Longer Life Expectancy Research Articles

Icaritin ameliorates RANKL-mediated osteoclastogenesis and ovariectomy-induced osteoporosis.

A rapidly aging society and longer life expectancy are causing osteoporosis to become a global epidemic. Over the last five decades, a number of drugs aimed at reducing bone resorption or restoring bone mass have been developed, but their efficacy and safety are limited. Icaritin (ICT) is a natural compound extracted from anti-osteoporosis herb Epimedium spp. and has been shown to inhibit osteoclast differentiation. However, the molecular mechanism by which ICT weaken RANKL-induced osteoclast differentiation has not been completely investigated. Here, we evaluated the anti-osteoclastogenic effect of ICT in vitro and the potential drug candidate for treating osteoporosis in vivo. In vitro study, ICT was found to inhibit osteoclast formation and bone resorption function via downregulating transcription factors activated T cell cytoplasm 1 (NFATc1) and c-fos, which further downregulate osteoclastogenesis-specific gene. In addition, the enhanced mitochondrial mass and function required for osteoclast differentiation was mitigated by ICT. The histomorphological results from an in vivo study showed that ICT attenuated the bone loss associated with ovariectomy (OVX). Based on these results, we propose ICT as a promising new drug strategy for osteoporosis that inhibits osteoclast differentiation.

Healthy lifestyle in late-life, longevity genes, and life expectancy among older adults: a 20-year, population-based, prospective cohort study

Lifestyle and longevity genes have different and important roles in the human lifespan; however, the association between a healthy lifestyle in late-life and life expectancy mediated by genetic risk is yet to be elucidated. We aimed to investigate the associations of healthy lifestyle in late-life and genetic risk with life expectancy among older adults. A weighted healthy lifestyle score was constructed from the following variables: current non-smoking, non-harmful alcohol consumption, regular physical activity, and a healthy diet. Participants were recruited from the Chinese Longitudinal Healthy Longevity Survey, a prospective community-based cohort study that took place between 1998 and 2018. Eligible participants were aged 65 years and older with available information on lifestyle factors at baseline, and then were categorised into unhealthy (bottom tertile of the weighted healthy lifestyle score), intermediate (middle tertile), and healthy (top tertile) lifestyle groups. A genetic risk score was constructed based on 11 lifespan loci among 9633 participants, divided by the median and classified into low and high genetic risk groups. Stratified Cox proportional hazard regression was used to estimate the interaction between genetic and lifestyle factors on all-cause mortality risk. Between Jan 13, 1998, and Dec 31, 2018, 36 164 adults aged 65 years and older were recruited, among whom a total of 27 462 deaths were documented during a median follow-up of 3·12 years (IQR 1·62-5·94) and included in the lifestyle association analysis. Compared with the unhealthy lifestyle category, participants in the healthy lifestyle group had a lower all-cause mortality risk (hazard ratio [HR] 0·56 [95% CI 0·54-0·57]; p<0·0001). The highest mortality risk was observed in individuals in the high genetic risk and unhealthy lifestyle group (HR 1·80 [95% CI 1·63-1·98]; p<0·0001). The absolute risk reduction was greater for participants in the high genetic risk group. A healthy lifestyle was associated with a gain of 3·84 years (95% CI 3·05-4·64) at the age of 65 years in the low genetic risk group, and 4·35 years (3·70-5·06) in the high genetic risk group. A healthy lifestyle, even in late-life, was associated with lower mortality risk and longer life expectancy among Chinese older adults, highlighting the importance of a healthy lifestyle in extending the lifespan, especially for individuals with high genetic risk. National Natural Science Foundation of China. For the Mandarin translation of the abstract see Supplementary Materials section.

Implementation of a Shielding Guideline for Pediatric Patients Receiving Intraoperative Ionizing Radiation

Introduction Approximately 350 million diagnostic radiation imaging procedures are performed on pediatric patients annually. This population is at a greater risk of developing cancer after exposure to ionizing radiation because of a higher intake, accumulation, and increased sensitivity to radiation as well as a long-life expectancy postexposure. Methods This quality improvement project used convenience sampling with a pre–post design to evaluate two independent samples: (a) pediatric intraoperative staff members including registered nurses and scrub technicians and (b) pediatric patients receiving intraoperative ionizing radiation imaging. Outcome measures included pediatric intraoperative staff knowledge and confidence of education for intraoperative shielding (preimplementation: n = 9; postimplementation: n = 6). Shielding audits were performed to assess for frequency of shield placement to radiosensitive organs and accuracy of shield placement (preimplementation: n = 26; postimplementation: n = 27). Results Data analysis showed improvement in staff confidence related to gonad shield placement ( p = .013) and self-reported frequency of gonad shield use ( p = .032). Knowledge scores showed nonsignificant improvement ( p = .076). Shielding audits showed statistically significant improvement in shield placements for thyroid, gonads, and breast tissue ( p &lt; .05). Discussion The pediatric population has unique characteristics to consider when making decisions about shielding practice. This project discusses these characteristics, considerations for “exception-based shielding,” and how to improve the rates of shielding in situations where the practice is appropriate.

The impact of bequest taxation on savings and transfers

Research background: The paper investigates the impact of bequest taxation on saving and transfers when parents and children make decisions consistently. It complements the predictions of Gale and Perozek's life-cycle modeling (2001) when decisions of parents and children are set independently and can be time-inconsistent. Purpose of the article: The paper strives to answer the question of whether taxation of bequest harms savings and inter vivos transfers. The previous results indicated that this is possible for some bequest motives. Our results show that this is not likely for the most typical values of parameters. Methods: The analysis involves economic modeling of four bequest motives: altruistic, paternalistic, accidental, and exchange. The method is based on the overlapping generation approach and life-cycle approach in the case of a paternalistic bequest. The results are supplemented with numerical simulations. Findings &amp; value added: For the altruistic motive, savings are smaller if interest rates are low relative to the tax rate and the utility of one's consumption is more valuable than the utility of the next generations. For the accidental motive, savings decrease with small interest rates, high taxation and long-life expectancy. For the paternalistic motive, savings decrease when the interest rate and the value of future utility are low. For the exchange motive, savings are higher after a tax increase, but it depends on the value of attention and life expectancy. The general conclusion is that higher bequest taxation hamper saving behavior and may disturb the intergenerational exchange process. The bequest tax should, therefore, be set low, especially for aging populations, in order to induce higher savings and force the young to provide the elderly with higher attention.

State of urinary continence after radical prostatectomy: 10-year experience in multiple hospitals in Dhaka, Bangladesh

Background: Radical prostatectomy is a recommended treatment method for patients with localized prostate cancer and a long-life expectancy. Post-radical prostatectomy urinary incontinence (PPI) negatively affects the quality of life. The objective of this study was to assess the state of urinary continence after one year of radical retropubic prostatectomy (RRP). Methods: This prospective study was conducted between 2010 and 2020, at the Department of Urology, in BIRDEM General Hospital, Dhaka Community Medical College Hospital and Evercare Hospital, Dhaka, Bangladesh. During these 10 years, we completed 60 RRP and followed up every patient for 1 year. Results: The mean age was 64.5±7 years and the age ranged from 50 to 75 years. The most common clinical stage was T2b and it was 43 (71.7%). Surgical approach was open retropubic in all cases. The mean operative time was 150 minutes and ranged from 120 to 270 minutes. The mean hospital stays of the respondents was 5 days and the mean catheterization period was 2 weeks. Prolong drainage (more than 5 days) was found in 1 (1.7%) case. Thirty-eight (63.33%) patients were continent by 3 months, 15 (25%) patients were continent by 6 months, 4 (6.66%) by 12 months and the rest 3 (5%) were incontinent at the end of 1 year. Conclusion: In our series, most patients achieved continence after 1 year from RRP and only 5% patients were incontinent after 1 year. BIRDEM Med J 2023; 13(3): 130-135

Dose Volume and Liver Function Test Relationship following Radiotheraphy for Right Breast Cancer: A Multicenter Study.

The liver is a critical organ at risk during right breast radiotherapy (RT). Liver function tests (LFTs) such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) serve as biochemical markers for hepatobiliary damage. In this multicenter cross-sectional study, the effects of liver dose-volume on changes in LFTs pre- and post-RT in patients treated for right breast cancer were evaluated. Between January 2019 and November 2022, data from 100 patients who underwent adjuvant right breast RT across three centers were retrospectively assessed. Target volumes and normal structures were contoured per the RTOG atlas. Patients were treated with a total dose of 50 Gy in 25 fractions to the CTV, followed by a boost to the tumor bed where indicated. The percentage change in LFT values in the first two weeks post-RT was calculated. Statistics were analyzed with SPSS version 22 software, with significance set at p < 0.05. Statistical correlation between liver doses (in cGy) and the volume receiving specific doses (Vx in cc) on the change in LFTs were analyzed using Kolmogorov-Smirnov, Mann-Whitney U test. The median age among the 100 patients was 56 (range: 29-79). Breast-conserving surgery was performed on 75% of the patients. The most common T and N stages were T1 (53%) and N0 (53%), respectively. None of the patients had distant metastasis or simultaneous systemic treatment with RT. A total of 67% of the treatments utilized the IMRT technique and 33% VMAT. The median CTV volume was 802 cc (range: 214-2724 cc). A median boost dose of 10 Gy (range: 10-16 Gy) was applied to 28% of the patients with electrons and 51% with IMRT/VMAT. The median liver volume was 1423 cc (range: 825-2312 cc). Statistical analyses were conducted on a subset of 57 patients for whom all three LFT values were available both pre- and post-RT. In this group, the median values for AST, ALT, and GGT increased up to 15% post-RT compared to pre-RT, and a median liver Dmean below 208 cGy was found significant. While many factors can influence LFT values, during RT planning, attention to liver doses and subsequent regular LFT checks are crucial. Due to factors such as anatomical positioning, planning technique, and breast posture, the liver can receive varying doses during right breast irradiation. Protecting patients from liver toxicity secondary to RT is valuable, especially in breast cancer patients with a long-life expectancy. Our study found that, even in the absence of any systemic treatment or risk factors, there was an average increase of nearly 15% in enzymes, indicating acute liver damage post-RT compared with pre-RT. Attention to liver doses during RT planning and regular follow-up with LFTs is essential.

The Moderating Role of Psychological Safety in the Relationship between Job Embeddedness, Organizational Commitment, and Retention Intention among Home Care Attendants in Taiwan.

As Taiwan's population ages, the need for long-term care, such as home care, is increasing due to improved medical services and longer life expectancy; however, the current coverage rate for home care services is only 50%, highlighting the importance of retaining home care workers. This study applies job embeddedness, organizational commitment, and psychological safety as variables to explore the retention intention of Taiwan's home care workers. A questionnaire survey was distributed among home care workers using convenience sampling, resulting in 547 collected questionnaires, of which 458 were valid. Data analysis was conducted with SPSS 22.0 and AMOS 22.0, and a structural equation model (SEM) was used to test the hypotheses. Our findings suggest that job embeddedness has a positive impact on organizational commitment (γ = 0.649, γ = 0.607, and γ = 0.628; p < 0.001) and retention intention (γ = 0.253, γ = 0.242, γ = 0.271; p < 0.001), similar to organizational commitment (γ = 0.721, p < 0.001). Additionally, organizational commitment mediates job embeddedness and retention intention, while psychological safety moderated organizational commitment and retention intention (β = 0.639; p < 0.001). This study aims to provide information for the development of more effective human resource policies and contribute to practical advancements in the home care service environment and management structure of home care organizations. By analyzing and exploring the main factors contributing to home care workers' retention intention, we hope to enhance the overall benefits of home service organizations and the industry.

Awareness, prevalence and risk burden of cataract among adults in IDO/OSI local government area, a rural community of Ekiti state, southwest Nigeria

Background: Cataract is characterized by lens opacity, making images look blurred and hazy. It causes increased light sensitivity, decreased vision at night, and seeing double images, leading to total blindness. The WHO also estimates that cataract blindness will reach 40 million by 2025 due to ageing population and longer life expectancy. Developing countries, including Sub-Saharan Africa have the highest number of people who are blind due to cataract. This study aims to determine the awareness, prevalence and risk burden of cataract among adults in Ido/Osi LGA, a rural community of Ekiti State. Methods: This is a descriptive cross-sectional study. The estimated sample size is 361 and a multi stage sampling technique was used. Data collection was through ophthalmic examinations and questionnaires which were analyzed using SPSS version 25.0. Results: The mean age of respondents was 54.94±11.17. Most respondents, 287 (79.5%), had a good awareness of cataracts. The prevalence of cataract in this study is 3.9%. Cataract significant Visual Acuity was found in 49 (13.5%) of the respondents. Age (&lt;0.001), visual impairment (&lt;0.001), hypertension (&lt;0.001) and diabetes mellitus (0.003) were the factors associated with having cataracts. Conclusions: Intersectorial collaboration, health education through the mass media, evidenced based policies and research will help reduce the prevalence of cataract.

Patriarchy Without Masculinity in Homa-Bay County of Kenya (1894-2022)

Purpose: The purpose of this treatise is to justify the existence of patriarchy without masculinity because of the existence of patriarchal shell as evidenced in the male failure to meet the societal expectation of a functioning masculinity. This study is premised in the pre-colonial belief that in patriarchal society men made far-reaching decisions, they were the breadwinners and wielded exclusive authority and power.&#x0D; Methodology: The study used historical research design of Gottschalk Louis to collect, verifies, and synthesizes evidence from the past to establish facts that defended the existence of patriarchy without masculinity in Homa Bay. Purposive and snowball sampling techniques were used to identify the individuals and gender groups informants during the primary data collection. Primary data was also gathered from the National Archives to triangulate oral and secondary data. Secondary data were collected from, thesis, journal articles, books, and other publications from the internet, university, and other libraries.&#x0D; Findings: The data collected is given thematic content analysis based on study question. Primary and secondary data sources were corroborated to attain the validity and reliability of findings. The publication utilizes patriarchal theory of Robert Filmer which highlights the role of culture on gender performance roles and explains the role of patriarchal ideology in elevating men and making woman to depend on them for survival. In this study masculinity is viewed as a quality or set of habitual performed roles which were stereotypically connected with male gender as opposed to inherent in male. Contrary to the above, this study established that men still claim to have socio-economic and political entitlement in Homa Bay but the level of degeneration and reduction on the same is below expectation. Such degeneration makes patriarchy a shadow of its original reality. This premised in the study findings that there exists a widening masculine gap between the pre and postcolonial men of Homa Bay. The evidence in Homa Bay shows that most men fail to meet the societal expectation in their performances but grapple with vulnerability as they helplessly stare at the systematic loss of pre-colonial socio-economic and political patriarchal authority.&#x0D; Unique Contribution to Theory, Policy and Practice The existence indicators of the decline of patriarchal dominance in Homa Bay such as long-life expectancy among women, high birth rate among baby girls and the socioeconomic and political degeneration, make patriarchal; theory to be rethought. This paper shows that in the pre-colonial society, there was a concept of valorized hegemonic masculinity which men strived to emulate that consequently established patriarchy. Therefore, the policy makers, governments and the non-governmental organizations should reorganize their strategies to save masculinity from extinction for the purpose of gender egalitarian societies.

Human Factors Considerations for Quantifiable Human States in Physical Human-Robot Interaction: A Literature Review.

As the global population rapidly ages with longer life expectancy and declining birth rates, the need for healthcare services and caregivers for older adults is increasing. Current research envisions addressing this shortage by introducing domestic service robots to assist with daily activities. The successful integration of robots as domestic service providers in our lives requires them to possess efficient manipulation capabilities, provide effective physical assistance, and have adaptive control frameworks that enable them to develop social understanding during human-robot interaction. In this context, human factors, especially quantifiable ones, represent a necessary component. The objective of this paper is to conduct an unbiased review encompassing the studies on human factors studied in research involving physical interactions and strong manipulation capabilities. We identified the prevalent human factors in physical human-robot interaction (pHRI), noted the factors typically addressed together, and determined the frequently utilized assessment approaches. Additionally, we gathered and categorized proposed quantification approaches based on the measurable data for each human factor. We also formed a map of the common contexts and applications addressed in pHRI for a comprehensive understanding and easier navigation of the field. We found out that most of the studies in direct pHRI (when there is direct physical contact) focus on social behaviors with belief being the most commonly addressed human factor type. Task collaboration is moderately investigated, while physical assistance is rarely studied. In contrast, indirect pHRI studies (when the physical contact is mediated via a third item) often involve industrial settings, with physical ergonomics being the most frequently investigated human factor. More research is needed on the human factors in direct and indirect physical assistance applications, including studies that combine physical social behaviors with physical assistance tasks. We also found that while the predominant approach in most studies involves the use of questionnaires as the main method of quantification, there is a recent trend that seeks to address the quantification approaches based on measurable data.

The Evolving Role of Surgical Aortic Valve Replacement in the Era of Transcatheter Valvular Procedures.

Surgical aortic valve replacement (SAVR) has long been the standard treatment for severe symptomatic aortic stenosis (AS). However, transcatheter aortic valve replacement (TAVR) has emerged as a minimally invasive alternative; it was initially intended for high-risk patients and has now expanded its use to patients of all risk groups. While TAVR has demonstrated promising outcomes in diverse patient populations, uncertainties persist regarding its long-term durability and potential complications, raising the issue of the ideal lifetime management strategy for patients with AS. Therefore, SAVR continues to play an important role in clinical practice, particularly in younger patients with longer life expectancies, those with complex aortic anatomy who are unsuitable for TAVR, and those requiring concomitant surgical procedures. The choice between TAVR and SAVR warrants personalized decision-making, considering patient characteristics, comorbidities, anatomical considerations, and overall life expectancy. A multidisciplinary approach involving an experienced heart team is crucial in the preoperative evaluation process. In this review, we aimed to explore the current role of surgical management in addressing aortic valve stenosis amidst the expanding utilization of less invasive transcatheter procedures.

All-cause procedural readmissions following transcatheter aortic valve replacement

ObjectiveWith expanding eligibility criteria, transcatheter aortic valve replacement is being performed on patients with longer life expectancy, and subsequent procedures after index transcatheter aortic valve replacement are inevitable. This study examines the incidence and outcomes of patients undergoing subsequent procedural readmissions after transcatheter aortic valve replacement. MethodsAll patients who underwent index transcatheter aortic valve replacement and were discharged alive from January 2012 to December 2019 at a single institution were evaluated. Study end points were mortality and readmission for procedure with more than 1-day hospital stay. Effect on survival was evaluated by treating procedural readmission as a time-dependent variable by Cox proportional hazard model and competing risk analysis. ResultsA total of 1092 patients met inclusion criteria with a median follow-up time of 34 months. A total of 218 patients (20.0%) had 244 subsequent procedural readmissions. During the 244 procedural readmissions, there were 260 procedures; 96 (36.9%) were cardiac (most commonly pacemaker implantation, percutaneous coronary interventions, and surgical aortic valve replacements), and 164 (63.1%) were noncardiac (most commonly orthopedic and gastrointestinal procedures). The overall procedural readmission rates were 32%, 39%, and 42%, and all-cause mortality was 27%, 44%, and 54% at 20, 40, and 60 months, respectively. Procedural readmissions were not associated with a survival penalty in any surgical risk group or on Cox regression (hazard ratio, 1.25; 0.91-1.64, P = .17). ConclusionsAfter transcatheter aortic valve replacement, procedural interventions are seen frequently, with most procedures occurring within the first year after transcatheter aortic valve replacement. However, subsequent procedural readmissions do not appear to have a survival penalty for patients after transcatheter aortic valve replacement. After transcatheter aortic valve replacement with resolution of aortic stenosis, subsequent procedures can and should be pursued if they are needed.

Redo-TAVR: Essential Concepts, Updated Data and Current Gaps in Evidence.

Within the last two decades, transcatheter aortic valve replacement (TAVR) has transformed the treatment strategy for symptomatic severe aortic stenosis (AS), representing a less invasive alternative to traditional open-chest surgery. With time, advances in device features, imaging planning, and implantation techniques have contributed to an improvement in safety as well as a reduction in procedural complications. This has led to the expansion of TAVR to lower-risk patients, where TAVR has shown favorable outcomes compared to surgical aortic valve replacement (SAVR). As TAVR expands to younger and lower-risk patients with longer life expectancies, the need for reintervention for failing transcatheter heart valves is expected to increase. Redo-TAVR has gained increasing relevance in the lifetime management of AS as one of the treatment strategies available for structural valve dysfunction (SVD). However, some issues are associated with this approach, including coronary re-access and the risk of coronary obstruction. In this review, we provide essential concepts to properly select candidates for Redo-TAVR, updated data on clinical outcomes and complication rates, and current gaps in evidence.

Happy people live longer because they are healthy people

ObjectivesHigher levels of happiness are associated with longer life expectancy. Our study assessed the extent to which various factors explain the protective effect of happiness on all-cause mortality risk, and whether the association differs between older men and women.MethodsUsing data from the Singapore Longitudinal Aging Studies (N = 6073) of community-dwelling older adults aged ≥ 55 years, we analyzed the association of baseline Likert score of happiness (1 = very sad to 5 = very happy) and mortality from mean 11.7 years of follow up. Cox regression models were used to assess the extent to which confounding risk factors attenuated the hazard ratio of association in the whole sample and sex-stratified analyses.ResultsHappiness was significantly associated with lower mortality (p < .001) adjusted for age, sex and ethnicity: HR = 0.85 per integer score and HR = 0.57 for fairly-or-very happy versus fairly-or-very sad. The HR estimate (0.90 per integer score) was modestly attenuated (33.3%) in models that included socio-demographic and support, lifestyle or physical health and functioning factor, but remained statistically significant. The HR estimate (0.94 per integer score) was substantially attenuated (60%) and was insignificant in the model that included psychological health and functioning. Including all co-varying factors in the model resulted in statistically insignificant HR estimate (1.04 per integer score). Similar results were obtained for HR estimates for fairly-to-very happy versus fairly-to- very sad).DiscussionMuch of the association between happiness and increased life expectancy could be explained by socio-demographic, lifestyle, health and functioning factors, and especially psychological health and functioning factors.

Design and Content Validation using Expert Opinions of an Instrument Assessing the Lifestyle of Adults: The 'PONTE A 100' Questionnaire.

Lifestyle, a major determinant of health status, comprises a number of habits and behaviours that form a part of daily life. People with healthy lifestyles have a better quality of life, suffer less disease, and have a longer life expectancy. This work reports the design and content validation of a questionnaire-the 'PONTE A 100' questionnaire-assessing the lifestyle of adults. This collects information across five dimensions-'Eating Habits', 'Physical Activity', 'Smoking and use of Alcohol and other Drugs', 'Emotional Wellbeing', and 'Safety and Non-intentional Injuries'-via the answering of a total 33 items. Psychometric validation of the instrument's content was obtained via expert opinions. This was performed by two rounds of assessment and involved 34 experts representing different health science disciplines (mean experience, 27.4 ± 9.4 years). At the end of each round, adjustments were made according to their recommendations. Agreement between the experts was examined using the Aiken V test. A final V value of 0.95 (95% CI, 0.90-1.00) was obtained for the questionnaire as a whole, highlighting the validity of its content. The questionnaire would therefore appear to be an appropriate instrument for assessing the lifestyle of adults.

Lifetime risk, life expectancy, loss-of-life expectancy and lifetime healthcare expenditure for Stevens-Johnson syndrome/toxic epidermal necrolysis in Taiwan: follow-up of a nationwide cohort from 2008 to 2019.

Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) not only cause acute, devastating mucocutaneous reactions but also have long-lasting implications on survivors' lives. To quantify the lifetime burden of SJS/TEN. The cumulative incidence rate (CIR), life expectancy (LE), loss-of-life expectancy (LoLE) and lifetime healthcare expenditure (HE) for SJS/TEN were estimated over the period from 2008 to 2019 using data from the National Health Insurance Research Database of Taiwan and life tables of vital statistics. In this nationwide cohort of 6552 incident SJS/TEN cases, a trend towards a decrease in the CIR was observed between 2008 and 2019. Compared with the general population, patients with SJS/TEN experience a tremendous loss of 9.43 (1.06) [mean (SEM)] years of LE after diagnosis of SJS/TEN. Male patients with SJS/TEN had higher LoLE [10.74 (1.22) vs. 7.69 (1.43) years] and annual HE than females. Younger age at diagnosis of SJS/TEN was associated with longer LE but greater LoLE and higher lifetime HE. Patients with intensive care unit admission on diagnosis, malignancy, diabetes mellitus, end-stage renal disease and SJS/TEN-associated sequelae experienced substantially greater LoLE and HE per life year. Patients with SJS/TEN suffer substantial loss-of-LE and HE, particularly young patients, compared with the general population. These data provide a reference estimate of the lifetime burden of SJS/TEN to help health authorities evaluate the cost-effectiveness of future preventive and treatment strategies to minimize the burden of SJS/TEN.

Emotional Reactions to Different Indoor Solutions: The Role of Age

Longer life expectancy and global population growth result in new environmental demands to meet different material and psychological needs across the lifespan. Since the physical environment is a fundamental factor in the quality of life, here we investigated which different indoor features (i.e., colors, materials/textures) have the most positive impact on individuals in terms of emotional reactions and whether these reactions could vary with age. Four groups of participants (i.e., younger adults, adults, middle-aged, elderly, age range 19–86 years) were presented with pictures of five different rooms: (1) Modern (white and cold colors with good-quality essential coverings); (2) Basic (white and blue colors; plastic and metal furniture); (3) Vivacious (red, blue, and green elements; soft-textured materials); (4) Comfort (different shades of blue and green; velvet coverings); (5) Nature (brown, orange, and green colors; wood furniture and leather coverings). Participants underwent a six-item questionnaire evaluating their positive and negative reactions to each image. The results showed a more positive evaluation of nature and vivacious rooms than all others. In turn, basic and modern rooms evoked more negative emotions than all others. Aged-related emotional reactions emerged, with the elderly appearing to be more inclined to rely on features, such as colors and covering materials, for the affective evaluation of the environment compared to adults and middle-aged adults. These preliminary results support the need for human-centered design approaches to improve well-being across the lifespan.

Actions taken and barriers encountered by professionals working with adults with intellectual disabilities who experience grief: a qualitative approach

Experience of grief has increased among people with intellectual disability because of their longer life expectancy. Professionals supporting this population are often critical of the lack of adequate tools for dealing with this situation. The objective of this study was to identify the strategies and barriers that these professionals are confronted with when dealing people with intellectual disability who are going through the grieving process. A qualitative study was conducted involving 20 professionals working with people with intellectual disability. Four themes were extracted using thematic analysis: Exclusion of clients from end-of-life and grief processes, Strategies to support the client’s grief process, Emotional and personal difficulties faced by the professionals, and Coping and regulation of the professional’s grief process. Barriers identified by these professionals include not having the specific skills to support clients in their grief and the emotional impact of the death of a client.

Hepatosellüler kanser nedeniyle tek merkezde yapılan karaciğer nakli sonuçları

Objective: Hepatocellular cancer (HCC) is the most common malignancy of the hepatobiliary system. There are significant differences in the global spread of HCC. It is the major cause of death in patients with cirrhosis. Its molecular pathogenesis is highly complex and heterogeneous. Major risk factors for the development of HCC are chronic hepatitis B virus (HBV) infection, chronic hepatitis C virus (HCV) infection and alcohol-related liver cirrhosis. Hepatocellular cancer is rarely seen in the first 4 decades of life, except in communities where HBV infection is hyperendemic.&#x0D; Method: The study was conducted by retrospectively scanning the files of 204 patients diagnosed with HCC who applied to Organ Transplantation Center between 21.09.2014 and 13.04.2019. Patients were transplanted liver by being classified according to Milan criteria, San Francisco [University of California San Francisco (UCSF)] criteria, and Barcelona Clinic Liver Cancer (BCLC) criteria.&#x0D; Result: The median age of the patients was 58.03 (range 31 to 72). 170 of the patients were men and 34 of them were female. Liver transplantation was performed from cadaveric donors to 31 patients and from living donors to 173 patients. There is a significant relationship between the life span of the patients and their gender. Female patients have a longer life expectancy [t (202) = 2,963, p =, 003]. A significant relationship was found between life expectancy and surgical classification [F (3) = 3,008, (p =, 031)].&#x0D; Conclusion: In patients diagnosed with HCC and undergoing liver transplantation; the gender being female and the classification method before transplantation affect life expectancy.

Implementing Shared Decision-making for Patients With Aortic Stenosis With Longer Life Expectancy

This Viewpoint describes how shared decision-making should be used in patients with aortic stenosis who have a longer life expectancy.