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Background Adults with congenital heart disease (ACHD) are a vulnerable population. Routine vaccination is the only strategy to prevent a life-threatening infection. However, concerns on the cardiac safety and efficacy of COVID-19 vaccines have been raised. Aim To assess safety and efficacy of available COVID-19 vaccines in ACHD patients. Methods Data on COVID-19 infection and vaccines including booster doses and any suspected or confirmed adverse events were prospectively collected for all ACHD patients attending our tertiary centre from the beginning of the vaccination campaign (March 2021). A group of 75 healthy volunteers, matched per age and sex, was included for comparison. Antispike IgG titre was routinely obtained at the ACHD clinic. Patients' attitude towards COVID-19 was explored with a questionnaire. Results As of February 2022, 498 ACHD patients (36.7±16 years, 54% male,69% with moderate-complex defects, 48% with advanced physiological stage) were enrolled. Four hundred and sixty-one (92%) were fully vaccinated: the type of vaccine was Pfizer-BioNTech for 399 (86%) patients, Moderna for 20 (4%) and AstraZeneca for 26 (6%), 9 received a mixed vaccine regimen (2%). Forty-two (9%) had a history of previous COVID-19 infection and therefore received only one dose. Two-hundred and sixty-nine (58%) patients received a booster dose. Adverse events were mainly mild and transient. One patient complaining of chest pain following administration of mRNA-based vaccination was diagnosed with acute pericarditis, which made full remission after appropriate therapy. Two patients reported a non-specific increment of inflammatory markers. No other severe adverse events were reported. Thirty-seven (7%) refused COVID-19 vaccination being scared of potential cardiac/extra-cardiac adverse events. Among those not-vaccinated, 9 (24%) had a history of previous mild COVID-19 infection. IgG titre was measured in 243 patients at 1915 [835–5934] BAU/ml, which was significantly higher compared to controls (1196 [827–2048] BAU/ml, p=0.002). Three ACHD patients contracted COVID-19 infection after the first dose, while 65 (14%) fully vaccinated patients tested positive for COVID-19, all with mild to moderate symptoms. COVID-19 symptoms duration was significantly longer in case of infection before vaccination (10 [2.7–15] vs 3 [1.2–7], p=0.03). One Fontan patient was tested positive for COVID-19 twice, before and after COVID-19 vaccination, requiring hospitalization in both cases. Four hundred and seven patients completed the questionnaire: 128 (31%) declared to be scared of potential cardiac effects of the vaccine and that the discussion with the ACHD cardiologist was crucial to decide to undergo COVID-19 vaccination. Conclusions Our data provide real-world evidence on COVID-19 vaccines safety and efficacy in ACHD patients. Patients' education from the ACHD team may play a key role in vaccine acceptance in this vulnerable population. Funding Acknowledgement Type of funding sources: None.

L’ipotesi che provo ad argomentare in questo saggio è che Plotino abbia un certo rispetto per il venerando Parmenide, anche quello storico e non solo quello platonico, e che ciò si faccia evidente quando lo cita per sottolineare l’unità dell’intera tradizione filosofica greca. L’obiettivo è quindi dimostrare che 1) secondo Plotino il Parmenide storico è colui che dà fondamento logico alla postulazione di un principio al di là dell’essere; 2) nel confronto col Parmenide di Platone emerge che l’accuratezza del Parmenide storico è numerica e non dialettica; e 3) l’immagine suggerita in un testo neoplatonico tardo – cioè di Platone come una sorta di analogo dell’Uno – non fa che confermare una tendenza già plotiniana a pensare anche la filosofia presocratica come un momento necessario per lo sviluppo del sistema metafisico-causale neoplatonico.

To describe a feasibility pilot study for older adults that addresses the digital divide, unmet health care needs, and the 4Ms of Age-Friendly Health Systems via the emergency department (ED) follow-up home visits supported by telehealth.Data sources were a pre-implementation site survey and pilot phase individual-level patient data from six US Department of Veterans Affairs (VA) EDs.A pre-implementation survey assessed existing geriatric ED processes. In the pilot called SCOUTS (Supporting Community Outpatient, Urgent careTelehealth Services), sites identified high-risk patients during an ED visit. After ED discharge, Intermediate Care Technicians (ICTs, former military medics), performed follow-up telephone, or home visits. During the follow-up visit, ICTs identified "what matters," performed geriatric screens aligned with Age-Friendly Health Systems, observed home safety risks, assisted with video telehealth check-ins with ED providers, and provided care coordination. SCOUTS visit data were recorded in the patient's electronic medical record using a standardized template.Sites were surveyed via electronic form. Administrative pilot data extracted from VA Corporate Data Warehouse, May-October 2021.Site surveys showed none of the EDs had a formalized way of identifying the 4 M "what matters." During the pilot, ICT performed 56 telephone and 247 home visits. All home visits included a telehealth visit with an ED provider (n = 244) or geriatrician (n = 3). ICTs identified 44 modifiable home fall risks and 99 unmet care needs, recommended 80 pieces of medical equipment, placed 36 specialty care consults, and connected 180 patients to a Patient Aligned Care Team member for follow-up.A post-ED follow-up program in which former military medics perform geriatric screens and care coordination is feasible. Combining telehealth and home visits allows providers to address what matters and unmet care needs.

Background Evidence-based models are needed to deliver exercise-related services for knee osteoarthritis efficiently and according to patient needs. Objective To examine a stepped exercise program for patients with knee osteoarthritis (STEP-KOA). Design Randomized controlled trial. (ClinicalTrials.gov: NCT02653768). Setting 2 U.S. Department of Veterans Affairs sites. Participants 345 patients (mean age, 60 years; 15% female; 67% people of color) with symptomatic knee osteoarthritis. Intervention Participants were randomly assigned in a 2:1 ratio to STEP-KOA or an arthritis education (AE) control group, respectively. The STEP-KOA intervention began with 3 months of an internet-based exercise program (step 1). Participants who did not meet response criteria for improvement in pain and function after step 1 progressed to step 2, which involved 3 months of biweekly physical activity coaching calls. Participants who did not meet response criteria after step 2 went on to in-person physical therapy visits (step 3). The AE group received educational materials via mail every 2 weeks. Measurements Primary outcome was Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score. Scores for the STEP-KOA and AE groups at 9 months were compared by using linear mixed models. Results In the STEP-KOA group, 65% of participants (150 of 230) progressed to step 2 and 35% (81 of 230) to step 3. The estimated baseline WOMAC score for the full sample was 47.5 (95% CI, 45.7 to 49.2). At 9-month follow-up, the estimated mean WOMAC score was 6.8 points (CI, -10.5 to -3.2 points) lower in the STEP-KOA than the AE group, indicating greater improvement. Limitation Participants were mostly male veterans, and follow-up was limited. Conclusion Veterans in STEP-KOA reported modest improvements in knee osteoarthritis symptoms compared with the control group. The STEP-KOA strategy may be efficient for delivering exercise therapies for knee osteoarthritis. Primary funding source Department of Veterans Affairs, Health Services Research and Development Service.

BACKGROUND Older veterans have greater medical complexity, lower physical function, and less daily physical activity compared to age-matched civilians. Telehealth programs offer promising approaches to address these complex needs and improve access for diverse patient populations. OBJECTIVE The purpose of this program evaluation was to understand veterans’ experiences of the telehealth program’s quality, feasibility, safety, and effectiveness. METHODS Interviews were conducted by a provider and external evaluator who had expertise in qualitative methods; veterans were interviewed following completion of the 12-week program. Questions were designed to explore both positive and negative experiences of the program and its 4 components, which were physical therapy, biobehavioral intervention (coaching), social support, and technology. Interviews were audio recorded and transcribed verbatim. Team-based–directed content analysis, using deductive and inductive thematic analysis, was conducted to identify themes; analysis was supported by structured debriefs following each interview and using Dedoose software. RESULTS Twenty-one veterans enrolled in the program (n=14 completed). All 14 completers and 1 withdrawer completed the interviews (mean 60.4, SD 8.2 minutes); interviewees were mostly male (73.3%), White (60.0%), and non-Hispanic (86.7%). The following 6 domains were identified (subthemes to follow): (1) technology, (2) social network, (3) therapeutic relationship, (4) access, (5) feasibility, and (6) patient characteristics. Technology—although veterans noted varying levels of technology competency and satisfaction, most felt encouraged and held accountable to being active by the technology. Social Network—this domain highlighted themes surrounding veterans’ social support both within and outside of the program, which reportedly enhanced motivation and commitment to regular exercise. Therapeutic Relationship—interviewees shared specific ways that providers significantly contributed to their overall experience and their progress. Access—older veterans described the pros and cons of telehealth and noted the program made it possible to begin physical therapy sooner than they would have in person. Telehealth also made it easier for them to fit physical therapy sessions into their workdays, and for some, it provided a solution to overcome mental and physical health issues precluding in-person care. Feasibility—themes of preparedness, fit with daily routine, manageability, and outcomes of the program emerged. Patient Characteristics—motivation, self-efficacy, attitudes and beliefs, and expectations influenced the perceived benefits, overall experience, and therapeutic relationship experienced by the veterans. Finally, many veterans provided constructive feedback to improve the program (eg, organizing group sessions based on functional ability and further integrating technology and wearable data). CONCLUSIONS This program evaluation identified impactful aspects of the telehealth program and mechanisms of how those aspects contributed to participants’ satisfaction and outcomes. Veterans offered suggestions to inform ongoing quality and operational improvements, with implications for staffing, training, and patient engagement. Qualitative feedback from the program evaluation identified additional questions to explore through rigorous qualitative research.

To evaluate the outcomes of vertebral stabilisation after acute traumatic thoracolumbar fractures, correlating the outcome with patient clinical data, type and location of fracture, presence of neurological damage, timing of surgical intervention and number of instrumented levels. The results have been evaluated also through the AO classification and AOSIS score. Retrospective analysis of 101 patients with traumatic thoracolumbar injuries from T3 to L5 operated 2011–2016 by posterior or antero-posterior fixation. The demographic data, trauma dynamics, number and type of fractures, associated lesions, timing of surgery, hospital stay, AOSIS score, RKA, SF-36 and ODI scores, pre- and post-operative neurological condition (ASIA grade), possible complications and re-interventions were evaluated for each patient. Fractures mainly involved the region between T11 and L2. The probability of medullary involvement increases with the increase in severity of the main fracture type with no relation with the vertebral region. Type B and C fractures were common in the thoracic region and rare in the thoracolumbar junction. ODI and SF-36 scores were significantly better in patients with a lower AOSIS score, specifically in lesions classified as type A, amyelic and with no comorbidity. No difference was found in the clinical scores between thoracic, thoracolumbar and lumbar fractures, nor between male and female patients. None of the 10 patients with ASIA A lesion at presentation achieved any degree of recovery: 50% of them had a thoracic lesion. Re-intervention rate was 15%. Hospital stay was significantly higher in patients with type C fractures, and complication rate was on average 14% (7% in type A fractures, 16% in B and 25% in C). This study confirmed the validity of the posterior approach in the surgical treatment of thoracolumbar fractures. Outcomes and complication risks are related to fracture severity. Surgical treatment can be recommended even with an AOSIS score of two or three. The combined antero-posterior approach could be useful in cases with LSC > 8, especially in the thoracolumbar region. The degree of neurological recovery depends on fracture type, location, ASIA score and presence of comorbidities. Early intervention in myelic patients allows for a better prognosis. Level of evidence III retrospective case series.

Funding Acknowledgements Type of funding sources: None. Background Adults with coarctation of the aorta (CoA) may present residual aortic obstruction and develop arterial vasculopathy and subclinical left ventricular (LV) dysfunction. Myocardial work (MW) is a novel non-invasive index of myocardial efficiency calculated from echocardiographic LV pressure-strain loops, which yields incremental information over ejection fraction and global longitudinal strain. (GLS) Purpose Aim of the present study is to analyze LVMW in a cohort of adult patients with operated aortic CoA Methods CoA patients aged > 18 years who underwent transthoracic echocardiography between September 2020 and July 2021 at our tertiary centre were included. Exclusion criteria were significant recoarctation, impaired LVEF, significant valvular disease and suboptimal image quality. A group of healthy individuals with no cardiac abnormalities. GLS and peak strain dispersion(PSD) were measured. MW indices were calculated using the blood pressure measured in the right arm at the time of the exam. Results Sixty patients (26[22-33]years, 66%male) were included. Data on previous medical history, clinical status at last assessment and Coa-related echocardiographic findings are showed in table 1. No significant differences in traditional parameters of LV systolic and diastolic function were found between groups (EF 60[57-64] vs 57[53-61],p = 0.6), however Coa patients had higher LVmass (84[75-97] vs 68[56-75]g). GLS and MW indices in the study population and in the control group are reported in table 2. Coa group showed lower GLS values and higher PSD (p 0.0001). Conclusion MW indices assessment is feasible in Coa patients may provide a more comprehensive understanding of the overall myocardial mechanics and performance. In particular, MW demonstrated impaired LV efficiency, which was strongly related to increased mechanical dispersion in Coa patients. Abstract Figure. Abstract Figure.

Background Transthoracic echocardiogram is the most important non-invasive screening tool for pulmonary hypertension (PH), but right heart catheterization (RHC) remains mandatory to establish the diagnosis. According to the current guidelines, the echocardiographic probability of PH is based on the combination of direct and indirect signs. In the 6th World Symposium on Pulmonary Hypertension, PH has been defined as mean pulmonary artery pressure (mPAP) >20 mmHg, and pulmonary vascular resistance (PVR) ≥3 WU. Aim To validate the echocardiographic direct and indirect signs of PH suggested by the guidelines in view of the new definition of PH in patients who underwent echocardiography and RHC. Methods All consecutive patients referred between January 2018 and December 2019 to undergo RHC for suspected PH were prospectively enrolled in the study. Echocardiography was performed within one hour from indicated RHC. Results Overall, 263 patients were enrolled: 33 (13%) had normal pulmonary pressures, and 230 (87%) had PH. Among the 230 patients with PH, 136 (59%) had pre-capillary and 94 (41%) had post-capillary PH. All underwent echocardiography within one hour from RHC. At univariable logistic regression test, tricuspid regurgitant jet (TRJ) >2.9 m/sec [OR 8.32 (3.15–26.37, p1.1 [OR 5.57 (2.44–14.41, p25 mm [OR 4.74 (2.01–13.09, p=0.001)], right-to-left ventricle basal diameter >1 [OR 4.54 (1.83–13.74, p=0.003)], and early diastolic pulmonary regurgitation velocity >2.2 m/sec [OR 3.14 (1.07–13.46, p=0.067)], predicted PH, whereas dilated inferior vena cava and right atrial area did not. At multivariable analysis, only TRJ >2.9 m/sec [OR 7.95 (2.78–27.07, p1.1 [OR 4.89 (1.75–15.35, p=0.004)] showed a positive correlation to PH. The best area under the curve (AUC, 0.86) for predicting PH was obtained with TVR >2.9 m/sec + 2 indirect signs (sensitivity 0.77, specificity 0.94). Non-invasive estimate of mPAP showed a good correlation to invasive measurement (regression coefficient β 16.8±0.7, p Conclusions Echocardiographic direct and indirect signs of PH as suggested by the current guidelines should be used to assess the probability of PH being present. Echocardiographic measurements have high accuracy (low bias) and moderate precision (acceptable limits of agreement) The best area under the curve for predicting PH according to the new definition (mPAP >20 mmHg and PVR ≥3 WU) can be obtained with TVR >2.9 m/sec + 2 indirect signs. Funding Acknowledgement Type of funding sources: None. Figure 1

We studied the electronic structure of LaNiO3 using band structure and cluster model calculations. This compound is a paramagnetic metal with a R3c rhombohedral structure. The band structure was calculated using the generalized gradient approximation (GGA). The cluster model was solved using the configuration interactions (CI) many-body method. We present results for the density of states (DOS), the spectral weight, and the dielectric function e 2 . The calculations are compared to previous photoemission (PES), O 1s X-ray absorption (XAS), as well as optical absorption spectra. Both band structure and cluster model results are in good agreement with the experimental data. We point out that this concordance is very rare and far from trivial; we argue that this may be due to the unusual characteristics of the ground state of LaNiO3.

Recent research showed that physical activity (PA)-adjusted pain measures were more strongly associated with radiographic osteoarthritis (OA) severity than an unadjusted pain measure. This exploratory study examined whether PA-adjusted pain measures were more closely associated with other key OA-related measures, compared to unadjusted pain scores.Participants were 122 Veterans (mean age = 61.2 years, 88.5% male) with knee OA. Baseline Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) pain scores were adjusted for accelerometer-derived daily: (1) step counts, (2) minutes of any activity, (3) minutes of moderate or greater intensity activity, (4) minutes of light intensity activity, and (5) energy expenditure. Partial correlations, adjusted for age, sex, and body mass index, estimated associations of unadjusted and PA-adjusted WOMAC pain scores with functional assessments (6-minute walk test, 8-foot walk test, chair stand test, satisfaction with physical function), fatigue (Brief Fatigue Inventory), and anxiety/depressive symptoms (single item).Significant (p 0.05) associations were found in 29 of 36 of models. For the four function-related assessments, step count and energy expenditure-adjusted WOMAC pain scores had stronger associations (partial rs = 0.24-0.48) than WOMAC pain score (partial rs = 0.19-0.25). For fatigue and anxiety/depressive symptoms, WOMAC pain score had stronger, positive associations than most PA-adjusted pain scores. Of the PA-adjusted measures, the strongest associations overall were observed for step count and energy expenditure.PA-adjusted pain scores may have particular value for OA studies involving functional assessments, whereas unadjusted WOMAC pain scores are more closely associated with psychological symptoms. This has implications for measurement in clinical OA studies.NCT01058304 KEY POINTS: • Among patents with osteoarthritis, physical activity-adjusted pain measures (particularly those adjusted for step count and energy expenditure) were more strongly associated with measures of physical function, compared to unadjusted pain scores, whereas unadjusted pain score was more strongly associated with a measure of psychological symptoms. • In clinical osteoarthritis research, the most appropriate or sensitive symptom measure (pain vs. physical activity-adjusted pain) may depend on the type of intervention or outcome being studied.

This paper provides a quantitative assessment of students' attitude and behaviors towards marine litter before and after their participation to SEACleaner, an educational and citizen science project devoted to monitor macro- and micro-litter in an Area belonging to “Pelagos Sanctuary” (Mediterranean Sea). This approach produced interesting outcomes both for the research sector of marine pollution and environmental monitoring, as well for the scientific and environmental education. Here we focus on citizen science as an effective vector for raising young people awareness of marine litter and fostering sound behaviors. A specially designed questionnaire was administered to 87 High School students, to test the validity of such approach. The results state that the students change quantitatively their perception of beach-litter causes and derived problems, and they improved their knowledge about the main marine litter sources and the role of the sea in the waste transport and deposition along the coast.

OBJECTIVES: Food insecurity, limited or uncertain access to adequate nutrition, is an increasingly recognized determinant of health outcomes and is often associated with having obesity. It is unclear, however, if this association persists in elderly populations. METHODS: We conducted a cross-sectional study of 2868 participants’ aged 65+ years from the Health and Retirement Study. Multivariate logistic regression was used to assess associations between food insecurity and body mass index, demographic characteristics, psychiatric history, and medical history. RESULTS: Participants with overweight/obesity had a higher prevalence of food insecurity than leaner counterparts, however, weight status was not a significant predictor of food insecurity after multivariate adjustment. Instead, mental illness, current smoking status, and non-White race were all independently associated with food insecurity. DISCUSSION: Beyond financial status, health care providers are encouraged to use these characteristics to identify elderly patients that may be at risk of food insecurity.

Background Older veterans have greater medical complexity, lower physical function, and less daily physical activity compared to age-matched civilians. Telehealth programs offer promising approaches to address these complex needs and improve access for diverse patient populations. Objective The purpose of this program evaluation was to understand veterans’ experiences of the telehealth program’s quality, feasibility, safety, and effectiveness. Methods Interviews were conducted by a provider and external evaluator who had expertise in qualitative methods; veterans were interviewed following completion of the 12-week program. Questions were designed to explore both positive and negative experiences of the program and its 4 components, which were physical therapy, biobehavioral intervention (coaching), social support, and technology. Interviews were audio recorded and transcribed verbatim. Team-based–directed content analysis, using deductive and inductive thematic analysis, was conducted to identify themes; analysis was supported by structured debriefs following each interview and using Dedoose software. Results Twenty-one veterans enrolled in the program (n=14 completed). All 14 completers and 1 withdrawer completed the interviews (mean 60.4, SD 8.2 minutes); interviewees were mostly male (73.3%), White (60.0%), and non-Hispanic (86.7%). The following 6 domains were identified (subthemes to follow): (1) technology, (2) social network, (3) therapeutic relationship, (4) access, (5) feasibility, and (6) patient characteristics. Technology—although veterans noted varying levels of technology competency and satisfaction, most felt encouraged and held accountable to being active by the technology. Social Network—this domain highlighted themes surrounding veterans’ social support both within and outside of the program, which reportedly enhanced motivation and commitment to regular exercise. Therapeutic Relationship—interviewees shared specific ways that providers significantly contributed to their overall experience and their progress. Access—older veterans described the pros and cons of telehealth and noted the program made it possible to begin physical therapy sooner than they would have in person. Telehealth also made it easier for them to fit physical therapy sessions into their workdays, and for some, it provided a solution to overcome mental and physical health issues precluding in-person care. Feasibility—themes of preparedness, fit with daily routine, manageability, and outcomes of the program emerged. Patient Characteristics—motivation, self-efficacy, attitudes and beliefs, and expectations influenced the perceived benefits, overall experience, and therapeutic relationship experienced by the veterans. Finally, many veterans provided constructive feedback to improve the program (eg, organizing group sessions based on functional ability and further integrating technology and wearable data). Conclusions This program evaluation identified impactful aspects of the telehealth program and mechanisms of how those aspects contributed to participants’ satisfaction and outcomes. Veterans offered suggestions to inform ongoing quality and operational improvements, with implications for staffing, training, and patient engagement. Qualitative feedback from the program evaluation identified additional questions to explore through rigorous qualitative research. Conflicts of Interest None declared.

OBJECTIVE: Post-traumatic stress disorder (PTSD) is common in Veterans. Symptoms can perpetuate into late life, negatively impacting physical and mental health. Exercise and social support are beneficial in treating anxiety disorders such as PTSD in the general population, although less is known about the impact on Veterans who have lived with PTSD for decades. This study assessed associations between social connectedness, physical function and self-reported change in PTSD symptoms among older Veterans specifically participating in Gerofit. DESIGN: Prospective clinical intervention. SETTING: Twelve sites of Veterans Affairs (VA) Gerofit exercise program across the United States. PARTICIPANTS: Three hundred and twenty one older Veteran Gerofit participants (mean age = 74) completed physical assessments and questionnaires regarding physical and emotional symptoms and their experience. MEASUREMENTS: Measures of physical function, including 30-second chair stands, 10-m and 6-min walk were assessed at baseline and 3 months; change in PTSD symptoms based on the Diagnostic Statistical Manual—5 (DSM-5) assessed by a self-report questionnaire; and social connection measured by the Relatedness Subscale of the Psychological Need Satisfaction in Exercise scale (PNSE) were evaluated after 3 months of participation in Gerofit. RESULTS: Ninety five (29.6%) Veterans reported PTSD. Significant improvement was noted in self-rated PTSD symptoms at 3 months (P < .05). Moderate correlation (r = .44) was found between social connectedness with other participants in Gerofit and PTSD symptom improvement for those Veterans who endorsed improvement (n = 59). All participants improved on measures of physical function. In Veterans who endorsed PTSD there were no significant associations between physical function improvement and PTSD symptoms. CONCLUSION: Veterans with PTSD that participated in Gerofit group exercise reported symptom improvement, and social connectedness was significantly associated with this improvement. In addition to physical health benefits, the social context of Gerofit may offer a potential resource for improving PTSD symptoms in older Veterans that warrants further study.

For persons with osteoarthritis (OA), nutrition education may facilitate weight and OA symptom management.The primary aim of this study was to determine preferred OA-related nutritional and weight management topics and their preferred delivery modality. The secondary aim was to determine whether there is a disconnect between what patients want to know about nutrition and OA management and what information health-care professionals (HCPs) are providing to patients.The Osteoarthritis Action Alliance surveyed individuals with OA to identify their preferences, categorized in 4 domains:Survey responses from 338 individuals with OA and 104 HCPs were included. The highest preference rankings in each domain were:There is disparity between the nutrition education content preferred by individuals with OA (which often lacks empirical support) and evidence-based topics being discussed by HCPs. HCPs must communicate evidence-based management of joint health and OA symptoms in patient-preferred formats. This study explored the information gap between what individuals with OA want to know and what HCPs believe they need to know.

Data on the abundance and distribution of Anthropogenic Marine Debris (AMD) on the coastal areas of the northern Tyrrhenian coast are still scarce. The objective of this study is to characterize, in terms of size, color, morphology and polymeric nature, the Large Microplastics (LMPs), i.e., plastic objects within 1 and 5 mm, sampled on three beaches located within the coastal macro-area of the Pelagos Sanctuary, an international protected zone in the north-western Mediterranean. The beaches have similar morphological characteristics but different degrees of urbanization. LMPs were sampled seasonally for one year. The polymeric nature of a representative subsample of the collected LMPs was investigated using a portable Raman instrument, to assess the feasibility of in situ characterization. In this study, 26,486 items were sorted by typology (Expanded Polystyrene-EPS, fragments, and resin pellets), size, and for fragments and resin pellets, also by color and chemical nature. Statistical data on the quantity, density, type, spatial distribution, and seasonality of the sampled LMPs are presented. Differences in LMP abundance and composition were detected among sites. A seasonality trend emerges from our statistical analysis, depending on both LMP typology and urbanization degrees of the beaches. Our data do not show the existence of a relationship between the size of the investigated MPs and their color, while they suggest that the type of polymer influences the degree of fragmentation. This underlines the need to further investigate the mechanisms leading to the production and dispersion of MPs in coastal areas, taking into account both the urbanization of the beach, and therefore the possible sources of input, and the different types of MPs. Finally, a Raman portable instrument proved to be a valuable aid in performing in situ polymeric characterization of LMPs.

We have performed valence-band resonant photoemission spectroscopy across the transition-metal (TM) ${L}_{3}$ edge of ${\mathrm{Rh}}_{2}{\mathrm{O}}_{3}, {\mathrm{RuO}}_{2}$, and ${\mathrm{MoO}}_{2}$. This technique allows us to access important information on the partial contribution of each respective TM. We show that an extended cluster model, coupled with transitions between discrete and continua states, describes well the overall resonance behavior as well as the experimental constant initial-state (CIS) spectra. Moreover, we analyze the resonant enhancement of the main lines and satellite structures to discuss the influence of the different charge regimes, the TM--O $2p$ hybridization, and additional charge screenings to the CIS signal. Finally, we argue that this approach can be extended to the study of other transition-metal oxides.

Aim of the study was to get in-depth information on Aelurostrongylus abstrusus first-stage larvae (L1s) survival at different temperatures and to assess the capability of these larvae to develop into the third infective stage (L3s). Faeces of a naturally infected cat were split into two aliquots: the first was divided in subsamples assigned to four groups (F1-F4); from the second aliquot, L1s were extracted by Baermann technique, suspended in water and divided into four groups (W1-W4). Groups were stored at different temperatures (F1/W1 -20 ± 1°C; F2/W2 +4 ± 1°C; F3/W3 +14 ± 1°C; and F4/W4 +28 ± 1°C) and L1s vitality assessed every seven days. The capability of L1s stored in water to develop into L3s in snails was evaluated at the beginning and every 21 days. The L1s of W2 and F2 groups remained viable for a longer period (231 and 56 days, respectively) compared to those of other groups. The capability of L1s to moult into L3s in snails showed a decreasing trend; the group W2's L1s maintained the capability to moult into L3s for the longest time (day 189) compared to the other groups. The time of survival of A. abstrusus L1s is influenced by temperature. However, the species seems to be more resistant to temperature variations than other feline lungworms, and this may explain its wider distribution across Europe.

The host cell receptors and associated anti-viral genes mediating SARS-CoV-2 infections are still elusive Here, we show that COVID-19 patients compared with he

We have studied the growth, interface and chemical stability of ultra-thin CoO films supported on different single crystal oxides as substrates, namely SiO2, Al2O3 and MgO. The films have been grown by reactive evaporation of Co in an oxygen atmosphere at room temperature and analyzed in situ by photoemission spectroscopy. Analysis of the Co 2p 3/2 photoemission spectra, supported by theoretical cluster model calculations, reveals size effects for coverages below 5 equivalent monolayers for all substrates. In the case of the Al2O3 substrate, the predicted charge transfer from the substrate to the CoO ultra-thin-film has been experimentally observed. The way of growth of the ultra-thin films is dictated by the crystalline structure of each substrate in terms of the lattice mismatch. It has been found that the quality and stability of the films depend more on the structural parameters of the oxide substrates rather than on their covalent/ionic character. The chemical stability of the films upon air exposure and aggressive oxidizing thermal annealing has also been studied. The most suitable substrate to grow ordered and stable CoO ultra-thin-films is MgO whereas nanoclusters of CoO formed at the early stages of growth on SiO2 appear also to be very stable.

Objective To identify patient demographic and clinical characteristics associated with osteoarthritis (OA) treatment use. Methods This was a secondary data analysis of three clinical trials among patients with hip or knee OA conducted in 1) Duke Primary Care practices, 2) the Durham Veterans Affairs Health Care System (DVAHCS), and 3) the University of North Carolina-Chapel Hill (UNC). At baseline, participants reported socio-demographic characteristics, OA-related pain and function, and OA treatment use including oral analgesia, topical creams, joint injections and physical therapy. Separate, multivariable logistic models (adjusted for clustering of clinics and providers for Duke and VA cohorts) were used to estimate odds ratios and 95% confidence intervals (OR, 95% CI) for the associations between participant characteristics and each type of OA treatment. Results Oral analgesic use was reported by 70-82% of participants across the three cohorts. Physical therapy, knee injections, and topical creams were used by 39%-52%, 55-60%, and 25-39% of participants, respectively. In multivariable models, worse pain, stiffness, and function, per 5-unit increase, were associated with greater odds of using any oral analgesic for the Duke (OR=1.18 (1.08, 1.28)) and UNC (OR=1.14 (1.05, 1.24)) cohorts but not for the VA cohort (OR=1.04 (0.95, 1.14)). For all three cohorts, Non-Whites had higher odds of use of topical creams compared to Whites. Conclusion Results suggest potential under-utilization of therapies other than oral analgesia. Patient characteristics may affect OA treatment use, and understanding the relationship between these factors and OA treatment preferences may improve adherence to OA treatment guidelines. This article is protected by copyright. All rights reserved.

We studied the electronic structure of Sr2FeMoO6using core level and valence band photoemission. Thespectra were obtained using high energy X-rays of 1840 eV, which provide bulk sensitive information onthe electronic structure. The experimental data were analyzed using the spectral weight from clustermodel calculations. The ground state reveals a large Fe–O and Mo–O hybridization, as well as theimportance of non-local Fe–O–Mo chargefluctuations. The latter is crucial to explain the half-metalliccharacter attributed to the Sr2FeMoO6compound. The core level and valence band photoemissionspectra show charge transfer satellites. These satellites are related to many-body effects and are largerfor the Fe levels than for the Mo states. Fil: Martins, Henrique P.. Universidade Federal do Paraná; Brasil Fil: Guedes, Eduardo B.. Universidade Federal do Paraná; Brasil Fil: Mossanek, Rodrigo J.O.. Universidade Federal do Paraná; Brasil Fil: Prado, Fernando Daniel. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Bahía Blanca. Instituto de Física del Sur. Universidad Nacional del Sur. Departamento de Física. Instituto de Física del Sur; Argentina Fil: Caneiro, Alberto. Comisión Nacional de Energía Atómica; Argentina Fil: Abbate, Miguel. Universidade Federal do Paraná; Brasil

We study the electronic structure of GdCrTiO 5 polycrystals by means of magnetic susceptibility and heat capacity measurements, as well as x-ray absorption spectroscopies on the Cr 2 p , Ti 2 p and O 1 s levels. The experimental results were interpreted with Charge Transfer Multiplet and Density Functional Theory calculations. Magnetic susceptibility and specific heat measurements indicate a long-range antiferromagnetic ordering at 0.9 K probably related to the Gd sublattice. The results indicate that spin-orbit interaction, rather than hybridization, may be crucial for the stabilization of magnetic ordering in the RCrTiO 5 (R = rare earth) family.

We study the electronic structure of MoO 2 using an extended cluster model. The calculations confirm that the compound is in a highly mixed covalent Mott-Hubbard regime. These results are then compared to other calculations and to x-ray absorption and (resonant) photoemission spectroscopies. The good agreement with the experimental spectra indicates a strong covalent character for the Mo 4d-O 2p bond. Finally, we show that, not only local charge fluctuations from the oxygen ions are necessary, but also nonlocal screenings, from the Mo dimer and from coherent (metallic) states, must be included in the description of the electronic structure of MoO 2 .

BackgroundThe aim of this systematic review was to identify principles of exercise interventions associated with improved physical function, weight management or musculoskeletal pain relief among young and middle-aged adults with obesity and propose an evidence-based exercise prescription that could assist in secondary prevention of osteoarthritis.MethodsA structured electronic review was conducted using MEDLINE, PubMed, and SPORTDiscus. The search string included 1) “obes*” AND “exercise” AND “interven*” AND “musculoskeletal pain OR knee pain OR hip pain”. Studies 1) were randomized controlled trials of humans, with a non-exercise control, 2) included participants aged 18–50 years, and 3) had outcomes that included physical function, musculoskeletal pain, and/or body composition. Studies were excluded if participants had peri-menopausal status, cancer, or obesity-related co-morbidities. A recommended exercise prescription was developed based on common principles used in the included exercise interventions with greatest change in function or pain.ResultsSeven studies were included. Similarities in exercise intensity (40–80% VO2max), frequency (three times per week), duration (30–60 min), and exercise mode (treadmill, cross-trainer, stationary bike, aquatic exercise) were observed in exercise interventions that resulted in improved physical function and/or pain, compared to non-exercise control groups.ConclusionCommon principles in exercise prescription for improvements in weight management, physical function and pain relief among otherwise healthy people with obesity. Exercise prescription including moderate intensity exercise for 30–60 min, three times per week can be considered an effective treatment for weight management and obesity-related musculoskeletal symptoms. Exercise should be recommended to at-risk individuals as part of secondary prevention of osteoarthritis.

We studied the changes in the optical properties of the RVO3 series (R = Sr, Ca, La, Y) using band structure calculations. These oxides present a transition from a non-magnetic metallic phase in SrVO3–CaVO3, to an antiferromagnetic insulator state in LaVO3–YVO3. The standard LDA and GGA approach to DFT fails to reproduce the observed band gap in the LaVO3–YVO3 insulating compounds. We show here that the use of the modified Becke-Johnson exchange potential in the calculation of the optical properties solves this problem. In particular, the optical conductivity of the metallic SrVO3–CaVO3 oxides exhibits a Drude contribution, whereas the insulating LaVO3–YVO3 materials reflects the opening of the optical gap. We also show that the calculated optical conductivity of these materials is in good agreement with previous experimental results.

The interaction of CoO with highly oriented pyrolytic graphite (HOPG) was studied using a set of complementary techniques. The morphology of the CoO thin film was determined using atomic force microscopy (AFM), whereas the electronic structure was investigated using X-ray absorption (XAS) and photoemission (PES) spectroscopies. The experimental spectra were analyzed using a configuration interaction CoO cluster model calculation. The early stages of growth are characterized by the formation of a CoO wetting layer at the CoO/HOPG interface. The electronic structure of the CoO wetting layer presents a clear 2D character, which is closer to the 2D HOPG substrate than to the 3D CoO bulk. This character of the wetting layer explains the posterior formation of CoO islands and excludes the alternative layer by layer growth mode. Further, the interaction between the CoO wetting layer and the outermost graphite layer favors the oxidation of the HOPG substrate which can be controlled by the thickness of the deposited CoO overlayer, This investigation has been funded by the MINECO of Spain through the FIS2015-67367-C2-1-P project and by the Comunidad de Madrid through the NANOMAGCOSTCM-P2018/NMT4321 project. Authors R.J.O.M and M.A. thank the financial support of CNPq-Brazil. Funding from the European Community's Seventh Framework Programme (FP7/2007-2013) under grant agreement n.°312284 is acknowledged

Little is known about the relationship between exercise and health care utilization in older adults. This study examined hospitalizations/emergency Department (ED) visits in the 12 months prior to and during 12 months of active Gerofit participation (across 5 sites). Data were compared for each outcome to a propensity matched nearest neighbor sample from the same site [Mean, 95% CI]. Of the 226 Veterans who were active in the program for ≥12 months and enrolled in VA and Traditional Medicare for 12 months prior to Gerofit participation, hospitalizations/ED visits were greater prior to (15.3%/42.0%) than during (6.8%/37.1%) Gerofit participation. Gerofit participants were 8% less likely to have a hospitalization in the 12 months following enrollment than controls [-0.08 (-0.14, -0.02)] but no between-group differences in ED use [-0.00 (-0.11, 0.10)] were observed. Participation in Gerofit may reduce hospitalizations, but its impact on ED use is inconclusive.

We studied the partial contributions to the valence band spectra of MoO2, RuO2 and Rh2O3. The experimental technique of choice was the Cooper minimum method to X-ray photoemission spectroscopy. The spectra were interpreted with an extended cluster model and compared to usual band structure calculations. We conclude that, for the correct description of the valence band, one must include charge transfer, final-state and many-body effects in the description of the electronic structure of these compounds, which can also be extended to other systems.

Exercise is critical for health maintenance in late life. The COVID-19 shelter in place and social distancing orders resulted in wide-scale interruptions of exercise therapies, placing older adults at risk for the consequences of decreased mobilization. The purpose of this paper is to describe rapid transition of the Gerofit facility-based group exercise program to telehealth delivery. This Gerofit-to-Home (GTH) program continued with group-based synchronous exercise classes that ranged from 1 to 24 Veterans per class and 1 to 9 classes offered per week in the different locations. Three hundred and eight of 1149 (27%) Veterans active in the Gerofit facility-based programs made the transition to the telehealth delivered classes. Participants’ physical performance testing continued remotely as scheduled with comparisons between most recent facility-based and remote testing suggesting that participants retained physical function. Detailed protocols for remote physical performance testing and sample exercise routines are described. Translation to remote delivery of exercise programs for older adults could mitigate negative health effects.

The dehydrating power of cat litters may reduce the vitality of first-stage larvae (L1s) of feline lungworms, limiting copromicroscopical diagnosis. This study assessed the effect of the most commonly used cat litters onFour types of cat litters were used: clumpling clay (group A); non-clumpling clay (group B); silica crystals (group C); and biodegradable (group D). A control group without litter (group E) was also included. On study day 0 (TA decreasing trend of L1 survival was observed in all groups, with highest significant values at TThis study demonstrates how the survival of

A 3 year monitoring programme, realized in a citizen science context, from 2014 until 2016, allowed us to gather information on the prevalent quantities and qualities of anthropogenic waste in five Mediterranean coastal areas within the Pelagos Sanctuary, three of them located in Liguria, near La Spezia Gulf, and the other two in Tuscany. Here, we present results concerning the Polymeric Articles’ abundances registered during the survey. Moreover, we show the results of the first study devoted to describe and quantify the anthropogenic content of the nest of a pair of Northern Gannets (Morus bassanus), a pelagic bird that, starting from some years, has been reproducing regularly in La Spezia Gulf. This breeding is atypical for this species, as is associated with artificial structures such as piers, floating docks, or boats; the material used in the construction of the nest reflects the “anthropogenic” link with the chosen location and objects of polymeric origin in particular abound. We detect the existence of a correlation between the most abundant types of Anthropogenic Marine Debris found in the Northern Gannet’ nest (fragments of polypropylene nets) and one of the productive activities of the zones. © 2018, Accademia Nazionale dei Lincei.

So far, knowledge of the mechanisms of glomerular toxicity of drugs and chemicals was largely descriptive, mainly reflecting the associated pathology, or biochemical and functional consequences of exposing glomerular cells to a given toxic molecule. However, more recently understanding of glomerular toxicity has expanded, orienting toward new cell surface molecules, soluble mediators, and novel mechanisms of injury. Moreover, studies of drug toxicity had allowed us to better define functional and structural determinants of glomerular filtration and to identify pathways of abnormal permeability to macromolecules that may cause progressive renal disease.

Physical activity is an established intervention for the management of arthritis. This study evaluated the effect of 3 months of participation in Gerofit on physical function by arthritis status. Participants, 519 Veterans aged ≥ 65 years self-reported either no arthritis (NA) (49%), upper body arthritis (UB) (8.2%), lower body arthritis (LB) (12.7%), or both upper and lower body arthritis (UB&LB) (30.4%) upon enrollment. Physical function measures [10-meter usual gait speed (m/s) (GS), arm curls (AC), chair stands (CS), and 6-minute walk (yards) (SMW)] were assessed at baseline and follow-up. Mean differences between time points were calculated. At baseline, compared to NA, LB and UB&LB had slower GS (1.10 and 1.06 vs 1.13) and shorter SMW distance (468.8 and 448.8 vs 490.7). All groups tended to increase physical function, with greatest improvement among LB (GS=0.27, AC=2.06, CS=2.52, SMW=42.53). Participation in Gerofit is associated with functional gains, regardless of burden of disease.

We studied the Fe and Mo valence states in Sr2FeMoO6 using X-ray absorption spectroscopy. The exper- imental results were analyzed using atomic multiplet plus crystal field calculations. The analysis indi- cates that the Fe ions present a fairly ionic Fe3+ (3d5) valence, and that the Mo ions are in a strongly covalent Mo5+ (4d1) state. The presence of Fe ions in a 2+ valence state can be excluded from the Fe-L2,3 spectrum. These results can be understood taking into account the relative energy of the d-levels, the relative strength of the M d?O p mixing, and the exchange stabilization of the Fe3+ ion. Fil: Martins, H.P.. Universidade Federal Do Parana; Brasil Fil: Prado, F.. Universidad Nacional del Sur; Argentina Fil: Caneiro, Alberto. Comisión Nacional de Energía Atómica. Centro Atómico Bariloche; Argentina Fil: Vicentin, F.C. . Laboratório Nacional de Luz Síncrotron; Brasil Fil: Chaves, D.S.. Laboratório Nacional de Luz Síncrotron; Brasil Fil: Mossanek, R.J.O. . Universidade Federal Do Parana; Brasil Fil: Abbate, M.. Universidade Federal Do Parana; Brasil

MoO y with 1.85 ≤ y ≤ 2.20 has been studied by X-ray diffractometry and photoemission spectroscopy at room temperature and by electrical resistance as a function of temperature from 2 to 300 K. Although X-ray diffractograms are very similar to the stoichiometric MoO2 with monoclinic structure of the space group P21/c (14), the electrical properties are strongly dependent on the oxygen composition. Samples with y = 1.85 and 1.90 show anomalous behavior in electrical conductivity. Photoemission and X-ray absorption spectroscopy measurements suggest that this anomalous behavior is related to the presence of Mo3+ ions such as in KxMoO2 compound.

We report here the O K-edge x-ray absorption spectra of hexagonal and orthorhombic YMnO