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The COVID-19 pandemic caused by worldwide infection with SARS-CoV-2 has established itself as one of the most disruptive infectious disease events in recorded history. The impact of this pandemic has [...], * Context.--Autopsies performed on COVID-19 patients have provided critical information about SARS-CoV-2's tropism, mechanisms of tissue injury, and spectrum of disease. Objective.--To provide an updated database of postmortem disease in COVID-19 patients, assess relationships among clinical and pathologic variables, evaluate the accuracy of death certification, and correlate disease variables to causes of death. Design.--The 272 postmortem examinations reported in this paper were submitted by 14 pathologists from 9 medical or forensic institutions across the United States. The study spans the eras of the 3 principal COVID-19 strains and incorporates surveyed demographic, clinical, and postmortem data from decedents infected with SARS-CoV-2, including primary and contributing causes of death. It is the largest database of its kind to date. Results.--Demographics of the decedents reported here correspond well to national statistics. Primary causes of death as determined by autopsy and official death certificates were significantly correlated. When specifically cited disease conditions found at autopsy were correlated with COVID-19 versus non-COVID-19 deaths, only lung findings characteristic of SARS-CoV-2 infection or the absence of lung findings were significantly associated. Conclusions.--Changes in hospitalization and disease likely stem from longer lifespans after COVID-19 diagnosis and alteration in treatment approaches. Although Omicron variants preferentially replicate in the upper airways, autopsied patients who died of COVID-19 in that time period showed the same lung damage as earlier decedents. Most importantly, findings suggest that there are still unelucidated risk factors for death from COVID-19 including possibly genetic susceptibility. (Arch Pathol Lab Med. 2024;148:e386-e393; doi: 10.5858/arpa.2023-0380-OA)

Rocky Mountain spotted fever (RMSF) is the deadliest tickborne disease in the Western Hemisphere. RMSF is caused by the bacterium Rickettsia rickettsii, which is primarily transmitted to humans by Dermacentor [...]

Introduction Although the coronavirus disease 2019 (COVID-19) pandemic was a global catastrophe, its impact was not felt equally around the world. Despite being home to only 8% of the world's [...], The normative role of the World Health Organization (WHO) involves creating evidence-based, principled guidelines to guide its Member States in making well-informed public health decisions. While these guidelines often need to be adapted to ensure contextual relevance, foster better implementation and adherence, adapting existing guidelines is more efficient than creating new ones. Here we describe the adaptation of the WHO coronavirus disease 2019 (COVID-19) living guideline on pharmacological interventions for the Caribbean using the grading of recommendations, assessment, development and evaluation (GRADE)-ADOLOPMENT method. The Caribbean Public Health Agency and the Pan American Health Organization led the effort, assembling a diverse panel of 16 experts from seven Caribbean countries and territories. The adaptation process, involving 15 steps, was guided by an experienced methodologist and included selecting relevant clinical questions and prioritizing them based on regional needs. The panel evaluated the latest WHO guidelines and integrated additional local data. They adjusted the direction and strength of several recommendations to better fit the Caribbean context, considering local values and preferences, resources, accessibility, feasibility and impact on health equity. Ultimately, we changed the direction of two recommendations and the strength of five, tailoring them to regional realities. This effort highlights the importance of adapting global guidelines to local settings, improving their applicability and effectiveness. The adaptation process also serves as a valuable opportunity for skill transfer and capacity-building in guideline development. Continued research is needed to assess the impact of these adaptations on health-care outcomes in the Caribbean. [phrase omitted] Le role normatif de l'Organisation mondiale de la sante (OMS) consiste a elaborer des lignes directrices fondees sur des donnees scientifiques et sur des principes afin d'aider ses Etats membres a prendre des decisions eclairees en matiere de sante publique. Bien qu'elles necessitent souvent des adaptations pour garantir leur pertinence par rapport a des contextes precis et pour favoriser une meilleure mise en oeuvre et adhesion, il est plus efficace d'adapter les lignes directrices existantes que d'en creer de nouvelles. La presente publication decrit l'adaptation de la ligne directrice evolutive de l'OMS sur les interventions pharmacologiques dans le cadre de la maladie a coronavirus (COVID-19) pour les Caraibes en appliquant la methodologie GRADE (classement des recommandations, de l'appreciation, du developpement et de l'evaluation)-ADOLOPMENT. LAgence de sante publique des Caraibes et l'Organisation panamericaine de la Sante ont dirige les travaux en reunissant un groupe diversifie de 16 experts issus de sept pays et territoires des Caraibes. Le processus d'adaptation, comptant 15 etapes et encadre par un methodologiste experimente, a consiste a selectionner des questions cliniques pertinentes et a les classer par ordre de priorite selon les besoins regionaux. Ce groupe a evalue les dernieres lignes directrices de l'OMS et a integre des donnees locales supplementaires. Il a ensuite ajuste l'orientation et le poids de plusieurs recommandations afin de mieux les adapter au contexte des Caraibes, en tenant compte des valeurs et des preferences locales, des ressources, de l'accessibilite, de la faisabilite et de l'impact sur l'equite en matiere de sante. En fin de compte, l'orientation de deux recommandations et le poids de cinq autres ont ete modifies, en les adaptant aux realites regionales. Cet effort souligne l'importance d'adapter des lignes directrices mondiales aux contextes locaux, afin d'en ameliorer l'applicabilite et l'efficacite. Le processus d'adaptation represente egalement une occasion precieuse de transfert de competences et de renforcement des capacites en matiere d'elaboration de lignes directrices. Des recherches continues s'imposent pour evaluer l'impact de ces adaptations sur les resultats des soins de sante dans les Caraibes. [phrase omitted] La funcion normativa de la Organizacion Mundial de la Salud (OMS) consiste en elaborar directrices basadas en pruebas y principios para orientar a sus Estados Miembros en la toma de decisiones de salud publica bien fundamentadas. Aunque con frecuencia es necesario adaptar estas directrices para garantizar su pertinencia contextual y fomentar una mejor implementacion y observancia, la adaptacion de directrices existentes es mas eficiente que la creacion de otras nuevas. Aqui describimos la adaptacion de la directriz vigente de la OMS sobre la enfermedad por coronavirus (COVID-19) relativa a las intervenciones farmacologicas para el Caribe utilizando el metodo de clasificacion de valoracion, elaboracion y evaluacion de las recomendaciones (GRADE)ADOLOPMENT. La Agencia de Salud Publica del Caribe y la Organizacion Panamericana de la Salud lideraron la iniciativa, que reunio a un variado grupo de 16 expertos de siete paises y territorios caribenos. El proceso de adaptacion, que comprendio 15 pasos y fue guiado por un metodologo experimentado, Incluyo la seleccion de preguntas clinicas pertinentes y su priorizacion en funcion de las necesidades regionales. El grupo evaluo las ultimas directrices de la OMS e integro datos locales adicionales. Ajustaron la orientacion y la fuerza de varias recomendaciones para adaptarlas mejor al contexto caribeno, teniendo en cuenta los valores y preferencias locales, los recursos, la accesibilidad, la viabilidad y el impacto en la equidad sanitaria. Finalmente, cambiamos la orientacion de dos recomendaciones y la fuerza de cinco para adaptarlas a las realidades regionales. Esta iniciativa destaca la importancia de adaptar las directrices mundiales a los contextos locales, lo que mejora su aplicabilidad y eficacia. El proceso de adaptacion tambien constituye una valiosa oportunidad para la transferencia de conocimientos y el desarrollo de capacidades en la elaboracion de directrices. Es necesario seguir investigando para evaluar el impacto de estas adaptaciones en los resultados de la atencion sanitaria en el Caribe.

Extreme heat contributes to 8000-12 000 excess U.S. deaths per year. Partly due to increasing summer temperatures and a renewed focus on environmental justice, local governments started new initiatives to manage and adapt to extreme heat. For example, Miami-Dade County, Florida, United States, appointed Jane Gilbert as the world's first Chief Heat Officer. This manuscript summarizes Miami-Dade County's preliminary efforts to build local evidence, engage the community, and rapidly respond to extreme heat. The manuscript's goal is to expedite the translation of existing tools into mainstream extreme heat, health, and equity planning. The study generated local evidence to identify the places and periods of time with elevated heat-related illness using a statistical vulnerability and time series analysis, respectively. The places with the highest severe heat-related illness rates had hotter land surface temperatures and/or higher proportions of people who were outdoor workers, Indigenous, living in poverty or mobile homes, and households with children. "Everyday" summer conditions instead of rare heatwaves increase the risk of a heat-related death. The Chief Heat Officer convened workshops that engaged 298 unique community members on six cross-sectoral heat topics. Key recommendations included increasing multisectoral heat monitoring and risk communication, building more affordable housing, preserving and expanding greenspace, and creating heat resilience hubs. The activities culminated in a Heat Action Plan, which was completed in less than two years from the receipt of project funding. SIGNIFICANCE STATEMENT: Extreme heat is a contributing factor to more U.S. deaths per year than any other weather hazard. This manuscript summarizes the world's first Chief Heat Officer's efforts to build local heat and health evidence. The places with the highest heat-related illness rates had hotter surface temperatures and/or higher proportions of people who were outdoor workers, Indigenous, and living in poverty or mobile homes. On hot and humid days, 7.8% (603 deaths) of the summer deaths per year were associated with the concurrent and preceding day's heat exposures. In response, Miami-Dade County is targeting heat interventions, lowering heat advisory thresholds, and considering new heat safety laws. KEYWORDS: Adaptation; Health; Heat islands; Societal impacts; Vulnerability, 1. Introduction Over 2002-20, an increasing proportion of jurisdictions considered extreme heat in their planning activities (Bernard and McGeehin 2004; Meerow and Keith 2021). In Miami-Dade County, Florida, United States [...]

The trajectory of research in communication illustrates a sensitive issue: the search for a paradigm that would help to understand the phenomenon in question. As time progressed, the paradigm itself [...]

Shakespeare mentions a contemporary Italian artist by name in only one play. Near the end of The Winter's Tale, four courtiers are discussing the fate of the leading characters: The [...]

Author(s): Carol Gilbert [sup.1] , Marilyn Johnson [sup.1] , Bibhusha Karki [sup.2] , Kiara Lyons [sup.4] , Melissa Tibbits [sup.1] , Drissa Toure [sup.3] , Aislinn C. Rookwood [sup.1] , [...], Purpose To assess the potential of workplace support to protect public health equity workers against job burnout and to identify key workplace support components. Description This mixed-methods, explanatory sequential study analyzed survey and interview data collected between August 2020 and June 2021. Participants included governmental and non-governmental public health employees whose programs largely focus on Maternal and Child Health populations and who reported that their jobs involved working to reduce health inequities ("equity work"). Regression analysis tested the effect of emotional labor on job burnout, and whether workplace support modified that effect. Qualitative analysis of interview transcripts explored possible components of needed workplace support. Assessment Emotional labor was positively associated with job burnout (p < .001), and there was a significant negative interaction between emotional labor and workplace support, meaning workplace support appeared to reduce the effect of emotional labor on burnout (p = .036). Qualitative analysis identified four support components: peer-to-peer mentoring connections, workplace accommodations, engaged and empathetic supervision, and mental health resources. Conclusion Workplace support is associated with reduced job burnout for public health equity workers, especially those whose jobs involve high levels of emotional labor. Few public health employers are providing needed emotional supports for their equity workers, but certain supports appear to be helpful in reducing job burnout.

End-stage kidney disease (ESKD) is the most severe form of renal impairment, which requires renal replacement therapy (RRT) to sustain life. (1) RRT is defined as replacement of nonendocrine renal [...], * Context.--End-stage kidney disease (ESKD) is defined as renal impairment requiring renal replacement therapy to sustain life. With a 1-year mortality of ~20% to 30%, many die of complications related to this disease. Objective.--To determine the percentage of autopsy cases of decedents with ESKD in which the contribution of ESKD to death is accurately reflected in the final report. Design.--Autopsy case records were retrospectively reviewed at 4 institutions (Yale New Haven Hospital, University of Chicago Medical Center, University of Illinois at Chicago Hospital, University of Iowa Hospital). Clinical, macroscopic, and microscopic autopsy findings were reviewed, with attention to renal disease findings. Results.--One hundred sixty decedents with documented ESKD and premortem dialysis who underwent autopsy assessment were identified. ESKD was implicated as a cause of death (CoD) or significant contributing factor in 44 cases (28%), but not in the remaining 116 cases (72%). Cardiovascular disease was the most common CoD in ESKD. There was significant interpathologist variation in the inclusion of ESKD as a CoD across institutions. These rates ranged from 85% correlation (23 of 27 cases), to 13% (4 of 31 and 8 of 62 cases at 2 institutions), and 22.5% (9 of 40 cases) across the 4 participating institutions. Conclusions.--The recognition at autopsy of ESKD as a CoD or contributing CoD at autopsy in patients undergoing dialysis remains low (28%). The detrimental impact of ESKD is not reflected in hospital autopsy reports, which carries implications for collection of vital statistics and allocation of research funding for kidney diseases. doi: 10.5858/arpa.2022-0338-OA

INTRODUCTION. 511 I. Misinformation and Proposals for Reform 519 A. Increasing the Supply of True Information 520 B. Decreasing the Supply of False Information 522 C. Distinguishing True and False [...], False information poses a threat to individuals, groups, and society. Many people struggle to judge the veracity of the information around them, whether that information travels through newspapers, talk radio, TV, or social media. Concerned with the spread of misinformation and harmful falsehoods, much of the policy, popular, and scholarly conversation today revolves around proposals to expand the regulation of individuals, platforms, and the media. While more regulation may seem inevitable, it faces constitutional and political hurdles. Furthermore, regulation can have undesirable side effects and be ripe for abuse by powerful actors, public and private. This Article presents an alternative for fighting misinformation that avoids many pitfalls of regulation: truth bounties. We develop a contractual mechanism that would enable individuals, media, and others to pledge money to support the credibility of their communications. Any person could claim the bounty by presenting evidence of the falsity of the communication before a dedicated body of private arbitrators. Under the system we envision, anyone consuming information on the internet would know immediately if a given communication had a bounty attached, whether the communication had been challenged, and whether the challenge succeeded or failed. As John Stuart Mill recognized, we can trust our grasp of the truth only by putting it to the fire of challenge. Truth bounties open the challenge to all.

Geonoma maxima (Poit.) Kunth is an example of a species complex, among many others restricted to Neotropical rain forests, which contribute to their high species diversity. Using environmental, morphological, karyological, and molecular data, we aim to test the taxonomic circumscription of 3 of the 11 G. maxima subspecies defined in the latest taxonomic treatment. We evaluated 217 samples of G. maxima complex from Ducke Reserve in the state of Amazonas, Brazil. Environmental preferences were significant at the 0.1% level. Subspecies maxima occurred in the slope, subsp. chelidonura in the floodplain, and subsp. spixiana in the plateau. Leaf morphology and height were different for each subspecies, but not leaf anatomy. The karyotypes of subspp. chelidonura and maxima were symmetrical with 2n = 28 chromosomes, 16 metacentric and 12 submetacentric. Molecular analysis revealed two groups, one comprised subspp. maxima and chelidonura, and the other formed exclusively by subsp. spixiana. At Ducke Reserve, it is clear that the three subspecies are easily recognizable morphologically and ecologically, and it is likely that they do not interbreed locally. However, if these subspecies are analyzed on a larger geographic scale, it may not be possible to separate them. Key words: Arecaceae, taxonomy, understory, Brazilian Amazon, Introduction Geonoma Willd. (Arecaceae) is a genus restricted to Neotropical forests. It stands out not only because of the great number of species it comprises, but also and mainly because [...]

LAND ACKNOWLEDGMENT AND SOCIAL LOCATION This work has been a culminating effort while living on various lands in Canada and the United States; unceded territories of the lekwenen people and [...], Men who have sex with men (MSM) living with HIV have been studied extensively for stigmatization and inequitable factors affecting well-being. Although intersecting factors are acknowledged in some studies, they are rarely discussed in the context of health implications among multiple minority identities. This leaves psychosocial research outputs to focus their efforts among less stigmatized MSM groups, white men, while disregarding specific issues among historically marginalized MSM-related identities (e.g., racialized, Indigenous, and aging populations). As per the 95-95-95 goals set by the Joint United Nations Programme on HIV and AIDS, this systematic review covers psychosocial protective and risk factors experienced by HIV-positive MSM while also considering other intersecting identities. Following a standardized search inquiry, 2,139 records were identified and narrowed down to 24 peer-reviewed articles which were systematically reviewed. Psychological and social protective factors are contextually described. Some risk factors such as co-occurring stigmas, psychological distress, exposure to violence, and trauma among diverse MSM can potentiate greater risk-taking behaviours associated with HIV transmission among HIV-positive men. These findings highlight factors that contribute to resilient pathways among racialized minorities and other intersections among MSM while also examining specific psychological stressors. Tailored interventions and care for minorities with intersecting identities, with a focus on co-occurring stigmas, are crucial to ensure the well-being of diverse HIV-positive MSM and reduce HIV transmission. We propose an adaptation to the minority stress model to refine available tools and provide future studies with more accurate depictions of the lived experiences among diverse MSM. KEYWORDS: 95-95-95 target, HIV transmission, intersectionality, mental health, minority stress model, MSM, psychosocial

The intracellular bacterium Chlamydia pneumoniae is a recognized cause of community-acquired pneumonia (1). High-frequency estimates were initially derived from serologic studies, but the advent of molecular techniques has revealed rates [...]

Author(s): William Gilbert [sup.1] , Julien S. Bureau [sup.2] , Bruno Poellhuber [sup.3] , Frédéric Guay [sup.2] Author Affiliations: (1) https://ror.org/04sjchr03, grid.23856.3a, 0000 0004 1936 8390, School of Psychology, Université [...], Psychological distress and unhealthy lifestyle behaviors are highly prevalent among undergraduate students. Importantly, numerous longitudinal studies show that these phenomena rise significantly during the first months of college and remain high thereafter. However, research identifying theory-driven mechanisms to explain these phenomena is lacking. Using two complementary statistical approaches (person- and variable-centered), this study assesses basic psychological needs (BPNs) and self-control as possible explanatory factors underlying the association between student&apos;s educational experience and multiple health-related outcomes. A total of 2450 Canadian undergraduates participated in this study study involving two time points (12 months apart; N.sub.Time1 = 1783; N.sub.Time2 = 1053), of which 386 participated at both measurement occasions. First, results from person-centered analyses (i.e., latent profile and transition analyses) revealed three profiles of need-satisfaction and frustration in students that were replicated at both time points. Need-supportive conditions within college generally predicted membership in the most adaptive profile. In turn, more adaptive profiles predicted higher self-control, lower levels of psychological distress (anxiety, depression), and healthier lifestyle behaviors (physical activity, fruit and vegetable consumption). Second, results from variable-centered analyses (i.e., structural equation modeling) showed that the association between students&apos; BPNs and health-related outcomes was mediated by self-control. In other words, high need satisfaction and low need frustration were associated with higher self-regulatory performance at Time 1, which in turn predicted a more adaptive functioning at Time 2. Overall, these findings help clarify the mechanisms underlying the association between college educational climate and students&apos; health-related functioning.

Fish passages are constructed to facilitate movement around barriers, but few are quantitatively evaluated for non- salmonids. We quantified the efficiency of a selective, nature-like fish passage for three native fishes, Colorado pikeminnow (Ptychocheilus lucius), flannelmouth sucker (Catostomus latipinnis), and razorback sucker (Xyrauchen texanus), in the San Juan River, NM, USA, by estimating the probabilities of completing three navigational phases and associated delay times. We compared passage efficiency in years when fish were captured in a trap and manually moved upstream to years when the trap was removed in the spring. All species were less efficient at navigating the attraction and exit phases compared with the ascent phase. Operating the passage without the trap generally increased passage success and shortened delay times. The mean probability of passage and delay time among species when the trap was removed ranged from 34%-55% and 5-21 days, respectively. Our results suggest species- and phase-specific variation in passage efficiency and highlight the need for evaluations to aid future passage design and operation for a greater diversity of fish. Key words: instream barriers, endangered fish, selective passage, PIT antennas, fishway, Introduction Fragmentation is one of the greatest threats to the ecological integrity of riverine ecosystems. Fish populations across the globe are impacted by dams and diversions that shunt water for [...]

Sergei Rachmaninoff: Cross Rhythms of the Soul. By Valeria Z. Nollan. Lanham, MD: Lexington Books, 2022. [xi, 386 p. ISBN 9781666917598 (hardcover), $125; ISBN 9781666917604 (ebook), $50.] Illustrations, discography, bibliography, [...]

INTRODUCTION Eastern Europe and central Asia (EECA), including Kazakhstan [1], is the only region with a rising HIV incidence, with an estimated 33,000 people living with HIV (PLWH). Of these, [...], : Introduction: There is a research gap in how mental health and cognition are associated with antiretroviral treatment (ART) adherence among people living with HIV (PLWH) in Kazakhstan. Methods: We randomly selected and enrolled 230 PLWH from the Almaty City AIDS Center registry (June−November 2019) into a cross‐sectional study. We examined associations between self‐reported ART adherence for the last 1 and 2 weeks; the Adherence Self‐Efficacy Scale (ASES) and symptoms of depression (Patient Health Questionnaire‐9 [PHQ‐9]), anxiety (Generalized Anxiety Disorder tool [GAD‐7]), post‐traumatic stress disorder (PTSD Checklist [PTSD]); cognitive function (PROMIS v2.0 Adult Cognitive Function 8a short form) and forgetfulness (Forgetfulness Assessment Inventory). We used cut points of ≥5 for at least mild and ≥10 for at least moderate symptom severity for PHQ‐9 and GAD‐7 and of ≥44 for PTSD. Logistic and linear regression analyses were used. Results: Participants’ median age was 40.0 (IQR: 34−47) with 40.9% (n = 94) of females in the sample. Those who missed at least one pill for the last 2 weeks had higher odds of reporting at least mild depression (aOR = 3.34, 95% CI: 1.22–9.11, p < 0.05); mild anxiety (aOR = 3.27, 95% CI: 1.20–8.92, p < 0.05); and PTSD (aOR = 4.04, 95% CI: 1.15–14.21, p < 0.05) symptoms. Participants who missed at least one pill for the last week had higher odds of at least mild depression (aOR = 7.74, 95% CI: 1.31–45.7, p < 0.05), moderate anxiety (aOR = 21.33, 95% CI: 3.24–140.33, p < 0.005) and PTSD (aOR = 13.81, 95% CI: 2.36–80.84, p < 0.005) symptoms. Participants with better cognitive function had lower odds of non‐adherence over the last week (aOR = 0.88, 95% CI: 0.81–0.96, p < 0.005) and higher ASES scores (β = 0.26, 95% CI: 0.13–0.40, p < 0.005). Poor memory was associated with higher odds of non‐adherence over the last week (aOR = 4.64, 95% CI: 1.76–12.24, p < 0.005) and lower ASES score (β = −0.31, 95% CI: −0.45 to 0.16, p < 0.005). Those who had at least mild depression (β = −0.21, 95% CI: −0.35 to −0.07, p < 0.005); moderate anxiety (β = −0.21, 95% CI: −0.34 to −0.07, p < 0.005) and PTSD (β = −0.19, 95% CI: −0.33 to −0.05, p < 0.005) symptoms had lower ASES scores. Conclusions: Depression, anxiety and PTSD symptoms, poorer cognition, and forgetfulness were associated with poorer ART adherence and worse adherence self‐efficacy. It is crucial to assess and treat mental illness and provide support for PLWH with worsened cognition to enhance ART adherence.