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BackgroundDigital contact tracing apps have the potential to augment contact tracing systems and disrupt COVID-19 transmission by rapidly identifying secondary cases prior to the onset of infectiousness and linking them into a system of quarantine, testing, and health care worker case management. The international experience of digital contact tracing apps during the COVID-19 pandemic demonstrates how challenging their design and deployment are. ObjectiveThis study aims to derive and summarize best practice guidance for the design of the ideal digital contact tracing app. MethodsA collaborative cross-disciplinary approach was used to derive best practice guidance for designing the ideal digital contact tracing app. A search of the indexed and gray literature was conducted to identify articles describing or evaluating digital contact tracing apps. MEDLINE was searched using a combination of free-text terms and Medical Subject Headings search terms. Gray literature sources searched were the World Health Organization Institutional Repository for Information Sharing, the European Centre for Disease Prevention and Control publications library, and Google, including the websites of many health protection authorities. Articles that were acceptable for inclusion in this evidence synthesis were peer-reviewed publications, cohort studies, randomized trials, modeling studies, technical reports, white papers, and media reports related to digital contact tracing. ResultsEthical, user experience, privacy and data protection, technical, clinical and societal, and evaluation considerations were identified from the literature. The ideal digital contact tracing app should be voluntary and should be equitably available and accessible. User engagement could be enhanced by small financial incentives, enabling users to tailor aspects of the app to their particular needs and integrating digital contact tracing apps into the wider public health information campaign. Adherence to the principles of good data protection and privacy by design is important to convince target populations to download and use digital contact tracing apps. Bluetooth Low Energy is recommended for a digital contact tracing app's contact event detection, but combining it with ultrasound technology may improve a digital contact tracing app's accuracy. A decentralized privacy-preserving protocol should be followed to enable digital contact tracing app users to exchange and record temporary contact numbers during contact events. The ideal digital contact tracing app should define and risk-stratify contact events according to proximity, duration of contact, and the infectiousness of the case at the time of contact. Evaluating digital contact tracing apps requires data to quantify app downloads, use among COVID-19 cases, successful contact alert generation, contact alert receivers, contact alert receivers that adhere to quarantine and testing recommendations, and the number of contact alert receivers who subsequently are tested positive for COVID-19. The outcomes of digital contact tracing apps' evaluations should be openly reported to allow for the wider public to review the evaluation of the app. ConclusionsIn conclusion, key considerations and best practice guidance for the design of the ideal digital contact tracing app were derived from the literature.

This paper focuses on automatically assessing language proficiency levels according to linguistic complexity in learner English. We implement a supervised learning approach as part of an automatic essay scoring system. The objective is to uncover Common European Framework of Reference for Languages (CEFR) criterial features in writings by learners of English as a foreign language. Our method relies on the concept of microsystems with features related to learner-specific linguistic systems in which several forms operate paradigmatically. Results on internal data show that different microsystems help classify writings from A1 to C2 levels (82% balanced accuracy). Overall results on external data show that a combination of lexical, syntactic, cohesive and accuracy features yields the most efficient classification across several corpora (59.2% balanced accuracy).

Purpose: To assess objective strain and subjective muscle soreness in "Bigs" (offensive and defensive line), "Combos" (tight ends, quarterbacks, line backers, and running backs), and "Skills" (wide receivers and defensive backs) in American college football players during off-season, fall camp, and in-season phases. Methods: Twenty-three male players were assessed once weekly (3-wk off-season, 4-wk fall camp, and 3-wk in-season) for hydroperoxides (free oxygen radical test [FORT]), antioxidant capacity (free oxygen radical defense test [FORD]), oxidative stress index (OSI), countermovement-jump flight time, Reactive Strength Index (RSI) modified, and subjective soreness. Linear mixed models analyzed the effect of a 2-within-subject-SD change between predictor and dependent variables. Results: Compared to fall camp and in-season phases, off-season FORT (P ≤.001 and <.001), FORD (P ≤.001 and <.001), OSI (P ≤.001 and <.001), flight time (P ≤.001 and <.001), RSI modified (P ≤.001 and <.001), and soreness (P ≤.001 and <.001) were higher for "Bigs," whereas FORT (P ≤.001 and <.001) and OSI (P =.02 and <.001) were lower for "Combos." FORT was higher for "Bigs" compared to "Combos" in all phases (P ≤.001,.02, and.01). FORD was higher for "Skills" compared with "Bigs" in off-season (P =.02) and "Combos" in-season (P =.01). OSI was higher for "Bigs" compared with "Combos" (P ≤.001) and "Skills" (P =.01) during off-season and to "Combos" in-season (P ≤.001). Flight time was higher for "Skills" in fall camp compared with "Bigs" (P =.04) and to "Combos" in-season (P =.01). RSI modified was higher for "Skills" during off-season compared with "Bigs" (P =.02) and "Combos" during fall camp (P =.03), and in-season (P =.03). Conclusion: Off-season American college football training resulted in higher objective strain and subjective muscle soreness in "Bigs" compared with fall camp and during in-season compared with "Combos" and "Skills" players. [ABSTRACT FROM AUTHOR]

DNA methylation-based biomarkers of aging are highly correlated with actual age. Departures of methylation-estimated age from actual age can be used to define epigenetic measures of child development or age acceleration (AA) in adults. Very little is known about genetic or environmental determinants of these epigenetic measures of aging. We obtained DNA methylation profiles using Infinium HumanMethylation450 BeadChips across five time-points in 1018 mother-child pairs from the Avon Longitudinal Study of Parents and Children. Using the Horvath age estimation method, we calculated epigenetic age for these samples. AA was defined as the residuals from regressing epigenetic age on actual age. AA was tested for associations with cross-sectional clinical variables in children. We identified associations between AA and sex, birth weight, birth by caesarean section and several maternal characteristics in pregnancy, namely smoking, weight, BMI, selenium and cholesterol level. Offspring of non-drinkers had higher AA on average but this difference appeared to resolve during childhood. The associations between sex, birth weight and AA found in ARIES were replicated in an independent cohort (GOYA). In children, epigenetic AA measures are associated with several clinically relevant variables, and early life exposures appear to be associated with changes in AA during adolescence. Further research into epigenetic aging, including the use of causal inference methods, is required to better our understanding of aging.

Purpose: To assess associations between a free oxygen radical test (FORT), free oxygen radical defense test (FORD), oxidative stress index, urinary cortisol, countermovement jump (CMJ), and subjective wellness in American college football. Methods: Twenty-three male student athlete American college football players were assessed over 10 weeks: off-season conditioning (3 wk), preseason camp (4 wk), and in season (3 wk). Assessments included a once-weekly FORT and FORD blood sample, urinary cortisol sample, CMJ assessment including flight time, reactive strength index modified and concentric impulse, and a daily subjective wellness questionnaire. Linear mixed models analyzed the effect of a 2 within-subject SD change in the predictor variable on the dependent variable. The effects were interpreted using magnitude-based inference and are presented as standardized effect size (ES) ± 90% confidence intervals. Results: Small negative associations were observed between FORT–flight time, FORT–fatigue, FORT–soreness (ES range = −0.30 to −0.48), FORD–sleep (ES = 0.42 ± 0.29), and oxidative stress index soreness (ES = 0.56 ± 0.29). Small positive associations were observed between FORT–cortisol (ES = 0.36 ± 0.35), FORD–flight time, FORD reactive strength index modified and FORD–soreness (0.37–0.41), oxidative stress index concentric impulse (ES = 0.37 ± 0.28), and with soreness–concentric impulse, soreness–flight time, and soreness reactive strength index modified (0.33–0.59). Moderate positive associations were observed between cortisol–concentric impulse and cortisol–sleep (0.57–0.60). Conclusion:FORT/FORD was associated with CMJ variables and subjective wellness. Greater amounts of subjective soreness were associated with decreased CMJ performance, increased FORT and cortisol, and decreased FORD. [ABSTRACT FROM AUTHOR]

Jewish suicides increased heavily under Nazi-rule. This research investigated risk factors for dying from suicide according to sociodemographic characteristics, local context, and time periods. Nazi-registration of Amsterdam residents of Jewish origin in 1941 linked to death and suicide lists. The added suicides after the Nazi-invasion (1940, n = 115) and the suicides when deportation trains ran (1942/1943, n = 182) were each matched to 25 controls using sex and age. Suicide was compared across migrant, occupational, marital, and religious status and neighborhood religiosity. Conditional logistic regression was applied, stratified by time period. In 1940, immigrant (cf. native born, odds ratio (OR) 1.89, 95%CI 1.21–2.96, p =.005) and married Jews (cf. previously married) showed higher suicide risk; members of Israelite Congregations (cf. nonmembers, OR 0.35, 95%CI 0.22–0.56, p <.001) showed reduced risk. Jews living in low synagogue rate neighborhoods showed higher risk compared to those living in neighborhoods without any synagogues (OR 2.48, 95%CI 1.65–3.72, p <.001) while those living in high synagogue rate neighborhoods showed no increased risk (OR 0.58, 95%CI 0.30–1.11, p =.10). In 1942/1943, the association between religious status (OR 1.07, 95%CI 0.67, 1.72, p =.77), synagogue rate (OR 1.27, 95%CI 0.91–1.77, p =.16), immigrant status (OR 1.30, 95%CI 0.92–1.84, p =.14) and suicide attenuated; Jews in managerial/professional occupations (cf. workers) or unmarried (cf. married) showed higher risk. In 1940, immigrants' higher suicide risk likely indicates greater fear of Nazis while religious affiliation's lower risk might indicate a protective effect of religious belief. In 1942/1943, risk differences markedly attenuated likely indicating increased fear of Nazis among all Jews. Religiously affiliated Jews showed reduced risk of dying from suicide after the Nazi-invasion Jewish immigrants showed higher risk of dying from suicide after the Nazi-invasion By 1942/1943, these risks attenuated indicating fear of the Nazis spread and nullified religion's protection [ABSTRACT FROM AUTHOR]