You can't take it with you: asset run-down at the end of the life cycle

This article presents evidence on the extent to which households run down their assets after retirement. The authors show that, once corrections are made for several econometric problems, households engage in very little asset decumulation after retirement.Retirement ; Income ; Wealth

Rural Health in Virginia: Disparities, Dilemmas, and Overview of a JMU School of Nursing Solution

Background: There is no unified definition of rurality; this makes studying rurality, rural health, and associated health disparities and health outcomes difficult. Rural Americans constitute approximately 15% of the U.S. population, and they experience multiple barriers to healthcare and numerous health disparities as a result, particularly related to chronic disease, mental health, and increased lifestyle-linked health risks. Rural Americans should be viewed as a unique and vulnerable population, one with specific health promotion and disease prevention needs. Local problem: Although Virginia as a whole is a wealthy state, much inequity exists between the “Golden Crescent” and the “Rural Horseshoe” regions of Virginia, which includes the western portion of the State. Rural Virginians face higher unemployment, a higher poverty rate, and decreased access to care. One such area is Page County, Virginia, a local underserved health professional shortage area. Methods: In 2018, JMU obtained a HRSA grant focusing on Nursing Education, Practice, Quality, and Retention called, “The Undergraduate Primary Care and Rural Education (UPCARE) Project: a Community-based Nursing Education Collaboration. Intervention: The UPCARE Project allows JMU School of Nursing to respond to the needs for 1) BSN student education focusing on community health and primary care in a rural area, and 2) the creation two RN preceptor positions which incorporate a enhanced primary care RN role within 4 Rural Health Clinics (RHCs), all of whom are facilitated by a faculty-led grant team, including a Nurse Liaison. This two-pronged approach enables nurses to work to meet the health needs of the residents of Page County, Virginia. It is an innovative approach in keeping with Virginia’s State Rural Health Plan. Results: The JMU UPCARE Project is a collaborative, community-focused solution to the rural health disparities facing Page County. To date, nine students have started their clinical experiences in Page County, and two RN preceptors are starting their enhanced primary care RN role in the Rural Health Clinics. Conclusions/ Implications: This presentation will focus on rural health nursing in general, rural health disparities in Virginia, the creation of the UPCARE Project as part of the solution to meet the health care needs of rural Virginians. In keeping with the theme of the conference, the presentation will focus on the development of an enhanced primary care RN role, which is designed for RNs to work at the top of their practice scope

Improved Quality of Life Following Addiction Treatment Is Associated with Reductions in Substance Use

People seeking treatment for substance use disorders (SUD) ultimately aspire to improve their quality of life (QOL) through reducing or ceasing their substance use, however the association between these treatment outcomes has received scant research attention. In a prospective, multi-site treatment outcome study (‘Patient Pathways’), we recruited 796 clients within one month of intake from 21 publicly funded addiction treatment services in two Australian states, 555 (70%) of whom were followed-up 12 months later. We measured QOL at baseline and follow-up using the WHOQOL-BREF (physical, psychological, social and environmental domains) and determined rates of “SUD treatment success” (past-month abstinence or a statistically reliable reduction in substance use) at follow-up. Mixed effects linear regression analyses indicated that people who achieved SUD treatment success also achieved significantly greater improvements in QOL, relative to treatment non-responders (all four domains p 0.001). Paired t-tests indicated that non-responders significantly improved their social (p = 0.007) and environmental (p = 0.033) QOL; however, their psychological (p = 0.088) and physical (p = 0.841) QOL did not significantly improve. The findings indicate that following treatment, QOL improved in at least some domains, but that reduced substance use was associated with both stronger and broader improvements in QOL. Addressing physical and psychological co-morbidities during treatment may facilitate reductions in substance use

The Moderating Effect of Different Types of Internet Use on the Relationship between Transitional Aging Changes and Self-esteem of Older Adults

This study investigates the moderating effect of different types of Internet use regarding the relationship between three transitional aging changes and self-esteem of older adults. The current paper is still in progress; this is a research-in-progress paper. An aging population increases government expenditures and family responsibilities, thus drawing more attention from the academic community. Recent research posits that self-esteem tends to decline in individuals from the ages around 50-65 due to role loss, social loss, and dissatisfaction resulting from unaccomplished life goals. To address this issue, previous studies considered that the general use of the Internet may help to enhance self-esteem among older adults. To fill this research gap, the present study proposes that the cultural use of the Internet could moderate role loss of older adults, while social use of the Internet could mitigate social loss. Furthermore, economic use could moderate the dissatisfaction of unfulfilled life goals. Regarding various theoretical contributions, this is the first study to apply different types of Internet use, so as to investigate its moderating effect concerning the relationship between transitional aging changes and self-esteem. Findings of the present study can also help shed light on interventions for the caregiver in both community centers and the domestic environment to moderate the decline of self-esteem among older adults. The data will be collected through surveys distributed to District Elderly Community Centers (DECCs) in Hong Kong. Multiple regression analysis will then be utilized to test the moderating effect of each type of Internet use

CIB1 is an endogenous inhibitor of agonist-induced integrin αIIbβ3 activation

In response to agonist stimulation, the αIIbβ3 integrin on platelets is converted to an active conformation that binds fibrinogen and mediates platelet aggregation. This process contributes to both normal hemostasis and thrombosis. Activation of αIIbβ3 is believed to occur in part via engagement of the β3 cytoplasmic tail with talin; however, the role of the αIIb tail and its potential binding partners in regulating αIIbβ3 activation is less clear. We report that calcium and integrin binding protein 1 (CIB1), which interacts directly with the αIIb tail, is an endogenous inhibitor of αIIbβ3 activation; overexpression of CIB1 in megakaryocytes blocks agonist-induced αIIbβ3 activation, whereas reduction of endogenous CIB1 via RNA interference enhances activation. CIB1 appears to inhibit integrin activation by competing with talin for binding to αIIbβ3, thus providing a model for tightly controlled regulation of αIIbβ3 activation

Fabricating water dispersible superparamagnetic iron oxide nanoparticles for biomedical applications through ligand exchange and direct conjugation

Stable superparamagnetic iron oxide nanoparticles (SPIONs), which can be easily dispersed in an aqueous medium and exhibit high magnetic relaxivities, are ideal candidates for biomedical applications including contrast agents for magnetic resonance imaging. We describe a versatile methodology to render water dispersibility to SPIONs using tetraethylene glycol (TEG)-based phosphonate ligands, which are easily introduced onto SPIONs by either a ligand exchange process of surface-anchored oleic-acid (OA) molecules or via direct conjugation. Both protocols confer good colloidal stability to SPIONs at different NaCl concentrations. A detailed characterization of functionalized SPIONs suggests that the ligand exchange method leads to nanoparticles with better magnetic properties but higher toxicity and cell death, than the direct conjugation methodology

A Deep Learning Pipeline for Assessing Ventricular Volumes from a Cardiac Magnetic Resonance Image Registry of Single Ventricle Patients

Purpose: To develop an end-to-end deep learning (DL) pipeline for automated ventricular segmentation of cardiac MRI data from a multicenter registry of patients with Fontan circulation (FORCE). / Materials and Methods: This retrospective study used 250 cardiac MRI examinations (November 2007–December 2022) from 13 institutions for training, validation, and testing. The pipeline contained three DL models: a classifier to identify short-axis cine stacks and two UNet 3+ models for image cropping and segmentation. The automated segmentations were evaluated on the test set (n = 50) using the Dice score. Volumetric and functional metrics derived from DL and ground truth manual segmentations were compared using Bland-Altman and intraclass correlation analysis. The pipeline was further qualitatively evaluated on 475 unseen examinations. / Results: There were acceptable limits of agreement (LOA) and minimal biases between the ground truth and DL end-diastolic volume (EDV) (Bias: -0.6 mL/m2, LOA: -20.6–19.5 mL/m2), and end-systolic volume (ESV) (Bias: - 1.1 mL/m2, LOA: -18.1–15.9 mL/m2), with high intraclass correlation coefficients (ICC > 0.97) and Dice scores (EDV, 0.91 and ESV, 0.86). There was moderate agreement for ventricular mass (Bias: -1.9 g/m2, LOA: -17.3–13.5 g/m2) and a ICC (0.94). There was also acceptable agreement for stroke volume (Bias:0.6 mL/m2, LOA: -17.2–18.3 mL/m2) and ejection fraction (Bias:0.6%, LOA: -12.2%–13.4%), with high ICCs (> 0.81). The pipeline achieved satisfactory segmentation in 68% of the 475 unseen examinations, while 26% needed minor adjustments, 5% needed major adjustments, and in 0.4%, the cropping model failed. / Conclusion: The DL pipeline can provide fast standardized segmentation for patients with single ventricle physiology across multiple centers. This pipeline can be applied to all cardiac MRI examinations in the FORCE registry

Assessing secondary attack rates among household contacts at the beginning of the influenza A (H1N1) pandemic in Ontario, Canada, April-June 2009: A prospective, observational study

<p>Abstract</p> <p>Background</p> <p>Understanding transmission dynamics of the pandemic influenza A (H1N1) virus in various exposure settings and determining whether transmissibility differed from seasonal influenza viruses was a priority for decision making on mitigation strategies at the beginning of the pandemic. The objective of this study was to estimate household secondary attack rates for pandemic influenza in a susceptible population where control measures had yet to be implemented.</p> <p>Methods</p> <p>All Ontario local health units were invited to participate; seven health units volunteered. For all laboratory-confirmed cases reported between April 24 and June 18, 2009, participating health units performed contact tracing to detect secondary cases among household contacts. In total, 87 cases and 266 household contacts were included in this study. Secondary cases were defined as any household member with new onset of acute respiratory illness (fever or two or more respiratory symptoms) or influenza-like illness (fever plus one additional respiratory symptom). Attack rates were estimated using both case definitions.</p> <p>Results</p> <p>Secondary attack rates were estimated at 10.3% (95% CI 6.8-14.7) for secondary cases with influenza-like illness and 20.2% (95% CI 15.4-25.6) for secondary cases with acute respiratory illness. For both case definitions, attack rates were significantly higher in children under 16 years than adults (25.4% and 42.4% compared to 7.6% and 17.2%). The median time between symptom onset in the primary case and the secondary case was estimated at 3.0 days.</p> <p>Conclusions</p> <p>Secondary attack rates for pandemic influenza A (H1N1) were comparable to seasonal influenza estimates suggesting similarities in transmission. High secondary attack rates in children provide additional support for increased susceptibility to infection.</p