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Background Latinos are the fastest growing minority group of the older adult population. Although physical activity (PA) has documented health benefits, older Latinos are less likely to engage in leisure time PA than older non-Latino whites. Dance, popular among Latinos, holds promise as a culturally relevant form of PA. Purpose To describe self-reported and device-assessed changes in PA as a result of a randomized controlled trial of BAILAMOS, a 4-month Latin dance program with a 4-month maintenance program, versus a health education control group. Methods Adults, aged 55+, Latino/Hispanic, Spanish speaking, with low PA levels at baseline, and risk for disability were randomized to the dance program (n = 167) or health education condition (n = 166). Data were analyzed using multilevel modeling with full information maximum likelihood. Results A series of multilevel models revealed significant time × group interaction effects for moderate-to-vigorous physical activity (MVPA), dance PA, leisure PA, and total PA. Exploring the interaction revealed the dance group to significantly increase their MVPA, dance PA, leisure PA, and total PA at months 4 and 8. Household PA and activity counts from accelerometry data did not demonstrate significant interaction effects. Conclusions The study supports organized Latin dance programs to be efficacious in promoting self-reported PA among older Latinos. Efforts are needed to make dancing programs available and accessible, and to find ways for older Latinos to add more PA to their daily lives. Clinical Trial information NCT01988233.

Sickle Cell Disease (SCD) has a complex array of symptoms and is associated with high healthcare expenditures. A comprehensive care program may help to reduce expenditures of children with SCD. This research describes SCD comprehensive care program enrollees’ expenditure patterns by level of hospitalization risk over a three-year period and estimates whether coordination of care services reduced costs for those with different risk levels. Medicaid claims data were collected for program patients with SCD. Data from the one year prior to program enrollment categorized patients as High, Medium, or Low risk for incurring inpatient expenditures. We compared utilization risk groups on inpatient expenditures by year after program enrollment. The trends in expenditures are shown in the subgroup analyses (descriptively). 361 program enrollees ages 1 to 27y had SCD; 8.9% were categorized as High risk of utilizing hospitalization services, 47.9% were at Medium risk, and 43.2% were at Low risk. The High Utilization and Medium Utilization Risk groups showed trends of expenditure reduction, but the trends may be due to regression of extreme group costs toward the mean. The lack of a statistically significant cost benefit might be due to small sample size, low engagement in the program services, short duration of intervention, and inability to distinguish the appropriateness of healthcare utilization for SCD.

This study was to compare the results of texture analyzer with those of farinograph and extensograph and determine whether texture analyzer could be used to evaluate the processing quality of highland barley flour (HBF) dough sheet. The farinograph and extensograph tests were used to determine the reconstituted flour properties, a texture analyzer was applied to measure the tensile strength (TS) of HBF dough sheet, and the content of glutenin macropolymer (GMP), free sulfhydryl (-SH) and secondary structure of protein and microstructure in HBF dough sheet were investigated. Furthermore, correlations between these parameters were determined by regression analysis and Pearson correlation coefficient. It was suggested that the reconstituted flours with a higher gluten index showed a higher farinograph quality number (FQN) and greater maximum resistance to extension (R

The majority of mental, emotional, and behavioral (MEB) disorders have an initial onset before age 24, with 20% annual incidence, and with major depressive disorder (MDD) being the most common MEB. Health systems may be able to reduce costs by transitioning from the current treatment-focused model for MDD to a prevention model. However, evidence is needed for (1) the comparative effectiveness of a "scalable intervention" and (2) an implementation model for such a scalable intervention in the primary care setting. This paper describes a comparative effectiveness trial evaluating the efficacy of two evidence-based cognitive-behavioral prevention (CBP) programs: Teens Achieving Mastery over Stress (TEAMS), the "gold standard," group therapy model, and Competent Adulthood Transition with Cognitive Behavioral, Humanistic and Interpersonal Training (CATCH-IT), a scalable, self-directed, technology-based model. Eligible adolescents, age 13-19, are offered one of these two depression prevention programs across five health systems (30 clinics) in urban and suburban Chicago, IL, rural Western IL, and Louisville, KY. We are comprehensively evaluating patient-centered outcomes and stakeholder-valued moderators of effect versus baseline at two, six, 12, and 18-month assessment points. Using a hybrid clinical trial design that simultaneously examines the implementation process, the study is also assessing adolescents', parents', and providers' experiences (e.g., efficacy, time commitment, cultural acceptability) within each intervention approach.

Objectives: A validated means to predict inhospital cardiac arrest is lacking. The purpose of this study was to evaluate the changes in end-tidal carbon dioxide, as it correlates with the progression to inhospital cardiac arrest in ICU patients. Design, Setting, and Patients: Single-center, retrospective cohort study of mechanically ventilated ICU patients (age > 18 yr old) having inhospital cardiac arrest with advanced cardiac life support and continuous end-tidal carbon dioxide monitoring at a single academic center from 2014 to 2017. Demographics, clinical variables, and outcomes were collected. End-tidal carbon dioxide was collected from 5 to 2,880 minutes before inhospital cardiac arrest. Data were analyzed using descriptive statistics, and model estimates were generated using a repeated-measures categorical model with restricted maximum likelihood estimation and fully specified (autoregressive) covariance to assess the effect of time on changes in end-tidal carbon dioxide. Measurements and Main Results: A total of 788 patients were identified and 104 met inclusion criteria, where 62% were male with an average age of 58.5 years. Seventy-four percent required vasopressors and 72% experienced pulseless electrical activity. Mean end-tidal carbon dioxide 5 minutes prior to inhospital cardiac arrest was significantly lower than all evaluated time points except 180 minutes (p < 0.05). One patient survived to hospital discharge. In multivariate logistic regression modeling for return of spontaneous circulation, a greater change in the prearrest end-tidal carbon dioxide maximum to prearrest end-tidal carbon dioxide minimum was associated with a decreased likelihood of return of spontaneous circulation (odds ratio 0.903; 95% CI, 0.832–0.979; p = 0.014). Additionally, a change from prearrest end-tidal carbon dioxide maximum to prearrest end-tidal carbon dioxide minimum greater than 17 mm Hg was associated with a decreased likelihood of return of spontaneous circulation and odds ratio 0.150; 95% CI, 0.036–0.66; p = 0.012). Conclusions: Mean end-tidal carbon dioxide is significantly lower immediately before inhospital cardiac arrest. The statistical and clinical significance of end-tidal carbon dioxide may highlight its utility for predicting inhospital cardiac arrest in ICU patients. Comparison analysis and modeling explorations in a larger cohort are needed.

Early forecasting is important for health officials and decision-makers to respond to public health emergencies such as the 2019 novel coronavirus (COVID-19) outbreak. The spread of epidemic is mainly impacted by the interaction among agents, i.e., individual, hospital and government. In an effort to efficiently mitigate the impact of the virus, this original study designed a multi-agents complex adaptive system model of COVID-19 to detect the trend of the spread in 8 countries by simulating the adaptation and interaction among the agents. The results show that there should be 127,726 infections in China, 12,000 in South Korea, 729,377 in the USA, 176,623 in Italy, 194,359 in Spain, 165,122 in Germany, 177,462 in France and 149,540 in UK. It is impossible to screen and report all the cases, and the detection rate may be 82% in Italy, 65% in China, 55% in the USA, and 41% in UK on April 8, 2020. Scenario simulation results imply that action time is the most important factor in containing the spread of epidemic. If China had locked down Wuhan city five days later, the total infection would be tripled. The forces of individual, hospital and government should be united in fighting the virus.

Background: Equitable access to women’s health services, including cancer prevention programs, is lacking in many countries. Sénégal ranks 17 th in the world in the age-standardized incidence rate of cervical cancer. The Kédougou region is located in the southeastern corner of Sénégal and has many structural barriers to preventive care, including economic disadvantage, a low literacy rate, and a shortage of healthcare workers. The goal of this study was to investigate the barriers and facilitators of cervical cancer screening uptake in this region. Methods: We conducted a cross-sectional survey of 158 participants, 101 women and 57 men (ages 30 - 59) across nine non-probability-sampled communities located throughout three districts in the Kédougou region of Sénégal from October 2018 through January 2019. We collected demographic information and data on health service utilization, cervical cancer knowledge, and experience of cervical cancer screening. Associations were tested using the Fisher’s Exact test statistic. Results: The majority of our study population speaks one or both of the prevalent local languages, Malinké (62.7%) and Pulaar (59.5%), with fewer Wolof (26.6%) and French (31%) speakers. Among the women in our sample, 84.2% had never been screened for cervical cancer. Among men, 78.9% stated that they have the final say at home regarding healthcare decisions. In contrast, only 16.0% of women made their own healthcare decisions. For those who speak Malinké, 48.0% received services in another language. We found significant gender differences between women and men in the knowledge that a woman is at risk if she has multiple sexual partners (p = 0.010) and that a woman is at increased risk if her partner has multiple sexual partners (p < 0.001). Conclusions: This study demonstrates the critical need to overcome both clinical and informational barriers, as well as structural barriers, to ensure the implementation and sustainment of an equitable health service. In this highly underdeveloped region where workforce challenges are extraordinary, innovative solutions are needed to address these underlying social determinants of health while simultaneously improving quality of care at the point of service. Trial registration: This study is registered on clinicaltrials.gov with the Clinical Trials Study Identifier: NCT03540069

Cervical cancer is the leading cause of female cancer deaths in Senegal which is ranked 17th in incidence globally, however, the screening rate there is very low. Nuanced gendered perceptions and health behaviors of both women and men play a significant role in women's health. Our study analyzed gender differences on perceptions of gender roles, discrimination, cancer attitudes, cancer stigma, and influences in healthcare decision making within our study population to inform ongoing cervical cancer prevention work in the rural region of Kedougou, Senegal. We conducted a cross-sectional survey of 158 participants, 101 women and 57 men (ages 30-59) across nine non-probability-sampled communities from October 2018 through February 2019. Bivariate analysis was conducted to assess gender differences across all variables. We also conducted analyses to determine whether there were significant differences in beliefs and attitudes, by screening behavior and by education. We found significant gender differences regarding the perception of a woman's role (P < 0.001) and a man's role (P = 0.007) as well as in the everyday discrimination questions of "decreased respect by spouse" (P < 0.001). Regarding cancer stigma, among women, 18.00% disagreed and 10.00% strongly disagreed while among men, 3.6% disagreed and 1.8% strongly disagreed that "If I had cancer, I would want my family to know that I have it." When making decisions about one's healthcare, women are more likely than men to trust social contacts such as their spouse (46.5% vs 5.3%, p < 0.001) while men are more likely than women to trust health service personnel such as a nurse (50.9% vs 18.8%, p < 0.001). Furthermore, men and women were both more likely to state that men have the final decision regarding the healthcare decisions of women (p < 0.001). Our data reveal structural disadvantages for women within our study population as well as gender differences in the adapted everyday discrimination scale and cancer stigma scale. Higher rates of both personal and perceived cancer stigma among women has profound implications for how population and community level communication strategies for cancer prevention and control should be designed. Efforts to advance the goal of the elimination of cervical cancer should, in the short-term, seek to gain a more profound understanding of the ways that gender, language, and other social determinants impact negative social influences and other barriers addressable through interventions. Social and behavior change communication may be one approach that can focus both on education while seeking to leverage the social influences that exist in achieving immediate and long-term goals.

Objectives. Carrageenan is well known to cause inflammation and is used in laboratory experiments to study mediators and treatments of inflammation. However, carrageenan is added to hundreds of processed foods to improve texture. Previous work indicated that low concentrations of carrageenan in drinking water caused marked glucose intolerance and insulin resistance in a mouse model. This exploratory, clinical study tested the impact of the no-carrageenan diet in prediabetes. Research Design and Methods. Participants with prediabetes (n=13), defined as HbA1c of 5.7%-6.4%, enrolled in a 12-week, randomized, parallel-arm, feeding trial. One group (n=8) was provided all meals and snacks with no carrageenan. A second group (n=5) received a similar diet with equivalent content of protein, fat, and carbohydrate, but with carrageenan. Blood samples were collected at baseline and during oral glucose tolerance tests at 6 and 12 weeks. The primary outcome measure was changed in %HbA1c between baseline and 12 weeks. Statistical analysis included paired and unpaired t-tests, correlations, and 2×2 ANOVAs. Results. Subjects on no carrageenan had declines in HbA1c and HOMA-IR (p=0.006, p=0.026; paired t-test, two tailed). They had increases in C-peptide (p=0.029) and Matsuda Index (2.1±0.7 to 4.8±2.3; p=0.052) and declines in serum IL-8, serum galectin-3, and neutrophil phospho-(Ser307/312)-IRS1 (p=0.049, p=0.003, and p=0.006; paired t-tests, two tailed). Subjects on the diet with carrageenan had no significant changes in these parameters. Significant differences between no-carrageenan and carrageenan-containing diet groups for changes from baseline to 12 weeks occurred in C-peptide, phospho-Ser-IRS1, phospho-AKT1, and mononuclear cell arylsulfatase B (p=0.007, p=0.038, p=0.0012, and p=0.0008; 2×2 ANOVA). Significant correlations were evident between several of the variables. Conclusions. Findings indicate improvement in HbA1c and HOMA-IR in participants on no-carrageenan diets, but not in participants on carrageenan-containing diets. Significant differences between groups suggest that removing carrageenan may improve insulin signaling and glucose tolerance. Larger studies are needed to further consider the impact of carrageenan on development of diabetes.

Background: Systems science methodologies offer a promising assessment approach for clinical trials by: 1) providing an in-silico laboratory to conduct investigations where purely empirical research may be infeasible or unethical; and, 2) offering a more precise measurement of intervention benefits across individual, network, and population levels. We propose to assess the potential of systems sciences methodologies by quantifying the spillover effects of randomized controlled trial via empirical social network analysis and agent-based models (ABM). Design/methods: We will evaluate the effects of the Patient Navigation in Medically Underserved Areas (PNMUA) study on adult African American participants diagnosed with breast cancer and their networks through social network analysis and agent-based modeling. First, we will survey 100 original trial participants (50 navigated, 50 non-navigated) and 150 of members of their social networks (75 from navigated, 75 non-navigated) to assess if navigation results in: 1) greater dissemination of breast health information and breast healthcare utilization throughout the trial participants’ networks; and, 2) lower incremental costs, when incorporating navigation effects on trial participants and network members. Second, we will compare cost-effectiveness models, using a provider perspective, incorporating effects on trial participants versus trial participants and network members. Third, we will develop an ABM platform, parameterized using published data sources and PNMUA data, to examine if navigation increases the proportion of early stage breast cancer diagnoses. Discussion: Our study results will provide promising venues for leveraging systems science methodologies in clinical trial evaluation. Keywords: patient navigation, Social network analysis, Agent-based models, Cost-effectiveness

The performance of domestic processors and databases cannot meet the requirements of real-time data processing and high-speed data query in aerospace industry. In order to make up for the lack of domestic hardware and software, according to the data characteristics of spacecraft, clustered servers are used to build distributed systems. New load balancing algorithms are proposed, and data mining software algorithms are designed at the Server Array level to realize the application of distributed data processing system in aerospace industry.

This note investigates the problem of moving-center formation of multi vehicles, such that the controlled vehicles orbit around a center moving with time-varying radius along the common circle, or move along the same straight line like geese in V formation. Cooperative controllers of these two formations flying are developed for each vehicle based on neighborhood information only. Finally, the effectiveness of the proposed controller is verified by the simulation results of different missions.

This paper provides a new flight control method which adopts thrust vector control only using the synthetic jet for a fixing-wing unmanned aerial vehicle(UAV). The pitching control of this fixed-wing UAV is controlled only by the thrust vector produced by the synthetic jet installed at the outside of the engine jet mouth. Firstly, we rebuild the fluid model of the engine with synthetic jet, and we obtain the relationship between the deflection angle of primary jet with the amplitude of metal diaphragm of the synthetic jet. Then we design an adaptive backstepping sliding mode control for the pure pitching motion of the UAV. Simulations are conducted in order to analyze the controller and compare the thrust vectoring control (TVC) method with traditional aerodynamic elevator. Finally, we find out that the thrust vectoring control produced by synthetic jet can realize the pure pitching control of the UAV, and the TVC method can replace the traditional aerodynamic elevator. The adaptive backstepping sliding mode controller performs well in the presence of the dynamic uncertainties and external disturbance.

In this paper, a robust adaptive tracking control law is designed and optimized for a multistage hypersonic vehicle (HV) tracking reference command in the existence of unknown but bounded varying system uncertainties during ascent stage. The original problem is transformed into a second-order error tracking system. Based on nonlinear dynamic inversion control and robust adaptive control, the proposed approach can resist model uncertainties and achieve tracking to the reference of angle of pitch, and the stability of the closed-loop system is theoretically proved. Simulation results demonstrate the effectiveness of the control law under the condition of certain specific uncertainties. Moreover, a cost function that represents the consumption of controller and integrated tracking error is introduced. Then, parameters of the control law are optimized with genetic algorithm (GA), and the ultimate optimized parameter combinations for nominal and uncertain systems are directly tested.

We compared risk of progression from subjective cognitive decline (SCD) to mild cognitive impairment (MCI) in an academic memory clinic versus a population-based study.Older adults presenting at a memory clinic were classified as SCD (n = 113) or as noncomplainers (n = 82). Participants from a population study were classified as SCD (n = 592) and noncomplainers (n = 589) based on a memory complaint score. Annual follow-up performed for a mean of 3 years.The adjusted hazard ratio for SCD was 15.97 (95% confidence interval: 6.08-42.02, P .001) in the memory clinic versus 1.18 (95% confidence interval: 1.00-1.40, P = .047) in the population study, where reported "worry" about memory further increased SCD-associated risk for MCI.SCD is more likely to progress to MCI in a memory clinic than the general population; participants' characteristics vary across settings. Study setting should be considered when evaluating SCD as a risk state for MCI and dementia.

The relationship between subjective memory complaints (SM) and objective memory (OM) performance in aging has been variably characterized in a substantial literature, to date. In particular, cross-sectional studies often observe weak or no associations. We investigated whether subjective memory complaints and objectively measured cognition influence each other over time, and if so, which is the stronger pathway of change—objective to subjective, or subjective to objective—or whether they are both important. Using bivariate latent change score modeling in data from a population study (N=1980) over 5 annual assessment cycles, we tested four corresponding hypotheses: (1) no coupling between SM and OM over time; (2) SM as leading indicator of change in OM; (3) OM as leading indicator of change in SM; (4) dual coupling over time, with both SM and OM leading subsequent change in the other. We also extended objective cognition to two other domains, language and executive functions. The dual-coupling models best fit the data for all three objective cognitive domains. The SM–OM temporal dynamics differ qualitatively compared to other domains, potentially reflecting changes in insight and self-awareness specific to memory impairment. Subjective memory and objective cognition reciprocally influence each other over time. The temporal dynamics between subjective and objective cognition in aging are nuanced, and must be carefully disentangled to shed light on the underlying processes. (JINS, 2015,21, 732–742)

This paper investigates the problem of attitude stabilization control for rigid spacecraft subject to actuator output deviation disturbance and external disturbances without angular velocity measurement. Firstly, an angular velocity observer is designed which ensures asymptotic convergence of angular velocity estimation error. Furthermore, taking actuator output deviation disturbance into consideration, a reaction wheel output deviation disturbance observer is constructed to give an estimate of the disturbance signal which is then compensated in feed-forward channel to realize high-precision attitude stabilization control. Subsequently, a composite control law which consists of aforementioned angular velocity observer and disturbance observer is developed. Finally, numerical simulations are given to demonstrate effectiveness of the proposed control scheme.

Amidine-substituted phenylbenzimidazoles are well-established DNA-binding structural motifs that have contributed to the development of diverse classes of DNA-targeted agents; this ring system not only assists in increasing the overall DNA affinity of an agent, but can also influence its site selectivity. Seeking a means to conveniently exploit these attributes, a protocol for the on-resin synthesis of amino acid- and peptide-phenylbenzimidazole-amidine conjugates was developed to facilitate installation of phenylbenzimidazole-amidines into peptide chains during the course of standard solid-phase syntheses. Building from a resin-bound amino acid or peptide on Rink amide resin, 4-formyl benzoic acid was coupled to the resin-bound free amine followed by introduction of 3,4-diamino-N'-hydroxybenzimidamide (in the presence of 1,4-benzoquinone) to construct the benzimidazole heterocycle. Finally, the resin-bound N'-hydroxybenzimidamide functionality was reduced to an amidine via 1 M SnCl2·2H2O in DMF prior to resin cleavage to release final product. This procedure permits the straightforward synthesis of amino acids or peptides that are N-terminally capped by a phenylbenzimidazole-amidine ring system. Employing this protocol, a series of amino acid-phenylbenzimidazole-amidine (Xaa-R) conjugates was synthesized as well as dipeptide conjugates of the general form Xaa-Gly-R (where R is the phenylbenzimidazole-amidine and Xaa is any amino acid).

The above article from the Journal of Cellular Physiology, published online on 7 December 2017 in Wiley Online Library (wileyonlinelibrary.com), has been withdrawn by agreement between the authors, the journal Editor in Chief, Gary Stein, and Wiley Periodicals, Inc. The withdrawal has been agreed due to the article being submitted for publication without the consent of the authors' instructor.

Background Numerous cross-sectional studies have related exposure to neurotropic infectious agents with cognitive dysfunction in older adults, however, the temporal sequence is uncertain. Methods In a representative, well-characterized, population-based aging cohort, we determined whether the temporal trajectories of multiple cognitive domains are associated with exposure to cytomegalovirus (CMV), Herpes Simplex virus, type 1 (HSV-1), Herpes Simplex virus, type 2 (HSV-2), or Toxoplasma gondii (TOX). Complex attention, executive functions, memory, language, and visuospatial function were assessed annually for 5 years among consenting individuals. Study entry IgG antibody titers indexing exposure to each infectious agent were examined in relation to slopes of subsequent temporal cognitive decline using multiple linear regressions adjusted for potential confounders. Results The IgG levels for HSV-2 were significantly associated with baseline cognitive domain scores (N=1022 participants). Further, the IgG levels for HSV-2, TOX, and CMV, but not HSV-1 were significantly associated with greater temporal cognitive decline that varied by type of infection. Conclusions Exposure to CMV, HSV-2, or TOX is associated with cognitive deterioration in older individuals, independent of general age-related variables. An increased understanding of the role of infectious agents in cognitive decline may lead to new methods for its prevention and treatment.

Depression is associated with worse clinical outcome in patients with heart failure (HF), but few studies have evaluated its effect in HF patients with comorbid atrial fibrillation (AF). We investigated this question among a cohort of hospitalized patients with systolic HF (AF-HF) who were followed