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Eleanna Makris,1 Lucy Hu,1 Graham B Jones,1,2 Justin M Wright1 1TRD Innovation Group, Novartis Pharmaceuticals, East Hanover, NJ 07936, USA; 2Clinical and Translational Science Institute, Tufts University Medical Center, Boston, MA 02111, USACorrespondence: Graham B Jones Email graham.jones@novartis.comIntroduction: Heart failure remains a substantive contributor to patient morbidity and mortality rates worldwide and represents a significant burden on the healthcare ecosystem. Faced with persistent physical symptoms and debilitating social consequences, patients follow complex treatment regimens and often have difficulty adhering to them.Purpose: In this manuscript, we review factors which contribute to low adherence rates and advance potential single- and multi-factor-based interventions. It is hoped that these observations can lead to improvements in managed care of this vulnerable population of patients.Methods: A narrative review of the primary literature was performed on contributing factors with primary focus on the period 2015– 2020 using available databases and search engines. Adherence pain points identified were mapped against a series of potential solutions which are presented.Results: Enhancement of treatment adherence relies on two approaches viz. single-factor and multi-factor solutions. Single factors identified include electronic reminders, enhanced health education, financial incentives, gamification strategies, community drivers, persona-based modeling, and burden relief of poly pharmacy. Multi-factor solutions combine two or more of the seven approaches offering the potential for flexible interventions tailored to the individual.Discussion and Conclusion: Heart failure patients with poor adherence have increased mortality, hospitalization needs, and healthcare costs. This review highlights current single-factor and multi-factor adherence methods. Against a backdrop of diversity of approaches, multi-factor solutions cast the widest net for positively influencing adherent behaviors. A key enabler lies in the development and leveraging of patient personas in the synthesis of successful intervention methods. Deployable solutions can also be envisioned in clinical trials where adherence tracking represents an essential component.Keywords: heart failure, cardiac disease, treatment adherence, intervention, connected health

Staff ratings of 595 supervised forensic psychiatric patients on the Proximal Risk Factor Scale and the Problem Identification Checklist were completed monthly for an average of 33 months. During the follow-up, there were 265 incidents, 86 of which were violent. The average ratings, excluding those from the index month, differentiated patients who had incidents from those who did not. As well, the average ratings distinguished between individuals with and without incidents of a violent or sexual nature. There were significant increases in staff ratings in the months preceding the index incident month. Within-patient analyses showed that changes in dynamic risk scales comprising the best items for predicting incidents of any kind and violent or sexual incidents were strongly related to their respective outcomes and were significantly related to outcome in an independent sample. Changes in monthly staff ratings predict the imminent occurrence of antisocial and violent behaviors. [ABSTRACT FROM AUTHOR]

The purpose of this cross-cultural, correlational study was to evaluate two popular clinical/research assessment tools, the NCAST Teaching Scale and the Home Observation Measurement of the Environment (HOME) Inventory, as measures of infant health promotion behaviors for low-income, foreign-born Hispanic mothers in the United States. Based on the assumption that both measures tap universal attributes of the mother-infant relationship, it was hypothesized that maternal performance for the study group and a comparison group of U.S.-born, low-income mothers would be similar. Comparable performance on the NCAST Teaching Scale included a full range of scores, including the capacity to identify mothers most in need of clinical intervention. Study findings supported the clinical use of this assessment scale with mothers represented by the study sample. Consistently lower scores by the foreign-born Hispanic mothers on the HOME Inventory led to the conclusion that the instrument may not tap cultural universals in the mother-infant relationship. [ABSTRACT FROM AUTHOR]

Parkinson's Disease is a progressive neurodegenerative disorder afflicting almost 12 million people. Increased understanding of its complex and heterogenous disease pathology, etiology and symptom manifestations has resulted in the need to design, capture and interrogate substantial clinical datasets. Herein we advocate how advances in the deployment of artificial intelligence models for Federated Data Analysis and Federated Learning can help spearhead coordinated and sustainable approaches to address this grand challenge., Competing Interests: Competing interests: AK, LG and GJ are all employees of Novartis Pharmaceuticals and may hold common stock in the company. MD and JR are employees of Merck Sharp & Dohme LLC, a subsidiary of Merck & Co., Inc., Rahway, NJ, USA, and may own stock and/or stock options. JA has received research support from the Michael J. Fox Foundation for Parkinson’s Research, NIH/NINDS, the Huntington Study Group, and PhotoPharmics; received compensation as a consultant/steering committee/advisory board member from the Huntington Study Group, the Parkinson Study Group, Sana Biotechnology, Biohaven, and the Michael J. Fox Foundation for Parkinson’s Research. CA is supported by the National Institute for Health Research Oxford Biomedical Research Centre and received research grant support from UCB Pharma, MSD, EPSRC and has been a consultant for UCB and J & J. BRB: No declaration. CC has been a consultant for AbbVie, Mission Therapeutics and Roche and received research funding from Parkinson’s UK, Edmond J Safra Foundation, National Institute of Health and Care Research and Cure Parkinson’s. JCe has been a consultant for VanquaBio, MiCure, Elsie Bio, has stock/options from Vanqua Bio, Micure, Immunobrain Checkpoint and has received grant funding from ASAP, the Marcus Foundation. JCo is an employee of AbbVie Pharmaceuticals. DTD: No declaration. JE is an employee of Biogen. EG is an employee of UCB Pharmaceuticals. DH has been a consultant for the Critical Path Institute, a share holder and employee of Panoramic Digital Health and received funding from the EPSRC, and France Relance. FH is employed part-time at Clario. ESI is an employee of Koneksa Health and may own company stock. TK is an employee of Takeda Pharmaceuticals. DK No declaration. CK No declaration. ML is a consultant to F. Hoffmann– La Roche Ltd via Inovigate. JM has consulted for and received funding from the Michael J Fox Foundation for Parkinson’s Research. KM No declaration. KMc No declaration. AM has been a consult for Koneksa and received grant funding from MJFF, JPND, US Department of Defense, and the EU IMI. MM No declaration. GP is an employee of F. Hoffmann La-Roche. MJP is an employee of Sanofi, and may hold shares and/or stock options in the company. LR has received honorarium from the MJ Fox Foundation and grant funding from EU, NIHR, MRC, EPSRC, Cure Parkinson’s Trust, PDUK, Dunhill Medical Trust. SS No declaration. AS has been a consultant to the following companies in the past year: Acadia, Boerhinger-Ingelheim, GE Healthcare, Wave Life Sciences, Inhibikase, Prevail, Mitzubishi and Alertity Therapeutics. He has served on DSMBs for the Huntington Study Group and The Healey ALS Consortium (Massachusetts General Hospital).He has received grant funding from the Michael J. Fox Foundation, NIA and NINDS. TS has served as a consultant for AskBio, Amneal, Blue Rock Therapeutics, Critical Path for Parkinson’s Consortium (CPP), Denali, General Electric, Kyowa, Neuroderm/ MTPA, Prevail/ Lilly, Roche, Sanofi, Sinopia, Takeda and Vanqua Bio. She has served on the ad board for AskBio, Amneal, Biohaven, Denali, GAIN, General Electric, Kyowa, MJFF, Neuron23, Parkinson Study Group, Prevail/ Lilly, and Roche. She has also served as a member of the scientific advisory board of Koneksa, Neuroderm/ MTPA, Sanofi and UCB. Dr. Simuni has received research funding from Amneal, Biogen, Neuroderm, Prevail, Roche, UCB and is an investigator for NINDS, MJFF, Parkinson’s Foundation. DS No declaration. CS-F No declaration. JAW is an employee of Koneksa Health and may own stock and/or stock options. No funding is associated with the production of this manuscript., (© 2024. The Author(s).)

Microalgae biofilms have been demonstrated to recover nutrients from wastewater and serve as biomass feedstock for bioproducts. However, there is a need to develop a platform to quantitatively describe microalgae biofilm production, which can provide guidance and insights for improving biomass areal productivity and nutrient uptake efficiency. This paper proposes a unified experimental and theoretical framework to investigate algae biofilm growth on a rotating algae biofilm reactor (RABR). Experimental laboratory setups are used to conduct controlled experiments on testing environmental and operational factors for RABRs. We propose a differential-integral equation-based mathematical model for microalgae biofilm cultivation guided by laboratory experimental findings. The predictive mathematical model development is coordinated with laboratory experiments of biofilm areal productivity associated with ammonia and inorganic phosphorus uptake by RABRs. The unified experimental and theoretical tool is used to investigate the effects of RABR rotating velocity, duty cycle (DC), and light intensity on algae biofilm growth, areal productivity, nutrient uptake efficiency, and energy efficiency in wastewater treatment. Our framework indicates that maintaining a reasonable light intensity range improves biomass areal productivity and nutrient uptake efficiency. Our framework also indicates that faster RABR rotation benefits biomass areal productivity. However, maximizing the nutrient uptake efficiency requires a reasonably low RABR rotating speed. Energy efficiency is strongly correlated with RABR rotating speed and DC., (© 2023 Wiley Periodicals LLC.)

Sosuga virus (SOSV) is a recently discovered paramyxovirus with a single known human case of disease. There has been little laboratory research on SOSV pathogenesis or immunity, and no approved therapeutics or vaccines are available. Here, we report the discovery of human mAbs from the circulating memory B cells of the only known human case and survivor of SOSV infection. We isolated 6 mAbs recognizing the functional attachment protein hemagglutinin-neuraminidase (HN) and 18 mAbs against the fusion (F) protein. The anti-HN mAbs all targeted the globular head of the HN protein and could be organized into 4 competition-binding groups that exhibited epitope diversity. The anti-F mAbs can be divided into pre- or postfusion conformation-specific categories and further into 8 competition-binding groups. The only Ab in the panel that did not display neutralization activity was the single postfusion-specific anti-F mAb. Most of the anti-HN mAbs were more potently neutralizing than the anti-F mAbs, with mAbs in 1 of the HN competition-binding groups possessing ultrapotent (<1 ng/mL) half-maximal inhibitory virus neutralization values. These findings provide insight into the molecular basis for human Ab recognition of paramyxovirus surface proteins and the mechanisms of SOSV neutralization.

A 2020 World Health Organization report underscored the impact of rising healthcare spending globally and questioned the long-term economic sustainability of current funding models. Increases in costs associated with care of late-stage irreversible diseases and the increasing prevalence of debilitating neurodegenerative disorders, coupled with increases in life expectancy are likely to overload the healthcare systems in many nations within the next decade if not addressed. One option for sustainability of the healthcare system is a change in emphasis from illness to wellness centered care. An attractive model is the P4 (Predictive, Preventative, Personalized and Participatory) medicine approach. Recent advances in connected health technology can help accelerate this transition; they offer prediction, diagnosis, and monitoring of health-related parameters. We explain how to integrate such technologies with conventional approaches and guide public health policy toward wellness-based care models and strategies to relieve the escalating economic burdens of managed care., (© 2022. The Author(s).)

A recent first detection of pigeon aviadenovirus-1 and pigeon circovirus co-infection associated with Young Pigeon Disease Syndrome (YPDS) in a pigeon flock in Turkey, prompted a study focused on documenting the distribution of Pigeon aviadenovirus (PiAdV-1 and PiAdV-2), Pigeon circovirus (PiCV), Columbid alphaherpesvirus 1 (pigeon herpesvirus (PiHV)) and Fowl aviadenovirus (FAdV) in the country. These viruses were selected as they are associated with severe disease in pigeons across the world. A total of 192 cloacal swabs were collected from young (<1 year old) pigeons from 16 different private pigeon flocks across Turkey, between 2018 and 2021 as part of routine diagnostic sampling. PiCV genetic material was the most frequently detected 4/16 (25%), PiAdV-1 and CoHV-1 DNA were both found in one flock each, while neither PiAdV-2 and FAdV were detected in any of the studied pigeon flocks. PiCV and PiHV genetic material were both detected in the same pigeon flock's cloacal samples as a co-infection with the identification of PiHV being a first in Turkey., Competing Interests: The authors have declared that no competing interests exist.

The widespread deployment of telemedical approaches to managed care during the CoV2 pandemic has provided an opportunity for clinicians to engage in the development and refinement of this mode of delivery. This also represents a pivotal moment to help effect a paradigm shift in how new and more sophisticated digital health services are designed and delivered with the caregiver playing a guiding role. Building on momentum this way can allow the fuller potential of digital health to be realized by focusing on "end user pull" which balances the omnipresent "technology push" of the consumer product and medical device industries. Perhaps nowhere is this more critical than in the care of neurological illnesses where patient-provider interactions must be managed frequently and rely on a complex battery of data measures. The emergent role of the physician-entrepreneur can be envisioned, complimenting established physician-scientist career paths and represents a timely and opportune moment to refine medical education curricula., Competing Interests: Conflict of interest: All authors are employees of Novartis., (© The Author(s) 2022.)

Advances in mobile phone technologies coupled with the availability of modern wireless networks are beginning to have a marked impact on digital health through the growing array of apps and connected devices. That said, limited deployment outside of developed nations will require additional approaches to collectively reach the 8 billion people on earth. Another consideration for development of digital health centered around mobile devices lies in the need for pairing steps, firmware updates, and a variety of user inputs, which can increase friction for the patient. An alternate, so-called Beyond the Mobile approach where medicaments, devices, and health services communicate directly to the cloud offers an attractive means to expand and fully realize our connected health utopia. In addition to offering highly personalized experiences, such approaches could address cost, security, and convenience concerns associated with smartphone-based systems, translating to improved engagement and adherence rates among patients. Furthermore, connecting these Internet of Medical Things instruments through next-generation networks offers the potential to reach patients with acute needs in nonurban regions of developing nations. Herein, we outline how deployment of Beyond the Mobile technologies through low-power wide-area networks could offer a scalable means to democratize digital health and contribute to improved patient outcomes globally., (©Graham B Jones, Andrew Bryant, Justin Wright. Originally published in JMIR Biomedical Engineering (http://biomsedeng.jmir.org), 11.02.2022.)

The SARS-Cov-2 pandemic placed a dramatic burden on managed healthcare and perhaps nowhere as evident as in neurological and psychiatric disease care. This said, the duration of the pandemic mandated adaptability of the entire care system and the oft-vaunted benefits of telehealth and telemedicine were subjected to deep scrutiny at scale. Positive experiences were reported by both patients and providers from routine check-ups, to use of cognitive behavioral therapy associated with mental disorders, and management of complex diseases such as multiple sclerosis and other neurological and psychiatric conditions. Integration into standard care looks likely in the post pandemic era with many healthcare systems moving to expand reimbursement categories and develop equitable incentive models for developers and providers. In this commentary we share perspective on how the future of care may evolve through hybrid delivery models, and the advent of new therapeutic approaches which can address pain points identified during the pandemic., Competing Interests: AK and GJ are employed by Novartis Pharmaceuticals., (Copyright © 2021 Khanna and Jones.)

The mRNA-1273 vaccine is effective against SARS-CoV-2 and was granted emergency use authorization by the FDA. Clinical studies, however, cannot provide the controlled response to infection and complex immunological insight that are only possible with preclinical studies. Hamsters are the only model that reliably exhibits severe SARS-CoV-2 disease similar to that in hospitalized patients, making them pertinent for vaccine evaluation. We demonstrate that prime or prime-boost administration of mRNA-1273 in hamsters elicited robust neutralizing antibodies, ameliorated weight loss, suppressed SARS-CoV-2 replication in the airways, and better protected against disease at the highest prime-boost dose. Unlike in mice and nonhuman primates, low-level virus replication in mRNA-1273-vaccinated hamsters coincided with an anamnestic response. Single-cell RNA sequencing of lung tissue permitted high-resolution analysis that is not possible in vaccinated humans. mRNA-1273 prevented inflammatory cell infiltration and the reduction of lymphocyte proportions, but enabled antiviral responses conducive to lung homeostasis. Surprisingly, infection triggered transcriptome programs in some types of immune cells from vaccinated hamsters that were shared, albeit attenuated, with mock-vaccinated hamsters. Our results support the use of mRNA-1273 in a 2-dose schedule and provide insight into the potential responses within the lungs of vaccinated humans who are exposed to SARS-CoV-2.