Decision support systems can seriously help medical doctors in the diagnosis of different diseases, especially in complicated cases. This article is devoted to recognizing and diagnosing heart disease based on automatic computer processing of the electrocardiograms (ECG) of patients. In the general case, the change of the ECG parameters can be presented as a random sequence of the signals under processing. Developing new computational methods for such signal processing is an important research problem in creating efficient medical decision support systems. Authors consider the possibility of increasing the diagnostic accuracy of cardiovascular diseases by implementing of the new proposed computational method of information processing. This method is based on the generalized nonlinear canonical decomposition of a random sequence of the change of cardiogram parameters. The use of a nonlinear canonical model makes it possible to significantly simplify the maximum likelihood criterion for classifying diseases. This simplification is provided by the transition from a multi-dimensional distribution density of cardiogram parameters to a product of one-dimensional distribution densities of independent random coefficients of a nonlinear canonical decomposition. The absence of any restrictions on the class of random sequences under study makes it possible to achieve maximum accuracy in diagnosing cardiovascular diseases. Functional diagrams for implementing the proposed method reflecting the features of its application are presented. The quantitative parameters of the core of the computational diagnostic procedure can be determined in advance based on the preliminary statistical data of the ECGs for different heart diseases. That is why the developed method is quite simple in terms of computation  and can be implemented in medical computer decision systems for monitoring cardiovascular diseases and for their diagnosis in real time. The results of the numerical experiment confirm the high accuracy of the developed method for classifying cardiovascular diseases. Therefore, timely high-precision diagnostics of heart diseases, prevention and treatment at an early stage of the development of the disease acquire exceptional relevance. To improve the accuracy of diagnosing the state of the heart in recent decades, computer systems for automatic analysis6 of electrocardiographic data obtained during the processing of an electrocardiographic signal have been widely used. Automatic analysis of electrocardiograms is a rather complex theoretical problem. First of all, this is due to the physiological origin of the signal9, which is the reason for its indeterminacy, diversity, variability, unpredictability, non-stationarity and susceptibility to numerous types of interference.Medical statistics showAt present, the analysis process, as a rule, is a study of isopotential and other maps generated from the data obtained using the software supplied with the signal recording apparatus.In medical practice, the conclusions of cardiologists about patients’ diagnoses have, as usual, qualitative or verbal character and are not always confirmed by enough number of quantitative data. In special or difficult situations with disease recognition, diagnosis errors by young or insufficiently experienced medical doctors are possible, and the real diagnostic process may be significantly extended until a final correct decision about the truth diagnosis.Decision support systems can seriously help medical doctors in the decision-making processes about the diagnosis of different heart diseases, especially in complicated cases. The most perspective approach is based on the recognizing and diagnosing heart disease using automatic computer processing of the electrocardiograms (ECG) of patients.In the general case, the change of the ECG parameters can be presented as a random sequence of the signals under processing. Developing new computational methods for such signal processing is an important research problem in creating efficient medical decision support systems.In this article, the authors consider the possibility of increasing the diagnostic accuracy of cardiovascular diseases by implementing the computational method, which is based on the generalized nonlinear canonical decomposition of a random sequence of the change of cardiogram parameters. The absence of any restrictions on the class of random sequences under study makes it possible to achieve maximum accuracy in diagnosing cardiovascular diseases. The main advantage is that quantitative parameters of the computational diagnostic procedure can be determined in advance based on the preliminary statistical data of the ECGs for different heart diseases. That is why the developed method is quite simple in terms of computation  and can be implemented in medical computer decision systems for monitoring cardiovascular diseases and for their diagnosis in real time.Thus, the development of efficient mathematical models and computation methods for identifying the high-accuracy individual characteristics of an electrocardiogram (with subsequent classification), as well as the creation of an automated computer diagnostic support system, is an urgent and important task in “medicine–computer science” multidisciplinary research.The rest of the article covers multiple aspects related to the topic discussion. “Diagnostics of electrocardiograms consist of three successive stages: (a) preliminary processing, (b) feature extraction , and (c) classification. Let us analyze all these stages consequently.Fist stage—Preprocessing reduces signal measurement noise by smoothing the electrocardiogram signal, reducing drift suppression and baseline deviation. The most common existing methods used to reduce signal noise are (a) second order low pass and (b) high pass Butterworth filters10, (c) Daubechies wavelet11 and (d) orthogonal wavelet-filter12. Besides, for baseline adjustment, such techniques as median filter, linear phase high pass filter, mean median filter and others are used also.Second stage—Feature extraction is an interactive process that includes a series of automatic data transformation procedures. In cases with a large number of measurements-features that describe the characteristics of the input signal, the correlation and factor analysis of data can be used to reduce the dimension of the problem. According to the extraction and analysis methods, the features can be divided into the following categories:13 ;Temporary features15 ;Spectral features17 ;Time-frequency/wavelet features18 .Signs of the complexity of geometric distortions14; direct feature selection19; genetic algorithms20; (b) filter methods (correlation)21; Chi-Square15; analysis of variance (ANOVA)22; ReliefF23; (c) built-in methods24.The stage of feature extraction ends with the optimization of their number, which allows reducing the set of redundant functions, reducing computational costs and improving the overall performance of the system. This step uses the following three main categories of feature selection methods: (a) wrapper methods 30; Decision Trees (DT)31.32, a combination of statistical, geometric, and nonlinear heart rate variability features32, a semantic web ontology and heart failure expert system33, signal averaging method, multivariate analysis34, RPCA—recursive principal component analysis35, SPSA—simultaneous perturbation stochastic approximation method36, ABT—Amplitude Based Technique FDBT—First Derivative Based Technique, SDBT—Second Derivative Based Technique37, Hilbert transform38 and others.Several different approaches for ECG analysis are based on a chaos theoryAt the same time, each of the above-mentioned methods has its drawbacks and limitations. That is why the need to develop new effective methods of medical diagnostics has not lost its relevance.Thus, the change in the values of the electrocardiogram has a stochastic character; therefore, for the diagnosis of cardiovascular diseases, it is necessary to use methods for recognizing random functions and random sequences.39) is applied in conditions when the stochastic properties of classes of random sequences are fully known. If the prior probabilities of the classes of random sequences are not known, then equal values are assigned to them and the decision rule is modified into the maximum likelihood criterion. The criterion is especially important when solving problems of recognition, in which unlikely events cannot be excluded from consideration . However, for the maximum likelihood method, as well as for the Bayes rule, the problem of approximating the multivariate distribution density for a random sequence with a large number of sampling points remains unresolved.The main method for recognition of the realizations of random sequences is the Bayes decision rule, according to which a decision about the belonging of the realization to a certain class, for which the posterior probability is maximum, is made. The method is theoretically accurate, however, as well as many of its modifications  is significantly simplified, however, the transition from the vector To eliminate all existing probabilistic relationships C are determined by the expressionsThe parameters of the matrix C. Consider this array as a vector random sequence A priori information onent of .8\documeThe coordinate functions position  are deteThe values The block diagram of the algorithm for calculating the parameters of the canonical expansion  is shownExpression  is a non51.The absence of assumptions about the form of the distribution density of random variables The computational method for diagnosing cardiovascular diseases consists in the realization of the following stages:Estimation of moment functions Formation of canonical decompositions  for variSynthesis of one-dimensional distribution densities of independent random coefficients Calculation of the values Determination of the belonging of the cardiogram ion rule .The diagram of the functioning of the system of diagnostics of cardiovascular diseases based on the developed method is shown in Fig. The proposed method was tested on the basis of statistical data of nine cardiovascular diseases: (a) mild neurocirculatory dystonia, (e) hypertrophy of myocardium, 52.For the numerical experiment two hundred different cardiograms for each disease 53 and the Bloom criterion54, showed the truth of the hypothesis about the independence of coefficients at 40 of the studied random sequences 55; (c) fuzzy logic method 58; (d) neural network 60 based on the Daubechies wavelet function of the fourth order and the Levenberg–Marquardt algorithm for learning; (e) generalized non-linear criterion Neural network59.Daubechies wavelet function of the fourth order and the Levenberg–Marquardt algorithm for learning were used Expressions for the determination of approximation coefficients and detailing of discrete wavelet transform are presented in the form:Output signal of each of separate neuron of output layer was forming asContinuous sigmoid bipolar function Tables The data in Tables riterion  makes itmentclasspt{minimariterion  by maximA computational method for computer systems for automated diagnosis of cardiovascular diseases based on a generalized nonlinear canonical decomposition of a random sequence of change of cardiograms has been obtained. The use of the canonical model made it possible to form the decision rule for the maximum distribution density in the form of a product of one-dimensional distribution densities of random coefficients. The canonical decomposition does not impose any significant restrictions  on the class of random sequences under study, which makes it possible to maximally take into account the stochastic characteristics of sequences related to various cardiovascular diseases.Taking into account the recurrent regularity of calculations, the diagnostic method is quite simple in terms of computation and allows using an arbitrary number of input parameters. A significant advantage of the method is the ability to use characteristics not directly related to the cardiogram .During the operation of the diagnostic system based on the proposed computational method, new diseases unknown to medicine can be identified in the case of a significant difference in the values of the likelihood function for the investigated cardiogram and the classified cardiograms of known diseases.The results of the numerical experiment indicate a high reliability of the diagnostics of cardiovascular diseases based on the proposed method.


Epidemic wavefront models predict the spread of medieval pandemics such as the plague well. Our aim was to explore whether they contribute to understanding the spread of COVID-19, the first truly global pandemic of the 21st century with its fast and frequent international travel links.We analysed the spatial spread of reaching a threshold of very high incidence of new daily infections of the virus across European countries in the autumn of 2021 in which the Delta variant was dominant, as well as an even higher threshold of incidence in the subsequent spread of infections across the same set of countries during the winter of 2021/2022 when the Omicron variant of the virus became dominant.We found patterns that are consistent with wavefront models for both periods of the pandemic in Europe.Modern means of transportation strongly accelerated the spread of the virus and typically generated diffusion patterns along bidirectional constrained mobility networks in addition to stochastic diffusion processes. However, since the majority of mobility, including mobility across international borders, is over short distances, wavefront patterns in the spread of a pandemic are still to be expected. Tobler’s well-known first law of geography claims that ‘everything is related to everything else, but near things are more related than distant things’ . Local nWavefront models predict the diffusion patterns of the plague, cholera and Ebola in Sierra Leone ,8 well, Our analysis differs from classical models explaining the spatial spread of infectious diseases, since we do not consider the wavefront of the virus itself . After tFew European countries have the capacity and willingness for extensive genome sequencing, with all but six of them sequencing <2.5% of tests during December 2021  In the UTo account for the higher infection rate of Omicron relative to Delta , we emplAn understanding of epidemic diffusion patterns can help public health officials to predict and therefore prepare for when and from where a significant increase in infections is likely to occur. To our knowledge, this is the first paper providing evidence for the existence of wavefront diffusion patterns during the Delta and the Omicron waves of the COVID-19 pandemic and that wavefront models still contribute to understanding the spread of infectious diseases such as SARS-CoV-2. Naturally, spread also occurs stochastically and along bidirectional constrained mobility network patterns, including seeded infections imported from far-away places facilitated by international air travel such that non-proximate spread occurs simultaneously to proximate wavefront-type spread . There aTobler’s law is not the only possible explanation for the observable empirical patterns in


In schizophrenia, there are disorders in all sensory modalities, but the regularities of their occurrence, their pathogenesis and attitude towards cognitive functions are not sufficiently studied.Examine the interrelation between the dysfunctions in different analysers  and their dependence on the duration of the disease and the severity of psychotic symptoms and cognitive deficit in schizophrenic patients (F20 according to ICD 10 criteria).All subjects were determined the threshold of olfactory sensitivity to n-butanol, the ability to discriminate against odors and the amount of error in comparing the same sections. Cognitive functions were evaluated using the BACS scale.The inverse correlation between the value of the visual assessment error and the reduction of the threshold of olfactory sensitivity  and the inverse correlation between the value of the visual assessment error and the ability to discriminate smells  were revealed. There are no significant correlations between the duration of the disease and sensory disturbances. Olfactory and visual disturbances in schizophrenic patients were connected with cognitive functions .The data confirm that sensory impairments have a common pathogenesis and are closely related to cognitive deficits. Sensory and cognitive deficits in schizophrenia may be the result of top-down regulation failure.No significant relationships.


In the original publication of the article, the author noticed an error in Section, "Classification of Edematous States" under second paragrapgh, the sentence should read, "It was Domenico Cotugno (1736–1822) who the first described the association of edema and proteinuria in his 1770 De ischiade nervosa commentaries " instead of "It was Domenico Cotugno (1736–1822) who the first described the association of edema and proteinuria in his 1770 De ischiade nervosa commentaries . but did not link it to kidney disease".


Brain functions rely on the communication network formed by axonal fibers. However, the number of axons connecting different brain regions is unknown. A study in PLoS Biology addresses this question and finds that most areas of the human cerebral cortex are linked by an astoundingly small number of fibers. Activity patterns and complex functions of the brain rely on the characteristic communication network formed by axonal fiber networks, but how many axons actually connect different brain regions? This Primer explores a study in PLOS Biology which finds that most areas of the human cerebral cortex are linked by an astoundingly small number of fibers. In recent years, network neuroscience has provided a new perspective of how brain function emerges from the communication among distributed, specialized regions in the brain. This framework explains patterns of neural activity and brain functions on the basis of the structural connections among brain regions. The structural connection scaffold has been uncovered systematically by histological approaches in non-human primate models  as well Amazingly, however, while the general existence or the relative strength of pathways connecting regions of the human brain can be well estimated, the actual numbers of neurons linking one region to others are still uncertain. This uncertainty is due to methodological limitations. For example, the number of streamlines inferred in diffusion tractography varies with the voxel resolution of the imaging data, and the number of stained projection neurons in histological studies depends on the amount of injected tracer, so that current approaches only deliver estimates of relative, but not absolute connectivity.This problem was addressed by Rosen and Halgren  who compThe small number of projections can be seen against the background of the number of neurons under one square millimeter of cortical surface, which is in the order of 60,000 neurons . About 8To give a functional example, Rosen and Halgren  looked aDespite the generally very sparse connectivity, there do exist some substantial connections, highlighting the factors that underlie the existence of such highways among a majority of byways. Distance has been indicated as one of these factors, while another is the cytoarchitectonic similarity of connected regions, according to the structural model of connections , which aBut do these principles imply that cortical signals only propagate between strongly connected adjacent or architectonically similar areas? What then is the functional role and significance of the majority of sparse long-distance projections in the human cortex? More specifically, what are the mechanisms by which signals may become amplified even though they are traveling along just a few projection axons? Models by which signals simply diffuse across the global network do not appear plausible given the sparsity of most long-distance projections relative to the massive number of local connections. By contrast, potential mechanisms through which long-range projection signals could be amplified include particularly large projection neurons , the forThe finding of sparse connectivity crucially hinges on the inferred conversion factor of streamlines to axons. Therefore, Rosen and Halgren  were conFuture comparative investigations may also address if the connection sparsity found here is particularly characteristic of the human brain, or if large brains of other animals possess similar sparsity. This question is relevant in the context of functional interpretations of sparsity as a basis for the segregation and stabilization of signals in the human brain .The skillful integration of cortical scales demonstrated by the present study  may shap


Autism spectrum disorders (ASD) is one of the most urgent problems of psychiatry because of their high prevalence, diagnostic difficulties as well as insufficient knowledge of the pathogenetic mechanisms.To determine the number of inflammation markers in patients with various forms of ASD in links with features of a clinical condition for creating diagnostic criteria for differential diagnosis and improve reliability.The clinical examination of patients (135 children with various ASD forms) was carried out by using psychometric scales . The activity of inflammation markers (LE and α1-PI) and the level of autoantibodies to S-100b and MBP were measured in plasma. Complex evaluation of immune system activation was also conducted, taking into consideration interactions of innate and adaptive immunity.Non-psychotic ASD forms (Asperger’s syndrome and Kanner’s syndrome) were not accompanied by a change of the immunological indices in comparison with control. In psychotic ASD forms, a significant increase of the studied indices was revealed (р<0.05). Correlation between the complex evaluation of the immune system activation and the stage of the disease  was demonstrated. Also the significant correlations between the severity of autistic disorders according to CARS , catatonic disorders by BFCRS , and the assessment by CGI  were observed.The immune markers as well as their complex evaluation may be used as additional diagnostic criteria in the clinical examination for differential ASD diagnostics and assessment of the quality of remission, and also monitoring of the patient condition.No significant relationships.


Jafar Mazumder  The author regrets that the funding information was incorrectly shown in the acknowledgements section of the original manuscript. The corrected funding acknowledgement is as shown below.The author gratefully acknowledges the research facilities provided by King Fahd University of Petroleum and Minerals (KFUPM) and the financial assistance of the Deanship of Scientific Research, KFUPM, Saudi Arabia through Internal project (# IN131047).The Royal Society of Chemistry apologises for these errors and any consequent inconvenience to authors and readers.


The Reframing Aging initiative began in 2012 with the aim of changing the way in which the public views aging, and one of the key tenets of the initiative centers around language that perpetuates negative views of aging. Despite widespread knowledge about the initiative, recent publications in high-tier journals point to a gap in adopting the Reframing Aging initiatives outside of aging journals. Terms that project a negative view of older adults are still used in manuscript titles and within abstracts and bodies of research publications in non-aging journals. As researchers who publish aging-related work, members of organizations such as the Gerontological Society of America are often solicited as reviewers for their expertise in the field of aging. While many researchers in aging may review for aging-related journals, such expertise is often needed in non-aging journals. As such, it is critical for aging researchers to continue to advance the Reframing Aging initiative when conducting reviews of manuscripts that do not adhere to the guidelines. This presentation will provide explicit examples of such publications and review specific steps that reviewers can take in addressing the Reframing Aging initiative in future reviews.


For 40 years the Federal Centre for Health Education in Germany has been analysing the contraception behaviour of young people. The current Survey is the ninth iteration, carried out in 2019. This continuous monitoring generates insights on the sexual and reproductive health of young people in Germany. The survey provides an important basis for the development of sexuality education and family planning measures.A total of N = 6032 adolescents and young adults participated in the survey. Date collection was conducted by computer-assisted personal interviewing (CAPI). The current sexual and contraceptive behaviour of adolescents and young adults will be summarized using descriptive results. In addition, the association between contraception non-use and sociodemographic factors, characteristics of sexuality education and situated factors of first sexual intercourse is analysed by multivariate logistic regressions.A key finding of this iteration is that with regards to the age of the first sexual intercourse, the proportion of adolescents younger than 17 years has been declining for several years. For contraception, adolescents most frequently used condoms, and use of the pill has decreased. 9% of the participants reported non-contraception use at first sexual intercourse. This is significantly associated (p < .01) with unexpected and only unilaterally desired sexual intercourse and the absence of sexuality education in School. In addition, the younger the adolescence were at first sexual intercourse the greater the risk for contraception non-use.The data from the current iteration indicate safe and responsible contraceptive behaviour among young people in Germany. It is important to maintain the commitment in the field of sexual health promotion and expand prevention measures for young people. This is the only way to ensure the sexual and reproductive health also in the next generation.Data from Youth Sexuality Study indicate safe and responsible contraceptive behaviour among young people in Germany.Commitment in the field of sexual health promotion needs to be continued.


Schizoaffective disorder is a psychotic disorder of controversial nosological entity. Affective symptomatology and psychotic features of varying intensity coexist simultaneously in him throughout evolution. The lack of consensus on the existence of this entity determines its diagnostic delay and the absence of specific treatment guidelines.To review the diagnostic criteria for schizoaffective disorder and the published scientific evidence on the efficacy and safety of the different therapeutic options available. To analyze the efficacy of a multidisciplinary treatment plan implemented in an intensive follow-up program, presenting the evolution of a clinical case.To review the psychiatric history and psychopathological evolution of a patient diagnosed with schizoaffective disorder from the beginning of an intensive follow-up program in a day center to the present. Review the existing scientific evidence on the usefulness of the treatments used in this nosological entity.This is a longitudinal and retrospective study of a clinical case in which the areas for improvement are analyzed before implementing a multidisciplinary therapeutic program and the favorable results obtained today. Currently, the patient is euthymic and attenuated and chronic positive and negative symptoms persist that do not interfere with his functionality.From the implementation of an individualized, personalized and multidisciplinary maintenance treatment plan, an overall improvement in psychopathological stability and functional recovery is observed. Among the psychopharmacological options in this patient, Paliperidone Long Acting Injection (PLAI) stands out for its long-term efficacy and safety.


In this paper, we present an extensive image dataset produced during the detailed micropaleontological analysis of 146 samples of bottom sediments collected by multicorer and gravity corer AMK-5656 from the Westray Basin on the north-western Scotland shelf (North Atlantic Ocean). In total, 106 taxa (at species and genera level) of benthic foraminifera were identified and photographed using the high-resolution microscope camera. This dataset can aid as a guide for identification of the benthic foraminiferal taxa at the paleoecological studies, stratigraphic works and interregional paleoceanographic correlation in the North Atlantic Ocean.Geological studies in the seas and oceans often give preference to the study of benthic  The North Atlantic (NA) is one of the key areas of the thermohaline circulation system of currents that transfer the heat, salt, dissolved elements and gases and sedimentary matter to the Subarctic and Arctic regions. This circulation being a part of the large-scale circulation of the World Ocean affects the warming and cooling of the global climate and regional oceanography in the NA and Arctic . The clist cruise of the research vessel Akademic Mstislav Keldysh  from the latest Pleistocene to the the Holocene sediments in the Westray Basin on the north-western Scotland shelf (NWSS). The sediment material was collected in summer 2018 during the 71 Keldysh . Laboratforaminifera in the North Atlantic bottom sediments  and gravity corer (GC) sediments on the AMK-5656 station obtained during the 71mer 2018 . The locThe NWSS is a shallow water region of western North Atlantic Ocean dominated by the warm saline surface water of the North Atlantic Current branch crossing the NWSS from west to east between Orkney and Shetland . The colBio-monitoring studies, based on the living fauna, indicate that the taxonomically diverse benthic foraminifers densely populate the high-latitude shelf areas . They seTable foraminifera at the GC core level of 295 cm. Under the level: the content of terrigenous matter increases, CaCO3 content is between 25 and 40%, total abundance of benthic foraminifers is low and the infaunal shelf/slope species Buliminamarginata and Fursenkoinafusiformis have increased concentrations indicating the high fluxes of the total organic carbon and oxygen-depleted conditions  and 127 samples from the GC (every 5 cm). All samples were freeze-dried, weighed, washed in the distilled water through a sieve with mesh size of 63 µm as recommended in The microphotograph tables with images of benthic foraminifers can be used in the practical micropaleontological work with the modern and Quaternary sediment samples from the high-latitude areas of the North Atlantic. They will help the species identification, description of the foraminiferal assemblages and interpretation of the micropaleontological data for the biostratigraphy and paleoecology.


The ecological dimension is expressed, among other things, in the matter of movement and the process of appropriation of local spaces. The creation of public space is oriented towards centralising and bringing exchanges closer together. It is a recognition of the ways of life of the individual who has become aware of the other essentials for human well-being. How does the proximity of multimodality and culture strengthen the urbanity? And how does it influence urban intensity, livability, health & the salutogenic approach of public space? The study investigates the quality of public mobility spaces through design, multimodality and sustainable planning by surveying the case of Bourse-Grand-Place station in Brussels. This transformation project is the subject of an empirical method using the material of recent research on urban design and professional practice. Falling within the scope of the “Cities for People” vision of the future, the design of this project integrates socio-cultural activities around the idea of “Station for People”. A concept based on universal accessibility ensures that all individuals can access it. Thereafter, an evolving social economy programme promoted cycling through equipment, maintenance, recycling, training, innovation and the encouragement of cycling culture. The breakthrough of the innovative multimodal design process based on multidisciplinarity could become a helpful urban strategy, oriented toward making proximate neighbourhoods both residentially and practically attractive. The present article carries out an enquiry of how design and urban activities take part in strategies to improve the quality of the public spaces. It reveals some hints that could help urban practitioners when making decisions regarding the quality of an urban place and ‘living together’ oriented developments. With a contribution to climate change issues, this article demonstrates how urban design can contribute to the quality of life of users and citizens.


Knowing how to train the next generation of gerontological leaders involves understanding where we are now and where we want to be in the coming decades. We outline the results of a survey of the membership of Directors of Aging Centers. The Directors of Aging Centers interest group in GSA has representation from the USA, Canada, and Europe. A survey was sent to the membership in late December with reminders in January and had 31 respondents. We discuss the results of the survey, highlighting the demographics of the current leadership (Neil Charness), perceived need for training by current leaders (Peter Lichtenberg), and consensus content of leadership training programs (Patricia Heyn). Patricia D’Antonio provides a perspective on GSA’s approach to professional development programs and avenues for soliciting funding for leadership training. Our discussant  will reflect on the need for training in the context of building the next generation of gerontological leadership. We plan to devote significant symposium time to solicit audience input on next steps for supporting the effort to improve the quantity, quality, and diversity of the gerontological leadership workforce.


The aim of this paper is to present a novel case for the formation, operation and evaluation of a community advisory aboard comprised of Muslims residing in the San Francisco Bay Area, California that utilised a community based participatory approach to address local Muslim mental health needs. The CAB was recruited in partnership with the Muslim Community Association (MCA), one of the largest Islamic centres in the San Franscisco Bay Area. In addition to describing the development of the CAB, the authors present the findings of the evaluation and synthesis of best processes based on CAB members' feedback.et al. (To evaluate the perceived community advisory board members' perceptions of their roles and elicit feedback on how to enhance the relationship between the university team and the CAB, an evaluation was conducted by an independent team who was not part of the research process. Data was collected using anonymous individual surveys and small group open discussions that were conducted over three evaluation meetings. The evaluation utilised mixed method data collection strategies using questions from Schulz Results of the evaluation within the sphere of CAB operation indicated that CAB members found the greatest satisfaction from their contributions through direct participation in the research activities that were conducted by the university-CAB team. The collective responses indicated that most CAB members were satisfied with trust built between the university-CAB team and the diversity represented in the members of the board. However, given that the Bay Area is home to a very diverse Muslim community, challenges in recruiting representatives that account for all possible self-identifying groups was reported by the CAB with recommendations to recruit religious leaders. Recommendations also included eliciting funds for potential financial compensation for CAB members.The Stanford-San Francisco Bay Area CAB demonstrated that empowering community members through direct participation, creating channels and safe spaces for feedback help create community rooted research that carry the true voices of marginalised communities and reflects their evolving needs In addition to describing the development of the CAB, the authors present the findings of its evaluation and the synthesis of best processes based on CAB members' feedback.Our approach to the development of the CBPR partnership with Muslim communities in the San Franscisco Bay Area, California was guided by an adaptation of Wallerstein and Duran  that conA summary of the conceptual logic model is illustrated in The Stanford Muslim Mental Health Lab & Islamic Psychology (MMHIP) lab was established in 2014 as an academic home for the study of mental health in the context of the Islamic faith and Muslim populations. The Lab aims to provide intellectual resources to clinicians, researchers, trainees, educators, community and religious leaders working with or studying Muslims. In 2016, the Center for Clinical and Translational Research and Education (SPECTRUM) at Stanford University awarded a pilot grant to the MMHIP lab in an effort to enhance an emerging research partnership with the Muslim Community Association (MCA), the largest Muslim community centre in the SFBA. Utilising a CPBR approach, one of the major goals of the project was the establishment of a CAB made up of Muslim representatives residing in SFBA to lead the research partnership and guide the design and implementation of research projects. The primary goal of the CAB was to help the research team design and conduct focus groups to explore barriers and facilitators to utilisation of mental health services among Muslims residing in SFBA.It is estimated that over 250 000 Muslims reside in the SFBA, California, making it one of the largest Muslim populations in the United States  served on the CAB during the year of 2016.The CAB members agreed to serve a renewable, one-year term and participated in monthly 2-h meetings. The participation was entirely voluntary with no monetary compensation. The primary goal of the CAB was to guide the design and implementation of community sensitive focus groups to explore the barriers and facilitators of their fellow community members' utilisation of mental health services. To help the CAB carry on this role, the research team and the CAB were engaged in collaborative monthly meetings with ongoing mutual learning about the research process and what best fit the community. The CAB was introduced to the principles of CBPR and research process framework which included a brief introduction to the concept of the IRB, ethical research standards and confidentiality, the concept and steps needed to conduct focus groups. Details on the scope of the meetings are included in online Supplementary appendix 1. CAB participation spanned various domains that included providing feedback on the makeup and the needs of the SFBA community. With increasing dedication and motivation of the CAB, members contributed across the entire research design and implementation process, from participating in the development of focus groups manual and formulating the case scenarios that were used to facilitate focus groups discussions to eventually leading the recruitment process, including the development of the recruitment matrix, advertisement of the focus groups and the recruitment of participant inclusion. CAB activities were all conducted during the monthly meetings except for the day of the implementation of the focus groups.et al., It is important to note that the establishment of the CAB took place in 2016, a year in which a spike of Islamophobia was observed in light of the presidential election cycle  and more men.’ Suggested strategies to increase diversity were: (1) Physically rotating the site of meeting to create accessibility for all (2) Announcements at centres where marginalised communities congregate using social media and creating third spaces (3) Encouraging current CAB members to recruit individuals who are not represented.When presented with a multiple-choice question developed by the evaluation team to elicit understanding of the purpose of the group as perceived by community members, the consensus amongst participants regarding applicable statements amongst those provided were as follows: to assess, recommend and evaluate the availability and accessibility of mental health services to the Muslim community (43%), to evaluate and analyse the mental health care needs of the Muslim community (29%), to understand mental health services barriers/stigma (14%), to raise awareness of mental illness within the Bay Area Muslim community (7%) and to gather a group of educated Muslim professionals to get together and discuss the matter going on in their worlds (7%). Quantitative assessment of group dynamics also indicated overall satisfaction with the process of running the CAB. 86% of participants found the group meeting useful, 79% reported that they enjoyed attending the group meetings, and 71% reported that the meetings were well organised.In addition to overall group satisfaction and understanding, two main themes were discussed amongst participants during the open-forum discussion regarding CAB operation: successful strategies of CAB operation and recommendations for further enhancements. Successful strategies were identified based on expressed satisfaction from CAB members regarding the following topics: leadership, the positive culture that prevailed, the group dynamics, meeting workflows and direct participation and engagement in research design and implementation see .Table 1Recommendations for operation enhancement included further refinement of logistical operations with sustainability in mind, iterative development of CAB training and educational curriculum and the possibility of compensation of CAB members for their participation. One member suggested future utilisation of strategies to create opportunities to enhance creativity and heterogeneity of CAB feedback. A few CAB members also reported interest in incorporating spirituality into meetings stating that ‘[they] would like to see a spiritual warm up or prayer scheduled into the meeting.’The CAB members expressed interest in maintaining the work beyond the focus groups and crafting short and long-term outcomes. The goals suggested included more research activities, mental health interventions, building collaborations and mental health advocacy. One participant expressed that he would like the goals to include, ‘raising mental health awareness, eliminating stigma, and easier access to services and providers.’ Another member advocated for the development of more ‘support groups and discussions , focus groups, and more meetings with key stakeholders in our community.’ Some participants stressed the importance of building collaborations with other Muslim and faith-based mental health organisations. One participant offered insight into the nature of these collaborations and the types of institutions that should be involved, ‘think tanks, meetings, and continuous dialogue to identify other mental health or social welfare organizations, particularly faith-based organizations; and collaborate, exchange ideas, and work on projects, all of which should start at the county level.’This case study reviewed the formation, operation and maintenance of a CAB using best processes. The formation and operation of the CAB was founded on CBPR principles that included a strength-based approach that leverages existing resources and networks from within the community, models respect and values mutual learning and power sharing. The long-standing relationship between the Stanford Muslim Mental Health and Islamic Psychology Lab and the MCA provided an invaluable opportunity to build upon this tenet of CBPR by providing a strong foundation for the formation of the Stanford-SFBA CAB. Identifying key stakeholders who have credibility in the community is a vital step in building trust with a partnering community in any CBPR model. In our case, the MCA was the trustworthy entity that facilitated the inception of the partnership and provided a safe physical space rooted in shared values and morals that allowed for the partnership to flourish. In addition, the research team's lead investigator is from the Bay Area Muslim community and was well-known and respected for both her scientific and religious backgrounds, both of which provided credibility and comfort to research participants that this project would be spiritually and culturally congruent.et al., As part of the maintenance phase (Newman et al. (et al., Although feedback from CAB members and its evaluation was largely positive, key challenges were highlighted that were largely related to recruitment diversity, retention strategies and increased support of CAB member participation through monetary compensations. Given that the SFBA is the home to very diverse Muslim communities, challenges in recruiting representatives that account for all possible self-identifying groups was expected. However, through an iterative and social-justice integrated recruitment paradigm, CAB members are already improving community representation through continuous recruitment of underrepresented ethnicities, religious sectors and organisations. Retention continues to be a challenge to maintain a CAB with active participation of 8–14 diverse community members in meetings. Although the Stanford Muslim Mental Health and Islamic Psychology Lab team continues to apply for grants to secure monetary compensations, evaluation of CAB feedback only further highlights another of the five key tenets of CBPR according to McAllister et al. : suffici et al., .The Stanford-SFBA partnership, which was guided by a commitment to community-rooted research, brought religious and cultural sensitivity and contributed towards meaningful translational research in the field of Muslim mental health. The development of the Stanford-SFBA CAB and its subsequent outcomes, both intended and unintended, have exceeded our expectations as a research team. While our primary aim was to include community voices in the implementation of religiously and culturally sensitive focus groups, the CAB was empowered to become a platform for the inception of many mental health projects. Despite the need for public health funding, the CAB continues to function at a high momentum, fuelled by self-efficacy, dedication of its members and support from the SFBA Muslim communities.


Personality disorders are frequently encountered by all healthcare professionals and can often pose a diagnostic dilemma due to the crossover of different traits amongst the various subtypes. The ICD 10 classification comprised of succinct parameters of the 10 subtypes of personality disorders but lacked a global approach to address the complexity of the disease. The ICD 11 classification provides a more structural approach to aid in clinical diagnosis.A literature review of the diagnostic applicability of ICD 11 classification of personality disorders is presented in comparison with the ICD 10 classification.A retrospective analysis of the literature outlining the ICD 10 and 11 classifications of personality disorders, exploring the differences in evidence-based applications of both.The ICD 11 classification of personality disorders supersedes the ICD 10 classification in describing the severity of the personality dysfunction in conjunction with a wide range of trait domain qualifiers, thus enabling the clinician to portray the disease dynamically. The current evidence available on the utility of the ICD 11 classification gives a promising outlook for its application in clinical settings.The ICD 11 has transformed the classification of personality disorders by projecting a dimensional description of personality functioning, aiming to overcome the diagnostic deficiencies in the ICD 10 classification. The versatility offered by the application of the ICD 11 classification can be pivotal in reshaping the focus and intensity of clinical management of the disease.No significant relationships.


The problem of homosexuality is constantly in the spotlight of the mass media, social media and politicians. At the same time, the cultural and national specificity of attitudes towards the phenomenon of homosexuality seems obvious, as well as a significant polarization of opinions within Russian society itself. With significant attention to this issue, there are not many attempts to analyze the socio-psychological basis of representations about homosexuality. At the same time, in a number of foreign studies it was revealed that the modern Z Gen is distinguished by greater tolerance and freedom of views in terms of attitude towards traditionally segregated social groups.The purpose of this study was to identify representations about homosexuality among different generations of modern Russians.The methodological basis of the research was the study of the structure of social representations (Vergesse methodique). The research methods implied the author’s questionnaire aimed at identifying representations about homosexuality and a modified version of the RAHI questionnaire. The sample was N = 444 .There was shown a significant difference between the Z Gen in terms of tolerance of representations about homosexuality. So called ‘double standards’ were identified in terms of attitudes towards male and female homosexuality. The rooted concept of homosexuality as a relationship based, rather, on a sexual rather than a romantic-spiritual level of relationships, was stated.Main hypothesis was confirmed: an inverse relationship between age and perceptions of homosexuality as normative was revealed.No significant relationships.


Background and Objectives: Basal carcinoma of the skin (BCC) is part of the nonmelanoma skin cancer (NMSC) family and is the most frequently occurring type of skin cancer in humans. A combination of clinical and histopathological approaches is necessary in order to establish the best treatment regime for patients who have been diagnosed with this type of cancer. The objective of the present study was to establish the statistical value of prediction for certain sociodemographic characteristics (age category and environment of origin) and histopathological parameters of the subjects that could be related to the incidence of diagnosis with certain histopathological subtypes of BCC. Materials and Methods: In order to verify the veracity of the established research hypotheses, we conducted a retrospective study based on the histopathological reports of 216 patients who were treated at the Pathology Department of Mureș Clinical County Hospital. Results: Cystic BCC is higher in patients who are older than 71 years of age, and the superficial multicentric and keratotic subtypes are more frequently diagnosed in urban areas. Patients who have been diagnosed with the superficial multicentric BCC subtype are not usually very old in contrast to the patients who tend to be diagnosed with the cystic BCC subtype. The nodular BCC subtype is positively associated with ulceration (p = 0.004); the superficial multicentric BCC subtype is positively associated with intra- and peritumoral inflammatory infiltrate  and negatively associated with ulceration . The infiltrative BCC subtype is positively associated with ulceration (p = 0.021), and the keratotic BCC subtype is positively associated with peritumoral inflammatory infiltrate (p = 0.02). Conclusions: Depending on each patient’s epidemiological and sociodemographic data, a pattern can be established regarding the appropriate clinical and treatment approaches for that patient, which can be supported based on the implications of the histopathological diagnostic. This can lead to an improvement in the patient’s quality of life and increased satisfaction with the provided medical services. Basal cell carcinoma of the skin can be defined as a group of malignant tumors that are part of the nonmelanoma skin cancers (NMSC) that include basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and metatypical (basosquamous) carcinoma ,2,3. TheRisk factors for BCC include different categories of various associated parameters such as UV radiation, which includes sun exposure due to specific professions as well as exposure that occurs due to leisure activities, but other risk factors also include age, gender, a family history of skin cancer, and individual skin phenotype, among others ,9,10.Histopathological diagnostics remains one of the most important tools for the management of BCC, and it continues to be important due to the fact that the quality of life of patients who have been diagnosed with skin cancer must be improved, even though the rate of mortality due to BCC is not very significant ,12.The collection and analysis of data from histopathological bulletins from tissue samples obtained through surgical excision from subjects who have been diagnosed with BCC within the period of 2016–2020;The establishment of the incidence of histopathological subtypes of BCC that have been diagnosed and their comparison according to the years of diagnosis;The analysis of the degree of occurrence of histological and histopathological parameters  in each subtype of diagnosed BCC;The establishment of the statistical value of prediction of certain sociodemographic characteristics of the subjects (age category and environment of origin) on the incidence of diagnosis with certain histopathological subtypes of BCC;The establishment of a correlation between the age of the subjects and the incidence of diagnosis with certain histopathological subtypes of BCC;The establishment of correlations between certain histological and histopathological parameters of the analyzed tumors and the different histopathological subtypes of diagnosed BCC.The main objective of our study is to analyze the characteristics of skin BCC, which can be subdivided into six additional target objectives: Based on these six target objectives, we aim to determine the veracity of three general research hypotheses, the first of which comprises the two following hypotheses:Hypothesis 1 (H1). There are significant differences in the incidence of certain histopathological subtypes of BCC, and these differences depend on certain sociodemographic characteristics.Specific hypotheses:Hypothesis 1.1 (H1.1). The incidence of certain histopathological subtypes of BCC differs significantly depending on the age category of the subjects.Hypothesis 1.2 (H1.2). The incidence of certain histopathological subtypes of BCC differs significantly depending on the subject’s environment of origin.Hypothesis 2 (H2). There are statistically significant relationships between the age of the subjects and the incidence of certain histopathological subtypes of BCC that are diagnosed.Hypothesis 3 (H3). There are statistically significant relationships between certain histological and histopathological parameters of the analyzed tumor formations and different histopathological subtypes of BCC that are diagnosed.In order to determine the veracity of the established research hypotheses, a retrospective study was performed between 2016 and 2020 that involved the analysis of data from histopathological bulletins of skin tissue samples that were obtained through surgical excision and that were received from the departments of Dermatology, Plastic Surgery, or General Surgery in the Pathology Department of Mureș County Clinical Hospital. Tissue samples came from outpatient visits, day hospitalizations, or continuous hospitalizations and were obtained from a total of 216 patients.The inclusion criteria for the patients to be enrolled in the study was the diagnosis of skin BCC established by our pathology department and the period when the diagnosis was established. The exclusion criteria were other histopathological diagnoses and a BCC diagnosis that was established outside of the study period. All of the histopathological diagnostics that met the inclusion criteria were included in the study. The limitations of the study were represented by the fact that the classification of BCC presented in this study is based on the data from the histopathological reports in our Pathology Department on a retrospective basis.Year of diagnosis;Age of the patient at the time of diagnosis;Area where the patient lived at the time of diagnosis;Gender of the patient;Tumor ulceration and the presence or the absence of a hemorrhage or inflammation area on the surface of the tumor;Excision within surgical safety limits and whether or not the tumor resection margins were invaded by the tumor in order to determine whether it had been completely excised and whether any tumoral tissue remained inside of the patient;Intratumorally inflammatory infiltrate and whether or not any inflammatory infiltrate was present inside of the tumor;Peritumoral inflammatory infiltrate and where there was any inflammatory infiltrate around the tumor;Perineural/perivascular invasion of tumor cells.Sample analysis was conducted by embedding the tissues in paraffin, and the tissues were stained with hematoxylin–eosin; through this procedure, histopathological diagnoses of basal cell carcinoma (BCC) on the skin were established. All tissue samples came from complete excision of the lesion. The following factors and parameters were analyzed:After the data were collected, they were coded with their nominal and ordinal values so that they could be entered into SPSS . The collected data were coded in accordance with each type of data analyzed.t-tests were conducted for independent samples, and Pearson bivariate correlations were conducted to determine the veracity of the research hypotheses.The statistical analysis consisted of the use of frequency and comparative tables and graphs for each of the six histopathological subtypes of basal cell carcinoma that were diagnosed and the five histological and histopathological parameters of the analyzed tumors; t-tests were used for independent samples to analyze the differences between the following subgroups:Subjects under the age of 70 and those over the age of 71;Subjects from urban and rural areas.To verify the first research hypothesis and to measure significant differences in the incidence of certain histopathological subtypes of basal cell carcinoma, To verify the second research hypothesis, Pearson bivariate correlations were used to analyze the existence of statistically significant relationships between the age of the subjects and the incidence of certain histopathological subtypes of BCC that had been diagnosed.To verify the latest research hypothesis, Pearson bivariate correlations were also used to analyze the existence of statistically significant relationships between each of the five histological and histopathological parameters of the analyzed tumors  and the six histopathological subtypes of BCC that had been diagnosed.To determine the veracity of the research hypotheses, the data from the histopathological bulletins of the tissue samples that had been obtained by surgical excision from 216 subjects who had been diagnosed with basal cell carcinoma between 2016 and 2020 were analyzed.There are significant differences in the incidence of certain histopathological subtypes of BCC that are dependent on certain sociodemographic characteristics of the subjects.This hypothesis refers to the diagnostic incidence of subjects with the six histopathological basal cell carcinoma subtypes , depending on their sociodemographic characteristics.We chose the age group to which each subject belonged and their environment of origin as two sociodemographic characteristics representing differentiating criteria, and thus, we divided this general hypothesis into two specific hypotheses. The two specific hypotheses refer to sociodemographic characteristics, according to which we assumed that there would be significant differences in terms of the diagnostic incidence of subjects with the six histopathological BCC subjects.The incidence of certain histopathological subtypes of basal cell carcinoma differs significantly depending on the age of the subject.t-test was used for independent samples in order to measure the existence of significant differences in the incidence of diagnosis with the six histopathological basal cell carcinoma subtypes that were diagnosed between subjects under 70 years of age (n = 112) and those over 71 years of age (n = 104). The values, significance thresholds of t, and the average incidence of the six histopathological basal cell carcinoma subtypes with which subjects under 70 years of age and those over 71 years of age were diagnosed are shown in In order to verify this hypothesis, a The incidence of certain histopathological BCC subtypes differs significantly depending on the environment of origin of the subjects.t-test was used for independent samples in order to measure the existence of significant differences in the incidence of diagnosis with the six histopathological basal cell carcinoma subtypes between urban subjects (n = 110) and those living in a rural environment (n = 106). The values, significance thresholds of t, and the average incidence of the six histopathological BCC subtypes with which urban and rural subjects were diagnosed are shown in In order to verify this hypothesis, a There are statistically significant relationships between the age of the subjects and the incidence of certain histopathological subtypes of BCC that were diagnosed.In order to verify the veracity of this hypothesis, we used Pearson bivariate correlations to determine the existence of statistically significant relationships between the age of the subjects and the incidence of their diagnosis with the six histopathological BCC subtypes: nodular, superficial multicentric, adenoid, cystic, infiltrative, and keratotic. The values and significance thresholds of the correlation coefficients are shown in Correlations were calculated based on the values related to the coding of each histopathological BCC subtype, with 1 = absent and 2 = present.There are statistically significant relationships between certain histological and histopathological parameters of the analyzed tumor formations and the different histopathological subtypes of BCC that were diagnosed.In order to determine the veracity of this hypothesis, we used Pearson bivariate correlations to determine the existence of statistically significant relationships between each of the five histological and histopathological parameters of the analyzed tumors, ulceration, excision within surgical safety limits, intra-inflammatory infiltrate and peritumoral, perineural invasion, and perivascular invasion, and the incidence of diagnosis with each of the histopathological BCC subtypes .The correlations between each parameter of the analyzed tumor formations and the incidence of diagnosis with the six histopathological basal cell carcinoma subtypes mentioned above are presented in Nonmelanoma skin cancers (NMSC) are divided into the categories of basal cell carcinoma (BCC), squamous cell carcinoma (SCC), and metatypical (basosquamous) carcinoma. From these categories, BCC is the most frequent type of NMSC that is found worldwide, making it the skin cancer type that is the most frequently observed . The incThe first part of our study presented some demographic characteristics that may be attributed to the incidence of BCC among the Romanian population, and especially in those members of the population who visit the Pathology Department of the Mureș Clinical County Hospital, which is where the analyzed samples were collected .The COVID-19 pandemic strongly influenced the way that patients were treated in terms of surgery, especially oncological patients. The expectation is that the number of skin cancers that will be diagnosed will increase. Specifically, there will not only be an increase in the number of skin BCC diagnosed, but there will also be an increase observed in the other NMSC categories as well as in the number of melanoma cases. Unfortunately, we are prepared to see cases of skin cancer that are in more advanced stages due to the fact that patients did not receive adequate treatment on time, as well as because skin cancer management during the diagnosis and treatment phases was affected by the transformation of hospitals in to hospitals that were meant for the exclusive treatment of COVID-19. The Omicron variant of the SARS-CoV-2 virus may further the diagnosis of NMSCs by overloading healthcare systems worldwide ,16.The gender distribution of the entire group of subjects is approximately equivalent, with 54% of the cases being male patients and 46% being female patients. In terms of the gender distribution of the subjects, depending on the year when the patient was diagnosed with BCC, most of the male subjects were diagnosed in 2019 (39%), and most of the female participants were also diagnosed in 2019 (34%). In their research, Fidelis et al. mentioned that that there was a higher incidence of BCC in men than there was in women in Brazil in 2021 ; this isRegarding the age distribution of the subjects depending on the year in which they were diagnosed with BCC, most of the participants who were under 70 years old were diagnosed in 2019 (37%), and most of the patients over the age of 71 were diagnosed in 2019 (37%), 2018 (24%), and 2020 (17%). Based on Lang et al., most cases of BCC are diagnosed in individuals who are 71 years of age and over. This is also in accordance with the results that were obtained in our study .The distribution of BCC cases based on the origin of the patients at the level of the study group was approximately equivalent, with 51% of the individuals coming from urban areas, and 49% of the included individuals coming from rural areas. Regarding the environmental distribution of the subjects based on the year in which they were diagnosed with BCC, most of the people who were living in urban areas were diagnosed in 2019 (38%), and most of the people who were living in rural areas were also diagnosed in 2019 (35%). In their study, Carcin et al. observed a higher incidence of BCC in urban areas such as Dublin, Cork, Galway, and Waterford in Ireland, which can also be seen in our study area of Târgu Mureș . Targu MThere are various BCC subtypes, with many lesions only presenting one BCC subtype; however, there have been cases where more than one BCC subtype has been found in an individual lesion. Our 216 subjects were divided into two main categories: those demonstrating only one BCC subtype in their histopathological diagnostic, and those with a mixed BCC type. A total of 60% of the 216 subjects were diagnosed with mixed BCC, presenting several histopathological subtypes of this neoplastic disease, while 40% were diagnosed with simple BCC, presenting a single histopathological subtype. One third of the subjects (35%) presented with two subtypes, and 20% presented with three histopathological BCC subtypes. Of the subjects with a mixed diagnosis, almost half (47%) represented the nodular BCC subtype, which was the most frequent one, a fact that was also mentioned by Chung in his research, but this type occurred less frequently in our study . ApproxiThe second part of our study was targeted on proving our three established research hypotheses. Taking the hypothesis that there are significant differences between subjects under 70 years of age and those over 71 years of age into consideration, we found that there were significant differences in terms of the incidence of the cystic BCC subtype. Taking Ulceration occurs in more than half of the cases of infiltrative subtype BCC alone, which is in direct accordance with Tanase, who states that the infiltrative subtype of BCC is the most common subtype that is able to present with ulcerations .Ulceration showed a highly significant and positive correlation with the incidence of the diagnosis of subjects with the nodular BCC subtype and with the infiltrative BCC subtype. The higher the incidence at which subjects were diagnosed with the nodular and infiltrative BCC subtypes, the higher the probability of ulceration in this histopathological subtype of BCC. It can be said that most diagnoses of the nodular and infiltrative subtypes of BCC are associated with ulceration. Ulceration showed a significant and negative correlation with the incidence of the diagnosis of subjects with superficial multicentric BCC, which means that the higher the incidence at which patients are diagnosed with superficial multicentric BCC, the lower the probability of ulceration. Most diagnoses of the superficial multicentric subtype BCC are not associated with ulceration, as proven by our results.Regarding excision within surgical safety limits, it can be seen that surgical excision safety was possible in more than half of the cases in all of the six subtypes of BCC that were diagnosed. In their systemic review from 2020, Quazi et al. observed that excision within surgical safety limits depends on the subtype of BCC . During As shown in our results, intratumoral inflammatory infiltrate occurred in more than half of the cases of the superficial multicentric BCC subtype and the keratotic BCC subtype, whereas peritumoral inflammatory infiltrate occurred in more than half of the cases for the superficial multicentric BCC subtype. Regarding the intratumorally inflammatory infiltrate, it is seen that it correlates significantly with the diagnostic incidence of two of the six histopathological basal cell carcinoma subtypes, specifically with superficial multicentric BCC subtype. Most diagnoses of the superficial multicentric subtype BCC are associated with intratumorally inflammatory infiltrate. Peritumoral inflammatory infiltrate correlates significantly with the diagnostic incidence of three of the six histopathological basal cell carcinoma subtypes, especially with the superficial multicentric and keratotic BCC subtypes. This means that most diagnoses of superficial multicentric and keratotic BCC subtypes are associated with peritumoral inflammatory infiltrate.Neither perineural nor perivascular invasion have an incidence in more than half of the cases of any of the diagnosed BCC subtypes.The data that were analyzed here showed the existence of statistically significant relationships between five of the histological and histopathological parameters of the analyzed tumors, specifically ulceration, excision within surgical safety limits, and intra- and peritumoral inflammatory infiltrate, and the different histopathological subtypes of basal cell carcinoma that were diagnosed, leading to the confirmation of the third general research hypothesis.The present study confirmed the research hypotheses that were established and emphasized the importance of taking the specific particularities of each individual patient starting from their age into consideration before arriving at an adequate diagnosis. The incidence of the cystic subtype of BCC is statistically higher in patients who are older than 71 years of age. In terms of environment, the superficial multicentric and keratotic BCC subtypes are found more often in patients from urban areas. The patients who had been diagnosed with the superficial multicentric BCC subtype tended not to be very old, which was in contrast with the patients who were diagnosed with the cystic BCC subtype, who tended to be older. The relationships between the statistically significant association between the diagnosed basal cell carcinoma subtypes and the histological and histopathological parameters that are present have shown that the nodular BCC subtype is positively associated with ulceration, the superficial multicentric BCC subtype is positively associated with intra- and peritumoral inflammatory infiltrate; the cystic BCC subtype is positively associated with excision within surgical safety limits; the infiltrative BCC subtype is positively associated with ulceration; and the keratotic BCC subtype is positively associated with peritumoral inflammatory infiltrate. In conclusion, using the epidemiological and sociodemographic data of a patient can create a pattern for clinical and treatment approaches. This can lead to improvements in patient quality of life and increased satisfaction regarding the medical services provided.


More than 92% of people in Bangladesh are deprived from any sort of mental health care due to severe scarcity of mental health professionals, widespread stigma, lack of awareness, the inability to travel from remote area to Dhaka and maintaining the cost of travel and clinics. Moreover, the COVID-19 crisis made the scenario worse. To solve this problem we designed, developed and implemented “Monerdaktar”.The process development Monerdaktar- website and mobile application started with the initial idea and concept by TRS followed by extensive literature review and naturalistic observation of the mental health care service delivery from two tertiary hospitals in Bangladesh. We conducted 3 focus group discussion with the patients, their care givers, mental health professions. Based on the user feedback and technical suggestion of the mental health professional and IT professionals we developed the prototype of the Monerdaktar mobile application and website. After piloting for two months, the final version of the mobile application and website was finalized incorporating the feedback of the patients and experts.Monerdaktar created the unique opportunity to connect with the most the reputed mental health professional both psychiatrists and clinical psychologists online. Moreover, monerdaktar delivered the service free of cost to more than 700 clients during the peak of COVID crisis in Bangladesh.The COVID-19 crisis has potentiated the acceptance and adaptation of the Moenrdaktar solved the long-standing crisis of access to mental health care in Bangladesh and ensure the evidence-based care from anywhere.The Monerdaktar website and mobile application was design and developed by under the leadership of Dr. Tanjir Rashid Soron. Though the initial support was delivered free of cost, the consulting expert psychiatrist and Clinical Psychologist may take their


The field of child and adolescent psychiatry is receiving growing attention, although a number of local differences still exist in terms of academic curricula, board certifications and even definitions of what is to be considered part of this field or not. An Italian study showed that approximately 1 out of 10 children showed significant psychopathological problems ) that thThe main goal of this Special Issue is therefore to provide cutting-edge data regarding all aspects of child and adolescent psychiatry, including (but not limited to) the etiopathogenesis and presentation of the different disorders, treatment options and management of comorbidities. This is important because the peculiarities of the psychopathological manifestations in different age groups are increasingly recognized in classification systems, when a developmental perspective is applied .Two papers in this Special Issue are case reports. Colizzi et al. provide a detailed description of a case of mosaic trisomy 20, analyzing the neuropsychiatric aspects in the light of a careful analysis of the existing literature . EspositThree more papers focused on different psychopathological sequelae of traumatic experiences. Calvano et al. provide evidence of the utility of a highly specialized approach in the form of an outpatient trauma clinic to start the therapeutic process and increase victims’ motivation towards a more prolonged intervention . ForresiTwo papers focused on the consequences of the COVID-19 pandemic. De Pasquale et al. studied the prevalence of online videogaming during the so-called “lockdown” in Italy, with anxiety  being a relevant predictor of videogame use and addiction .The other papers testify the variety of subjects and approaches in child and adolescent psychiatry. Thun-Hohenstein et al. applied a naturalistic approach to assess the outcome of a group of adolescents consecutively admitted to an inpatient and day-clinic treatment ; they alThese contributions, with their variety in terms of explored topics and used methods, provide a mirror of the complexity of the topic of this Special Issue; hopefully, they will be thought- and action-stimulating reading for all those willing to pay comprehensive attention to children and adolescents.