Exuberant fibroblast activity compromises lung function via ADAMTS4

© 2020, The Author(s), under exclusive licence to Springer Nature Limited. Severe respiratory infections can result in acute respiratory distress syndrome (ARDS)1. There are no effective pharmacological therapies that have been shown to improve outcomes for patients with ARDS. Although the host inflammatory response limits spread of and eventually clears the pathogen, immunopathology is a major contributor to tissue damage and ARDS1,2. Here we demonstrate that respiratory viral infection induces distinct fibroblast activation states, which we term extracellular matrix (ECM)-synthesizing, damage-responsive and interferon-responsive states. We provide evidence that excess activity of damage-responsive lung fibroblasts drives lethal immunopathology during severe influenza virus infection. By producing ECM-remodelling enzymes—in particular the ECM protease ADAMTS4—and inflammatory cytokines, damage-responsive fibroblasts modify the lung microenvironment to promote robust immune cell infiltration at the expense of lung function. In three cohorts of human participants, the levels of ADAMTS4 in the lower respiratory tract were associated with the severity of infection with seasonal or avian influenza virus. A therapeutic agent that targets the ECM protease activity of damage-responsive lung fibroblasts could provide a promising approach to preserving lung function and improving clinical outcomes following severe respiratory infections

Publisher Correction: Exuberant fibroblast activity compromises lung function via ADAMTS4 (Nature, (2020), 587, 7834, (466-471), 10.1038/s41586-020-2877-5)

© 2020, The Author(s), under exclusive licence to Springer Nature Limited. An amendment to this paper has been published and can be accessed via a link at the top of the paper

Understanding the Use of Crisis Informatics Technology among Older Adults

Mass emergencies increasingly pose significant threats to human life, with a disproportionate burden being incurred by older adults. Research has explored how mobile technology can mitigate the effects of mass emergencies. However, less work has examined how mobile technologies support older adults during emergencies, considering their unique needs. To address this research gap, we interviewed 16 older adults who had recent experience with an emergency evacuation to understand the perceived value of using mobile technology during emergencies. We found that there was a lack of awareness and engagement with existing crisis apps. Our findings characterize the ways in which our participants did and did not feel crisis informatics tools address human values, including basic needs and esteem needs. We contribute an understanding of how older adults used mobile technology during emergencies and their perspectives on how well such tools address human values.Comment: 10 page

SOCIAL AND POLITICAL PARTICIPATION OF BLACKS AND WHITES IN A METROPOLITAN AREA: A TEST OF THREE PERSPECTIVES.

SOCIAL AND POLITICAL PARTICIPATION OF BLACKS AND WHITES IN A METROPOLITAN AREA: A TEST OF THREE PERSPECTIVES

Factors Predicting Decisions About Technology Adoption Among Older Adults

Abstract Background and Objectives Numerous technology applications are available that have the potential to improve the quality of life (QoL) of older adults. However, older adults are less likely to adopt new and emerging technologies and reap the potential benefits. This study examines factors that influence older adults’ decisions about the adoption of new technology. Research Design and Methods Fifty-two older adults participated in a mixed-method procedure, which entailed: (1) observing presentations detailing nine differing technologies, (2) assessing the technologies using tailored questionnaires, and (3) participating in focus group discussions. Participants were assigned into one of seven groups separated by age (65–74, 75+) and language (English, Spanish). The outcome was willingness to adopt technology. Predictors included self-assessed abilities (e.g., numeric ability), computer/Internet skills and knowledge, technology readiness, age, language, and technology ratings (e.g., perceived value). Analyses included Spearman’s ρ, t-tests, and regression analysis. Focus group discussions were examined for supportive examples. Results Self-assessed abilities and computer/Internet skills were predictive of willingness to adopt technologies although the relationship varied according to the technology examined. Technology readiness, age, and language group showed weak associations with the outcome. Of the technology ratings, perceived value, confidence in ability to learn the technology, and the perceived impact on QoL were the most robust predictors of willingness to adopt technology. Discussion and Implications Findings indicate that various stakeholders in technology adoption among older adults must be cognizant of a technology’s functionality and complexity as well as the characteristics and abilities of older adults. However, certain factors such as perceptions about the value of the technology and potential impact on QoL are also critically important to decisions regarding technology adoption among older people

Designing a Web-Based Application to Train Aging Adults to Successfully Use Technologies Important to Independent Living

The purpose of this study was to develop and pilot-test a web-based application that could train a diverse group of aging adults to more successfully use technologies vital to functional tasks and independent, everyday living. The training application simulated the use of automatic teller machines (ATMs) and the use of a mobile phone to call and fill a prescription. Thirty-two adults (age range 28–71, 63 % aged 55+) were assessed at baseline on functional task performance by being given an ATM task and a prescription task assessment to complete. Participants then underwent 2 weeks of training before being given a follow-up assessment; informal evaluation interviews were also administered. Overall, participants found it easy to use the training interface and that the presentation of material was favorable, however some would have preferred less repetition in training tasks. Recommendations on application-development and design as well as training structure are discussed

Seeking and Resolving Complex Online Health Information Age Differences in the Role of Cognitive Abilities

Presently, adults can exploit a vast amount of online health information for solving relatively complex health problems. This study examined the performance of 60 adults ranging in age from 18-82 years on a complex online health information search task. Measures of search time, amount of search, search accuracy, and six cognitive abilities were obtained. The older participants exhibited similar search accuracy, significantly less amount of search, and significantly longer time to complete the problem compared to the younger participants. For the younger participants having higher cognitive ability typically translated into significantly better search accuracy and greater amount of search accomplished. For the older participants, only processing speed significantly distinguished the lower and higher ability older adults on search accuracy and none of the ability measures differentiated these participants on amount of search. These differences and their implications are discussed in the context of supporting older online health information seekers

Augmenting cognitive training in older adults (The ACT Study): Design and Methods of a Phase III tDCS and cognitive training trial

Adults over age 65 represent the fastest growing population in the US. Decline in cognitive abilities is a hallmark of advanced age and is associated with loss of independence and dementia risk. There is a pressing need to develop effective interventions for slowing or reversing the cognitive aging process. While certain forms of cognitive training have shown promise in this area, effects only sometimes transfer to neuropsychological tests within or outside the trained domain. This paper describes a NIA-funded Phase III adaptive multisite randomized clinical trial, examining whether transcranial direct current stimulation (tDCS) of frontal cortices enhances neurocognitive outcomes achieved from cognitive training in older adults experiencing age-related cognitive decline: the Augmenting Cognitive Training in Older Adults study (ACT). ACT will enroll 360 participants aged 65 to 89 with age-related cognitive decline, but not dementia. Participants will undergo cognitive training intervention or education training-control combined with tDCS or sham tDCS control. Cognitive training employs a suite of eight adaptive training tasks focused on attention/speed of processing and working memory from Posit Science BrainHQ. Training control involves exposure to educational nature/history videos and related content questions of the same interval/duration as the cognitive training. Participants are assessed at baseline, after training (12weeks), and 12-month follow-up on our primary outcome measure, NIH Toolbox Fluid Cognition Composite Score, as well as a comprehensive neurocognitive, functional, clinical and multimodal neuroimaging battery. The findings from this study have the potential to significantly enhance efforts to ameliorate cognitive aging and slow dementia