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IntroductionOlder adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as "hang ups, let downs, bad breaks, setbacks" that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic factors may also be key resiliencies.MethodsWe linked state-level data reflecting the racialized landscape of economic opportunity across the 20th Century from the U.S. Census (1930-2010) with individual-level data on cognitive outcomes from the U.S. Health and Retirement Study participants racialized as Black. A purposive sample of participants born after the Brown v. Board ruling (born 1954-59) were selected who completed the modified Telephone Interview for Cognitive Status between 2010 and 2020 (N=1381). We tested associations of exposure to structural racism and resilience before birth, and during childhood, young-adulthood, and midlife with cognitive trajectories in mid-late life using mixed-effects regression models.ResultsOlder adults born in places with higher state-level structural socioeconomic racism experienced a more rapid cognitive decline in later life compared to those with lower levels of exposure. In addition, participants born in places with higher levels of state-level structural socioeconomic resilience experienced slower cognitive change over time than their counterparts.DiscussionThese findings reveal the impact of racist U.S. policies enacted in the past that influence cognitive health over time and dementia risk later in life.

Digital tools have evolved into a way of life, and as a result, they have become a growing area of interest for academics who research teaching and learning. Scholars increasingly agree that because digital tools affect human-to-human connection, a greater emphasis on understanding their function in engagement from an interdisciplinary viewpoint is required. However, there does not appear to have been much research on how these tools facilitate social engagement, especially in teaching and learning. This mixed methods study employs a case-study design and explores how digital tools help or hinder social engagement in teaching and learning at a South African-based tertiary institution. A questionnaire consisting of open and closed questions was used to collect data from 88 students from four academic departments at a University of Technology (UoT): Media, Retail and Business Management, Entrepreneurship, and Food Science. Based on the concept of social engagement and the uses and gratifications theory, this interdisciplinary project examines how different fields employ digital tools for social engagement. Some of the findings are that of the communication technologies considered, WhatsApp (97%), video conferencing via Blackboard Collaborate (96.6%) and blackboard course content (95.5%) were the top three ranked tools. Further, WhatsApp was the preferred digital tool for communication with lecturers and peers, while Blackboard was the preferred platform for accessing course materials such as readings and videos. Other than video conferencing platforms such as Zoom, Blackboard Collaborate and YouTube, students use digital tools for engagement with peers. For example, around a quarter of students who used Blackboard Discussion Forums reported engaging with each other. From the qualitative reflections, the study found that students were communicating more with their lecturers through digital tools. Despite having access to lecture recordings, there was still a sense that the educational experience was not as engaging as students wanted it to be because of the lack of in-person engagement.

Abstract Images collected during NASA’s Double Asteroid Redirection Test (DART) mission provide the first resolved views of the Didymos binary asteroid system. These images reveal that the primary asteroid, Didymos, is flattened and has plausible undulations along its equatorial perimeter. At high elevations, its surface is rough and contains large boulders and craters; at low elevations its surface is smooth and possesses fewer large boulders and craters. Didymos’ moon, Dimorphos, possesses an intimate mixture of boulders, several asteroid-wide lineaments, and a handful of craters. The surfaces of both asteroids include boulders that are large relative to their host body, suggesting that both asteroids are rubble piles. Based on these observations, our models indicate that Didymos has a surface cohesion ≤ 1 Pa and an interior cohesion of ∼10 Pa, while Dimorphos has a surface cohesion of

Abstract Spacecraft observations revealed that rocks on carbonaceous asteroids, which constitute the most numerous class by composition, can develop millimeter-to-meter-scale fractures due to thermal stresses. However, signatures of this process on the second-most populous group of asteroids, the S-complex, have been poorly constrained. Here, we report observations of boulders’ fractures on Dimorphos, which is the moonlet of the S-complex asteroid (65803) Didymos, the target of NASA’s Double Asteroid Redirection Test (DART) planetary defense mission. We show that the size-frequency distribution and orientation of the mapped fractures are consistent with formation through thermal fatigue. The fractures’ preferential orientation supports that these have originated in situ on Dimorphos boulders and not on Didymos boulders later transferred to Dimorphos. Based on our model of the fracture propagation, we propose that thermal fatigue on rocks exposed on the surface of S-type asteroids can form shallow, horizontally propagating fractures in much shorter timescales (100 kyr) than in the direction normal to the boulder surface (order of Myrs). The presence of boulder fields affected by thermal fracturing on near-Earth asteroid surfaces may contribute to an enhancement in the ejected mass and momentum from kinetic impactors when deflecting asteroids.

Abstract Asteroids smaller than 10 km are thought to be rubble piles formed from the reaccumulation of fragments produced in the catastrophic disruption of parent bodies. Ground-based observations reveal that some of these asteroids are today binary systems, in which a smaller secondary orbits a larger primary asteroid. However, how these asteroids became binary systems remains unclear. Here, we report the analysis of boulders on the surface of the stony asteroid (65803) Didymos and its moonlet, Dimorphos, from data collected by the NASA DART mission. The size-frequency distribution of boulders larger than 5 m on Dimorphos and larger than 22.8 m on Didymos confirms that both asteroids are piles of fragments produced in the catastrophic disruption of their progenitors. Dimorphos boulders smaller than 5 m have size best-fit by a Weibull distribution, which we attribute to a multi-phase fragmentation process either occurring during coalescence or during surface evolution. The density per km2 of Dimorphos boulders ≥1 m is 2.3x with respect to the one obtained for (101955) Bennu, while it is 3.0x with respect to (162173) Ryugu. Such values increase once Dimorphos boulders ≥5 m are compared with Bennu (3.5x), Ryugu (3.9x) and (25143) Itokawa (5.1x). This is of interest in the context of asteroid studies because it means that contrarily to the single bodies visited so far, binary systems might be affected by subsequential fragmentation processes that largely increase their block density per km2. Direct comparison between the surface distribution and shapes of the boulders on Didymos and Dimorphos suggest that the latter inherited its material from the former. This finding supports the hypothesis that some asteroid binary systems form through the spin up and mass shedding of a fraction of the primary asteroid.

Introduction: Older adults racialized as Black experience higher rates of dementia than those racialized as White. Structural racism produces socioeconomic challenges, described by artist Marvin Gaye as ?hang ups, let downs, bad breaks, setbacks? that likely contribute to dementia disparities. Robust dementia literature suggests socioeconomic factors may also be key resiliencies. Methods: We linked state-level data reflecting the racialized landscape of economic opportunity across the 20th Century from the U.S. Census (1930?2010) with individual-level data on cognitive outcomes from the U.S. Health and Retirement Study participants racialized as Black. A purposive sample of participants born after the Brown v. Board ruling (born 1954?59) were selected who completed the modified Telephone Interview for Cognitive Status between 2010 and 2020 (N=1381). We tested associations of exposure to structural racism and resilience before birth, and during childhood, young-adulthood, and midlife with cognitive trajectories in mid-late life using mixed-effects regression models. Results: Older adults born in places with higher state-level structural socioeconomic racism experienced a more rapid cognitive decline in later life compared to those with lower levels of exposure. In addition, participants born in places with higher levels of state-level structural socioeconomic resilience experienced slower cognitive change over time than their counterparts. Discussion: These findings reveal the impact of racist U.S. policies enacted in the past that influence cognitive health over time and dementia risk later in life.

Abstract Background The burden of non-communicable diseases is becoming unmanageable by primary healthcare facilities in low- and middle-income countries. Community-based approaches are promising for supporting healthcare facilities. In Vietnam, community health volunteers are trained in providing health promotion and screening in a culturally adapted training. This study aims to assess the change in knowledge, attitude and practice regarding NCD prevention and management after a culturally adapted training, and the potential mechanisms leading to this change. Methods The Knowledge Attitude and Practice survey was assessed before and after an initial training, and before and after a refresher training (n = 37). We used a focus group discussion with community health volunteers (n = 8) to map potential mechanisms of the training and applying learned knowledge in practice. Data were collected in the districts Le Chan and An Duong of Hai Phong, Vietnam, in November 2021 and May 2022. Results We found that knowledge increased after training (mean = 5.54, 95%-confidence interval = 4.35 to 6.74), whereas attitude and practice did not improve. Next, knowledge decreased over time (m=-12.27;-14.40 to -10.11) and did not fully recover after a refresher training (m=-1.78;-3.22 to -0.35). As potential mechanisms for change, we identified the use of varying learning methods, enough breaks, efficient coordination of time located for theory and practice, handout materials, large group size and difficulty in applying a digital application for screening results. Conclusion Culturally adapted trainings can improve knowledge among community health volunteers which is important for the support of primary healthcare in low- and middle-income countries. Using a digital screening application can be a barrier for the improvement of knowledge, attitude and practice and we suggest using an intergenerational or age-friendly approach, with the supervision of primary healthcare professionals. Future research on behavioral change should include additional components such as self-efficacy and interrelationships between individuals.

Despite increasing diversity in research recruitment, research finding reporting by gender, race, ethnicity, and sex has remained up to the discretion of authors. This study developped and piloted tools to standardize the inclusive reporting of gender, race, ethnicity, and sex in health research. A modified Delphi approach was used to develop standardized tools for the inclusive reporting of gender, race, ethnicity, and sex in health research. Health research, social epidemiology, sociology, and medical anthropology experts from 11 different universities participated in the Delphi process. The tools were pilot tested on 85 health research manuscripts in top health research journals to determine inter-rater reliability of the tools. The tools each spanned five dimensions for both sex and gender as well as race and ethnicity: Author inclusiveness, Participant inclusiveness, Nomenclature reporting, Descriptive reporting, and Outcomes reporting for each subpopulation. The sex and gender tool had a median score of 6 and a range of 1-15 out of 16 possible points. The percent agreement between reviewers piloting the sex and gender tool was 82%. The interrater reliability or average Cohens Kappa was 0.54 with a standard deviation of 0.33 demonstrating moderate agreement. The race and ethnicity tool had a median score of 1 and a range of 0-15 out of 16 possible points. Race and ethnicity were both reported in only 25.8% of studies evaluated. Most studies that reported race reported only the largest subgroups; White, Black, and Latinx. The percent agreement between reviewers piloting the race and ethnicity tool was 84 and average Cohens Kappa was 0.61 with a standard deviation of 0.38 demonstrating substantial agreement. While the overall dimension scores were low (indicating low inclusivity), the interrater reliability measures indicated moderate to substantial agreement for the respective tools. Efforts in recruitment alone will not provide more inclusive literature without improving reporting.

There have been over 100 years of literature discussing the deleterious influence of racism on health. Much of the literature describes racism as a driver of social determinants of health, such as housing, employment, income, and education. More recently, increased attention has been given to measuring the structural nature of a system that advantages one racialized group over others rather than solely relying on individual acknowledgement of racism. Despite these advances, there is still a need for methodological and analytical approaches to complement the aforementioned. This commentary calls on epidemiologists and other health researchers at large to engage the discourse on measuring structural racism. First, we address the conflation between race and racism in epidemiologic research. Next, we offer methodological recommendations (linking of interdisciplinary variables and data sets and leveraging mixed-method and life-course approaches) and analytical recommendations (integration of mixed data, use of multidimensional models) that epidemiologists and other health researchers may consider in health equity research. The goal of this commentary is to inspire the use of up-to-date and theoretically driven approaches to increase discourse among public health researchers on capturing racism as well as to improve evidence of its role as the fundamental cause of racial health inequities.

The global effects of climate change will increase the frequency and intensity of extreme events such as heatwaves and power outages, which have consequences for buildings and their cooling systems. Buildings and their cooling systems should be designed and operated to be resilient under such events to protect occupants from potentially dangerous indoor thermal conditions. This study performed a critical review on the state-of-the-art of cooling strategies, with special attention to their performance under heatwaves and power outages. We proposed a definition of resilient cooling and described four criteria for resilience—absorptive capacity, adaptive capacity, restorative capacity, and recovery speed —and used them to qualitatively evaluate the resilience of each strategy. The literature review and qualitative analyses show that to attain resilient cooling, the four resilience criteria should be considered in the design phase of a building or during the planning of retrofits. The building and relevant cooling system characteristics should be considered simultaneously to withstand extreme events. A combination of strategies with different resilience capacities, such as a passive envelope strategy coupled with a low-energy space-cooling solution, may be needed to obtain resilient cooling. Finally, a further direction for a quantitative assessment approach has been pointed out.

BackgroundA high prevalence of hypertension is found in Low- and Middle-income Countries (LMICs) including in Indonesia. However, hypertension awareness, treatment, and control are relativity poor. A community-based program to screen and educate people on non-communicable disease prevention (POSBINDU) was launched by the Indonesian government. However, the association between participation in the POSBINDU program with increasing knowledge, attitude, and practice of hypertension has not been widely assessed. In this study, we compared the knowledge, attitudes, and practices among people who accessed the POSBINDU and those who did not access the POSBINDU program. Subsequently, factors associated with the knowledge, attitudes, and practices among people who accessed the POSBINDU and those who did not access the POSBINDU were explored.MethodsThis was an observational study with a cross-sectional design measuring the knowledge, attitudes, and practices for hypertension control in four districts in Indonesia from October 2019 to January 2020. A total of 1,988 respondents were included in this study. A questionnaire was used to assess the knowledge, attitudes, and practices of hypertension. Simple logistic regression was used to investigate the correlation between the characteristics of respondents and knowledge, attitudes, and practice status. Multiple logistic regression tests were conducted to investigate factors associated with knowledge, attitudes, and practice status.ResultsWe found that people who accessed POSBINDU had higher odds of having better knowledge (aOR:1.4; 95%CI:1.2-1.8), however, accessed to POSBINDU was associated with lower attitudes (aOR:0.6; 85%CI: 0.5-0.7) and had no association with hypertension-related practice.ConclusionPeople who accessed POSBINDU have an association with good knowledge, but the association with good attitude and practice was less clear. Therefore, an improvement in the POSBINDU program is needed to increase the attitudes and practices of hypertension.

The tourism industry is distinguished from many other economic activities by the dominance of small-scale enterprises and micro-firms. Small tourism firms are critical change agents for destinations, local economic development and poverty reduction most especially in peripheral regions. This paper is situated within a growing international literature on tourism entrepreneurship and specifically the characteristics and motivations of small tourism entrepreneurs and their business operations. The research is conducted in Eastern Cape province of South Africa which is a resource-scarce or resource-constrained environment. Results are presented from a survey of 79 Black-owned small accommodation businesses and 19 semi-structured interviews with key stakeholders. It is shown that women own and operate the majority of these small accommodation businesses. These are mainly bed and breakfast establishments or small guest houses for which the clientele is mostly business tourists and government employees in particular. Issues under scrutiny are business motivations, start-up and operational issues. Networking emerges as an important business strategy for these peripheral entrepreneurs to address the challenges of business development. Overall, this study provides original findings and fresh insight into a segment of peripheral entrepreneurs operating in a resource-scarce context.

Neighborhoods have been identified as important determinants of health-related outcomes, but limited research has assessed the influence of neighborhood context along the cancer continuum. This study used census tract-level data from the United States Census Bureau and Centers for Disease Control and Prevention to characterize Miami-Dade County census tracts (n = 492) into social vulnerability clusters and assess their associated breast, cervical, and colorectal cancer screening participation rates. We identified disparities by social vulnerability cluster in cancer screening participation rates. Further investigation of geographic disparities in social vulnerability and cancer screening participation could inform equity-focused cancer control efforts.

Chemical and physical stress, weathering, organic and inorganic matter deposition, and microbial growth over time, or “aging”, affect the optical-radiative performance of building envelope materials. Natural exposure helps to quantify these effects, but it usually requires several years. Further, the contribution of the different degradation agents cannot be isolated, and results from different campaigns cannot be easily compared because of the variability in the boundary conditions producing aging. Here we present an adaptation of the protocol implemented by ASTM as D7897-18 “Standard Practice for Laboratory Soiling and Weathering of Roofing Materials to Simulate Effects of Natural Exposure on Solar Reflectance and Thermal Emittance”. The aim is to reproduce in the laboratory the changes in albedo (solar reflectance) and thermal emittance experienced by building envelope materials in European urban areas rather than in the United States. We tuned the spraying duration and weathering cycles, and we compared the UV–vis–NIR reflectances of naturally-aged specimens (48 months in Rome and Milan) of roofing and wall finish materials to those exposed to laboratory weathering and soiling. Excluding those materials that show early physical-chemical degradation, the mean absolute deviation between natural and laboratory exposure of roofing products is equal to 0.027 in albedo. This is a lower value than the differences between two natural exposure campaigns at the same site. We clearly defined the limits of application of the protocol, providing an appraisal of the repeatability of natural aging. Moreover, we identified possible improvements in the methodology to conduct both natural and laboratory exposure.

Chemical and physical stress, weathering, organic and inorganic matter deposition, and microbial growth over time, or “aging”, affect the optical-radiative performance of building envelope materials. Natural exposure helps to quantify these effects, but it usually requires several years. Further, the contribution of the different degradation agents cannot be isolated, and results from different campaigns cannot be easily compared because of the variability in the boundary conditions producing aging. Here we present an adaptation of the protocol implemented by ASTM as D7897-18 “Standard Practice for Laboratory Soiling and Weathering of Roofing Materials to Simulate Effects of Natural Exposure on Solar Reflectance and Thermal Emittance”. The aim is to reproduce in the laboratory the changes in albedo (solar reflectance) and thermal emittance experienced by building envelope materials in European urban areas rather than in the United States. We tuned the spraying duration and weathering cycles, and we compared the UV–vis–NIR reflectances of naturally-aged specimens (48 months in Rome and Milan) of roofing and wall finish materials to those exposed to laboratory weathering and soiling. Excluding those materials that show early physical-chemical degradation, the mean absolute deviation between natural and laboratory exposure of roofing products is equal to 0.027 in albedo. This is a lower value than the differences between two natural exposure campaigns at the same site. We clearly defined the limits of application of the protocol, providing an appraisal of the repeatability of natural aging. Moreover, we identified possible improvements in the methodology to conduct both natural and laboratory exposure.

BackgroundLow-and middle-income countries mostly have ageing populations with many unmet economic, social, or health-related needs, Vietnam being an example. Community-based support in Vietnam, organized as Intergenerational Self-Help Clubs (ISHCs) based on the Older People Associations (OPA) model, can help to meet these needs by the provision of services for various aspects of life. This study aims to assess the implementation of the ISHCs and whether successful implementation is associated with more member-reported positive health.MethodsWe used the RE-AIM (Reach, Effectiveness, Adoption, Implementation, and Maintenance) framework to evaluate the implementation using multiple data sources: ISHC board surveys (n = 97), ISHC member surveys (n = 5,080 in 2019 and n = 5,555 in 2020), focus group discussions (6; n = 44), and interviews with members and board leaders (n = 4).ResultsReach ranged between 46 and 83% of ISHCs reaching target groups, with a majority of women and older people participating. Regarding Effectiveness, members indicated high satisfaction with the ISHCs. Adoption scores were high, with 74%–99% for healthcare and community support activities, and in 2019, higher adoption scores were associated with more members reporting good positive health. In 2020, reported positive health slightly decreased, probably due to the influence of the COVID-19 pandemic. A total of 61 ISHCs had consistent or improving Implementation from 2019 to 2020, and confidence in Maintenance was high.ConclusionThe implementation of the OPA model in Vietnam is promising regarding its promotion of health and may help to tackle the needs of an ageing population. This study further shows that the RE-AIM framework helps to assess community health promotion approaches.

On 2022 September 26, the Double Asteroid Redirection Test (DART) mission was the first successful demonstration of a kinetic impactor for planetary defense. The DART mission utilized a novel autonomous data processing pipeline architecture to quickly produce and analyze the quality of raw and calibrated images from the camera mounted on board the spacecraft. Optimization of the data processing pipeline allowed the final 150 images prior to impact to be calibrated and delivered to the Investigation Team and the press within 15 minutes of acquisition. A data quality analysis pipeline allowed for rapid identification of detector misconfigurations, missing data, and other adverse events. DART data products, along with data from LICIACube and data from ground observatories, used common file formats to facilitate the development of analysis and archiving software. This architecture is described for future missions with large volumes of data and an emphasis on quick-turnaround applications such as planetary defense.

The NASA Double Asteroid Redirection Test (DART) spacecraft impacted the moon Dimorphos of the [65803] Didymos binary system and changed the binary orbit period, demonstrating asteroid deflection by a kinetic impact and indicating that more momentum was transferred to Dimorphos by escaping impact ejecta than was incident with DART. Images of the DART impact ejecta plume were obtained by the Light Italian cubesat for Imaging of Asteroids (LICIACube) in the first few minutes after the DART impact. The ejecta plume imaged by LICIACube 158 s after the DART impact prior to closest approach shows no evidence for plume clearing at low altitude. The ejecta plume imaged 175 s after the DART impact is optically thick up to projected altitudes of 200 m above the surface of Dimorphos. These observations are compared with models of the impact ejecta plume optical depth, structure, and evolution, which are developed from point-source scaling models fitted to numerical simulations of the DART impact into a rubble pile Dimorphos with different material strengths. The observations of the impact plume optical depth and the high momentum transfer from the DART impact are not consistent with impact and ejecta plume models assuming the Dimorphos cohesive strength to be as high as 5000 Pa. Models with 5 and 50 Pa Dimorphos cohesive strength provide the overall best consistency with plume opacity observations and high momentum transfer.

The ASI cubesat LICIACube has been part of the first planetary defense mission DART, having among its scopes to complement the DRACO images to better constrain the Dimorphos shape. LICIACube had two different cameras, LEIA and LUKE, and to accomplish its goal, it exploited the unique possibility of acquiring images of the Dimorphos hemisphere not seen by DART from a vantage point of view, in both time and space. This work is indeed aimed at constraining the tridimensional shape of Dimorphos, starting from both LUKE images of the nonimpacted hemisphere of Dimorphos and the results obtained by DART looking at the impacted hemisphere. To this aim, we developed a semiautomatic Computer Vision algorithm, named VADER, able to identify objects of interest on the basis of physical characteristics, subsequently used as input to retrieve the shape of the ellipse projected in the LUKE images analyzed. Thanks to this shape, we then extracted information about the Dimorphos ellipsoid by applying a series of quantitative geometric considerations. Although the solution space coming from this analysis includes the triaxial ellipsoid found by using DART images, we cannot discard the possibility that Dimorphos has a more elongated shape, more similar to what is expected from previous theories and observations. The result of our work seems therefore to emphasize the unique value of the LICIACube mission and its images, making even clearer the need of having different points of view to accurately define the shape of an asteroid.

On 2022 September 26, NASA's Double Asteroid Redirection Test (DART) successfully hit Dimorphos, the smaller companion of the binary system formed with the asteroid (65803) Didymos. Both the binary system and the impact event were imaged by the Light Italian Cubesat for Imaging of Asteroids, detached from DART 15 days before the impact. Images from the onboard LUKE red, green, and blue camera together with ground-based observations enabled the reconstruction of Didymos's brightness phase curve, with phase angles ranging from 2.35° to 107.7°. The opposition effect regime was studied using the exponential-linear equation, the “Shevchenko” function and the linear-by-parts model while the IAU-official HG1G2 magnitude system was applied to the full phase curve. The opposition effect indicates an unusual asteroid surface for an S type, with characteristics similar to M-type asteroids. While the HG1G2 parameters from the full phase curve place Didymos well among asteroids of the taxonomic C complex. Didymos’s phase curve parameters when compared to near-Earth asteroids are very close to the Q type (1862) Apollo, indicating possible depletion of fine submicrometric grains through resurfacing. Didymos's geometric albedo (0.15 ± 0.01) is reported to be 30%–45% smaller than the average geometric albedo for near-Earth S types (0.26 ± 0.04). We propose that Didymos might be an LL ordinary chondrite analog containing albedo-suppressing, shock-darkened/impact melt minerals that have undergone resurfacing processes in the past. A comparison with meteorites indicates that, less likely, Didymos could also contain materials analog to carbon-bearing brecciated L3 ordinary chondrites.

NASA's Double Asteroid Redirection Test (DART) mission was the first to demonstrate asteroid deflection, and the mission's Level 1 requirements guided its planetary defense investigations. Here, we summarize DART's achievement of those requirements. On 2022 September 26, the DART spacecraft impacted Dimorphos, the secondary member of the Didymos near-Earth asteroid binary system, demonstrating an autonomously navigated kinetic impact into an asteroid with limited prior knowledge for planetary defense. Months of subsequent Earth-based observations showed that the binary orbital period was changed by –33.24 minutes, with two independent analysis methods each reporting a 1 σ uncertainty of 1.4 s. Dynamical models determined that the momentum enhancement factor, β , resulting from DART's kinetic impact test is between 2.4 and 4.9, depending on the mass of Dimorphos, which remains the largest source of uncertainty. Over five dozen telescopes across the globe and in space, along with the Light Italian CubeSat for Imaging of Asteroids, have contributed to DART's investigations. These combined investigations have addressed topics related to the ejecta, dynamics, impact event, and properties of both asteroids in the binary system. A year following DART's successful impact into Dimorphos, the mission has achieved its planetary defense requirements, although work to further understand DART's kinetic impact test and the Didymos system will continue. In particular, ESA's Hera mission is planned to perform extensive measurements in 2027 during its rendezvous with the Didymos–Dimorphos system, building on DART to advance our knowledge and continue the ongoing international collaboration for planetary defense.

Dimorphos was the target of the Double Asteroid Redirection Test (DART) mission. This paper summarizes the properties of an updated shape model of Dimorphos, describes the differences between the updated shape model and an earlier version published by Daly, Ernst, Barnouin et al. (doi: https://doi.org/10.1038/s41586-023-05810-5 ), summarizes the data products associated with this model, and explains where the products can be accessed. The updated shape model benefited from improved methods of incorporating limb information, which will accelerate future shape modeling efforts for other objects with limited imaging data. The updated shape model is similar to the earlier model but slightly smaller (−2.8% change in volume) than the previous Dimorphos global shape model, and the updated shape is slightly more elongated. The additional analysis reported here supports an oblate preimpact shape for Dimorphos. This result indicates that the postimpact elongation of Dimorphos derived from ground-based observations is evidence for a large crater or global reshaping of the asteroid due to the DART impact. The updated global shape model of Dimorphos, as well as the earlier version, will be available in the Planetary Data System Small Bodies Node and through the public Small Body Mapping Tool.

Exceptional advances have been made with systemic treatment for psoriasis (PSO). However, that disease still represents a heavy burden in terms of impact on healthcare systems worldwide. This study comprehensively assesses medication adherence in a real world setting in Italy across all phases—initiation, implementation, and persistence—of PSO therapies. By distinguishing between switches and swaps, it provides unique insights into the patient’s own approach to prescribed therapy as well as clinical decision-making processes, enhancing our understanding of medication adherence and discontinuation in a real world daily setting. The study’s refined methodology for assessing persistence, considering variations in refill gaps and complex dosing regimens, shows that anti-interleukin (IL) therapies are associated with longer periods of adherence compared with other available therapeutic strategies. Among the selected drugs, ixekizumab and secukinumab were the ones with higher rate of treatment adherence at the expense of anti-TNF-α and anti-PDE4 agents. Notably, patients who opt for swaps are approximately 2.8 times more likely to discontinue their PSO therapy within one year. These findings carry practical implications for optimizing medication adherence, including tailored patient counseling, monitoring, and therapeutic adjustments, highlighting the need for a comprehensive and patient-centered approach to managing these conditions.

Chimeric Antigen Receptor (CAR)-modified T lymphocytes represent one of the most innovative and promising approaches to treating hematologic malignancies. CAR-T cell therapy is currently being used for the treatment of relapsed/refractory (r/r) B-cell malignancies including Acute Lymphoblastic Leukemia, Large B-Cell Lymphoma, Follicular Lymphoma, Multiple Myeloma and Mantle Cell Lymphoma. Despite the unprecedented clinical success, one of the major issues of the approved CAR-T cell therapy – tisagenlecleucel, axicabtagene, lisocabtagene, idecabtagene, ciltacabtagene and brexucabtagene – is the uncertainty about its persistence which in turn could lead to weak or no response to therapy with malignancy recurrence. Here we show that the prognosis of patients who do not respond to CAR-T cell therapy is still an unmet medical need. We performed a systematic review and meta-analysis collecting individual data on Duration of Response from at least 12-month follow-up studies. We found that the pooled prevalence of relapse within the first 12 months after CAR-T infusion was 61% (95% CI, 43%−78%); moreover, one year after the infusion, the analysis highlighted a pooled prevalence of relapse of 24% (95% CI, 11%−42%). Our results suggest that identifying potential predictive biomarkers of response to CAR-T therapy, especially for patients affected by the advanced stage of blood malignancies, could lead to stratification of the eligible population to that therapy, recognizing which patients will benefit and which will not, helping regulators to make decision in that way.

Background: Non-communicable diseases, specifically the burden of hypertension, have become a major public health threat to low- and middle-income countries, such as Myanmar. Inadequate knowledge of hypertension and its management among people may hinder its effective prevention and treatment with some groups at particular increased risks, but evidence on this is lacking for Myanmar. The aims of this study were therefore to assess the level of knowledge of risk factors, symptoms and complications of hypertension, by hypertension treatment status, community group-membership, and sociodemographic and socioeconomic factors in Myanmar. Methods: Data was collected through structured questionnaires in 2020 on a random sample of 660 participants, stratified by region and existence of community groups. Knowledge of hypertension was measured with the ‘Knowledge’ part of a validated ‘Knowledge, Attitude and Practice’ survey questionnaire and categorised into ill-informed and reasonably to well-informed about hypertension. Results: The majority of respondents seem reasonably to well-informed about risk factors, symptoms and complications of hypertension. This did not vary by hypertension treatment status and community group membership. People with jobs (B=0.96; 95%-confidence interval 0.343 to 1.572) and higher education (B=1.96; 0.060 to 3.868) had more hypertension knowledge than people without jobs or low education. Adherence to treatment among hypertensive people was low. Conclusion: This study shows a majority of participants in this study in Myanmar seem reasonably to well-informed, with no differences by hypertension status, treatment status, and community group-membership. People without jobs and low education have less hypertension knowledge, making them priority groups for tailored education on health care level as well as community level, lowering the burden of hypertension. Almost half of the hypertensive patients did not take their medicines and therefore, adherence to treatment of hypertension should be an important element for future health education.

Since 2017 the Italian Space Agency (ASI) participates to so-called 'Alternanza Scuola-Lavoro' (i.e. 'school-work synergy') outreach projects promoted by the Italian government, and the ASI Space Science Data Center (SSDC) actively contributes to them, with the primary aim of bringing students closer to space-related activities before choosing their university studies. The SSDC outreach programme is split into two parts: one theoretical, in which relevant topic are presented and explained, and one practical, consisting of hands-on activities aimed to replicate scientific analysis of real space data. The impact of the programme on students' attitude is then evaluated by means of questionnaires specifically designed to gather information on the students' educational background, the level of engagement triggered by the proposed activities, their relevance to school-based activities, and the perceived ease of understanding of the covered topics. As reported in this paper, the analysis of the answers clearly shows that students greatly appreciated this outreach project, supporting its possible expansion and development, even articulated in a more complex pedagogical plan, as already done for one school in a pilot case. Therefore, we plan to expand these activities in the next future both by including new topics (e.g. cosmology, stellar physics), and by proposing new more articulated teaching pathways inclusive of on-site activities in the classroom.

Shifting consumer travel preferences in the COVID-19 environment open potential new opportunities for rural tourism. This paper examines the challenges facing the development of rural tourism in a ‘left behind’ peripheral rural space in Raymond Mhlaba Local Municipality, Eastern Cape. 20 detailed qualitative interviews with key tourism stakeholders, mainly tourism businesses, are analysed. The key findings point to the structural constraints and limits on rural tourism in many parts of South Africa from the shortcomings of local government. The core constraints upon maximising local tourism assets surround the performance of local government, its inadequate provision and maintenance of local infrastructure (especially roads) as well as of service delivery issues.

The first-generation tropomyosin receptor kinase (TRK) inhibitors, larotrectinib and entrectinib, represent exciting new developments in cancer treatment that offer relevant, rapid, and long-lasting clinical benefits. Larotrectinib and entrectinib are recommended as first-line treatments for locally advanced or metastatic non-small cell lung cancer (NSCLC) patients with positive TRK gene fusions. In this study, using the U.S. Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS) database between 2019 and 2022, a retrospective analysis was conducted to evaluate the safety profiles of these drugs. During our study period, 807 individual case safety reports (ICSRs) related to larotrectinib or entrectinib were retrieved from the FAERS database, of which 48.7% referred to females and 24.7% referred to adult patients (18–64 years) with a median age of 61.0 years. A total of 1728 adverse drug reactions (ADRs) were identified. The most frequently reported ADRs were dizziness and pain, which belong to the System Organ Classes (SOCs) “nervous system disorders” and “general disorders and administration site conditions”. Regarding all ADRs, the median time to onset was 37.0 days for larotrectinib and 12.0 days for entrectinib. No evident safety concerns emerged in the long-term safety profiles (>365 days). Only 18 ICSRs were related to pediatric populations (≤16 years), of which 94.0% of the ICSRs were related to larotrectinib. The median age was 10.5 years, while most patients were female (44.4%). Our results show favorable risk-benefit profiles for larotrectinib and entrectinib. Considering the increased use of neurotrophic tyrosine receptor kinase (NTRK) inhibitors, continuous safety monitoring of larotrectinib and entrectinib is required for the detection of possible new adverse drug reactions.

Multisystem inflammatory syndrome in children (MIS-c) is an uncommon, but serious, inflammatory response that occurs after SARS-CoV-2 infection. As time went by, MIS-c was also reported as a potential adverse event following COVID-19 vaccination. A descriptive analysis was performed of Individual Case Safety Reports (ICSRs) associated with anti COVID-19 vaccines and related to the pediatric population from 2020 to 2022. The present pharmacovigilance study aimed to describe cases of MIS-c following COVID-19 vaccination, stratified by sex, reported in the Vaccine Adverse Events Reporting System (VAERS) and meeting the Brighton Collaboration criteria for case definition. We assessed all suspected cases through the case definition and classification of the Brighton Collaboration Group, and only definitive, probable, and possible cases were included in the analysis. The Reporting Odds Ratio (ROR) with 95% Confidence Interval (CI) was computed to assess if males have a lower/higher probability of reporting ICSRs with MIS-c compared with females. Overall, we found 79 cases of potentially reported MIS-c following vaccination. This study demonstrated that MIS-c following vaccination was more commonly reported for male subjects with a median age of 10 years (IQR 10.0–11.4), especially after the first dose of anti COVID-19 vaccines with a median time to onset of 27 days. Even so, the rate of occurrence of MIS-c following anti COVID-19 vaccines is lower (0.12/100,000 vaccinated subjects; 95% CI, 0.12–0.13). Overall, all ICSRs were serious and caused or prolonged hospitalization. Finally, disproportionality analysis showed that males had a higher reporting probability of MIS-c compared with females following immunization with mRNA COVID-19 vaccines. Since only a few years of marketing are available, further data from real-life contexts are needed.

During pre-approval clinical trials, the safety of axi-cel, a second-generation CAR-T-cell therapy directed against CD19, which dramatically improved the prognosis of intractable B-cell lymphomas, has been investigated only in about 400 patients. Therefore, additional information on this issue is urgently needed. In the present paper, we evaluated the 2905 ICSRs with axi-cel as the suspected drug that had been uploaded in the EudraVigilance database from 1 January 2018 to 31 December 2022. About 80% of the reported adverse events were serious, and about 20% of them did not fully resolve or caused death. The adverse events most-frequently reported were Nervous system disorders (25.6%) and, among them, immune-effector-cell-associated neurotoxicity syndrome, followed by Immune system disorders (23.1%), General disorders and administration site conditions (12.0%), Blood and lymphatic system disorders (7.2%), and Infections and infestations (5.8%). Disproportionality analysis showed that the frequency of reported adverse events related to the nervous system was higher with axi-cel than with the other approved CAR-T-cells, except brexu-cel. In conclusion, real-world pharmacovigilance data showed that nervous system and immune system disorders are the adverse events most reported in axi-cel-related ICSRs and suggest that axi-cel could be more neurotoxic than other CAR-T-cells.