Recent advances in the relationships between biofilms and microplastics in natural environments.

Plastic pollution in the form of microplastics (MPs), poses a significant threat to natural ecosystems, with detrimental ecological, social, and economic impacts. This review paper aims to provide an overview of the existing research on the interaction between microbial biofilms and MPs in natural environments. The review begins by outlining the sources and types of MPs, emphasizing their widespread presence in marine, freshwater, and terrestrial ecosystems. It then discusses the formation and characteristics of microbial biofilms on MPs surfaces, highlighting their role in altering the physicochemical properties of MPs and facilitating processes such as vertical transport, biodegradation, dispersion of microorganisms, and gene transfer. Different methods used to assess these interactions are discussed, including microbiological and physicochemical characterization. Current gaps and challenges in understanding the complex relationships between biofilms and MPs are identified, highlighting the need for further research to elucidate the mechanisms underlying these complex interactions and to develop effective mitigation strategies. Innovative solutions, including bioremediation techniques and their combination with other strategies, such as nanotechnology, advanced filtration technologies, and public awareness campaigns, are proposed as promising approaches to address the issue of MPs pollution. Overall, this review underscores the urgent need for a multidisciplinary approach to combating MPs pollution, combining scientific research, technological innovation, and public engagement to safeguard the health and integrity of natural ecosystems.

Distinguishing Between Genuine and Feigned Dementia Using Event-related Potentials.

BACKGROUND: Individuals with probable Alzheimer disease (AD) may perform below cutoffs on traditional, memory-based performance validity tests. Previous studies have found success using event-related potentials (ERPs) to detect feigned neurocognitive impairment in younger populations. OBJECTIVE: To evaluate the utility of an auditory oddball task in conjunction with the P3b peak amplitude to distinguish probable AD from simulated dementia. METHOD: Twenty individuals with probable AD and 20 older healthy controls (HC) underwent an ERP auditory oddball protocol and the Test of Memory Malingering (TOMM). The HC were asked to perform honestly for one condition and to simulate dementia for the other. The individuals with probable AD were asked to perform honestly. The P3b peak amplitude and button press accuracy were collected from each participant and were analyzed to determine their effectiveness in detecting performance validity. RESULTS: The P3b peak amplitude remained stable regardless of behavioral condition in the HC group. When combined with the TOMM Trial 2 score, the P3b peak amplitude further improved the ability to correctly differentiate individuals with probable AD from HC simulating dementia with 100% sensitivity and 90% specificity. CONCLUSION: The P3b peak amplitude was found to be an effective physiologic measure of cognitive impairment in individuals with probable AD compared with HC simulating dementia. When combined with the TOMM Trial 2 score, the P3b peak amplitude served as a promising performance validity measure for differentiating individuals with probable AD from HC simulating dementia.

Age-related differences in the perception of COVID-19 emergency during the Italian outbreak.

OBJECTIVES: Older adults have been identified as a high-risk population for COVID-19, therefore it is crucial to understand how they perceived and reacted to the emergency. We examined age-related differences in emotions, cognitive attitudes, and behavioral responses to the COVID-19 crisis. Based on the Socioemotional Selectivity Theory, we expected to find a positive approach in older adults, which may translate into lower compliance with restrictive measures.Methods: We analyzed data (n = 306) from a nation-wide online survey conducted between April 1st and April 16th, 2020. We compared young (18-29 years), middle-aged (30-50 years), and older (65-85 years) adults' self-reported emotions, attitudes toward the emergency, and compliance with governmental rules.Results: Older adults showed lower negative emotions than young and middle-aged adults. Also, older adults were more confident about COVID-related information received, more favorable toward the restrictive measures, and perceived lower underestimation of the emergency compared to the other age groups. However, older people anticipated a longer time for the emergency to resolve. No age-related differences in compliance with the rules emerged.Conclusion: Older people showed a positive attitude toward the emergency. This attitude was confined in the here and now and did not extend to expectations for the future. Compliance with rules was high across our sample. However, less compliant individuals were also less confident in COVID-related information received by the media and official sources, suggesting the importance of providing precise and reliable information to promote adherence to restrictive measures.

"What's next?" Individual differences in expected repercussions of the COVID-19 pandemic.

The effects of the COVID-19 pandemic on the future are hardly predictable, and people differ in terms of expected repercussions on their future. This study investigated individual differences in the pandemic's expected repercussions, with particular attention to a Balanced Time Perspective (BTP). BTP reflects an individual profile with optimal temporal orientations, it is positively associated with mental health, and it has proven to promote successful coping with unexpected crises. We analyzed data from 3991 adults from 18 to 85 years old participating in an online survey conducted during the Italian lockdown. Participants provided information on BTP, affective states, financial resources, and expectations for the future. Multi-group path analysis was used to test the hypothesized model and to explore gender differences. Results showed that people with a more BTP had fewer negative beliefs about COVID-19's consequences on their future life. BTP affected expected repercussions also indirectly, via affects and beliefs. Finally, gender emerged as a significant moderator of some of the relationships highlighted. The present study contributes to the understanding of the psychological reactions to the current health emergency by confirming its impact on several life domains besides health, not only in the present but also in the anticipated future.

False Memories: The Other Side of Forgetting.

OBJECTIVE: To measure caregivers' and clinicians' perception of false memories in the lives of patients with memory loss due to Alzheimer's disease (AD) and mild cognitive impairment (MCI) using a novel false memories questionnaire. Our hypotheses were that false memories are occurring as often as forgetting according to clinicians and family members. METHOD: This prospective, questionnaire-based study consisting of 20 false memory questions paired with 20 forgetting questions had two forms: one for clinicians and the other for family members of older subjects. In total, 226 clinicians and 150 family members of 49 patients with AD, 44 patients with MCI, and 57 healthy older controls (OCs) completed the questionnaire. RESULTS: False memories occurred nearly as often as forgetting according to clinicians and family members of patients with MCI and AD. Family members of OCs and patients with MCI reported fewer false memories compared to those of the AD group. As Mini-Mental State Examination scores decreased, the mean score increased for both forgetting and false memories. Among clinicians, correlations were observed between the dementia severity of patients seen with both forgetting and false memories questionnaire scores as well as with the impact of forgetting and false memories on daily life. CONCLUSION: Patients with AD experience false memories almost as frequently as they do forgetting. Given how common false memories are in AD patients, additional work is needed to understand the clinical implications of these false memories on patients' daily lives. The novel false memories questionnaire developed may be a valuable tool.

Challenges and difficulties in assessing the environmental status under the requirements of the Ecosystem Approach in North African countries, illustrated by eutrophication assessment.

Marine ecosystems provide many ecosystem goods and services. However, these ecosystems and the benefits they create for humans are subject to competing uses and increasing pressures. As a consequence of the increasing threats to the marine environment, several regulations require applying an ecosystem-based approach for managing the marine environment. Within the Mediterranean Sea, in 2008, the Contracting Parties of the Mediterranean Action Plan decided to progressively apply the Ecosystem Approach (EcAp) with the objective of achieving Good Environmental Status (GES) for 2018. To assess the environmental status, the EcAp proposes 11 Ecological Objectives, each of which requires a set of relevant indicators to be integrated. Progress towards the EcAp entails a gradual and important challenge for North African countries, and efforts have to be initiated to propose and discuss methods. Accordingly, to enhance the capacity of North African countries to implement EcAp and particularly to propose and discuss indicators and methods to assess GES, the aim of this manuscript is to identify the practical problems and gaps found at each stage of the environmental status assessment process. For this purpose, a stepwise method has been proposed to assess the environmental status using Ecologic Objective 5-Eutrophication as example.

The Use of Event Related Potentials to Predict Amyloid PET Status Among Patients from a Memory Disorders Clinic.

Background: Amyloid positron emission tomography (PET) scans provide in vivo evidence of Alzheimer's disease (AD); however, their high cost limits their use in standard clinical care. Event related potentials (ERPs) may represent an inexpensive and non-invasive additional method for detecting AD pathology. Objective: We investigated whether ERPs, along with neuropsychological data, serve as predictors of amyloid PET status in patients with memory complaints. Methods: Veterans aged 50-100 were recruited from a memory disorders clinic. Participants underwent a neuropsychological battery and an ERP auditory oddball protocol. Twenty-eight patients had a positive amyloid PET scan, and thirty-nine patients had a negative scan. Results: ERP-P200 target amplitude and P200 standard latency were predictors of amyloid PET status. When submitting to ROC analysis, P200 standard latency exhibited the highest specificity and sensitivity in predicting amyloid PET positivity, correctly classifying the amyloid PET status for 86% of patients. Conclusions: ERP-P200 measures are strong indicators of amyloid-ß presence in patients from a memory disorder clinic. Increased P200 amplitude and decreased P200 latency in patients with a positive amyloid PET scan may be attributed to hyperactivation of perceptual bottom-up processes compensating for AD-related synaptic loss in the fronto-parietal networks.

Algorithmic Spaced Retrieval Enhances Long-Term Memory in Alzheimer Disease: Case-Control Pilot Study.

BACKGROUND: Spaced retrieval is a learning technique that involves engaging in repeated memory testing after increasingly lengthy intervals of time. Spaced retrieval has been shown to improve long-term memory in Alzheimer disease (AD), but it has historically been difficult to implement in the everyday lives of individuals with AD. OBJECTIVE: This research aims to determine, in people with mild cognitive impairment (MCI) due to AD, the efficacy and feasibility of a mobile app that combines spaced retrieval with a machine learning algorithm to enhance memory retention. Specifically, the app prompts users to answer questions during brief daily sessions, and a machine learning algorithm tracks each user's rate of forgetting to determine the optimal spacing schedule to prevent anticipated forgetting. METHODS: In this pilot study, 61 participants (young adults: n=21, 34%; healthy older adults: n=20, 33%; people with MCI due to AD: n=20, 33%) used the app for 4 weeks to learn new facts and relearn forgotten name-face associations. Participation during the 4-week period was characterized by using the app once per day to answer 15 questions about the facts and names. After the 4-week learning phase, participants completed 2 recognition memory tests approximately 1 week apart, which tested memory for information they had studied using the app as well as information they had not studied. RESULTS: After using the mobile app for 1 month, every person with MCI due to AD demonstrated improvements in memory for new facts that they had studied via the app compared to baseline (P<.001). All but one person with MCI due to AD (19/20, 95%) showed improvements of more than 10 percentage points, comparable to the improvements shown by young adults and healthy older adults. Memory for name-face associations was similarly improved for all participant groups after using the app but to a lesser degree. Furthermore, for both new facts and name-face associations, we found no memory decay for any participant group after they took a break of approximately 1 week from using the app at the end of the study. Regarding usability, of the 20 people with MCI due to AD, 16 (80%) self-adhered to the app's automated practice schedule, and half of them (n=10, 50%) expressed an interest in continuing to use it. CONCLUSIONS: These results demonstrate early evidence that spaced retrieval mobile apps are both feasible for people with early-stage AD to use in their everyday lives and effective for supporting memory retention of recently learned facts and name-face associations.

Recent advances in understanding Alzheimer's Disease: diagnosis and management strategies.

As the rates of Alzheimer's Disease (AD) increase in the world due to the aging of the population, research has made tremendous advances to target the two hallmark pathologies of AD: amyloid-ß (Aß) plaque deposition and neurofibrillary tangles of hyperphosphorylated tau. Here, we discuss recent advances in the clinical evaluation and management of AD, with a focus on new hypotheses related to the etiology of AD and new evidence related to AD-mimicking neurodegenerative diseases. Though recent clinical studies suggest anti-amyloid disease modifying agents may slow the progression of AD, there is currently no medication that stops it. Moreover, slowing the progression will result in more individuals in the mild cognitive impairment (MCI) and mild dementia stages of AD. Given this reality, we evaluate the development of non-pharmacological strategies to help sustain cognitive function and quality of life.

Microbiological Characterization of the Biofilms Colonizing Bioplastics in Natural Marine Conditions: A Comparison between PHBV and PLA.

Biodegradable polymers offer a potential solution to marine pollution caused by plastic waste. The marine biofilms that formed on the surfaces of poly(lactide acid) (PLA) and poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) were studied. Bioplastics were exposed for 6 months to marine conditions in the Mediterranean Sea, and the biofilms that formed on their surfaces were assessed. The presence of specific PLA and PHBV degraders was also studied. PHBV showed extensive areas with microbial accumulations and this led to higher microbial surface densities than PLA (4.75 vs. 5.16 log CFU/cm2). Both polymers' surfaces showed a wide variety of microbial structures, including bacteria, fungi, unicellular algae and choanoflagellates. A high bacterial diversity was observed, with differences between the two polymers, particularly at the phylum level, with over 70% of bacteria affiliated to three phyla. Differences in metagenome functions were also detected, revealing a higher presence of proteins involved in PHBV biodegradation in PHBV biofilms. Four bacterial isolates belonging to the Proteobacteria class were identified as PHBV degraders, demonstrating the presence of species involved in the biodegradation of this polymer in seawater. No PLA degraders were detected, confirming its low biodegradability in marine environments. This was a pilot study to establish a baseline for further studies aimed at comprehending the marine biodegradation of biopolymers.

Effect of the Presence of Lignin from Woodflour on the Compostability of PHA-Based Biocomposites: Disintegration, Biodegradation and Microbial Dynamics.

Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) has gained attention as a possible substitute for conventional polymers that could be integrated into the organic recycling system. Biocomposites with 15% of pure cellulose (TC) and woodflour (WF) were prepared to analyze the role of lignin on their compostability (58 °C) by tracking the mass loss, CO2 evolution, and the microbial population. Realistic dimensions for typical plastic products (400 µm films), as well as their service performance (thermal stability, rheology), were taken into account in this hybrid study. WF showed lower adhesion with the polymer than TC and favored PHBV thermal degradation during processing, also affecting its rheological behavior. Although all materials disintegrated in 45 days and mineralized in less than 60 days, lignin from woodflour was found to slow down the bioassimilation of PHBV/WF by limiting the access of enzymes and water to easier degradable cellulose and polymer matrix. According to the highest and the lowest weight loss rates, TC incorporation allowed for higher mesophilic bacterial and fungal counts, while WF seemed to hinder fungal growth. At the initial steps, fungi and yeasts seem to be key factors in facilitating the later metabolization of the materials by bacteria.

Changing Decisions: The Interaction between Framing and Decoy Effects.

BACKGROUND: Cognitive biases are popular topics in psychology and marketing, as they refer to systematic cognitive tendencies in human thinking that deviate from logical and rational reasoning. The framing effect (FE) and the decoy effect (DE) are examples of cognitive biases that can influence decision making and consumer preferences. The FE involves how options are presented, while the DE involves the addition of a third option that influences the choice between the other two options. METHODS: We investigated the interaction between the FE and the DE in the case of both incongruent (ID) and congruent (CD) decoys in a sample of undergraduates (n = 471). The study had a two (positive vs. negative valence) × three (original, congruent decoy, incongruent decoy) within-subject design. RESULTS: The ID option reduces the FE in both positive- and negative-framed conditions compared to the controls, while adding the CD option increases the FE only in the positive-framed condition. Additionally, the inclusion of the CD option enhances the level of decision confidence, whereas no significant differences were found in the ID condition. CONCLUSIONS: Our findings gave new insights into the interplay between two of the most frequent cognitive biases.

Side of motor symptom onset predicts sustained attention deficits and motor improvements after attention training in Parkinson's disease.

OBJECTIVE: Parkinson's disease (PD) side of motor symptom onset has been associated with distinct cognitive deficits; individuals with left-side onset (LPD) show more visuospatial impairments, whereas those with right-side onset (RPD) show more verbal impairments. Non-spatial attention is a critical cognitive ability associated with motor functioning that is right hemisphere lateralized but has not been characterized with regard to PD side of onset. We compared individuals with LPD and RPD on non-spatial attention tasks and examined differential responses to a 4-week sustained attention training program. METHOD: Participants included 9 with LPD and 12 with RPD, who performed both brief and extended go/no-go continuous performance tasks and an attentional blink task. Participants also engaged in an at-home sustained attention training program, Tonic and Phasic Alertness Training (TAPAT), 5 days/week for 4 weeks. We assessed cognitive and motor symptoms before and after training, and after a 4-week no-contact period. RESULTS: At baseline, participants with LPD exhibited worse performance than those with RPD on the extended continuous performance task, indicating specific deficits in sustaining attention. Poorer attention was associated with worse clinical motor scores. Notably, side of onset had a significant effect on clinical motor changes after sustained attention training, with only LPD participants improving after training, and 4/9 showing clinically meaningful improvements. CONCLUSIONS: Compared to RPD, participants with LPD had poorer sustained attention pre-training and were more likely to improve on clinical motor functioning after sustained attention training. These findings support mechanistic differences between LPD and RPD and suggest potential differential treatment approaches.

Valorization of Agricultural Waste Lignocellulosic Fibers for Poly(3-Hydroxybutyrate-Co-Valerate)-Based Composites in Short Shelf-Life Applications.

Biocircularity could play a key role in the circular economy, particularly in applications where organic recycling (composting) has the potential to become a preferred waste management option, such as food packaging. The development of fully biobased and biodegradable composites could help reduce plastic waste and valorize agro-based residues. In this study, extruded films made of composites of polyhydroxybutyrate-co-valerate (PHBV) and lignocellulosic fibers, namely almond shell (AS) and Oryzite® (OR), a polymer hybrid composite precursor, have been investigated. Scanning electron microscopy (SEM) analysis revealed a weak fiber-matrix interfacial interaction, although OR composites present a better distribution of the fiber and a virtually lower presence of "pull-out". Thermogravimetric analysis showed that the presence of fibers reduced the onset and maximum degradation temperatures of PHBV, with a greater reduction observed with higher fiber content. The addition of fibers also affected the melting behavior and crystallinity of PHBV, particularly with OR addition, showing a decrease in crystallinity, melting, and crystallization temperatures as fiber content increased. The mechanical behavior of composites varied with fiber type and concentration. While the incorporation of AS results in a reduction in all mechanical parameters, the addition of OR leads to a slight improvement in elongation at break. The addition of fibers improved the thermoformability of PHBV. In the case of AS, the improvement in the processing window was achieved at lower fiber contents, while in the case of OR, the improvement was observed at a fiber content of 20%. Biodisintegration tests showed that the presence of fibers promoted the degradation of the composites, with higher fiber concentrations leading to faster degradation. Indeed, the time of complete biodisintegration was reduced by approximately 30% in the composites with 20% and 30% AS.

Pleasure before business: emotions and age effects on daily activity scheduling.

Activity scheduling represents a key process in daily life, involving the evaluation of the costs and benefits of the resources to be invested, but also a preference for when to engage in pleasant or unpleasant activities. Aging affects the evaluation processes and individual preferences due to changes in cognitive functioning and life perspectives. The present study investigated the differences between younger adults (age range 19-33) and older adults (age range 65-87) in a task assessing preferential scheduling of activities. Participants were asked to schedule thirty emotional activities (positive, negative, or neutral) within a 30-day time window, assigning one activity for each day. Results indicated that older adults, but not younger adults, planned positive activities closer in time, supporting the "positivity effect". Also, both younger and older adults tended to postpone negative activities, scheduling them in the last days. Finally, for older adults only, negative affect was associated with the tendency to put positive activities closer in time. Present findings showed age-specific effects of emotional content on daily activity scheduling.

With or without the Mask: Age Differences in Perceived Trustworthiness and Health during the COVID-19 Pandemic.

The COVID-19 pandemic and the obligation to wear surgical face masks have affected social interactions. Wearing a mask can cause impairments in face identification, emotion recognition, and trait impressions. The present study investigated, during the COVID-19 period, age-related differences in perceived trustworthiness (Study 1) and health (Study 2) when viewing faces with or without masks. Younger (YAs, 18-35 years) and older (OAs, over 65 years) adults' ratings were compared. Through a web-based platform, a series of neutral younger and older faces (YFs vs. OFs) were presented, on a computer screen, with or without a mask (Mask vs. No-Mask), and participants were asked to rate them on a 7-point scale. Furthermore, data collected during the pandemic (Mask and No-Mask conditions) were compared with ratings obtained before it (Pre-COVID condition). Perceived trustworthiness was lower in the No-Mask condition for both age groups compared to Mask and Pre-COVID conditions, which did not differ. For health ratings, no differences emerged for OAs between the conditions, whereas YAs' ratings were lower in both the Mask and No-Mask conditions compared to the Pre-COVID condition. The fear of contracting COVID-19 affected both trustworthiness and health ratings. Wearing a surgical face mask affects trait impressions for YAs and OAs, partly due to the fear of COVID-19. Trait impressions are also influenced by the age of the face to be evaluated.

Characteristics of Home and Neighborhood Built Environments During COVID-19 for Older Adults in the United States and Italy.

The home and neighborhood environments impact the social and mental health of older adults, yet little research has addressed the various contexts that can affect these relationships, such as community culture, built and natural elements, and demographics. This survey-based study examined community-dwelling older adults' access and use of transitional outdoor/indoor space (i.e., porches, gardens, windows, etc.), and how that use was related to health variables and changed with the pandemic in two available samples of older adults in the United States and Italy. Use of both outdoor and indoor space was found to be more individualistic in Boston, in the United States, than in Chieti, Italy, where use of these areas with others was more common. Results suggest that window viewing from within the home may be an activity that individuals in Italy engage in when feeling lonely. Changes in the use of home and community space after COVID-19 were minimal; only in the United States did individuals report greater time indoors since the onset of the pandemic. Use of the built environment in and around the home by older adults was found to have multidimensional characteristics between the United States and Italy, with the potential to foster connections and improve well-being.

Nano- and micro-sized carnauba wax emulsions-based coatings incorporated with ginger essential oil and hydroxypropyl methylcellulose on papaya: Preservation of quality and delay of post-harvest fruit decay.

Carnauba wax nano and micro-sized emulsions and hydroxypropyl methylcellulose coatings, alone or combined with ginger essential oils (GEO) were applied on papayas and evaluated under several storage conditions. In a first experiment, storage parameters were: 6 days at 22 °C, and 9 days at 13 °C followed by 5 days at 22 °C. In a second experiment, storage was: 5 days at 22 °C, and 10 days at 16 °C followed by 3 days at 22 °C. Coating effects were dependent on storage conditions. While fruits were in cold storage, there were few changes; however, at 22 °C, the differences between coatings became more evident. Nanoemulsions maintained papaya quality during storage by retarding firmness loss, color changes, and reducing respiration rates, resulting in delayed ripening. GEO exhibited some positive effect on fungal disease control. Nanoemulsion-based coatings improved shelf life by reducing weight loss, color development, and slowing ripening of papaya fruit.

Home-Based Electronic Cognitive Therapy in Patients With Alzheimer Disease: Feasibility Randomized Controlled Trial.

BACKGROUND: Can home-based computerized cognitive training programs be a useful tool to sustain cognition and quality of life in patients with Alzheimer disease (AD)? To date, the progressive nature of the disease has made this question difficult to answer. Computerized platforms provide more accessibility to cognitive trainings; however, the feasibility of long-term, home-based computerized programs for patients with AD dementia remains unclear. OBJECTIVE: We aimed to investigate the feasibility of a 24-week home-based intervention program using the Constant Therapy app and its preliminary efficacy on cognition in patients with AD. Constant Therapy is a program developed for patients with speech and cognitive deficits. We hypothesized that patients with AD would use Constant Therapy daily over the course of the 24-week period. METHODS: Data were collected over a 48-week period. We recruited participants aged between 50 and 90 years with a diagnosis of mild cognitive impairment due to AD or mild AD dementia. Participants were randomly assigned to either the Constant Therapy (n=10) or active control (n=9) group. The Constant Therapy group completed a tablet-based training during the first 24 weeks; the second 24 weeks of computerized training were optional. The active control group completed paper-and-pencil games during the first 24 weeks and were invited to complete an optional Constant Therapy training during the second 24 weeks. Every 6 weeks, the participants completed the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). The participants independently accessed Constant Therapy using an Apple iPad. Our primary feasibility outcomes were the rate of adherence and daily use of Constant Therapy over 24 weeks. Our secondary outcomes were Constant Therapy performance over 24 weeks and change in RBANS scores between the 2 experimental groups. RESULTS: Feasibility analyses were computed for participants who completed 24 weeks of Constant Therapy. We found that long-term use of the Constant Therapy program was feasible in patients with AD over 24 weeks (adherence 80%; program use 121/168 days, for 32 minutes daily). These participants showed an overall improvement in accuracy and latency (P=.005) in the Constant Therapy scores, as well as specific improvements in visual and auditory memory, attention, and arithmetic tasks. The Constant Therapy group showed improvement in the RBANS coding subtest. No unexpected problems or adverse events were observed. CONCLUSIONS: Long-term (eg, 24 weeks) computerized cognitive training using Constant Therapy is feasible in patients with AD in the mild cognitive impairment and mild dementia stages. Patients adhered more to Constant Therapy than to the paper-and-pencil training over 24 weeks and improved their performance over time. These findings support the development of future randomized controlled trials that will investigate the efficacy of Constant Therapy to sustain cognitive function in patients with AD. TRIAL REGISTRATION: ClinicalTrials.gov NCT02521558; https://clinicaltrials.gov/ct2/show/NCT02521558.

Perceptions of COVID-19 Maternal Vaccination among Pregnant Women and Healthcare Workers and Factors That Influence Vaccine Acceptance: A Cross-Sectional Study in Barcelona, Spain.

COVID-19 is associated with poor maternal and pregnancy outcomes. COVID-19 vaccination is recommended in Spain, yet vaccination rates in pregnancy are suboptimal. This study investigates the perceptions of pregnant women and healthcare workers (HCW) regarding COVID-19 vaccination. A web-based cross-sectional quantitative study was conducted in 2021-2022 among 302 pregnant women and 309 HCWs in the Catalan public health system. Most pregnant women (83%) and HCWs (86%) were aware of COVID-19 maternal vaccines. The recommendation of the COVID-19 vaccination by an HCW was identified as the greatest facilitator for maternal vaccine uptake, while the fear of harming the foetus was the most significant barrier reported for rejecting vaccination. HCWs recognised they received limited information and training about COVID-19 vaccination in pregnancy, which hindered them from providing informed recommendations. This study highlights that information and education on COVID-19 vaccines to pregnant women and health professionals are pivotal to ensuring informed decision-making and increasing vaccine uptake.