University of Tennessee System

Background: Social determinants of health (SDOH)—the conditions in which people are born, grow, live, work, and age—strongly influence health. Rural adults with cardiovascular disease (CVD) are especially vulnerable to the negative effects of SDOH and sleep problems, which lead to poor sleep-related functioning, such as difficulties concentrating or safe driving. Understanding how SDOH impact sleep-related functional outcomes is essential for developing effective interventions. Perceived control and depressive symptoms are key potential pathways linking SDOH to these outcomes. Objective: To explore if perceived control and depressive symptoms mediate the association between SDOH and sleep-related functional outcomes among rural adults with CVD. Method: We enrolled 158 rural adults with CVD (female: 42%, age: 59±12) from out-patient settings. The SDOH were assessed using the Protocol for Responding to and Assessing Patient Assets, Risks, and Experiences. Sleep-related functional outcomes were measured using the Functional Outcomes of Sleep Questionnaire-10. The potential mediators, perceived control and depressive symptoms, were measured using the Control Attitudes Scale-Revised and the Patient Health Questionnaire-9, respectively. Mediation analysis using Hayes' PROCESS macro (Model 6) was conducted for data analysis. Results: Higher SDOH risks were associated with lower levels of perceived control. Higher levels of perceived control and lower levels of depressive symptoms were significantly associated with better sleep-related functional outcomes. The SDOH risks were not directly associated with sleep-related functional outcomes; but indirectly associated with sleep-related functional outcomes through the following two paths: 1) perceived control and 2) perceived control and depressive symptoms (Figure). Conclusion: Rural patients with CVD who have higher SDOH risks have worse sleep-related functional outcomes due to lower levels of perceived control and higher levels of depressive symptoms. These findings suggest that interventions targeting perceived control and depressive symptoms may improve sleep-related functional outcomes for those with higher SDOH risks among rural patients with CVD.

International audience

Astrophysical observations provide compelling evidence for gravitationally interacting dark matter in the universe that cannot be explained by the standard model of particle physics. The extraordinary amount of data from the CERN LHC presents a unique opportunity to shed light on the nature of dark matter at unprecedented collision energies. This Report comprehensively reviews the most recent searches with the CMS experiment for particles and interactions belonging to a dark sector and for dark-sector mediators. Models with invisible massive particles are probed by searches for signatures of missing transverse momentum recoiling against visible standard model particles. Searches for mediators are also conducted via fully visible final states. The results of these searches are compared with those obtained from direct-detection experiments. Searches for alternative scenarios predicting more complex dark sectors with multiple new particles and new forces are also presented. Many of these models include long-lived particles, which could manifest themselves with striking unconventional signatures with relatively small amounts of background. Searches for such particles are discussed and their impact on dark-sector scenarios is evaluated. Many results and interpretations have been newly obtained for this Report.

Abstract Dementia care can cause emotional distress among caregivers. As technology advances, innovative interventions to alleviate stress in this group have emerged, highlighting the need for more investigation. We aimed to develop a deep learning-based smarthealth intervention using acoustic monitoring and ecological momentary assessment to detect stress and deliver stress management messages. We also intended to identify the intervention effects on the reactions and emotions of caregivers of people living with dementia. During the four-month intervention period, we collected data about participants’ emotional status and reactions to their care recipients’ symptoms through pre- and post-questionnaires, periodic phone surveys, and semi-structured interviews. Descriptive analysis, Wilcoxon signed-rank test, and abductive thematic analysis were used. Ten of 11 participants completed the study. The average age was 60 years, and participants reported providing care for approximately three years. Participants were predominently female (72.3%), White (81.8%), and spouses (63.6%). Pre-and post-questionnaires showed significant changes in caregivers’ perceived frequency of care recipients’ disruptive symptoms (p=.026) and their reactions to these symptoms (p=.006), but not in other emotional-related variables. Although answers to periodic phone surveys varied, participants tended to consider self-care when they reported better physical health and less stress and depressive mood. Interviews revealed seven themes—affective attitudes, burden, ethicality, intervention adherence, intervention coherence, perceived effectiveness, and suggestions—containing 27 categories. While participants’ feedback on our smarthealth intervention was mixed, the intervention improved participants’ awareness of emotions and caregiving situations. The findings suggest the potential benefits of the smarthealth intervention on caregivers’ awareness of emotions and self-care.

Abstract In the realm of large-scale additive manufacturing, the deposition time for each layer, often termed ‘layer time’, plays a pivotal role in shaping the temperature of the layer. This, in turn, has a profound impact on the overall quality and performance of the manufactured product. Hence, the optimization and precise control of layer time emerge as critical challenges. Striking a balance is essential because both excessively high and low layer temperatures can adversely affect the manufacturing process. Traditional layer time optimization models typically introduce constraints on upper and lower temperature limits. However, the imposition of strict, hard constraints on these temperature bounds may lead to infeasible solutions, depending on factors like geometric design, material properties, and size. In response to these challenges, our study introduces a novel layer time control model that incorporates chance constraints, also known as soft constraints. These chance constraints offer a higher degree of flexibility, enhancing the robustness of the control approach. Our proposed model is validated through comprehensive case studies, demonstrating notable improvements in efficiency and feasibility.

Abstract Dispositional optimism has been associated with healthy aging, as well as coping with and making meaning from life challenges. Social support plays a similarly positive role in promoting adaptation in late life and helping individuals feel closer to loved ones. During the pandemic, disruptions in older adults’ social interactions placed a high demand on both of these potential resources, challenging individuals’ ability to derive meaning from these events. Exploring data from a community sample of 136 older adults (M age = 68, range 50-91; 69% females; 93% White) assessed three times over six months during 2021-2022, we examined how optimism and positive and negative social exchanges predicted changes in attitudes about how COVID-19 shaped family life. We found that T1 optimism predicted changes in older adults’ feeling closer to their families and appreciating them more at T2 (3 months later), above and beyond T1 positive social exchanges, which were only marginally associated. Older adults who were more optimistic at T1 also reported greater declines in tension and strain in their family ties due to the pandemic at T2 - but not at T3 (6 months later). However, T2 negative social exchanges did predict increased reports of family tension and strain from T2 to T3. Findings suggest that as new COVID-19 variants emerged, benefits of optimism waned, but costs of negative social exchanges increased. These findings illustrate how personality, micro-level context (i.e., social interactions), and macro-level context may work together to shape older adults’ views of their families during the pandemic.