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Abstract: Loneliness and chronic stress are prevalent issues for older adults in the United States and have been linked to decrements in mental and physical health. Prior research has suggested that increasing compassion and empathy may reduce loneliness and chronic stress in older individuals. The present study is an efficacy pilot of a remote empathy- and compassion-based intervention targeting loneliness and chronic stress in older adults, consisting of a 6-week control and 6-week intervention period. Repeated measures ANOVAs were used to compare changes in ratings and biomarkers over the 12-week period from baseline to completion of the intervention. Bonferroni-adjusted post-hoc analyses were conducted to compare changes during control and intervention periods. The full sample consisted of 43 older adults (Mean Age=76.9 years, SD=7.5), and 12 completed additional biomarker assessments. Over the 12-week period, there were significant decreases in loneliness (p=.001) and perceived stress (p=.03). Post-hoc analyses found that perceived stress significantly decreased during the intervention period (Mdifference=1.59, p=.04), but not the control period. Loneliness significantly decreased during the control period (Mdifference=2.44, p=.003) and stayed lower during the intervention period. Preliminary results revealed reduced inflammation as well as improvements in sleep quality and variability over the 12-week period. These results support the efficacy of a remote empathy- and compassion-based intervention at reducing loneliness and stress in older adults. Further investigation in a larger sample is needed to verify whether changes in biomarkers are clinically meaningful.

La formazione della coppia è un processo in continua evoluzione, negli ultimi anni le richieste d’aiuto per la psicoterapia di coppia sono sempre più in aumento. I motivi sembrano riguardare il presente, ma spesso sono legati ad un malessere radicato nel tempo. Attraverso la lente dello psicoterapeuta della Gestalt abbiamo analizzato prevalentemente gli studi della teoria dell’attaccamento riferiti al lavoro con le coppie attraverso un’integrazione di approcci, teorie e pratiche, in particolare la terapia di coppia focalizzata sulle emozioni. Secondo la teoria dell’attaccamento gli stili relazionali degli adulti con i propri partner sono paralleli alle relazioni bambino-caregiver, caratterizzandosi perciò per la ricerca di determinate caratteristiche nell’altra persona. Il lavoro psicoterapeutico con le coppie ha tra i propri obiettivi quello di modificare i modelli operativi interni di attaccamento dei pazienti. La terapia di coppia focalizzata sulle emozioni si basa sulla risposta emotiva e su quello che i partner sentono all’interno di una relazione supportante. Consente un’esperienza emotiva risanatrice, trasformando i cicli di interazione negativa presenti nella relazione e sperimentati con i caregiver primari. La psicoterapia della Gestalt ci aiuta a osservare come i partner della coppia realizzano o bloccano la loro intenzionalità di raggiungere e farsi raggiungere dall'altro. Lo scopo della ricerca è stato esaminare i correlati tra teoria dell’attaccamento, terapia focalizzata sulle emozioni e terapia della Gestalt, in vista di ulteriori studi che permettano un maggior approfondimento delle dinamiche di coppia in terapia.

Abstract The mutual information characterizes correlations between spatially separated regions of a system. Yet, in experiments we often measure dynamical correlations, which involve probing operators that are also separated in time. Here, we introduce a space-time generalization of mutual information which, by construction, satisfies several natural properties of the mutual information and at the same time characterizes correlations across subsystems that are separated in time. In particular, this quantity, that we call the space-time mutual information, bounds all dynamical correlations. We construct this quantity based on the idea of the quantum hypothesis testing. As a by-product, our definition provides a transparent interpretation in terms of an experimentally accessible setup. We draw connections with other notions in quantum information theory, such as quantum channel discrimination. Finally, we study the behavior of the space-time mutual information in several settings and contrast its long-time behavior in many-body localizing and thermalizing systems.

Background Previous work has demonstrated disparities in the management of cardiovascular disease among men and women. We sought to evaluate these disparities and their associations with clinical outcomes among patients admitted with acute coronary syndromes to the Veterans Affairs Healthcare System. Methods and Results We identified all patients that were discharged with acute coronary syndromes within the Veterans Affairs Healthcare System from October 1, 2015 to September 30, 2022. Medical and procedural management of patients was subsequently assessed, stratified by sex. In doing so, we identified 76 454 unique admissions (2327 women, 3.04%), which after propensity matching created an analytic cohort composed of 6765 men (74.5%) and 2295 women (25.3%). Women admitted with acute coronary syndromes were younger with fewer cardiovascular comorbidities and a lower prevalence of preexisting prescriptions for cardiovascular medications. Women also had less coronary anatomic complexity compared with men (5 versus 8, standardized mean difference [SMD]=0.40), as calculated by the Veterans Affairs SYNTAX score. After discharge, women were significantly less likely to receive cardiology follow‐up at 30 days (hazard ratio [HR], 0.858 [95% CI, 0.794–0.928]) or 1 year (HR, 0.891 [95% CI, 0.842–0.943]), or receive prescriptions for guideline‐indicated cardiovascular medications. Despite this, 1‐year mortality rates were lower for women compared with men (HR, 0.841 [95% CI, 0.747–0.948]). Conclusions Women are less likely to receive appropriate cardiovascular follow‐up and medication prescriptions after hospitalization for acute coronary syndromes. Despite these differences, the clinical outcomes for women remain comparable. These data suggest an opportunity to improve the posthospitalization management of cardiovascular disease regardless of sex.

This narrative review aimed to identify young cancer survivors’ behaviours, experiences, and perspectives concerning physical activity, and identify useful strategies for promoting a healthy lifestyle. A manual search on the following databases was conducted: PubMed, Scopus, and Web of Science. The search was conducted between June 1, 2023, and April 12, 2024. Articles published from database inception up to April 12, 2024, were retrieved. Articles published in any language were considered. Perspectives including ideas, perceived barriers, and facilitators have been identified. Young cancer survivors seem to engage in physical activity as a useful coping strategy to regain normality and keep healthy after the cancer diagnosis. Although emotional and social support seems fundamental to increase participation, several other factors, including physical limitations, fatigue, sex, cancer type, and socio-economic status can influence physical activity participation. For those engaged in physical activity, the preferred activities are walking, biking, going to the gym, and exercising at home, while the least preferred are exercising at the hospital or boot camp-based exercises. Yoga is more frequently chosen by those still under treatment. Young cancer survivors appear to have unique needs different from those of adult cancer survivors. Mode of treatment delivery, increased awareness concerning the effects of physical activity, including families and friends, connecting survivors, and providing social support together with increasing motivation are key strategies for the promotion of physical activity in young cancer survivors. Fitness and healthcare professionals should consider these aspects to increase young cancer survivors' involvement in physical activities.

Importanti contributi alla definizione della nozione di estetica e creatività colgono il contemporaneo mutamento di paradigma, il quale in modo trasversale alle scienze umane e a quelle biologiche mette in evidenza l’ineludibile dimensione incarnata dell’intelligenza e della creatività umana, traendone ispirazione e anche importanti sollecitazioni per ridefinire nozioni, concetti e teorie. Al fine di attivare una sensibilità etica ed estetica, in cui gioca un ruolo fondamentale la coscienza corporea, ci è sembrato necessario partire dagli aspetti epistemologici, per poi soffermarci sul “come” avviene e “cosa” emerge dall’integrazione dell’arte con la scienza. Tale incontro, reso possibile dall’interazione con un prodotto artistico, ad un livello fenomenologico ha messo in comunicazione due mondi: quello dell’artista e quello del fruitore artistico. Dall’osservazione della qualità di questo incontro, al “confine di contatto” tra i due mondi, emerge una connotazione poetica e poietica di nuovi legami associativi e, dunque, nuove sensazioni che si aggiungono alla costruzione mentale del mondo. Ciò permette di aprirci a nuove possibilità di espressione della creatività della mente umana e al superamento di qualunque forma di stereotipo, giudizio e pregiudizio, a cui siamo sempre più esposti. Partendo dagli Archetipi e dalle ultime ricerche nel campo della neuroestetica, si vuole utilizzare nella disciplina della psicosomatica e come approccio pedagogico all’arte un metodo di “Esperienza Estetica Incarnata Creativa Consapevole”® di stampo bio-psico-sociale. In un’ottica Gestaltica, questa ipotesi metodologica mira a comprendere i meccanismi e i processi che sono alla base delle transizioni efficaci tra l’individuo e l’ambiente, agevolando un sano sviluppo del Sé creativo. Tale proposta metodologica fonde tecniche corporee con quelle immaginative attraverso la visualizzazione e l'interpretazione gestuale di un'opera d'arte, per consentire di avviare un percorso di empowerment psicocorporeo e permettere una gestione creativa del proprio mondo emozionale. Il metodo, con la sua sperimentazione ormai decennale, è stato già utilizzato come intervento di Medical Humanities nell’Azienda Sanitaria Locale di Napoli, nei Centri di riabilitazione e nei Corsi Universitari. Nello specifico di questo studio pilota, l'efficacia del metodo è stata monitorata da osservazioni partecipate di psicologi tutor circa i vissuti personali post-laboratoriali dei partecipanti, inoltre è stato utilizzato un questionario auto valutativo degli indicatori rappresentativi della qualità della comunicazione non verbale: la Diade Rev.3. Al fine di sostenere il processo di co-creazione dell’esperienza relazionale vissuta durante i laboratori sono state raccolte testimonianze narrative riferite alle percezioni personali di ciascun partecipante, poi archiviate in un e-book quale report dell’intero percorso esperienziale. L’obiettivo è stato sviluppare un percorso di riappropriazione corporea e di decodificazione imitativa dell’opera d’arte, al fine di attivare l'esperienza empatica attraverso l'esplorazione dell’aspetto motorio, delle life skills, della creatività, delle capacità di coping ed il miglioramento delle capacità relazionali. Attraverso la rappresentazione artistica, l’utilizzo di tecniche psicocorporee e la catarsi è stato possibile prendere consapevolezza di aspetti profondi della propria realtà psicologica ed esistenziale e avviare un processo di risoluzione di conflitti interni e con l'ambiente esterno, condividendone il senso per farne cultura.

OBJECTIVE: Older adults are vulnerable to perceived stress and loneliness, exacerbated by the COVID-19 pandemic. We previously reported inverse relationships between loneliness/perceived stress and wisdom/resilience. There are few evidence-based tele-health interventions for older adults. We tested a new remotely-administered manualized resilience- and wisdom-focused behavioral intervention to reduce perceived stress and loneliness in older adults. METHODS: This pilot controlled clinical trial used a multiple-phase-change single-case experimental design, with three successive 6-week phases: control, intervention, and follow-up periods. The intervention included six once-a-week one-hour sessions. Participants were 20 adults >65 years, without dementia. RESULTS: All 20 participants completed every session. The study indicated feasibility and acceptability of the intervention. While the sample was too small for demonstrating efficacy, there was a reduction (small-to-medium effect size) in perceived stress and loneliness, and increase in resilience, happiness, and components of wisdom and positive perceptions of aging. CONCLUSION: These preliminary data support feasibility, acceptability, and possible efficacy of a remotely-administered resilience- and wisdom-focused intervention in older adults to reduce stress and loneliness.

Chronic pain is common in our population, and most of these patients are inadequately treated, making the development of safer analgesics a high priority. Knee osteoarthritis (OA) is a primary cause of chronic pain and disability worldwide, and lower extremity OA is a major contributor to loss of quality-adjusted life-years. In this study we tested the hypothesis that a novel JDNI8 replication-defective herpes simplex-1 viral vector (rdHSV) incorporating a modified carbonic anhydrase-8 transgene (CA8*) produces analgesia and treats monoiodoacetate-induced (MIA) chronic knee pain due to OA. We observed transduction of lumbar DRG sensory neurons with these viral constructs (vHCA8*) (~40% of advillin-positive cells and ~ 50% of TrkA-positive cells colocalized with V5-positive cells) using the intra-articular (IA) knee joint (KJ) route of administration. vHCA8* inhibited chronic mechanical OA knee pain induced by MIA was dose- and time-dependent. Mechanical thresholds returned to Baseline by D17 after IA KJ vHCA8* treatment, and exceeded Baseline (analgesia) through D65, whereas negative controls failed to reach Baseline responses. Weight-bearing and automated voluntary wheel running were improved by vHCA8*, but not negative controls. Kv7 voltage-gated potassium channel-specific inhibitor XE-991 reversed vHCA8*-induced analgesia. Using IHC, IA KJ of vHCA8* activated DRG Kv7 channels via dephosphorylation, but negative controls failed to impact Kv7 channels. XE-991 stimulated Kv7.2–7.5 and Kv7.3 phosphorylation using western blotting of differentiated SH-SY5Y cells, which was inhibited by vHCA8* but not by negative controls. The observed prolonged dose-dependent therapeutic effects of IA KJ administration of vHCA8* on MIA-induced chronic KJ pain due to OA is consistent with the specific activation of Kv7 channels in small DRG sensory neurons. Together, these data demonstrate for the first-time local IA KJ administration of vHCA8* produces opioid-independent analgesia in this MIA-induced OA chronic pain model, supporting further therapeutic development.

Accurate predictive modeling of pandemics is essential for optimally distributing biomedical resources and setting policy. Dozens of case prediction models have been proposed but their accuracy over time and by model type remains unclear. In this study, we systematically analyze all US CDC COVID-19 forecasting models, by first categorizing them and then calculating their mean absolute percent error, both wave-wise and on the complete timeline. We compare their estimates to government-reported case numbers, one another, as well as two baseline models wherein case counts remain static or follow a simple linear trend. The comparison reveals that around two-thirds of models fail to outperform a simple static case baseline and one-third fail to outperform a simple linear trend forecast. A wave-by-wave comparison of models revealed that no overall modeling approach was superior to others, including ensemble models and errors in modeling have increased over time during the pandemic. This study raises concerns about hosting these models on official public platforms of health organizations including the US CDC which risks giving them an official imprimatur and when utilized to formulate policy. By offering a universal evaluation method for pandemic forecasting models, we expect this study to serve as the starting point for the development of more accurate models.

Chronic pain is common and inadequately treated, making the development of safe and effective analgesics a high priority. Our previous data indicate that carbonic anhydrase-8 (CA8) expression in dorsal root ganglia (DRG) mediates analgesia via inhibition of neuronal ER inositol trisphosphate receptor-1 (ITPR1) via subsequent decrease in ER calcium release and reduction of cytoplasmic free calcium, essential to the regulation of neuronal excitability. This study tested the hypothesis that novel JDNI8 replication-defective herpes simplex-1 viral vectors (rdHSV) carrying a CA8 transgene (vHCA8) reduce primary afferent neuronal excitability. Whole-cell current clamp recordings in small DRG neurons showed that vHCA8 transduction caused prolongation of their afterhyperpolarization (AHP), an essential regulator of neuronal excitability. This AHP prolongation was completely reversed by the specific Kv7 channel inhibitor XE-991. Voltage clamp recordings indicate an effect via Kv7 channels in vHCA8-infected small DRG neurons. These data demonstrate for the first time that vHCA8 produces Kv7 channel activation, which decreases neuronal excitability in nociceptors. This suppression of excitability may translate in vivo as non-opioid dependent behavioral- or clinical analgesia, if proven behaviorally and clinically.

Abstract National parks and other protected areas are important for preserving landscapes and biodiversity worldwide. An essential component of the mission of the United States (U.S.) National Park Service (NPS) requires understanding and maintaining accurate inventories of species on protected lands. We describe a new, national-scale synthesis of amphibian species occurrence in the NPS system. Many park units have a list of amphibian species observed within their borders compiled from various sources and available publicly through the NPSpecies platform. However, many of the observations in NPSpecies remain unverified and the lists are often outdated. We updated the amphibian dataset for each park unit by collating old and new park-level records and had them verified by regional experts. The new dataset contains occurrence records for 292 of the 424 NPS units and includes updated taxonomy, international and state conservation rankings, hyperlinks to a supporting reference for each record, specific notes, and related fields which can be used to better understand and manage amphibian biodiversity within a single park or group of parks.

Qual è la relazione tra benessere digitale e benessere nel digitale? Pur appartenendo a due campi semantici affini, la prima delle due espressioni si riferisce all’insieme di risorse (personali e collettive), tools, app ed accorgimenti tecnico-regolativi, ideati da chi progetta il web ed i suoi contenuti, per far sì che le persone navighino nel web secondo i principi di sicurezza e benessere; la seconda si centra maggiormente sull’azione diretta delle persone nel digitale e chiama in causa le capacità critiche e riflessive dei singoli nel muoversi in qualsiasi tipo di ambiente, reale o virtuale che sia. Il benessere digitale è soprattutto frutto del lavoro di chi ha il compito di rendere l’esperienza di fruizione del virtuale il più confortevole possibile. Il benessere nel digitale è un atto volitivo, conoscitivo ed euristico durante il quale, a partire dall’identificazione dei nostri bisogni e desideri, proviamo a trovare una loro soddisfazione nel digitale. Se da un lato l’applicazione dei principi dell’ergonomia alla costruzione degli spazi digitali risulta fondamentale per promuovere il benessere digitale, dall’altra esistono diversi tipi di App che propongono ai fruitori esperienze di benessere variamente declinate. Risulta, comunque, di fondamentale importanza coniugare lo sviluppo di competenze personali di natura affettiva e cognitiva con la costruzione di habitat digitali centrati sulla persona al fine di garantire il Ben-Essere delle persone che, in maniera parziale o totale, abitano il virtuale.

Persons with serious mental illnesses experience high rates of medical comorbidity, especially diabetes. This study examined initial implementation feasibility, acceptability, and appropriateness of a new 6-month Multicomponent Intervention for Diabetes risk reduction in Adults with Serious mental illnesses (MIDAS) among persons in residential care facilities (RCFs). We conducted a mixed-methods study using four types of quantitative and qualitative data sources (administrative data; structured facility-level observations; resident assessments including blood-based biomarkers, 24-h dietary recalls, and self-report physical activity; and focus groups/interviews with staff and participants), to assess evidence of and factors affecting intervention feasibility, acceptability, and appropriateness. It was feasible to provide a high percentage of MIDAS class sessions (mean 50 of 52 intended sessions delivered) and make nutrition-related RCF changes (substitutions for healthier food items and reduced portion sizes). Class attendance rates and positive feedback from residents and staff provided evidence of MIDAS acceptability and appropriateness for addressing identified health needs. The residents who attended ≥ 85% of the sessions had greater improvement in several desired outcomes compared to others. Implementing a fully integrated MIDAS model with more extensive changes to facilities and more fundamental health changes among residents was more challenging. While the study found evidence to support feasibility, acceptability, and appropriateness of individual MIDAS components, some challenges for full implementation and success in obtaining immediate health benefits were also apparent. The study results highlight the need for improving health among RCF populations and will inform MIDAS adaptations designed to improve intervention fit and effectiveness outcomes.

Abstract Background Sleep disorders are often complained by cancer patients and can last years after the end of therapies, leading to different negative consequences. Non‐pharmacological strategies such as exercise interventions may be considered to counteract this phenomenon. The literature supports the beneficial effects of aerobic training (AT), while evidence on resistance training (RT) is scarce. Accordingly, our systematic review aims to investigate the potential novel effect of RT on sleep outcomes in cancer survivors. Methods The literature search was conducted on MEDLINE (Pubmed), Web of Science, Scopus, and Cochrane Central Register of Controlled Trials databases, including only randomized controlled trials (RCTs). The screening procedure was conducted using the web‐based software COVIDENCE. Sleep outcomes assessed through self‐reported questionnaires or objective sleep measurements were extracted from RCTs recruiting cancer survivors of any age and gender, on or off treatment. The risk of bias (RoB) for each study was assessed using the Cochrane RoB 2 tool for RCTs. Meta‐analytic syntheses were performed on sleep quality and insomnia. Results A total of 21 studies were included in the review. Considering the mean percentage differences of all studies combined, promising positive results were found after combined aerobic and resistance exercise program (COMB) for sleep quality (−19%) and sleep disturbance (−17.3%). The meta‐analysis results showed significant improvement for both sleep quality and insomnia (d = 0.28, SE: 0.11, Z = 2.51, p

Background Portopulmonary hypertension (PoPH), associated with increased mortality, can limit treatment options for liver diseases. Data on the continuum of clinical risk related to cardiopulmonary hemodynamics in PoPH are lacking. Methods and Results As part of the United States national Veterans Affairs Clinical Assessment, Reporting, and Tracking database, we performed a retrospective cohort study of adults with cirrhosis undergoing right heart catheterization between October 1, 2017, and September 30, 2022. Pulmonary hypertension (mean pulmonary arterial pressure [mPAP] >20 mm Hg without PoPH) and PoPH (mPAP >20 mm Hg+pulmonary artery wedge pressure ≤15 mm Hg+pulmonary vascular resistance ≥3 WU) were defined by right heart catheterization hemodynamics. Multivariable Cox proportional hazards using natural splines for hemodynamic variables were used to evaluate the association between cardiopulmonary hemodynamics and mortality following right heart catheterization. A total of 4409 patients were included in the final analysis, predominantly men (96.3%), with a mean age of 68.5 years. Pulmonary hypertension and PoPH were observed in 71.6% and 10.2% of the cohort, respectively. Compared with a reference cardiac index of 2.5 L/min per m2, the hazard for mortality increased progressively with decreasing cardiac index, even after adjustment for mPAP and pulmonary vascular resistance. The minority of patients with PoPH (N=65, 14.5%) were prescribed pulmonary vasodilator therapy. Conclusions These data suggest that pulmonary hypertension and PoPH are prevalent in veterans with chronic liver disease, but low use of targeted PoPH therapy persists. Cardiac function discriminated mortality risk across a wide range of mPAP and pulmonary vascular resistance values and may diagnose and clarify prognosis in this patient population.

IntroductionThe Veterans Health Administration introduced a clinical reminder system in 2018 to help address process gaps in colorectal cancer screening, including the diagnostic evaluation of positive fecal immunochemical test (FIT) results. We conducted a qualitative study to explore the differences between facilities who performed in the top vs bottom decile for follow-up colonoscopy.MethodsSeventeen semistructured interviews with gastroenterology (GI) providers and staff were conducted at 9 high-performing and 8 low-performing sites.ResultsWe identified 2 domains, current practices and perceived barriers, and most findings were described by both high- and low-performing sites. Findings exclusive to 1 group mainly pertained to current practices, especially arranging colonoscopy for FIT-positive patients. We observed only 1 difference in the perceived barriers domain, which pertained to primary care providers.DiscussionThese results suggest that what primarily distinguishes high- and low-performing sites is not a difference in barriers but rather in the GI clinical care process. Developing and disseminating patient education materials about the importance of diagnostic colonoscopy, eliminating in-person precolonoscopy visits when clinically appropriate, and involving GI in missed colonoscopy appointments and outside referrals should all be considered to increase follow-up colonoscopy rates. Our study illustrates the challenges of performing a timely colonoscopy after a positive FIT result and provides insights on improving the clinical care process for patients who are at substantially increased risk for colorectal cancer.

Transductional targeting of herpes simplex virus (HSV)-based gene therapy vectors offers the potential for improved tissue-specific delivery and can be achieved by modification of the viral entry machinery to incorporate ligands that bind the desired cell surface proteins. The interaction of nerve growth factor (NGF) with tropomyosin receptor kinase A (TrkA) is essential for survival of sensory neurons during development and is involved in chronic pain signaling. We targeted HSV infection to TrkA-bearing cells by replacing the signal peptide and HVEM binding domain of glycoprotein D (gD) with pre-pro-NGF. This TrkA-targeted virus (KNGF) infected cells via both nectin-1 and TrkA. However, infection through TrkA was inefficient, prompting a genetic search for KNGF mutants showing enhanced infection following repeat passage on TrkA-expressing cells. These studies revealed unique point mutations in envelope glycoprotein gH and in UL24, a factor absent from mature particles. Together these mutations rescued efficient infection of TrkA-expressing cells, including neurons, and facilitated the production of a completely retargeted KNGF derivative. These studies provide insight into HSV vector improvements that will allow production of replication-defective TrkA-targeted HSV for delivery to the peripheral nervous system and may be applied to other retargeted vector studies in the central nervous system.

Abstract The Coronavirus disease 2019 (COVID-19) pandemic, caused by the virus severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has impacted over 200 countries leading to hospitalizations and deaths of millions of people. Public health interventions, such as risk estimators, can reduce the spread of pandemics and epidemics through influencing behavior, which impacts risk of exposure and infection. Current publicly available COVID-19 risk estimation tools have had variable effectiveness during the pandemic due to their dependency on rapidly evolving factors such as community transmission levels and variants. There has also been confusion surrounding certain personal protective strategies such as risk reduction by mask-wearing and vaccination. In order to create a simple easy-to-use tool for estimating different individual risks associated with carrying out daily-life activity, we developed COVID-19 Activity Risk Calculator (CovARC). CovARC is a gamified public health intervention as users can ”play with” how different risks associated with COVID-19 can change depending on several different factors when carrying out routine daily activities. Empowering the public to make informed, data-driven decisions about safely engaging in activities may help to reduce COVID-19 levels in the community. In this study, we demonstrate a streamlined, scalable and accurate COVID-19 risk calculation system. Our study also demonstrates the quantitative impact of vaccination and mask-wearing during periods of high case counts. Validation of this impact could inform and support policy decisions regarding case thresholds for mask mandates, and other public health interventions.

BackgroundWith the aging of populations worldwide, early detection of cognitive impairments has become a research and clinical priority, particularly to enable preventive intervention for dementia. Automated analysis of the drawing process has been studied as a promising means for lightweight, self-administered cognitive assessment. However, this approach has not been sufficiently tested for its applicability across populations.ObjectiveThe aim of this study was to evaluate the applicability of automated analysis of the drawing process for estimating global cognition in community-dwelling older adults across populations in different nations.MethodsWe collected drawing data with a digital tablet, along with Montreal Cognitive Assessment (MoCA) scores for assessment of global cognition, from 92 community-dwelling older adults in the United States and Japan. We automatically extracted 6 drawing features that characterize the drawing process in terms of the drawing speed, pauses between drawings, pen pressure, and pen inclinations. We then investigated the association between the drawing features and MoCA scores through correlation and machine learning-based regression analyses.ResultsWe found that, with low MoCA scores, there tended to be higher variability in the drawing speed, a higher pause:drawing duration ratio, and lower variability in the pen's horizontal inclination in both the US and Japan data sets. A machine learning model that used drawing features to estimate MoCA scores demonstrated its capability to generalize from the US dataset to the Japan dataset (R2=0.35; permutation test, P

Snake fungal disease (SFD; ophidiomycosis), caused by the pathogen Ophidiomyces ophiodiicola (Oo), has been documented in wild snakes in North America and Eurasia, and is considered an emerging disease in the eastern United States of America. However, a lack of historical disease data has made it challenging to determine whether Oo is a recent arrival to the USA or whether SFD emergence is due to other factors. Here, we examined the genomes of 82 Oo strains to determine the pathogen's history in the eastern USA. Oo strains from the USA formed a clade (Clade II) distinct from European strains (Clade I), and molecular dating indicated that these clades diverged too recently (approximately 2,000 years ago) for transcontinental dispersal of Oo to have occurred via natural snake movements across Beringia. A lack of nonrecombinant intermediates between clonal lineages in Clade II indicates that Oo has actually been introduced multiple times to North America from an unsampled source population, and molecular dating indicates that several of these introductions occurred within the last few hundred years. Molecular dating also indicated that the most common Clade II clonal lineages have expanded recently in the USA, with time of most recent common ancestor mean estimates ranging from 1985 to 2007 CE. The presence of Clade II in captive snakes worldwide demonstrates a potential mechanism of introduction and highlights that additional incursions are likely unless action is taken to reduce the risk of pathogen translocation and spillover into wild snake populations.

ObjectivesThere has been growing research interest in loneliness and wisdom in recent decades, but no cross-cultural comparisons of these constructs using standardized rating measures in older adults, especially the oldest-old. This was a cross-sectional study of loneliness and wisdom comparing middle-aged and oldest-old adults in Cilento, Italy and San Diego, United States.MethodWe examined loneliness and wisdom, using the UCLA Loneliness Scale Version 3 (UCLA-3) and San Diego Wisdom Scale (SD-WISE), respectively, in four subject groups: adults aged 50-65 and those ≥90 years from Cilento, Italy (N = 212 and 47, respectively) and San Diego, California, USA (N = 138 and 85, respectively).ResultsAfter controlling for education, there were no significant group differences in levels of loneliness, while on SD-WISE the Cilento ≥90 group had lower scores compared to the other three groups. There was a strong inverse correlation between loneliness and wisdom in each of the four subject groups. Loneliness was negatively associated while wisdom was positively associated with general health, sleep quality, and happiness in most groups, with varying levels of significance.ConclusionThese results largely support cross-cultural validity of the constructs of loneliness and wisdom, and extend previous findings of strong inverse correlations between these two entities. Loneliness has become a growing public health problem, and the results of our study suggest that wisdom could be a protective factor against loneliness, although alternative explanations are also possible. Research on interventions to reduce loneliness by enhancing wisdom in older adults is needed.

Over the past two decades, there has been a renewed interest in the development of a new generation of supersonic aircraft for civil purposes that could potentially succeed Concorde. However, the noise annoyance is still considered one of the hampering factors to meet public consensus. This paper aims at revealing the potential of numerical simulations to predict sonic boom signature in Near Field at early design stages. In particular, the paper further demonstrates the applicability of the numerical approach proposed by NASA and other partners during the Sonic Boom Prediction Workshops held between 2014 and 2021, to compute the pressure signature of aircraft in the zone close to it. The results highlight the suitability of the approach (1) to capture the impact of aircraft flight condition variations on the sonic boom signature, (2) to enable the characterization of novel aircraft layout, including Mach 5 waverider configuration, (3) to provide near-field shock wave noise predictions that can be used to evaluate shock propagation, on-ground signature analyses, and annoyance assessment.

Persons with serious mental illnesses experience high rates of medical comorbidity, especially diabetes. This study examined initial implementation feasibility, acceptability, and appropriateness of a new 6-month Multicomponent Intervention for Diabetes risk reduction in Adults with Serious mental illnesses (MIDAS) among persons in residential care facilities (RCFs). We conducted a mixed-methods study using four types of quantitative and qualitative data sources (administrative data; structured facility-level observations; resident assessments including blood-based biomarkers, 24-h dietary recalls, and self-report physical activity; and focus groups/interviews with staff and participants), to assess evidence of and factors affecting intervention feasibility, acceptability, and appropriateness. It was feasible to provide a high percentage of MIDAS class sessions (mean 50 of 52 intended sessions delivered) and make nutrition-related RCF changes (substitutions for healthier food items and reduced portion sizes). Class attendance rates and positive feedback from residents and staff provided evidence of MIDAS acceptability and appropriateness for addressing identified health needs. The residents who attended [greater than or equal to] 85% of the sessions had greater improvement in several desired outcomes compared to others. Implementing a fully integrated MIDAS model with more extensive changes to facilities and more fundamental health changes among residents was more challenging. While the study found evidence to support feasibility, acceptability, and appropriateness of individual MIDAS components, some challenges for full implementation and success in obtaining immediate health benefits were also apparent. The study results highlight the need for improving health among RCF populations and will inform MIDAS adaptations designed to improve intervention fit and effectiveness outcomes.