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The prevalence of Alzheimer's disease and related dementias (ADRD) is increasing. In the United States, older adults are among those most likely to have firearms in the home. Addressing firearm access among persons with ADRD can be confusing and stressful for family caregivers, healthcare providers, firearm industry representatives and law enforcement. This study sought to examine key stakeholder perspectives concerning legal and logistic considerations for temporary firearm transfers when a person with ADRD owned firearms. A secondary analysis of 24 qualitative interviews conducted to inform the development of a firearm safety tool for ADRD caregivers revealed four types of barriers. These barriers were each associated with logistical challenges and legal ambiguities that hampered ADRD-related firearm transfers (1) legal questions on firearm ownership and permitted transferees; (2) transfer logistics and duration; (3) issues of engaging law enforcement or retailers for transfers; and, (4) lack of information resources and guidance. GSK1070916 Siloes between stakeholder groups persist and limit information sharing. Broad initiatives engaging caregivers, older adults, clinicians, aging service providers, law enforcement, and firearm outlets could inform the development of policies, programs, and practices to enhance the safety and well-being of people with ADRD and their caregivers.The potential public health risk through utilizing of zinc oxide nanoparticles (ZnO NPs) in food constitutes the major obstacle to the expansion of nanoparticle (NP) in food industry. Liver histology, bone marrow and liver genotoxicity, immunity, and oxidant status were investigated upon long-term ZnO NPs feed supplementation. One hundred and sixty male IR (Indian River) chicks were randomly allocated to one of the four dietary treatments control, ZnO NPs at 10, 20, or 40 mg/kg for 42 days. This study revealed non-significant hepatic histopathological alterations and DNA damage and the treatment had no influence on body and organ weights, liver enzymes, lipid peroxidation (MDA), IgG, IgM, and interferon gamma (IFN-γ). This study suggests that low-dose ( less then 40 mg/kg diet) long-term ZnO NPs supplementation to broiler chicks has no observed potential adverse effects on normal histology of the liver, blood physiology, immune system, and DNA damage of liver and bone marrows, which are critical features for validating ZnO NPs for use in food. Further studies are required to evaluate the probable withdrawal period of ZnO NPs before approval as a dietary supplement in broiler or livestock diets.Objectives Seasonal influenza vaccine coverage remains low in China due to possible influenza vaccine hesitancy (IVH) and practical issues. We sought to investigate IVH and its determinants among children's guardians and the elderly for a better understanding of the situation and for future intervention. Methods We performed two cross-sectional studies to identify the profiles and determinants of IVH using stratified cluster random sampling in an eastern China province in 2019.Results Of the 1564 guardians and 522 elders, 43.2% (95%CI 40.4-46.0%) of guardians and 33.5% of elders (95%CI 29.5-37.6%) had IVH. 'From rural area' (odds ratio 1.36), 'don't know government recommendation for flu vaccination' (1.39), 'don't know flu vaccine is vaccinated annually' (1.93), and 'family members (0.22), friends and neighbors had positive attitude toward flu vaccine' (0.58) were related factors of the guardians' IVH. 'Aged 70-79 years' (0.46), 'had flu before' (0.35) and 'once had been vaccinated' (0.42) were related to the elderly's IVH.Conclusion Poor awareness of influenza and vaccination, relatives' negative/positive attitude, lack of government recommendations, anxiety about vaccine quality, and practical issues such as short supply are related to IVH in China. Precision education aimed at hesitancy in wider groups is anticipated to increase vaccine confidence and coverage in influenza-vulnerable groups.Objective Given the association between vitamin D deficiency and risk for cardiovascular disease, we used machine learning approaches to establish a model to predict the probability of deficiency. Determination of serum levels of 25-hydroxy vitamin D (25(OH)D) provided the best assessment of vitamin D status, but such tests are not always widely available or feasible. Thus, our study established predictive models with high sensitivity to identify patients either unlikely to have vitamin D deficiency or who should undergo 25(OH)D testing.Methods We collected data from 1002 hypertensive patients from a Spanish university hospital. The elastic net regularization approach was applied to reduce the dimensionality of the dataset. The issue of determining vitamin D status was addressed as a classification problem; thus, the following classifiers were applied logistic regression, support vector machine (SVM), random forest, naive Bayes, and Extreme Gradient Boost methods. Classification accuracy, sensitivity, specificity, and predictive values were computed to assess the performance of each method.Results The SVM-based method with radial kernel performed better than the other algorithms in terms of sensitivity (98%), negative predictive value (71%), and classification accuracy (73%).Conclusion The combination of a feature-selection method such as elastic net regularization and a classification approach produced well-fitted models. The SVM approach yielded better predictions than the other algorithms. This combination approach allowed us to develop a predictive model with high sensitivity but low specificity, to identify the population that could benefit from laboratory determination of serum levels of 25(OH)D.In multiple myeloma, atypical forms with extramedullary involvement exhibit poor survival. The poly-chemotherapeutic regimen D(T)-PACE has shown high activity in relapsed or refractory multiple myeloma. In this large monocentric retrospective study, we addressed the activity of D(T)-PACE-based regimens in 43 heavily pretreated patients with relapsed/refractory multiple myeloma and extramedullary disease.Median age at initiation was 57 years. Four patients had a t(4;14) translocation, 3 had a t(11;14) translocation and 7 had a del(17p). Extramedullary sites were mostly the skin (15 patients), central nervous system (10 patients), and thorax or abdomen (10 patients each). Overall response was achieved in 25 (58%) patients, including 6 (14%) with a complete response. Median progression-free survival was 5.0 months. Median overall survival was 9.0 months. Fourteen patients subsequently underwent stem-cell transplantation. Cytogenetics had no impact on response rate, overall survival and progression-free survival.