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Objective: Hospital-at-home (HaH) has emerged as an alternative to conventional in-hospital care in older adults, possibly reducing hospital admissions and related complications. This study aimed to describe the characteristics and outcomes of patients referred to "Gruppo di Intervento Rapido Ospedale-Territorio" (GIROT), a HaH service based on comprehensive geriatric assessment, developed in Florence, Italy, during the postpandemic period., Design: Retrospective longitudinal study., Setting and Participants: GIROT provided home-based care to patients with acute or exacerbated chronic diseases and a high risk of hospital-related complications (ie, patients with moderate-to-severe disability and/or dementia), referred from primary care, emergency departments, or in-hospital units., Methods: All-cause mortality and hospitalization rates were assessed at 1, 3, and 6 months, and predictors of 6-month mortality were investigated., Results: Among 391 patients (mean age, 88.4 years; 62.4% female) referred from emergency departments (58.6%), primary care (27.9%), and acute medical units (13.6%), the main diagnoses were respiratory failure (28.4%), acute heart failure (25.3%), and delirium (13.6%). Patients referred from primary care were older and showed a higher prevalence of severe disability and hypomobility. After 1, 3, and 6 months, mortality rates were 34.5%, 45.6%, and 53.8%, and hospitalization rates 7.2%, 21.5%, and 37.9%, respectively. Predictors of 6-month mortality included age [odds ratio (OR), 1.039], severe disability (OR, 3.446), impossible/assisted walking (OR, 4.450) and referral from primary care (OR, 2.066). High global satisfaction with the service was reported., Conclusions and Implications: The GIROT model may help expanding acute health care capacity for older adults at high risk of hospital-related complications. Customized care plans are needed in patients with severe disability/hypomobility, considering also simultaneous palliative care., Competing Interests: Disclosures The authors declare no conflicts of interest., (Copyright © 2024 The Author(s). Published by Elsevier Inc. All rights reserved.)

Cancer impairs spermatogenesis, whereas results on sperm DNA integrity are controversial and no data are available about sperm oxidative stress. In cancer patients, we detected sperm DNA fragmentation (sDF) and both viable (ROS production in viable sperm fraction/viable spermatozoa) and total (ROS production in viable sperm fraction/total spermatozoa) oxidative stress. We found that cancer (22.50 (17.00-26.75)%, n = 85) increased sDF with respect to the control groups in both normozoospermic subfertile patients (NSP) (12.75 (8.63-14.88)%, n = 52, p < 0.001) and in healthy donors (HD) (8.50 (7.00-14.00)%, n = 19, p < 0.001). The induction of viable oxidative stress ( n = 96) with cancer was even higher: 36.60 (24.05-58.65)% versus 11.10 (8.63-14.90)% in NSP ( p < 0.001) and 9.60 (8.00-14.03)% in HD ( p < 0.001). Similar, albeit lower, differences were found for total oxidative stress. SDF sharply correlated to viable oxidative stress when we considered all subjects (cancer patients and controls) (r = 0.591, p < 0.001, n = 134), but no correlation was found when only cancer patients were studied (r = 0.200; p > 0.05, n = 63). In conclusion, cancer significantly increases sDF and sperm oxidative stress levels. Additional mechanisms to oxidative attack might be responsible for increased sDF in cancer patients. Because sperm oxidative stress might affect the outcomes of sperm cryopreservation, of cancer treatments and of sperm epigenoma, the detection of oxidative stress could be of help in managing the reproductive issues of cancer patients.

Identifying determinants of COVID-19 vaccine uptake is essential for developing effective strategies for promoting vaccination. This longitudinal study aimed to explore predictors of actual COVID-19 vaccine uptake in workers involved in essential services during the first lockdown period in the Prato Province (Italy). All essential workers were invited and surveyed before COVID-19 vaccine approval (96.5% participation rate). Participants were followed up to evaluate their actual COVID-19 vaccination uptake using the vaccination register. Multinomial models were performed to assess predictors of delayed vaccination or non-vaccination. A total of 691 participants were included, of whom 21.7% had delayed the vaccination and 4.4% were unvaccinated. Participants with a sufficient level of health literacy were 50.2% in the vaccinated-on-time group and 32.3% in the unvaccinated group. The multinomial model predictors of delayed vaccination were work type (OR = 0.51), age between 50 and 59 years (OR = 1.82), and influenza vaccination uptake in the last season (OR = 2.51). Predictors of being unvaccinated were work type (OR = 0.33) and attitudes related to attributing less importance to COVID-19 preventive measures (OR = 0.47). Findings showed distinct predictors for COVID-19 vaccination delay and for being unvaccinated. Being unvaccinated seems to be associated with a general skepticism toward prevention measures.

In an eastern North American tree frog, the spring peeper (Pseudacris crucifer), calling rate has been correlated with reproductive success in the field. To determine the sources of individual variation in calling rate in this species, I analyzed males calling at rates greater than and less than the chorus average throughout one breeding season. Compared to low-rate callers, high-rate callers were relatively larger, heavier, older, and in better body condition, and their muscles used in calling had higher activities of the enzymes citrate synthase and beta-hydroxyacyl-CoA dehydrogenase. This muscle profile is functionally matched by cardiovascular correlates, as indicated by the larger ventricles and higher blood hemoglobin concentrations in high-calling rate males. These cardiovascular features are much less developed in females and may result from the fact that females do not engage in vigorous calling behavior. In P. crucifier, a male's calling rate may function as an indicator of the presence of a suite of functionally interrelated traits responsible for the maintenance of this sexually selected display behavior.