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Introduction/aims: Fatigue (subjective perception) and fatigability (objective motor performance worsening) are relevant aspects of disability in individuals with spinal muscular atrophy (SMA). The effect of nusinersen on fatigability in SMA patients has been investigated with conflicting results. We aimed to evaluate this in adult with SMA3., Methods: We conducted a multicenter retrospective cohort study, including adult ambulant patients with SMA3, data available on 6-minute walk test (6MWT) and Hammersmith Functional Motor Scale-Expanded (HFMSE) at baseline and at least at 6 months of treatment with nusinersen. We investigated fatigability, estimated as 10% or higher decrease in walked distance between the first and sixth minute of the 6MWT, at baseline and over the 14-month follow-up., Results: Forty-eight patients (56% females) were included. The 6MWT improved after 6, 10, and 14 months of treatment (p < 0.05). Of the 27 patients who completed the entire follow-up, 37% improved (6MWT distance increase ≥30 m), 48.2% remained stable, and 14.8% worsened (6MWT distance decline ≥30 m). Fatigability was found at baseline in 26/38 (68%) patients and confirmed at subsequent time points (p < 0.05) without any significant change over the treatment period. There was no correlation between fatigability and SMN2 copy number, sex, age at disease onset, age at baseline, nor with 6MWT total distance and baseline HFMSE score., Discussion: Fatigability was detected at baseline in approximately 2/3 of SMA3 walker patients, without any correlation with clinical features, included motor performance. No effect on fatigability was observed during the 14-month treatment period with nusinersen., (© 2024 The Author(s). Muscle & Nerve published by Wiley Periodicals LLC.)

Vaccine adjuvants are thought to work by stimulating innate immunity in the draining lymph node (LN), although this has not been proven in humans. To bridge data obtained in animals to humans, we have developed an in situ human LN explant model to investigate how adjuvants initiate immunity. Slices of explanted LNs were exposed to vaccine adjuvants and revealed responses that were not detectable in LN cell suspensions. We used this model to compare the liposome-based AS01 with its components MPL and QS-21, and TLR ligands. Liposomes were predominantly taken up by subcapsular sinus-lining macrophages, monocytes and dendritic cells. AS01 induced dendritic cell maturation and a strong pro-inflammatory cytokine response in intact LN slices but not in dissociated cell cultures, in contrast to R848. This suggests the onset of the immune response to AS01 requires a coordinated activation of LN cells in time and space. Consistent with the robust immune response observed in older adults with AS01-adjuvanted vaccines, the AS01 response in human LNs was independent of age, unlike R848. This human LN explant model is a valuable tool for studying the mechanism of action of adjuvants in humans and for screening new formulations to streamline vaccine development.

Early-life adversity increases the risk of health problems. Interventions supporting protective and responsive caregiving offer a promising approach to attenuating adversity-induced changes in stress-sensitive biomarkers. This study tested whether participation in an evidence-based dyadic psychosocial intervention, child-parent psychotherapy (CPP), was related to lower epigenetic age acceleration, a trauma-sensitive biomarker of accelerated biological aging that is associated with later health impairment, in a sample of children with trauma histories. Within this quasi-experimental, repeated-measures study, we examined epigenetic age acceleration at baseline and postintervention in a low-income sample of children receiving CPP treatment ( n = 45; age range = 2-6 years; 76% Latino) compared with a weighted, propensity-matched community-comparison sample ( n = 110; age range = 3-6 years; 40% Latino). Baseline epigenetic age acceleration was equivalent across groups. However, posttreatment, epigenetic age acceleration in the treatment group was lower than in the matched community sample. Findings highlight the potential for a dyadic psychosocial intervention to ameliorate accelerated biological aging in trauma-exposed children.

Background: In Amyotrophic Lateral Sclerosis (ALS) patients with SOD1 mutation the intrathecal administration of tofersen slowed down the progression of disease in a controlled clinical study, but results were not statistically significant., Methods: In this multicentre, observational study, we evaluated a cohort of 27 ALS-SOD1 patients who were treated with tofersen, focussing on 17 patients who were followed for at least 48 weeks (median period of 84 weeks, range 48-108). We compared the clinical slopes, as measured by ALSFRS-R, MRC scale and Forced Vital Capacity, during tofersen treatment with retrospective data at 1 year prior to therapy. Cerebrospinal fluid (CSF) and serum neurofilament light chains (NFL) were measured in all patients., Results: Cumulative evaluation of the ALSFRS-R and MRC progression rates showed a statistically significant change during treatment with respect to the period prior to therapy (p = 0.023 and p = 0.007, respectively). The analysis of individual patients showed that nine of the seventeen patients substantially stabilized or slightly improved. Four patients deteriorated during treatment, while in the remaining patients the very slow course did not allow to identify significant changes. CSF and serum NFL concentration markedly decreased in the near totality of patients. Increased levels of white blood cells and proteins in the CSF were found in 60% of patients. Such alterations were clinically asymptomatic in all but two patients who showed an acute pure motor radiculitis, which responded to steroid therapy., Conclusions: Clinical findings and NFL analysis strongly suggest that tofersen may have a disease-modifying effect in a subset of SOD1-ALS patients., (© 2024. Springer-Verlag GmbH Germany, part of Springer Nature.)

Placental corticotropin-releasing hormone (pCRH) is a neuroactive peptide produced in high concentrations in mid-late pregnancy, during key periods of fetal brain development. Some evidence suggests that higher pCRH exposure during gestation is associated with adverse neurodevelopment, particularly in female offspring. In 858 mother-child dyads from the sociodemographically diverse CANDLE cohort (Memphis, TN), we examined: (1) the slope of pCRH rise in mid-late pregnancy and (2) estimated pCRH at delivery as a measure of cumulative prenatal exposure. When children were 4 years-old, mothers reported on problem behaviors using the Child Behavior Checklist (CBCL) and cognitive performance was assessed by trained psychologists using the Stanford-Binet Intelligence Scales. We fitted linear regression models examining pCRH in relation to behavioral and cognitive performance measures, adjusting for covariates. Using interaction models, we evaluated whether associations differed by fetal sex, breastfeeding, and postnatal neighborhood opportunity. In the full cohort, log-transformed pCRH measures were not associated with outcomes; however, we observed sex differences in some models (interaction p-values≤0.01). In male offspring, an interquartile (IQR) increase in pCRH slope (but not estimated pCRH at delivery), was positively associated with raw Total (β=3.06, 95%CI: 0.40, 5.72), Internalizing (β=0.89, 95%CI: 0.03, 1.76), and Externalizing (β=1.25, 95%CI: 0.27, 2.22) Problem scores, whereas, in females, all associations were negative (Total Problems: β=-1.99, 95%CI: -3.89, -0.09; Internalizing: β=-0.82, 95%CI: -1.42, -0.23; Externalizing: β=-0.56, 95%CI: -1.34, 0.22). No associations with cognitive performance were observed nor did we observe moderation by breastfeeding or postnatal neighborhood opportunity. Our results provide further evidence that prenatal pCRH exposure may impact subsequent child behavior in sex-specific ways, however in contrast to prior studies suggesting adverse impacts in females, steeper mid-gestation pCRH rise was associated with more problem behaviors in males, but fewer in females., Competing Interests: Declaration of Competing Interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

The investigation goal here was to analyze how the level of public debt affects preparedness of health systems to face emergencies. In particular, this study examined the negative effects of high public debt on health systems of European countries in the presence of the COVID-19 pandemic crisis. Empirical evidence revealed that European countries with a lower level of government debt as a percentage of GDP both in 2009 and 2019 (the period before the arrival of the pandemic) had lower COVID-19 fatality rates compared to countries with higher levels of public debt. The explanation is that high levels of public debt in countries trigger budget constraints that limit their ability to allocate resources to healthcare systems (e.g., health expenditures and investments), weakening health system performance and causing systemic vulnerability and lower preparedness during emergencies, such as with the COVID-19 pandemic. Implications of health policies are suggested to improve strategies of crisis management., Competing Interests: Conflict of interest: Mario Coccia is an editorial board member for AIMS Public Health and was not involved in the editorial review or the decision to publish this article. All authors declare that there are no competing interests., (© 2024 the Author(s), licensee AIMS Press.)

Introduction: The use of novel adjuvants in human vaccines continues to expand as their contribution to preventing disease in challenging populations and caused by complex pathogens is increasingly understood. AS01 is a family of liposome-based vaccine Adjuvant Systems containing two immunostimulants: 3- O -desacyl-4'-monophosphoryl lipid A and the saponin QS-21. AS01-containing vaccines have been approved and administered to millions of individuals worldwide., Areas Covered: Here, we report advances in our understanding of the mode of action of AS01 that contributed to the development of efficacious vaccines preventing disease due to malaria, herpes zoster, and respiratory syncytial virus. AS01 induces early innate immune activation that induces T cell-mediated and antibody-mediated responses with optimized functional characteristics and induction of immune memory. AS01-containing vaccines appear relatively impervious to baseline immune status translating into high efficacy across populations. Currently licensed AS01-containing vaccines have shown acceptable safety profiles in clinical trials and post-marketing settings., Expert Opinion: Initial expectations that adjuvantation with AS01 could support effective vaccine responses and contribute to disease control have been realized. Investigation of the utility of AS01 in vaccines to prevent other challenging diseases, such as tuberculosis, is ongoing, together with efforts to fully define its mechanisms of action in different vaccine settings.

Due to poor data in literature, we aimed to investigate the respiratory function in a large cohort of naïve Italian adult (≥18 years) SMA patients in a multi-centric cross-sectional study. The following respiratory parameters were considered: forced vital capacity (FVC), forced expiratory volume in one second (FEV1) and need for non-invasive ventilation (NIV). We included 145 treatment-naïve adult patients (SMA2=18, SMA3=125; SMA4=2), 58 females (40 %), with median age at evaluation of 37 years (range 18-72). Fifty-six (37 %) and 41 (31 %) patients had abnormal (<80 %) values of FVC and FEV1, respectively. Fourteen (14 %) patients needed NIV, started at median age of 21 (range 4-68). Motor function, measured by Hammersmith Functional Motor Scale Expanded and Revised Upper Limb Module as well as SMA2, loss of walking ability, surgery for scoliosis, use of NIV, and cough assisting device (CAD) were all significantly associated to lower FVC and FEV1 values, while no association with age at baseline, disease duration, gender or 6 min walking test was observed, except for a correlation between FVC and age in SMA3 walkers (p < 0.05). In conclusion, respiratory function in adult SMA patients is relatively frequently impaired, substantially stable, and significantly correlated with motor function and disease severity., Competing Interests: Declaration of Competing Interest The authors do not declare any financial and personal relationships with other people or organizations that could inappropriately influence their work., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background and Objectives: Timely identification of dysarthria progression in patients with bulbar-onset amyotrophic lateral sclerosis (ALS) is relevant to have a comprehensive assessment of the disease evolution. To this goal literature recognized the utmost importance of the assessment of the number of syllables uttered by a subject during the oral diadochokinesis (DDK) test., Methods: To support clinicians, this work proposes a remote deep learning-based system, which consists (i) of a web application to acquire audio tracks of bulbar-onset ALS patients and healthy control subjects while performing the oral DDK test (i.e., repeating the /pa/, /pa-ta-ka/ and /oo-ee/ syllables) and (ii) a DDK-AID network designed to process the acquired audio signals which have different duration and to output the number of per-task syllables repeated by the subject., Results: The DDK-AID network overcomes the comparative method achieving a mean Accuracy of 90.23 in counting syllables repeated by the eleven bulbar-onset ALS-patients while performing the oral DDK test., Conclusions: The proposed remote monitoring system, in the light of the achieved performance, represents an important step towards the implementation of self-service telemedicine systems which may ensure customised care plans., Competing Interests: Declaration of Competing Interest • All authors have participated in (a) conception and design, or analysis and interpretation of the data; (b) drafting the article or revising it critically for important intellectual content; and (c) approval of the final version. • This manuscript has not been submitted to, nor is under review at, another journal or other publishing venue. • The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 The Author(s). Published by Elsevier B.V. All rights reserved.)

Objective: The aim of this study was to provide an overview of the clinical phenotypes associated with 4 SMN2 copies., Methods: Clinical phenotypes were analyzed in all the patients with 4 SMN2 copies as part of a nationwide effort including all the Italian pediatric and adult reference centers for spinal muscular atrophy (SMA)., Results: The cohort includes 169 patients (102 men and 67 women) with confirmed 4 SMN2 copies (mean age at last follow-up = 36.9 ± 19 years). Six of the 169 patients were presymptomatic, 8 were classified as type II, 145 as type III (38 type IIIA and 107 type IIIB), and 8 as type IV. The remaining 2 patients were asymptomatic adults identified because of a familial case. The cross-sectional functional data showed a reduction of scores with increasing age. Over 35% of the type III and 25% of the type IV lost ambulation (mean age = 26.8 years ± 16.3 SD). The risk of loss of ambulation was significantly associated with SMA type (p < 0.0001), with patients with IIIB and IV less likely to lose ambulation compared to type IIIA. There was an overall gender effect with a smaller number of women and a lower risk for women to lose ambulation. This was significant in the adult (p = 0.009) but not in the pediatric cohort (p = 0.43)., Interpretation: Our results expand the existing literature on natural history of 4 SMN2 copies confirming the variability of phenotypes in untreated patients, ranging from type II to type IV and an overall reduction of functional scores with increasing age. ANN NEUROL 2023;94:1126-1135., (© 2023 The Authors. Annals of Neurology published by Wiley Periodicals LLC on behalf of American Neurological Association.)

Purpose: Despite growing recognition that unfortunately common maternal stress exposures in childhood and pregnancy may have intergenerational impacts on children's psychiatric health, studies rarely take a life course approach. With child psychopathology on the rise, the identification of modifiable risk factors is needed to promote maternal and child well-being. In this study, we examined associations of maternal exposure to childhood traumatic events (CTE) and pregnancy stressful life events (PSLE) with child mental health problems in a large, sociodemographically diverse sample., Methods: Participants were mother-child dyads in the ECHO-PATHWAYS consortium's harmonized data across three U.S. pregnancy cohorts. Women completed questionnaires regarding their own exposure to CTE and PSLE, and their 4-6-year-old child's mental health problems using the Child Behavior Checklist (CBCL). Regression analyses estimated associations between stressors and child total behavior problems, adjusting for confounders., Results: Among 1948 dyads (child age M = 5.13 (SD = 1.02) years; 38% Black, 44% White; 8.5% Hispanic), maternal history of CTE and PSLE were independently associated with children's psychopathology: higher CTE and PSLE counts were related to higher total problems ([ß CTE  = 0.11, 95% CI [.06, .16]; ß SLE  = 0.21, 95% CI [.14, 0.27]) and greater odds of clinical levels of problems (OR CTE  = 1.41; 95% CI [1.12, 1.78]; OR PSLE  = 1.36; 95% CI [1.23, 1.51]). Tests of interaction showed PSLEs were more strongly associated with child problems for each additional CTE experienced., Conclusion: Findings confirm that maternal exposure to CTE and PSLE are independently associated with child mental health, and history of CTE exacerbates the risk associated with PSLE, highlighting intergenerational risk pathways for early psychopathology. Given the prevalence of these exposures, prevention and intervention programs that reduce childhood trauma and stress during pregnancy will likely positively impact women's and their children's health., (© 2023. The Author(s).)

Evidence suggests that adversity experienced during fetal development may shape infant physiologic functioning and temperament. Parental sensitivity is associated with child stress regulation and may act as a buffer against risk for intergenerational health effects of pre- or postnatal adversity. Building upon prior evidence in a racially and ethnically diverse sample of infants (M infant age = 6.5 months) and women of low socioeconomic status, this study examined whether coded parenting sensitivity moderated the association between an objective measure of prenatal stress exposures (Stressful Life Events (SLE)) and infant parasympathetic (respiratory sinus arrhythmia; RSA) or sympathetic (pre-ejection period; PEP) nervous system functioning assessed during administration of the Still-Face-Paradigm (SFP) ( n  = 66), as well as maternal report of temperament ( n  = 154). Results showed that parental sensitivity moderated the associations between prenatal stress exposures and infant RSA reactivity, RSA recovery, PEP recovery, and temperamental negativity. Findings indicate that greater parental sensitivity is associated with lower infant autonomic nervous system reactivity and greater recovery from challenge. Results support the hypothesis that parental sensitivity buffers infants from the risk of prenatal stress exposure associations with offspring cross-system physiologic reactivity and regulation, potentially shaping trajectories of health and development and promoting resilience.

Objective: Spinal Muscular Atrophy (SMA) is a genetic neuromuscular disease affecting the lower motor neuron, carrying a significant burden on patients' general motor skills and quality of life, characterized by a great variability in phenotypic expression. As new therapeutic options make their appearance on the scene, sensitive clinical tools and outcome measures are needed, especially in adult patients undergoing treatment, in which the expected clinical response is a mild improvement or stabilization of disease progression., Methods: Here, we describe a new functional motor scale specifically designed for evaluating the endurance dimension for the upper and lower limbs in adult SMA patients., Results: The scale was first tested in eight control healthy subjects and then validated in ten adult SMA patients, proving intra- and inter-observer reliability. We also set up an evaluation protocol by using wearable devices including surface EMG and accelerometer., Conclusions: The endurance evaluation should integrate the standard clinical monitoring in the management and follow-up of SMA adult patients., Competing Interests: Authors have no conflict of interest to disclose., (©2023 Gaetano Conte Academy - Mediterranean Society of Myology, Naples, Italy.)

Background and Objectives: Patients suffering from neurological diseases may develop dysarthria, a motor speech disorder affecting the execution of speech. Close and quantitative monitoring of dysarthria evolution is crucial for enabling clinicians to promptly implement patients' management strategies and maximizing effectiveness and efficiency of communication functions in term of restoring, compensating or adjusting. In the clinical assessment of orofacial structures and functions, at rest condition or during speech and non-speech movements, a qualitative evaluation is usually performed, throughout visual observation., Methods: To overcome limitations posed by qualitative assessments, this work presents a store-and-forward self-service telemonitoring system that integrates, within its cloud architecture, a convolutional neural network (CNN) for analyzing video recordings acquired by individuals with dysarthria. This architecture - called facial landmark Mask RCNN - aims at locating facial landmarks as a prior for assessing the orofacial functions related to speech and examining dysarthria evolution in neurological diseases., Results: When tested on the Toronto NeuroFace dataset, a publicly available annotated dataset of video recordings from patients with amyotrophic lateral sclerosis (ALS) and stroke, the proposed CNN achieved a normalized mean error equal to 1.79 on localizing the facial landmarks. We also tested our system in a real-life scenario on 11 bulbar-onset ALS subjects, obtaining promising outcomes in terms of facial landmark position estimation., Discussion and Conclusions: This preliminary study represents a relevant step towards the use of remote tools to support clinicians in monitoring the evolution of dysarthria., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Modern society has increasingly a diffusion of pollutants and emerging contaminants (e.g., different types of chemicals and endocrine disruptors in pharmaceuticals, pesticides, household cleaning, and personal care products, etc.) that have detrimental effects on the environment (atmosphere, hydrosphere, biosphere and anthroposphere) and also generate diseases and disorders on the people health. Environmental science requires efforts in the detection and elimination of manifold pollutants and emerging pollutants with appropriate product and process technologies. This study aims to analyze different paths of treatment technologies to investigate their evolution and predict new directions of promising technological trajectories to support the removal of contaminants directed to reach, whenever possible, sustainable development objectives. The work is mainly devoted to wastewater treatment technologies. A proposed model analyzes the evolution of patents (proxy of innovation and new technology) on publications (proxy of science and knowledge advances) to quantify the relative growth rate of new trajectories of technologies to remove pollutants and emerging contaminants. Results reveal that new directions of treatment technologies having an accelerated rate of growth are (in decreasing order): biochar and reverse osmosis in physical-based technologies, coagulation, and disinfection water treatments in chemical-based technologies and anaerobic processes in biological-based technologies. Other main technologies, such as carbon nanotubes and advanced oxidation processes, seem to be in the initial phase of development and need learning by using processes and further science and technology advances to be implemented as effective treatments and cost-effective methods. The results here show similar trends to global market revenue in water and wastewater treatment technologies. These findings bring us to the main information to extend the knowledge about new directions of technologies for the treatment and/or elimination of pollutants and microorganisms in order to support decisions of policymakers towards goals of sustainable development by reducing environmental degradation and people health disorders., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Spinal muscular atrophy (SMA) is a rare neuromuscular disease which may cause impairments in oro-facial musculature. Most of the individuals with SMA present bulbar signs such as flaccid dysarthria which mines their abilities to speak and, as consequence, their psychic balance. To support clinicians, recent work has demonstrated the feasibility of video-based techniques for assessing the oro-facial functions in patients with neurological disorders such as amyotrophic lateral sclerosis. However, no work has so far focused on automatic and quantitative monitoring of dysarthria in SMA. To overcome limitations this work's aim is to propose a cloud-based store-and-forward telemonitoring system for automatic and quantitative evaluation of oro-facial muscles in individuals with SMA. The system integrates a convolutional neural network (CNN) aimed at identifying the position of facial landmarks from video recordings acquired via a web application by an SMA patient.Clinical relevance- The proposed work is in the preliminary stage, but it represents the first step towards a better understanding of the bulbar-functions' evolution in patients with SMA.

Background: Early childhood is a pivotal period for the development of healthy eating practices. One way to promote child health is to identify early modifiable factors that affect child eating and weight. Given the intergenerational transmission of eating behaviors, this study examined how mothers' eating behaviors were associated with child feeding practices, and whether child weight-for-length (z-WFL) moderated this relation, in a community sample., Methods: Participants were 72 mother-child dyads. Maternal eating behaviors-emotional, external and restrained-were assessed 9-months postpartum, using the Dutch Eating Behavior Questionnaire. Child feeding-restrictive, pressure, and concern about overeating/overweight or undereating/underweight-was measured using the Infant Feeding Questionnaire, and child z-WFL were assessed 18-months postpartum. Linear regressions were used to test the main effect of maternal eating and the interaction effect of maternal eating and child z-WFL, on child feeding practices., Results: Maternal restrained eating was associated with child pressure feeding, and contrarily with concerns about overeating/overweight. However, a significant interaction between child z-WFL and both maternal emotional and external eating were found with regard to concern about child undereating/underweight. Paradoxically, among children who weighed more, greater maternal emotional and greater external eating were associated with greater concern about child undereating/underweight., Conclusions: In this community sample, mothers were more likely to report contradictory feeding practices and concerns, suggesting complicated relations among a mother's own eating behavior, her child's weight, and her perceptions of child eating and weight. This may indicate a need for better communication and support of infant feeding practices., Trial Registration: Data was collected as part of two grants (MAMAS Grant ID: HL097973-01; SEED Grant ID: HL116511-02) conducted at the University of California, San Francisco (UCSF). All subjects gave their informed consent for inclusion before they participated in the study. The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by institutional review board at UCSF., (© 2023. The Author(s).)

Background: The recovery of independence in activities of daily living is a fundamental goal of rehabilitation programs in subjects affected by subacute stroke. Rehabilitation is focused both on motor and cognitive aspects, and some evidence has reported cognitive deficits as prognostic factors of motor recovery. However, rehabilitation is a dynamic process during which executive functions and motor functions should be improved., Aim: The aim of the study is to evaluate the relationships between impairments in cognitive functions and recovery of functional independence in stroke patients during the subacute phase., Design: Multicenter observational study., Setting: Intensive rehabilitation units., Population: A sample of 319 stroke patients in subacute phase (70.6±11.6 years, 40.4% females), consecutively admitted from November 2019 to July 2021 at sixteen rehabilitation centers were enrolled in this observational, prospective and multicentric study with longitudinal assessments., Methods: Cognitive and functional assessments were performed at hospital admission and discharge, including Oxford Cognitive Screen, modified Barthel Index, Functional Independent Measure, Fugl-Meyer assessment scale and National Institutes of Health Stroke Scale., Results: A regression analysis identified five predictors (out of about 200 tested variables) of functional recovery related to four aspects assessed at admission: functional status (P<0.001), lower limb functioning (P=0.002), attention (P=0.011), and executive functions (P=0.017). Furthermore, patients who recovered deficits in executive functions had the same recovery of those without deficits, whereas those who maintained deficits had a smaller recovery (P=0.019)., Conclusions: The relationship between cognitive and motor deficits is increasingly highlighted and the recovery of executive functions deficits seems to contribute to motor recovery., Clinical Rehabilitation Impact: Our results suggest that the recovery of executive functions may promote the recovery of the functional outcome of the patient with subacute stroke. Future treatment protocols may benefit from paying more attention to the recovery of executive functions.

Some countries in the presence of unforeseen Coronavirus Disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), have experienced lower total deaths, though higher numbers of COVID-19 related infections. Results here suggest that one of the explanations is the critical role of ventilator technology in clinical health environment to cope with the initial stage of COVID-19 pandemic crisis. Statistical evidence shows that a large number of ventilators or breathing devices in countries (26.76 units per 100,000 inhabitants) is associated with a fatality rate of 1.44% (December 2020), whereas a higher fatality rate given by 2.46% is in nations with lower numbers of ventilator devices (10.38 average units per 100,000 people). These findings suggest that a large number of medical ventilators in clinical setting has a high potential for more efficient healthcare and improves the effective preparedness of crisis management to cope with new respiratory pandemic diseases in society. Hence, a forward-thinking and technology-oriented strategy in healthcare sector, based on investments in high-tech ventilator devices and other new medical technologies, can help clinicians deliver effective care and reduce negative effects of present and future respiratory infectious diseases, in particular when new drugs and appropriate treatments are missing in clinical environment to face unknown respiratory viral agents ., (© 2023 Elsevier Ltd. All rights reserved.)

Women's social experiences can have long-term implications for their offspring's health, but little is known about the potential independent contributions of multiple periods of stress exposures over time. This study examined associations of maternal exposure to adversity in childhood and pregnancy with children's anxiety and depression symptoms in a large, sociodemographically diverse sample. Participants were 1389 mother-child dyads (child age M = 8.83 years; SD = 0.66; 42% Black, 42% White; 6% Hispanic) in the ECHO-PATHWAYS Consortium's three U.S. pregnancy cohorts. Women reported their exposure to childhood traumatic events (CTE) and pregnancy stressful life events (PSLE). Children self-reported on their symptoms of anxiety and depression at age 8-9 years. Regression analyses estimated associations between maternal stressors and children's internalizing problems, adjusting for confounders, and examined child sex as a modifier. Exploratory interaction analyses examined whether geospatially-linked postnatal neighborhood quality buffered effects. In adjusted models, PSLE counts positively predicted levels of children's anxiety and depression symptoms ([ß Anxiety =0.08, 95%CI [0.02, 0.13]; ß Depression =0.09, 95%CI [0.03, 0.14]); no significant associations were observed with CTE. Each additional PSLE increased odds of clinically significant anxiety symptoms by 9% (95%CI [0.02, 0.17]). Neither sex nor neighborhood quality moderated relations. Maternal stressors during pregnancy appear to have associations with middle childhood anxiety and depression across diverse sociodemographic contexts, whereas maternal history of childhood adversity may not. Effects appear comparable for boys and girls. Policies and programs addressing prevention of childhood internalizing symptoms may benefit from considering prenatal origins and the potential two-generation impact of pregnancy stress prevention and intervention., (© 2022. The Author(s).)

Objective: Spinal muscular atrophy (SMA) is a neurodegenerative disorder caused by mutations in the SMN1 gene. The aim of this study was to assess the prevalence of SMA and treatment prescription in Italy., Methods: An online survey was distributed to 36 centers identified by the Italian government as referral centers for SMA. Data on the number of patients with SMA subdivided according to age, type, SMN2 copy number, and treatment were collected., Results: One thousand two hundred fifty-five patients with SMA are currently followed in the Italian centers with an estimated prevalence of 2.12/100,000. Of the 1,255, 284 were type I, 470 type II, 467 type III, and 15 type IV with estimated prevalence of 0.48, 0.79, 0.79 and 0.02/100,000, respectively. Three patients with SMA 0 and 16 presymptomatic patients were also included. Approximately 85% were receiving one of the available treatments. The percentage of treated patients decreased with decreasing severity (SMA I: 95.77%, SMA II: 85.11%, SMA III: 79.01%)., Discussion: The results provide for the first time an estimate of the prevalence of SMA at the national level and the current distribution of patients treated with the available therapeutical options. These data provide a baseline to assess future changes in relation to the evolving therapeutical scenario., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.)

The mechanisms by which antibodies confer protection vary across vaccines, ranging from simple neutralization to functions requiring innate immune recruitment via Fc-dependent mechanisms. The role of adjuvants in shaping the maturation of antibody-effector functions remains under investigated. Using systems serology, we compared adjuvants in licensed vaccines (AS01 B /AS01 E /AS03/AS04/Alum) combined with a model antigen. Antigen-naive adults received two adjuvanted immunizations followed by late revaccination with fractional-dosed non-adjuvanted antigen ( NCT00805389 ). A dichotomy in response quantities/qualities emerged post-dose 2 between AS01 B /AS01 E /AS03 and AS04/Alum, based on four features related to immunoglobulin titers or Fc-effector functions. AS01 B/E and AS03 induced similar robust responses that were boosted upon revaccination, suggesting that memory B-cell programming by the adjuvanted vaccinations dictated responses post non-adjuvanted boost. AS04 and Alum induced weaker responses, that were dissimilar with enhanced functionalities for AS04. Distinct adjuvant classes can be leveraged to tune antibody-effector functions, where selective vaccine formulation using adjuvants with different immunological properties may direct antigen-specific antibody functions., (© 2023. GSK.)

Scholars and experts argue that future pandemics and/or epidemics are inevitable events, and the problem is not whether they will occur, but when a new health emergency will emerge. In this uncertain scenario, one of the most important questions is an accurate prevention, preparedness and prediction for the next pandemic. The main goal of this study is twofold: first, the clarification of sources and factors that may trigger pandemic threats; second, the examination of prediction models of on-going pandemics, showing pros and cons. Results, based on in-depth systematic review, show the vital role of environmental factors in the spread of Coronavirus Disease 2019 (COVID-19), and many limitations of the epidemiologic models of prediction because of the complex interactions between the new viral agent SARS-CoV-2, environment and society that have generated variants and sub-variants with rapid transmission. The insights here are, whenever possible, to clarify these aspects associated with public health in order to provide lessons learned of health policy that may reduce risks of emergence and diffusion of new pandemics having negative societal impact., Competing Interests: Conflict of interests: I declare that I am the sole author of this manuscript, and I have no known competing financial interests or personal relationships that could influence the work reported in this paper. This study has no funders., (© 2023 the Author(s), licensee AIMS Press.)

Competing Interests: The authors declared no conflict of interest. SL is serving as one of the Editorial Board members of this journal. We declare that SL had no involvement in the peer review of this article and has no access to information regarding its peer review. Full responsibility for the editorial process for this article was delegated to GR.

Tokyo Summer Olympics and Paralympics have raised social issues regarding the potential rise in COVID-19 cases in Japan and risks associated with the safe organization of mega sporting events during the pandemic, such as the FIFA World Cup Qatar 2022. This study investigates the Tokyo Summer Olympics as a unique case study to clarify the drivers of infectivity and provide guidelines to host countries for the safe organization of subsequent international sporting events. The result here reveals that Tokyo and Japan did not experience a rise in confirmed cases of COVID-19 due to the hosting of the Summer Olympics. Still, transmission dynamics seems to be mainly driven by the high density of population (about 1.2%, p-value <0.001) like other larger cities in Japan (result confirmed with Mann-Whitney U test, significance at 0.05). Our study provided evidence that hosting mega sporting events during this COVID-19 pandemic is safe if strictly maintained the precautions with non-pharmaceutical (and pharmaceutical) measures of control of infections. The Tokyo Summer Olympics hosting will be exemplary for next international events due to the successful implementation of preventive measures during COVID-19 pandemic crisis., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

The goal of the study here is to analyze and assess whether strict containment policies to cope with Coronavirus Disease 2019 (COVID-19) pandemic crisis are effective interventions to reduce high numbers of infections and deaths. A homogenous sample of 31 countries is categorized in two sets: countries with high or low strictness of public policy to cope with COVID-19 pandemic crisis. The findings here suggest that countries with a low intensity of strictness have average confirmed cases and fatality rates related to COVID-19 lower than countries with high strictness in containment policies (confirmed cases are 24.69% vs. 26.06% and fatality rates are 74.33% vs. 76.38%, respectively, in countries with low and high strictness of COVID-19 public policies of containment). What this study adds is that high levels of strict restriction policies may not be useful measures of control in containing the spread and negative impact of pandemics similar to COVID-19 and additionally a high strictness in containment policies generates substantial social and economic costs. These findings can be explained with manifold socioeconomic and environmental factors that support transmission dynamics and circulation of COVID-19 pandemic. Hence, high levels of strictness in public policy (and also a high share of administering new vaccines) seem to have low effectiveness to stop pandemics similar to COVID-19 driven by mutant viral agents. These results here suggest that the design of effective health policies for prevention and preparedness of future pandemics should be underpinned in a good governance of countries and adoption of new technology, rather than strict and generalized health polices having ambiguous effects of containment in society., (© 2022. The Author(s).)

The principal goal of this study is to analyze the evolution of sensor research and technologies from 1990 to 2020 to clarify outlook and future directions. This paper applies network analysis to a large dataset of publications concerning sensor research covering a 30-year period. Results show that the evolution of sensors is based on growing scientific interactions within networks, between different research fields that generate co-evolutionary pathways directed to develop general-purpose and/or specialized technologies, such as wireless sensors, biosensors, fiber-optic, and optical sensors, having manifold applications in industries. These results show new directions of sensor research that can drive R&D investments toward promising technological trajectories of sensors, exhibiting a high potential of growth to support scientific, technological, industrial, and socioeconomic development.

Objective: Depression is a public health crisis, and scalable, affordable interventions are needed. Although many psychosocial interventions are effective, there is little research investigating their sustained, long-term influence on well-being. The purpose of this study was to examine whether a prenatal mindfulness intervention with demonstrated benefit for women's depressive symptoms during the early postpartum period would exert effects through 8 years., Method: The sample of 162 lower income women was racially and ethnically diverse. Women were assigned to receive an 8-week mindfulness-based intervention during pregnancy (MIND) or treatment as usual (TAU). Repeated assessments of depressive symptoms were collected using the Patient Health Questionnaire-9 at baseline, postintervention, and following childbirth (1, 2, 3-4, 5, 6, and 8 years from baseline). The most recent assessment of depressive symptoms was collected during the COVID-19 pandemic., Results: MIND and TAU women were equivalent on sociodemographic factors and depressive symptoms at baseline. Depressive symptoms at all follow-up assessments through 8 years were significantly lower among women in MIND compared to TAU. The odds of moderate or higher depressive symptoms were greater among TAU compared to MIND women at all time points except the 6-year assessment. By Year 8, 12% of women in MIND reported moderate or more severe depressive symptoms compared to 25% of women in TAU., Conclusions: Results suggest the effects of a group-based psychosocial intervention during pregnancy may endure for years, well beyond the initial perinatal period. Investing in prevention and intervention efforts for mental health during pregnancy may have sustained benefits for the well-being of women. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Background: Natural history of spinal muscular atrophy (SMA) in adult age has not been fully elucidated yet, including factors predicting disease progression and response to treatments. Aim of this retrospective, cross-sectional study, is to investigate motor function across different ages, disease patterns and gender in adult SMA untreated patients., Methods: Inclusion criteria were as follows: (1) clinical and molecular diagnosis of SMA2, SMA3 or SMA4 and (2) clinical assessments performed in adult age (>18 years)., Results: We included 64 (38.8%) females and 101 (61.2%) males (p=0.0025), among which 21 (12.7%) SMA2, 141 (85.5%) SMA3 and 3 (1.8%) SMA4. Ratio of sitters/walkers within the SMA3 subgroup was significantly (p=0.016) higher in males (46/38) than in females (19/38). Median age at onset was significantly (p=0.0071) earlier in females (3 years; range 0-16) than in males (4 years; range 0.3-28), especially in patients carrying 4 SMN2 copies. Median Hammersmith Functional Rating Scale Expanded scores were significantly (p=0.0040) lower in males (16, range 0-64) than in females (40, range 0-62); median revised upper limb module scores were not significantly (p=0.059) different between males (24, 0-38) and females (33, range 0-38), although a trend towards worse performance in males was observed. In SMA3 patients carrying three or four SMN2 copies, an effect of female sex in prolonging ambulation was statistically significant (p=0.034)., Conclusions: Our data showed a relevant gender effect on SMA motor function with higher disease severity in males especially in the young adult age and in SMA3 patients., Competing Interests: Competing interests: LM has received honoraria for speaking, advisory boards and compensation for congress participations from Sanofi Genzyme, Roche and Biogen, outside the submitted work. LB participated in advisory boards for PTC Therapeutics, Sarepta Therapeutics, Edgewise Therapeutics, Epirium Bio and has received speaker honoraria from PTC Therapeutics and participated in research sponsored by Santhera Pharmaceuticals. SB has received funds for travel and congress participation from Sanofi Genzyme and Biogen. MG has received honoraria for speaking from Pfizer, Alnylam, Biogen and Sanofi-Aventis and has received financial support for research, not related to the study described in this manuscript, from Sanofi-Aventis. SCP has been Scientific board member for Esperare and Sarepta and PI of clinical trials for Esperare, FibroGen, Wave, Mallinckrodt, Dyne, Adienne. MT has received compensation for congress participations from Roche and Biogen. MC has received honoraria for speaking, advisory boards and compensation for congress participations from Roche and Biogen. RM has received funding for travel, meeting attendance or Advisory Board participation from Alexion, Argenx, Biomarin, Catalyst, SANOFI, Regeneron and UCB. RL reports personal fees from Biogen, Sanofi- Genzyme, Argon Healthcare s.r.l., Amicus Therapeutics s.r.l. and Alfasigma for Advisory Board consultancy and Lecture fees from Dynamicom Education, SIMG Service, Adnkronos salute unipersonale s.r.l. and DOC Congress s.r.l. outside the submitted work. ILS has received compensation for congress and honoraria for speaking from Biogen, Sanofi Genzyme, Roche, and Celgene Bristol Myers Squibb. TM has received honoraria for speaking, advisory boards and compensation for congress participations from Sanofi Genzyme, Roche and Biogen, outside the submitted work. GC has received compensation for participation ad advisory board for Roche, Sarepta and Italfarmaco. EP reports personal fees from Sarepta, grants and non-financial support from Santhera, personal fees and nonfinancial support from PTC Pharmaceuticals, non-financial support from Genzyme, personal fees from Roche, outside the submitted work., (© Author(s) (or their employer(s)) 2022. No commercial re-use. See rights and permissions. Published by BMJ.)

Transcriptional responses to adjuvanted vaccines can vary substantially among populations. Interindividual diversity in levels of pathogen exposure, and thus of cell-mediated immunological memory at baseline, may be an important determinant of population differences in vaccine responses. Adjuvant System AS01 is used in licensed or candidate vaccines for several diseases and populations, yet the impact of pre-existing immunity on its adjuvanticity remains to be elucidated. In this exploratory post-hoc analysis of clinical trial samples (clinicalTrials.gov: NCT01424501), we compared gene expression patterns elicited by two immunizations with the candidate tuberculosis (TB) vaccine M72/AS01, between three groups of individuals with different levels of memory responses to TB antigens before vaccination. Analyzed were one group of TB-disease-treated individuals, and two groups of TB-disease-naïve individuals who were (based on purified protein derivative [PPD] skin-test results) stratified into PPD-positive and PPD-negative groups. Although TB-disease-treated individuals displayed slightly stronger transcriptional responses after each vaccine dose, functional gene signatures were overall not distinctly different between groups. Considering the similarities with the signatures found previously for other AS01-adjuvanted vaccines, many features of the response appeared to be adjuvant-driven. Across groups, cell proliferation-related signals at 7 days post-dose 1 were associated with increased anti-M72 antibody response magnitudes. These early signals were stronger in the TB-disease-treated group as compared to both TB-disease-naïve groups. Interindividual homogeneity in gene expression levels was also higher for TB-disease-treated individuals post-dose 1, but increased in all groups post-dose 2 to attain similar levels between the three groups. Altogether, strong cell-mediated memory responses at baseline accelerated and amplified transcriptional responses to a single dose of this AS01-adjuvanted vaccine, resulting in more homogenous gene expression levels among the highly-primed individuals as compared to the disease-naïve individuals. However, after a second vaccination, response heterogeneity decreased and was similar across groups, irrespective of the degree of immune memory acquired at baseline. This information can support the design and analysis of future clinical trials evaluating AS01-adjuvanted vaccines., Competing Interests: I have read the journal’s policy and the authors of this manuscript have the following competing interests: All authors are or were employees of the GSK group of companies. All authors hold shares in the GSK group of companies. Part of the activities conducted by MC and RAvdB (excluding RAvdB’s salary) were funded by grant OPP1220977 from the Bill and Melinda Gates Foundation. MC is named as an inventor on novel methods for inducing an immune response: Publication Number WO2017/017050 and WO2015/150567. Each of these applications is granted and/or pending in several countries. RvdM is currently an employee of BioNTech (Mainz, Germany). PG is currently an employee of PPD, part of Thermo Fisher Scientific (Zaventem, Belgium). This does not alter our adherence to PLOS ONE policies on sharing data and materials., (Copyright: © 2022 Coccia et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

In the presence of pandemic threats, such as Coronavirus Disease 2019 (COVID-19) crisis, vaccination is one of the fundamental strategies to cope with negative effects of new viral agents in society. The rollout of vast vaccination campaigns also generates the main issue of hesitancy and resistance to vaccines in a share of people. Many studies have investigated how to reduce the social resistance to vaccinations, however the maximum level of vaccinable people against COVID-19 (and in general against pandemic diseases), without coercion in countries, is unknown. The goal of this study is to solve the problem here by developing an empirical analysis, based on global data, to estimate the max share of people vaccinable in relation to socioeconomic wellbeing of nations. Results, based on 150 countries, reveal that vaccinations increase with the income per capita, achieving the maximum share of about 70% of total population, without coercion. This information can provide new knowledge to establish the appropriate goal of vaccination campaigns and in general of health policies to cope with next pandemic impacts, without restrictions that create socioeconomic problems. Overall, then, nations have a natural level of max vaccinable people (70% of population), but strict policies and mandates to achieve 90% of vaccinated population can reduce the quality of democracy and generate socioeconomic issues higher than (pandemic) crisis., (Copyright © 2022 Elsevier Inc. All rights reserved.)

The coronavirus disease 2019 (COVID-19), with new variants, continues to be a constant pandemic threat that is generating socio-economic and health issues in manifold countries. The principal goal of this study is to develop a machine learning experiment to assess the effects of vaccination on the fatality rate of the COVID-19 pandemic. Data from 192 countries are analysed to explain the phenomena under study. This new algorithm selected two targets: the number of deaths and the fatality rate. Results suggest that, based on the respective vaccination plan, the turnout in the participation in the vaccination campaign, and the doses administered, countries under study suddenly have a reduction in the fatality rate of COVID-19 precisely at the point where the cut effect is generated in the neural network. This result is significant for the international scientific community. It would demonstrate the effective impact of the vaccination campaign on the fatality rate of COVID-19, whatever the country considered. In fact, once the vaccination has started (for vaccines that require a booster, we refer to at least the first dose), the antibody response of people seems to prevent the probability of death related to COVID-19. In short, at a certain point, the fatality rate collapses with increasing doses administered. All these results here can help decisions of policymakers to prepare optimal strategies, based on effective vaccination plans, to lessen the negative effects of the COVID-19 pandemic crisis in socioeconomic and health systems.

Accumulating evidence suggests that maternal exposure to objectively stressful events and subjective distress during pregnancy may have intergenerational impacts on children's mental health, yet evidence is limited. In a multisite longitudinal cohort (N = 454), we used multi-variable linear regression models to evaluate the predictive value of exposure to stressful events and perceived distress in pregnancy for children's internalizing problems, externalizing problems, and adaptive skills at age 4. We also explored two- and three-way interactions between stressful events, distress, and child sex. Both objective and subjective maternal stress independently predicted children's behavior, with more stressful events and higher distress predicting more internalizing and externalizing problems and worse adaptability; stress types did not significantly interact. There was some evidence that more stressful events predicted higher externalizing behaviors only for girls. Three-way interactions were not significant. The current findings highlight the importance of considering the type of stress measurement being used (e.g., counts of objective event exposure or subjective perceptions), suggest prenatal stress effects may be transdiagnostic, and meet calls for rigor and reproducibility by confirming these independent main effects in a relatively large group of families across multiple U.S. regions. Results point to adversity prevention having a two-generation impact and that pre- and postnatal family-focused intervention targets may help curb the rising rates of children's mental health problems., (© 2022. The Author(s).)

New Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) causes the Coronavirus Disease 2019 (COVID-19), an infectious illness that has generated a pandemic crisis worldwide. One of the fundamental questions in science and society is how SARS-CoV-2 has been originated to design best practices directed to prevent and/or to cope with future hazardous pathogens. The study confronts this question here developing a meta-analysis, which endeavors to explain, whenever possible, unknown sources of the SARS-CoV-2. Findings suggest that the natural spillover of novel viral agents that generate more than 6.00 M deaths worldwide in about two years (such as, SARS-CoV-2 from February 2020 to March 2022) has a remote probability of occurrence (using an analogy with the probability of natural disasters generating a lot of fatalities), whereas science advances on hazardous viral agents and consequential lab accident have a (higher) probability of occurrence (about 13-20% like in manifold lab accidents). The findings of this meta-analysis suggest the vital role of improving the technical guidelines of biosafety at all levels in laboratories during the development of scientific research of experimental virology on hazardous pathogens to minimize risks of pandemic threats in environment and human society., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Immunization strategies against tuberculosis (TB) that confer better protection than neonatal vaccination with the 101-year-old Bacille Calmette-Guerin (BCG) are urgently needed to control the epidemic, but clinical development is hampered by a lack of established immune correlates of protection (CoPs). Two phase 2b clinical trials offer the first opportunity to discover human CoPs against TB. Adolescent BCG re-vaccination showed partial protection against Mycobacterium tuberculosis ( Mtb) infection, as measured by sustained IFNγ release assay (IGRA) conversion. Adult M72/AS01 E vaccination showed partial protection against pulmonary TB. We describe two collaborative research programs to discover CoPs against TB and ensure rigorous, streamlined use of available samples, involving international immunology experts in TB and state-of-the-art technologies, sponsors and funders. Hypotheses covering immune responses thought to be important in protection against TB have been defined and prioritized. A statistical framework to integrate the data analysis strategy was developed. Exploratory analyses will be performed to generate novel hypotheses.

Objective: Maternal health and wellness during pregnancy are associated with long-term health outcomes in children. The current study examined whether infants of women who participated in a mindfulness-based intervention during pregnancy that reduced levels of stress and depression, increased physical activity, and improved glucose tolerance differed on biobehavioral markers of psychopathological and physical health risk compared with infants of women who did not., Methods: Participants were 135 mother-infant dyads drawn from a racially and ethnically diverse, low-income sample experiencing high stress. The women participated in an intervention trial during pregnancy that involved assignment to either mindfulness-based intervention or treatment-as-usual (TAU). Infants of women from both groups were assessed at 6 months of age on sympathetic (preejection period), parasympathetic (respiratory sinus arrhythmia), and observed behavioral (negativity and object engagement) reactivity and regulation during the still face paradigm. Linear mixed-effects and generalized linear mixed-effects models were used to examine treatment group differences in infant outcomes., Results: Relative to those in the intervention group, infants in the TAU group showed a delay in sympathetic activation and subsequent recovery across the still face paradigm. In addition, infants in the intervention group engaged in higher proportions of self-regulatory behavior during the paradigm, compared with the TAU group. No significant effect of intervention was found for parasympathetic response or for behavioral negativity during the still face paradigm., Conclusions: Findings provide evidence that maternal participation in a short-term, group mindfulness-based intervention during pregnancy is associated with the early development of salutary profiles of biobehavioral reactivity and regulation in their infants. Because these systems are relevant for psychopathology and physical health, prenatal behavioral interventions may benefit two generations., (Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Psychosomatic Society.)

Objective: To retrospectively evaluate quality of life (QoL) in a large multicenter cohort of adult patients affected by spinal muscular atrophy (SMA) during nusinersen treatment., Methods: We included adult (≥ 18 years) patients clinically and genetically defined as SMA2, SMA3 and SMA4, who started nusinersen treatment in adulthood. QoL was rated by the Individualized Neuromuscular Quality of Life (INQoL) questionnaire. Concurrent motor function evaluation included the Hammersmith Functional Motor Scale Expanded (HFMSE), the Revised Upper Limb Module (RULM), the 6 min walking test (6MWT)., Results: 189 completed questionnaires were collected during a 14 months' treatment period. 78 patients were included (7 SMA2 and 69 SMA3 and 2 SMA4) with mean disease duration at first nusinersen administration of 33.2 years (± 12.5 years). All the scores for each INQoL domain (weakness, fatigue, activities, independence, social relationship, emotions, body images) and the derived QoL total score, significantly improved during the observation period, except the muscle locking and pain items. Exploratory analyses suggested that emotions and social relationships were more relevant issues for females compared to males. Social relationships were affected also by a longer disease duration (> 30 years). In SMA3 non-walker patients, activities ameliorate better compared to walkers. The HFMSE and RULM significantly improved from baseline; however, no associations with QoL total score and weakness, activities or independence were demonstrated., Conclusion: In our cohort, adult SMA patients showed a global improvement at the INQoL assessment over 14 months of nusinersen treatment. QoL assessment is relevant to SMA multidisciplinary evaluation., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

How is the dynamics of Coronavirus Disease 2019 (COVID-19) in 2020 with an health policy of full lockdowns and in 2021 with a vast campaign of vaccinations? The present study confronts this question here by developing a comparative analysis of the effects of COVID-19 pandemic between April-September 2020 (based upon strong control measures) and April-September 2021 (focused on health policy of vaccinations) in Italy, which was one of the first European countries to experience in 2020 high numbers of COVID-19 related infected individuals and deaths and in 2021 Italy has a high share of people fully vaccinated against COVID-19 (>89% of population aged over 12 years in January 2022). Results suggest that over the period under study, the arithmetic mean of confirmed cases, hospitalizations of people and admissions to Intensive Care Units (ICUs) in 2020 and 2021 is significantly equal (p-value<0.01), except fatality rate. Results suggest in December 2021 lower hospitalizations, admissions to ICUs, and fatality rate of COVID-19 than December 2020, though confirmed cases and mortality rates are in 2021 higher than 2020, and likely converging trends in the first quarter of 2022. These findings reveal that COVID-19 pandemic is driven by seasonality and environmental factors that reduce the negative effects in summer period, regardless control measures and/or vaccination campaigns. These findings here can be of benefit to design health policy responses of crisis management considering the growth of COVID-19 pandemic in winter months having reduced temperatures and low solar radiations ( COVID-19 has a behaviour of influenza-like illness). Hence, findings here suggest that strategies of prevention and control of infectious diseases similar to COVID-19 should be set up in summer months and fully implemented during low-solar-irradiation periods (autumn and winter period)., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Across a range of challenging contexts, a complex system of stress responses within multiple domains (e.g., behavior, physiology) support, or thwart, an infant's capacity to navigate an ever-changing world. As understanding of these individual stress response systems has improved, researchers have called for integrated examinations across multiple systems and domains. However, extant research has usually focused on reactivity within a single system and very few explore the associations between multiple domains of stress responding. Drawing on a diverse sample of 135 mother-infant dyads, the current study explored biobehavioral concordance across the Autonomic Nervous System (ANS; measured via both cardiac and salivary indicators), Hypothalamic-pituitary-adrenal (HPA; measured via salivary indicators) axis, observed behavior, and maternal reports of temperament. Correlation analysis generally revealed moderate negative associations between ANS and HPA axis, moderate negative associations between ANS and coded negative behavior, and small-to-moderate positive associations between ANS and coded object engagement and social behavior. Salivary biomarkers and maternal report of infant temperament showed less concordance across systems and domains than cardiac ANS indicators. These findings provide a foundational understanding of the associations between biobehavioral indicators of stress responses in infancy, a period of high developmental plasticity., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Sleep is an important process that can influence and be influenced by daily events and emotions. We examined the bidirectional relationships between sleep, daily events, and emotions with a daily diary method completed by 181 mothers ( M age = 41.91, SD = 5.06). They answered morning and evening questionnaires for 1 week at three different points in time separated by nine months each, 21 days in total. Measures of sleep quality and emotional experiences each morning were assessed, and they reported on their best and worst experience of the day, peak emotional responses to these events, and affect in the evening. Sleep behavior, including total sleep time and sleep efficiency, was objectively quantified using wrist actigraphy. Multilevel modeling analyses showed that longer sleep duration and better subjective quality predicted greater positive emotions and lower negative emotions upon waking, and lower levels of peak perceived stressfulness, but not peak positivity ratings. Daily experiences did not predict sleep duration. Conversely, negative affect in the evening and greater peak perceived stressfulness during the day predicted worse sleep quality that night, whereas positive affect and positive events were not related to sleep. Although correlational, these findings suggest that good sleep can improve waking affect and help mitigate the impact of stressful experiences but does not amplify responses to the positive events of the day. In turn, daily perceived stress reactivity impairs sleep quality. These novel findings show stronger bidirectional relationships between sleep with daily stress, than sleep with daily positivity., Supplementary Information: The online version contains supplementary material available at 10.1007/s42761-022-00112-x., Competing Interests: Conflict of InterestThe authors declare no competing interests., (© The Author(s) 2022, corrected publication 2022.)

Background: Epidemiological studies link psychological resources to better physical health. One reason may be that psychological resources are protective in stressful contexts. This study tested whether indeed psychological resources are protective against biological degradation for healthy mid-life women under the chronic stress of caring for a child with an autism spectrum disorder diagnosis ("caregivers")., Methods: We tested whether five types of psychosocial resources (i.e., eudaimonic well-being, autonomy, purpose in life, self-acceptance, and mastery) were associated with biological indices of aging in a sample of mid-life women stratified by chronic stress; half were caregivers (n = 92) and half were mothers of neurotypical children (n = 91; controls). Selected stress and age related biological outcomes were insulin resistance (HOMA-IR), systemic inflammation (IL-6, CRP), and cellular aging (leukocyte telomere length). We tested whether each resource was associated with these biomarkers, and whether caregiving status and high parenting stress moderated that relationship., Results: All the psychological resources except mastery were significantly negatively associated with insulin resistance, while none were related to systemic inflammation or telomere length. The relationships between eudaimonic well-being and HOMA-IR, and self-acceptance and HOMA-IR, were moderated by parental stress; lower resources were associated with higher insulin resistance, but only for women reporting high parental stress. The well-known predictors of age and BMI accounted for 46% of variance in insulin resistance, and psychological resources accounted for an additional 13% of variance.  CONCLUSION: These findings suggest that higher eudaimonic well-being and greater self-acceptance may be protective for the metabolic health of mid-life women, and particularly in the context of high parenting stress. This has important implications given the rising rates of both parental stress and metabolic disease, and because psychological interventions can increase eudaimonic well-being and self-acceptance., (© 2021. The Author(s).)

Coronavirus disease 2019 (COVID-19) continues to be a pandemic threat that is generating a constant state of alert in manifold countries. One of the strategies of defense against infectious diseases (e.g., COVID-19) is the vaccinations that decrease the numbers of infected individuals and deaths. In this context, the optimal level of vaccination for COVID-19 is a basic point to control this pandemic crisis in society. The study here,-using data of doses of vaccines administered per 100 inhabitants, confirmed cases and case fatality ratio of COVID-19 between countries (N=192) from March to May 2021,- clarifies the optimal levels of vaccination for reducing the number of infected individuals and, consequently, the numbers of deaths at global level. Findings reveal that the average level of administering about 80 doses of vaccines per 100 inhabitants between countries can sustain a reduction of confirmed cases and number of deaths. In addition, results suggest that an intensive vaccination campaign in the initial phase of pandemic wave leads to a lower optimal level of doses administered per 100 inhabitants (roughly 47 doses of vaccines administered) for reducing infected individuals; however, the growth of pandemic wave (in May, 2021) moves up the optimal level of vaccines to about 90 doses for reducing the numbers of COVID-19 related infected individuals. All these results here could aid policymakers to prepare optimal strategies directed to a rapid COVID-19 vaccination rollout, before the takeoff of pandemic wave, to lessen negative effects of pandemic crisis on environment and socioeconomic systems., (Copyright © 2021 Elsevier Inc. All rights reserved.)

The Coronavirus Disease 2019 (COVID-19) continues to generate a constant pandemic threat with new mutations of the viral agent (SARS-CoV-2) that create socioeconomic issues. One of the fundamental problems is the evaluation of the preparedness of countries to cope with COVID-19 pandemic crisis to detect and support factors associated with the reduction of mortality and the growth of vaccinations in society. The study here confronts this problem by developing two basic indexes, which measure the performance of countries to face pandemic threats. In particular, the Index r (as resilience) detects the countries having the best performance in the reduction of the negative impact of mortality related to COVID-19 pandemic and the Index p (as preparedness and prevention) assesses best-performer countries to support COVID-19 vaccinations in order to constrain future pandemic threats and support the recovery of socioeconomic systems. Index of resilience is a composite measure based on three indicators associated with COVID-19, given by average mortality, hospital occupancy and Intensive Care Units occupancy per 100 000 people, producing an overall score; Index of preparedness/prevention is a composite measure of two indicators related to COVID-19 vaccinations (i.e., doses of vaccines administered and total vaccinates per 100 000 people), producing also an overall score of performance. The application of these indexes on a case study of European countries, having a homogenous socioeconomic area, shows the strategic positioning of countries to cope with a major pandemic threat. Findings reveal that all countries have some weaknesses and no country has a high preparedness to cope with a major epidemic or pandemic. Moreover, results suggest that best-performer countries to cope with COVID-19 pandemic crisis have a smaller size of population and/or better public governance, associated with high expenditures in health system. These indexes can help policymakers for designing effective strategies to improve preparedness and prevention of countries to face future pandemic threats., (Copyright © 2021 Elsevier Inc. All rights reserved.)