Search

A transformation in our food production system is being enabled by the convergence of advances in genome-based technologies and traditional fermentation. Science at the intersection of synthetic biology, fermentation, downstream processing for product recovery, and food science is needed to support technology development for the production of fermentation-derived food ingredients. The business and markets for fermentation-derived ingredients, including policy and regulations are discussed. A patent landscape of fermentation for the production of alternative proteins, lipids and carbohydrates for the food industry is provided. The science relating to strain engineering, fermentation, downstream processing, and food ingredient functionality that underpins developments in precision fermentation for the production of proteins, fats and oligosaccharides is examined. The production of sustainably-produced precision fermentation-derived ingredients and their introduction into the market require a transdisciplinary approach with multistakeholder engagement. Successful innovation in fermentation-derived ingredients will help feed the world more sustainably. [ABSTRACT FROM AUTHOR]

A reduced reliance on animal-based diets with a move towards a more plant-based diet has driven the market demand for new generation sustainable plant-based meat alternatives. This review covers science and business perspectives relating to the development of plant-based meat alternatives. A conceptual framework to help inform the innovation pathway is provided. The market opportunity, consumer perspectives, the science that underpins the development of plant-based meat alternatives and patent information relating to these products are discussed. Careful navigation through the public domain science literature and patent landscape is necessary for informing the choice of ingredients, formulations and processes for producing plant-based meat alternatives. Attention to design of ingredient systems for optimization of flavor, texture, binding, color and nutrition is necessary for development of plant-based meat alternatives with desirable consumer attributes. Recommendations for further research for developing superior formulations for consumer-acceptable plant-based meat alternative products for improving sustainability outcomes are suggested. [ABSTRACT FROM AUTHOR]

This article is an exploration of Psychological Operations, focusing on both the role which fear plays in Psychological Operations, and how the Russian Federation employed Psychological Operations in the War in Ukraine (2014–2021). A qualitative methodology is used to explore fear as a neurological, psychological and social phenomenon, and how it may be utilised in Psychological Operations. The author finds that Russia's initial use of Psychological Operations was focused on making tactical gains against the Ukrainian military. Shock tactics, combined with strategic messaging, encouraged mass defections from the Ukrainian army and border guard, significantly degrading the combat effectiveness of Kyiv's forces, and increasing the likelihood of victory for the Donbass secessionists. The case study is limited in scope to 2014–2021. The paper can thus be read as both an analysis of one element of Russia's shaping phase prior to the 2022 invasion, and/or a framework for analysing the current stage of conflict. [ABSTRACT FROM AUTHOR]

Major organ-based in vitro diagnostic (IVD) tests like ALT/AST for the liver and cardiac troponins for the heart are established, but an approved IVD blood test for the brain has been missing, highlighting a gap in medical diagnostics. In response to this need, Abbott Diagnostics secured FDA clearance in 2021 for the i-STAT Alinity™, a point-of-care plasma blood test for mild traumatic brain injury (TBI). BioMerieux VIDAS, also approved in Europe, utilizes two brain-derived protein biomarkers: neuronal ubiquitin C-terminal hydrolase-L1 (UCH-L1) and glial fibrillary acidic protein (GFAP). These biomarkers, which are typically present in minimal amounts in healthy individuals, are instrumental in diagnosing mild TBI with potential brain lesions. The study explores how UCH-L1 and GFAP levels increase significantly in the bloodstream following traumatic brain injury, aiding in early and accurate diagnosis. The introduction of the i-STAT Alinity™ and the Biomerieux VIDAS TBI blood tests mark a groundbreaking development in TBI diagnosis. It paves the way for the integration of TBI biomarker tools into clinical practice and therapeutic trials, enhancing the precision medicine approach by generating valuable data. This advancement is a critical step in addressing the long-standing gap in brain-related diagnostics and promises to revolutionize the management and treatment of mild TBI. [ABSTRACT FROM AUTHOR]

Immunotoxicity is the critical endpoint used by some regulatory agencies to establish toxicity values for perfluorooctanoic acid (PFOA) and perfluorooctane sulfonate (PFOS). However, the hypothesis that exposure to certain per- and polyfluoroalkyl substances (PFAS) causes immune dysregulation is subject to much debate. An independent, international expert panel was engaged utilizing methods to reduce bias and "groupthink". The panel concluded there is moderate evidence that PFOS and PFOA are immunotoxic, based primarily on evidence from animal data. However, species concordance and human relevance cannot be well established due to data limitations. The panel recommended additional testing that includes longer-term exposures, evaluates both genders, includes other species of animals, tests lower dose levels, assesses more complete measures of immune responses, and elucidates the mechanism of action. Panel members agreed that the Faroe Islands cohort data should not be used as the primary basis for deriving PFAS risk assessment values. The panel agreed that vaccine antibody titer is not useful as a stand-alone metric for risk assessment. Instead, PFOA and PFOS toxicity values should rely on multiple high-quality studies, which are currently not available for immune suppression. The panel concluded that the available PFAS immune epidemiology studies suffer from weaknesses in study design that preclude their use, whereas available animal toxicity studies provide comprehensive dataset to derive points of departure (PODs) for non-immune endpoints. The panel recommends accounting for potential PFAS immunotoxicity by applying a database uncertainty factor to POD values derived from animal studies for other more robustly supported critical effects. [ABSTRACT FROM AUTHOR]

Sabore field is characterised by a high level of artisan activities that contributes to water pollution by heavy metals; these heavy metals when present in drinking water can be deleterious to human health. Consequently, in 2018 we investigated the seasonal variations of the water samples from the Sabore vicinity to determine its suitability for drinking. Six metals (Mn, Cu, Cd, Zn, Ni, Pb) were studied, the health risk assessment was investigated using Hazard Index (HI), Hazard Quotient (HQ) and Cancer Risk (CR). The results showed that water from this locality have HI values > 1, Pb and Cd were top contributors to non-carcinogenic risk while Ni and Cd caused concern for carcinogenic health risk making it unsuitable for consumption. The seasonal spread of the metals shows that Mn varied from 148 to 976 µg/L; Cu from 923 to 1676 µg/L; Cd from 1.167 to 22.5 µg/L; Zn from 63 to 118 µg/L, Ni from 37 to 95 µg/L and Pb from 128 to 185 µg/L in the rainy season. For the dry season, Mn shows a spread of 1442–1802 µg/L; 344–776 µg/L for Cu; 57–82 µg/L for Cd; 48–187 µg/L for Zn; 147–242 µg/L for Ni and 79–256 µg/L for Pb. The increased concentration of some metals during the dry seasons could be attributed to the increased human activities around the field, increased evaporation rate, absence of rainfall and runoff water. The heavy metal content of water from some of the sites exceeded the stipulated permissible limits and poses serious health risk to its consumers. [ABSTRACT FROM AUTHOR]

This scoping review aims to synthesize existing literature on good practice in sexual health interventions for adults over 45 years and in vulnerable groups. Using PRISMA-ScR guidelines, search terms focused on sexual health, good practice, and vulnerable groups, in over-45s. Of the nine studies that met the inclusion criteria, seven were focused on HIV and risk reduction. Use of alternative methods of communication, alongside inclusion of behavioral and cognitive measures such as condom use and perceived stigma, was key to tailoring interventions. This review highlights the imperative for further research on sexual health interventions with these overlooked populations. [ABSTRACT FROM AUTHOR]

Negative stereotypes about female intellectual abilities occur in children as young as 6-years-old and can shape a child's educational path and career choice, particularly in relation to Science, Technology, Engineering and Math (STEM). The current study (N = 40) explored preexisting gender stereotypes in a purposeful sample of 6 to 8-year-old white British girls at a dance and performing arts center and tested the impact of a brief story-based intervention that exposed young girls to intellectually brilliant female role models in STEM. Rch Findings: Findings indicated that exposure to stories about women in science can help counter negative stereotypes concerning female intellectual ability. Another stereotype, "females are nicer than males", was prevalent in most participants and was not affected by the current intervention. Pre or Policy: A key implication of this study is that young girls who learn about members of their own gender group who accomplished success in STEM fields may be more inclined to think of STEM careers as a possibility for females in future. [ABSTRACT FROM AUTHOR]

The wider societal attitudes held toward mothers' breastfeeding in public seem to impact infant feeding choices. The present study employed an online (N = 396) experimental pretest–posttest design set to examine whether a mere exposure effect of briefly viewing and rating the valence of four different images of public breastfeeding (i.e., mother and baby alone, females in background, males in background, and females and males in background) would impact on participants' attitudes toward a mother breastfeeding in public. There was a marginal increase in the positive attitudes toward public breastfeeding at Time 2 when compared with Time 1 following exposure to the four images. These findings support a potential positive mere exposure effect in enhancing attitudes toward breastfeeding in public. This suggests a greater use of promotional material using visual stimuli may improve societal acceptance of breastfeeding in public. [ABSTRACT FROM AUTHOR]

Traumatic brain injury (TBI) is a major global health issue, resulting in debilitating consequences to families, communities, and health-care systems. Prior research has found that biomarkers aid in the pathophysiological characterization and diagnosis of TBI. Significantly, the FDA has recently cleared both a bench-top assay and a rapid point-of-care assays of tandem biomarker (UCH-L1/GFAP)-based blood test to aid in the diagnosis mTBI patients. With the global necessity of TBI biomarkers research, several major consortium multicenter observational studies with biosample collection and biomarker analysis have been created in the USA, Europe, and Canada. As each geographical region regulates its data and findings, the International Initiative for Traumatic Brain Injury Research (InTBIR) was formed to facilitate data integration and dissemination across these consortia. This paper covers heavily investigated TBI biomarkers and emerging non-protein markers. Finally, we analyze the regulatory pathways for converting promising TBI biomarkers into approved in-vitro diagnostic tests in the United States, European Union, and Canada. TBI biomarker research has significantly advanced in the last decade. The recent approval of an iSTAT point of care test to detect mild TBI has paved the way for future biomarker clearance and appropriate clinical use across the globe. [ABSTRACT FROM AUTHOR]

A system based on cyanobacterial split inteins, SICLOPPs (Split Intein Circular Ligation of Proteins and Peptides), has been used to synthesise a small natively cyclic plant protein, kalata B1, and cyclised versions of the natively linear therapeutic peptides ziconotide and leconotide. The cyclic versions of these naturally linear peptides include linker sequences between their native termini to allow the correct tertiary structure to form. The native structure of each includes three disulphide bonds characteristic of knottins. Cyclic permutations of leconotide yielded different proportions of correctly spliced product, identifying an optimal splice site and revealing the influence of residues around the splice junction. The rate of splicing was manipulated to facilitate affinity purification prior to intein-mediated removal of the affinity tag. [ABSTRACT FROM AUTHOR]

In neoliberalising universities, collegial and collective practices such as reading groups are often positioned by students, staff and managers as less important than meeting individual KPIs (such as producing research publications, seeking research grants, or meeting the increasing demands of producing quality teaching outcomes.) However, reading groups can be vital for cultivating caring collectives and spaces of collegiality. In this paper we use assemblage thinking to explore 25 years of a Geography reading group at the University of Newcastle. The paper addresses two questions: what does reading together do and make possible; and how might we think about the labours of reading together as a way of building caring collectives. The paper draws on reflections from 24 past and present members of reading group to explore how these kinds of academic practices nourish our working lives. [ABSTRACT FROM AUTHOR]

Objective: Global and national trends of out-of-hospital cardiac arrest (OHCA) have been examined; however, geographic variation and socioeconomic disparities of OHCA outcomes in the community setting are less understood. We developed and tested a replicable, community-oriented assessment strategy aimed to identify spatial variations in OHCA outcomes using socioeconomic, prehospital, and in-hospital factors. Methods: Emergency medical service (EMS) records of adult, non-traumatic OHCA within Alachua County, FL (2012–2017) were retrospectively reviewed and matched to corresponding medical records at the University of Florida (UF). Incidence of cardiac arrest was geocoded to census tracts and connected to U.S. census socioeconomic attribute data. Primary outcomes include survival to emergency department (ED), hospital admission, discharge, and discharge to home. Multilevel mixed-effects logistic regression models were developed to assess sub-county geographic variance, probabilities of survival, and prehospital risk factors. Getis-Ord Gi statistic and Moran's I-test was applied to assess spatial clustering in outcome survival rates. Results: Of the 1562 OHCA cases extracted from EMS records, 1,335 (85.5%) were included with 372 transported to study site. Predicted probability of survival to ED was 57.0% (95CI: 51.3–62.3%). Of transported cases to study site ED, predicted probabilities of survival was to 41.7% (95CI: 36.1–47.6%) for hospital admission, 16.1% (95CI: 10.7–23.5%) for hospital discharge, and 7.1% (95CI: 3.7–13.3%) for home discharge. Census tracts accounted for significant variability in survival to ED (p < 0.001), discharge (p = 0.031), and home discharge outcomes (p = 0.036). There was no significant geographic variation in survival to admission outcome. Neighborhood-level factors significantly improved model fit for survival to ED, discharge, and discharge home outcomes. Multiple modifiable patient- and neighborhood-level variables of interest were identified, including rural-urban differences. Conclusion: We identified important geographic disparities that exist in OHCA outcomes at the community level. By using a replicable schematic, this variation can be explained through community-oriented modifiable socioeconomic and prehospital factors. [ABSTRACT FROM AUTHOR]

Background: Chronic hepatitis C virus (HCV) infection is common among people who inject drugs (PWID) and is associated with morbidity and premature death. Although HCV can be cured, treatment may be inaccessible. We studied HCV testing, status and treatment among marginalized people who use drugs in Ottawa, Canada, a setting with universal insurance coverage for physician services. Methods: We analyzed data from the Participatory Research in Ottawa: Understanding Drugs study, a cross-sectional, peer-administered survey of people who use drugs from 2012 to 2013. We linked responses to population-based health administrative databases and used multivariable Poisson regression to identify factors independently associated with self-reported HCV testing, self-reported positive HCV status, and database-determined engagement in HCV treatment. Results: Among 663 participants, 562 (84.8%) reported testing for HCV and 258 (45.9%) reported HCV-positive status. In multivariable analysis, HCV-positive status was associated with female gender (RR 1.27; 95%CI 1.04 to 1.55), advancing age (RR 1.03/year; 95%CI 1.02 to 1.04), receiving disability payments (RR 1.42; 95%CI 1.06 to 1.91), injecting drugs (RR 5.11; 95%CI 2.64 to 9.91), ever injecting with a used needle (RR 1.30; 95%CI 1.12 to 1.52), and ever having taken methadone (RR 1.26; 95%CI 1.05 to 1.52). Of HCV positive participants, 196 (76%) were engaged in primary care but only 23 (8.9%) had received HCV therapy. Conclusions/Importance: Although HCV testing and positive status rates are high among PWID in our study, few have received HCV treatment. Innovative initiatives to increase access to HCV treatment for PWID are urgently needed. [ABSTRACT FROM AUTHOR]

Previous research suggests that training relational operant responding using the SMART (Strengthening Mental Abilities with Relational Training) program over several months can result in improved performance on cognitive intelligence tests. This study aimed to investigate whether engaging in a 3-week relational training program would improve (i) scores and (ii) reaction times on a standardised intelligence test, and (iii) to pilot a new multiple exemplar training procedure targeting complex analogical operant responding (SMARTA; SMART for Analogy). We administered the Kaufman Brief Intelligence Test (KBIT-2) to eight adults across four time points. Control: Time 1-4: No intervention. Experimental: Time 1-2: No intervention. Time 2-3: SMART relational operant training. Time 3-4: SMARTA analogical relational operant training. Experimental participants demonstrated greater improvements in terms of both (i) response latencies and (ii) response fluencies on the Verbal Knowledge subscale of the KBIT-2. [ABSTRACT FROM AUTHOR]

Law enforcement officers (LEO) and their partners face many stressors. Secure attachments minimize stress but building secure bonds require meaningful interactions; interactions impeded by LEO's culture of suppressing feelings. Study participants included 54 male officers and their partners. Using dyadic data, 3 APIMs were used to explore the association between attachment, communication, and satisfaction. Results suggest that secure behaviors increase constructive communication, decrease demand-withdrawal, and increase satisfaction. It appears that male behaviors have a stronger influence on the findings than female partners. Clinicians are encouraged to consider interventions that not only increase secure bonds but engage the male partner. [ABSTRACT FROM AUTHOR]

Introduction: Traumatic brain injury (TBI) is a major worldwide neurological disorder of epidemic proportions. To date, there are still no FDA-approved therapies to treat any forms of TBI. Encouragingly, there are emerging data showing that biofluid-based TBI biomarker tests have the potential to diagnose the presence of TBI of different severities including concussion, and to predict outcome. Areas covered: The authors provide an update on the current knowledge of TBI biomarkers, including protein biomarkers for neuronal cell body injury (UCH-L1, NSE), astroglial injury (GFAP, S100B), neuronal cell death (αII-spectrin breakdown products), axonal injury (NF proteins), white matter injury (MBP), post-injury neurodegeneration (total Tau and phospho-Tau), post-injury autoimmune response (brain antigen-targeting autoantibodies), and other emerging non-protein biomarkers. The authors discuss biomarker evidence in TBI diagnosis, outcome prognosis and possible identification of post-TBI neurodegernative diseases (e.g. chronic traumatic encephalopathy and Alzheimer’s disease), and as theranostic tools in pre-clinical and clinical settings. Expert commentary: A spectrum of biomarkers is now at or near the stage of formal clinical validation of their diagnostic and prognostic utilities in the management of TBI of varied severities including concussions. TBI biomarkers could serve as a theranostic tool in facilitating drug development and treatment monitoring. [ABSTRACT FROM PUBLISHER]

The demands passengers place on contemporary public transport systems are increasingly focused on providing a safe, comfortable and reliable transport experience. One expression of these demands is the recent introduction of designated quiet carriages to trains. The experience of travelling in these spaces has been given little academic scrutiny. Using a case study of the commuting experience between Newcastle and Sydney, New South Wales (NSW), Australia, this paper investigates the practices, relations and affective atmospheres of quiet carriages. The paper argues that passengers on trains come together to craft quiet through interactions between human and material actors. This crafting of quiet results in noticeably different quiet atmospheres at different times of day and in different parts of the journey. Drawing on participant observation including an auto-ethnographic account of travelling in a quiet carriage, the paper distinguishes between four types of quiet crafted by the passenger collective – sleepy and comfortable quiet, busy quiet, tense quiet and spooky quiet. These four types of quiet play upon the body with different intensities and some have stronger affects that linger after the completion of the journey. [ABSTRACT FROM PUBLISHER]

Introduction: Primary IF can be due to impaired gut length or impaired gut function; short bowel syndrome (SBS) is the leading cause of IF. In IF patients complete enteral starvation should be avoided whenever possible and enteral/oral nutrition (EN/ON) should be employed at the maximum tolerated amount in each phase of the clinical evolution of IF. Intraluminal nutrients have stimulatory effects on epithelial cells and on trophism that enhance intestinal adaptation. Areas covered: Evidence for nutritional interventions in pediatric IF is limited and of poor quality. Clinical practice in SBS feeding are more ‘experience-based’ rather than ‘evidence-based’ and this dearth of clinical evidence is partly due to the rarity of this condition. This review updates knowledge concerning the impact of the initial diet with EN/ON in neonatal onset SBS in the process of bowel adaption. Expert commentary: Human milk resulted the preferred starting diet and it is generally combined with amino-acids (AAs) in Northern America and with hydrolyzed proteins (HFs) in Europe; polymeric diet is rarely employed. HFs were not more effective than AAs in promoting intestinal adaptation. [ABSTRACT FROM AUTHOR]

Carsharing programs have demonstrated a potential to significantly shift incentives with regard to private vehicle ownership. The advent of free-floating vehicle fleets has enabled providers to offer ubiquitous vehicle access in designated urban areas. The ability of users to choose where to drop off vehicles presents the possibility that the density of available vehicles in particular areas will be insufficient to supply a reasonable level of service to local residents. The current paper will use exclusive data on vehicle location from a free-floating carshare service that operates in ten U.S. cities. Analysis will relate the availability of vehicles to census tract demographics. Results show vehicles cluster in tracts that are disproportionately populated by residents who are educated, young, employed, and white. Carshare systems have received significant in-kind incentives from government to operate. The mobility benefits of free-floating carshare systems appear to accrue disproportionately to advantaged populations. [ABSTRACT FROM PUBLISHER]

Six women faculty came together to research their peers asking other women in COAMFTE-accredited programs about their personal and professional identities. The goal of this research was to develop recommendations for the field of Couple/Marriage and Family Therapy to support the engagement and advancement of women faculty. The research collaboration itself became a heuristic, feminist praxis, a co-creation of insight, support network, and professional relationships which had liberating results for the collaborators. We intended to create a research project that would be collaborative, empowering, and transformative for participants; in the process, the collaboration became empowering and transformative for ourselves. This article will reflect on our experiences and provide recommendations for future feminist research teams. [ABSTRACT FROM AUTHOR]

Background: Synthetic cannabinoid containing products are a public health threat as reflected by a number of outbreaks of serious adverse health effects over the past 4 years. The designer drug epidemic is characterized by the rapid turnover of synthetic cannabinoid compounds on the market which creates a challenge in identifying the particular etiology of an outbreak, confirming exposure in cases, and providing current information to law enforcement. Results: Between 28 May 2014 and 8 June 2014, 35 patients were evaluated and treated at the University of Florida Health Medical Center in Gainesville following reported exposure to a synthetic cannabinoid containing product obtained from a common source. Patients demonstrated acute delirium (24) and seizures (14), and five required ventilator support and ICU-level care; none died. The presence of N-[(1S)-1-(aminocarbonyl)-2-methylpropyl]-1-(cyclohexylmethyl)-1H-indazole-3-carboxamide (AB-CHMINACA), or one of its predicted metabolites was confirmed in 15 of 21 cases. A rapid public health response and aggressive public messaging prevented further morbidity, identified the source, and led to law enforcement seizure of the implicated product. Discussion: The significance of this outbreak lies as much in the rapid occurrence of unpredictable, life-threatening adverse health effects from a newly identified synthetic cannabinoid compound as it does in the multidisciplinary investigation and novel partnership between local public health, the laboratory, and the chemical industry, resulting in termination of the outbreak. Conclusion: A coordinated response and collaboration between law enforcement, the local public health, emergency medical services and Health Center staff, were all key interventions in preventing a more substantial public health outbreak resulting from use of a novel synthetic cannabinoid compound. Real time collaborations between toxicology laboratories, suppliers of analytical standards and the public health system may be useful in the face of future novel chemical exposures. [ABSTRACT FROM AUTHOR]

Community-based participatory research (CBPR) is an approach to research that recognizes the specific knowledge and abilities that individuals from diverse backgrounds bring to the generation of new knowledge for the purpose of social action aimed at improving public health and health equity. In this article, the authors apply Gaventa and Cornwall's dimensions of participatory research to the analysis of 12 semistructured interviews with members of our Community Advisory Committee for the Participatory Research in Ottawa: Understanding Drugs (PROUD) study. This process-to-outcomes framework may help projects more systematically explore their experiences in relation to common CBPR principles and lead to greater conceptual clarity. [ABSTRACT FROM AUTHOR]

Nitrate pollution from agricultural drainage has caused water quality concerns worldwide, but there are several promising technologies to help mitigate this environmental degradation. While these practices primarily aim to improve water quality, they may also provide other ‘additive’ benefits or ecosystem services and the awareness of such benefits may influence their potential to be adopted by farmers. To investigate the impact that perceived ecosystem services has on a practice's adoption potential, we used a mixed methods approach consisting of a literature review, producer surveys, and a group discussion to explore farmer interest in and perceived benefits (on-farm and regional) of seven subsurface drainage nitrate reduction practices (controlled drainage, bioreactors, wetlands, nitrogen management rate, nitrogen management timing, cover crops, and diversified crop rotations). The nitrogen management practices were shown to be accessible and realistic options for water quality improvement as they elicited high interest and had the highest level of compatibility. However, these practices did not provide many other complementary ecosystem services. Conversely, wetlands had a high literature review-derived ecosystem service count, but were considered to have low compatibility, and survey respondents indicated less interest in this practice. The practice of cover cropping showed more moderate, yet consistently positive results for all factors. [ABSTRACT FROM PUBLISHER]

Copyright of Culture, Health & Sexuality is the property of Routledge and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

An essay is presented on the U.S. sustainable agricultural systems. It offers information on the use of denitrification bioreactors by the farmers that is effective for nitrate mitigation. The author states that according to certain critics technology cannot play a potential role in agriculture and belies the complexity of sustainability.

There are concerns that Vancouver's supervised injection facility (SIF) for injection drug users (IDU) is an amplifier of drug-related crime. Therefore, we sought to evaluate the possible association between SIF use and recent incarceration among IDU. We examined incarceration experiences among participants in the Scientific Evaluation of Supervised Injecting (SEOSI) prospective cohort. The relationship between recent incarceration and frequent SIF use was assessed using generalised estimating equations (GEE). Nine-hundred two individuals were included in this analysis, of whom 255 (28.27%) were female. The rate of incarceration remained stable throughout follow-up with between one-quarter and one-third reported incarceration in the previous 6 months at each study visit. In a multivariate GEE analysis, frequent SIF use was not associated with recent incarceration (AOR: 0.99, p = 0.916). Although incarceration is a common experience among local IDU, our analysis does not provide evidence to support claims that, use of the SIF is increasing involvement in drug-related crime in the community. Our findings also indicate that incarceration continues to be associated with high-risk behaviours. [ABSTRACT FROM AUTHOR]

Lymphocyte transformation tests (LTT) are time-consuming radioactive assays used in the clinic for the determination of allergic drug reactions and extensively in basic immunological research. In the present study we propose an alternative method in the monitoring of T-cell responses by isothermal microcalorimetric (IMC) measurements of overall cellular heat production as a function of time. For mitogen-induced lymphocyte proliferation, we analyzed a concentration dependent effect of phytohemaglutinin (PHA) and both tests showed a good correlation. This was also the case for specific antigenic stimulation with Varidase® or tetanus toxoid. On the other hand, antigen-induced lymphocyte proliferation analyzed by pre and post influenza vaccine (Inflexal® V) samples, showed no such correlation. Our study suggests that IMC measurements, despite the advantages of simplicity, on-line recording of metabolic activity and no use of radioactivity, may be limited to monitoring mitogen-induced lymphocyte proliferation. [ABSTRACT FROM AUTHOR]

A supervised injection facility (SIF), where individuals can inject drugs under medical supervision, opened in Vancouver in 2003. The scientific evaluation of the SIF has demonstrated positive public health-related outcomes. However, the influence of supervised injection facilities on individual efforts to reintegrate into mainstream society has not been studied. We examined for a possible relationship between use of the SIF and employment among a cohort of 1090 SIF users using generalized estimating equations (GEE). In a multivariate analysis of factors associated with employment, using the SIF for ≥ 25% of injections (versus > 25% of injections) was not statistically significant (AOR = 1.05, 95% CI: 0.88-1.27). These findings suggest that the SIF is not having an adverse impact on efforts to seek employment. [ABSTRACT FROM AUTHOR]

Non-fatal overdose among injection drug users (IDU) is a source of significant morbidity. Since it has been suggested that supervised injecting facilities (SIF) may increase risk for overdose, we sought to evaluate patterns of non-fatal overdose among a cohort of SIF users. We examined recent non-fatal overdose experiences among participants enrolled in a prospective study of IDU recruited from within North America's first medically supervised safer injecting facility. Correlates of recent non-fatal overdoses were identified using generalized estimating equations (GEE). There were 1,090 individuals recruited during the study period of which 317 (29.08%) were female. At baseline, 638 (58.53%) reported a history of non-fatal overdose and 97 (8.90%) reported at least one non-fatal overdose in the last six months. This proportion remained approximately constant throughout the study period. In the multivariate GEE analysis, factors associated with recent non-fatal overdose included: sex-trade involvement (Adjusted Odds Ratio [AOR]: 1.45 [95% Confidence Interval [CI] 1.07-1.99], p = 0.02) and public drug use (AOR: 1.50 [95% CI 1.09-2.06]; p = 0.01). Using the SIF for ≥ 75% of injections was not associated with recent non-fatal overdose in univariate (Odds Ratio: 1.05, p = 0.73) or multivariate analyses (AOR: 1.01, p = 0.96). The proportion of individuals reporting recent non-fatal overdose did not change over the study period. Our findings indicate that a sub-population of IDU might benefit from overdose prevention interventions. Our findings refute the suggestion that the SIF may increase the likelihood of overdose. [ABSTRACT FROM AUTHOR]

The present analysis compares HIV and HCV prevalence and associated gender-specific risk patterns of dual users (i.e., crack smokers who inject drugs) and never injectors. Two logistic models, one restricted to female and the other to male crack smokers, were constructed to identify gender-specific risk factors associated with dual use (p < 0.05). Of 437 crack smokers, 246 (56%) were dual users while 191 (44%) were never injectors. In a fitted logistic regression model, dual use among female crack smokers was associated with HCV infection (adjusted OR = 4.65, 95% CI: 1.92-9.70), exchanging sex for money, drugs, or shelter while using crack (aOR = 4.47, 95% CI: 1.56-12.80), having a casual partner who injects (aOR = 4.13, 95% CI: 1.05-16.26), having equipment broken or confiscated by police without being arrested (aOR = 3.66, 95% CI: 1.43-9.34), and HIV infection (aOR = 2.07, 95% CI: 1.18-5.96). Among male crack smokers, dual use was associated with HCV infection (aOR = 5.34, 95% CI: 2.10-13.18), exchanging sex for money, drugs, or shelter (aOR = 3.25, 95% CI: 1.59-6.65), crack use history ≥ 5 years (aOR = 2.16, 95% CI: 1.29-3.63), and smoking in a group of unknown people (such as crack houses, alleys; aOR = 1.70, 95% CI: 1.10-2.81). These findings highlight the need for evidence-based prevention and harm reduction initiatives that directly targeting crack cocaine smokers, with particular attention given to female dual users of injection drugs. [ABSTRACT FROM AUTHOR]

Previous studies have described links between violence, decreased condom use and drug sharing among intimate partners, though limited information exists about the predictors of drug sharing among female sex workers and their clients. The following analysis explored the association between sharing illicit drugs with clients and sexual and drug-related harms among survival sex workers. A total of 198 women participated in interview-administered questionnaires and confidential HIV testing. Of the total, 117 (59%) reported sharing drugs with clients/johns in the last six months and crack cocaine was the primary drug shared (n=108). In logistic regression analysis, sharing drugs with clients/johns was associated with borrowing a used crack pipe (AOR=5.63; 95%CI: 2.71-9.44; p<0.001), intensive/daily crack cocaine smoking (AOR=3.78; 95%CI:1.60-8.92; p<0.002), inconsistent condom use by a client/john (AOR=3.17; 95%CI:1.48-6.77; p<0.003) and having a recent bad date (verbal harassment, physical and/or sexual assault) (AOR=2.71; 95%CI:1.17-6.32; p=0.021). Sharing illicit drugs with clients/johns may be a crucial risk marker for increased violence and sexual and drug-related harms among survival sex workers. HIV prevention and harm reduction initiatives targeting both women and clients/johns are urgently needed, including enhanced support for community and peer-driven sex work initiatives, to address some of the structural facilitators for HIV transmission. [ABSTRACT FROM AUTHOR]

Background: Canada's prostitution laws are under scrutiny, and there has been growing debate about the optimal strategies for reducing the harms associated with prostitution. Methods: We evaluated whether sex trade involvement was associated with elevated HIV incidence in a cohort of injection drug users. HIV incidence rates were calculated using Kaplan-Meier methods and Cox proportional hazards regression. Results: At 48 months after enrolment, the rate of HIV was 11.7% among those who did not report baseline sex trade involvement compared to 16.7% among those who did (p = 0.049). The elevated HIV infection rate associated with sex trade involvement was also observed in a Cox model that considered sex trade involvement as a time-updated covariate (relative hazard = 1.51 [95% CI: 1.02-2.25]). Interpretation: These findings should be useful to those currently considering the optimal legal framework for addressing the community and health related harms associated with prostitution in Canada. [ABSTRACT FROM AUTHOR]

The study examined whether North America's first medically supervised safer injection facility (SIF) attracts young injection drug users (IDUs) who are at high risk of health-related harm. Prevalence of SIF use was determined based on data obtained after the SIF's opening. Predictors of initiating future SIF use were determined based on behavioral information obtained from the participant's study visit immediately preceding the SIF's opening. The median duration between the acquisition of pre-SIF opening behavioral data and the more recent interview, where SIF use was measured, was 16 months. Characteristics of IDUs who did and did not subsequently initiate SIF use were statistically compared (N = 135). Data from the 6-month period prior to the SIF's opening showed that youth initiating SIF use were significantly more likely to have been in jail, to use heroin daily, to have overdosed, to have binged on drugs, to have loaned needles, and to have been homeless. The study suggests that among IDUs 29 years of age or younger, those who used the SIF were at higher risk than those who were not. [ABSTRACT FROM AUTHOR]

Background: We evaluated factors associated with public drug injection among a cohort of injection drug users (SEOSI) originally recruited from within Vancouver's supervised injecting facility (SIF). Methods: We used univariate statistics and logistic regression to examine factors associated with public drug injection among SEOSI participants. Findings: Between June 2004 and July 2005, 714 IDU were followed up as part of SEOSI. In multivariate analyses, factors associated with public drug injection included homelessness (adjusted odds ratio (aOR) = 3.10; p < .001), syringe lending (aOR = 5.39; p < .001), requiring help injecting (aOR = 1.60; p = .05), and reporting that wait times affected frequency of SIF use (aOR = 3.26; p < .001). Interpretation: Persistent public injection was independently associated with elevated HIV risk behaviors, as well as programmatic factors that limit SIF use. SIF program expansion may further help to reduce persistent risk behaviors and the community concerns related to public injection drug use. [ABSTRACT FROM AUTHOR]

We performed analyses of syringe buying and syringe selling among Vancouver injection drug users, recruited from May 1996 and followed up between November 2002 and August 2003, in the context of one of North America's largest syringe exchange programs (SEPs). An interviewer-administered questionnaire, approximately 45 minutes in duration, was used to collect information regarding risk factors for HIV infection and sources of sterile syringes. Seventy participants (15%) reported syringe selling and 122 (26%) reported syringe buying. Syringe sellers were more likely to be female, reside in unstable housing, need help injecting, and have visited the SEP at least once weekly. Syringe buyers were more likely to need help injecting, have difficulty finding new syringes, have binged on drugs, and have visited the SEP at least once weekly. Syringe buying most frequently occurred when the SEP was closed. [ABSTRACT FROM AUTHOR]

The objective of this study was to identify psychosocial determinants of, and self-reported reasons for, HAART discontinuation among HIV-positive injection drug users (IDUs). We examined correlates between sociodemographic characteristics, drug use and risk behaviors, outcome expectations, adherence self-efficacy, social support and HAART discontinuation among 160 HIV-positive participants in the Vancouver Injection Drug Users' Study (VIDUS). Logistic regression was used to identify the factors independently associated with discontinuation of HAART. Seventy-one (44%) study participants discontinued HAART during the study period. Factors independently associated with discontinuation of HAART included recent incarceration (OR = 4.84, p = 0.022), negative outcome expectations (OR = 1.41, p = 0.001), adherence efficacy expectations (OR = 0.70, p = 0.003) and self-regulatory efficacy (OR = 0.86, p = 0.050). The most frequently cited reasons provided for discontinuing HAART were being in jail (44%) and medication side effects (41 %). The results of this study suggest that psychological constructs derived from self-efficacy theory are highly germane to the understanding of HAART discontinuation behavior and interventions that may change it. Incarceration may result in interruptions in HAART among IDUs, and programmatic changes may be needed to promote optimal retention on HAART among incarcerated HIV-infected IDUs. [ABSTRACT FROM AUTHOR]

The influence of phenylboronic acid on the silylation of d-mannitol by TBDMSCl and TBDPSCl has been investigated. Terminal silyation was found to dominate, with PBA significantly enhancing the yield of 1,6 di-TBDMS d-mannitol compared to the control. The intermediate 1,6-disilyl bis(phenylboronates) showed unusually high stability, such that oxidative conditions were required to cleave the boronate esters. X-ray crystal structures of both bis(phenylboronates) were determined, revealing both diboronate esters to exist as two fused six-membered rings. The results of 11B NMR experiments suggest that these structures also predominate in solution, whereas the bis(phenylboronate) ester of d-mannitol itself exists as a mixture of five-membered and six-membered cyclic boronates. [ABSTRACT FROM AUTHOR]

In Canada, very little is known about the factors and processes that cause drug-related harm among female intravenous drug users (IDUs). Women who inject drugs and participate in the survival sex trade are considered to be at increased risk for sexual and drug-related harms, including HIV infection. Between September 1999 and September 2000, women participating in the VIDUS cohort in Vancouver and the St. Luc Cohort in Montreal completed interviewer-administered questionnaires. Analyses were conducted to compare the demographic characteristics, sexual risk behaviours, risky injection practices and drug use patterns among women who self-identified as participating in the sex trade with those who did not identify as participating in the sex trade. Logistic regression was used to identify factors independently associated with exchanging sex for money or drugs. HIV prevalence at the study visit (September 1999-2000) was 29% for sex trade workers and 29.2% for non-sex trade workers. While patterns of sexual risk were similar, the risky injection practice and drug use patterns between sex trade workers and non-sex trade workers were markedly different. Logistic regression analysis of cross-sectional data revealed that independent behaviours associated with the sex trade included: greater than once per day use of heroin (adjusted OR 2.7), smokeable crack cocaine (adjusted OR = 3.3) and borrowing used syringes (adjusted OR = 2.0). Creative, client-driven interventions are urgently needed for women who trade sex for money or for drugs. [ABSTRACT FROM AUTHOR]

Objective: To describe the sociodemographic characteristics and HIV and Hepatitis C prevalence among persons who died of a drug overdose in the Vancouver metropolis health region in 1998. Methods: A retrospective review was conducted on all overdose death files in the Vancouver/Richmond health region reported to the Office of the Chief Coroner. The files included, autopsy, toxicology, virology, and coroner reports. External linkages were done to determine the proportion of individuals on antiretroviral treatment. Contingency analyses were conducted to determine factors associated with Hepatitis C and HIV seropositivity. Results: Data on a total of 199 deaths were obtained from the coroner's office. Of these 37 (18.6%) were female and 162 (81.4%) were male. A total of 25 (12.6%) deaths were among persons of First Nations descent and 134 (73.6%) were among chronic drug users. The median age at death was 38 years (Interquartile range [IQR]: 32-45 years). The drug most commonly responsible for overdose was heroin [89 (47.3%) deaths]. A total of 91 (45.7%) deaths were tested for HIV and 95 (47.7%) deaths were tested for HCV. Of those deaths, 28 (29.8%) were HIV-positive and 78(78.0%) were HCV-positive. Conclusion: Our analysis suggests that those dying of illicit drug overdose in Vancouver during 1998, are largely comprised of older, male, chronic injection drug users. Rates of HIV and HCV positivity are very high in this group. [ABSTRACT FROM AUTHOR]

IntroductionMethodsResultsConclusionDodecafluoropentane emulsion (DDFPe) administration has previously demonstrated improved gas exchange in single-organ perfusion models. This could translate to prevention of brain injury in cardiac arrest.We induced cardiac arrest in 12 pigs, performing CPR after 5-minute downtime. Pigs were randomly assigned to DDFPe (n = 7) or saline placebo (n = 5) groups. Neurologic injury biomarkers were measured at baseline, after return of spontaneous circulation (ROSC), and every 24 hours in survivors. Blinded Neurological Alertness Score, Neurological Dysfunction Score, and Overall Performance Score was performed in addition to histopathological scoring of parietal and hippocampal sections.One placebo and four DDFPe pigs survived the 96-hour observation period. The odds ratio for ROSC was 7.2 (p = 0.22). Survival odds ratio was 4.6 (p = 0.29). All surviving animals had impaired motor responses that recovered by 72 hours. DDFPe animals showed better neuro-behavioral scores than placebo.The findings of this novel study provide a proof of concept and early signal toward efficacy of intravenous DDFPe in cardiac arrest. The trend toward improved ROSC and functional survival may reflect improved microcirculatory gas exchange in DDFPe animals. Improving gas exchange in brain microcirculation during resuscitation from cardiac arrest may provide a significant therapeutic benefit. [ABSTRACT FROM AUTHOR]

Background: Indigenous children and adolescents experience life circumstances that significantly affect their social and emotional well-being (SEWB) and limit their capacity to fulfil their potential. This contributes to inequities in health, education, employment, and justice system involvement.Aim: We aimed to synthesise the existing literature to comprehensively understand the protective and risk factors for SEWB of Indigenous youth in Canada, Australia, New Zealand, and the United States (CANZUS).Methods: We conducted a systematic search of English literature using Google Scholar, Scopus, Informit, HealthInfonet, and PubMed.Results: Sixty-nine articles met the inclusion criteria. The identified risk and protective factors were mapped according to seven thematic and interconnected areas including connection to the (a) body; (b) mind and emotions; (c) family and kinship; (d) community; (e and f) culture, country, and land (place/space); and (g) ancestry and spirituality.Conclusions: Indigenous peoples’ perceptions of SEWB differ from traditional Western conceptualisations of health. Their perceptions carry a culturally distinct meaning, which is largely shared by Indigenous peoples across the CANZUS societies. An understanding of risk and protective factors for SEWB can inform targeted policy and public health practice frameworks aimed at improving Indigenous youth’s health and well-being. [ABSTRACT FROM AUTHOR]