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David Calderon Guzman,1 Norma Osnaya Brizuela,1 Armando Valenzuela Peraza,1 Maribel Ortiz Herrera,2 Gerardo Barragan Mejia,2 Hugo Juarez Olguin3 1Laboratory of Neurosciences. Instituto Nacional de Pediatria (INP), Mexico City, Mexico; 2Laboratory of Experimental Bacteriology. INP, Mexico City, Mexico; 3Laboratory of Pharmacology. INP, Mexico City, MexicoCorrespondence: Hugo Juarez Olguin, Laboratorio de Farmacología, Instituto Nacional de Pediatría. Avenida Imán, N 1, 3rd piso Colonia Cuicuilco CP 04530, Mexico City, Mexico, Tel/Fax +5255 10840900, Email juarezol@yahoo.comCase Summary: Female nurse, 44-years-old with a weight of 127 pounds. She attended our emergency clinic for an urgent care due to post COVID-19 vertigo and anxiety. Her problem began with severe, short-lived attacks of objective-circular type vertigo, accompanied by nausea and vomiting. The symptoms occurred when she assumed a lying position, turn right and sat or stood upright.Interventions: The patient received medical prescription for hypothyroidism, vertigo and anxiety symptoms. Oral route feeding was started and was well tolerated.Outcomes: The patient showed good evolution with the treatment. Currently, she is at home with daily intake of levothyroxine and losartan without complications.Conclusion: The clinical case suggests that in patients with hypothyroidism, COVID-19 infection may trigger and exacerbate vertigo and anxiety.Keywords: hypothyroidism, COVID-19, vertigo, thyroid

BackgroundThe US homeless population is aging. Older adults and those living in poverty are at a high risk of food insecurity.MethodsWe conducted a cross-sectional analysis of baseline data from a population-based study of 350 homeless adults aged ≥50. We assessed food security and receipt of food assistance. We used multivariable logistic regression to examine factors associated with very low food security.ResultsThe majority of the cohort was male and African American. Over half (55.4%) met criteria for food insecurity, 24.3% reported very low food security. Half (51.7%) reported receiving monetary food assistance. In the multivariable model, those who were primarily sheltered in the prior 6 months, (multi-institution users [AOR = 0.44, 95% CI: 0.22-0.86]) had less than half the odds of very low food security compared with those who were unsheltered. Depressive symptoms (AOR = 3.01, 1.69-5.38), oral pain (AOR = 2.15, 1.24-3.74) and cognitive impairment (AOR = 2.21, 1.12-4.35) were associated with increased odds of very low food security.ConclusionsOlder homeless adults experience a high prevalence of food insecurity. To alleviate food insecurity in this population, targeted interventions must address specific risk groups.

BackgroundThe homeless population in the United States is aging. Aging-associated comorbidities are associated with increased symptoms.ObjectiveTo describe the prevalence of symptoms among older homeless-experienced adults, analyze factors associated with moderate-high physical symptom burden, and identify symptom clusters.DesignCross-sectional analysis within longitudinal cohort study.ParticipantsUsing population-based sampling from shelters, meal programs, encampments, and a recycling center in Oakland, CA, we recruited homeless adults aged ≥ 50 for a longitudinal cohort. This study includes participants who participated in the 18-month follow-up visit.Main measuresWe assessed physical symptoms using the Patient Health Questionnaire-15 (PHQ-15); psychological symptoms using the Center for Epidemiologic Studies Depression Scale (CES-D), Primary Care PTSD Screen (PC-PTSD), and psychiatric section of the Addiction Severity Index (ASI); loneliness using the Three-Item Loneliness Scale; and regret using a six-item regret scale.Key resultsTwo hundred eighty-three participants (75.6% men and 82.3% African-Americans) completed symptoms interviews. Over a third (34.0%) had moderate-high physical symptom burden. The most prevalent physical symptoms were joint pain, fatigue, back pain, and sleep trouble. Over half (57.6%) had psychological symptoms; 39.6% exhibited loneliness and 26.5% had high regret. In a multivariate model, being a woman (AOR 2.54, 95% CI 1.28-5.03), childhood abuse (AOR 1.88, 95% CI 1.00-3.50), cannabis use (AOR 2.59, 95% CI 1.38-4.89), multimorbidity (AOR 2.50, 95% CI 1.36-4.58), anxiety (AOR 4.30, 95% CI 2.24-8.26), hallucinations (AOR 3.77, 95% CI 1.36-10.43), and loneliness (AOR 2.32, 95% CI 1.26-4.28) were associated with moderate-high physical symptom burden. We identified four symptom clusters: minimal overall (n = 129), moderate overall (n = 68), high physical and high psychological (n = 67), and high physical and low psychological (n = 17).ConclusionsOlder homeless-experienced adults exhibit a high prevalence of symptoms across multiple dimensions. To reduce suffering, clinicians should recognize the interaction between symptoms and address multiple symptom dimensions.

Background: The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and Care Transitions Measure (CTM-3) scores are patient experience measures used to determine hospital value-based purchasing reimbursement. Interventions to improve 30-day readmissions have met with mixed results, but less is known about their potential to improve the patient experience among older ethnically and linguistically diverse adults receiving care at safety-net hospitals. In this study, we assessed the effect of a nurse-led hospital-based care transition intervention on discharge-related patient experience in an older multilingual population of adults hospitalized at a safety-net hospital. Methods: We randomized 700 inpatients aged 55 and older at an academic urban safety-net hospital. In addition to usual care, intervention participants received inpatient visits by a language-concordant study nurse and post-discharge phone calls from a language-concordant nurse practitioner to reinforce the care plan and to address acute complaints. We measured HCAHPS nursing, medication, and discharge communication domain scores and CTM-3 scores at 30 days after hospital discharge. Results: Of 685 participants who survived to 30 days, 90 % (n = 616) completed follow-up interviews. The mean age was 66.2 years; over half (54.2 %) of the participants had cognitive impairment, and 33.8 % had moderate to severe depression. The majority (62.1 %) of interviews were conducted in English; 23.3 % were conducted in Chinese and 14.6 % in Spanish. Study nurses spent an average of 157 min with intervention participants. Between intervention and usual care participants, CTM-3 scores (80.5 % vs 78.5 %; p = 0.18) and HCAHPS discharge communication domain scores (74.8 % vs 68.7 %; p = 0.11) did not differ, nor did HCAHPS scores in medication (44.5 % vs 53.1 %; p = 0.13) and nursing domains (67.9 % vs 64.9 %; p = 0.43). When stratified by language, no significant differences were seen. Conclusion: An inpatient standalone transition-of-care intervention did not improve patient discharge experience. Older multi-lingual and cognitively impaired populations may require higher-intensity interventions post-hospitalization to improve discharge experience outcomes.

Background: Consumption of sugar-sweetened beverage (SSB) has risen over the past two decades, with over 10 million Californians drinking one or more SSB per day. High SSB intake is associated with risk of type 2 diabetes, obesity, hypertension, and corona

Global surface temperatures are projected to increase in the future; this will modify regional precipitation regimes and increase global atmospheric drying. Despite many drought studies examining the consequences of reduced precipitation, there are few experimental studies exploring plant responses to atmospheric drying via relative humidity and vapor pressure deficit (VPD). We examined eight native California perennial grass species grown in pots in a greenhouse in Los Angeles, California for 34 weeks. All pots were well‐watered for 21 weeks, at which point we reduced watering to zero and recorded daily growth and dormancy for 3 weeks. We used this information to better understand the drought tolerance of our species in a larger soil drying × atmospheric drying experiment. In this larger experiment, we grew all eight species together in outdoor mesocosms and measured changes in community composition after 4 years of growth. Soil drying in our small pot experiment mirrored compositional shifts in the larger experiment. Namely, our most drought‐tolerant species in our pot experiment was Poa secunda, due to a summer dormancy strategy. Similarly, the grass community shifted toward P. secunda in the driest soils as P. secunda was mostly unaffected by either soil drying or atmospheric drying. We found that some species responded strongly to soil drying (Elymus glaucus, Festuca idahoensis, and Hordeum b. californicum), while others responded strongly to atmospheric drying (Bromus carinatus and Stipa cernua). As result, community composition shifted in different and interacting ways in response to soil drying, atmospheric drying, and their combination. Further study of community responses to increasing atmospheric aridity is an essential next step to predicting the future consequences of climate change. [ABSTRACT FROM AUTHOR]

We present the results of a study of the performance of InGaAs detectors conducted for the SuperNova Acceleration Probe (SNAP) dark energy mission concept. Low temperature data from a nominal 1.7um cut-off wavelength 1kx1k InGaAs photodiode array, hybridized to a Rockwell H1RG multiplexer suggest that InGaAs detector performance is comparable to those of existing 1.7um cut-off HgCdTe arrays. Advances in 1.7um HgCdTe dark current and noise initiated by the SNAP detector research and development program makes it the baseline detector technology for SNAP. However, the results presented herein suggest that existing InGaAs technology is a suitable alternative for other future astronomy applications.