Prospective Memory in Older Adults : Where We Are Now and What Is Next

M. Kliegel acknowledges financial support from the Swiss National Science Foundation (SNSF).Peer reviewedPostprin

Protecting American Health from Climate Change: What is needed to expand adaptation planning by U.S. state and local health departments?

Over the last decade, there have been growing calls for national and local governments to adapt to a changing climate to protect human health. Due to the shift in U.S. federal climate policy under the Trump Administration, leadership for this climate and health adaptation rests increasingly among state, local and tribal health authorities. These authorities need effective strategies for planning climate and health adaptation in funding-constrained environments. This study proposes an adapted model for planning climate and health adaptation among state and local health departments, based on a review of existing efforts in the U.S., with a particular focus on the U.S. CDC’s Building Resilience Against Climate Effects (BRACE) model employed in the CDC-funded Climate Ready States and Cities Initiative (CRSCI). Study methods comprised: a literature review of existing adaptation efforts in the U.S.; analysis of 11 CDC interviews with CRSCI grantees; and 11 online, videoconference focus group discussions with 46 city and county health officials. The study characterizes the key inputs and processes involved in BRACE implementation by 9 states and 2 cities, revealing key challenges and enabling factors that influenced successful climate and health adaptation planning. The study also summarizes the input of health authorities on operational requirements to expand climate and health adaptation at state and local levels, and their recommendations for an adapted BRACE model. Lastly, the study proposes an adapted BRACE model for state and local health departments facing resource constraints, and recommendations for how CDC and the broader health community can advance climate and health adaptation nationwide.Doctor of Public Healt

Spontaneous memory strategies in a videogame simulating everyday memory tasks

People can use different internal strategies to manage their daily tasks, but systematic research on these strategies and their significance for actual performance is still quite sparse. Here we examined self-reported internal strategy use with a 10-block version of the videogame EPELI (Executive Performance in Everyday LIving) in a group of 202 neurotypical adults of 18-50 years of age. In the game, participants perform lists of everyday tasks from memory while navigating in a virtual apartment. Open-ended strategy reports were collected after each EPELI task block, and for comparison also after an EPELI Instruction Recall task and a Word List Learning task assessing episodic memory. On average, 45% of the participants reported using some strategy in EPELI, the most common types being grouping (e.g., performing the tasks room by room), utilising a familiar action schema, and condensing information (e.g., memorising only keywords). Our pre-registered hypothesis on the beneficial effect of self-initiated strategy use gained support, as strategy users showed better performance on EPELI as compared with no strategy users. One of the strategies, grouping, was identified as a clearly effective strategy type. Block-by-block transitions suggested gradual stabilisation of strategy use over the 10 EPELI blocks. The proneness to use strategies showed a weak but reliable association between EPELI and Word List Learning. Overall, the present results highlight the importance of internal strategy use for understanding individual differences in memory performance, as well as the potential benefit for internal strategy employment when faced with everyday memory tasks

Quantifying ADHD Symptoms in Open-Ended Everyday Life Contexts With a New Virtual Reality Task

Objective: To quantify goal-directed behavior and ADHD symptoms in naturalistic conditions, we developed a virtual reality task, EPELI (Executive Performance in Everyday LIving), and tested its predictive, discriminant and concurrent validity. Method: We collected EPELI data, conventional neuropsychological task data, and parent-ratings of executive problems and symptoms in 38 ADHD children and 38 typically developing controls. Results: EPELI showed predictive validity as the ADHD group exhibited higher percentage of irrelevant actions reflecting lower attentional-executive efficacy and more controller movements and total game actions, both indicative of hyperactivity-impulsivity. Further, the five combined EPELI measures showed excellent discriminant validity (area under curve 88 %), while the correlations of the EPELI efficacy measure with parent-rated executive problems (r = .57) and ADHD symptoms (r = .55) pointed to its concurrent validity. Conclusion: We provide a proof-of-concept validation for a new virtual reality tool for ecologically valid assessment of ADHD symptoms.Peer reviewe

Pulmonary Arterial Hypertension Related to HIV Infection: Improved Hemodynamics and Survival Associated with Antiretroviral Therapy

This study aimed to assess the long-term course of pulmonary arterial hypertension related to infection with human immunodeficiency virus (PAHRH) and the influence of antiretroviral therapy (ART) on its characteristics. We retrospectively analyzed all 47 patients in the Swiss HIV Cohort Study in whom PAHRH was diagnosed. Among 35 patients who underwent follow-up Doppler echocardiography, the right ventricular systolic pressure over right atrial pressure gradient increased by a median of 25 mm Hg in 9 patients who had not received ART, decreased by a median of 3 mm Hg in 12 patients who had received nucleoside analogs, and decreased by a median of 21 mm Hg in 14 patients who had received highly active ART (HAART) (P < .005). Among all 47 patients, median duration of survival after PAHRH diagnosis was 2.7 years. HAART significantly decreased mortality due to PAHRH as well as other causes. This study suggests a beneficial effect of combination ART in patients with PAHR

Microbial Diversity in a Hypersaline Sulfate Lake: A Terrestrial Analog of Ancient Mars

Life can persist under severe osmotic stress and low water activity in hypersaline environments. On Mars, evidence for the past presence of saline bodies of water is prevalent and resulted in the widespread deposition of sulfate and chloride salts. Here we investigate Spotted Lake (British Columbia, Canada), a hypersaline lake with extreme (&gt;3 M) levels of sulfate salts as an exemplar of the conditions thought to be associated with ancient Mars. We provide the first characterization of microbial structure in Spotted Lake sediments through metagenomic sequencing, and report a bacteria-dominated community with abundant Proteobacteria, Firmicutes, and Bacteroidetes, as well as diverse extremophiles. Microbial abundance and functional comparisons reveal similarities to Ace Lake, a meromictic Antarctic lake with anoxic and sulfidic bottom waters. Our analysis suggests that hypersaline-associated species occupy niches characterized foremost by differential abundance of Archaea, uncharacterized Bacteria, and Cyanobacteria. Potential biosignatures in this environment are discussed, specifically the likelihood of a strong sulfur isotopic fractionation record within the sediments due to the presence of sulfate reducing bacteria. With its high sulfate levels and seasonal freeze-thaw cycles, Spotted Lake is an analog for ancient paleolakes on Mars in which sulfate salt deposits may have offered periodically habitable environments, and could have concentrated and preserved organic materials or their biomarkers over geologic time

Quantifying ADHD Symptoms in Open-Ended Everyday Life Contexts With a New Virtual Reality Task

Objective: To quantify goal-directed behavior and ADHD symptoms in naturalistic conditions, we developed a virtual reality task, EPELI (Executive Performance in Everyday LIving), and tested its predictive, discriminant and concurrent validity. Method: We collected EPELI data, conventional neuropsychological task data, and parent-ratings of executive problems and symptoms in 38 ADHD children and 38 typically developing controls. Results: EPELI showed predictive validity as the ADHD group exhibited higher percentage of irrelevant actions reflecting lower attentional-executive efficacy and more controller movements and total game actions, both indicative of hyperactivity-impulsivity. Further, the five combined EPELI measures showed excellent discriminant validity (area under curve 88 %), while the correlations of the EPELI efficacy measure with parent-rated executive problems (r = .57) and ADHD symptoms (r = .55) pointed to its concurrent validity. Conclusion: We provide a proof-of-concept validation for a new virtual reality tool for ecologically valid assessment of ADHD symptoms.</p

Mid-term changes in cognitive functions in patients with atrial fibrillation: a longitudinal analysis of the Swiss-AF cohort

Background: Longitudinal association studies of atrial fibrillation (AF) and cognitive functions have shown an unclear role of AF-type and often differ in methodological aspects. We therefore aim to investigate longitudinal changes in cognitive functions in association with AF-type (non-paroxysmal vs. paroxysmal) and comorbidities in the Swiss-AF cohort. Methods: Seven cognitive measures were administered up to five times between 2014 and 2022. Age-education standardized scores were calculated and association between longitudinal change in scores and baseline AF-type investigated using linear mixed-effects models. Associations between AF-type and time to cognitive drop, an observed score of at least one standard deviation below individual's age-education standardized cognitive scores at baseline, were studied using Cox proportional hazard models of each cognitive test, censoring patients at their last measurement. Models were adjusted for baseline covariates.Results2,415 AF patients (mean age 73.2 years; 1,080 paroxysmal, 1,335 non-paroxysmal AF) participated in this Swiss multicenter prospective cohort study. Mean cognitive scores increased longitudinally (median follow-up 3.97 years). Non-paroxysmal AF patients showed smaller longitudinal increases in Digit Symbol Substitution Test (DSST), Cognitive Construct Score (CoCo)and Trail Making Test part B (TMT-B) scores vs. paroxysmal AF patients. Diabetes, history of stroke/TIA and depression were associated with worse performance on all cognitive tests. No differences in time to cognitive drop were observed between AF-types in any cognitive test. Conclusion: This study indicated preserved cognitive functioning in AF patients, best explained by practice effects. Smaller practice effects were found in non-paroxysmal AF patients in the DSST, TMT-B and the CoCo and could indicate a marker of subtle cognitive decline. As diabetes, history of stroke/TIA and depression—but not AF-type—were associated with cognitive drop, more attention should be given to risk factors and underlying mechanisms of AF

Mid-term changes in cognitive functions in patients with atrial fibrillation: a longitudinal analysis of the Swiss-AF cohort.

BACKGROUND Longitudinal association studies of atrial fibrillation (AF) and cognitive functions have shown an unclear role of AF-type and often differ in methodological aspects. We therefore aim to investigate longitudinal changes in cognitive functions in association with AF-type (non-paroxysmal vs. paroxysmal) and comorbidities in the Swiss-AF cohort. METHODS Seven cognitive measures were administered up to five times between 2014 and 2022. Age-education standardized scores were calculated and association between longitudinal change in scores and baseline AF-type investigated using linear mixed-effects models. Associations between AF-type and time to cognitive drop, an observed score of at least one standard deviation below individual's age-education standardized cognitive scores at baseline, were studied using Cox proportional hazard models of each cognitive test, censoring patients at their last measurement. Models were adjusted for baseline covariates. RESULTS 2,415 AF patients (mean age 73.2 years; 1,080 paroxysmal, 1,335 non-paroxysmal AF) participated in this Swiss multicenter prospective cohort study. Mean cognitive scores increased longitudinally (median follow-up 3.97 years). Non-paroxysmal AF patients showed smaller longitudinal increases in Digit Symbol Substitution Test (DSST), Cognitive Construct Score (CoCo)and Trail Making Test part B (TMT-B) scores vs. paroxysmal AF patients. Diabetes, history of stroke/TIA and depression were associated with worse performance on all cognitive tests. No differences in time to cognitive drop were observed between AF-types in any cognitive test. CONCLUSION This study indicated preserved cognitive functioning in AF patients, best explained by practice effects. Smaller practice effects were found in non-paroxysmal AF patients in the DSST, TMT-B and the CoCo and could indicate a marker of subtle cognitive decline. As diabetes, history of stroke/TIA and depression-but not AF-type-were associated with cognitive drop, more attention should be given to risk factors and underlying mechanisms of AF

Toward understanding and exploiting tumor heterogeneity

The extent of tumor heterogeneity is an emerging theme that researchers are only beginning to understand. How genetic and epigenetic heterogeneity affects tumor evolution and clinical progression is unknown. The precise nature of the environmental factors that influence this heterogeneity is also yet to be characterized. Nature Medicine, Nature Biotechnology and the Volkswagen Foundation organized a meeting focused on identifying the obstacles that need to be overcome to advance translational research in and tumor heterogeneity. Once these key questions were established, the attendees devised potential solutions. Their ideas are presented here