Scientific Reports

In Italy, 311,364 cases and 35,851 deaths of people who tested positive for SARS-CoV-2 were registered as of September 29th, 2020. To avoid the spreading of the virus, mathematical models predicting the course of infections spread1 become the basis to plan stringent countermeasures. We applied a published algorithm to real data up to September 27th, modeling two scenarios where predicted and real data were compared: a conservative scenario with a lockdown still ongoing and a scenario reflecting what actually happened in Italy, where the lockdown has been removed. Results revealed that the number of individuals in life-threatening condition is much lower than predicted, as well as the number of symptomatic individuals. Contrarily, the number of asymptomatic individuals is much higher than predicted. This suggest that human beings are not passive victims, but active fighters able to change the course of the infection creating adaptive strategies against the infections spread.

Our ability to recognize facial expressions is crucial for understanding others emotions1 and facilitating smooth communication2. Numerous studies have explored how we perceive these cues, considering factors such as health3, social signals4 and personality traits5. However, most of this research involves observers facing a monitor and assessing facial stimuli presented directly in front of them. Real-life scenarios offer more diverse spatial dynamics, such as conversing with someone at a table or glancing back at a passerby. Thus, faces behind the observer might trigger heightened recognition, akin to reacting swiftly to a perceived threat. Herein, we demonstrate that facial expression recognition is influenced by spatial relationships, i.e., faces in front of versus behind the observer. Participants judged the expressions of faces appearing in front of or behind them in virtual space. The findings of three experiments reveal an enhanced level of recognition for faces behind the participant. Interestingly, this effect varies with emotional valence; anger is amplified merely by the presence of a face behind the observer, while happiness requires actively turning to the rear for enhancement to occur. These findings suggest a biological instinct for perceiving threats behind us, potentially influencing subsequent actions. Hence, spatial relationships may modulate facial expression recognition.

Mutual phase shifts between three German COVID-19 incidence curves corresponding to the age classes of children, juveniles and adults, respectively, are calculated by means of delay-cross-correlations. At the country level, a phase shift of -5 weeks during the first half of the epidemic between the incidence curves corresponding to the juvenile age class and the curve corresponding to the adult class is observed. The childrens incidence curve is shifted by -3 weeks with respect to the adults curve. On the regional level of the 411 German districts (Landkreise) the distributions of observed time lags are inclined towards negative values. Regarding the incidence time series of the juvenile sub-population, 20% of the German districts exhibit negative phase shifts and only 3% show positive shifts versus the incidence curves of the adult sub-population. Similarly for the children with 6% positive shifts. Thus, childrens and juveniles epidemic activity is ahead of the adults activity. The correlation coefficients of shifted curves are large (> 0.9 for juveniles versus adults on the country level) which indicates that aside from the phase shift the sub-populations follow a similar epidemic dynamics. Negative phase shifts of the childrens incidence curves during the first and second epidemic waves are predictors for high incidences during the current fourth wave with respect to the corresponding districts.

Several risk factors have been identified but the etiology and pathogenesis of Bacterial vaginosis (BV) are still not completely understood, and the recurrence rate of BV remains high despite adequate chemotherapy treatment. The primary objective of the study was to assess the effectiveness of a new vaginal medical device, which contains polycarbophil, 0.04 % lauryl glucoside, and glycerides (Polybactum(R) - Effik Italia), in reducing BV recurrence rate. This was a multicenter, open label, not comparative study performed in Italy and Romania. Female subjects over 18-years-old affected by recurrent BV were included. The latest episode was diagnosed by Amsel criteria 6-9 days before the start of the study and treated with vaginal metronidazole (gel 0.75% mg for 5 days or ovules 500 mg for 7 days). The recurrence was defined by at least 2 episodes in the previous 12 months. Polybactum(R) vaginal ovules, day 1-4-7, were started within the 12th and the 24th hr after the end of metronidazole therapy and repeated monthly for 3 cycles. The first 41 patients enrolled were evaluated for an interim analysis 6 months after the study started; 2 patients interrupted the trial, leaving 39 evaluable subjects. The recurrence rate was significantly reduced compared to previous published data (10.26% vs 40% p<0.001). In 35 patients without recurrence, the assessment of Lactobacillus vaginal flora performed by phase contrast microscopy evidenced a significant improvement form baseline (p=0.022) The Investigator global assessment of tolerability was excellent in 38 out of 39 cases. IMPORTANCEBacterial vaginosis (BV) is the most common vaginal disorder in women of childbearing age. In BV, Lactobacillus species, which are predominant in a healthy vaginal flora, are replaced by anaerobes, mainly Gardnerella vaginalis. BV is responsible for more than 60% of vulvovaginal infections and has been linked to serious, potentially life-threatening conditions, including: pelvic inflammatory disease, postoperative infections, acquisition and transmission of the human immunodeficiency virus, preterm birth, and several adverse pregnancy outcomes. Our research showed that 3 monthly cycles of Polybactum(R) ovules administered after one course of metronidazole vaginal therapy can reduce the rate of Bacterial vaginosis recurrence and improve the vaginal milieu, favouring the growth of vaginal lactobacillus species. Taken together our results confirm that Polibactum(R) is a safe and effective treatment to reduce BV recurrence rate after a first line therapy with metronidazole.

While pandemic waves are often studied on the national scale, they typically are not distributed evenly within countries. This paper employs a novel approach to analyze the tempo-spatial dynamics of the COVID-19 pandemic in Germany. First, we base the analysis on a composite indicator of pandemic severity to gain a more robust understanding of the temporal dynamics of the pandemic. Second, we subdivide the pandemic during the years 2020 and 2021 into fifteen phases, each with a coherent trend of pandemic severity. Third, we analyze the patterns of spatial association during each phase. Fourth, similar types of trajectories of pandemic severity among all German counties were identified through hierarchical clustering. The results imply that the hotspots and cold spots of the first four waves of the pandemic were relatively stationary in space so that the pandemic moved in time but less in space.

The embodied brain is highly dynamic, changing with every thought, sensory input and motor activity. It keeps us coherent and healthy via its connections to every organ within the body, particularly the heart, which in turn supplies nutrients and oxygen to all bodily organs and the brain. Listening to music can instantly alter brain-body dynamics. Yet, the acoustic, neural, and physiologic parameters and processes that facilitate these effects are not well understood. Here, we tested the hypothesis that a custom music composition can promote healing in patients recovering from liver transplant surgery within an intensive care unit (ICU). The music presented consisted of custom,15-minute music sets curated and recorded by an experienced medical musician. We obtained cortisol samples from saliva samples [~]15 minutes before and after music presentation and captured autonomic activity by recording electrocardiography for 5 minutes before, during, and 5 minutes after music presentation in normal subjects and patients. Discriminant analysis showed a significant decrease in cortisol production (n = 17) after music presentation. Detailed analysis in a single patient showed significant changes in multiple cardiac parameters, including heart-rate variability (HRV). Multidimensional scaling of twenty-five parameters related to HRV in a patient mapped all five instances of the music presentation condition outside of the mixed cluster of baseline conditions before and after music presentation. Our results show that listening to music promotes homeostasis in ICU patients by transiently shifting physiological parameters towards a state of recovery that may stabilize over time.

The mechanisms behind human action planning and mental object manipulation are still not well understood. These core cognitive abilities are essential not only for interaction with physical spaces, e.g., for assembling objects, but also for effective problem-solving in the digital world. Here we ask, which strategies humans employ when assessing whether or not an object will fit into a cavity. To this end, objects and cavities were presented with different orientations on a computer screen and we measured errors, reaction-times and gaze patterns, where the latter can point to different problem-solving strategies. On the one hand our findings confirm that simpler configurations are solved faster and more efficiently than more complex ones. On the other hand, by analyzing about 80,000 gazes, we observed that participants used three different strategies. In many instances, the investigated task -- featuring relatively large objects -- could be completed using only peripheral vision (37%). In a larger number of cases quite "specific" gaze patterns were observed, primarily focusing on the Gestalt of a concave corner (46%). Less frequently, but still notably often, participants employed a strategy of fixating near to object or cavity (17%), potentially minimizing the length of the required saccadic eye movements while relying on perifoveal/peripheral vision. Ultimately, these findings highlight the crucial roles of proximity, spatial orientation, and visual cues in object recognition tasks, suggesting that the perceptual strategies used depend on distinct aspects of the object configurations.

The personal well-being of workers may be influenced by the risk of job automation brought about by technological innovation. Here we use data from the Understanding Society survey in the UK and a fixed-effects model to examine associations between working in a highly automatable job and life and job satisfaction. We find that employees in highly automatable jobs report significantly lower job satisfaction, a result that holds across demographic groups categorised by gender, age and education, with higher negative association among men, higher degree holders and younger workers. On the other hand, life satisfaction of workers is not generally associated with the risk of job automation, a result that persists among groups disaggregated by gender and education, but with age differences, since the life satisfaction of workers aged 30 to 49 is negatively associated with job automation risk. Our analysis also reveals differences in these associations across UK industries and regions.

Prism adaptation is a well-known experimental procedure to study sensorimotor plasticity. It has been shown that following prism exposure, after-effects are not only restricted to the sensorimotor level but extend as well to spatial cognition. In the present study, we used a visuo-motor rotation task which approaches the perturbations induced by prism exposure. We induced either leftward or rightward 15-degree rotations and we presented the perturbation either abruptly (from one trial to the next) or gradually (over a 34-trial transition). First, we found that none of the conditions produced cognitive after-effects in perceptive line bisection task. This result has a strong methodological impact for prospective investigations focusing on sensorimotor plasticity while sparing space cognition; it is particularly relevant when investigating sensorimotor plasticity in patients with specific representational feature to preserve from aggravation. Second, another interesting result was the increase of the sensitivity with which we discriminate the center of the line, that we propose to call representational acuity. It improved following the perturbation more particularly after gradual exposure and persisted for some time after the sensorimotor adaptation. These innovative results are discussed in terms of sensorimotor processes underpinning the transfer of visuomotor plasticity to spatial cognition.

We test the hypothesis of COVID-19 contagion being influenced by meteorological parameters such as temperature or humidity. We analysed data at high spatial resolution (regions in Italy and counties in the USA) and found that while at low resolution this might seem the case, at higher resolution no correlation is found. Our results are consistent with a poor outdoors transmission of the disease. However, a possible indirect correlation between good weather and a decrease in disease spread may occur, as people spend longer time outdoors.

Fetal growth is monitored periodically during pregnancy via ultrasound measurements of fetal dimensions such as femur length (FL), head circumference (HC), abdominal circumference (AC), and biparietal diameter (BPD). Multiple growth standards have been published for each of these, which are clinically used to place a fetus on a "growth chart". These consist of percentile tables varying by weeks of gestation, computed from cohorts of "low-risk" women with healthy lifestyles, living conditions, and clinical parameters. Such charts are prescriptive of ideal growth, but not necessarily descriptive of diverse real-world populations where they may be used. Moreover, they are constructed by pooling all fetal measurements across the cohort, not based on a growth model, and therefore not necessarily predictive of growth of an individual fetus. We show that the Gompertz model, a standard model for constrained growth, with just three intuitive parameters, convincingly fits the growth of fetal ultrasound biometries. Two of these parameters--t0 (the inflection time) and c (the rate of decrease of growth rate)--can be treated as universal to all fetuses, while the third parameter A can be modeled as an overall scale parameter specific to each fetus, which captures the individual variation in growth. On our cohort of 817 pregnant women ("Seethapathy cohort"), we show that not only can the value of A for each fetus be inferred from ultrasound data available by the second or the third trimester, but the weight of the baby at delivery can also be predicted with remarkable accuracy using these inferred Gompertz parameters. A model trained on the Seethapathy cohort performs well in estimating the birth weight in an independent validation cohort of 365 women, demonstrating the predictive power of the model. Moreover, we find that deviation from Gompertz-like growth is linked to neonatal complications. Finally, we show that the Gompertz growth curve is a close fit to the standards from WHO, NICHD and INTERGROWTH, with the optimal t0 and c close to that in the Seethapathy cohort. We propose that the Gompertz formula be a basis for future growth standards, with almost all variation described by a single scale parameter A, which can serve either as a descriptor of mean or variance in population, or as a descriptor for growth of an individual fetus. Indeed, the formula is descriptive of typical growth, predictive of future growth, and may be used in prescriptive standards.

In the Covid-19-pandemic, the numbers of deceased do not consistently follow the number of new infections. The CFR mortality has declined in Germany from 5 % to 0.4 %. However, if we interpret the portion of positive tests as a positive rate, we find the positive rate and the numbers of deceased to run parallel with an offset of about 13 days. This has been observed worldwide in ten other countries and locally in Germany and North Rhine-Westphalia. In Germany the IFR mortality is about 29 per one million inhabitants, in the USA about 42, in Israel about 17, in the Netherlands 23, in Austria 27, in France 33, in Spain 36, in the UK 47 and Italy about 56 per million inhabitants. In Japan and South-Korea the mortality rate is only about 3 per million inhabitants, with an offset of about 25 days. The daily positive ratio, which is reported by state health authorities, allows to estimate the number of deaths (and seriously ill people) about 13 days ahead. This gives local hospitals more time for detailed planning. The daily positive rate may be interpreted as a "thermometer" of the respective country. The positive rate gives a much better picture of the state of the pandemic and should be reported by the media in addition to infection numbers. In official guidelines a 7-day-positive-rate is a much better guideline than the 7-day-incidence.

The modulation of instrumental action by conditioned Pavlovian cues is hypothesized to play a role in the emergence and maintenance of maladaptive behavior. The Pavlovian-to-instrumental transfer (PIT) task is designed to examine the magnitude of the influence of cues on behavior and we aim to manipulate the motivational value of Pavlovian cues to reduce their effect on instrumental responding. To this end, we utilized a joystick-based modification of approach and avoidance propensities that has shown success in clinical populations. In 35 healthy subjects, we examined changes in PIT after completion of either avoidance training or sham training. We found no effect of training on approach avoidance propensities but higher response rate towards negative stimuli during PIT after systematic avoidance training compared to sham training. On the other hand, we saw an increased PIT effect after sham training. These results imply that training can alter the strength of the influence of cues on instrumental behavior and suggest training to be beneficial in reducing environmental triggers of maladaptive behavior.

COVID-19 affects a variety of organs and systems of the body including the central nervous system. Recent research has shown that COVID-19 survivors often experience neurological and psychological complications that can last for months after infection. We conducted a large internet study using online tests to analyze the effects of SARS-CoV-2 infection, COVID-19 severity, and vaccination on health, intelligence, memory, and information processing precision and speed in a cohort of 4,446 subjects. We found that both SARS-CoV-2 infection and COVID-19 severity were associated with negative impacts on patients health. Furthermore, we observed a negative association between COVID-19 severity and cognitive performance. Younger participants had a higher likelihood of SARS-CoV-2 contraction, while the elderly had a higher likelihood of severe COVID-19 and vaccination. The association between age and COVID-19 severity was primarily mediated by older participants impaired long-term health. Vaccination was positively associated with intelligence and the precision of information processing. However, the positive association between vaccination and intelligence was likely mediated by achieved education, which was itself strongly associated with the likelihood of being vaccinated.

Human social behaviour unfolds in complex real-world environments influenced by social and environmental factors, yet reliable markers of social engagement and connection remain elusive. Interpersonal physiological synchrony (IPS) has been proposed as one such marker, but its occurrence in everyday settings is not well established. To investigate the social and environmental factors that influence IPS, we continuously measured heart rate, GPS, and the acoustic environment from 72 participants across three multi-day trips to New York City, capturing naturalistic social behaviour. Across all three trips, heart rates reliably synchronized when participants were in close physical proximity, indicating that shared environmental context was sufficient to elicit IPS. IPS was stronger among socially familiar peers, and context dependent, emerging during close-proximity interactions and joint attention to shared stimuli, but not dispersed interactions. IPS was also modulated by acoustic context, with low-to-moderate sound pressure levels and moderate-to-high signal-to-noise ratios enhancing synchrony, while excessive environmental noise reduced it to levels comparable to non-interactive settings, which may reflect lower levels of joint engagement in noisier environments. These findings demonstrate that IPS emerges in naturalistic social settings and is modulated by physical proximity, social familiarity, social context, and the acoustic environment, establishing IPS as a reliable marker of real-world social engagement.

Bioluminescence of Mediterranean sea pens has been known for a long time, but basic parameters such as the emission spectra are unknown. Here we examined bioluminescence in three species of Pennatulacea, Pennatula rubra, Pteroeides griseum, and Veretillum cynomorium. Following dark adaptation, all three species could easily be stimulated to produce green light. All species were also fluorescent, with bioluminescence being produced at the same sites as the fluorescence. The shape of the fluorescence spectra indicates the presence of a GFP closely associated with light production, as seen in Renilla. Our videos show that light proceeds as waves along the colony from the point of stimulation for all three species, as observed in many other octocorals. Features of their bioluminescence are strongly suggestive of a "burglar alarm" function.

In humans, theta ({theta}) band activity (defined as 4-8 or 5-7 Hz), measured over the frontal midline of the scalp, is an important EEG correlate of voluntary and conscious self-control. Theta waves specifically reflect the workings of the frontal lobes, and can therefore be useful in distinguishing cortical from more ancient control mechanisms. In dogs, inhibitory self-control is extensively studied, but mostly through behavioural tests. Here, we present a first inquiry into a possible EEG correlate of cognitive control in the domestic dog, by comparing short ([~]30-second-long) EEG recordings from two conditions: passive wakefulness (baseline) versus a delayed gratification challenge (test). Both were recorded alternating, under similar conditions for each dog within the same session. In total, we collected and analysed 226 short recordings from fourteen dogs. Within and across animals, we found an increase in activity (test > baseline) that resembles human cognitive theta in frequency range (5-7 Hz) and scalp localization. Our results are a first demonstration that frontal midline theta in awake dogs can peak under similar conditions to those in humans. These findings indicate that compliant behaviour in dogs is under prefrontal control.

We validated our state-of-the-art deep learning algorithm for detection of wheezes and crackles in sound files by comparing the classification of our algorithm with those of human experts. We had two validation sets classified by experienced raters that were not used to train the algorithm with 615 (A) and 120 (B) sound files, respectively. We calculated Area Under Curve (AUC) of the algorithms probability scores for wheezes and crackles. We dichotomized the scores and calculated sensitivity and specificity as well as kappa agreement. In set A, the AUC was 0.88 (95% CI 0.84 - 0.92) for wheezes and 0.88 (95% CI 0.84 - 0.92) for crackles. The sensitivities and specificities of the labels were 81% and 89% for wheezes and 67% and 96% for crackles. In set B, the kappa agreement between the algorithm and the validation set was 0.78 (95% CI 0.58 - 0.99) for wheezes and 0.75 (95% CI 0.59 - 0.92) for crackles. The 24 observers who had rated the same 120 sound files agreed less with the reference classification with a mean kappa of 0.68 for wheezes and 0.55 for crackles. We found the algorithm to be superior to doctors in detecting wheezes and crackles in lung sound files.

The selection of competent human sperm influences the successful outcome of Assisted Reproductive Technology. Conventionally used techniques like density gradient and swim-up, use motility-based separation, which may not correlate with the maturity and quality of the sperm. Existing techniques that select mature sperm based on hyaluronic acid binding ability, select very small numbers of sperm, rendering them unsuitable for intra-uterine insemination. We report the development of a new method, USelect that selects and isolates millions of mature sperms based on their ability to bind to hyaluronic acid. Validation of Uselect was done on semen samples (n=40) compared with the conventional methods, like density gradient, and swim up. Subsequently, Uselect selected sperms were used for intra-uterine insemination in a clinical trial (n=50 female patients). Sperm isolated using USelect showed similar mean sperm count and rapid progressive motility compared to SU, but lower than the density gradient method. However, the DNA fragmentation index and hyaluronic acid binding capacity were statistically significant in the USelect sperms that promoted the fertilization rate and showed a higher percentage of biochemical pregnancy (32%, n=16) than density gradient (18%, n=9).

We studied variations of all-cause human mortality during the weekly cycle, using deathdates collected from death notices published in regional or local newspapers in three distinct regions in Germany (South Baden, North Bavaria, Saarland), total database size N {approx} 44000. Probability distributions of death on different days of the week show significant (P = 0.0155) departures from the uniformity hypothesis. The day of maximum mortality is Friday (probability of dying = 0.148), whereas minimum mortality is observed on Sundays and Mondays (probability of dying = 0.140 for both days). This Friday excess effect seems to be a novel phenomenon, unrelated to other findings on weekly modulation of human mortality.