Search Results (40)

Despite the increasing adoption of a syndemic approach in HIV research, few health communication campaigns have used a syndemic approach in messaging to improve health outcomes for persons living with HIV (PWH). This paper introduces a framework for practitioners and researchers developing health communication messages in support of a syndemic approach to HIV care for PWH in the United States. Grounded in insights from a review of counseling and psychosocial interventions that demonstrated significant positive effects on HIV clinical outcomes, the C4H Framework emphasizes four components: compassion, comprehensive messaging, capacity-building, and coordination. Compassion ensures that messages resonate with individuals experiencing the intertwined challenges of HIV, substance abuse, and mental health issues. Comprehensive messaging integrates a holistic view of the barriers faced by PWH. Capacity-building empowers individuals to effectively engage with and act upon health information. Coordination promotes alignment between stakeholders and resources to ensure consistent and supportive messaging. The C4H Framework bridges the gap between research and practice, offering a foundation for crafting effective communication messages that resonate with individuals facing the complex challenges inherent in HIV syndemics. Future research should explicitly test the effectiveness and acceptability of messages developed using the C4H Framework with people living with HIV. Full article

Low uptake of pre-exposure prophylaxis (PrEP) for HIV prevention among Black women has been partly attributed to barriers related to patient-provider communication. The goal of this paper was to investigate the association between exposure to the #ShesWell campaign and Black women’s communication about PrEP with a healthcare provider (HCP). We conducted a cross-sectional survey of 403 sexually active, Black women after the initial phase of #ShesWell and used multivariable regression models to analyze whether exposure to #ShesWell was associated with talking to an HCP about PrEP or intention to discuss PrEP with an HCP in the future. Approximately 33% of women surveyed reported exposure to #ShesWell. Campaign exposure was significantly associated with talking to an HCP in the past year about PrEP (OR = 4.96, p = 0.001) and intention to discuss PrEP with an HCP in the next six months (B = 0.29, p = 0.038). Stronger beliefs that doctors should initiate sexual health conversations were positively associated with past PrEP conversations (OR = 2.32, p < 0.001) and future intention (B = 0.11, p = 0.029). Greater comfort discussing prevention (B = 0.35, p < 0.001), self-efficacy discussing PrEP (B = 0.29, p = 0.001), and concern about getting HIV (B = 0.51, p < 0.001) were also associated with intention to discuss PrEP with an HCP. Findings highlight the potential for communication campaigns to motivate patient-provider communication about PrEP, addressing a reported barrier to PrEP uptake among Black women. Full article

Background: Brain magnetic resonance imaging (MRI) of infants with congenital heart disease (CHD) shows brain immaturity assessed via a cortical-based semi-quantitative score. Our primary aim was to develop an infant paralimbic-related subcortical-based semi-quantitative dysmaturation score, termed brain dysplasia score (BDS), to detect abnormalities in CHD infants compared to healthy controls and secondarily to predict clinical outcomes. We also validated our BDS in a preclinical mouse model of hypoplastic left heart syndrome. Methods: A paralimbic-related subcortical BDS, derived from structural MRIs of infants with CHD, was compared to healthy controls and correlated with clinical risk factors, regional cerebral volumes, feeding, and 18-month neurodevelopmental outcomes. The BDS was validated in a known CHD mouse model named Ohia with two disease-causing genes, Sap130 and Pchda9. To relate clinical findings, RNA-Seq was completed on Ohia animals. Findings: BDS showed high incidence of paralimbic-related subcortical abnormalities (including olfactory, cerebellar, and hippocampal abnormalities) in CHD infants (n = 215) compared to healthy controls (n = 92). BDS correlated with reduced cortical maturation, developmental delay, poor language and feeding outcomes, and increased length of stay. Ohia animals (n = 63) showed similar BDS findings, and RNA-Seq analysis showed altered neurodevelopmental and feeding pathways. Sap130 mutants correlated with a more severe BDS, whereas Pcdha9 correlated with a milder phenotype. Conclusions: Our BDS is sensitive to dysmaturational differences between CHD and healthy controls and predictive of poor outcomes. A similar spectrum of paralimbic and subcortical abnormalities exists between human and Ohia mutants, suggesting a common genetic mechanistic etiology. Full article

The present study explored the incorporation of health-related organisms within drinking water biofilms and bulk water quality using benchtop-scale distribution systems. The annular reactors simulated the dead-end pipes of distribution systems with low shear stress but maintained a chlorine residual and formed young biofilms on plastic surfaces. Spiked coliforms and Escherichia coli were introduced to the annular reactors after 1 month of growth. Although initially detected in the spike, the coliforms were inactivated in the bulk water phase, likely due to environmental stresses, such as nutrient starvation and residual chlorine. Also, coliform incorporation within biofilm was only detected in a single coupon in the reactor 24 h post-spike (with 100% lake water), suggesting they were not incorporated or under the detection limit. Full article

Dating violence is a serious public health issue among adolescents due to the detrimental short- and long-term consequences. The purpose of this study is to examine the relationship between adolescent dating violence (ADV) and adverse health behavioral outcomes related to substance abuse, mental health, and select risky health behaviors such as feeling unsafe, school performance, and inadequate sleep within the state of Florida. This study used data from the 2015 Youth Risk Behavior Survey (YRBS). The high school students represented a weighted total of 542,818 (n = 4301). Logistic regression analyses, stratified by gender, examined the relationship between ADV and health risk behaviors after adjusting for race and grade. Proportions of ADV were as follows: 3.1% of students reported being abused both physically and sexually; 3.4% reported being abused only physically; 3.9% reported being abused only sexually; and 89.6% were uninvolved. ADV was associated with almost all the health risk behavior outcomes studied, with a few exceptions. Experiencing both kinds of abuse held the highest odds ratio among the four mutually exclusive categories of ADV. The findings from this study could be helpful in identifying youths who demonstrate warning signs of ADV abuse and thus could provide opportunities for targeted preventive interventions. Full article

Background and Objectives: Vitamin D is a secosteroid hormone essential for calcium homeostasis and skeletal health, but established evidence highlights its significant roles also in muscle health and in the modulation of immune response. This review aims to explore the impact of impaired vitamin D status on outcomes of muscle function and involvement in inflammatory and autoimmune rheumatic diseases damaging the skeletal muscle efficiency both with direct immune-mediated mechanisms and indirect processes such as sarcopenia. Methods: A comprehensive literature search was conducted on PubMed and Medline using Medical Subject Headings (MeSH) terms: “vitamin D, muscle, rheumatic diseases.” Additionally, conference abstracts from The European Alliance of Associations for Rheumatology (EULAR) and the American College of Rheumatology (ACR) (2020–2023) were reviewed, and reference lists of included papers were scanned. The review emphasizes the evidence published in the last five years, while also incorporating significant studies from earlier years, structured by the extent of evidence linking vitamin D to muscle health in the most commonly inflammatory and autoimmune rheumatic diseases encountered in clinical practice. Results: Observational studies indicate a high prevalence of vitamin D serum deficiency (mean serum concentrations < 10 ng/mL) or insufficiency (<30 ng/mL) in patients with idiopathic inflammatory myopathies (IIMs) and polymyalgia rheumatica, as well as other autoimmune connective tissue diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and systemic sclerosis (SSc). Of note, vitamin D insufficiency may be associated with reduced muscle strength (2 studies on RA, 2 in SLE and 1 in SSc), increased pain (1 study on SLE), fatigue (2 studies on SLE), and higher disease activity (3 studies on IIMs and 1 on SLE) although there is much heterogeneity in the quality of evidence and different associations for the different investigated diseases. Therefore, linked to the multilevel biological intervention exerted by vitamin D, several translational and clinical studies suggest that active metabolites of this secosteroid hormone, play a role both in reducing inflammation, but also in enhancing muscle regeneration, intra-cellular metabolism and mitochondrial function, although interventional studies are limited. Conclusions: Altered serum vitamin D status is commonly observed in inflammatory and autoimmune rheumatic diseases and seems to be associated with adverse muscle health outcomes. While maintaining adequate serum vitamin D concentrations may confer muscle-protective effects, further research is needed to confirm these findings and establish optimal supplementation strategies to obtain a safe and efficient serum threshold. Full article

The purpose of this study was to examine cervical cancer among women with Human Immunodeficiency Virus (HIV) and to discuss targeted strategies to reduce the risk of developing cervical cancer. This study used retrospective data from surveillance reports collected between January 2001 and December 2012. Women with HIV/Acquired Immunodeficiency Syndrome (AIDS) were linked through a crosswalk file to Florida’s cancer registry database to determine which women developed cervical cancer during this period. We examined the cervical cancer trends using age-adjusted cervical cancer rates to examine the changes over time; the geographic variations in cervical cancer and HIV across service areas using a Geographic Information System (GIS); and finally, the cervical cancer rates among women with HIV compared with the cervical cancer rates in the general population. The results show that, over time, the cervical cancer rates in women with HIV/AIDS decreased; however, we detected increases in the cervical cancer rates among women in the general population. The findings of this study show that more work is required to address cervical cancer. This growing burden of cervical cancer implies that targeted interventions are imperative to improving the health status of women with cervical cancer. If properly addressed, the potential to reduce and prevent cervical cancer is achievable. Full article

Magnetoencephalography (MEG) non-invasively provides important information about human brain electrophysiology. The growing use of optically pumped magnetometers (OPM) for MEG, as opposed to fixed arrays of cryogenic sensors, has opened the door for innovation in system design and use cases. For example, cryogenic MEG systems are housed in large, shielded rooms to provide sufficient space for the system dewar. Here, we investigate the performance of OPM recordings inside of a cylindrical shield with a 1 × 2 m² footprint. The efficacy of shielding was measured in terms of field attenuation and isotropy, and the value of post hoc noise reduction algorithms was also investigated. Localization accuracy was quantified for 104 OPM sensors mounted on a fixed helmet array based on simulations and recordings from a bespoke current dipole phantom. Passive shielding attenuated the vector field magnitude to 50.0 nT at direct current (DC), to 16.7 pT/√Hz at power line, and to 71 fT/√Hz (median) in the 10–200 Hz range. Post hoc noise reduction provided an additional 5–15 dB attenuation. Substantial field isotropy remained in the volume encompassing the sensor array. The consistency of the isotropy over months suggests that a field nulling solution could be readily applied. A current dipole phantom generating source activity at an appropriate magnitude for the human brain generated field fluctuations on the order of 0.5–1 pT. Phantom signals were localized with 3 mm localization accuracy, and no significant bias in localization was observed, which is in line with performance for cryogenic and OPM MEG systems. This validation of the performance of a small footprint MEG system opens the door for lower-cost MEG installations in terms of raw materials and facility space, as well as mobile imaging systems (e.g., truck-based). Such implementations are relevant for global adoption of MEG outside of highly resourced research and clinical institutions. Full article

The Arctic-Boreal zone (ABZ) covers over 26 million km² and is home to numerous duck species; however, understanding the spatiotemporal distribution of their populations across this vast landscape is challenging, in part due to extent and data scarcity. Species abundance models for ducks in the ABZ commonly use static (time invariant) habitat covariates to inform predictions, such as wetland type and extent maps. For the first time in this region, we developed species abundance models using high-resolution, time-varying wetland inundation data produced using satellite remote sensing methods. This data captured metrics of surface water extent and inundated vegetation in the Peace Athabasca Delta, Canada, which is within the NASA Arctic Boreal Vulnerability Experiment core domain. We used generalized additive mixed models to demonstrate the improved predictive value of this novel data set over time-invariant data. Our findings highlight both the potential complementarity and efficacy of dynamic wetland inundation information for improving estimation of duck abundance and distribution at high latitudes. Further, these data can be an asset to spatial targeting of biodiversity conservation efforts and developing model-based metrics of their success under rapidly changing climatic conditions. Full article

Globally and historically, Indigenous healthcare is efficacious, being rooted in Traditional Healing (TH) practices derived from cosmology and place-based knowledge and practiced on the land. Across Turtle Island, processes of environmental dispossession and colonial oppression have replaced TH practices with a colonial, hospital-based system found to cause added harm to Indigenous Peoples. Growing Indigenous health inequities are compounded by a mental health crisis, which begs reform of healthcare institutions. The implementation of Indigenous knowledge systems in hospital environments has been validated as a critical source of healing for Indigenous patients and communities, prompting many hospitals in Canada to create Traditional Healing Spaces (THSs). After ten years, however, there has been no evaluation of the effectiveness of THSs in Canadian hospitals in supporting healing among Indigenous Peoples. In this paper, our team describes THSs within the Center for Addiction and Mental Health (CAMH), Canada’s oldest and largest mental health hospital. Analyses of 22 interviews with hospital staff and physicians describe CAMH’s THSs, including what they look like, how they are used, and by whom. The results emphasize the importance of designating spaces with and for Indigenous patients, and they highlight the wholistic benefits of land-based treatment for both clients and staff alike. Transforming hospital spaces by implementing and valuing Indigenous knowledge sparks curiosity, increases education, affirms the efficacy of traditional healing treatments as a standard of care, and enhances the capacity of leaders to support reconciliation efforts. Full article

Both glioblastoma (GBM) and dementia are devastating diseases with limited treatments that are usually not curative. Having clinically diagnosed dementia with an associated biopsy-proven etiology and a coexisting GBM diagnosis is a rare occurrence. The relationship between the development of neurodegenerative dementia and GBM is unclear, as there are conflicting reports in the literature. We present two cases of simultaneous biopsy-proven dementia, one with Alzheimer’s disease (AD) and GBM, and one with cerebral amyloid angiopathy (CAA) and GBM. We discuss how these diseases may be associated. Whether one pathologic process begins first or develops concurrently is unknown, but certain molecular pathways of dementia and GBM appear directly related while others inversely related. Further investigations of these close molecular relationships between dementia and GBM could lead to development of improved diagnostic tools and therapeutic interventions for both diseases. Full article

We report the results of a structured expert elicitation to identify the most likely types of potential food system disruption scenarios for the UK, focusing on routes to civil unrest. We take a backcasting approach by defining as an end-point a societal event in which 1 in 2000 people have been injured in the UK, which 40% of experts rated as “Possible (20–50%)”, “More likely than not (50–80%)” or “Very likely (>80%)” over the coming decade. Over a timeframe of 50 years, this increased to 80% of experts. The experts considered two food system scenarios and ranked their plausibility of contributing to the given societal scenario. For a timescale of 10 years, the majority identified a food distribution problem as the most likely. Over a timescale of 50 years, the experts were more evenly split between the two scenarios, but over half thought the most likely route to civil unrest would be a lack of total food in the UK. However, the experts stressed that the various causes of food system disruption are interconnected and can create cascading risks, highlighting the importance of a systems approach. We encourage food system stakeholders to use these results in their risk planning and recommend future work to support prevention, preparedness, response and recovery planning. Full article

The geoheritage value in the Thames District, North Island, New Zealand, is notable for its over 50 epithermal gold deposits associated with the Coromandel Volcanic Zone, significant to the region’s geological, cultural, and mining heritage. This case study was conducted in collaboration with the Thames School of Mines and Mineralogical Museum to develop a series of web-based applications for public outreach and an accessible museum experience through the utilization of specimens from the mineralogical museum. This research applies a conceptual framework of ex situ geoheritage to explore links between local geology with cultural and mining heritage. Minerals and rock specimens collected for the Thames School of Mines Mineralogical Museum were used to create 3D virtual models demonstrating the epithermal mineralization in the Thames Goldfield. Outputs of this project consist of two digital products, including a digital mineral and rock repository and the dissemination of the geological collection through integrating the photogrammetric models into a user-friendly outreach, ArcGIS Storymaps, to depict the geoheritage relationship of the specimens to regional gold mining, and at the same time, to be developed to be implemented in geoscience education and communication. The results of this paper are intended to promote the use of digital tools for enhancing and raising awareness of the geoheritage values of the Thames Goldfield. This approach has relevance for Papua New Guinea and the Pacific Islands in raising awareness of geological, mineral, and mining heritage within widely distributed and often isolated communities across island archipelago nations. Full article

Arboviruses, such as yellow fever virus (YFV), dengue virus (DENV), and chikungunya virus (CHIKV), present wide global dissemination and a pathogenic profile developed in infected individuals, from non-specific clinical conditions to severe forms, characterised by the promotion of significant lesions in different organs of the harbourer, culminating in multiple organ dysfunction. An analytical cross-sectional study was carried out via the histopathological analysis of 70 samples of liver patients, collected between 2000 and 2017, with confirmed laboratory diagnoses, who died due to infection and complications due to yellow fever (YF), dengue fever (DF), and chikungunya fever (CF), to characterise, quantify, and compare the patterns of histopathological alterations in the liver between the samples. Of the histopathological findings in the human liver samples, there was a significant difference between the control and infection groups, with a predominance of alterations in the midzonal area of the three cases analysed. Hepatic involvement in cases of YF showed a greater intensity of histopathological changes. Among the alterations evaluated, cell swelling, microvesicular steatosis, and apoptosis were classified according to the degree of tissue damage from severe to very severe. Pathological abnormalities associated with YFV, DENV, and CHIKV infections showed a predominance of changes in the midzonal area. We also noted that, among the arboviruses studied, liver involvement in cases of YFV infection was more intense. Full article

Objective: To investigate in an unselected, systemic sclerosis (SSc) cohort if baseline laser speckle contrast analysis (LASCA) peripheral blood perfusion (PBP) measurements differ between ‘early’ SSc (without skin involvement, or ‘limited’ SSc—LSSc) and ‘clinically overt’ SSc (with skin involvement, limited cutaneous SSc—LcSSc and diffuse cutaneous SSc—DcSSc) in routine setting. Methods: A group of twenty consecutive ‘early’ SSc patients and forty consecutive ‘clinically overt’ SSc patients (twenty LcSSc and twenty DcSSc) underwent clinical and LASCA examinations (to assess the peripheral blood perfusion [PBP] of both hands volar). Results: No statistically significant difference in adjusted PBP was found in the ‘early’ versus the ‘clinically overt’ group (p = 0.77) when adjusted for possible confounding factors (e.g., vasoactive medication, active smoking, history of DTL and disease duration). A wide variability was noted when observing the individual datapoints of each subset. Conclusion: This study with an unselected SSc population in daily routine, non-research setting, showed there was no difference in adjusted PBP at baseline between ‘early’ SSc and ‘clinically overt’ SSc when corrected for possible confounding factors. Interestingly a wide variation of individual datapoints were observed in each subset, which emphasizes the heterogeneity of SSc. Full article