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Background: Ambient air pollution, detrimental built and social environments, social isolation (SI), low socioeconomic status (SES), and rural (versus urban) residence have been associated with cognitive decline and risk of Alzheimer's disease and related dementias (ADRD). Research is needed to investigate the influence of ambient air pollution and built and social environments on SI and cognitive decline among rural, disadvantaged, ethnic minority communities. To address this gap, this cohort study will recruit an ethnoracially diverse, rural Florida sample in geographic proximity to seasonal agricultural burning. We will (1) examine contributions of smoke-related fine particulate matter (PM2.5) exposures to SI and cognitive function; (2) determine effects of built and social environments on SI and cognitive function; and (3) contextualize SI and cognitive function among residents from different ethnoracial groups during burn and non-burn seasons. Methods: We will recruit 1,087 community-dwelling, dementia-free, ≥45-year-olds from five communities in Florida's Lake Okeechobee region. Over 36 months, participants will complete baseline visits to collect demographics, health history, and health measurements (e.g., blood pressure, body mass index) and 6-month follow-ups assessing cognitive function and social isolation at each visit. A subsample of 120 participants representative of each community will wear smartwatches to collect sensor data (e.g., heart rate) and daily routine and predefined activities (e.g., GPS-captured travel, frequent destinations) over two months. Ecological momentary assessments (EMA) (e.g., whether smoke has bothered participant in last 30 minutes) will occur over two months during agricultural burning and non-burning months. PurpleAir monitors (36 total) will be installed in each community to continuously monitor outdoor PM2.5 levels. Discussion: We expect to identify individual- and community-level factors that increase the risk for SI and cognitive decline in a vulnerable rural population. [ABSTRACT FROM AUTHOR]

Objectives: We examined the association of urinary incontinence (UI) with physical, mental, and social health among older Korean Americans living in subsidized senior housing. Design: Data were obtained from surveys conducted in 2023 with older Korean Americans residing in subsidized senior housing in the Los Angeles area (n = 313). UI was measured using a question about the frequency of involuntary urine loss. Physical, mental, and social health risks were assessed with a single item for self-rated health (fair/poor rating), the Patient Health Questionnaire−9 (probable depression), and the Lubben Social Network Scale−6 (isolation from family and friends). Results: Over half of the sample reported UI, with 46.3% experiencing it infrequently (i.e. seldom) and 10.3% frequently (i.e. sometimes or often). UI was significantly associated with physical and mental health indicators; the odds of reporting fair or poor health and having probable depression were 1.94–7.32 times higher among those with either infrequent or frequent UI compared to those without UI. While family isolation was not associated with UI, the odds of being isolated from friends were 2.85 times greater among those with frequent UI compared to those without UI. Conclusion: Our findings confirm the adverse impact of UI on physical and mental health and highlight its unique role in social health. UI-associated social isolation was significant only in relationships with friends, providing new insights into the distinction between isolation from family and friends. These findings enhance our understanding of the health risks associated with UI and inform strategies for health management and promotion within the senior housing context. [ABSTRACT FROM AUTHOR]

ObjectiveBone grafts in patients with cleft lip and palate can undergo a significant amount of resorption. The aim of this study was to investigate the effects of bisphosphonates (BPs) on the success of bone grafts in rats.DesignThirty-five female 15-week-old Fischer F344 Inbred rats were divided into the following experimental groups, each receiving bone grafts to repair an intraoral CSD: (1) Graft/saline: systemic administration of saline and (2) systemic administration of zoledronic acid immediately following surgery (graft/BP/T0), (3) 1 week postoperatively (graft/BP/T1), and (4) 3 weeks postoperatively (graft/BP/T2). As an additional control, the defect was left empty without bone graft.Main outcome measuresMicrocomputed tomography and histologic analyses were performed in addition to evaluation of osteoclasts through tartrate-resistant acid phosphatase staining.ResultsBone volume fraction (bone volume/tissue volume) for the delayed BP treatment groups (graft/BP/T1 = 45.4% ± 8.8%; graft/BP/T2 = 46.1% ± 12.4%) were significantly greater than that for the graft/saline group (31.0% ± 7.9%) and the graft/BP/T0 (27.6% ± 5.9%) 6 weeks postoperatively (P < .05). Hematoxylin and eosin staining confirmed an evident increase in bone volume and fusion of defect margins with existing palatal bone in the graft/BP/T1 and graft/BP/T2 groups. The graft/BP/T0 group showed the lowest bone volume with signs of acute inflammation.ConclusionsDelayed BP administration following cleft bone graft surgery led to significant increase in bone volume and integration compared with saline controls. However, BP injection immediately after the surgery did not enhance bone volume, and rather, may negatively affect bone graft incorporation.

Background: Neuropsychiatric symptoms (NPS) are prevalent among persons with Alzheimer's disease and related dementias (ADRD). However, there are limited safe and effective nonpharmacological treatments for controlling NPS. Transcranial direct current stimulation (tDCS) is a promising noninvasive and safe treatment. Materials and Methods: This study investigated the effects of remotely supervised tDCS in managing NPS in older adults with mild to moderate ADRD. Forty older adults diagnosed with early-stage ADRD were randomly assigned in a 1:1 ratio to receive home-based active tDCS (n = 20) or sham tDCS (n = 20). Results: Results showed a significantly greater improvement in the following NPS: scratching (P = 0.052, Hedges' g = −0.60 [confidence interval {CI}: −1.24, 0.04], Cliff's δ = −0.41 [CI: −0.67, −0.06]), nighttime behaviors (P = 0.041; Hedges' g = −0.62 [CI: −1.26, 0.03]; Cliff's δ = −0.41 [CI: −0.67, −0.06], and appetite/eating changes (P = 0.010; Hedges' g = −0.78 [CI: −1.43, −0.13]; Cliff's δ = −0.41 [CI: — 0.56, −0.10]). Conclusion: This study shows promising initial results for using home-based, remotely supervised tDCS to manage NPS, such as nighttime behaviors, changes in eating and appetite, and scratching. Larger studies with more participants are needed to explore various tDCS doses and their long-term effects on NPS. [ABSTRACT FROM AUTHOR]

Objectives: Language accommodation is indispensable in making evidence-based interventions available and accessible to ethnic minorities with limited English proficiency. As part of the larger effort to culturally adapt the Savvy Caregiver Program for Korean American dementia caregivers, we first conducted linguistic adaptation, and the present study reports the preliminary findings on participants' changes in depressive Symptoms. Methods: The linguistically adapted program was delivered to two small groups of Korean American dementia caregivers (total n = 13) by two Savvy-certified Korean-speaking trainers. Participants' depressive symptoms were assessed at three time points (pre-intervention, immediate post-intervention, and 6-month follow-up). Results: Following the intervention, participants exhibited lowered depressive symptoms (t = 8.64, p <.001, Cohen's d =.89). This benefit was sustained at 6-month follow-up. Conclusions: Findings suggest that the therapeutic benefit of the Savvy Caregiver Program could potentially be shared with linguistic minorities when delivered in their native language. Clinical Implications: Although limited in its scope and nature, the pilot study with linguistic adaptation sheds light on efforts to close the gap in the evidence-based intervention delivery. [ABSTRACT FROM AUTHOR]

IntroductionAlthough current techniques for accelerated tooth movement often involve invasive surgical procedures, micro-osteoperforations (MOPs) using mini-implants may facilitate orthodontic tooth movement without raising flaps, reduce surgical risks, and increase patient acceptance. In this study, we evaluated the effectiveness of mini-implant-facilitated MOPs in inducing accelerated tooth movement and investigated the potential risks for root resorption.MethodsFive MOPs were placed on the left side around the maxillary first molars in 6 rats using an automated mini-implant driver, whereas the right side received no MOPs as the control. Closed-coiled springs were secured from incisors to first molars for orthodontic tooth movement. Tooth movement was measured, and samples underwent radiologic and histologic analyses.ResultsThe MOP side exhibited a 1.86-fold increase in the rate of tooth movement with decreased bone density and bone volume around the first molars compared with the control side. Hematoxylin and eosin and tartrate-resistant acid phosphatase analyses showed increased numbers of osteoclasts as well as new bone formation. Three-dimensional volumetric analysis of all 5 roots of the maxillary first molars demonstrated no statistically significant difference in root volumes.ConclusionsMini-implant-facilitated MOPs accelerated tooth movement without increased risk for root resorption and therefore may become a readily available and efficient treatment option to shorten orthodontic treatment time with improved patient acceptance.

Osteoporosis is a skeletal disorder attributable to an imbalance in osteoblast and osteoclast activity. NELL-1, a secretory protein that promotes osteogenesis while suppressing osteoclastic activity, holds potential as an osteoporosis therapy. Recently, we demonstrated that PEGylation of NELL-1 significantly improves its thermostability while preserving its bioactivity in vitro. However, the effect of PEGylation on the pharmacokinetics and osteogenic potential of NELL-1 in vivo have yet to be investigated. The present study demonstrated that PEGylation of NELL-1 significantly increases the elimination half-life time of the protein from 5.5 h to 15.5 h while distributing more than 2-3 times the amount of protein to bone tissues (femur, tibia, vertebrae, calvaria) in vivo when compared to naked NELL-1. In addition, microCT and DXA analyses demonstrated that systemic NELL-PEG therapy administered every 4 or 7 days significantly increases not only femoral and lumbar BMD and percent bone volume, but also new bone formation throughout the overall skeleton after four weeks of treatment. Furthermore, immunohistochemistry revealed increased osteocalcin expression, while TRAP staining showed reduced osteoclast numbers in NELL-PEG groups. Our findings suggest that the PEGylation technique presents a viable and promising approach to further develop NELL-1 into an effective systemic therapeutic for the treatment of osteoporosis.

Given the significant role of culture and place in dementia caregiving, we conducted a qualitative study with Korean American family caregivers of persons with dementia. Guided by the sociocultural model of dementia caregivers' service use, we explored the categories of care decisions, caregiving situations, and formal service use within the context of culture and place. Data from in-depth interviews with 16 Korean American dementia caregivers living in the greater Los Angeles area were analyzed using the constant comparison method. Across the three conceptual categories, we derived eight themes: (1) personal motivation; (2) family context; (3) attitude toward formal care; (4) strains; (5) rewards; (6) language and geographic region; (7) knowledge and awareness; and (8) social support and cultural stigma. Our findings demonstrate not only varied experiences in care decisions, caregiving situations, and formal service use but also their interconnectedness. Supporting the influential role of culture and place in dementia caregiving, the findings include positive and negative elements within each domain and provide implications for programs and services to respond to identified needs and barriers. [ABSTRACT FROM AUTHOR]

Background: Veterans have a high prevalence of opioid prescriptions to manage chronic low back pain (CLBP), resulting in increased risk of becoming addicted and overdosing. It is important to identify effective and safe mind–body interventions to reduce opioid use for veterans with CLBP. Qigong, a mind–body therapy, is a promising approach to manage CLBP in veterans. This study assessed the feasibility and acceptability of qigong and examined whether pain is reduced after a qigong intervention. Methods: In this randomized controlled trial, 31 participants were randomized to the qigong intervention (n = 15) or a wait-list control group (WLCG; n = 16). The qigong intervention was conducted twice weekly in 45-minute sessions for 8 weeks (total of 16 sessions). Participants who completed the qigong intervention were invited to participate in a focus group conducted through videoconferencing. In addition to assessing feasibility and acceptability of the qigong intervention, pain intensity, pain interference, and low back pain and disability were measured at baseline and postintervention. Results: Qigong is a feasible intervention for veterans with CLBP, based on retention (83%), attendance (70%), and fidelity (100%), with no injury or other adverse events. Qigong was acceptable to the veterans with CLBP, who reported that they would continue to practice qigong to manage CLBP for long-term effects. Statistically significant differences in reduction in pain intensity (p =.047), pain interference (p =.04), and pain-related disability (p =.028) between the qigong group and WLCG from baseline to postintervention were identified. Conclusion: Qigong is a mind–body approach to manage CLBP in veterans who receive care through the Veterans Health Administration and in the community. For future studies, a larger sample would provide a higher level of empirical evidence to support qigong practice for CLBP in veterans. Future studies should assess sustainability of the intervention. [ABSTRACT FROM AUTHOR]