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Early modern medical literature described miscarriage as an especially dangerous process for women's health. Recipe books, diary entries and personal correspondence show that some women experienced significant pain and complications, including retention of the foetus and placenta, fevers, haemorrhaging, headaches, and fertility issues. This article illuminates the management of the bodily process of miscarriage and the means used to promote women's recovery after the event. It considers the interventions that were necessary to combat the complications associated with pregnancy loss allowing the two-stage process of recovery to take place. In doing so it underlines the gendered nature of treatment in this area. It also reveals that married women who desired pregnancies configured even early miscarriages as losses and emphasized the need for the body to recover. [ABSTRACT FROM AUTHOR]

Early modern medical literature described miscarriage as an especially dangerous process for women's health. Recipe books, diary entries and personal correspondence show that some women experienced significant pain and complications, including retention of the foetus and placenta, fevers, haemorrhaging, headaches, and fertility issues. This article illuminates the management of the bodily process of miscarriage and the means used to promote women's recovery after the event. It considers the interventions that were necessary to combat the complications associated with pregnancy loss allowing the two-stage process of recovery to take place. In doing so it underlines the gendered nature of treatment in this area. It also reveals that married women who desired pregnancies configured even early miscarriages as losses and emphasized the need for the body to recover. [ABSTRACT FROM AUTHOR]

Background The current opioid epidemic across the United States has fueled a surge in the rate of new hepatitis C virus (HCV) infections among young persons who inject drugs (PWIDs). Paramount to interrupting transmission is targeting these high-risk populations and understanding the underlying network structures facilitating transmission within these communities. Methods Deep sequencing data were obtained for 52 participants from 32 injecting partnerships enrolled in the U-Find-Out (UFO) Partner Study, which is a prospective study of self-described injecting dyad partnerships from a large community-based study of HCV infection in young adult PWIDs from San Francisco. Phylogenetically linked transmission events were identified using traditional genetic-distance measures and viral deep sequence phylogenies reconstructed to determine the statistical support of inferences and the direction of transmission within partnerships. Results Using deep sequencing data, we found that 12 of 32 partnerships were genetically similar and clustered. Three additional phylogenetic clusters were found describing novel putative transmission links outside of the injecting relationship. Transmission direction was inferred correctly for 5 partnerships with the incorrect transmission direction inferred in more than 50% of cases. Notably, we observed that phylogenetic linkage was most often associated with a lower number of network partners and involvement in a sexual relationship. Conclusions Deep sequencing of HCV among self-described injecting partnerships demonstrates that the majority of transmission events originate from outside of the injecting partnership. Furthermore, these findings caution that phylogenetic methods may be unable to routinely infer the direction of transmission among PWIDs especially when transmission events occur in rapid succession within high-risk networks. [ABSTRACT FROM AUTHOR]

This co-authored article draws upon two distinct genres of photography, police mugshots and amateur soldier snapshots, to illustrate the value of queer visual culture methodologies for how to think about the visualization of violence, masculinity and desire. Building upon two vastly different depictions of male to female cross-dressing, one produced between 1934 and 1938 by the Berlin police and Gestapo of a transvestite and the other produced between 1940 and 1944 by cross-dressing Wehrmacht soldiers behind the lines, we argue that in searching for evidence of intact identities, we overlook important ambiguities. We first show how different photographic traditions have framed gender and sexual non-conformity in the historical record and then go deeper into an image analysis. Drawing upon cross-dressing as a polyvalent performance of masculinity, as play, camp and an identity category, we explore how photographic sources help us better appreciate the multiple and sometimes coexisting layers of feminized masculinity at work during the Third Reich. By queering Nazi history and reading the police mugshots and amateur Wehrmacht photographs within and beyond their visual frames, we point out the limits of reducing every image of cross-dressing to an expression of an inchoate gay or trans identity and argue for analysis that embraces the multiple layers of histories gathered around visual sources. [ABSTRACT FROM AUTHOR]

Background Ketamine has rapid-acting antidepressant effects but is associated with psychotomimetic and other adverse effects. A 7-chlorokynurenic acid is a potent and specific glycine site N -methyl- d -aspartate receptor antagonist but crosses the blood-brain barrier inefficiently. Its prodrug, L-4-chlorokynurenine (4-Cl-KYN), exerts acute and sustained antidepressant-like effects in rodents and has no reported psychotomimetic effects in either rodents or healthy volunteers. This study examined whether 4-Cl-KYN has rapid antidepressant effects in individuals with treatment-resistant depression. Methods After a 2-week drug-free period, 19 participants with treatment-resistant depression were randomized to receive daily oral doses of 4-Cl-KYN monotherapy (1080 mg/d for 7 days, then 1440 mg/d for 7 days) or placebo for 14 days in a randomized, placebo-controlled, double-blind, crossover manner. The primary outcome measure was the Hamilton Depression Rating Scale score, assessed at several time points over a 2-week period; secondary outcome measures included additional rating scale scores. Pharmacokinetic measures of 7-chlorokynurenic acid and 4-Cl-KYN and pharmacodynamic assessments were obtained longitudinally and included 1H-magnetic resonance spectroscopy brain glutamate levels, resting-state functional magnetic resonance imaging, and plasma and cerebrospinal fluid measures of kynurenine metabolites and neurotrophic factors. Results Linear mixed models detected no treatment effects, as assessed by primary and secondary outcome measures. No difference was observed for any of the peripheral or central biological indices or for adverse effects at any time between groups. A 4-Cl-KYN was safe and well-tolerated, with generally minimal associated adverse events. Conclusions In this small crossover trial, 4-Cl-KYN monotherapy exerted no antidepressant effects at the doses and treatment duration studied. ClinicalTrials.gov identifier: NCT02484456. [ABSTRACT FROM AUTHOR]

In the United States, hepatitis C virus (HCV) transmission is rising among people who inject drugs (PWID). Many regions have insufficient prevention intervention coverage. Using modeling, we investigated the impact of scaling up prevention and treatment interventions on HCV transmission among PWID in Perry County, Kentucky, and San Francisco, California, where HCV seroprevalence among PWID is >50%. A greater proportion of PWID access medication-assisted treatment (MAT) or syringe service programs (SSP) in urban San Francisco (established community) than in rural Perry County (young, expanding community). We modeled the proportion of HCV-infected PWID needing HCV treatment annually to reduce HCV incidence by 90% by 2030, with and without MAT scale-up (50% coverage, both settings) and SSP scale-up (Perry County only) from 2017. With current MAT and SSP coverage during 2017–2030, HCV incidence would increase in Perry County (from 21.3 to 22.6 per 100 person-years) and decrease in San Francisco (from 12.9 to 11.9 per 100 person-years). With concurrent MAT and SSP scale-up, 5% per year of HCV-infected PWID would need HCV treatment in Perry County to achieve incidence targets—13% per year without MAT and SSP scale-up. In San Francisco, a similar proportion would need HCV treatment (10% per year) irrespective of MAT scale-up. Reaching the same impact by 2025 would require increases in treatment rates of 45%–82%. Achievable provision of HCV treatment, alongside MAT and SSP scale-up (Perry County) and MAT scale-up (San Francisco), could reduce HCV incidence. [ABSTRACT FROM AUTHOR]

This essay examines ways in which historians might learn from queer approaches to the past. Drawing inspiration from queer theory and ideas long circulating in cultural, literary and medieval studies, it argues that there is much to be gained when we adopt a more self-reflexive, genealogical, context-specific analysis of lives lived. A queered history interrogates whether our guiding questions and assumptions might actually foreclose possible lines of analysis, especially around matters of identity. Emphasizing overlap, contingency, ambiguity and complexity, it asks us to linger over our own assumptions--individual as well as societal--to interrogate the role they play in the past we seek out, discover and recreate in our writing. Not just the preserve of scholars of LGBT history, it questions universal experience, suggests new historical pivots and periodizations, while pointing out the unconscious ways in which progressive narrative arcs often seep into our analyses. [ABSTRACT FROM AUTHOR]

Scholars of early modern gender and medicine have tended to focus on female infertility. Discussions that have included male reproductive failure have considered sexual ability and impotence, rather than infertility. Nonetheless, fathering children was important to male social standing and the fulfilment of their patriarchal roles. This article will demonstrate that male infertility was not absent from medical literature, but appeared in a variety of settings including tests for infertility, seventeenth-century handbills for treatments, and surgical treatises. It will show that medical and surgical writers accepted that men could be rendered infertile, but still sexually capable, in a variety of ways. Moreover, the article will show that seventeenth-century surgeons expected male readers to be concerned about their reproductive potential and constructed a framework of efficacy based upon their ability to secure on-going fertility [ABSTRACT FROM AUTHOR]

Aims: To test the value of phosphatidylethanol (PEth) as a biomarker for alcohol consumption among injecting drug users (IDUs). Methods: As part of a longitudinal study of young IDUs, dried blood spots and self-reported alcohol by structured interview were collected at baseline. We compared self-reported alcohol use to detectable PEth (≥8 ng/ml) in the blood spots as well as the relationships between quantitative PEth results and quantity measures of alcohol consumption. Results: There were strong associations between PEth and self-reported categorical measures of alcohol consumption (all P < 0.01). There was high specificity for reporting abstaining from alcohol; 94% of those who reported not consuming alcohol in the prior month tested negative for PEth. PEth was well correlated with measures of alcohol use (e.g. with reported number of days drinking in the prior month: Spearman r = 0.70 (P < 0.001)). Conclusions: The positive correlation of PEth with reported alcohol consumption suggests that PEth may be a useful marker in settings where alcohol consumption is difficult to assess, or to corroborate or invalidate self-reported measures of alcohol consumption. [ABSTRACT FROM AUTHOR]

Across the seventeenth century medical self-help manuals noted that aromatic substances were a suitable remedy for female barrenness. It has often been suggested that in the early modern period physicians did not touch their patients but instead relied upon patient narrative to diagnose and treat the sick body. This article problematizes this issue by investigating the multi-sensory approach to treating infertility, a disorder invested with concerns of gendered bodily access. It will be demonstrated that the recommendation of aromatic treatments for infertility allowed male physicians a means to negotiate the complex gender boundaries that restricted their access to women's bodies. [ABSTRACT FROM AUTHOR]

An essay is presented on the topic of erotic photography and the optics of same-sex desire during the latter half of the 20th century. It particularly focuses upon the photographs and career of photographer Herbert Tobias. The article also discusses how historians interpret such photographs, how photographs are utilized as sources by historians, and the concept of the role of the image in the construction of queer structures of feeling.

Defining clear hepatitis C virus (HCV) infection outcomes, including reinfection and viral intercalation after clearance of infection, requires ongoing, frequent follow-up, most importantly with longitudinal viral sequencing. Patients who have cleared HCV infection may demonstrate sustained viral clearance despite ongoing HCV exposure.Background. Detection of hepatitis C virus (HCV) reinfection and intercalation (ie, intermittent recurrent bouts of viremia with homologous virus interspersed with aviremic periods) requires extensive and frequent evaluation and viral sequencing.Methods. HCV infection outcomes were studied prospectively in active injection drug users with recurrent HCV RNA–positive tests after serial negative results. HCV viremia and viral sequences (Core/E1) were assessed from monthly blood samples.Results. Viral clearance, reinfection, and intercalating infection were all detected. Among 44 participants with apparently resolved HCV (26 incident HCV clearers and 18 enrolled with already resolved infection), 36 (82%) remained persistently HCV RNA negative, but 8 demonstrated intermittent recurrent viremia. Four of these (50%) had confirmed reinfection with a heterologous virus; 3 demonstrated viral intercalation, and 1 was not classifiable as either. Estimated incidence of first reinfection was 5.4 per 100 person-years (95% confidence interval, 2.0–14.5). Six (75%) participants, including 3 of 4 with reinfection, demonstrated sustained viral clearance for a median of 26 months since last HCV RNA test.Conclusions. These results show that frequent monitoring and viral sequencing are required to correctly assess HCV outcomes and estimate incidence of reinfection (which was previously overestimated). Sustained clearance may take many months and occur after episodes of reinfection and viral intercalation. Three of 4 subjects who had confirmed reinfection showed evidence of long-term clearance. Viral intercalation occurs with significant frequency. Further studies of these events, especially immunological, are needed to inform HCV clinical care and vaccine development. [ABSTRACT FROM PUBLISHER]

Background. Data from the largest randomized, controlled trial for the treatment of children hospitalized with severe malaria were used to identify such predictors of a poor outcome from severe malaria Methods. African children (<15 years) with severe malaria participated in a randomized comparison of parenteral artesunate and parenteral quinine in 9 African countries. Detailed clinical assessment was performed on admission. Parasite densities were assessed in a reference laboratory. Predictors of death were examined using a multivariate logistic regression model. Results. Twenty indicators of disease severity were assessed, out of which 5 (base deficit, impaired consciousness, convulsions, elevated blood urea, and underlying chronic illness) were associated independently with death. Tachypnea, respiratory distress, deep breathing, shock, prostration, low pH, hyperparasitemia, severe anemia, and jaundice were statistically significant indicators of death in the univariate analysis but not in the multivariate model. Age, glucose levels, axillary temperature, parasite density, heart rate, blood pressure, and blackwater fever were not related to death in univariate models Conclusions. Acidosis, cerebral involvement, renal impairment, and chronic illness are key independent predictors for a poor outcome in African children with severe malaria. Mortality is markedly increased in cerebral malaria combined with acidosis. [ABSTRACT FROM AUTHOR]

Throughout the early modern period, medical writers described a plethora of remedies designed to provoke menstruation. This article will address the close relationship these substances had with provokers of lust. Historians have often viewed emmenagogues as covert expressions of abortive drugs. While they acknowledge that some women utilised these treatments for their intended purpose, to restore a regular menstrual cycle, they have more frequently asserted that they were more likely to be employed to remove an unwanted pregnancy. This article asserts that this understanding is in need of reappraisal and argues that these substances can be viewed as a key component of early modern fertility and sexual health care. This article demonstrates that provokers of venery and emmenagogues shared similar humoral virtues and that many compound remedies designed to restore purgation contained potent aphrodisiacs. By promoting a healthy menstrual cycle these substances ensured that the female reproductive system was fecund. [ABSTRACT FROM PUBLISHER]

The present study investigated age-related differences in the amygdala and other nodes of face-processing networks in response to facial expression and familiarity. fMRI data were analyzed from 31 children (3.5–8.5 years) and 14 young adults (18–33 years) who viewed pictures of familiar (mothers) and unfamiliar emotional faces. Results showed that amygdala activation for faces over a scrambled image baseline increased with age. Children, but not adults, showed greater amygdala activation to happy than angry faces; in addition, amygdala activation for angry faces increased with age. In keeping with growing evidence of a positivity bias in young children, our data suggest that children find happy faces to be more salient or meaningful than angry faces. Both children and adults showed preferential activation to mothers’ over strangers’ faces in a region of rostral anterior cingulate cortex associated with self-evaluation, suggesting that some nodes in frontal evaluative networks are active early in development. This study presents novel data on neural correlates of face processing in childhood and indicates that preferential amygdala activation for emotional expressions changes with age. [ABSTRACT FROM PUBLISHER]

Background. Hepatitis C virus (HCV) infection, clearance, and reinfection are best studied in injection drug users (IDUs), who have the highest incidence of HCV and are likely to represent most infections. Methods. A prospective cohort of HCV-negative young IDUs was followed up from January 2000 to September 2007, to identify acute and incident HCV and prospectively study infection outcomes. Results. Among 1,191 young IDUs screened, 731 (61.4%) were HCV negative, and 520 (71.1%) of the 731 were enrolled into follow-up. Cumulative HCV incidence was 26.7/100 person-years of observation (95% confidence interval [CI], 21.5-31.6). Of 135 acute/incident HCV infections, 95 (70.4%) were followed; 20 (21.1%) of the 95 infections cleared. Women had a significantly higher incidence of viral clearance than did men (age-adjusted hazard ratio, 2.91 [95% CI, 1.68-5.03]) and also showed a faster rate of early HCV viremia decline (P < .01). The estimated reinfection rate was 24.6/100 person-years of observation (95% CI, 11.7-51.6). Among 7 individuals, multiple episodes of HCV reinfection and reclearance were observed. Conclusions. In this large sample of young IDUs, females show demonstrative differences in their rates of viral clearance and kinetics of early viral decline. Recurring reinfection and reclearance suggest possible protection against persistent infection. These results should inform HCV clinical care and vaccine development. [ABSTRACT FROM AUTHOR]

The anion-exchange protein 1 (AE1 or band 3) is involved in the erythrocyte invasion of the malaria parasite Plasmodium falciparum, the adhesion of infected erythrocytes to endothelial cells, and the regulation of acid-base homeostasis, which is a critical factor for human survival in severe malaria. A variant of the AE1 gene promoter 512 base pairs (bp) distant from the transcription start site and 5699 bp from the translation start codon (AE1-5699T→C) has been shown to be highly frequent in a population from the Ashanti region, Ghana. In a matched-pair case-control study (736 pairs), children heterozygous for the mutation (AE1-5699CT) had an increased risk of severe malarial anemia (odds ratio [OR], 1.45 [95% confidence interval {CI}, 1.05–2.01]; P<.03). In children who developed this complication, carriers of the mutation AE1-5699C had a higher fatality rate than those with the genotype AE1-5699TT (relative risk, 7.1 [95% CI, 1.0–52.8]). Moreover, in children with cerebral malaria, AE1-5699C was positively associated with a distinctive metabolic acidosis (P<.02), and results of luciferase assays showed higher transcriptional activity of the AE1-5699C allele. These results demonstrate that the AE1 promoter allele might influence the infection phenotype and the risk of fatal outcome in children with severe malaria. In this regard, a crucial role of the AE1 protein in malaria is emphasized. [ABSTRACT FROM AUTHOR]

In the five years following the Worker's Uprising of 1953, the GDR government employed moral reform strategies to build a strong firmament for socialist transformation. It marshalled discourses of respectability and decency in the fight against sexual deviance, casting the traditional family as an important feature of social and political life. In the uranium-mining region of Saxony and Thuringia, a special wing of the district attorney's office, the Bergbaustaatsanwaltschaft, oversaw the regulation of sexual comportment in trying cases of homosexuality among workers in the Wismut mines. With the régime's belief that homosexuality contravened the 'healthful mores of the working people', the policing of sexual conduct represented the confluence of socialist morality with the productivist demands of the state. In other words, the SED régime employed masculine archetypes to promote greater discipline, accelerate economic output, and generate wider acceptance of political reorientation. Alternatively viewed as a remnant of bourgeois decadence, a sign of moral weakness, and a threat to the social and political health of the nation, same-sex acts among men became a hot-button issue for local authorities who were charged with weeding out class enemies and living up to the changing directives of the Ministry of Justice. As in West Germany, moral regulation was an important feature of East German statecraft. [ABSTRACT FROM AUTHOR]

Background. Incarcerated populations are at high risk for hepatitis C virus (HCV) infection, yet prisoners are not routinely screened or treated for HCV infection. Understanding the risk factors of HCV infection among prisoners could help improve HCV interventions. Methods. Prevalence and risk of HCV infection among 469 prisoners entering California State correctional facilities were assessed using HCV antibody screening, HCV RNA measurement, and structured interviews. Multivariate logistic regression analysis was used to identify independent correlates of HCV infection. Results. The prevalence of HCV infection was 34.3% overall (95% confidence interval [CI], 30%-38%) and was 65.7% among those with a history of injection drug use (IDU), compared with 10.2% among those with no history of IDU (odds ratio [OR], 17.24; 95% CI, 10.52-28.25). Significant differences in HCV antibody positivity were found in association with age at first detention but not with the nature of the crime. Independent correlates of HCV infection included age, history of IDU, cumulative time of incarceration, biological sex (OR for females subjects compared with males subjects, 0.35; 95% CI, 0.13-0.96), and a history of having sex with a male IDU (OR, 4.42; 95% CI, 1.46-13.3 7). We identified significant differences in risk factors between male and female subjects-notably, that the risk of HCV infection was significantly elevated among female non-IDUs who reported having sexual partners with a history of IDU. Among non-IDUs, correlates of HCV infection included history of receipt of blood products and cumulative years of incarceration. Conclusions. HCV infection is pervasive among the California prison population, including prisoners who are non-IDUs and women with high-risk sexual behavior. These results should promote consideration of routine HCV antibody screening and behavioral interventions among incarcerated men and women. [ABSTRACT FROM AUTHOR]

The present study examined reasons for the high incidence of hepatitis C virus (HCV) infection among young injection drug users (IDUs). IDUs <30 years old who tested negative for HCV antibody were enrolled in a prospective cohort. Risk factors for seroconversion were examined using time-dependent regression analyses: 48 of 195 IDUs seroconverted to HCV, for an incidence rate of 25.1/100 person-years (95% confidence interval, 18.7-32.9/100 personyears). Independent risk factors included sharing needles with an HCV-infected sex partner (borderline statistical significance, P = .11) or a person who was not a sex partner, sharing nonsterile drug-preparation equipment, pooling money with another IDU to buy drugs, and exchanging sex for money. Ubiquitous behaviors among young IDUs, such as the forming of injecting or sexual partnerships and consequent sharing of needles and drug preparation equipment, are risk factors for HCV. Interventions to reduce HCV transmission must recognize the importance of relationships on injecting risk. [ABSTRACT FROM AUTHOR]

Background Sharing needles and ancillary injecting equipment is a primary risk exposure for hepatitis C virus (HCV) infection among people who inject drugs (PWID); however, infectivity of these exposures is not well quantified. We aimed to estimate per-event HCV infectivity associated with receptive needle sharing (RNS) among susceptible PWID. Methods Participants in a prospective cohort study of young adult PWID who were anti-HCV and HCV RNA negative at baseline and attended at least 2 follow-up study visits between 2003 and 2014 were eligible. Data were selected from the first HCV-negative through the first HCV-positive visit (or last HCV-negative among those uninfected). Anti-HCV and HCV-RNA tests were used to determine infection status. A probabilistic exposure model linking observed HCV infection outcomes to self-reported exposure events was applied to estimate infectivity. Results Among 344 participants, a maximum likelihood estimate considering RNS yielded a pooled population per RNS event HCV probability of 0.25% (95% confidence interval [CI], 0.10%–0.43%), and 1.12% (95% CI, 0.48%–2.35%) among those who acquired any HCV infection (primary or reinfection). Conclusions HCV is highly infectious in association with RNS, a primary injection-related risk exposure. Our infectivity estimate among participants who acquired any HCV infection is 1.7 times higher than that estimated for HIV infection in PWID and 2.24 times higher than that estimated among health care workers exposed through needle sticks. The strengths of this study include the assessment of receptive needle sharing events, the prospective design, and relatively short recall and testing periods. These results can inform transmission models and research to prevent HCV infection. [ABSTRACT FROM AUTHOR]

In a recent report, the cellular receptor CD55 was identified as a molecule essential for the invasion of human erythrocytes by Plasmodium falciparum, the causal agent of themost severe formof malaria. As this invasion process represents a critical step during infection with the parasite, it was hypothesized that genetic variants in the gene could affect severe malaria (SM) susceptibility. We performed high-resolution variant discovery of rare and common genetic variants in the human CD55 gene. Association testing of these variants in over 1700 SM cases and unaffected control individuals from the malaria-endemic Ashanti Region in Ghana, West Africa, were performed on the basis of single variants, combined rare variant analyses, and reconstructed haplotypes. A total of 26 genetic variants were detected in coding and regulatory regions of CD55. Five variants were previously unknown. None of the single variants, rare variants, or haplotypes showed evidence for association with SM or P. falciparum density. Here, we present the first comprehensive analysis of variation in the CD55 gene in the context of SM and show that genetic variants present in a Ghanaian study group appear not to influence susceptibility to the disease. [ABSTRACT FROM AUTHOR]