Public health and social measures (PHSM) are key to reducing the spread of infectious diseases like COVID-19, especially in the early stages of an outbreak. PHSM include non-pharmaceutical actions that individuals, communities, and governments take to reduce person-to-person contact and/or make them safer. PHSM reduce the pressure on the health care system to allow for the continuation of essential services and buy time for the development and dissemination of treatments and vaccines. While a combination of PHSM has proven to be effective in reducing transmission during the COVID-19 pandemic, the evidence on the relative effectiveness and broader health, social and economic impact of individual interventions is still scarce. However, PHSM packages such as lockdowns can have severe unintended consequences for individuals and societies including economic hardship, decreased mental health and wellbeing and exacerbated social and health inequity; therefore, precision in PHSM decisions and implementation is needed. This requires a strengthened evidence base as well as tools that support countries in making balanced decisions about PHSM with the best possible cost-benefit ratio. WHO works with multisectoral partners to achieve effective and context- specific PHSM implementation while maximizing the benefits of PHSM and keeping their health, social and economic burden to a minimum and justifiable. In the WHO Regional Office for Europe, PHSM are a key pillar in the COVID-19 response. The office provides, amongst others, a PHSM monitoring dashboard to track the severity of implementation across all 53 Member States as well as a calibration tool and related capacity building to guide countries in their implementation decisions as the pandemic situation evolves. The WHO has further launched a global initiative in 2021 to measure the effectiveness and impact of PHSM and improve precision in future PHSM decisions and policies. The initiative aims at providing robust data and research evidence on PHSM through a global conceptual model and research agenda, a central research monitoring system and harmonized data collection mechanisms during health emergencies. It further seeks to integrate PHSM into emergency preparedness and response assessments and yield a decision-making tool to facilitate evidence-informed and context-specific PHSM implementation. This workshop will provide an overview of WHO's activities in advancing PHSM research and implementation for better decision-making during future emergencies. Three presentations by the WHO Secretariat at the regional and global levels will focus on the strategic approach and the main deliverables of the respective initiatives so far. The presentation by the University of Munich will provide in-depth insights into the conceptual model on PHSM. The workshop will actively solicit feedback from participants on planned activities and results gathered to-date.• The lack of evidence on PHSM effectiveness and impact hampered an evidence-driven implementation approach during the COVID-19 pandemic.• WHO works to achieve effective and context- specific PHSM implementation to maximize the benefits of PHSM while keeping their health, social and economic burden to a minimum and justifiable.


Develop a digital solution for automated data ingestion and rapid update of the large-scale Human Services Dataset (HSDS) which brings together data from across government to take a powerful view of the service usage to improve outcomes of communities.The Centre for Health Record Linkage (CHeReL) hosts a secure, high-performing data linkage system, including a Master Linkage Key (MLK) of administrative health datasets, and generates linked data to inform policy decisions. Since 2018, CHeReL has also been annually linking over 70 frontline datasets to create a large-scale longitudinal linked dataset of over 2.5 billion records.Over the course of 2021, the CHeReL led a project to incrementally improve the currency of the HSDS in compressed timeframes. This provided opportunity to assess value and feasibility of more frequent updates to the dataset within the evaluation and investment context.The automated data Ingestion and validation led to a significant reduction in the data processing timeframes for the Accelerated linkage. We observed 80\% reduction in Data ingestion and 75\% reduction in data validation.The digital solution also allows asset owners to register and approve new data providers, monitor their data provision in real-time and report on data sourcing. This provides transparency to the Asset Owner and reduces the need for time-intensive and manual processes to jointly monitor data provision with the Data Linkage Centre.The digital solution also has the capability to support Data Providers automate their data feeds and provide on a regular basis through a secure non- touch process. This reduces on-going workload and ensures on-time provision.The process requires a systematic change in the upstream data source, and we requested participating agencies to send us data in an agreed format. The receipt of files in standard format is pivotal for reducing the overall timeframes of HSDS creation and leverage it for policy and investment purpose.


To the Editor,Mizushima et al. recently published remarkable explorative data on the causes, treatment patterns and outcomes of short bowel syndrome with intestinal failure (SBS-IF) in Japanese adult patients . The obsOverall, the characteristics of these Japanese adults with SBS-IF are very similar to what is observed elsewhere in the world but they notably differ from those of the small population included in a contemporary clinical trial (CT) evaluating the efficacy and safety of a glucagon-like-peptide-2 analog .Observed differences in patients’ characteristics support the discussion raised by Mizushima et al. (1) CD is typically diagnosed in early adulthood; (2) CD surgeries are usually performed in late age and after a long disease duration; and (3) biologics reduce the rate of surgery, preserve the residual bowel and facilitate earlier weaning from PN.SBS is the most common cause of chronic intestinal failure (IF) in CD . Risk faDetailed data about the features of CD and administered treatments  would help to provide a better picture of SBS-IF in Japan.These differences between RW and CT data in Japanese adult patients with SBS also perfectly illustrate how real-world data and randomized control trial data can be mutually complementary and how the first can improve the conclusions of clinical trial by better tackling the variety and heterogeneity of populations.


In this presentation, Dr Orcutt, will outline the health system responses needed to respond effectively to the health needs of forcibly displaced populations - from initial health assessments to the longer term - and the role that research can play in ensuring evidence-informed policies and practice. She will present the main areas of the WHO's new global research agenda on migration and health and outline how translating evidence into implementation is essential to improve the health of migrants.


Hye-Young Kwon was not included a corresponding author in the published article by mistake. As stated, both Jung-Yeol Han and Hye-Young Kwon both equally contributed to the article as corresponding authors.The authors apologize for this error and state that this does not change the scientific conclusions of the article in any way. The original article has been updated.


Introduction: Most studies on the efficacy of psychiatric treatments consider overall scale scores as outcome measures. A focus on individual symptoms would, however, result in a more precise assessment of treatment efficacy and has potential in improving our understanding of the working mechanisms of treatment. Such an approach may also help in improving the identification of patients who are -based on their pretreatment symptomatology- the most likely to benefit from a particular treatment. Objectives: To show the potential of network estimation techniques in a) unraveling the diverse symptom-specific responses to various depression treatments and b) improving the identification of patients who are the most likely to benefit from these treatments. Methods: First, we combined patient-level data of multiple trials considering various depression treatments, such as antidepressant medication and (internet-based) cognitive-behavioral therapy. Network estimation techniques were used to determine the complex patterns in which symptom-specific responses to treatment were related. Results: Individual clinical symptoms differed substantially in their responses to treatment and these symptom-specific responses were related in a complex manner. Patients suffering from symptoms that were directly affected by a particular treatment were -by definition- the most likely to benefit from that treatment. Conclusions: Network estimation techniques were able to unravel the diverse symptom-specific responses to treatment and could help in improving our understanding of the chain of events leading to a clinical response. Information from the networks could also help in improving the identification of patients who were the most likely to benefit from a particular treatment.No significant relationships.


A stratified random sample of participants was interviewed in each region of Pennsylvania during each phase of the implementation. In addition, comparison groups were interviewed from the third implementation region. This allowed us to draw causal inferences regarding the effect of the program on participant quality of life and psychological well-being. The sample was stratified to represent: people age 21-59 and those over age 60 who receive home and community based services (HCBS), plus people age 21 and older who are dually eligible for Medicaid and Medicare but do not use long-term services and supports. We found that engagement in preferred activities both inside and outside the home increased among people who used HCBS and those who did not. In addition, psychological well-being improved slightly while the prevalence of depressive symptoms declined. In general, the implementation of Community HealthChoices appears to have led to improvements in several measures of well-being.


There is little known about the effect of hospice post-disaster. This study utilized exposure to Hurricane Irma (2017) to evaluate the differential mortality effect of the disaster on Florida NH residents  compared to a control group of residents in the same NHs in 2015  by hospice status. We also examine the difference in hospice utilization rates post-storm for short- and long-stay (LS) residents. There was an increase in mortality for those in the cohort not on hospice within 90 days in 2017 compared to 2015 . For the rate of hospice enrollment post-storm among residents previously not on hospice, there was an increase among LS residents within 30 days  and 90 days . It is important to further examine the increase in the rate of hospice enrollment in LS NH residents post-storm.


Nitric Oxide in Plants comprises 12 manuscripts and aims to provide new insights into the molecular networks of NO through both original articles and detailed reviews related to seed and plant development, abiotic stress responses, signaling, and beneficial plant-microbial interactions.Nitric oxide (NO) is a multifunctional gaseous signaling molecule implicated in both physiological and pathological functions in plant systems. Since the first publication accounting for the presence of NO in plants in 1979, numerous milestone discoveries have revealed the complexity of its metabolic and signaling networks. This Research Topic on Oláh et al. in an original article where the interplay between NO and strigolactones (SLs) in stress-free Arabidopsis plants is studied. Authors correlate the deficiency in SL synthesis or signaling with decreased S-nitrosoglutathione (GSNO) reductase (GSNOR) protein abundance and activity and conclude underlining the need for functional GSNOR to control NO/S-nitrosothiol levels during SL-induced primary root elongation. However, the authors specify that both SL and karrikin phytohormone signaling could have overlapping roles in their experimental design. Another big challenge for plant biotechnology is the improvement of crop productivity. It is well-established the positive correlation between the supply of nitrogen (N) fertilizers and the seed yield. In this context, the original article of Nejamkin et al. investigates the link between N availability and NO in the promotion of growth and seed production in transgenic tobacco plants transformed with the Ostreococcus tauri NOS gene (OtNOS). They show a severe attenuation in the OtNOS-promoted stimulation of growth and production in transgenic plants under conditions of nitrogen scarcity and emphasize the beneficial effects of the application of nitrate  gene in fresh fruits to demonstrate that NR-derived NO negatively regulated fruit coloration/ripening by suppressing anthocyanin de novo biosynthesis, as well as by redirecting the flavonoid biosynthetic pathway to proanthocyanidins production, a colorless taste factor. They also found the antagonistic effects of NO and abscisic acid (ABA) in the regulation of the coloration of Lycium fruits.In the scope of plant development, the role of NO as a root growth regulator is investigated by Signorelli et al. reviews the current knowledge about the sources and fundamental roles of NO during the different stages of the interaction and discuss the connections between the metabolism of NO and cytokinins, auxin, and ABA signaling pathways. They also report dose- and time-dependent effects of NO on bacterial nitrogenase expression and activity in mature nodules and the protective role of leghemoglobins as reactive oxygen species (ROS)/ reactive nitrogen species (RNS)-scavengers which in turn could inactivate nitrogenase. Following the same thematic, the original article of Berger et al. investigates the contribution of NR, as the main source of NO in plants, for the functioning of the symbiosis. In this paper, a dual role in nodule functioning is attributed to NR: generating NO as a signal for gene regulation and metabolic adaptation, and contributing to the energy supply under the hypoxic conditions prevailing inside the nodule.Two manuscripts go in-depth in the study of the role of NO in the nitrogen fixation by the symbiotic interaction between legume and rhizobium partners. Wang et al. analyze the crosstalk between NO and the inhibitory effects of ABA in releasing potato seed dormancy. Researchers probe in their original article the ABA-dependent decrease of the NO content and the NOS-like and NR activities in potato during sprouting. On the other hand, the promotion by NO of ABA catabolism and the inhibition of ABA biosynthesis ultimately induced dormancy release and tuber sprouting. In the same line, Ciacka et al. summarize in their mini-review the current knowledge on NO and other RNS contribution in the modulation of crucial events related to the preservation of seed vigor and/or regulation of seed longevity during aging. Authors highlight the interest of ROS-RNS cross-talk as NO counteracts ROS generation and stimulates the antioxidant system. Additionally, the authors indicate a concentration- and time-dependent effect of NO on ethylene, polyamines and ABA biosynthesis as well as the implication of the protein modification by S-nitrosylation in the regulation of the deterioration processes in seeds. Another kind of NO-derived modification, consistent with the nitration of unsaturated fatty acids, has been highlighted in the last few years in plant systems. This interaction results in the formation of nitro-fatty acids (NO2-FAs). In this regard, the original article of Mata-Pérez et al. reports the ability of nitro-linolenic acid (NO2-Ln) to move from roots to leaves in Arabidopsis plants. Moreover, given the potential of NO2-Ln to release NO at physiological pH and temperature, it can modulate the in vitro and in vivo levels of GSNO, the major mobile biological reservoir of NO bioactivity. The manuscript provided by Nabi et al. analyzes the interaction of NO with biological molecules too. In particular, they contribute to this Topic with an original sequencing study aiming at the functional characterization of NO-responsive domains of unknown function (DUF)-containing genes in Arabidopsis leaves. They identified 231 upregulated and 206 down-regulated DUF genes. The study focuses on AtDUF569 given its significant increase in expression and interesting interactions with other proteins. This gene negatively regulates biotic stress responses and differentially regulates plant shoot and root growth under nitro-oxidative stress conditions.Seed germination is another relevant issue for biologists and agriculture and the critical role of NO in breaking dormancy has been extensively demonstrated. In this Topic, Rather et al. highlights in their review the major aspects of copper (Cu)-induced toxicity in plants and summarize two possible strategies for NO to mitigate damages: the upregulation of the enzymatic and non-enzymatic antioxidant systems or defense genes, and the NO-participation in the root exclusion and/or activation of metal-chelating ligands such as metallothioneins and phytochelatins. In the same scope of environmental injuries, Pissolato et al. evidenced in their original article an interesting strategy for alleviating the negative effects of water deficit on sugarcane plants. These researchers demonstrate that the increase in the NO3 supply enhanced NO synthesis through NR which improves sugarcane performance under drought. Another environmental disaster is global warming and ozone layer depletion. Among others, nitrous oxide (N2O) is a potent greenhouse gas. The review of Timilsina et al. describes the mitochondrial reduction of the NR-derived NO to N2O under low oxygen conditions and proposes this route as a way to protect the mitochondrial and cellular integrity from the toxicity of NO accumulation under hypoxia and anoxia.In the context of the implication of NO in the tolerance against abiotic stress situations, In summary, the variety of the work reported here  reinforcAll authors listed have made a substantial, direct and intellectual contribution to the work, and approved it for publication.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.


Dyskeratosis congenita. Autops Case Rep[Internet]. 2020 Jul-Sep;10(3):e2020203. The reason for retracting this image is that, although the authors obtained authorizationfrom the deceased’s next-of-kin to perform the autopsy and use the data for publication,this specific picture should not have been included.This issue was brought to the attention of the journal's Editor-in-chief by the paper'scorresponding author. After exchanging correspondence with the authors and theirinstitution, the Editor-in-chief obtained a formal letter from the Pathology department atSUNY Upstate Medical University requesting the retraction. The letter states that the fourauthors of the paper are in agreement with this decision and also that this issue wasbrought to the attention of the Ethics Committee at the SUNY Upstate Medical University whosupports the image retraction.The Editorial Board and the authors would like to express their most sincere apologies tothe family members for this unintentional oversight by the authors.Prof. Dr. Fernando Peixoto Ferraz de CamposEditor-in-chief


Drama therapy is a widely acknowledged way to explore life-stories in late life. This presentation will describe a new model for creative interventions, based on the results of four studies that provide multiple perspectives on the integration of life-review and drama therapy for community dwelling older adults. The results of two quantitative studies  suggest that the drama therapy interventions have robust therapeutic potential to enhance mental health while aging. The findings of two qualitative studies with therapists (n=8), participants  and staff (n=13) provide a better understanding of the process, and support the mechanisms that lead to positive effects on mental health. Combining the results yielded a multidimensional model which points to three potential transformative routes: the evolution of the life-story, the evolution of improvised dramatic expression, and the expansion of social engagement.


One of the consequences of long-term exposure to air pollutants is increased mortality and deterioration of life parameters, especially among people diagnosed with cardiovascular diseases (CVD) or impaired respiratory system. Aqueous soluble inorganic components of airborne particulate matter containing redox-active transition metal ions affect the stability of S-nitrosothiols and disrupt the balance in the homeostasis of nitric oxide. Blood plasma’s protective ability against the decomposition of S-nitrosoglutathione (GSNO) under the influence of aqueous PM extract among patients with exacerbation of heart failure and coronary artery disease was studied and compared with a group of healthy volunteers. In the environment of CVD patients’ plasma, NO release from GSNO was facilitated compared to the plasma of healthy controls, and the addition of ascorbic acid boosted this process. Model studies with albumin revealed that the amount of free thiol groups is one of the crucial factors in GSNO decomposition. The correlation between the concentration of NO released and -SH level in blood plasma supports this conclusion. Complementary studies on gamma-glutamyltranspeptidase activity and ICP-MS multielement analysis of CVD patients’ plasma samples in comparison to a healthy control group provide broader insights into the mechanism of cardiovascular risk development induced by air pollution. In addition, it has been proven that air pollution not only initiates the emergence of cardiovascular diseases but also intensifies the course of existing diseases , two-sided. Statistical comparisons between groups were performed by student Numerous epidemiological studies emphasize that exposure to air pollution increases the risk of cardiovascular events. At the same time, the deciphering of the precise mechanisms involved in CVD pathophysiology is still needful. The results of the preliminary case-control studies presented herein demonstrate a novel approach in the investigation of the interplay of aqueous PM extract and CVD progression and are briefly summarized in


For this project, we are designing and testing the feasibility of employing components of a Faith-based Home Activity Toolbox (Faith-HAT). The goal of this NIH stage 1 intervention development project is to go beyond the four walls of the church to find ways to meet the spiritual needs of persons living with moderate and severe dementia “where they are” to help them remain religiously and spiritually engaged. This mixed-methods project is designed in 2 phases: (a) developing a prototype Faith-HAT and (b) testing the feasibility and exploring preliminary effectiveness. To successfully conduct this project, we have included a community advisory board of church leaders, caregivers, and persons living with dementia as members of the research design team to advise on the design and implementation of the Faith-HAT. Brainstorming workshops with the board are used to ensure the research is meeting the needs of the African American families affected by dementia.


We present a case of a 53-year-old female patient with chronic anemia, with no other significant medical history and on no regular medications. The patient was brought to the accident and emergency department following found on the floor of her home after having tripped over a mat and henceforth being unable to mobilize and complaining of pain in her bilateral hip and her right leg. X-rays confirmed bilateral neck of femur fractures and fractures of the distal end of the tibia and fibula. The bones were extremely gracile and osteoporotic. Investigations demonstrated raised parathyroid hormone levels  15-72), with low vitamin D  and adjusted calcium  levels. We have eliminated the diagnosis of myeloma. Calcium and vitamin D were replaced prior to the insertion of bilateral femoral nails.


The purpose of this collaborative study between researchers in Japan and the U.S. was to understand the retirement experience and potential changes in social interactions  among older adults living independently in the community. Specifically, we were interested in individuals’ expectations about retirement and the types of social interactions experienced prior to and post-retirement, situated within the context of the COVID-19 pandemic. Both research teams conducted in-depth one-on-one interviews with community-residing retired older adults in early 2021. In the findings we explore similarities and differences between the retirement experiences of Japanese and American older adults, including methodological differences that transpired; specifically, we evaluate the meaning and experience of the COVID-19 pandemic in each of these cultural contexts and how retired older adults experienced its impact in their social interactions.


Assisted living is generally understood to offer a greater degree of privacy and independence than a nursing home; most residents pay privately, with some receiving support from state subsidies and Medicaid; regulation and oversight are the purview of state agencies. Within these broad parameters, however, one assisted living community may look quite different from another across the country, or down the street, in its resident population and the regulations that govern its operating license. The purpose of this symposium is to explore that variation. The papers leverage an in-depth review of changes in assisted-living regulation from 2007 to 2019 and a methodology to identify Medicare beneficiaries in assisted living using ZIP codes. To set the stage, the first paper examines variation across assisted living licenses to identify six regulatory types and compare their populations’ characteristics and health-care use. The second paper analyzes trends over time in the clinical acuity of assisted living residents associated with changes in nursing home populations. The third paper investigates racial disparities in assisted living associated with memory-care designations and proportions of Medicaid recipients. The fourth investigates how regulation of hospice providers in assisted living affect end-of-life care and place of death. The final paper describes requirements related to care for the residents with mental illness in seven states. The symposium concludes with an expert in long-term care disparities and quality discussing the implications for policymakers, providers, and the population needing long-term care in assisted living.


Assistive robots support persons with disabilities to improve their quality of life and independence. These robots make the life of a physically weak person more comfortable and useful to society. They sense, process sensory information, and execute actions that are helpful to the disabled person. Similarly, these robots carry out rehabilitation by understanding and augmenting the rehabilitation process through a robotic system. These robots are expected to assist different sensorimotor functions, therapeutic training, and assessment of the sensorimotor performance of the patients.Assistive and rehabilitation robotic technologies have developed rapidly expanding the horizon of the field of robotics. These technologies are vital in the society in which around one billion among the growing global population experience some form of physical disability impacting everyday life. Assistive and rehabilitation robotic research, especially exoskeleton robotic research integrates advanced mechatronics and intelligent sensing to restore weak sensorimotor functions. Controlling these robots according to the requirement is one of the challenging tasks. Electromyography (EMG) signals have extensively been used to control assistive robots such as exoskeleton robots so that the wearer is free of actuating any additional device to control the robot. Additionally, many studies have been carried out recently to investigate the possibility of using Electroencephalography (EEG) signals to control robotic devices.This Research Topic is aimed at creating a multidisciplinary forum of discussion on the recent advances in controlling assistive and rehabilitation robots presenting the diversity of the current approaches. It was expected to include Research Topics related to developments of controllers for upper limb/lower limb robotic exoskeletons, biomechanical investigations of robotic exoskeletons and other assistive robots, novel sensors for exoskeleton robots to generate human-like motions, EMG/EEG signals-based exoskeleton robot control, mathematical and physical algorithms for control of exoskeleton robots, assessment and benchmarking of exoskeleton robots' functionality, and clinical studies of assistive robot control. The Research Topic received overwhelming attention from the relevant researchers. Eleven articles have been selected to be published on this Research Topic after carrying out a rigorous peer-review process. Out of 11 articles, seven articles are based on the use of EMG signals for the control of assistive and rehabilitation robots. They areToward Hand Pattern Recognition in Assistive and Rehabilitation Robotics Using EMG and Kinematics of Zhou et al.Multi-Joint Angles Estimation of Forearm Motion Using a Regression Model of Qin et al.A Multi-Information Fusion Method for Gait Phase Classification in Lower Limb Rehabilitation Exoskeleton of Zhang et al.Face-Computer Interface (FCI): Intent Recognition Based on Facial Electromyography (fEMG) and Online Human-Computer Interface with Audiovisual Feedback of Zhu et al.Improved Motion Classification with an Integrated Multimodal Exoskeleton Interface of Langlois et al.Robust Torque Predictions from Electromyography Across Multiple Levels of Active Exoskeleton Assistance Despite Non-linear Reorganization of Locomotor Output of George et al.Control of Newly-Designed Wearable Robotic Hand Exoskeleton Based on Surface Electromyographic Signals of Li et al.Another three articles are based on the use of EEG signals.Engagement Enhancement Based on Human-in-the-Loop Optimization for Neural Rehabilitation of Wang et al.Multi-Feature Input Deep Forest for EEG-Based Emotion Recognition of Fang et al.The Differences Between Motor Attempt and Motor Imagery in Brain-Computer Interface Accuracy and Event-Related Desynchronization of Patients with Hemiplegia of Chen et al.Evaluating Convolutional Neural Networks as a Method of EEG–EMG Fusion” of Tryon and Trejos presented the use of EMG and EEG signals with a hybrid approach to control the assistive and rehabilitation robots.The article titled “Out of seven articles discussed on the EMG signals-based control of assistive and rehabilitation robots, in three articles EMG signals have been used for the control of upper-limb rehabilitation robots. Another two of the articles explained the uses of EMG signals for lower-limb exoskeleton robots and the rest of the articles described the classification of EMG signals to use for rehabilitation purposes.The physiological and neurological differences among individuals can cause divergent responses to the same task, and the responses can further change considerably during training; both of these factors make engagement enhancement a challenge. This challenge can be overcome by training task optimization based on subjects' responses. In one article an engagement enhancement method based on human-in-the-loop optimization is proposed and the performance of the proposed method is demonstrated by the validation and comparison experiments. The results show that both subjects' surface EMG (sEMG) -based motor engagement and electroencephalography based neural engagement can be improved significantly and maintained at a high level.Another article proposes a feature fusion and decision fusion method that combines EMG features and kinematic features for hand pattern recognition toward application in upper limb assistive and rehabilitation robotics. Ten normal subjects and five post-stroke patients participating in the experiments were tested with eight hand patterns of daily activities while EMG and kinematics were recorded simultaneously.A prosthetic hand with high accuracy and robustness are necessary to improve the life quality of forearm amputees. The application of sEMG signals to control a prosthetic hand is challenging. The authors of one of the articles have proposed a time-domain Convolutional Neural Network (CNN) model for the regression prediction of joint angles in three degrees of freedom (DoFs) and 5-fold cross-validation was used to evaluate the correlation coefficient. The 3DOFs includes two wrist joint motion and one finger joint motion. In this study, CNN models were developed using combined EEG–EMG inputs to determine if they have potential as a method of EEG–EMG fusion that automatically extracts relevant information from both signals simultaneously. EEG and EMG signals were recorded during elbow flexion-extension and used to develop CNN models based on time-frequency and time-domain image inputs.It is very important to have a natural, stable, and comfortable human-computer interface for controlling rehabilitation assistance robots to solve problems of patients who have lost limb control ability, such as upper limb amputation and high paraplegia. One article presents a complete limbs-free face-computer interface framework based on facial electromyography including offline analysis and online control of mechanical equipment.One of the studies covered in this Research Topic explored the accuracy of the Brain-Computer-Interface (BCI) and event-related desynchronization between the two tasks. The articles identified the promise and the challenges faced by the field of assistive and rehabilitation robotic technologies and identified the critical need for additional prospective, in the design and control of relevant robots. Another article demonstrated a new wearable robotic hand exoskeleton with multi joints, higher degrees of freedom, and a larger range of motion. The exoskeleton hand comprises six linear actuators and can realize both independent movements of each digit and coordinative movement involving multiple fingers for grasp and pinch. The kinematic parameters of the hand exoskeleton were analyzed by using a motion capture system.EMG/EEG Signals-Based Control of Assistive and Rehabilitation Robots. All articles underlined both the promise and the challenges faced by the field of assistive and rehabilitation robots. The articles further recognized the need for additional perspective, in the control of these robotic devices. In summary, all the articles presented in the Research Topic have set a new trend in EMG/EEG Signals-Based Control of Assistive and Rehabilitation Robots.This Research Topic provides a snapshot of the current status of research on the All authors listed have made a substantial, direct, and intellectual contribution to the work and approved it for publication.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


This Supplement offers four articles addressing current challenges in the management of serious bacterial infections. In the opening article, Mark Wilcox and Matthew Dryden provide an overview of the epidemiology of healthcare-acquired bacterial infections in acute and long-term care facilities. Particular focus is given to assessing the healthcare burden of complicated skin and soft tissue infections (SSTIs) including surgical site infections. The epidemiology and general management of SSTIs is discussed and sets the scene for Christian Eckmann and Paul Tulkens, who review treatment options for SSTIs including a detailed assessment of delafloxacin and the long-acting lipoglycopeptide agents, dalbavancin and oritavancin. Valuable insights are provided into the consequences of under- and over-treatment, economic considerations, and the goal of combining effective treatment with optimal antimicrobial stewardship.The remainder of this Supplement offers a timely review of treatment strategies for multidrug-resistant Gram-negative bacteria. Matteo Bassetti and Javier Garau assess the burden of such infections and outline treatment options for a range of infection types. They discuss in detail the efficacy of old and new antimicrobials and offer a glimpse into the antibiotic pipeline to assess the potential of future treatments. The importance of local epidemiology and rapid diagnostics is also considered. Emilio Bouza continues this theme and focuses on carbapenems combined with β-lactamase inhibitors. An in-depth assessment of meropenem/vaborbactam is provided that covers pre-clinical and clinical trials as well as ‘real world’ outcomes for clinically challenging cases and/or extensively drug-resistant bacteria.The Supplement provides a valuable overview of the increasingly complex antibiotic-resistant bacteria in circulation and therapeutic options for the common infections they cause.


This paper presents findings from a University and Community-based Agency collaboration to design and implement a preliminary evaluation of the Elder Abuse Multidisciplinary Team (E-MDT) Intervention. This intervention brings professionals from a variety of fields to investigate and respond to elder abuse. Data from 22 Interviews with staff along with anonymous survey data from E-MDT team members/staff (n=312) sought to establish team successes, challenges in implementation, and ongoing functioning. Themes that emerged in creating successful teams include: Establishing Buy-In and Trust of the team members, The Benefit of sharing experience and practical knowledge with other program sites; and Recognizing the Differences related to Onboarding and Sustaining New programs versus Sustaining Existing Programs. Themes related to responding during COVID revealed challenges such as Adapting to Technology and Inconsistent Access to the Internet. It was noted that remote meetings were easier to attend than face-to-face meetings. Data from the survey found the vast majority of respondents view the E-MDTs as having a positive impact on Clients (93%); while 93% of respondents indicated a positive impact on their Approach to Practice and the service area of their agency. Approximately 80% of the respondents indicated their multidisciplinary teams were Effective. Responses to 3-Open Ended questions included in the survey echoed similar themes from the interviews, as well as comments about their Professional Development and the complexity of responding to elder abuse. The paper will close with a discussion of the strategies used to facilitate the collaboration and complete the evaluation during the COVID-19 pandemic.


Scientific Reports 10.1038/s41598-021-92543-y, published online 23 June 2021Correction to: The original version of this Article contained an error in the Abstract and in the Results section where the beta symbol did not display correctly.This error has now been corrected in the PDF version of the Article; the HTML version was correct from the time of publication.


As widely used instruments to identify risk factors and lay out preliminary plans of how to improve the built environment, home assessment tools play an important role in the process of modifying homes for older adults. Developed by a variety of disciplines and tailored to meet various needs, home assessment tools focus on features in homes and how they meet or hinder an older person’s ability to accomplish tasks — in other words, person-environment fit. Based on a comprehensive review of ten evidence-based home assessment tools identified by researchers at the USC Leonard Davis School of Gerontology and the National Council on Aging, we found that a common assessment strategy is the use of multidisciplinary teams (MDTs) in developing and testing the assessment tools to ensure the reliability vs validity of different home modification programs. To understand the nature of MDT practice and derive a set of generalizable protocols for developing person-centered home assessment tools, we conducted a systematic analysis of the ten evidence-based home assessment tools and 41 peer-reviewed journal papers about how the tools were developed, used, and modified. In addition, we applied the RE-AIM framework  to examine the use of MDTs in developing the tools and carrying out the programs. Based on our analysis, we propose a set of preliminary protocols for developing home assessment tools and a logic model for conducting person-centered home modification programs.


The current study examines the unique impacts of the ongoing COVID-19 Pandemic on the well-being of middle aged to older women from the 2020 Health and Retirement Study (n = 1252) and how their reports of social contact during the pandemic compare to age-matched women from 2018 (n = 2063). Although up to a third of women across age categories reported changes in social contact due to the pandemic, their rates of communication with friends and family were not significantly different from their counterparts in 2018. Results find expected age patterns in satisfaction with life during the pandemic), where the young-old report the highest levels. However, the association of life satisfaction with the extent to which women reported more loneliness during the pandemic was only significant among the young old and oldest old. Age differences in pandemic-specific experiences in relation to well-being are discussed within a life course developmental framework.


The University of Botswana Public Health Medicine Unit has made significant contributions to the national preparedness and response to COVID-19. The program alumni and Public Health Medicine residents have and continue to provide key technical support to the Ministry of Health and Wellness across the major pillars of COVID-19. This includes key roles in national and subnational coordination and planning, surveillance, case investigations and rapid response teams, points of entry, travel and transportation, infection prevention and control and case management. The unit is thus supporting the country in achieving the World Health Organization (WHO) primary objective of limiting human-to-human transmission, optimal care of the affected and maintaining essential services during the outbreak. The Public Health Medicine Unit has played a key role in capacity building including early rapid COVID-19 training of healthcare workers across the country. Furthermore faculty members and residents are involved in several COVID-19 research projects and collaborations.COVID-19 was declared a Public Health Emergency of International Concern (PHEIC) in January 2020 and a pandemic in March 2020. Botswana reported its first case on 30 A national task force was set up to coordinate the national response. The Ministry of Health and Wellness (MOHW) initially conducted risk assessments of all the district health teams which then informed the response . The couThe Public Health Medicine (PHM) unit is part of the department of Family Medicine and Public Health in the Faculty of Medicine (FOM) at the University of Botswana (UB) with a mandate to train public health physicians through a 4-year residency programme, Master of Medicine (MMed) Public Health Medicine. Its involvement in the national preparedness and response began even before the first cases of COVID-19 were reported in Botswana and it continues to play a key role as the epidemic evolves. WHO under the International Health Regulations requests partners to support state members to achieve the objectives of a coordinated response . The UniTechnical Support for Ministry of Health and Wellness (MOHW): from the onset of the epidemic, the PHM suspended formal didactic teaching and availed its trainees to the national response at national and sub-national levels. Alumni and residents of the programme all played important roles in the overall national coordination including among others, i) analysis of data and preparation of daily situational reports ii) residents played key roles within the national contact tracing, case management teams and testing and management of suspects at points of entry; iii) assessing and repurposing educational facilities for COVID-19 isolation and iv) substantial ongoing support to Greater Gaborone zone through case investigation, case management and testing. Residents' led case investigation teams played key roles in case mapping and identification of chains of transmission. More recently, the unit has had residents being part of the teams which assessed the capacity of the country's points of entry to handle a Public Health Emergency of International Concern.Capacity building: the PHM has worked with MOHW to train healthcare workers in the districts. The unit has excellent relationships with the two mining hospitals in Botswana namely Jwaneng Mine Hospital and Orapa Mine Hospital. The hospitals leveraged on this relationship and requested the unit to train staff in the mining districts. Faculty members and residents conducted training on key COVID-19 topics including surveillance, infection prevention and control, case management and laboratory preparedness and response. Residents and staff also joined the Ministry of Health and Wellness teams in training other districts across the country. Much of this training was done even before the country reported its first case. Additionally, the unit was heavily involved in the weekly national virtual COVID-19 CME sessions. These sessions were organized by MOHW and were supported by local partners. The target audience was doctors and other healthcare workers both in the public and private sector. Public Health Medicine residents made key presentations including infection prevention and control and contact tracing. Furthermore, public health medicine residents supported greater Gaborone in training staff at local private hospitals on COVID-19 and technical support during outbreak investigation at one of the hospitals.Research: the PHM unit is amongst the leaders in COVID-19 research in Botswana. Members are working with MOHW colleagues on the first few cases and contacts (FFX) investigation aimed at describing the clinical presentation and course of COVID-19, and estimating secondary infection and case fatality rates in Botswana. Faculty members and residents are also leading studies investigating the mental health impact of COVID-19 on healthcare workers. The aim of these studies is to determine the magnitude of stress, anxiety and depression among health care workers in the country, and also to shed light upon the protective and risk factors. The findings are expected to help guide interventions that could enable mitigation of mental health challenges during the COVID-19 pandemic in Botswana. Moreover, current literature on COVID-19 and health care workers mental health issues will be augmented. Public Health Medicine Residents are leading COVID-19 outbreak investigations in hospitals including infection prevention and control audits. This includes an outbreak investigation in the largest referral hospital in the country's public health system. This investigation included review of the hospital case reports and an assessment and audit of the hospital structures and processes with the aim of describing the cases in terms of person, place and time, identifying possible sources of infection and factors associated with continued transmission. Furthermore, the weekly journal clubs hosted in the Unit have strongly focused on COVID-19 research in recent months facilitating the sharing of up-to-date COVID-19 information. Undergraduate medical students have been participating in these journal clubs which has allowed faculty members and residents to directly share expertise with them.Safe campus and safe workplaces: when initial restrictions of extreme social distancing were lifted and people returned to work, the PHM unit developed guidelines for safe return to work including guidance on development of workplace preparedness and response plans. These would facilitate implementation of infection and control measures, allow prompt isolation of suspects and enforce effective workplace controls. The unit also led the development of the university´s COVID-19 preparedness procedures and protocols and provided technical advice to the faculty on preventing workplace transmission of COVID-19.The University of Botswana Public Health Medicine Unit under the Department of Family Medicine and Public Health in the Faculty of Medicine has made significant contributions to the Botswana national COVID-19 preparedness and response. Through active involvement in all the pillars described above, the unit has significantly contributed to minimizing importation of cases, prevention of human-to-human transmission and maintaining essential services.


In the originally published version of this manuscript, there was an error in the title. The title should read: ``Variation in financial protection and its association with health expenditure indicators: an analysis of low- and middle-income countries'', instead of: ``Variation in financial protection and it association with health expenditure indicators: an analysis of low- and middle-income countries''. This error has been corrected online and in print.


Irregular sleep-wake patterns are common in persons living with dementia (PLWD), pose a great burden to caregivers, and are the principal causes of distress and institutionalization of PLWD. A growing body of research supports the importance of activity-based interventions to reduce the frequency and intensity of sleep wake disruption, reduce neuropsychiatric symptoms, and improve quality of life. To date, there are no studies linking sleep disruption and well-being with the nature and timing of activity. This session focuses on lessons learned from the Healthy Patterns Study - a randomized trial of a home-based activity intervention in 200 dyads of PLWD and their caregivers (NCT03682185). Session 1 focuses on the main findings from the clinical trial. Session 2 focuses on the cultural adaptation of the timed activity protocol to improve quality of life (QOL), improve sleep and reduce neuropsychiatric symptoms in older Latinos Session 3 describes the community outreach efforts used over a one-year period to recruit a diverse sample of PLWD and their caregivers for the Healthy Patterns trial. Session 4 examine the relationship between caregiver mastery and neuropsychiatric symptoms in PLWD. Together these findings highlight the complex role of sleep and wake activity in promoting well-being in persons with dementia.


The Editor-in-Chief has retracted this article because after publication concerns were raised regarding multiple errors in the description of the methods and reagents, most notably primer sequences in Table 1. The authors did not provide the methods and the references sequences used to design the primers upon request. Furthermore, errors in the language throughout the text are potentially misleading to the reader. The Editor-in-Chief therefore no longer has confidence in the reliability of the work presented. None of the authors have responded to any correspondence from the editor about this retraction.supplementary informationFormer article version


In contrast, the AVN increased between-side differences in the sagittal IA (p = 0.01), and sagittal and frontal RCIA during DLS (p < 0.04), leading to bilaterally asymmetrical balance control. Secondary AVN significantly reduced IA and RCIA in the sagittal plane (p < 0.05), and reduced range of RCIA in the frontal plane during initial DLS (p < 0.05). The trend reversed during terminal DLS, indicating a conservative COM-COP control in the sagittal plane and a compromised control in the frontal plane during body weight acceptance, with a compromised COM-COP control in the frontal plane during weight release. The current results suggest that increased between-side differences in the sagittal IA, and sagittal and frontal RCIA during DLS are a sign of AVN secondary to treated unilateral DDH in female juveniles, and should be monitored regularly for early identification of the disease.Avascular necrosis of the hip (AVN) is one of the most severe complications of surgical reduction when treating developmental dysplasia of the hip (DDH). The current study identified the differences in the balance control during walking in terms of the inclination angle (IA) of the center of pressure (COP) to the center of mass (COM), and the rate of change of IA (RCIA) between female juveniles with and without secondary AVN at the hip who were treated for unilateral DDH during toddlerhood as compared to their healthy peers. When compared to female healthy controls, the non-AVN group showed bilaterally similar compromised balance control with significantly decreased IA ( Developmental dysplasia of the hip (DDH) is an abnormal development of the femoral head resulting in subluxation or dislocation of the hip in about 0.1–1% of the newborn population . Early tPrevious gait studies on people with treated DDH have focused mainly on the residual gait deviations . AdolescThe body’s dynamic balance control during gait can be evaluated in terms of the motions of the body’s center of mass (COM) in relation to the center of pressure (COP) of the ground reaction forces (GRF) . A commoThe purpose of the current study was to identify the alterations of the whole-body balance control during walking in terms of IA and RCIA in juveniles with treated unilateral DDH who developed secondary AVN at the treated hip and those who did not develop AVN as compared to their healthy peers. It was hypothesized that children with treated DDH, whether with or without secondary AVN, would show altered balance control with increased IA but decreased RCIA during walking when compared to female healthy controls, and that patients with AVN would show a reduced bilateral symmetry in balance control compared to those without AVN.Twenty-four female juvenile patients who had undergone Pemberton’s osteotomy for treating unilateral DDH during toddlerhood participated in the current study. Written informed assents were obtained from the participants as well as from their parents or guardians, as approved by the Institutional Review Board. The patients were divided into two groups: twelve patients in the AVN group  and twelve patients in the non-AVN group  according to the osteonecrosis diagnosis and classification described by Kalamchi and MacEwen . In the In a university hospital gait laboratory, each subject walked at the preferred walking speed on a 10-m walkway while wearing 49 retro-reflective markers to track the motions of the body segments . The marx-axis directed anteriorly, the positive y-axis superiorly and the positive z-axis to the right. An optimization-based method, which has been shown to have better performance than traditional prediction methods . An a priori power analysis using G*POWER  and toe-off (TO), the ranges and time-averages of the IA and RCIA during single-limb support (SLS), initial double-limb support (DLS) and terminal DLS, as well as the peak values of IA and RCIA during DLS, were obtained for each trial and for each subject. Note that initial DLS of one limb is the terminal DLS of the other limb. Data of a total of six trials were averaged for each of the variables, and the differences among non-AVN, AVN and control groups were analyzed using one-way analysis of variance (ANOVA). Once a significant main effect was found, the pair-wise differences were identified  G*POWER  based onNo significant differences were found in any of the spatiotemporal parameters between the non-AVN and Control groups, nor between the AVN and non-AVN groups . HoweverIn the sagittal plane, compared to Control, the non-AVN group showed significantly decreased average IA but significantly increased range of RCIA during SLS of the unaffected side, while the AVN group showed significantly increased average IA during terminal DLS of the affected side . Compared to non-AVN, the AVN group showed significantly decreased RCIA at toe-off, as well as significantly decreased range of RCIA during SLS of the unaffected side, but significantly increased average IA during terminal DLS of the affected side , 3 Figu.In the frontal plane, compared to Control, the non-AVN group showed significantly decreased average IA but significantly increased peak value of RCIA during terminal DLS of the affected side, while the AVN group showed significantly decreased RCIA at toe-off but increased range of RCIA during SLS of the unaffected side. Compared to non-AVN, the AVN group showed significantly decreased RCIA at toe-off and significantly decreased range of RCIA during SLS of the unaffected side , 5 Figu.Compared to the unaffected side, the affected side of the AVN group showed significantly decreased average IA, as well as significantly decreased RCIA at toe-off, peak value of RCIA and range of RCIA during initial DLS in the sagittal plane, but significantly increased RCIA at toe-off and significantly decreased range of RCIA during initial DLS in the frontal plane . No signThe current study aimed to identify the alterations of the whole-body balance control during walking in terms of IA and RCIA of COM relative to COP in juveniles who developed secondary AVN at the hip after treatment for DDH during toddlerhood and those without developing AVN as compared to their healthy peers. When compared to female healthy controls, the non-AVN group showed bilaterally similar compromised balance control with significantly decreased IA but increased RCIA in the sagittal plane during SLS of the unaffected side, and in the frontal plane during terminal DLS of the affected side . In contrast, the secondary AVN increased between-side differences in the sagittal IA and sagittal and frontal RCIA during DLS, leading to altered, bilaterally different balance control in the AVN group. This group showed significantly increased IA but decreased RCIA in the sagittal plane during terminal DLS of the affected side and in the frontal plane during SLS of the unaffected side compared to female healthy controls. Comparisons between the AVN and non-AVN groups showed that AVN secondary to unilateral DDH treatment increased sagittal IA during terminal DLS of the affected side and reduced both the sagittal and frontal RCIA during SLS of the unaffected side. The current results suggest that apart from routine assessment of the morphological changes of the affected hip, it is essential to monitor for any signs of decreased gait speed and cadence or increased between-side differences in the sagittal IA, and sagittal and frontal RCIA during DLS for early identification of AVN subsequent to unilateral DDH osteotomy in juveniles.via compensatory changes.Juveniles without secondary AVN walked with compromised, bilaterally similar balance control showing reduced IA and increased RCIA in the sagittal plane during SLS of the unaffected side, and in the frontal plane during terminal DLS of the affected side at normal gait speed, cadence, stride length, step length and step width. When supported only by the unaffected limb, the COM moved anteriorly at an increased speed while the COP was controlled within a relatively small range, suggesting a compromised velocity control of the COM-COP motion in the sagittal plane. During DLS, on the other hand, the COP moved towards the leading limb during weight transfer; thus, an increased RCIA during terminal DLS of the affected limb indicated a faster weight release to the unaffected side. These changes of the COM-COP control appeared to be a compensation for residual deficits of the hip such as muscle weakness, limited range of motion and modified mechanical properties of the surgically reduced joint . ReducedThe development of AVN secondary to the unilateral DDH treatment degraded or destroyed the hip biomechanics reconstructed by the osteotomy, increasing the difficulties in maintaining balance for the affected limb and in providing compensatory adjustments by the unaffected limb necessary for symmetrical balance control. In the sagittal plane, the juveniles with secondary AVN walked with increased IA but reduced RCIA during terminal DLS of the affected limb, indicating a compromised COM-COP control during weight release to the leading unaffected limb at a reduced speed. A plausible reason for this phenomenon is that AVN of the femoral head affects the biomechanics of the hip joint and the surrounding muscles, reducing the unresisted range of motion of the joint and the ability for generating power necessary for body-weight transfer from the trailing limb (affected side) to the leading limb (unaffected side). Reduced speed in weight transfer to the leading limb as a result of reduced forward propulsion of the affected trailing limb during terminal DLS further affects the balance control with reduced frontal RCIA during the subsequent SLS of the unaffected side.In the frontal plane, the patients with AVN also showed a compromised COM-COP control with increased IA but reduced RCIA during SLS of the unaffected limb. During this period the control of the COM motion relative to the COP vector can be considered as an inverted pendulum with the COP controlled within a small range. However, the COM moved beyond the unaffected foot while the affected limb swung from the trailing to the leading position. With the increased IA an increase in the corresponding RCIA would be needed for stable balance control . The patThe non-AVN group walked with similar COM-COP balance control strategies between affected and unaffected side, while those for the AVN group were bilaterally different mainly in the sagittal IA, and sagittal and frontal RCIA during DLS. Secondary AVN significantly reduced IA and RCIA in the sagittal plane, and reduced the range of RCIA in the frontal plane during initial DLS, with a reversed trend during terminal DLS as the trailing limb became the leading limb. These results indicate a conservative COM-COP control in the sagittal plane and a compromised control in the frontal plane during body-weight transfer to the leading affected limb, and a compromised COM-COP control in the frontal plane during weight release to the unaffected limb. These strategies were most likely related to the altered biomechanical conditions of the affected hip, including the changes in the shape and orientation of the femoral head and the neck-shaft angle, as well as the lines of action and lever-arm lengths of the surrounding muscles . TherefoThe current study was the first to identify the effects of AVN secondary to surgically treated unilateral DDH on the whole-body balance control and bilateral asymmetry of such control during walking in terms of IA and RCIA in juveniles. The bilateral asymmetry as a result of secondary AVN was found to occur mainly in the sagittal IA, and sagittal and frontal RCIA during DLS, while the COM-COP control remained symmetrical during SLS. A recent study showed that the loading rates on both the affected and unaffected sides were strongly correlated to the morphology of both the affected and unaffected hips . TherefoWithout secondary AVN, female juveniles who were treated for unilateral DDH during toddlerhood walked with bilaterally similar compromised balance control, showing significantly decreased IA but increased RCIA in the sagittal plane during SLS of the unaffected side, and in the frontal plane during terminal DLS of the affected side. Secondary AVN significantly reduced IA and RCIA in the sagittal plane, and reduced range of RCIA in the frontal plane during initial DLS, with a reversal during terminal DLS, indicating a conservative COM-COP control in the sagittal plane and a compromised control in the frontal plane during body-weight acceptance, and a compromised COM-COP control in the frontal plane during weight release. These strategies were most likely related to the altered biomechanical conditions of the affected hip, including the changes in the shape and orientation of the femoral head and the neck-shaft angle, as well as the lines of action and lever-arm lengths of the surrounding muscles. The current results suggest that increased between-side differences in the sagittal IA, and sagittal and frontal RCIA during DLS of level walking are a sign of AVN secondary to unilateral DDH osteotomy in female juveniles. These differences should be monitored for early identification of AVN secondary to treated unilateral DDH in this patient population.


The ongoing COVID-19 pandemic and subsequent economic recession have wreaked havoc on the United States’ economy and brought to the forefront stark racial and ethnic inequalities in our society. Older Black and Latinx adults are particularly hard hit by the pandemic as they have relatively lower levels of income and wealth to protect against crises. This study used data from the 2020 COVID-19 module of the Health and Retirement Study, to highlight how the COVID-19 pandemic has economically impacted older Black, U.S.-born Latinx and foreign-born Latinx adults. Results show the pandemic has economically devastated older Black and Latinx adults across a host of economic factors, with foreign-born Latinx experiencing greater economic hardships relative to other groups. Our findings document stark inequalities that are being exacerbated by the pandemic. We discuss the implications of the economic shocks of the pandemic for the health and well-being of older Black and Latinx adults.


This vesicular trafficking flows along highly organized, balanced and directional routes from the ER toward the Golgi apparatus and cell surface or toward lysosomes (the biosynthetic-secretory pathway) and from the plasma membrane to early endosomes and recycle them back to the surface to be reused or sort them to degradation , nucleotides, lipids, and short peptides to monitor the close environment  is a constituent of hepatocyte-generated EVs. Using FN1 knock-out cells, the authors characterize the role of FN1 hepatocyte-EVs. FN1 facilitates the integrin-dependent EV binding and EV uptake by endocytosis of target cells such as hepatocytes and hepatic stellate cells (HSC) but is dispensable for EV-mediated anti-fibrotic activity in vivo. A fascinating role in the use of EVs in the improvement of therapy strategy for the type 1 dyabete mellitus (T1DM) is highlighted by the work of Bai et al. The authors improved a previously characterized protocol for beta cell generation from iPSCs using miR-212/132-enriched EVs secreted by beta cells. Functional analysis defined the role of the miRNAs 212 and 132 in the regulation of target mRNAs important to promote differentiation of endocrine cells from induced iPSCs. Importantly, the generated beta cells from miR-212/132-enriched EVs are also able to secrete insulin under glucose stimulation and ameliorated hyperglycemia in vivo. All together these original works support the importance of the application of EVs both in physiology and pathological contexts due to their pivotal roles in cross-talk intercellular communication. Accordingly, Bergamelli et al. investigated the expression of surface markers of placental EVs after optimization of their isolation from a histoculture model of first trimester placental explants in normal conditions and after human cytomegalovirus (hCMV) infection. The authors found that a number of molecules changed in the surface of EVs after infection. This paper paves the way for downstream functional characterization of these non-invasive biomarkers that could be relevant for the outcome of the viral infection during pregnancy.In a multi-omics study of cell-to-cell communication, Finetti et al. brings to light to the identification of the intraflagellar transport protein IFT20 as a new regulator of the autophagic system. In particular, the authors found that IFT20 plays a direct role in autophagy as an adaptor that targets ATG16L1 and downstream autophagy regulators to a specific endomembrane compartment, resulting in autophagosome biogenesis. This discovery confers a new role for IFT20 in T cells beyond its implication in lysosome biogenesis, as recently demonstrated from the same group. In the original article submitted by Wen et al., another new player well-known for vesicular transport, the Golgi brefeldin A resistant guanine nucleotide exchange factor 1 (GBF1) protein, was also identified to play a role in autophagy in bone-resorbing osteoclasts (OCs). In particular, the authors show that the GBF1 inhibition impairs not only in vitro differentiation of osteoclasts but also causes ER stress and autophagy through alterations of different signaling molecules. Bodakuntla et al. summarize the crucial role of two important structural components of the vesicular trafficking (cytoskeleton and membranes) in axonal branches in which the local machinery dynamically controls and regulates the axonal growth to ensure a high degree of interconnectivity for neural network. The dysfunction of the endosomal-lysosomal system is nicely illustrated in the context of atherosclerosis, a disease whose etiology and pathogenesis are strictly dependent from defective lysosome functions. The review of Marques et al. fully describes the origin and impact of the malfunctioning of lysosomes in plaque cells in cardiovascular diseases. Moreover, they also reviewed the field of Lysosomal Storage Diseases (LSDs) research to point up how therapeutic approaches that target lysosomes in LSDs might hamper atherosclerosis progression and its high associated mortality.The main form of intracellular communication occurs through the trafficking of vesicles between several compartments, as exemplified by the endosomal-lysosomal system. Interestingly, the latter intersects the autophagic system thus increasing the complexity of the cross-talks between these cellular processes. Unraveling these pathways, the original article by Notwithstanding the continuous growth within the field of vesicles in cell communication, many unanswered questions remain that hold still several future perspectives. For example, what are the biological implications and functions of the extra- and intracellular vesicles size diversity? How can we generate a more comprehensive understanding of the molecular machinery and events of protein trafficking? Does the variety of vesicles produced or released by a defined cell type change over time? How do vesicles are spatiotemporally coordinated? How can modulate vesicle targeting to improve therapeutic strategies? These are important future challenges that we hope will bring light to our understanding of new functional and structural properties of cell communication through vesicles with a significant impact not only on translational medicine but also on more general fields, such as cell biology, virology and immunology.We would like to thank the authors and reviewers for their substantial contribution in participating on this Research Topic. Altogether, these studies significantly improve our knowledge on cellular communication and we hope they could encourage the birth of future works in this field to provide an ever better understanding on how the communication in-and-out of the cells occurs and how its dysregulation may be affected in disease.AO conceived and wrote the Editorial. AC reviewed and edited the manuscript. All authors contributed to the article and approved the submitted version.The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article, or claim that may be made by its manufacturer, is not guaranteed or endorsed by the publisher.


The workforce in residential long-term care (LTC) is key in providing high-quality, person-centered care for residents. However, low staffing and adverse staffing outcomes such as turnover or job dissatisfaction hinder the provision of high-quality care. International research can add valuable insights for policy and practice by learning from different settings and cultures. The initiative “To Harmonize Research In long-term care liVing Environments (WE-THRIVE)”, is led by an international group of LTC researchers to identify common data elements (CDE) for cross-comparative research that support older adults thriving in LTC. In this symposium, we will present an overview of the WE-THRIVE initiative with a specific focus on CDEs and measurement. The first talk will provide the context for the WE-THRIVE initiative, and discuss the collaborative and iterative processes required to develop the initial CDEs in the area of workforce and staffing. In the second talk, we will discuss which staff should be “in the house” to meet the needs of residents during and after a pandemic, and what type of workforce data system should be available to ensure the best quality outcomes for residents and carers. Next, current issues in the measurement of staffing in LTC based on a review of reviews of staffing’s relationship to quality of care will be discussed. Finally, we extend the debate to consider theoretical and empirical explanations for the relationship between staffing and quality in LTC and the promotion of person-centred care outcomes.


Understanding patterns in the types of activities older adults engage in during physical activity and sedentary time could help shape intervention designs. Few studies have adequately described the physical activity and sedentary pursuits older adults undertake, including during the COVID-19 pandemic. To answer these questions, this symposium uses data from three recent studies: Adult Changes in Thought (ACT),an epidemiologic study with self-reported and device-based measures of physical activity and sedentary time including time spent in various domains of activity; Objective Physical Activity and Cardiovascular Disease Health in Older Women (OPACH), an epidemiologic study with device and self-report measures of sedentary behavior; and an ongoing clinical trial, the Healthy Aging Resources to Thrive (HART) study with device and self-reported data on sitting time and patterns as well as physical activity. The first session in this symposium will present a description of the rates of meeting the aerobic, strength, and balance recommendations among older adults in the ACT study. Next, we will have a presentation describing sedentary activities in older adults by age, sex and device-based sitting patterns in the ACT study. In the third presentation we will use OPACH data to examine patterns and context of sedentary in relation to aging-related outcomes. Finally, we will describe changes in physical activity and sedentary time in the HART trial in the cohort enrolled prior to the COVID-19 pandemic vs. those enrolled during the pandemic. Our Discussant will provide new insights on the roles of sedentary behavior and physical activity in aging and health.


Due to the small Huang–Rhys factor, the GeV−-center zero-phonon line emission is expected to be very intensive and spectrally narrow. However, structural defects and the inhomogeneous distribution of local strains in the nanodiamonds result in the essential broadening of the ZPL. Therefore, clarification and elimination of the reasons for the broadening of the GeV− center ZPL is an important problem. We report on the effect of reactive ion etching in oxygen plasma on the structure and luminescence properties of nanodiamonds grown by hot filament chemical vapor deposition. Emission of GeV− color centers ensembles at about 602 nm in as-grown and etched nanodiamonds is probed using micro-photoluminescence and micro-Raman spectroscopy at room and liquid nitrogen temperature. We show that the etching removes the nanodiamond surface sp2-induced defects resulting in a reduction in the broad luminescence background and a narrowing of the diamond Raman band. The zero-phonon luminescence band of the ensemble of the GeV− centers is a superposition of narrow lines originated most likely from the GeV− center sub-ensembles under different uniaxial local strain conditions.The negatively charged germanium-vacancy GeV In ZPL 11 direct− centers in the NDs, hydrostatic-type pressure results in a blue shift of the ZPL. In contrast, uniaxial strain causes a larger redshift with different magnitudes depending on the direction of the strain [− centers, having the same structure as SiV− centers. Comparative analysis of the ZPL spectra in − centers is significantly more likely than a blue-shift. We believe that analogously to the SiV− case in HFCVD NDs, the distribution of uniaxial strains induces the shifts of ZPLs of sub-ensembles of GeV− centers. A blue-shift of the ZPL in the spectrum in The main mechanisms that lead to the color center wavelength shift are hydrostatic pressure and uniaxial strain. It was found by Lindner et al. that for SiVe strain . The sam− centers. The NDs with GeV− color centers were produced by the hot filament chemical vapor deposition (HFCVD) technique on silicon followed by reactive ion etching in oxygen plasma. We showed that the reactive ion etching in oxygen reduces the number of structural defects localized in the surface area of the NDs; this resulted in the Raman line of diamond narrowing to 5.5 cm−1 and increased the luminescence intensity, corresponding to neutral nitrogen-vacancy color center NV0. The cooling of the samples to the liquid nitrogen temperature enables us to observe the fine structure of the inhomogeneously broadened ZPL of ensembles of the GeV− centers in the strained nanodiamonds, using the high-resolution micro-photoluminescence technique. The origin of inhomogeneous broadening of the ZPL is speculated to be due to the fact that the observed ZPL spectra of the GeV− are overlapped with ZPLs of color center sub-ensembles under different strain conditions. At the same time, the color centers belonging to the one sub-ensemble experience practically the same local strain field. The strain response of ZPL spectra of the ensembles of GeV− at T = 80 K and its analysis provides a way to image the strain distribution in CVD nanodiamonds optically.We realized a top-down method to fabricate NDs with embedded GeV


Drama therapy is a widely acknowledged way to explore life-stories in late life. This presentation will describe a new model for creative interventions, based on the results of four studies that provide multiple perspectives on the integration of life-review and drama therapy for community dwelling older adults. The results of two quantitative studies  suggest that the drama therapy interventions have robust therapeutic potential to enhance mental health while aging. The findings of two qualitative studies with therapists (n=8), participants  and staff (n=13) provide a better understanding of the process, and support the mechanisms that lead to positive effects on mental health. Combining the results yielded a multidimensional model which points to three potential transformative routes: the evolution of the life-story, the evolution of improvised dramatic expression, and the expansion of social engagement.


The University of Massachusetts 5-campus system was the first university system to receive the Age-Friendly University designation in the AFU Global Network . Simultaneously, the town of Dartmouth and city of New Bedford became Age-Friendly Communities. This allowed for dynamic collaboration between our university and communities. This presentation highlights several examples. The Ora M. DeJesus Gerontology Center faculty and student researchers developed the original age-friendly survey items for New Bedford’s initial community assessment; and the College of Nursing and Health Sciences faculty and student researchers compiled data for Dartmouth’s survey. Community service during the pandemic has flourished. The Community Companions program, which matches students with community members in social need, went virtual. Nursing students and faculty have been on the frontline in the vaccination efforts in the town of Dartmouth. These partnerships will be presented as examples of potential opportunities for other age-friendly communities. Community-university partnerships are encouraged.


The global health system is facing a serious challenge after the recent outbreak of COVID-19 coronavirus infection which was first identified in Wuhan, China in November 2019 and declared as a pandemic in March 2020 by WHO. There is a wide consensus that this pandemic has negative psychosocial consequences as well as unforeseeable provision of mental health care services and just not on physical health alone. The aim of this research study is to determine the prevalence of psychological distress and to identify the sociodemographic variables with the main attributable factors associated with the psychological distress among healthcare workers and suggestions on how to reduce the impact on the mental health of healthcare workers during the COVID-19 pandemic in different regions of the world.We performed a cross-sectional study from September-November 2020. We used a self-administered survey tool which was distributed electronically to healthcare workers across the globe. The data were stored on an online database with password protected devices where survey responses were restricted to investigators exclusively.Data collected were: 1) Socio-demographic data ; 2) Psychological General Well-Being Index (PGWBI) questionnaire which contains 22 standardized items. This is a subjective assessment to score the degree of psychological well-being by focusing on 6 domains: depression; anxiety; positive-well-being; self-control; vitality and general health; 3) Subjective assessment from respondents of the main attributable factors causing psychological distress and suggested methods to help reduce the impact on mental health on health care workers.Majority out of the 217 respondents were from a younger age group; females and married/domestic partnership, mainly from Western Pacific Region, South East Asian and the African Region. More than half the respondents were moderate-severely psychologically distressed and the three main attributable factors causing psychological distress were: fear of family/friends contracting COVID-19 followed by lack of PPE and discomfort caused by wearing PPE for long hours. Respondents suggested that the distress would be reduced if: more resources were provided in hospital; protocols and guidelines were implemented and counselling facilities with recreational activities were available to frontline workers.This study showed that the COVID-19 pandemic has affected the mental health of healthcare workers and more support or strategies need to come in place to protect frontline workers at the time of crises.


LED (Light-Emitting Diode) presents advantages such as luminescence, reliability, durability compared with conventional lighting. It has been widely applied for life, healthcare, smart farm, industry, and lighting from indoor to the automotive headlamp. However, the LED is vulnerable to thermal damage originated from the high junction temperature, especially in high power applications. Hence, it requires precise qualification on the optical power and the junction temperature from the pilot line to secure reliability. In this study, the photo-thermal sensor is proposed by employing a sheet-type thermocouple composed of photo-absorbent metal film and thermocouple. This sensor aims low-cost qualification in pilot line for high-power luminous devices and optical monitoring of costly luminaire such as automobile LED headlamp. The sensor is designed to detect the increased temperature response of LED hot spots from the transferred thermal power and absorbed optical power. The temperature response of each sheet-type thermocouple is utilized as a signal output of the absorbed optical power and hot spot temperature based on the introduced sensor equation. The proposed thermal sensor is evaluated by comparing the experiment with the measured reference value from the integrating sphere and the attached thermocouple at a junction. The experiment result reveals 3% of the maximum error for the optical power of 645 mW. The LED has significantly been developed based on its advantages such as small volume, impact resistance, high reliability, long life, and low power consumption, and it became a remarkable measure for convenient use, energy-saving, and environmental protection. Recently, the high-power LED industry has widened its application from indoor lighting to the health care, display, architectural industry, and even automotive headlights; however, thermal reliability of high-power LED is required more than ever due to the high integration and miniaturization of the package. The optical power and the hot spot temperature of the LED must be qualified in the pilot line and tested robustly to secure the functions without failure. In terms of its optical performance, however, the total optical power must be increased with higher input power and integration of the light source, which results in instability of the thermal system and reduction in lifetime and lighting performance . Recent The hot spot temperature was also compared with an infrared thermal imaging camera measurement, but the result is still questionable due to the additional light loss on the phosphor layer, which can cause measuring error. Christensen and Zhao present a thermal network model integrated with a sub-model of a structure of LED in finite element to predict the die temperatures ,5. Cheng2 nanoparticles of average particle size with 10 nm to the adhesive layer as an enhancer of refractive index and light scattering additives to increase the luminous efficacy and luminous flux of the white-LED in the form of polymer matrix nanocomposites.The energy and optical efficiency of the lighting application using luminous devices also have been researched to enhance their advantages on green technology. Wang et al. investigate a design of aluminum nitride (AlN) based substrate for high-power LED to improve heat dissipation and its efficiency of multi-chip LED by taking advantage from hybrid substrate design, such as simple assembly on a printed circuit board, providing the subsidiary protection of ceramic and decrease of production cost . Lee et In this study, a new type of photo-thermal sensor is introduced, aiming low-cost qualification in pilot line for high-power luminous devices and optical monitoring of costly luminaire such as automobile LED headlamp, and a compact method of both optical power and temperature measurement is achieved by employing the photo-thermal sensor. The principle of the introduced photo-thermal sensor is based on photo-absorbent heat from the optical power of the luminous device. The photo-thermal sensor consists of a couple of sheet-type thermocouples which can measure the temperature increase from the transferred thermal energy and absorbed optical energy on the hot spot of the luminous devices. Because two sheet-type thermocouples are designed to have the same thermal property and different optical absorbance coefficients, measured temperature responses of each sensor provide temperature difference which contains information of actual optical energy term. This net temperature between two sheet-type thermocouples is utilized as an output of a photo-thermal sensor which can measure the optical power and estimate the actual hot spot temperature of the luminous device. The proposed measuring method is evaluated by the measured optical power using the commercial integrating sphere and the actual temperature of the LED hot spot from an attached thermocouple.The temperature measurement of the LED is significantly affected by the optical power absorption, and it leads to over-estimated temperature originated from additional thermal power input of the absorbed optical power. Eventually, the measurement error from light absorption makes it harder to manage the thermal system of the LEDs. To reduce the over-estimating error in indirect measurement and achieve the optical power measurement for the thermal management, the novel concept of the photo-thermal sensor is introduced with a couple of same sheet-type thermocouples that have a different light absorption coefficient each other. The difference of responses between two thermocouples is utilized as the sensor output of the photo-thermal sensor, which can present optical power history.The configuration of a photo-thermal sensor is depicted in As shown in The implementation of the photo-thermal sensor is based on the assumption that the sensor can be modeled as a lumped system accompanying the light absorption term. The dynamic thermal model with the lumped capacitance  is emploThe dimensional and thermal variables of the photo-thermal sensor are presented in The thermal model of a single thermocouple in Radiation term can be linearized by introducing characteristic temperature, As a result, the entire heat equation for a photo-thermal sensor is derived by subtracting Equation (6) from Equation (5) based on the assumption that two thermocouples have the same thermal properties and boundaries except for the light absorption coefficient as The three different experiments on the photo-thermal sensor were carried out to characterize the thermal behavior of each thermocouple and to evaluate the performance of its measurement on the optical power and the LED surface temperature. In In the sensor response test, as shown in As described in Equations (7) and (8), the introduced photo-thermal sensor employs thermal behavior of temperature response in thermocouple during the measurement, which is originated from the exchange of thermal energy between the sensor and the LED surface. The measurement of optical power is based on the difference in sensor response between thermocouples resulting from the difference in thermal input caused by the amount of light absorption only. The introduced photo-thermal sensor also shows a unique concave steady-state temperature distribution along with the sensor distance. As described in the derivation of the heat equation, it can be explained that the distribution is originated from the changes in thermal resistance (The evaluation of the proposed photo-thermal sensor was carried out based on the comparisons of the optical power measurement and the LED surface temperature estimation from a photo-thermal sensor with the pre-measured optical power and surface temperature result from an integrating sphere and attached thermocouple by the junction. As shown in In this study, the compact measurements of the LED optical power and the hot spot temperature of the LED are introduced by employing a photo-thermal sensor based on the photo-absorbent power of the thermocouple. For this purpose, a pair of sheet-type thermocouples are designed and fabricated to compose a photo-thermal sensor realizing real-time measurement with the simplified sensor equation and minimized ambient effect. The modeling of the sensor equation is established based on the lumped capacitance model of each sheet-type thermocouples with consideration of the view factor and additional optical power absorption term. The fabricated photo-thermal sensor was calibrated and evaluated by measuring the optical power and the surface temperature of the LED. From the results, the following achievements are obtained.First, the response of stepped input power shows high linearity with the regression  fashion .


In the current pandemic of COVID-19 affecting countries across the globe, there are wide variations on how each country is handling the crisis. World leadership, economic status of the country, health care infrastructure, established public health foundations and various other factors play a role in it. Hence it becomes imperative to understand how the current pandemic, the biggest public health crisis, was handled in the UAE from a public health perspective.The World Health Organization (WHO) has released recommendations on strategic preparedness and handling of the COVID-19 pandemic [The emergency response system of the UAE is managed by National Crisis and Emergency Management Authority (NCEMA) and the UAE government was vigilant in issuing the first alert of the new coronavirus outbreak, even before it was declared by WHO as a public health emergency of international concern .The UAE has a comprehensive, government-funded health service as well as private health facilities which delivers a high standard of health care to the population.During this pandemic, the entire health care system was prepared and alerted with protocols in place for efficient handling of the crisisRisk communication is a key factor during a pandemic and the UAE government executed a detailed awareness campaign that targeted different groups of the community and provided a daily update about the status of the disease locally and internationally. UAE adopted the mandatory use of face masks in March 2020 well ahead of the WHO recommending this policy . Smart tThe ALHOSN UAE app is the official integrated digital platform for COVID-19 tests in the UAE through which individuals can receive COVID-19 test results on their smartphones. Similarly, the StayHome app supported quarantine and isolation of patients .The coronavirus helpline was established by the Ministry of Health and Prevention (MoHAP), as well as a dedicated hotline for mental health counselling to respond to psychological concerns and anxiety of people during the pandemic .The government of the UAE made remarkable progress in testing for the SARS-CoV-2 virus and in the management of cases. Algorithms for segregation, isolation, and treatment were released to guide health care professionals in handling COVID-19 cases  has set up similar field hospitals at various locations and apart from these, a quarantine facility called Complex 3, with a capacity to quarantine 10000 patients was set up. The government vigorously worked to establish this in only 9 days .All these facilities followed rigid COVID -19 protocols in handling and management of cases.Circulars were released for all health care professionals and a series of training workshops were conducted to educate health care professionals about the disease diagnosis, reporting, and management to strengthen epidemiological surveillance and enhancing prompt reporting of all suspected COVID-19 cases to Abu Dhabi Public Health Centre (ADPHC). In addition, active surveillance was established to identify Severe Acute Respiratory Infections (SARI) admitted to different hospitals there are required to be tested for COVID-19  for COVID-19 inactivated vaccine in July 2020 by G42 Healthcare in collaboration with Sinopharm CNBG, Department of Health, Abu Dhabi and UAE Ministry of Health and Prevention. This is a vivid example of national initiatives to foster population health and to enhance the UAE's medical research and development capabilities . The vacSEHA plays a vital role in getting the residents vaccinated and it has vaccination centers established in various other Emirates for effective functioning and reach.The final priority work area for preparedness in dealing with this pandemic would be to develop all-of-society and business continuity plans. The UAE government is already leading the way in restarting business and announced a two-phase recovery plan to rebuild the economy . The twoThe United Arab Emirates, as of 27 December 2020, has a COVID- 19 cases recovery rate of almost 89% and has recorded 669 COVID-19 deaths since the epidemic began . The casThe UAE moves forward with successfully reopening the economy and addressing the newer challenges of the pandemic like the newer variants of the virus.The UAE government encourages research and development of newer technologies with regards to COVID-19 pandemic and aligned to the nation's objectives, G42 Healthcare introduced the LamPORE technology with strategic global partnerships that is now integral to the UAE national testing program .G42 Healthcare has implemented a COVID-19 virus genomic sequencing study aimed at monitoring the pattern of spread and evolution of the virus since the start of the pandemic. This sequencing will also identify the emergence of new strains. Studies have already been published from the UAE on genomic sequencing of COVID-19 virus which has contributed to the understanding of the global transmission network of SARS-CoV-2 .Thus, the UAE has been efficient and effective in handling the crisis of COVID-19. It continues to pioneer in health care and serves as a leading example in the Middle East in comprehensively protecting the population and responsibly reopening the economy.