An Integrative Review of the Feasibility and Effects of the Use of Location-Tracking Devices by Persons Living With Cognitive Impairment.

OBJECTIVES: This study aimed to examine the effects of location-tracking devices on persons living with cognitive impairment, investigate facilitators of and barriers to using the devices, and provide future directions for the use of the devices. METHODS: An integrative review was conducted using 5 databases: PubMed, Embase, Web of Science, CINAHL, and Scopus. From the 1429 initially identified studies, 10 were included in the review. RESULTS: Location-tracking devices benefited persons living with cognitive impairment and their informal caregivers. The devices brought more independence to persons living with cognitive impairment, allowing them to go outside and feel safer there. Furthermore, the devices reduced the caregivers' worries about their loved ones being lost. CONCLUSIONS: Location-tracking devices have the potential to increase independence in persons living with cognitive impairment and to decrease psychological stress in informal caregivers. In the future, ways to minimize the barriers to using location-tracking devices need to be determined.

Does cognitive impairment moderate the relationship between social isolation and anxiety? A 5-year longitudinal study of a nationally representative sample of community residing older adults.

BACKGROUND: Anxiety is common in older adults and social isolation is one of the leading factors associated with their anxiety. However, what is unknown is how the relationship between social isolation and anxiety differs by cognitive status. Therefore, this study was conducted to (1) compare the level of social isolation and anxiety in older adults who developed probable dementia and mild cognitive impairment (MCI) to those who maintained normal cognitive function over 5 years; and (2) determine if cognitive impairment moderates the relationship between changes in social isolation and changes in anxiety over 5 years. METHODS: A secondary data analysis was conducted using the National Social Life, Health, and Aging Project (NSHAP): Wave 2 (2010-2011) and Wave 3 (2015-2016). The participants were categorized into three groups: Participants who developed probable dementia over 5 years (4.3%), developed probable MCI (19.1%), or maintained normal cognitive function (76.6%). Weighted linear regression analyses with a group interaction were used to examine the moderating effect of cognitive impairment on the relationship between changes in social isolation and anxiety. RESULTS: At the 5-year follow up, there were statistically significant differences in social isolation between the three groups (p = 0.043). Regression analyses showed that increased social isolation over time was related to increased anxiety over 5 years regardless of cognitive status after controlling for covariates (p = 0.017). CONCLUSIONS: The relationship between social isolation and anxiety was a universal phenomenon regardless of cognitive status. Tailored interventions targeting both people with or without cognitive impairment are needed to lessen social isolation and anxiety.

Influence of caregivers' psychological well-being on the anxiety and depression of care recipients with dementia.

This study was conducted to examine how caregivers' psychological well-being influences the anxiety or depression of care recipients with dementia. A secondary data analysis was conducted using 666 dyads of older adults with dementia and their caregivers. The odds that care recipients with dementia would experience anxiety increased when caregivers had a negative relationship with care recipients (OR = 1.22, p = 0.042), lower perception of the positive aspects of caregiving (OR = 0.86, p = 0.047), or anxiety (OR = 2.41, p = 0.036). The odds that care recipients with dementia would experience depression increased when caregivers had a greater perception of the negative aspects of caregiving (OR = 1.15, p = 0.023) or anxiety (OR = 2.21, p = 0.045). Since care recipients with dementia and their caregivers spend considerable time together daily, caregivers' psychological well-being can impact care recipients' anxiety and depression.

Implementing Dementia Caregiver Programs in Real-World Settings: Fidelity Considerations.

Testing interventions in real-world settings requires fidelity monitoring to ensure implementation integrity. However, strategies to enhance, monitor, and measure fidelity deployed in efficacy trials may not be feasible in pragmatic trials or sustainable in practice. This paper reviews published translational or pragmatic studies of dementia caregiver support interventions to understand how fidelity was previously treated in order to derive recommendations for future pragmatic-like trials. A search using SCOPUS, EMBASE, and Google Scholar identified 31 translational caregiver intervention studies of which 20 (64.5%) referenced fidelity. Of these 20, 11 (55.0%) reported fidelity measurement, whereas 9 (45.0%) only recognized its importance. Of the 11 studies, fidelity was assessed using investigator-developed scoring forms, audio/video recordings, evaluations from caregivers and interventionists, and by comparing outcomes with the original efficacy trial. Additionally, 7 (63.6%) of 11 studies reported fidelity results, representing only 22.5% of 31 studies reporting outcomes demonstrating the inconsistency in the field concerning the reporting outcomes of fidelity. We conclude that fidelity methods used in translational studies to date are not practical nor sustainable for ongoing monitoring of evidence-based programs in real-world settings and that only 2 aspects of fidelity, intervention and adherence, are considered. New approaches are needed to ensure fidelity integrity in pragmatic trials and which can be sustained thereafter.

Parallelized Particle Swarm Optimization on FPGA for Realtime Ballistic Target Tracking.

This paper addresses the problem of tracking a high-speed ballistic target in real time. Particle swarm optimization (PSO) can be a solution to overcome the motion of the ballistic target and the nonlinearity of the measurement model. However, in general, particle swarm optimization requires a great deal of computation time, so it is difficult to apply to realtime systems. In this paper, we propose a parallelized particle swarm optimization technique using field-programmable gate array (FPGA) to be accelerated for realtime ballistic target tracking. The realtime performance of the proposed method has been tested and analyzed on a well-known heterogeneous processing system with a field-programmable gate array. The proposed parallelized particle swarm optimization was successfully conducted on the heterogeneous processing system and produced similar tracking results. Also, compared to conventional particle swarm optimization, which is based on the only central processing unit, the computation time is significantly reduced by up to 3.89×.

Better caregiver mastery is associated with less anxiety in individuals with cognitive impairment.

BACKGROUND: When caregivers have a high level of caregiver mastery, their care recipients with cognitive impairment have less behavioral health problems. However, the relationship between caregiver mastery and anxiety among care recipients over time is unknown. Therefore, this study was conducted to examine that better caregiver mastery is associated with less anxiety in individuals with cognitive impairment over time. METHODS: A secondary data analysis was conducted using the Healthy Patterns Clinical Trial (NCT03682185) dataset and guided by Factors Associated with Behavioral and Psychological Symptoms of Dementia conceptual framework. This study included 154 dyads of individuals with cognitive impairment and their caregivers. Multiple linear regression analyses were performed on changes in anxiety. Model 1 included variables at the level of neurodegeneration (i.e., cognitive impairment and age). Model 2 added patient factors (i.e., sleep problems and depression) with the Model 1. Finally, Model 3 included caregiver factor (i.e., caregiver mastery) with the Model 2 to examine how changes in caregiver mastery influence changes in anxiety of care recipients. RESULTS: Model 3 was statistically significant; after controlling for variables at the level of neurodegeneration associated with cognitive impairment and patient factors, improvement of caregiver mastery over time (ß =-0.230, p = 0.015) was related to decreased anxiety over time (R2 = 0.1099). CONCLUSIONS: Caregivers with high caregiver mastery may have better knowledge on how to care for their loved ones and how to manage their neuropsychiatric symptoms. Therefore, improving the level of caregiver mastery by providing psychoeducational programs and resources that family caregivers need will help reduce the frequency of anxiety in individuals with cognitive impairment.

Predictors of manual dexterity at 3 and 6 months after stroke: integration of clinical, neurophysiological, and neuroimaging factors.

This retrospective study aimed to predict dexterity at 3 and 6 months post-stroke by integrating clinical, neurophysiological, and neuroimaging factors. We included 126 patients with first-ever, unilateral, and supratentorial stroke. Demographic, stroke characteristics, and initial clinical assessment variables [Mini-mental state examination and Fugl-Meyer Assessment Upper Extremity (FMA-UE)] were evaluated 2 weeks after stroke. Dexterity, measured using the Manual Function Test (MFT) hand subscore, was the primary outcome. The neurophysiological variables, upper limb somatosensory evoked potential (SEP) and motor evoked potential (MEP), were assessed 2 weeks post-stroke. The neuroimaging variable, fractional anisotropy (FA) of the corticospinal tract (CST), was assessed 3 weeks post-stroke. Multiple regression analysis revealed significant predictors for improved dexterity at 3 and 6 months post-stroke, including younger age, higher FMA-UE score, presence of waveforms in the SEP and MEP, and higher FA values in the CST (adjusted R 2  = 0.776, P  < 0.001 at 3 months; adjusted R 2  = 0.668, P  < 0.001 at 6 months; where MEP, SEP, and FA accounted together for an additional 0.079 and 0.166 of variance beyond age and FMA-UE, respectively). Subgroup analysis was conducted by categorizing the participants based on their initial hand function: those with no hand function (MFT hand subscore = 0) (N = 60) and those with a score >0 (N = 51). Initial FMA-UE was a primary predictive factor regardless of the time point or initial severity, whereas the presence of MEP was a significant predictor only in the group with no initial hand dexterity.

Identification and characterization of Brevibacillus halotolerans B-4359: a potential antagonistic bacterium against red pepper anthracnose in Korea.

Our study aimed to identify potential biocontrol agents (BCAs) against major phytopathogens under in vitro conditions by screening the Freshwater Bioresources Culture Collection (FBCC), Korea. Of the identified 856 strains, only 65 exhibited antagonistic activity, among which only one representative isolation, Brevibacillus halotolerans B-4359 was selected based on its in vitro antagonistic activity and enzyme production. Cell-free culture filtrate (CF) and volatile organic compounds (VOCs) of B-4359 were shown to be effective against the mycelial growth of Colletotrichum acutatum. Notably, B-4359 was found to promote spore germination in C. acutatum instead of exhibiting a suppressive effect when the bacterial suspension was mixed with the spore suspension of C. acutatum. However, B-4359 showed an excellent biological control effect on the anthracnose of red pepper fruits. Compared to other treatments and untreated control, B-4359 played a more effective role in controlling anthracnose disease under field conditions. The strain was identified as B. halotolerans using BIOLOG and 16S rDNA sequencing analyses. The genetic mechanism underlying the biocontrol traits of B-4359 was characterized using the whole-genome sequence of B-4359, which was closely compared with related strains. The whole-genome sequence of B-4359 consisted of 5,761,776 bp with a GC content of 41.0%, including 5,118 coding sequences, 117 tRNA, and 36 rRNA genes. The genomic analysis identified 23 putative secondary metabolite biosynthetic gene clusters. Our results provide a deep understanding of B-4359 as an effective biocontrol agent against red pepper anthracnose for sustainable agriculture.

Novel evaluation of upper-limb motor performance after stroke based on normal reaching movement model.

BACKGROUND: Upper-limb rehabilitation robots provide repetitive reaching movement training to post-stroke patients. Beyond a pre-determined set of movements, a robot-aided training protocol requires optimization to account for the individuals' unique motor characteristics. Therefore, an objective evaluation method should consider the pre-stroke motor performance of the affected arm to compare one's performance relative to normalcy. However, no study has attempted to evaluate performance based on an individual's normal performance. Herein, we present a novel method for evaluating upper limb motor performance after a stroke based on a normal reaching movement model. METHODS: To represent the normal reaching performance of individuals, we opted for three candidate models: (1) Fitts' law for the speed-accuracy relationship, (2) the Almanji model for the mouse-pointing task of cerebral palsy, and (3) our proposed model. We first obtained the kinematic data of healthy (n = 12) and post-stroke (n = 7) subjects with a robot to validate the model and evaluation method and conducted a pilot study with a group of post-stroke patients (n = 12) in a clinical setting. Using the models obtained from the reaching performance of the less-affected arm, we predicted the patients' normal reaching performance to set the standard for evaluating the affected arm. RESULTS: We verified that the proposed normal reaching model identifies the reaching of all healthy (n = 12) and less-affected arm (n = 19; 16 of them showed an R2 > 0.7) but did not identify erroneous reaching of the affected arm. Furthermore, our evaluation method intuitively and visually demonstrated the unique motor characteristics of the affected arms. CONCLUSIONS: The proposed method can be used to evaluate an individual's reaching characteristics based on an individuals normal reaching model. It has the potential to provide individualized training by prioritizing a set of reaching movements.

Structural and functional characterization of a thermostable secretory phospholipase A2 from Sciscionella marina and its application in liposome biotransformation.

Secretory phospholipase A2 (sPLA2), which hydrolyzes the sn-2 acyl bond of lecithin in a Ca2+-dependent manner, is an important enzyme in the oil and oleochemical industries. However, most sPLA2s are not stable under process conditions. Therefore, a thermostable sPLA2 was investigated in this study. A marine bacterial sPLA2 isolated from Sciscionella marina (Sm-sPLA2) was catalytically active even after 5 h of incubation at high temperatures of up to 50°C, which is outstanding compared with a representative bacterial sPLA2 (i.e. sPLA2 from Streptomyces violaceoruber; Sv-sPLA2). Consistent with this, the melting temperature of Sm-sPLA2 was measured to be 7.7°C higher than that of Sv-sPLA2. Furthermore, Sm-sPLA2 exhibited an improved biotransformation performance compared with Sv-sPLA2 in the hydrolysis of soy lecithin to lysolecithin and free fatty acids at 50°C. Structural and mutagenesis studies revealed that the Trp41-mediated anchoring of a Ca2+-binding loop into the rest of the protein body is directly linked to the thermal stability of Sm-sPLA2. This finding provides a novel structural insight into the thermostability of sPLA2 and could be applied to create mutant proteins with enhanced industrial potential.

"I Have a Wish": Anti-Asian Racism and Facing Challenges Amid the COVID-19 Pandemic Among Asian International Graduate Students.

INTRODUCTION: Although Asian international graduate students (AIGS) were at risk for mental health problems during the pandemic, little is known about the experience of international students during COVID-19. This study aimed to examine the experiences of AIGS who lived in the United States during COVID-19. METHOD: This qualitative descriptive study included 22 participants from five large universities in Philadelphia. Semi-structured interviews were conducted during September and October 2020, and a thematic analysis was used for data analyses. RESULTS: Three themes were found: (a) "We are left alone here": Being an international student; (b) "Stay busy" and "Do something": Being a graduate student; and (c) "I have a wish": Seeking for support, perceived support, and preferred counseling services as a self-advocator. DISCUSSION: Help is needed for AIGS to navigate uncertainties, provide proper coping skills, make efforts against anti-Asian racism, and provide culturally based mental health resources.

Microbacterium elymi sp. nov., Isolated from the Rhizospheric Soil of Elymus tsukushiensis, a Plant Native to the Dokdo Islands, Republic of Korea.

Microbacterium elymi KUDC0405T was isolated from the rhizosphere of Elymus tsukushiensis from the Dokdo Islands. The KUDC0405T strain was Gram-stain-positive, non-spore forming, non-motile, and facultatively anaerobic bacteria. Strain KUDC0405T was a rod-shaped bacterium with size dimensions of 0.3-0.4 × 0.7-0.8 µm. Based on 16S rRNA gene sequences, KUDC0405T was most closely related to Microbacterium bovistercoris NEAU-LLET (97.8%) and Microbacterium pseudoresistens CC-5209T (97.6%). The dDDH (digital DNA-DNA hybridization) values between KUDC0405T and M. bovistercoris NEAU-LLET and M. pseudoresistens CC-5209T were below 17.3% and 17.5%, respectively. The ANI (average nucleotide identity) values among strains KUDC0405T, M. bovistercoris NEAU-LLET, and M. pseudoresistens CC-5209T were 86.6% and 80.7%, respectively. The AAI (average amino acid identity) values were 64.66% and 64.97%, respectively, between KUDC0405T and its closest related type strains. The genome contained 3,596 CDCs, three rRNAs, 46 tRNAs, and three non-coding RNAs (ncRNAs). The genomic DNA GC content was 70.4%. The polar lipids included diphosphatydilglycerol, glycolipid, phosphatydilglycerol, and unknown phospholipid, and the major fatty acids were anteiso-C17:0 and iso-C16:0. Strain KUDC0405T contained MK-12 as the major menaquinone. Based on genotypic, phylogenetic, and phenotypic properties, strain KUDC0405T should be considered a novel species within the genus Microbacterium, for which we propose the name M. elymi sp. nov., and the type strain as KUDC0405T (=KCTC 49411T, =CGMCC1.18472T).

Design and Synthesis of (Z)-5-(Substituted benzylidene)-3-cyclohexyl-2-thioxothiazolidin-4-one Analogues as Anti-Tyrosinase and Antioxidant Compounds: In Vitro and In Silico Insights.

Many compounds containing the ß-phenyl-α,ß-unsaturated carbonyl (PUSC) scaffold, including cinnamamide derivatives, have been shown to inhibit tyrosinase potently in vitro and in vivo. Structural changes to cinnamamide derivatives were produced by adding a dithionate functional group to provide eight (Z)-5-(substituted benzylidene)-3-cyclohexyl-2-thioxothiazolidin-4-one analogs with high log p values for skin. These analogs were synthesized using a two-step reaction, and their stereochemistry was confirmed using the 3JC4-Hß values of C4 measured in proton-coupled 13C mode. Analogs 2 (IC50 = 5.21 ± 0.86 µM) and 3 (IC50 = 1.03 ± 0.14 µM) more potently inhibited mushroom tyrosinase than kojic acid (IC50 = 25.26 ± 1.10 µM). Docking results showed 2 binds strongly to the active site of tyrosinase, while 3 binds strongly to an allosteric site. Kinetic studies using l-tyrosine as substrate indicated 2 and 3 competitively and non-competitively inhibit tyrosinase, respectively, which was supported by our docking results. In B16F10 cells, 3 significantly and concentration-dependently reduced α-MSH plus IBMX induced increases in cellular tyrosinase activity and melanin production and the similarity between these inhibitory patterns implied that the anti-melanogenic effect of 3 might be due to its tyrosinase-inhibitory ability. In addition, 2 and 3 exhibited strong antioxidant effects; for example, they reduced ROS and ONOO- levels and exhibited radical scavenging activities, suggesting that these effects might underlie their anti-melanogenic effects. Furthermore, 3 suppressed the expressions of melanogenesis-associated proteins and genes in B16F10 cells. These results suggest (Z)-5-(substituted benzylidene)-3-cyclohexyl-2-thioxothiazolidin-4-one analogs offer a means of producing novel anti-melanogenesis agents.

A Novel Class of Potent Anti-Tyrosinase Compounds with Antioxidant Activity, 2-(Substituted phenyl)-5-(trifluoromethyl)benzo[d]thiazoles: In Vitro and In Silico Insights.

Sixteen compounds bearing a benzothiazole moiety were synthesized as potential tyrosinase inhibitors and evaluated for mushroom tyrosinase inhibitory activity. The compound 4-(5-(trifluoromethyl)benzo[d]thiazol-2-yl)benzene-1,3-diol (compound 1b) exhibited the highest tyrosinase activity inhibition, with an IC50 value of 0.2 ± 0.01 µM (a potency 55-fold greater than kojic acid). In silico results using mushroom tyrosinase and human tyrosinase showed that the 2,4-hydroxyl substituents on the phenyl ring of 1b played an important role in the inhibition of both tyrosinases. Kinetic studies on mushroom tyrosinase indicated that 1b is a competitive inhibitor of monophenolase and diphenolase, and this was supported by docking results. In B16F10 murine melanoma cells, 1a and 1b dose-dependently and significantly inhibited melanin production intracellularly, and melanin release into medium more strongly than kojic acid, and these effects were attributed to the inhibition of cellular tyrosinase. Furthermore, the inhibition of melanin production by 1b was found to be partially due to the inhibition of tyrosinase glycosylation and the suppression of melanogenesis-associated genes. Compound 1c, which has a catechol group, exhibited potent antioxidant activities against ROS, DPPH, and ABTS, and 1b also had strong ROS and ABTS radical scavenging activities. These results suggest that 5-(trifluoromethyl)benzothiazole derivatives are promising anti-tyrosinase lead compounds with potent antioxidant effects.

Identification of a Novel Class of Anti-Melanogenic Compounds, (Z)-5-(Substituted benzylidene)-3-phenyl-2-thioxothiazolidin-4-one Derivatives, and Their Reactive Oxygen Species Scavenging Activities.

The rate-determining role of tyrosinase makes it a critical component in the mechanism that is responsible for melanogenesis. Thirteen (Z)-5-(substituted benzylidene)-3-phenyl-2-thioxothiazolidin-4-one ((Z)-BPTT) analogs were designed based on the structural features of two potent tyrosinase inhibitors, viz. (Z)-5-(3-hydroxy-4-methoxybenzylidene)-2-thioxothiazolidin-4-one (5-HMT) and (Z)-2-(2,4-dihydroxybenzylidene)benzo[4,5]imidazo[2,1-b]thiazol-3(2H)-one (compound I). The trisubstituted double bond geometry of the (Z)-BPTT analogs that were generated by Knoevenagel condensation was determined using vicinal 1H and 13C coupling constants in 13C NMR spectra. Four analogs, numbers 1-3 and 6, inhibited mushroom tyrosinase 9 to 29 times more potently than kojic acid did. Kinetic study results indicated that these four analogs inhibited mushroom tyrosinase competitively and this was supported by docking simulation. Also, docking results using human tyrosinase suggested that analogs 2 and 3 might be potent human tyrosinase inhibitors. In vitro studies using B16F10 cells (a melanoma cell line) showed that analogs 1, 2, 3, and 6 inhibited cellular tyrosinase and melanin production more than kojic acid did, without perceptible cytotoxicity. In particular, analog 2, which possesses a catechol group, exerted an extremely potent anti-melanogenic effect. In addition, analog 2 showed strong scavenging activity against DPPH and ABTS radicals. Furthermore, analog 2 not only reduced ROS levels, which induce melanogenesis, but it also suppressed tyrosinase and MITF (microphthalamia-associated transcription factor) protein levels and the expressions of melanogenesis-related genes. These results suggest that analog 2 is an efficient tyrosinase inhibitor that alleviates melanogenesis by dual mechanisms of (i) the inhibition of melanogenesis-related proteins and genes and (ii) the direct inhibition of tyrosinase activity.

Identification of (Z)-2-benzylidene-dihydroimidazothiazolone derivatives as tyrosinase inhibitors: Anti-melanogenic effects and in silico studies.

As part of our continuous search for novel tyrosinase inhibitors, we designed 5,6-dihydroimindazo[2,1-b]thiazol-3(2H)-one (DHIT) derivatives based on the structure of MHY773; a potent tyrosinase inhibitor with a 2-iminothiazolidin-4-one template. Of the 11 DHIT derivatives synthesized using a Knoevenagel condensation, three DHIT derivatives 1a (IC50 = 36.14 ± 3.90 µM), 1b (IC50 = 0.88 ± 0.91 µM), and 1f (IC50 = 17.10 ± 1.01 µM) inhibited mushroom tyrosinase more than kojic acid (IC50 = 84.41 ± 2.87 µM). Notably, compound 1b inhibited mushroom tyrosinase around 100- and 3.3-fold more potently than kojic acid and MHY773, respectively. Lineweaver-Burk plots demonstrated that compounds 1b and 1f competitively inhibited mushroom tyrosinase, and in silico docking results supported our kinetic results and indicated that these two compounds bind more strongly to the active site of tyrosinase than kojic acid. Docking simulation results using a human tyrosinase homology model confirmed the abilities of 1b and 1f to strongly inhibit human tyrosinase. B16F10 murine melanoma cells were used to investigate whether these two compounds display tyrosinase inhibitory activities and anti-melanogenesis effects in cells. Both compounds were found to significantly and dose-dependently inhibit cellular tyrosinase activity and intracellular and extracellular melanin production more potently than kojic acid. The similarities observed between the cellular tyrosinase and melanogenesis inhibitory effects of 1b and 1f suggest their observed anti-melanogenic effects were due to tyrosinase inhibition. These results indicate that compounds 1b and 1f, which possess the DHIT template, are promising candidates as anti-browning agents and therapeutic agents for hyperpigmentation disorders.

The Relationship Between Light Exposure before Bedtime and Daytime Sleepiness Among People Living With Cognitive Impairment.

While sleep disturbances are common in people living with cognitive impairment, little is known about the influence of evening light exposure on their sleep. The purpose of this study was to examine the relationship between evening light exposure in natural living environment and daytime sleepiness in community residing people living with cognitive impairment. A secondary data analysis was conducted using the baseline data of the Healthy Patterns Clinical Trial. Actiwatch Spectrum Plus was used to collect information on the average white light intensity of 4 hours before sleep for three consecutive days. Multivariate regression analyses were used. Among 173 participants, the average light intensity during evening was 80.25 ± 123.04 lux. After controlling for covariates, greater intensity of light exposure during evening was related to excessive daytime sleepiness (ß = 0.211, p = .004). The results of our study suggest exposure to light during evening may disturb sleep and subsequently influence daytime sleepiness the following day.

Relationships between racial discrimination, social isolation, and mental health among international Asian graduate students during the COVID-19 pandemic.

Objectives: Racial aggression against Asians and the implementation of state-wide stay-at-home orders during the COVID-19 pandemic may have negatively impacted mental health in Asian international graduate students in the United States, yet these relationships are unknown. Therefore, this study was conducted to investigate these relationships. Participants: Data were collected from 177 participants from four universities. Methods: On-line survey was used to assess perceived racial discrimination related to the COVID-19, daily racial discrimination during the pandemic, home boundness and loneliness, and depression and anxiety. Results: Daily racial discrimination was associated with an increased risk for depression. Home boundness was related to fewer depression symptoms (B = -0.728) and fewer anxiety symptoms (B = -0.558). Higher symptoms of loneliness (B = 0.377) were related to more depression symptoms. More loneliness (B = 0.257) was related to more anxiety symptoms. Conclusions: The findings can help university stakeholders to create a guideline for the development and implementation of resource programs for Asian international graduates.

The relationship between social isolation and anxiety in people with cognitive impairment in the United States.

OBJECTIVES: Social isolation among older adults with cognitive impairment is understudied. The purpose of this study is to examine the relationship between social isolation and anxiety in people with cognitive impairment in the United States. METHODS/DESIGN: Secondary data analyses were conducted using the National Social Life, Health, and Aging Project (NSHAP) Wave 2 (2010-2011) dataset which includes a nationally representative sample of American older adults living at home. A total of 1343 people who had probable cognitive impairment measured by a Montreal Cognitive Assessment (MoCA) score of 22 or less were selected. Anxiety was measured using the anxiety measure of Hospital Anxiety and Depression Scale (HADS-A) and social isolation was measured using Perceived Social Isolation Scale. A weighted multivariable linear regression analysis and weighted F tests were used to examine the relationship between social isolation and anxiety. RESULTS: We observed that greater social isolation was related to increased anxiety in people with cognitive impairment (coefficients = 0.7242, t = 2.51, p = 0.015), adjusting for severity of cognitive impairment, race, pain, depression, activities of daily living, and instrumental activities of daily living. Weighted F tests showed that persons with clinically significant anxiety (HADS-A ≥ 8) had higher levels of loneliness, including feeling a lack of companionship, feeling left out, and greater social isolation. CONCLUSIONS: The results of our study suggest that people with cognitive impairment can feel social isolation and it may contribute to their anxiety. Health care professionals, family, and friends of people with cognitive impairment should pay greater attention to social isolation of their loved ones.

Proof-of-Concept of a Sensor-Based Evaluation Method for Better Sensitivity of Upper-Extremity Motor Function Assessment.

In rehabilitation, the Fugl-Meyer assessment (FMA) is a typical clinical instrument to assess upper-extremity motor function of stroke patients, but it cannot measure fine changes of motor function (both in recovery and deterioration) due to its limited sensitivity. This paper introduces a sensor-based automated FMA system that addresses this limitation with a continuous rating algorithm. The system consists of a depth sensor (Kinect V2) and an algorithm to rate the continuous FM scale based on fuzzy inference. Using a binary logic based classification method developed from a linguistic scoring guideline of FMA, we designed fuzzy input/output variables, fuzzy rules, membership functions, and a defuzzification method for several representative FMA tests. A pilot trial with nine stroke patients was performed to test the feasibility of the proposed approach. The continuous FM scale from the proposed algorithm exhibited a high correlation with the clinician rated scores and the results showed the possibility of more sensitive upper-extremity motor function assessment.