Late Years Research Articles

Lifelong Disadvantage and Late Adulthood Frailty

Frailty is a complex state of objective and subjective vulnerability. It tends to increase with age, but the process is influenced by previous life course, especially previous disadvantages. The aim of this paper is to examine how the disadvantages suffered in adulthood (25 to 59 years) in four domains (unemployment, financial hardship, stress, and bad health) affect frailty in late adulthood (60 to 79 years). Using linear regression models on data from the Survey of Health, Ageing, and Retirement in Europe (2004–2017), we estimate frailty levels for several age groups (60–64, 65–69, 70–74, 75–79) accounting for both the persistence of these disadvantages over time and their coexistence, i.e., the number of years when they were simultaneously experienced. Results show that while frailty increases with age, as expected, there is also evidence of an accumulation of risks: the longer the periods of adult life affected by unemployment, stress, financial hardship or, most importantly, bad health, the frailer individuals are in their late years. Furthermore, periods of coexisting disadvantages in adulthood translate into additional frailty in late life. Our findings highlight the importance of fighting disadvantages early in life: long-term improvements in terms of reduced frailty (a concept interrelated with health) may be substantial.

Depression and Anxiety Plus Levels of Stress among Secondary School Students during the COVID-19 Lockdown: an Online CrossSectional Survey

Objective: To assess prevalence and factors associated with depression, anxiety and stress among adolescents experiencing lockdown during the 2019 coronavirus disease 2019 (COVID-19) in both Asian and Western countries. Material and Methods: From May-June 2020, secondary school students were enrolled in an online cross-sectional survey, through social media; including, but not limited to, Instagram, Snapchat, WhatsApp and LINE. We assessed the presence and severity of depression (Patient Health Questionnaire-9), anxiety (Generalized Anxiety Disorder Scale-7) and stress (Perceived Stress Scale-10) within the last month, and assessed significant associations with demographics, degree of social distancing, and other associated issues using univariate and multivariate logistic regression analyses.Results: From 392 respondents (56.4% male, 43.1% female), from Thailand (59.2%), the United Kingdom (26.5%) and other countries (14.3%), we identified depressive symptoms in 58.7%, anxiety in 40.3% and high levels of stress in 9.7%. By multivariate analysis, we found significant associations between being female and depression and anxiety, being in late secondary school years and depression, and changes in patterns of substance use and anxiety and stress. Participants not located in Thailand had increased risk of depression.Conclusion: Our study demonstrated depression, anxiety and stress in six, four and one out of ten adolescents, respectively, who were experiencing lockdowns due to the COVID-19 pandemic. We found female gender, older school years, and changes in substance use patterns to be significantly associated with these mental health conditions.

Poeta przed kompasem

The paper discusses the importance of the motif of clocks and sundials in the biography of the Eighteens century poet Franiszek Dionizy Kniaźnin and shows various stages of an image – in subsequent Polish poetry and prose – of this poet, deranged in his late years, after the fall of the independent Poland, as he used to stand for hours in front of a sundial, staring at the movement of the shadow and contemplating the arrival of his own end as well. This presentation covers a period of more than 170 years.

Study on the Newly Settled Elder’s Maladaptation in the Nursing Home—Taking an Example of the B Age Care Institution

In the aging era, the decline of physical performance makes it more difficult for the elder to take care of themselves. Therefore, as the aged-caring service is sprouting out during the aging tendency of the population, there are more people now preferring to place the elder in nursing homes, where they can be cared for in their late years. But, according to the previous researches and interviews, the elder probably do not adapt to the change of the living circumstances, and the aged-caring service is still not matured. To assist the elder in adjusting to the nursing home, this study enquirers into the elderly’s adaptive problems in the B age care institution. By means of interviews and the case method, the research finds out, due to the change of living condition, the elder start to have physiological and mental issues. Because of traditional thoughts and incorrect perspectives, the elder commonly have a negative attitude towards the nursing home. Also, the limited and monotonous lifestyle and the low quality and negligence of caregivers make the elder feel their needs can never be met in the nursing home. Moreover, the deficiency of transparency and the government inspection can lead to nonstandard running and management, which weakens the quality of caring service. Based on the issues above, the research conducts multi-faceted analysis and proposes suggestions in different angles. Hopefully, this study can provide reference and assistance for improving the adaptability of the elder that are new to the nursing home.

"But man is not made for defeat": insights into Ernest Hemingway's dementia.

Ernest Hemingway is widely regarded as one of the greatest fiction writers of all time. During his life, he demonstrated several signs of psychological suffering with gradual worsening and presentation of cognitive issues over his late years. Some of his symptoms and the course of his disease suggest that he might have suffered from an organic neurodegenerative condition that contributed to his decline, which culminated in his suicide in 1961. In this historical note, we discuss diagnostic hypotheses compatible with Hemingway's illness, in light of biographical reports.

Lead-Glazed Pottery at Late Medieval Corinth: Assessing Craft Production and Trade at a Greek City under Western Influence

We present a multimethod analysis of 97 lead-glazed tablewares from the so-called Frankish Area at Corinth, at the time of the transition from Frankish feudalism to an administration by powerful Florentine bankers, then the Despotate of the Morea in the late 13th to early 15th century a.d. This sector of the medieval city appears to have been continuously occupied after the Catalan raid of 1312. The results shed new light on the late years of the Corinthian Sgraffito ware industry, and on the role of northern Italian trading cities and their possessions overseas as production and distribution centers of lead-glazed pottery, including imitations of Zeuxippus and other Byzantine wares using specific glaze recipes and pigments.

Potential approaches for the diagnosis and treatment of drug-resistant leprosy

Leprosy, a chronic human disease with potentially debilitating neurological consequences, results from infection with Mycobacterium leprae, which is still a major health problem in several countries of Asia, Latin America, and Africa. With the mass campaigns, using multidrug therapy, the prevalence of leprosy has come down drastically worldwide. Antimicrobial resistance (AMR) is an important consideration in the management of leprosy. Unfortunately, quinolone-resistant strains of Mycobacterium leprae have also been reported in several countries, probably due to the extensive use of quinolones for treating several types of infections. To meet the challenge of containing the disease and being able to respond to an increase in circulation of drug-resistant strains, it is essential to assess drug-sensitivity patterns globally, as well as to monitor resistance among both new and retreatment cases. However, these studies highlight the need for increased vigilance to AMR. In this study, we thoroughly reviewed the molecular methods used to detect drug resistance in leprosy. We can infer that our article assessing strategies less complex than multifunction peripheral and genome sequencing are promising choices for the testing of AMR in leprosy patients. Furthermore, our analysis recommends that the extent of safe cases has not essentially expanded in late many years.

An exploratory bibliometric analysis of the evolution of HR analytics as a popular management concept

Human resource (HR) analytics is one of the hottest concepts in the field of HR management. In recent years, it has also started to attract the attention of academic researchers. In this paper, we carry out an exploratory bibliometric analysis to map the emerging academic field of HR analytics. By doing this, we provide more insight into the role of academic researchers in the evolution of HR analytics as a popular management concept. The bibliometric analysis draws on data extracted from the Scopus database, and analyses of the overall publication volume and growth trajectory, influential documents, authors, journals, and countries are performed. The results show that the academic discourse around HR analytics emerged relatively late and several years after the initial debate based on the practitioner-based literature. The findings are discussed in relation to the literature about the emergence and evolution of popular management concepts.

Проблема департизации государственной власти в РФ после 1993 года

The purpose of the research is to consider departization of the top executive officials in the Russian Federation after 1993 as a systemic legal and political problem, which in the new his-torical conditions has acquired a slightly different connotation than in the late Soviet years. The subject of the research is contradictions related to the necessity of compliance of the top leaders of the executive bodies of the Russian Federation with the outdated legislative norms and require-ments to departization in the conditions when the objective situation dictated to the government officials and loyal governors the need to consolidate under the auspices of the new “party of power”. Scientific novelty and relevance of the research lies in the almost complete absence of works devoted to the study of the process of departization of the Russian executive power in 1993–1999, based on the consistent application of the principles of historicism, as well as formal and legal, systemic and problem-chronological approaches. The study of this issue allows us to better understand the roots of the contradictions of the modern political system of the Russian Federation. In the course of the study it was concluded that the time from the end of 1993 to 1999 can be considered as a certain transitional period when the society was gradually getting rid of the rudiments of the former one-party dictatorship, and the weakened post-Soviet bureaucracy had no incentives and resources to build a new “vertical of power”. Therefore, the legislation regulating the party and political status of the federal and regional chiefs was not distinguished by its integrity. This circumstance left the question about the prospects of official departization of heads of executive bodies of power.

Women, Writing and the Iraqi Baʿthist State. Contending Discourses of Resistance and Collaboration, 1968–2003

Women, Writing and the Iraqi Baʿthist State. Contending Discourses of Resistance and Collaboration, 1968–2003

Impact of Polycystic Ovary Syndrome on Silent Coronary Artery Disease and Cardiovascular Events; A Long-term Population-based Cohort Study

The existing data regarding the impact of Polycystic Ovary Syndrome (PCOS) on the risk of developing cardiovascular disease (CVD) are conflicting. To explore the effect of PCOS status on the occurrence of silent coronary artery disease (CAD)/CVD. A total of 1591 women without CVD at baseline, aged 18-45 years, including 356 PCOS patients (defined by the Rotterdam criteria) and 1235 eumenorrheic non-hirsute women without polycystic ovarian morphology (controls), were selected from the Tehran Lipid and Glucose Study (TLGS). The median follow-up was 15.4 years, and most participants were in their late reproductive years at the end of the study. Silent CAD and CVD outcomes in PCOS and control groups were compared according to the multivariable-adjusted hazard ratios (HRs) and cumulative hazard functions. There was no difference in CVD risk factors between the PCOS and control groups. After controlling for confounders, PCOS status did not increase the risk of silent CAD (HR: 0.96, 95% CI 0.86-1.08). Regardless of PCOS status, women with a history of silent CAD showed 2.25 times higher CVD events than those without this history (95% CI 1.63-3.10). PCOS status reduced the CVD incidence by 42%, independently of silent CAD or traditional risk factors (HR: 0.58, 95% CI 0.35-0.98). Whereas silent CAD, regardless of PCOS, accelerated CVD, PCOS preserved it, most likely due to a combination of protective factors, including the endocrine pattern in the late reproductive period, environmental/social elements, and recruiting additional counseling and lifestyle modifications.

Derivation and Validation of the POD-IPI Score for Progression of T Cell Lymphoma

Background: Late years have witnessed that novel targeted treatment modalities are corroborated successful clinical applications in T cell lymphoma (TCL). Yet, there are a considerable proportion of patients suffering from relapse or progression of disease (POD). Early POD (ie, POD within 24 months) has been validated as a novel prognostic indicator in various pathological types of lymphoma. At present, the clinical function of early POD in TCL has not been explored with influencing factors unknown. Herein, we developed a novel risk stratification model for predicting early POD by integrating International Prognostic Index (IPI) score and serum total protein (TP) level.Methods: We retrospectively identified patients diagnosed with TCL in Shandong Provincial Hospital from Mar 2011 to Jan 2021. Patients aged≥18 years with confirmed tissue diagnosis of TCL were included and were divided into a training cohort and a validation cohort. The prognostic role of early POD was evaluated using Cox proportional hazards model. Univariate analysis was applied to identify covariates for a logistic regression model predicting early POD. A clinical point score was generated according to multivariate analysis. The predicting performance was assessed by validation cohort and compared to clinical models.Results: A total of 141 potentially eligible patients were identified. Overfitting was prevented by splitting the data into training (70%) and validation (30%) set. Median follow-up was 32 months. In the training cohort, the median age at diagnosis was 52.2 years (range 18-81), and 70 (67.3%) were under 60 years old. While in validation set, the median age was 55 years (range 21-77), among whom 73% were under 60. In both group combined, there was a male predominance (66.3% vs 73.0%). The most frequently had lymphoma that was NK/T-cell lymphoma (NKTCL) (31.7% vs 35.1%) with peripheral T-cell lymphoma (PTCL) (25.0% vs 24.3%) next. More than half of patients (51.0% vs 59.5%) suffered from early POD.In univariate and multivariate cox regression analysis, early POD was the most independent prognostic factor (p <0.001) with an adjusted HR for PFS of 310.708 (95% CI:27.625-3494.686) and for OS an adjusted HR of 23.416 (95% CI:8.178-67.05). K-M curve indicated a significant difference in both OS and PFS between early-POD and non-POD groups (Figure A).To ask whether early POD prediction could be made by analyzing clinical risk factors at diagnosis, univariate analysis in the training cohort identified variables significantly associated with early POD and were included into the multivariable logistic regression model that were 10-fold cross-validated. We found that IPI score, serum TP level were independent predictors for early POD (AUC 0.775, 95% CI, 0.683-0.866; p<0.001), and the Hosmer-Lemeshow test confirmed good calibration (p=0.635). In the validation set, the model remained strong predictive performance. Figures B, C showed the calibration curves and nomograms of early POD predicted by the model on training and validation cohorts, respectively.Cut-off points of TP level were determined by ROC analysis to simplify the risk model. Selected cut-off points were adjusted to the nearest whole integer to maximize ease of use. Eventually, two independent predictors (IPI score and serum TP≤64 g/L) of early POD were retained through multivariable regression analysis, and the risk score was then calculated for each factor according to the regression coefficient. This resulting algorithm was named as POD-IPI score. Afterwards, patients were stratified into 3 groups: low-risk (0 score, n=13, 12.5%), intermediate-risk (1-3 score, n=49, 47.1%), and high-risk (>3 score, n=42, 40.4%) groups. Compared to IPI score and NCCN-IPI score, the discriminative ability of the proposed score was good in the ROC, thereby outperforming existing clinical models in two cohorts (AUC=0.784, 95% CI: 0.695-0.873, AUC=0.809, 95% CI: 0.667-0.952, respectively). The outcomes of early POD by the stratification of POD-IPI score in training group were represented in Figure D. The curves were well separated, indicating the good discriminatory ability of this novel model.Conclusions: POD-IPI achieved a specific prediction of early POD in TCL patients, which was validated to allow for simplified stratification and comparison of risk distribution. Its use, together with clinical judgment, may provide guidelines on treatment decisions in TCL. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Ventricular arrhythmia ablation in the presence of mechanical valve utilization and complications of catheter ablation for ventricular arrhythmia in patients with mechanical prosthetic valves.

Catheter ablation (CA) for ventricular arrhythmias (VAs) is increasingly utilized in recent years. We aimed to investigate the nationwide trends in utilization and procedural complications of CA for VAs in patients with mechanical valve (MV) prosthesis. We drew data from the US National Inpatient Sample database to identify cases of VA ablations, including premature ventricular contraction and ventricular tachycardia, in patients with MVs, between 2003 and 2015. Sociodemographic and clinical data were collected and the incidence of catheter ablation complications, mortality, and length of stay were analyzed. We compared the outcomes to a propensity-matched cohort of patients without prior valve surgery. The study population included a weighted total of 647 CA cases in patients with prior MVs. The annual number of ablations almost doubled, from 34 ablations on average during the "early years" (2003-2008) to 64 on average during the "late years" (2009-2015) of the study (p = .001). Length of stay at the hospital did not differ significantly between patients with MVs and 649 matched patients without prior MVs (5.4 ± 0.4, 4.7 ± 0.3 days, respectively, p = .12). The data revealed a trend toward a higher incidence of complications (12.6% vs. 7.5% respectively, p = .14) and mortality (3.7% vs. 0.7%, respectively, p = .087) among patients with MVs compared to the matched control group, not reaching statistical significance. The data show increased utilization of VA ablations in patients with MVs and a trend toward a higher incidence of in-hospital mortality and complications compared to the propensity-matched control group without MVs.

Imaging, Endoscopic and Surgical Aspects Correlation of Inflammatory Bowel Disease: A Retrospective Perspective

Chronic inflammatory bowel disease have been the major focus of research in gastroenterology these late years. It is due to the elevated incidence of comorbidity as well as complications. MRI, endoscopy as well as histology are the three pillars of the diagnosis, follow-up and prognosis of these pathological entities. Our aim for this study was to determine the relationship between the radiologic, endoscopic modalities and the histological severity of the active disease.

Клинический случай острого интраоперационного помутнения интраокулярной линзы

Cataract surgery with intraocular lens implantation is one of the most frequently performed and safest surgical procedures worldwide. But cases of visual impairment after surgery associated with impaired transparency of the IOL are described. Most often, IOL opacity occurs in the late postoperative period, several months or years after implantation and develops gradually. At the same time, there are periodic reports of sudden cloudiness of the intraocular lens during its implantation. This "behavior" of the intraocular lens is always stressful for the surgeon and makes it necessary to choose: explant the IOL or wait. Рurpose. To analyze the case of acute intraoperative opacification of the IOL. Material and methods. In January 2019, within one operating day, we recorded 5 cases of acute opacification of hydrophilic acrylic IOL (I-flex, Germany) during implantation. In the first 5 patients on this operating day, the surgeon discovered IOL opacification immediately after implantation. When the lenses were installed in the injector cartridge, the transparency of the intraocular lenses was preserved. All other IOLs implanted that day were transparent. The surgeon chose a wait and see tactic. Results. Patients were monitored, within a day, the transparency of the lenses was completely restored, the visual functions were high. Discussion. We associate IOL clouding with a sharp temperature drop, since the lenses were delivered to the clinic in the morning immediately before the operations, by car during the cold season (the air temperature outside reached -19° С). During implantation, a temperature drop occurred, which led to temporary turbidity of the polymer. However, within a few hours after the operation, the opacity was resolved and the transparency of the lenses was completely restored within a day. Key words: phacoemulsification, intraocular lens implantation, intraocular lens opacification.

The Rationality of Using Diclofenac in Outpatient Cases of Osteoarthritis of RSUP MH Palembang Period January-March 2018

Rationality of Diclofenac Use in Osteoarthritis Outpatient Case at RSUP MH Palembang in January-March 2018. Osteoarthritis (OA) is the most common disease in joints that affects people in their middle until late years. In Indonesia the prevalence of OA is relatively high and disturbs their daily activity. Diclofenac is one of the drug of choice in treating OA. To avoid multiple side effects from Diclofenac use, the usage must be in accordance to rationality indicators which are correct dose, correct frequency, and correct length of use. This study is aimed to know the rationality of Diclofenac use in Osteoarthritis outpatient cases at RSUP Mohammad Hoesin Palembang. This study is a descriptive observational with a cross-sectional approach to know the rationality of Diclofenac use in outpatient cases of osteoarthritis at RSUP Mohammad Hoesin Palembang. Samples were medical records of OA patients in outpatient setting from January to March 2018 which fulfilled the inclusion and exclusion criteria. Sampling technique used was total sampling. The amount of samples fulfilling the inclusion criteria were 201 patients, with the most were aged 46-65 years (60.2%), female (55.7%), and has a history of comorbidity which includes low back pain (22.8%). The result of this study shows pattern of Diclofenac use with dosage of 2 x 25mg (73.6%), length of use about &lt;7 days (57.2%). In combination with other drugs there were no interaction to be found (84.4%), or synergistic interaction (8.5%) and antagonistic interaction (7.1%). The use of diclofenac in osteoarthritis cases at outpatient setting in RSUP Dr Mohammad Hoesin Palembang is rational and needs to be maintained.

Utilization and complications of catheter ablation for ventricular arrhythmias in patients with mechanical valves

Abstract Background Catheter ablation (CA) for ventricular arrhythmias (VAs) is increasingly utilized in the recent years. Ablation for VAs in patients with mechanical valves (MVs), can be challenging due to the chronic anticoagulation therapy, limitations in accessing the cardiac chambers, the risk for entrapment of mapping or ablation catheters between the leaflets of MVs and more. Purpose To investigate the nationwide trends in utilization and complications of CA for VAs in patients with prior MVs. Methods We drew data from the US National Inpatient Sample database to identify cases of VA ablations, including premature ventricular contraction (PVC) and ventricular tachycardia (VT) ablations, in patients with MVs between 2003 and 2015. Sociodemographic and clinical data were collected, and incidence of catheter ablation complications, mortality, and length of stay were analyzed. We compared the outcomes to a propensity matched cohort of patients without prior valve surgery. Results The study population included a weighted total of 647 CA cases in patients with prior MVs. The annual number of ablations almost doubled, from 34 ablations on average during the “early years” (2003–2008) to 64 annual ablation procedures on average during the “late years” (2009–2015) of the study (p=0.001). Length of stay at the hospital did not differ significantly between patients with MVs and 649 matched patients without prior MVs (5.4±0.4, 4.7±0.3 days respectively, p=0.12). The incidence of complications was higher among patients with and without MVs (12.6% vs. 7.5% respectively, p=0.14), however, not reaching statistical significance. Moreover, the data revealed a trend toward higher mortality among patients with MVs undergoing CA compared to matched control patients without MVs (3.7% vs. 0.7% respectively, p=0.087). Conclusion The utilization of catheter ablations for ventricular arrhythmias in patients with mechanical valves increased substantially over the years. The data show a trend towards increased incidence of morality and complications in the study population, requiring further investigation in larger population cohort. Funding Acknowledgement Type of funding sources: Public hospital(s). Main funding source(s): Padeh Medical Center Research Fund

Max Clara: Sweet life in Istanbul with a bitter end 1950–1966 and the search for unethically obtained tissue specimens from his estate in Turkish collections

The aim of this study was to examine the last period of Max Clara’s (1899–1966) life in Istanbul (1950–1966) and his scientific activities there. Clara’s career before and during the National Socialist (NS) era was extensively studied, however, almost no information is available regarding his late years and his relationship with old colleagues and the academic world after he was dismissed from the academic life in the postwar period. Max Clara’s life in Istanbul was based on primary sources from the Istanbul University Archive. Archival documents were supplemented by analyses of the available secondary literature on the history of Istanbul University and refugee scholars in Turkey, literature on Clara, and Clara’s publications. Furthermore, an attempt was made to find Clara’s histological and anatomical material that he brought with him from Germany, so that the identities of the NS era victims from whom the material were harvested could potentially be reached. Max Clara’s life, academic work, and his relations with the outside world during his Istanbul years were clearly and extensively brought into light. However, his histological and anatomical material which was divided into three parts could not be reached due to the reluctance of universities and faculty members who are the new owners of the material. Clara’s involvement of unethical practices during the NS era such as medical experiments on prisoners and use of the unethically procured bodies of the executed was further revealed. The analysis of his academic publications revealed that there are great inconsistencies and distortions in themselves and that these publications are not as important as it was thought. Finally, the author considers that international pressure is needed, as in the case of the Pernkopf Atlas, to reach the anatomical and histological material and honor and memorialize the victims.

SEVERAL DIMENSIONS, ANTHROPOMETRIC INDICES AND NUTRITIONAL CONDITION OF FRESHMEN IN HANOI MEDICAL UNIVERSITY, YEAR 2019-2020

Our aim is to describe the morphology, physical and nutritional status of Vietnamese medical students in the late years of second decade of the 21th Centery. A research about physical form included 861 freshmen (335 male, 526 female) from Hanoi Medical University (2019 - 2020): Male students’ physical form measurement and figures are much better than female students’ and these indices is largely better than the previous studies of other authors. Physical form seems to increase by the time, after 45 years: male was 9.5 cm higher and 15.9 kg heavier, female was 7.0 cm higher and 5.8 kg heavier. In comparison with students in 2007, male students were8.5 kgs heavier and female students were 3.9 kgs heavier. In comparison with a research ten years ago, the height of male and female increased 4.2 cm and 3.3 cm, respectively. According to an Asian - Pacific population classification, students from Hanoi Medical University had medium weight.

Romancing the Reds: early encounters with Soviet cinema in India

ABSTRACT Censorship records show an apparent absence of Soviet films in Indian cinemas during the late years of British colonialism (1920s–40s). Apart from a few ‘apolitical’ feature films, Indian audiences hardly got any chance to watch important works of Soviet cinema until the late 1940s. Contrastingly, a number of writings that appeared in film journals from the 1930s–40s provide evidence for a growing interest in Soviet cinema among Indian film enthusiasts. This cluster of writings virtually hides the fact that Soviet masterpieces were yet to reach the Indian viewers. Many Indian films from the same period also offer instances of Soviet influence revealed through political symbolism, visual styles and techniques. Exploring various layers of archival and filmic materials, the article traces the routes through which the Soviet influence provided motivations to filmmakers and enthusiasts about the new explorations in Soviet cinema in the absence of the actual films on Indian screens.