Extreme Groups Research Articles

Prediction and early warning model of mixed exposure to air pollution and meteorological factors on death of respiratory diseases based on machine learning.

In recent years, with the repeated occurrence of extreme weather and the continuous increase of air pollution, the incidence of weather-related diseases has increased yearly. Air pollution and extreme temperature threaten sensitive groups' lives, among which air pollution is most closely related to respiratory diseases. Owing to the skewed attention, timely intervention is necessary to better predict and warn the occurrence of death from respiratory diseases. In this paper, according to the existing research, based on a number of environmental monitoring data, the regression model is established by integrating the machine learning methods XGBoost, support vector machine (SVM), and generalized additive model (GAM) model. The distributed lag nonlinear model (DLNM) is used to set the warning threshold to transform the data and establish the warning model. According to the DLNM model, the cumulative lag effect of meteorological factors is explored. There is a cumulative lag effect between air temperature and PM2.5, which reaches the maximum when the lag is 3days and 5days, respectively. If the low temperature and high environmental pollutants (PM2.5) continue to influence for a long time, the death risk of respiratory diseases will continue to rise, and the early warning model based on DLNM has better performance.

Early cerebral hemodynamic changes following unilateral carotid artery stenting in patients with different degrees of carotid stenosis.

Few studies have focused on cerebral hemodynamics in the early stage following carotid artery stenting (CAS). This retrospective cohort study aimed to investigate cerebral hemodynamic changes within 6 hours of unilateral CAS in patients with different degrees of carotid stenosis. A total of 104 patients who underwent CAS accompanied by transcranial color-code Doppler or transcranial Doppler were enrolled in the study. The participants were divided into the following 3 groups based on the degree of carotid stenosis: severe stenosis group, extreme stenosis group, and near occlusion group. Bilateral middle cerebral artery (MCA) peak systolic velocity (PSV) and pulsatility index (PI) were measured using transcranial color-code Doppler before and 1 and 3 hours following CAS. Blood pressure, MCA-PSV, and PI were compared among the 3 groups. At 1 hour following CAS, ipsilateral MCA-PSV increased compared to the baseline in the severe stenosis group [84±21 vs. 93±27 cm/s; 8.1%; interquartile range (IQR), 1.4-20.1%; P<0.001]. A similar hemodynamic change, but of a larger magnitude, was observed in the extreme stenosis group (83±24 vs. 100±29 cm/s; 20.8%; IQR, 5.3-33.1%; P<0.001) and near occlusion group (73±24 vs. 109±29 cm/s, 45.8%; IQR, 24.3-73.1%; P<0.001). At 3 hours after CAS, the hemodynamic changes were the same as those at 1 hour. PI increased in all 3 groups following CAS. A subgroup analysis was performed according to symptoms, sex, smoking status, history of hypertension, and presence of hyperlipidemia or diabetes, and the increase in ipsilateral MCA-PSV was not significant. In terms of adverse events, only 4 patients in the near occlusion group experienced transient post-CAS hyperperfusion. The ipsilateral MCA-PSV and PI in patients following unilateral CAS increased significantly in the initial hours. The increase in ipsilateral MCA-PSV was considerably higher in patients with a severe degree of stenosis. Near occlusion of the carotid artery was an independent risk factor for hyperperfusion after unilateral CAS.

Геохимические особенности Ag-Au рудопроявления Кыплатап (центральная Чукотка)

The article considers the geochemical features of unconventional mineralization in secondary quartzite’s of the Kyplatap ore occurrence, located on the southeastern flank of the volcanic dome structure (VDS) of the same name, complicating the Palyavaam-Pykarvaam volcanotectonic depression (VTD) in the Chaun zone of the Central Chukotka sector of the Okhotsk-Chukotka volcanic Belt (OChVB). The Kyplatap VDS was formed due to the intrusion into the Late Cretaceous Alkaquun volcanites of a large laccolith-like subvolcanic body composed of rhyolite-trachyriolite-trachydacites. Based on the geochemical studies of the Kyplatap ore occurrence, the authors compiled a representative database of geochemical data, including the results of analyses of express-RFA, PKSA and XSA with coordinates and composition of ores and rocks. Correlation analysis of the database showed a positive relationship between Au and Ag, as well as Sb for ore mineralization, and a negative correlation of these elements with the association of the rock group of elements (Ti, Y, Zr, Nb and Yb) that were removed during ore formation. The authors also distinguished the second rock group of elements (K, Ga, Sn, Ba, V, W, Pb, Sc, La and B), characterized by medium and weak correlation of the first group of elements. They calculated the coefficients of enrichment and deficiency of ore-forming elements for the samples taken within the ore zones of the Kyplatap ore occurrence. The extreme enrichment group includes elements Au, Ag, Sb, Bi, As, the average contents of which are 100 times or more, and the minimum concentrations are at least 2-10 times higher than the average contents in the upper crust. The normal enrichment group includes elements S, Sn, Cu, Zn, Mn, Mo and Pb, the average contents of which are 2-10 times, and the maximum concentrations are 5-100 times higher than the average concentrations of the upper crust. The obtained values of the enrichment coefficients indicate a sufficiently intensive metensomatoses and ore formation within the Kyplatap ore occurrence.

Air sea conditions facilitate a transformation of the positive Indian Ocean Dipole with distinct east pole characteristics into an extreme event

The Indian Ocean Dipole (IOD) is one of the dominant interannual variabilities in the Indian Ocean (IO), and an extreme IOD, in particular, has dramatic effects on the weather, agriculture, and ecosystem around it. Therefore, the formation of an extreme IOD has been a worldwide research focus. Among 13 positive IOD (PIOD) events, two type-east and two type-comparable PIODs developed into extreme events during the 1960–2020 period. This investigation focuses on the cause of the formation of the type-east extreme PIOD, as previous studies have discussed the origin of the type-comparable extreme PIOD. Composite analysis showed that, as an entity, the strong East Asian and Australian monsoon (EAAM) may result in an evident easterly wind anomaly around the Indonesian region of the Marine Continent during May to August of the years when type-east PIODs occurred. The easterly wind anomaly associated with the EAAM was stronger in the extreme IOD group, whereas it was relatively weak in the regular group. The difference in the easterly wind anomaly between the extreme and regular groups could result in a vertical motion anomaly by enhancing the anomalous westward current. The stronger vertical motion created an upwelling in the deep-layer cold water, resulting in a more distinct difference in the vertical temperature gradient. All these conditions promoted the transformation of the type-east PIODs that occurred in 1961 and 1994 into extreme events and are indicative of the importance of vertical advection terms in the formation of type-east extreme PIODs. This study reveals the cause of the formation of type-east extreme PIODs, which will be helpful in understanding IOD diversity.

Lifespan differences in visual short-term memory load-modulated functional connectivity

Working memory is critical to higher-order executive processes and declines throughout the adult lifespan. However, our understanding of the neural mechanisms underlying this decline is limited. Recent work suggests that functional connectivity between frontal control and posterior visual regions may be critical, but examinations of age differences therein have been limited to a small set of brain regions and extreme group designs (i.e., comparing young and older adults). In this study, we build on previous research by using a lifespan cohort and a whole-brain approach to investigate working memory load-modulated functional connectivity in relation to age and performance. The article reports on analysis of the Cambridge center for Ageing and Neuroscience (Cam-CAN) data. Participants from a population-based lifespan cohort (N = 101, age 23–86) performed a visual short-term memory task during functional magnetic resonance imaging. Visual short-term memory was measured with a delayed recall task for visual motion with three different loads. Whole-brain load-modulated functional connectivity was estimated using psychophysiological interactions in a hundred regions of interest, sorted into seven networks (Schaefer et al., 2018, Yeo et al., 2011). Results showed that load-modulated functional connectivity was strongest within the dorsal attention and visual networks during encoding and maintenance. With increasing age, load-modulated functional connectivity strength decreased throughout the cortex. Whole-brain analyses for the relation between connectivity and behavior were non-significant. Our results give additional support to the sensory recruitment model of working memory. We also demonstrate the widespread negative impact of age on the modulation of functional connectivity by working memory load. Older adults might already be close to ceiling in terms of their neural resources at the lowest load and therefore less able to further increase connectivity with increasing task demands.

Investigation of higher-harmonic wave loads and low-frequency resonance response of floating offshore wind turbine under extreme wave groups

When floating offshore wind turbines (FOWT) encounter extreme waves in operation, it is a highly nonlinear system involving floater motion and extreme wave–structure interactions. The behavior is crucial for floating offshore wind turbine safety. With the aid of a high-fidelity CFD solver, a harmonic separation method through a ‘Stokes-like’ formulation was adopted to obtain the parameters for each harmonic response. The present study focuses on analyzing higher harmonic load, dynamic motion response, and tension load of the mooring line the DeepCwind semi-submersible FOWT. The results show that the higher-harmonic wave load cannot be ignored in the extreme marine environment, the second harmonic can be over 16% of the linear wave load, and the third harmonic can be over 10% of the linear wave load with large wave steepness. The duration of a focused wave crest interaction with the platform is a short process of only 1.4 s in model scale, corresponding to about 10 s for the prototype. The wave runup at the upstream column is larger than the other columns, and the flow velocity is double that of the wave without the floater in presence. The dynamic response of the floater contains two phases, ’forced oscillations’ is identified to be drag-driven from odd harmonics, and ’free decay’ mainly comes from second-order difference-frequency influence from even harmonics. The properly normalized wave forces of surge and heave motion are not influenced by steepness kpAlinear. For surge motion, the total motion mainly comes from the nonlinear low frequency component. For pitch motion, the linear response is dominant in small kpAlinear. When the steepness kpAlinear increases gradually, the second-order low-frequency response of pitch motion will increase rapidly and dominate the total response.

Group threat, political extremity, and collective dynamics in online discussions

Collectives adapt their network structure to the challenges they face. It has been hypothesized that collectives experiencing a real or imagined threat from an outgroup tend to consolidate behind a few group members, and that network structures in which a few members attract most of the attention are more likely in politically extreme groups. These hypotheses have not been tested in large-scale real-world settings. We reconstruct networks of tens of thousands of commenters participating in comment sections of high-profile U.S. political news websites spanning the political spectrum from left to right, including Mother Jones, The Atlantic, The Hill, and Breitbart. We investigate the relationship between different indices of inequality of attention in commenters’ networks and perceived group threat associated with significant societal events, from elections and political rallies to mass shootings. Our findings support the hypotheses that groups facing a real or imagined outgroup threat and groups that are more politically extreme are more likely to attend to a few high-profile members. These results provide an extensive real-world test of theoretical accounts of collective adaptation to outgroup threats.

Is it really empathy? The potentially confounding role of mental imagery in self-reports of empathy

Empathy refers to an individual’s responses to the experiences of others. We hypothesised that mental imagery is related to self-reported empathy if assessed with verbal empathy questionnaires or vignettes and that this association disappears when visual tests are used. In study 1, we examined the association between imagery vividness and empathy in a large-scale sample (N = 2,232) using the Vividness of Visual Imagery Questionnaire and the Interpersonal Reactivity Index. In study 2, we used an experimental extreme group approach, contrasting the responses of participants with aphantasia (=imagery-absence) (N = 112) and controls (N = 120) to pictorial and parallelised verbal scenarios. Both studies confirmed that mental imagery ability is positively associated with empathy when verbal material is used but not when visual material is used.

Risk factors of lower extremity injuries in youth athletes

ObjectiveLower extremity sports injuries frequently occur during an individual’s growth period. The object of the current study was to analyse the risk factors for lower extremity sports injuries for youth...

LEED-CI v4 Projects in Terms of Life Cycle Assessment in Manhattan, New York City: A Case Study

Over the last decade, it has been clearly shown that the same achievements in Leadership in Energy and Environmental Design (LEED) projects can lead to different life cycle assessments (LCAs). However, the problem of contradictory achievements in LEED and LCA has not yet been resolved. This study aimed to identify and evaluate different strategies for LEED projects using LCAs. Thirty-nine LEED projects with the same characteristics—location and transportation, rating system, rating version, certification level, and space type—were collected and sorted by their energy and atmosphere (EA) category, “optimize energy performance” credit (EAc6) achievement into three equal groups (EALow, EAMedium, and EAHigh, where each group includes 13 LEED projects) to minimize the influence of uncontrolled factors on the LEED project strategy. The author focused on two extreme groups with very different EAc6 credit scores: EALow (13 projects) and EAHigh (13 projects). The groups were compared across LEED categories and credits. Wilcoxon–Mann–Whitney and Cliff’s δ test results showed that the EALow and EAHigh groups are associated with high/low achievements in materials-related credits such as “interiors life cycle impact reduction”, “building product disclosure and optimization—material ingredients”, and “low-emitting materials”. As a result, the EALow and EAHigh groups were reclassified into EnergyLow–MaterialsHigh and Energyhigh–MaterialsLow certification strategy groups. In this context, LCAs were used to assess the differences between the two strategies. The results showed that if natural gas was used for operational energy (OE), the EnergyHigh–MaterialsLow strategy showed lower environmental damage compared to the EnergyLow–MaterialsHigh strategy (p = 0.0635); meanwhile, if photovoltaic energy was used for OE, the EnergyLow–MaterialsHigh strategy showed lower environmental damage compared to the EnergyHigh–MaterialsLow strategy (p = 0.0036). The author recommends using the LEED protocol and the LCA method in parallel to better reflect the environmental impact of different certification strategies.

Time trends, projections, and spatial distribution of low birthweight in Australia, 2009-2030: Evidence from the National Perinatal Data Collection.

Infants with low birthweight (LBW, birthweight <2500 g) have increased in many high-resource countries over the past two decades. This study aimed to investigate the time trends, projections, and spatial distribution of LBW in Australia, 2009-2030. We used standard aggregate data on 3 346 808 births from 2009 to 2019 from Australia's National Perinatal Data Collection. Bayesian linear regression model was used to estimate the trends in the prevalence of LBW in Australia. Wefound that the prevalence of LBW was 6.18% in 2009, which has increased to 6.64% in 2019 (average annual rate of change, AARC=+0.76%). If the national trend remains the same, the projected prevalence of LBW in Australia will increase to 7.34% (95% uncertainty interval, UI=6.99, 7.68) in 2030. Observing AARC across different subpopulations, the trend of LBW was stable among Indigenous mothers, whereas it increased among non-Indigenous mothers (AARC=+0.81%). There is also an increase among the most disadvantaged mothers (AARC=+1.08%), birthing people in either of two extreme age groups (AARC=+1.99% and +1.53% for <20 years and ≥40 years, respectively), and mothers who smoked during pregnancy (AARC=+1.52%). Spatiotemporal maps showed that some of the Statistical Area level 3 (SA3) in Northern Territory and Queensland had consistently higher prevalence for LBW than the national average from 2014 to 2019. Overall, the prevalence of LBW has increased in Australia during 2009-2019; however, the trends vary across different subpopulations. If trends persist, Australia will not achieve the Sustainable Development Goals (SDGs) target of a 30% reduction in LBW by 2030. Centering and supporting the most vulnerable subpopulations is vital to progress the SDGs and improves perinatal and infant health in Australia.

Assessing severity in anorexia nervosa: Do the DSM-5 and an alternative severity rating based on overvaluation of weight and shape severity differ in psychological and biological correlates?

This study evaluated the severity ratings for anorexia nervosa (AN) in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and an alternative severity rating based on overvaluation of weight/shape, on a range of psychological and biological variables. A sample of 312 treatment-seeking patients with AN (mean age=25.3, SD=7.6; mean BMI=16.8kg/m2 , SD=2.4) were categorised using both DSM-5 severity levels (mild/moderate/severe/extreme) and weight/shape (low/high) overvaluation. The severity categories were compared on a range of psychological (e.g., eating psychopathology) and biological (e.g., sodium) variables. Results showed that the overvaluation of weight/shape appeared better at indexing the level of severity in psychological variables among patients with AN compared to the DSM-5 severity rating with moderate to large effect sizes. Moreover, the DSM-5 mild and moderate severity groups experienced significantly higher eating and general psychopathology than the severe and extreme groups. Finally, neither the DSM-5 nor the weight/shape severity groups differed on any of the biological variables. This study provided no support for the DSM-5 severity rating for AN, while initial support was found for the weight/shape overvaluation approach in indexing psychological but not biological correlates.

Effects of Serum Albumin Level in Section Lower vs Upper Extremity Surgery: A Hospital-based Retrospective Study

Introduction: Trauma and major surgery often lead to low serum albumin level in patients. Several studies have been reported showing depressed serum albumin level in upper, lower extremity and other major surgery. Metabolic stress response from major surgical interventions and prolonged immobility are primarily responsible for low serum albumin level in these patients. Aim: To investigate the preoperative and postoperative serum albumin levels in patients who underwent extremity surgery and compare the changes in albumin levels between those who underwent upper extremities surgery versus lower extremities surgery. Materials and Methods: This was a hospital-based retrospective study, including 120 patients, who presented to the Emergency Department of Surgery and Orthopaedics, in Deben Mahata Government Medical College and Hospital, Purulia, West Bengal, India, due to trauma included in the present study (on and from November 30 2018 to November 30 2021). All the patients underwent either lower or upper extremity surgery (Group 1 and Group 2, respectively) by orthopaedic surgeons and were consecutively selected regardless of their ages. The serum albumin levels at the time of admission and on the third day after surgery were obtained from the hospital patient records. Continuous variables were expressed as mean±standard deviation. The normality test of the numerical variables using Kolmogorov-Smirnov test. Results: Mean age of population in the upper extremities surgery group was 38.8 years vs 30.5 years in the lower extremities. A statistically significant difference in the preoperative and postoperative serum albumin levels was found in both groups (p&lt;0.05). Moreover, the mean difference between preoperative and postoperative serum albumin levels was found to be significantly higher in the lower extremity group (1.52±0.32 gm/dL) than in the upper extremity group (0.95±0.39 g/dL) (p&lt;0.05) and the coefficient of correlation between these two groups r&gt; 0.7 indicating significant difference between albumin levels in two groups. Conclusion: This study revealed that both upper and lower extremity surgeries caused hypoalbuminemia. The study was novel in finding that lower extremity surgery caused more severe hypoalbuminemia in the patients compared with the patients of upper extremity surgery. A correlation study done between two groups and was found to be significant with p-value &lt;0.05 and r value&gt; 0.7. The reason for this significant difference was the longer duration of lower extremity surgery requiring more fluid support during the surgery and resultant increased metabolic stress.

A Rare Case of Anti-N-Methyl-D-Aspartate Receptor Encephalitis in an Infant Presenting with Regression and Movement Disorder.

A Rare Case of Anti-N-Methyl-D-Aspartate Receptor Encephalitis in an Infant Presenting with Regression and Movement Disorder.

The Influence of College Students' Second Language Level on Divergent Thinking

Previous studies have discussed the influence of two language level on creativity from many perspectives. The research has devoted itself to finding the embodiment of bilingual advantages in creative thinking, and also discussed the cognitive mechanism of two language level on creativity, but the relevant conclusions have not been consistent. In this study, adapted from the Gilfort divergent thinking self-measurement table, the results showed that the second language level and divergent thinking were significantly positively correlated. After grouping the second language level according to the 27% extreme grouping standard, the high English level group and the low English level group were significantly different.

Image feature extraction via local binary patterns for marbling score classification in beef cattle using tree-based algorithms

The objective of this study was to investigate the potential of creating a pipeline to classify the marbling score obtained from ribeye area (REA) images using computer vision and machine learning methods. Our database consisted of images and measurements (N = 2,446) from the transversal cut between the 12th and 13th ribs of the Longissimus dorsi muscle from carcasses of a beef cattle population (Bos taurus). Each sample was previously labeled by the industry using a low, medium or high marbling score. The prediction accuracies of two tree-based Machine Learning (ML) algorithms (Decision Tree - DT and Random Forest - RF) were compared, as well as different measures for extracting features from the REA images, which were used as input for the ML algorithms. In order to extract features based on detectable color patterns and textures contained in smaller parts of the grayscale image, we proposed the application of the local binary pattern (LBP) method prior to the adoption of ML methods. Mean classification accuracies for the test set ranged from 45.78% to 91.25% for different test scenarios. The results were mostly impacted by the feature extraction metrics, ML methods, potential subjectivity during the classification process by the industry, and the number of classes evaluated together. The best prediction accuracy results were achieved after performing the cross-validation (20% in each balanced group, 5 folds, and 10 repetitions), considering solely the extreme groups (low and high marbling scores) and pre-selecting from each group the 400 most visually representative samples. The RF algorithm outperformed the DT for most scenarios. After increasing the number of images to 580 samples for the same two groups, the highest testing accuracies were reduced to 83.05% for RF and 75.58% for DT. Such a decrease in the classification accuracies may be associated with the addition of erroneously classified images, due to the subjective nature of the industry evaluation. In conclusion, our preliminary studies showed the LBP method as a powerful feature extraction strategy considering a scenario where the labels were well defined. Our results revealed high accuracies for the classification of marbling extremes, but there is an evident need to improve the understanding of the biological and visual aspects that led to a sharp drop in classification accuracy after the insertion of the intermediate groups of marbling. In addition, the authors highlight the importance of an accurate labeling process for achieving better classification accuracy when applying supervised classification methods.

Frost hardiness of apple generative buds during dormancy

&lt;p class="042abstractstekst"&gt;The success of apple production is influenced by frost damages. Occurrence of extreme temperatures is increasing worldwide because of global warming, so the risk of frost damages is also increasing in apple orchards during dormancy and blooming time. In our work the frost hardiness of flower buds of eight apple cultivars was observed with artificial freezing tests during four subsequent dormancy periods in Hungary. The studied cultivar assortment contained two standard commercial cultivars (‘Gala’, ‘Idared’), two scab-resistant cultivars from abroad breeding programmes (‘Florina’, ‘Prima’) and four new Hungarian multi-resistant (mainly scab-resistant) cultivars (‘Artemisz’, ‘Cordelia’, ‘Hesztia’, ‘Rosmerta’). There were remarkable differences between cultivars and years from the aspect of frost hardiness of generative overwintering organs. At the end of hardening period, in January, the LT&lt;sub&gt;50&lt;/sub&gt; values of flower buds were between -22.4 °C and -30.4 °C according to cultivar and year. LT&lt;sub&gt;50&lt;/sub&gt; means the temperature causing 50 % frost damage in the flower buds of the certain cultivar in the certain time. ‘Gala’ and ‘Florina’ were the most frost hardy, while ‘Prima’, ‘Cordelia’ and ‘Idared’ the most sensitive to frost. Cold hardiness values of flower buds of ‘Artemisz’, ‘Rosmerta’ and ‘Hesztia’ cultivars were regularly between the values of two extreme groups. In winters with inappropriate weather the generative overwintering organs were unable to reach the genetically possible frost hardiness of them.&lt;/p&gt;

Numerical Analysis on Influences of Emergent Vegetation Patch on Runup Processes of Focused Wave Groups

During severe weather, the runup of the devasting surges and waves can cause extensive damages to the coastal facilities and results in significant loss of life. Therefore, it becomes necessary to find reliable measures to reduce the wave runup in coastal regions. As a natural barrier to the shorelines, coastal vegetation has great potential to attenuate wave runup and to prevent the coastal communities from extreme floodings and huge land loss. This study numerically discusses the influences of the emergent vegetation patch on the runup processes of extreme wave groups by applying a nonhydrostatic flow solver. Influences of the major factors, i.e., water depth, peak wave period, significant wave height, and density and length of the vegetation patch, are analyzed in detail. Research findings indicate that the presence of the emergent vegetation patch can substantially dissipate most of the incident wave energy and effectively reduce the maximum wave runup heights of extreme wave groups at the sloped beach. It is hoped that the research results of this study will be helpful to the design of coastal soft protection measures.

The Outcome of Psychiatric Rehabilitation Treatment Depends on Affective State at the Time of Admission.

In Austria, new approaches of rehabilitation programs focus on the prevention of mental illness and offer treatment not only for acute psychiatric patients, but also for those who are at risk of developing a mental disorder or have recovered from one.The aim of this study was to determine the effects of a psychiatric rehabilitation program on individuals with different mood states. 600 patients with a history of affective disorder were tested at the time of admission to an Austrian inpatient psychiatric rehabilitation center. Data of extreme groups - patients who were depressed (n=59; BDI-II<9 and HAMD<8) or euthymic (n=59; BDI<18 and HAMD>19) at the time of therapy start - were analyzed. The participants completed the Maslach Burnout Inventory - General Survey, the Symptom Checklist - Revised and the Stress Coping Questionnaire at the beginning and the end of the 6-weeks rehabilitation program. After 6 weeks, both groups showed significantly less psychiatric symptoms (BDI-II, HAMD, SCL-90, and negative coping strategies (SVF). Importantly, work-related stress symptoms ("burnout" symptoms) improved significantly in the euthymic group. Euthymic patients seem to be able to focus on work-related stress symptoms including reduced emotional exhaustion through treatment, while currently depressed patients primarily benefit by an improvement in general psychiatric symptomatology. The results indicate the crucial role of mood state validated with standardized psychological questionnaires BDI-II and HAMD at time of admission to such programs. These findings could have implications on treatment decisions for psychiatric patients and assist in making a forecast concerning ability to recover and treatment prognosis.

Impact of COVID-19 pandemic on medication use in the older Italian population.

This study aims to analyse the impact of the pandemic on the amount of use and new medication dispensation for chronic diseases in the Italian population aged 65years and older (almost 14 million inhabitants). The "Pharmaceutical Prescriptions database", which gathers data on medications, reimbursed by the National Health Service and dispensed by community pharmacies, was employed. Data were analysed as amount of use (defined daily dose-DDD per 1000 inhabitants); variation in DDD between 2020 and 2019 was calculated for the 30 categories with major consumption in 2020. Trends in prevalence and incidence of dispensations between 2020 and 2019 were calculated for four categories: antidiabetics, antihypertensives, antidepressants and drugs for respiratory diseases. All medications showed a negative variation in DDD/1000 inhabitants between 2020 and 2019 except for anticoagulants (+ 5%). The percentage variation ranged from -27.7% for antibiotics to -6.4% for antipsychotics in 85 + year-old persons, but increased for most classes in the youngest (65-69years). On the other hand, a decrease of the dispensation incidence of antidiabetics, antihypertensives, antidepressants and drugs for pulmonary disease was high, especially in the two extreme age groups, the youngest and the oldest one. Great variation in medication use between 2020 and 2019 was observed probably reflecting the low rate of infectious diseases due to the widespread use of protective devices and self-isolation, reduced healthcare access because of the lockdowns and the fear of going to hospital, and the reduction of screening and diagnostics due to health-care system overload.