counseling for Support." The strength of the application was acknowledged in providing easy-to-find, reliable, useful, and necessary information, highlighting the positive usability and applicability of the mobile support application for sexual violence victims.
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Thienamycin is a carbapenem antibiotic with potent activity against gram-negative and gram-positive bacteria. Due to its promising activity but lack of chemical stability, thienamycin serves as inspiration for new synthetic antibiotic scaffolds. In this study, we report a nine-step enantioselective formal synthesis of thienamycin. Our route utilizes an asymmetric reduction, enabled by NaBH4 and D-tartaric acid, followed by a series of diastereoselective reactions to access the key azetidinone precursor to thienamycin. This azetidinone precursor could be used as an intermediate to further develop and expand the scope of next-generation beta-lactam antibiotic scaffolds.
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This paper presents a control strategy synthesis method for dynamical systems with differential constraints, emphasizing the prioritization of specific rules. Special attention is given to scenarios where not all rules can be simultaneously satisfied to complete a given task, necessitating decisions on the extent to which each rule is satisfied, including which rules must be upheld or disregarded. We propose a learning-based Model Predictive Control (MPC) method designed to address these challenges. Our approach integrates a learning method with a traditional control scheme, enabling the controller to emulate human expert behavior. Rules are represented as Signal Temporal Logic (STL) formulas. A robustness margin, quantifying the degree of rule satisfaction, is learned from expert demonstrations using a Conditional Variational Autoencoder (CVAE). This learned margin is then applied in the MPC process to guide the prioritization or exclusion of rules. In a track driving simulation, our method demonstrates the ability to generate behavior resembling that of human experts and effectively manage rule-based dilemmas.
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Psychological science is divided into two distinct methodological traditions. One tradition seeks to understand how people function at the individual level, while the other seeks to understand how people differ from each other. Methodologies that have grown out of these traditions typically rely on different sources of data. While both use statistical models to understand the structure of the data, and these models are often similar, Molenaar (2004) showed that results from one type of analysis rarely transfer to the other, unless unrealistic assumptions hold. This raises the question how we may integrate these approaches. In this paper, we argue that formalized theories can be used to connect intra- and interindividual levels of analysis. This connection is indirect, in the sense that the relationship between theory and data is best understood through the intermediate level of phenomena: robust statistical patterns in empirical data. To illustrate this, we introduce a distinction between intra- and interindividual phenomena, and argue that many psychological theories will have implications for both types of phenomena. Formalization provides us with a methodological tool for investigating what kinds of intra- and interindividual phenomena we should expect to find if the theory under consideration were true.
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Objective: Cannabis use has been linked to physical, psychological, and behavioral changes. Although research indicates separately that informal social support and formal social engagement - which are correlated measures - serve as protective factors in cannabis use, much of this research focuses on youth and more urban samples, limiting our understanding of if these findings are true for rural populations where social support and social engagement are particularly important for health and health behaviors. To fill the research gap, this study examines the effects of informal social support (tangible support and emotional support) and formal social engagement on cannabis use among rural working-age adults. Methods: This research analyzed 1,122 observations from a cross-sectional online survey conducted in 2022 of working-age adults (18-64) from rural America. Multilevel logistic regression models were used to predict cannabis use in the past 12 months using informal social support (tangible support and emotional support) and formal social engagement and other sociodemographic covariates and state legalization status. Results: Multilevel logistic modeling indicates that low emotional support and low formal social engagement are associated with a higher odds of reporting cannabis use in the past 12 months among rural working-age adults, net of other sociodemographic variables and state legalization status. Conclusions: The study suggests that emotional support and social engagement may contribute to cannabis use prevention among rural working-age adults. These findings should inform future research as well as the development of tailored health interventions targeting rural working-age adults.
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Introduction: With a decreasing workforce of carers and a transition from care homes to home care, people with dementia (PwD) increasingly rely on informal caregivers (ICs) and assistive technologies (ATs). There is growing evidence that ATs in the home environment can reduce workload for formal carers (FCs) and ICs, reduce care costs, and can have a positive influence on quality of life (QoL) for PwD and their caregivers. In practice, using multiple ATs still often implies using different separate point solutions and applications. However, the integral, combined use of the data generated using various applications can potentially enhance the insight into the health and wellbeing status of PwD and can provide decision support for carers. The purpose of the current study was to evaluate the use of a DSS that integrated multiple ATs into one dashboard through a small-scale field study. Methods: The current study presents the formative evaluation of a Decision Support System (DSS) connected to multiple ATs. This DSS has been developed by means of co-creation during an international project. The DSS provides an insight into the physical and cognitive status of a PwD, as well as an insight into sleep activity and general wellbeing. Semi-structured interview sessions were held in three countries (Netherlands, Italy, and Taiwan) with 41 participants to gain insight into the experiences of formal and informal carers and PwD with both the ATs and the DSS Alpha prototype dashboard. Results: The results showed that participants using the DSS were satisfied and perceived added value and a fit with certain care demands from the PwD. In general, ICs and FCs have limited insight into the status of PwD living independently at home, and in these moments, the DSS dashboard and AT bundle can provide valuable insights. Participants experienced the DSS dashboard as well-organized and easy to navigate. The accuracy of the data displayed in the dashboard is important, the context, and (perceived) privacy issues should be tackled according to all users. Furthermore, based in the insight gained during the evaluation a set of design improvements was composed which can be used to further improve the DSS for the Beta evaluation. Discussion and conclusion: The current paper evaluates a possible solution for excess AT usage and how the use of a DSS which integrated multiple AT into one single technology could support caregivers in providing care for PwD. The formative evaluation scrutinized the integration of the developed DSS and the composed bundle of ATs across diverse cultural contexts. Insights from multi-center observations shed light on user experiences, encompassing overall usability, navigational efficacy, and attitudes toward the system. FCs and ICs expressed positivity toward the DSS dashboard's design and functionalities, highlighting its utility in remote monitoring, tracking changes in the person's abilities, and managing urgent situations. There is a need for personalized solutions and the findings contribute to a nuanced understanding of DSS and AT integration, providing insights for future developments and research in the field of DSS for the care of PwD.
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The RePair compression algorithm produces a context-free grammar by iteratively substituting the most frequently occurring pair of consecutive symbols with a new symbol until all consecutive pairs of symbols appear only once in the compressed text. It is widely used in the settings of bioinformatics, machine learning, and information retrieval where random access to the original input text is needed. For example, in pangenomics, RePair is used for random access to a population of genomes. BigRePair improves the scalability of the original RePair algorithm by using Prefix-Free Parsing (PFP) to preprocess the text prior to building the RePair grammar. Despite the efficiency of PFP on repetitive text, there is a scalability issue with the size of the parse which causes a memory bottleneck in BigRePair. In this paper, we design and implement recursive RePair (denoted as Re 2 Pair ), which builds the RePair grammar using recursive PFP. Our novel algorithm faces the challenge of constructing the RePair grammar without direct access to the parse of text, relying solely on the dictionary of the text and the parse and dictionary of the parse of the text. We compare Re 2 Pair to BigRePair using SARS-CoV-2 haplotypes and haplotypes from the 1000 Genomes Project. We show that our method Re 2 Pair achieves over a 40% peak memory reduction and a speed up ranging between 12% to 79% compared to BigRePair when compressing the largest input texts in all experiments. Re 2 Pair is made publicly available under the GNU public license here: https://github.com/jkim210/Recursive-RePair.
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BACKGROUND: This study investigates the excess costs of dementia from healthcare, social care services, and prescription drugs 3 years before to 6 years after diagnosis. Further, sociodemographic cost differences are explored. METHODS: Using Swedish register data from 2013 to 2016 to compare individuals diagnosed with dementia (n = 15,339) with population controls, the excess formal care costs for people with a dementia diagnosis are obtained with longitudinal regression analysis. RESULTS: People with dementia incur higher formal care costs for all years studied compared to people without dementia. The excess costs vary from 3400 3 years before diagnosis to 49,700 6 years after diagnosis. The costs are mainly driven by institutional care, and solitary living is a strong predictor of high excess costs. CONCLUSION: The results show that the formal care costs of individuals with dementia are substantial, and that the economic burden of dementia in Sweden is larger than previously estimated.
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The experience of losing a child is increasingly uncommon worldwide but is no less devastating for parents who experience it. An overlooked aspect of this phenomenon is its timing: at which age do bereft parents lose a child and how are these ages at loss distributed? We use demographic methods to explore the mean and variability of maternal age at child loss in 18 countries for the 1850-2000 birth cohorts. We find that the distribution of age of child loss is bimodal, with one component representing young offspring deaths and another representing adult offspring deaths. Offspring loss is transitioning from being a relatively common life event, mostly experienced by young mothers, to a rare one spread throughout the maternal life course. Moreover, there is no evidence of convergence in the variability of age at offspring loss. These results advance the formal demography of kinship and underline the need to support bereaved parents across the life course.
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This research presents two stable language metrics, namely Successful Prediction Rate (SPR) and Disfluency (DF), to objectively quantify the linguistic disturbances associated with schizophrenia. These novel language metrics can capture both off-topic responses and incoherence in patients' speech by modeling speech information and fine-tuning techniques. Additionally, these metrics exhibit cultural sensitivity while providing a more comprehensive evaluation of linguistic abnormalities in schizophrenia. This research fine-tuned the ELECTRA Pretrained Language Model on a 750 MB text corpus obtained from major Chinese mental health forums. The effectiveness of the fine-tuned language model is verified on a group comprising 38 individuals diagnosed with schizophrenia and 25 meticulously matched healthy controls. The study explores the association between the fine-tuned language model and the Positive and Negative Syndrome Scale (PANSS) items. The results demonstrate that SPR is higher in healthy controls, indicating better language understanding by the pre-trained language model. Conversely, DF is higher in individuals with schizophrenia, indicating more inconsistent language structure. The relationship between linguistic features and P2 (conceptual disorganization) reveals that patients with positive P2 exhibit lower SPR and higher DF. Binary logistic regression using the combined SPR and DF features achieves 84.5 % accuracy in classifying P2, exceeding the performance of traditional features by 20.5 %. Moreover, the proposed linguistic features outperform traditional linguistic features in discriminating FTD (formal thought disorder), as demonstrated by multivariate linear regression analysis.
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Objective: To investigate patterns of parenting stress and access to sufficient informal and formal support among parents of children with disabilities. To explore whether child cognitive level, conduct problems and the need of language interpretation in contacts between parents and professionals are associated with patterns of parenting stress and support. Method: Parents (N = 140) of children with disabilities in Sweden completed a questionnaire about parenting stress and support. Patterns of three variables-parenting stress and access to sufficient informal and formal support-were investigated using cluster analysis. The relationship of child cognitive level, level of conduct problems and of language interpretation needs between parents and professionals to cluster membership was explored using multinomial logistic regression. Results: Five different clusters of parenting stress and support emerged. Parents in cluster 1 had lower than sample mean ratings on all three variables. Cluster 2 had elevated parenting stress, cluster 3 had elevated insufficient informal support and cluster 4 had elevated insufficient formal support. Cluster 5 had elevated ratings on all three variables. Greater child cognitive difficulties increased the likelihood of parent membership in cluster 2 (elevated stress), cluster 3 (elevated insufficient informal support), or cluster 5 (elevated ratings on all variables). Child conduct problems increased the likelihood of membership in cluster 2 (elevated stress) or cluster 5 (elevated ratings on all variables). No relationship between language interpretation needs and cluster membership was found. Conclusions: Patterns of parenting stress and sufficiency of support, and their associations with child characteristics, vary substantially. However, families of children with conduct problems experiencing elevated parenting stress in combination with insufficient informal and formal support, may be particularly vulnerable. The results of the current study highlight the clinical importance of exploring and identifying individual parenting stressors and perceived levels of support, to be able to adapt services to better suit a variety of needs, and thus promote equitable care.
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AIM: To explore the views and experiences of formal caregivers caring for older inpatients with physical disabilities. METHODS: It was a qualitative phenomenological study. Using purposive sampling, twelve formal caregivers were chosen in a tertiary comprehensive hospital in Hangzhou, China. Semi-structured, face-to-face interviews were conducted, guided by open-ended questions that focused on gaining rich insights into participants' views and experiences. Coding reliability thematic analysis was used to guide data analysis and categorize, based on Lazarus and Folkman's theory of transactional coping. RESULTS: Four themes emerged from the data analysis: (1) Caregiving Threats. (2) motivations. (3) Responsibility Management. (4) Fear. CONCLUSION: Despite facing significant pressure at work, formal caregivers of elderly inpatients with physical disabilities possess the drive and various coping strategies to excel in their role. Identifying caregivers' experiences of care can be helpful in improving resilience to stress and maintaining stability in formal caregivers.
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The study addressed two main objectives: (i) to investigate disparities in motivation dimensions regarding extracurricular physical activity and (ii) to identify the influence of motivation on time spent in formal and informal physical activity. A sample of 704 adolescents (56% girls) from middle (46%) and high school (54%), with an average age of 14.88 ± 2.52, was assessed for different motivation dimensions using the Questionnaire of Motivation for Sports Activities (QMSA). Additionally, participants were categorized based on extracurricular physical activity practice. Multivariate analyses and multiple linear regressions were conducted to examine the effect of physical activity type on motivation dimensions and identify predictors of time spent in formal and informal physical activities, respectively. Results indicated that motivation varied significantly with extracurricular physical activity practice (p < 0.05), with students involved in extracurricular activities being more motivated. Sex and age differences were observed, with boys showing higher motivation in certain dimensions (achievement status (p < 0.001); group activity (p = 0.027); contextual (p = 0.004); technical improvement (p = 0.012) and older participants having lower scores in all dimensions. The influence of family and friends was a significant predictor only for boys in formal physical activity (p = 0.039). In terms of time spent in physical activity, group activity was a predictor for informal activities (p < 0.001), while technical improvement was a predictor for formal activities (p < 0.001), with notable sex differences. These findings underscore the importance of considering sex- and age-specific motivations when promoting physical activity among adolescents.
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The human tendency to help others in need has been subject to trans-, inter-, and multidisciplinary studies (e.g., anthropology, neurobiology, evolutionary psychology, economy), within the frame of studying the mechanisms and adaptive significance of human prosocial behavior. Volunteering directed to unrelated and unfamiliar individuals is one common form of such helping behavior. Helping others may be adaptive for a species at a macro-level, which in turn is mediated by neurobiological mechanisms. A key target for analysis of the neurobiological underpinnings of volunteering is the endogenous opioid system (EOS). This chapter discusses EOS activity as a potential mediator of volunteering behavior. Evidence of the congruence between EOS involvement in social group behavior and social bonding and the role of these phenomena in volunteerism is reviewed. Models and empirical evidence of the mechanisms and adaptive value of helping unrelated others are discussed and integrated, including the mammalian caregiving system, the neurobiological model of prosocial behavior, synchrony promoting social bonding, and stress-driven motivation of prosocial action in immediate needs.
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Evolución Biológica , Conducta de Ayuda , Voluntarios , Animales , Humanos , Altruismo , Péptidos Opioides/metabolismo , Conducta Social , Voluntarios/psicologíaRESUMEN
The contributions of informal providers to the urban health system and their linkage to the formal health system require more evidence. This paper highlights the collaborations that exist between informal providers and the formal health system and examines how these collaborations have contributed to strengthening urban health systems in sub-Sahara Africa. The study is based on a scoping review of literature that was published from 2011 to 2023 with a focus on slums in sub-Sahara Africa. Electronic search for articles was performed in Google, Google Scholar, PubMed, African Journal Online (AJOL), Directory of Open Access Journals (DOAJ), ScienceDirect, Web of Science, Hinari, ResearchGate, and yippy.com. Data extraction was done using the WHO health systems building blocks. The review identified 26 publications that referred to collaborations between informal providers and formal health systems in healthcare delivery. The collaboration is manifested through formal health providers registering and standardizing the practice of informal health providers. They also participate in training informal providers and providing free medical commodities for them. Additionally, there were numerous instances of client referrals, either from informal to formal providers or from formal to informal providers. However, the review also indicates that these collaborations are unformalized, unsystematic, and largely undocumented. This undermines the potential contributions of informal providers to the urban health system.
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This study aimed to compare how vulnerable informal and formal households are to disaster risks in Bekkersdal mining area in the Rand West City municipality, using a mixed method. A qualitative approach was used to construct a situational analysis of the community, while a questionnaire was used to collect descriptive data. Findings showed both household types (formal and informal) experienced disaster-related risks as their coping resources are limited. Disaster risks such as mining-related incidents (dust, earth tremors and windstorms) are more significant in the informal areas than in formal areas because of their geographical locations. The latter are located in high density areas, with limited access to basic services. Resulting in among others, construction of illegal informal areas and use of illegal electricity connections. These disaster incidents occur against the backdrop of an already vulnerable dolomitic environment that tends to form sinkholes. Thus, the negative impact of mining is the highest disaster risk factor in the area, yet households seem tolerant and distant as they perceive mining as a job opportunity. The study recommended the municipality to include disaster risks in their integrated development plans to ensure that sustainable mining practices are in place to minimise the negative effects in the area. The rehabilitation of mines, measures to prevent informal construction or illegal occupation, and educational awareness on mitigation and adaptation measures are necessary. Contribution: The study adds to the body of knowledge by revising some old techniques of addressing disaster risk measures, especially in surrounding mining communities.
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I.J. Good's "On the Principle of Total Evidence" (1967) looms large in decision theory and Bayesian epistemology. Good proves that in Savage's (1954) decision theory, a coherent agent always prefers to collect, rather than ignore, free evidence. It is now well known that Good's result was prefigured in an unpublished note by Frank Ramsey (Skyrms 2006). The present paper highlights another early forerunner to Good's argument, appearing in Janina Hosiasson's "Why do We Prefer Probabilities Relative to Many Data?" (1931), that has been neglected in the literature. Section 1 reviews Good's argument and the problem it was meant to resolve; call this the value of evidence problem. Section 2 offers a brief history of the value of evidence problem and provides biographical background to contextualize Hosiasson's contribution. Section 3 explicates the central argument of Hosiasson's paper and considers its relationship to Good's (1967).