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Abstract Background HIV-1 is endemic in Botswana. The country’s primary challenge is identifying people living with HIV who are unaware of their status. We evaluated factors associated with undiagnosed HIV infection using HIV-1 phylogenetic, behavioural, and demographic data. Methods As part of the Botswana Combination Prevention Project, 20% of households in 30 villages were tested for HIV and followed from 2013 to 2018. A total of 12,610 participants were enrolled, 3596 tested HIV-positive at enrolment, and 147 participants acquired HIV during the trial. Extensive socio-demographic and behavioural data were collected from participants and next-generation sequences were generated for HIV-positive cases. We compared three groups of participants: (1) those previously known to be HIV-positive at enrolment (n = 2995); (2) those newly diagnosed at enrolment (n = 601) and (3) those who tested HIV-negative at enrolment but tested HIV-positive during follow-up (n = 147). We searched for differences in demographic and behavioural factors between known and newly diagnosed group using logistic regression. We also compared the topology of each group in HIV-1 phylogenies and used a genetic diversity-based algorithm to classify infections as recent (

Most seed plants produce both pollen and ovules. In principle, pollen export could interfere with pollen import through self‐pollination, resulting in ovule usurpation and reduced fruit set. Evidence for such interference exists under experimental settings but its importance under natural conditions is unknown. To test for sexual interference in nature, it is necessary to study together mating system, through paternity analyses, and fruit set, the proportion of flowers giving seeds or fruits. We developed a new model combining both processes, using chestnut (Castanea) as case study. We carried out a paternity analysis in an intensively studied plot of 273 trees belonging to three interfertile chestnut species and including a range of individuals with more or less functional stamens, resulting in a large data set of 1924 mating events. We then measured fruit set on 216 of these trees. Fruit set of male‐fertile trees was much lower than that of male‐sterile trees. Our process‐based model shows that pollen is not limiting in the study site and hence cannot account for reduced fruit set. It also indicates that self‐pollination is high (74%) but selfing rate is low (4%). Self‐pollen is less competitive than cross‐pollen, reducing sexual interference, but not sufficiently, as many ovules end up being self‐fertilized, 95% of which abort before fruit formation, resulting in the loss of 46% of the fruit crop. These results suggest that the main cause of reduced reproductive potential in chestnut is sexual interference by self‐pollen, raising questions on its evolutionary origins. [ABSTRACT FROM AUTHOR]

Objective: Pain management surrounding lumbar spine surgery is a complex topic. Though some authors suggest that preoperative opioid use is a negative prognostic factor, its association with patient-reported outcomes and satisfaction after surgery remains controversial. We aimed to uncover the effect of preoperative opioid use on long-term outcomes using a national sample., Methods: Using deidentified data from the lumbar spine surgery Quality Outcomes Database, we compared functional outcomes and satisfaction in 34,934 patients based on presence of preoperative opioid use. Outcomes included Visual Analogue Scale (VAS), Oswestry Disability Index (ODI), and satisfaction indices. Regression subanalysis illustrated the effect of preoperative opioid duration and daily MME., Results: 44.1 % used opioids preoperatively. A greater percentage of patients using opioids underwent surgery with instrumentation (p < .005). They exhibited clinically comparable improvement in VAS, ODI, and satisfaction at 3- (p = .069, p < .005, p < .005, respectively) and 12-months (p < .05). Return to work was lower at 3- (74.32 % vs. 80.82 %, p < .005) and 12-months (48.99 % vs. 62.95 %, p < .005). They maintained low postoperative use although greater than opioid naïve patients at 3- (3.1 % vs. 1.2 %, p < .005) and 12-months (3.6 % vs. 0.8 %, p < .005). Preoperative daily MME had no significant effect on outcomes, although increasing duration negatively impacted VAS and ODI scores., Conclusions: Preoperative opioid use by itself should not be used in surgical decision making but rather an individual risk assessment according to chronicity of opioid burden. Longer duration of use appears to impair postoperative improvement but not satisfaction with little influence by daily MME; however, larger, granular analyses remain necessary., (Copyright © 2025 Elsevier B.V. All rights reserved.)

Human immunodeficiency virus (HIV) remains a major public health issue in the United States (US) and Black women living with HIV (BWLWH) are disproportionately impacted among women. This study investigates the complexities in influences of family, friend, and special person support systems and their association with post-traumatic stress disorder symptoms (PTSD), depressive symptoms, gendered coping (self-silencing), and a composite HIV risk score related to risk of viral non-suppression through missed medical visits, low medication adherence, and high viral load. Cross-sectional data among BWLWH were analyzed using network analyses via RStudio. Data from 119 BWLWH was reduced to 104, because of missing data on indicators as well as pairwise deletion for the correlation function. Findings revealed variances based on the type of network. For composite risk scores, friend support source had a weak to moderate significant correlation, while symptoms of PTSD and depression only showed a weak positive correlation with the composite risk variable through self-silencing as a form of coping. The post-hoc analysis showed a strong correlation with care as self-sacrifice, based on the composite risk score. Based on the findings from this study, insight was given into symptoms for depression and PTSD, as well as self-silencing and viral non-suppression risk in relation to sources of support for BWLWH. Future interventions to improve the overall health of BWLWH may benefit from incorporating support from friends and lowering care as self-sacrifice., Competing Interests: Declarations. Ethics approval: This study was performed in accordance with the principles of the Declaration of Helsinki All study procedures and materials were approved by the Institutional review Board at the University of Miami (5/8/2017, No. 20170281). Consent to participate: Informed consent was obtained from all individual participants included in the study. Consent for publication: Research participants have provided informed consent for the publication of the research findings in a peer-reviewed journal. Conflict of interest: Unrelated to data in this manuscript, Dr. Dale is a co-investigator on a Merck & Co. funded project on “A Qualitative Study to Explore Biomedical HIV Prevention Preferences, Challenges and Facilitators among Diverse At-Risk Women Living in the United States” and has served as a workgroup consultant on engaging people living with HIV for Gilead Sciences, Inc., (© 2024. The Author(s).)

Recurrent stress on the isthmic pars interarticularis often leads to profound injury and symptom burden. When conservative and medical management fail, there are various operative interventions that can be used. The current review details the common clinical presentation and treatment of pars injury, with a special focus on the emerging minimally invasive procedures used in isthmic pars interarticularis repair. PubMed and Google Scholar database literature reviews were conducted. The keywords and phrases that were searched include but were not limited to; "history of spondylolysis", "pars interarticularis", "pars defect", "conventional surgical repair of pars", and "minimally invasive repair of pars". The natural history, conventional presentation, etiology, risk factors, and management of pars interarticularis injury are discussed by the authors. The surgical interventions described include the Buck's repair, Morscher Screw-Hook repair, Scott's Wiring technique, and additional pedicle screw-based repairs. Minimally invasive techniques are also reviewed, including the Levi technique. Surgical intervention has been proven to be safe and effective in managing pars interarticularis fractures. However, minimally invasive techniques often provide additional benefit to patients such as reducing damage of surrounding structures, decreasing postoperative pain, and limiting the time away from sports and other activities.

Background: Black individuals in the U.S. remain the most disproportionately impacted by new HIV diagnoses, represent the highest portion of individuals living with HIV, and have the highest morbidity rates. Structural inequities and historical oppression are the primary drivers. Such drivers limit access to HIV prevention tools that need to be delivered with culturally congruent and community-informed approaches., Methods: The Five Point Initiative (FPI) is a community-informed bundled implementation strategy developed and piloted between September 2019 and March 2020 in Miami, Florida in communities heavily impacted by HIV. Key components of the strategy included community consultants/experts, five categories (hence the "Five Point") of community businesses (e.g., corner stores, beauty supply stores, laundromats, mechanics, barbershops), local health organizations, an academic research program engrossed in community engaged research, and community residents who provided ongoing feedback throughout. Outcomes of FPI included (a) survey information (e.g., knowledge of and access to PrEP, barriers to care) and pilot data (acceptability and feasibility), (b) expansion of reach to Black individuals in HIV high impact zip codes in Miami, (c) insights on our bundled implementation strategy, (d) condom distribution, and (e) HIV testing., Results: Over the course of six months FPI carried out 10 outreach events, partnered with 13 community businesses and 5 health organizations, engaged 677 community residents, collected health information via a survey, distributed 12,434 condoms, provided information on PrEP, and offered voluntary HIV testing (131 completed). FPI's ability to reach residents who are not being reached (e.g., 68.8% never heard of PrEP, 8% no HIV testing ever, 65.9% no primary care provider), positive feedback from residents (e.g., 70% very satisfied, 21% satisfied; 62% strongly agree and 25% agree they would participate again) and qualitative interviews with businesses provide evidence of acceptability and feasibility. Further, survey data provided insights on factors such as socio-demographics, discrimination experiences, barriers to care, social-structural factors, physical and sexual health, and mental health and substance use., Conclusions: The FPI bundled implementation strategy shows promise to deliver health prevention/intervention for HIV and other health conditions to communities facing health inequities and for whom the current system for delivering care is insufficient., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Objective: Compared to non-Black women, Black women in the United States are more likely to be diagnosed with HIV, living with HIV, and have suboptimal HIV outcomes, disparities largely linked to structural and psychosocial factors that may impact mental health., Method: 151 Black women living with HIV (BWLWH) enrolled in a longitudinal cohort study completed baseline assessments between October 2019 and January 2020 in the Southeastern United States. Measures captured microaggressions (gendered-racial, HIV, and Lesbian/Gay/Bisexual/Transgender/Queer), "macro" discrimination acts (gender, race, HIV, sexual orientation), resilience factors (self-efficacy, trait resilience, posttraumatic growth, positive religious coping, and social support), and mental health (depressive symptoms, posttraumatic stress disorder (PTSD) symptoms, and posttraumatic cognitions). Four structural equation models were estimated with latent discrimination (LD), latent microaggression (LM), and latent resilience (LR) as predictors and depressive symptoms, PTSD symptoms, posttraumatic cognitions, and latent mental health (LH) as outcomes. Indirect pathways from LD and LM via LR and LR as a moderator were estimated., Results: Models fit well based on indices. There were significant direct pathways from LM and LR to depressive symptoms, posttraumatic cognitions, and LH and a significant direct pathway from LM to PTSD symptoms, but not from LD to any mental health outcome. Indirect pathways were not significant. However, LR moderated the relationships between both LM and LD with PTSD symptoms., Conclusion: Intersectional microaggressions and resilience factors may play key roles in BWLWH's mental health. Research is needed to examine these pathways overtime and provide opportunities to improve mental health and HIV outcomes among BWLWH. (PsycInfo Database Record (c) 2023 APA, all rights reserved).