Among outpatients with coronavirus disease 2019 (COVID-19) due to the severe acute respiratory coronavirus virus 2 (SARS-CoV-2) δ (delta) variant who did and did not receive 2 vaccine doses at 7 days after symptom onset, there was no difference in viral shedding (cycle threshold difference 0.59, 95% CI, −4.68 to 3.50; P = .77) with SARS-CoV-2 cultured from 2 (7%) of 28 and 1 (4%) of 26 outpatients, respectively.

Multiple micronutrient deficiencies are widespread in Ethiopia. However, the distribution of Se and Zn deficiency risks has previously shown evidence of spatially dependent variability, warranting the need to explore this aspect for wider micronutrients. Here, blood serum concentrations for Ca, Mg, Co, Cu and Mo were measured (n 3102) on samples from the Ethiopian National Micronutrient Survey. Geostatistical modelling was used to test spatial variation of these micronutrients for women of reproductive age, who represent the largest demographic group surveyed (n 1290). Median serum concentrations were 8·6 mg dl−1 for Ca, 1·9 mg dl−1 for Mg, 0·4 µg l−1 for Co, 98·8 µg dl−1 for Cu and 0·2 µg dl−1 for Mo. The prevalence of Ca, Mg and Co deficiency was 41·6 %, 29·2 % and 15·9 %, respectively; Cu and Mo deficiency prevalence was 7·6 % and 0·3 %, respectively. A higher prevalence of Ca, Cu and Mo deficiency was observed in north western, Co deficiency in central and Mg deficiency in north eastern parts of Ethiopia. Serum Ca, Mg and Mo concentrations show spatial dependencies up to 140–500 km; however, there was no evidence of spatial correlations for serum Co and Cu concentrations. These new data indicate the scale of multiple mineral micronutrient deficiency in Ethiopia and the geographical differences in the prevalence of deficiencies suggesting the need to consider targeted responses during the planning of nutrition intervention programmes.

We study the classical Hermite–Hadamard inequality in the matrix setting. This leads to a number of interesting matrix inequalities such as the Schatten p-norm estimates

$$ \begin{align*}\left(\|A^q\|_p^p + \|B^q\|_p^p\right)^{1/p} \le \|(xA+(1-x)B)^q\|_p+ \|((1-x)A+xB)^q\|_p, \end{align*} $$

$n\times n$

$A,B$

$0<q,x<1$

$X^*X+Y^*Y=XX^*+YY^*=I$

$$ \begin{align*}(X^*AX+Y^*BY)\oplus (Y^*AY+X^*BX) =\frac{1}{2n}\sum_{k=1}^{2n} U_k (A\oplus B)U_k^*, \end{align*} $$

$2n\times 2n$

$U_k$

Adhering to a Mediterranean diet (MD) is associated with reduced CVD risk. This study aimed to explore methods of increasing MD adoption in a non-Mediterranean population at high risk of CVD, including assessing the feasibility of a developed peer support intervention. The Trial to Encourage Adoption and Maintenance of a MEditerranean Diet was a 12-month pilot parallel group RCT involving individuals aged ≥ 40 year, with low MD adherence, who were overweight, and had an estimated CVD risk ≥ 20 % over ten years. It explored three interventions, a peer support group, a dietician-led support group and a minimal support group to encourage dietary behaviour change and monitored variability in Mediterranean Diet Score (MDS) over time and between the intervention groups, alongside measurement of markers of nutritional status and cardiovascular risk. 118 individuals were assessed for eligibility, and 75 (64 %) were eligible. After 12 months, there was a retention rate of 69 % (peer support group 59 %; DSG 88 %; MSG 63 %). For all participants, increases in MDS were observed over 12 months (P < 0·001), both in original MDS data and when imputed data were used. Improvements in BMI, HbA1c levels, systolic and diastolic blood pressure in the population as a whole. This pilot study has demonstrated that a non-Mediterranean adult population at high CVD risk can make dietary behaviour change over a 12-month period towards an MD. The study also highlights the feasibility of a peer support intervention to encourage MD behaviour change amongst this population group and will inform a definitive trial.

ABSTRACT IMPACT: This study is designed to address a critical gap in our understanding of how aging patients and caregivers recognize and respond to clinically important changes in heart failure symptoms during vulnerable transitions. OBJECTIVES/GOALS: Research on family involvement in heart failure (HF) symptom response is limited. Our objective is to examine HF symptom monitoring processes in couples after HF hospitalization, and quantify how coupled symptom assessments predict symptom response, patient clinical events, care strain, and dyad health during the high-risk post-discharge period. METHODS/STUDY POPULATION: This is an ongoing T2 translational study that employs an intensive longitudinal design. Adults aged ≥65 years hospitalized for HF and their caregiving spouse/partner are enrolled. The target n is 48 dyads. Over 5 weeks of follow-up, dyads complete daily diaries assessing patient HF symptoms. Clinical biomarkers of HF severity (NTproBNP, ST2) are also collected. Primary study endpoints are dyads’ HF symptom response behaviors and caregiver strain; secondary endpoints are dyads’ health status and patient clinical events. Dyadic dynamics of symptom assessment will first be characterized using dyadic autoregressive time series models. Subsequently, we will extract cross-partner effect parameters from the time series models and test whether dyadic effects predict the trajectories of each of our endpoints. RESULTS/ANTICIPATED RESULTS: This study is currently underway. In line with our study hypotheses, we anticipate that couples who assess patient symptoms similarly (dyadic agreement), and whose symptom assessments accurately reflect clinical severity, will be more likely to respond to symptoms appropriately with lower stress to the caregiving partner, and have better trajectories of health (self-reported and clinical). Characterizing dyadic symptom dynamics will provide important insight into the day-to-day process of symptom recognition in couples. Further, quantifying dyadic symptom dynamics in relation to our endpoints will provide information on the clinical value of dyadic symptom agreement, and whether it might be a target for future interventions to support better symptom response and health outcomes for both dyad members. DISCUSSION/SIGNIFICANCE OF FINDINGS: This project innovates on existing paradigms by applying family-level theory and techniques to better understand and support interventions for couples during post-discharge HF transitions - a vulnerable period for older adults that has traditionally been studied almost exclusively at the patient-level, with marginal success.

Abstract

We obtain several norm and eigenvalue inequalities for positive matrices partitioned into four blocks. The results involve the numerical range $W(X)$ of the off-diagonal block $X$, especially the distance $d$ from $0$ to $W(X)$. A special consequence is an estimate,

$$\begin{eqnarray}\text{diam}\,W\left(\left[\begin{array}{@{}cc@{}}A & X\\ X^{\ast } & B\end{array}\right]\right)-\text{diam}\,W\biggl(\frac{A+B}{2}\biggr)\geq 2d,\end{eqnarray}$$

Introduction: Postpartum weight management is difficult for many mothers due to the demands of parenthood. Women have highlighted a need for support but experience barriers to engaging with lifestyle interventions hence more adaptable approaches are required. This work examined participants’ engagement with a 12-month, theory-based, automated, text message (SMS) delivered, intervention supporting postpartum weight management.

Methods: SMS content was informed by: 1) the ‘Health Action Process Approach’ (HAPA)1; 2) behaviour change techniques associated with effectiveness in weight management interventions2; 3) women's accounts of postpartum weight-related experiences; and 4) personal and public involvement. A two-arm pilot RCT recruited women within two years postpartum, with a BMI ≥ 25 kg/m2, through community sources and social media. Women were randomised via a secure remote system to receive the intervention or an active control delivering child development messages. Participants received 353 messages during the 12 month intervention. Two-way messages were used to assess engagement: 50 messages prompted women to respond with their weight; 36 interactive messages requested participants’ to respond ‘Yes/No’ to a question which then triggered a feedback message. Participant engagement with two-way messages was calculated as a percentage of replies sent by women and was categorised as ‘high’ or ‘low’ according to the median number of replies sent. Weight was measured at 0, 3, 6, 9 and 12 months.

Results: 51 of 100 women recruited were randomised to receive the intervention. In months 0–6, (47%) and (95%) of participants responded to the weight messages and the ‘Yes/No’ messages respectively. In months 7–12, the responses were (77%) and (86%) respectively. Participants who were high engagers with weight messages had greater mean weight loss compared with low engagers at all time points: at 12 months high engagers (n = 18) lost -2.66 kg and had a reduction in waist circumference at 12 months of -8.9 cm, compared to changes in low engagers (n = 18) of -0.84 kg and -3.6 cm. Likewise, high engagers with ‘Yes/No’ messages had greater mean weight loss compared with low engagers at all time points: at 12 months high engagers (n = 16) lost -2.87 kg and had a reduction in waist circumference of -9.4 cm, compared to changes in low engagers (n = 20) of -0.86 kg and -3.6 cm.

Discussion: The use of two-way text messages was a useful way to encourage engagement with this SMS-delivered intervention. Higher engagement resulted in more weight loss compared to low engagement.