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A total of 3719 articles appearing in five key generalist forensic psychology journals (n = 1374) and six more specialist targeted forensically related journals (n = 2345) between 2015 and 2020 were subject to a bibliometric analysis to reveal trends in research topics, populations studied, jurisdiction, and research methods employed. Research on offenders dominated and over half of all the papers were located in North American jurisdictions. About a third of papers made explicit reference to diversity and two thirds of research designs employed quantitative methodologies. The discussion features comments on changing trends over time from forensic psychology's initial narrow focus on witness testimony to its current broader remit, and the different coverage between targeted and generalist journals. The conclusion offers some reflections for future forensic psychology. [ABSTRACT FROM AUTHOR]

Background: Although pre-exposure prophylaxis (PrEP) prevents HIV, little is known about PrEP awareness and factors associated with intention to take PrEP among people with opioid use disorder (OUD). Methods: HIV-negative adults recruited from an outpatient treatment program in Cincinnati, Ohio completed self-administered surveys. Items derived from literature and health behavioral theory included demographics, sexual and drug use behaviors, HIV prevention practices, PrEP knowledge, and attitudes toward PrEP. Primary outcomes were 1) intention to ask a clinician about PrEP and 2) intention to accept PrEP if recommended by a clinician. Outcomes were dichotomized into higher vs. lower intention for analyses in logistic regression models. Results: Among 198 participants, 60.3% reported past injection drug use. Among 58 participants (29.3%) meeting criteria for PrEP, 24% were aware of PrEP, 15.5% had discussed it with a clinician, and 5% had taken it. Factors associated with intention to ask a clinician about PrEP included being somewhat confident about consistent condom use (p < 0.01), motivation to comply with normative beliefs (p < 0.01), and reporting that PrEP fits very well (p < 0.01) and is easy to fit (p < 0.01) into current prevention practices. Factors associated with intention to accept PrEP if recommended by a clinician included motivation to comply with normative beliefs (p < 0.01) and PrEP being easy to fit into current prevention practices (p < 0.01). Conclusion: Among participants meeting indications for PrEP, only 24% were aware of it and few had taken it. Interventions that normalize PrEP and target incorporating PrEP into current prevention practices may improve uptake among individuals with OUD. [ABSTRACT FROM AUTHOR]

Background Human immunodeficiency virus low-level viremia (LLV) is associated with subsequent treatment failure at least with non nucleoside reverse transcriptase inhibitor (NNRTI)-containing antiretroviral therapy. Data on implications of LLV occurring under dolutegravir, which has largely replaced NNRTIs in Africa, are scarce, however. Methods We included adults with human immunodeficiency virus in Lesotho who had ≥2 viral loads (VLs) taken after ≥6 months of NNRTI- or dolutegravir-based antiretroviral therapy. Within VL pairs, we assessed the association of viral suppression (<50   copies/mL) and low- and high-range LLV (50–199 and 200–999   copies/mL, respectively) with virological failure (≥1000   copies/mL) using a mixed-effects regression model. Participants could contribute VLs to the NNRTI and the dolutegravir group. Results Among 18 550 participants, 12 216 (65.9%) were female and median age at first VL included was 41.2 years (interquartile range, 33.4–51.5). In both groups, compared with a suppressed VL, odds of subsequent virological failure were higher for low-range LLV (NNRTI: adjusted odds ratio; 95% confidence interval: 1.9; 1.4–2.4 and dolutegravir: 2.1; 1.3–3.6) and high-range LLV (adjusted odds ratio; 95% confidence interval, 4.2; 3.1–5.7 and 4.4; 2.4–7.9). Conclusions In the dolutegravir era, LLV remains associated with virological failure, endorsing the need for close clinical and laboratory monitoring of those with a VL ≥50 copies/mL. [ABSTRACT FROM AUTHOR]

This correction notice addresses an error in the original article titled "SNCA genetic lowering reveals differential cognitive function of alpha-synuclein dependent on sex." The error pertains to Figure 1c, where the images for the "2 weeks ASO" and "3 weeks ASO" groups were found to be identical. The authors have reviewed the original images and raw data files and confirmed that the published images for the "2 week ASO" group are inconsistent with the original raw files. The correction does not impact the conclusions of the study. The correct figure has been provided in the correction notice. [Extracted from the article]

An early diagnosis of autism spectrum disorder (ASD) can improve outcomes for children and assist families in accessing services. Part C providers are often tasked with screening for ASD. The purpose of this study was to survey Part C providers nationwide to understand their ASD screening practices and training needs and extend a survey conducted by Tomlin and colleagues. A total of 327 providers participated. Results indicated a majority of respondents (75.8%) screen for ASD using a variety of different measures, while only 26.9% are required by their program to conduct universal screenings. Most participants reported feeling confident in screening for ASD, discussing a child's red flags with a family, referring a child for further evaluation, and discussing recent evidence surrounding ASD. An area where providers were less confident was working with interpreters to screen for ASD or discuss screening results and ASD with families with cultural or linguistic diversity. Despite high confidence levels in screening for ASD, a vast majority of participants reported they would be interested in attending a training on screening for ASD. Professional development surrounding screening for ASD and discussing ASD with families from diverse backgrounds may assist in improving Part C provider screening practices. [ABSTRACT FROM AUTHOR]

The World Health Organization recommends same-day initiation of antiretroviral therapy (ART) for all persons diagnosed with HIV and ready to start treatment. Evidence, mainly from randomized trials, indicates offering same-day ART increases engagement in care and viral suppression during the first year. In contrast, most observational studies using routine data find same-day ART to be associated with lower engagement in care. We argue that this discrepancy is mainly driven by different time points of enrollment, leading to different denominators. While randomized trials enroll individuals when tested positive, most observational studies start at the time point when ART is initiated. Thus, most observational studies omit those who are lost between diagnosis and treatment, thereby introducing a selection bias in the group with delayed ART. This viewpoint article summarizes the available evidence and argues that the benefits of same-day ART outweigh a potential higher risk of attrition from care after ART initiation. [ABSTRACT FROM AUTHOR]

Background Serological data on endemic human coronaviruses (HCoVs) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in southern Africa are scarce. Here, we report on (1) endemic HCoV seasonality, (2) SARS-CoV-2 seroprevalence, and (3) correlates of SARS-CoV-2 seropositivity and strength of SARS-CoV-2 and endemic HCoV serological responses among adults living with human immunodeficiency virus (HIV). Methods Plasma samples were collected from February 2020 to July 2021 within an HIV cohort in Lesotho. We used the AntiBody CORonavirus Assay (ABCORA) multiplex immunoassay to measure antibody responses to endemic HCoV (OC43, HKU1, NL63, and 229E) and SARS-CoV-2 antigens. Results Results for 3173 samples from 1403 adults were included. Serological responses against endemic HCoVs increased over time and peaked in winter and spring. SARS-CoV-2 seropositivity reached >35% among samples collected in early 2021 and was associated with female sex, obesity, working outside the home, and recent tiredness or fever. Positive correlations were observed between the strength of response to endemic HCoVs and to SARS-CoV-2 and between older age or obesity and the immunoglobulin G response to SARS-CoV-2. Conclusions These results add to our understanding of the impact of biological, clinical, and social/behavioral factors on serological responses to coronaviruses in southern Africa. [ABSTRACT FROM AUTHOR]

Abstract Introduction Methods Results Conclusions This review synthesizes the literature on the associations between concealment and mental health problems among Black, Indigenous, and People of Color (BIPOC) men who have sex with men (MSM).Following PRISMA guidelines, a systematic search was conducted using five databases to identify peer-reviewed articles and published dissertations.Eleven studies were included. Mental health outcomes were (a) poor psychological well-being (k = 7), (b) depressive symptoms (k = 6), (c) anxiety symptoms (k = 4), and (d) substance use (k = 2).Results suggest potential differential associations by race/ethnicity. Methodological limitations and future directions are discussed. [ABSTRACT FROM AUTHOR]

INTRODUCTION Tobacco industry documents reveal companies' knowledge of a similar young adult market across countries in terms of attitudes and lifestyle aspirations. Some tobacco companies, therefore, use similar marketing approaches across different jurisdictions. We examined young adults' perceptions of flavored cigarette packs, including those containing flavor capsules, in Mexico and the Philippines. METHODS We conducted a secondary analysis of five focus groups held in Mexico and four in the Philippines with young adults who smoke (aged 18-24 years), separated by gender, in which participants interacted with cigarette packs purchased locally. Transcribed and translated data were thematically analyzed and compared between countries. RESULTS Three major themes were identified: 1) Flavor capsules cigarettes are recognizable via pack design through imagery on the pack that is understood to signify capsules; 2) Colors signal flavor and make the pack attractive; and 3) Young adults who smoke identify the target audience for these products as young people and those who are beginning to smoke. CONCLUSIONS Young adults who smoke in Mexico and the Philippines interpreted flavored cigarette pack design similarly and thought that young people are the main audience for these products. This suggests a successful marketing approach creating shared perceptions of flavored cigarette packs in different world regions. It is likely that similar tactics are used in other countries around the world. Therefore, jurisdictions might use evidence from other jurisdictions to support the implementation of evidence-based tobacco control policies. These findings also support the implementation of plain and standardized packaging and flavor bans that would also limit product innovation such as capsules. [ABSTRACT FROM AUTHOR]

Objective: Limitations of traditional geospatial measures, like the modified Retail Food Environment Index (mRFEI), are well documented. In response, we aimed to: (1) extend existing food environment measures by inductively developing subcategories to increase the granularity of healthy v. less healthy food retailers; (2) establish replicable coding processes and procedures; and (3) demonstrate how a food retailer codebook and database can be used in healthy public policy advocacy. Design: We expanded the mRFEI measure such that 'healthy' food retailers included grocery stores, supermarkets, hypermarkets, wholesalers, bulk food stores, produce outlets, butchers, delis, fish and seafood shops, juice/smoothie bars, and fresh and healthy quick-service retailers; and 'less healthy' food retailers included fast-food restaurants, convenience stores, coffee shops, dollar stores, pharmacies, bubble tea restaurants, candy stores, frozen dessert restaurants, bakeries, and food trucks. Based on 2021 government food premise licences, we used geographic information systems software to evaluate spatial accessibility of healthy and less healthy food retailers across census tracts and in proximity to schools, calculating differences between the traditional v. expanded mRFEI. Setting: Calgary and Edmonton, Canada. Participants: N/A. Results: Of the 10 828 food retailers geocoded, 26 % were included using traditional mRFEI measures, while 53 % were included using our expanded categorisation. Changes in mean mRFEI across census tracts were minimal, but the healthfulness of food environments surrounding schools significantly decreased. Conclusions: Overall, we show how our mRFEI adaptation, and transparent reporting on its use, can promote more nuanced and comprehensive food environment assessments to better support local research, policy and practice innovations. [ABSTRACT FROM AUTHOR]

Walkability is a critical component of built environments, yet there is still diverse conceptualization and measurement of the construct. The Walk Score® metric is one measure of walkability, which is widely used in scholarly, industry, and public domains. With increased interest in the use of Walk Score® as a research tool, it is necessary to examine the operationalization and scope of the measure. This scoping review examined how researchers utilized Walk Score® in walkability research, with specific attention to identifying limitations related to health outcomes as well as the use of the metric in non-health research contexts. Findings from the review provide a novel and critically nuanced understanding of how the assumptions and limitations of Walk Score® are addressed relative to socio-ecological aspects of walkability. [ABSTRACT FROM AUTHOR]

African American women experience a high prevalence of alcohol-related consequences, and no studies have explicitly examined the associations among lifetime interpersonal abuse, emotion dysregulation, and alcohol-related outcomes during the critical period of young adulthood within this population. This study used baseline data from a sample of African American young women (N = 560) who use alcohol, aged 18 to 24, enrolled in an HIV prevention intervention trial to examine whether emotion dysregulation mediated the relation between lifetime history of abuse and problematic alcohol use. Further, we sought to examine whether there were potential differential levels of problematic alcohol use based on the number of abuse types experienced. Multiple regression analyses showed that exposure to two or more forms of abuse was associated with problematic alcohol use, β =.24, p <.001, and heavy alcohol consumption, β =.23, p <.001, whereas history of a single form was not. Indirect effects of both single and multiple forms of abuse on problematic alcohol use (95% confidence interval [CI] [.16, 1.02]; [.46, 1.64]) and heavy alcohol consumption (95% CI [.02,.26]; [.05,.45]) via emotion dysregulation severity were found. Abuse and emotion dysregulation were associated with frequency of alcohol use and binge drinking, but not typical amount consumed. Hazardous alcohol consumption was prevalent among this sample of African American young women who use alcohol. This study provides preliminary evidence that emotion dysregulation may be an important mechanism buttressing the association between lifetime history of interpersonal abuse and problematic alcohol use among African American young women who use alcohol. [ABSTRACT FROM AUTHOR]

Purpose: Interprofessional practice within early intervention is underscored by policy, research, and recommended practices. The purpose of this study was to explore the impact of a brief interprofessional training on preservice speech-language pathology, early intervention/early childhood special education, physical therapy, and occupational therapy students’ knowledge, beliefs, and attitudes about teaming and collaboration. Students’ satisfaction with and perspectives of the training were also examined. Method: A one-group, pretest–posttest design was used to examine differences in 36 students’ knowledge, attitudes, and beliefs around interprofessional practice after the training. Descriptive approaches were used to analyze student satisfaction data and focus group data in order to evaluate student perceptions of the interprofessional training. Results: A paired–samples t test showed preservice students demonstrated increased scores in self-perceived ability, value, and comfort in working with others after the training institute. Descriptive analyses illustrated students gained a richer knowledge and appreciation for other disciplines and perceived the practice of interprofessional collaboration as a valuable learning experience. Conclusion: The interprofessional training procedures, evaluation of impacts, and future directions are discussed. [ABSTRACT FROM AUTHOR]

Introduction: HIV programmes across many countries in Africa have recently transitioned people living with HIV from efavirenz (EFV)‐ to dolutegravir (DTG)‐containing antiretroviral therapy (ART). As both drugs are associated with neuropsychiatric adverse effects, this study assessed the mental health and HIV/ART‐associated symptoms of people living with HIV before and after transition to DTG. Methods: The prospective DO‐REAL cohort enrolled people starting DTG‐based ART in Lesotho from February to December 2020. For this analysis within DO‐REAL, we included adults changing from tenofovir disoproxil fumarate (TDF)/lamivudine (3TC)/EFV to TDF/3TC/DTG within first‐line therapy. At transition and 16 weeks thereafter, participants completed the Patient Health Questionnaire‐9 (PHQ‐9; depression screening), the 12‐item Short‐Form Health Survey (SF‐12; mental and physical health), and a modified HIV Symptom Index (mHSI; HIV/ART‐related symptoms). We also assessed weight change. We used McNemar tests with Bonferroni corrections to assess binary outcomes. ClinicalTrials.gov: NCT04238767. Results: Among 1228 participants, 1131 completed follow‐up. Of these, 60.0% were female, the median age was 46 years (interquartile range [IQR] 38–55), and the median time taking ART was 5.7 years (IQR 3.5–8.9). No change was observed for weight or overall PHQ‐9 or SF‐12 outcomes. However, three mHSI items decreased at follow‐up: 'feeling sad/down/depressed' (bothered 6.0% vs. 3.3% of participants at least 'a little' before vs. after transition; adjusted p = 0.048); 'feeling nervous/anxious' (7.4% vs. 3.4%; adjusted p = 0.0009); and 'nightmares, strange/vivid dreams' (6.3% vs. 3.5%; adjusted p = 0.027). Individual PHQ‐9 or SF‐12 items also improved. Being symptom free across all measures increased from 5.1% to 11.4% (p < 0.0001). Conclusions: We observed no negative impacts and potential moderate improvements with DTG, providing further support for the rollout of DTG. [ABSTRACT FROM AUTHOR]

Protein arginine N-methyltransferases (PRMTs) have emerged as important actors in the eukaryotic stress response with implications in human disease, aging, and cell signaling. Intracellular free methylarginines contribute to cellular stress through their interaction with nitric oxide synthase (NOS). The arginine-dependent production of nitric oxide (NO), which is strongly inhibited by methylarginines, serves as a protective small molecule against oxidative stress in eukaryotic cells. NO signaling is highly conserved between higher and lower eukaryotes, although a canonical NOS homologue has yet to be identified in yeast. Since stress signaling pathways are well conserved among eukaryotes, yeast is an ideal model organism to study the implications of PRMTs and methylarginines during stress. We sought to explore the roles and fates of methylarginines in Saccharomyces cerevisiae. We starved methyltransferase-, autophagy-, and permease-related yeast knockouts by incubating them in water and monitored methylarginine production. We found that under starvation, methylarginines are expelled from yeast cells. We found that autophagy-deficient cells have an impaired ability to efflux methylarginines, which suggests that methylarginine-containing proteins are degraded via autophagy. For the first time, we determine that yeast take up methylarginines less readily than arginine, and we show that methylarginines impact yeast NO production. This study reveals that yeast circumvent a potential methylarginine toxicity by expelling them after autophagic degradation of arginine-modified proteins. [ABSTRACT FROM AUTHOR]

Antisense oligonucleotide (ASO) therapy for neurological disease has been successful in clinical settings and its potential has generated hope for Alzheimer's disease (AD). We previously described that ablating SNCA encoding for α-synuclein (αSyn) in a mouse model of AD was beneficial. Here, we sought to demonstrate whether transient reduction of αSyn expression using ASOSNCA could be therapeutic in a mouse model of AD. The efficacy of the ASOSNCA was measured via immunocytochemistry, RT-qPCR and western blotting. To assess spatial learning and memory, ASOSNCA or PBS-injected APP and non-transgenic (NTG) mice, and separate groups of SNCA-null mice, were tested on the Barnes circular maze. Hippocampal slice electrophysiology and transcriptomic profiling were used to explore synaptic function and differential gene expression between groups. Reduction of SNCA transcripts alleviated cognitive deficits in male transgenic animals, but surprisingly, not in females. To determine the functional cause of this differential effect, we assessed memory function in SNCA-null mice. Learning and memory were intact in male mice but impaired in female animals, revealing that the role of αSyn on cognitive function is sex-specific. Transcriptional analyses identified a differentially expressed gene network centered around EGR1, a central modulator of learning and memory, in the hippocampi of SNCA-null mice. Thus, these novel results demonstrate that the function of αSyn on memory differs between male and female brains. [ABSTRACT FROM AUTHOR]

Background: Good glycaemic control is a crucial part of diabetes management. Traditional assessment methods, including HbA1c checks and self-monitoring of blood glucose, can be unreliable and inaccurate. Continuous glucose monitoring (CGM) offers a non-invasive and more detailed alternative. Availability of this technology is increasing worldwide. However, there is no current comprehensive evidence on the acceptability and feasibility of these devices. This is a protocol for a mixed-methods systematic review of qualitative and quantitative evidence about acceptability and feasibility of CGM in people with diabetes. Methods: We will search MEDLINE, Embase, CINAHL, and CENTRAL for qualitative and quantitative evidence about the feasibility and acceptability of CGM in all populations with diabetes (any type) using search terms for "continuous glucose monitoring" and "diabetes". We will not apply any study-type filters. Searches will be restricted to studies conducted in humans and those published from 2011 onwards. We will not restrict the search by language. Study selection and data extraction will be carried out by two reviewers independently using Rayyan and Eppi-Reviewer, respectively, with disagreements resolved by discussion. Data extraction will include key information about each study, as well as qualitative evidence in the form of participant quotes from primary studies and themes and subthemes based on the authors' analysis. Quantitative data relating to acceptability and feasibility including data loss, adherence, and quantitative ratings of acceptability will be extracted as means and standard deviations or n/N as appropriate. Qualitative evidence will be analysed using framework analysis informed by the Theoretical Framework of Acceptability. Where possible, quantitative evidence will be combined using random-effects meta-analysis; otherwise, a narrative synthesis will be performed. The most appropriate method for integrating qualitative and quantitative findings will be selected based on the data available. Discussion: Ongoing assessment of the acceptability of interventions has been identified as crucially important to scale-up and implementation. This review will provide new knowledge with the potential to inform a programme theory of CGM as well as future roll-out to potentially vulnerable populations, including those with severe mental illness. Systematic review registration: PROSPERO CRD42021255141. [ABSTRACT FROM AUTHOR]

The present study examines the relationship between legal status and prisoner misconduct by comparing official disciplinary infraction reports between documented, undocumented, and native-born inmates. We also examine the extent to which such effects vary across different types (i.e., criminal and non-criminal) of reported infractions. Using data from the Florida Department of Corrections, the results reveal that undocumented foreigners have a higher likelihood and a higher frequency of any misconduct and criminal misconduct as well as a higher frequency of non-criminal misconduct than the other two groups, while no such differences are found between documented and native-born prisoners. Our research underscores the salient role of legal status in predicting the in-prison behaviors of foreign-born inmates. [ABSTRACT FROM AUTHOR]

A system for co-cultivation of anaerobic fungi with anaerobic bacteria was established based on lactate cross-feeding to produce butyrate and butanol from plant biomass. Several co-culture formulations were assembled that consisted of anaerobic fungi (Anaeromyces robustus, Neocallimastix californiae, or Caecomyces churrovis) with the bacterium Clostridium acetobutylicum. Co-cultures were grown simultaneously (e.g., 'one pot'), and compared to cultures where bacteria were cultured in fungal hydrolysate sequentially. Fungal hydrolysis of lignocellulose resulted in 7–11 mM amounts of glucose and xylose, as well as acetate, formate, ethanol, and lactate to support clostridial growth. Under these conditions, one-stage simultaneous co-culture of anaerobic fungi with C. acetobutylicum promoted the production of butyrate up to 30 mM. Alternatively, two-stage growth slightly promoted solventogenesis and elevated butanol levels (∼4–9 mM). Transcriptional regulation in the two-stage growth condition indicated that this cultivation method may decrease the time required to reach solventogenesis and induce the expression of cellulose-degrading genes in C. acetobutylicum due to relieved carbon-catabolite repression. Overall, this study demonstrates a proof of concept for biobutanol and bio-butyrate production from lignocellulose using an anaerobic fungal-bacterial co-culture system. [ABSTRACT FROM AUTHOR]

Background: Zanubrutinib is a next-generation, selective Bruton tyrosine kinase inhibitor with efficacy in relapsed chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL). We compared zanubrutinib with bendamustine-rituximab to determine its effectiveness as frontline therapy in patients with CLL or SLL.Methods: We conducted an open-label, multicentre, phase 3 study at 153 academic or community hospitals in 14 countries and regions. Eligible patients had untreated CLL or SLL requiring treatment as per International Workshop on CLL criteria; were aged 65 years or older, or 18 years or older and had comorbidities; and had an Eastern Cooperative Oncology Group performance status score of 0-2. A central interactive web response system randomly assigned patients without del(17)(p13·1) to zanubrutinib (group A) or bendamustine-rituximab (group B) by sequential block method (permutated blocks with a random block size of four). Patients with del(17)(p13·1) were enrolled in group C and received zanubrutinib. Zanubrutinib was administered orally at 160 mg twice per day (28-day cycles); bendamustine at 90 mg/m2 of body surface area on days 1 and 2 for six cycles plus rituximab at 375 mg/m2 of body surface area the day before or on day 1 of cycle 1, and 500 mg/m2 of body surface area on day 1 of cycles 2-6, were administered intravenously. The primary endpoint was progression-free survival per independent review committee in the intention-to-treat population in groups A and B, with minimum two-sided α of 0·05 for superiority. Safety was analysed in all patients who received at least one dose of study treatment. The study is registered with ClinicalTrials.gov, NCT03336333, and is closed to recruitment.Findings: Between Oct 31, 2017, and July 22, 2019, 590 patients were enrolled; patients without del(17)(p13·1) were randomly assigned to zanubrutinib (group A; n=241) or bendamustine-rituximab (group B; n=238). At median follow-up of 26·2 months (IQR 23·7-29·6), median progression-free survival per independent review committee was not reached in either group (group A 95% CI not estimable [NE] to NE; group B 28·1 months to NE). Progression-free survival was significantly improved in group A versus group B (HR 0·42 [95% CI 0·28 to 0·63]; two-sided p<0·0001). The most common grade 3 or worse adverse event was neutropenia (27 [11%] of 240 patients in group A, 116 [51%] of 227 in group B, and 17 [15%] of 111 patients in group C). Serious adverse events occurred in 88 (37%) of 240 patients in group A, 113 (50%) of 227 patients in group B, and 45 (41%) of 111 patients in group C. Adverse events leading to death occurred in 11 (5%) of 240 patients in group A, 12 (5%) of 227 patients in group B, and three (3%) of 111 patients in group C, most commonly due to COVID-19 (four [2%] of 240 patients in group A), diarrhoea, and aspiration pneumonia (two each [1%] of 227 patients in group B).Interpretation: Zanubrutinib significantly improved progression-free survival versus bendamustine-rituximab, with an acceptable safety profile consistent with previous studies. These data support zanubrutinib as a potential new treatment option for untreated CLL and SLL.Funding: BeiGene. [ABSTRACT FROM AUTHOR]

This letter to the editor responds to a commentary on the rise of unregulated clinical decision support software. The authors express concern that the commentary did not accurately report the main outcomes of their study on a prescription drug monitoring program risk screening tool. They clarify that their study recommended the use of the tool as an introductory screener to eliminate the burden of manually screening low-risk opioid users, and that targeted screening should be used to confirm risky opioid use. The authors also mention their current NIDA-funded trial, which integrates their identified cut-points into the Bamboo platform and designs a clinical decision support tool for pharmacists. They hope that this study will address concerns about the scientific foundation and transparency of the Bamboo Health platform. [Extracted from the article]

To create, validate, and apply an aerodigestive provider assessment survey. A survey assessing provider knowledge and current practice in the transition of patients with chronic aerodigestive disorders from pediatric to adult care was drafted by a multidisciplinary expert panel. Once agreement of the initial survey items was obtained, the survey was distributed to a national multidisciplinary panel of aerodigestive experts for review. Responses from the national panel were systematically quantified and a content validity index (CVI) was calculated. A final survey was developed and distributed to pediatric and adult aerodigestive providers. From the initial 22 items presented to the national panel, 20 of the initial questions were included in the final instrument. Two additional questions were developed as a result of feedback from the expert panel. All items included in the survey had an Item Content Validity Index (I-CVI) of >0.85. The average Scale CVI in proportion to the average proportion of relevance (S-CVI/Ave) for the tool was 0.88. The average Scale CVI in proportion to universal agreement (S-CVI/UA) was 0.52. The survey was then administered to pediatric and adult specialty providers at our institution. Twenty-two providers completed the final survey. The content validity index measurements from this newly developed survey suggest that it is a valid tool for assessing current knowledge and practice in care transitions among patients with complex aerodigestive needs. The survey developed in this project has been used to identify knowledge gaps and process issues that can be addressed to ease the transition of adolescents from pediatric specialty care into adult specialty care. [ABSTRACT FROM AUTHOR]

Cavernous sinus haemangiomas are neoplastic lesions notoriously difficult to diagnose and excise. We present a case of a lesion that was clinically, biochemically, and radiologically consistent to a giant pituitary macroadenoma and discuss the unexpected near intra-operative exsanguination which enabled a pathognomonic diagnosis of a much rarer lesion to be made. This highlights the sinister nature of such a lesion, and its potential impact on patient care if partially excised, and that despite our advances in neurosurgical diagnostics the unexpected is to be expected. [ABSTRACT FROM AUTHOR]

Congenital lymphocytic choriomeningitis virus syndrome: A disease that mimics congenital toxoplasmosis or cytomegalovirus infection. Diseases of the central nervous system caused by lymphocytic choriomeningitis virus and other arenaviruses. Onsite investigation at a mail-order hatchery following a multistate salmonella illness outbreak linked to live poultry-United States, 2018. Salmonella illness outbreaks linked to backyard poultry purchasing during the COVID-19 pandemic: United States, 2020. [Extracted from the article]

Youth-centered health services have become a global practice and South Africa is no exception. This paper describes a project conducted in Mangaung in 2018 using cultural consensus modeling. We conducted 25 interviews and used a combination of hermeneutics, phenomenology theory, and thematic analysis. Our research found that girls in our sample have confidentiality concerns associated with the stigma of attending a clinic and cannot talk openly about sex and HIV. Themes related to negative experiences included the lack of confidentiality, the stigma of HIV, the lack of professional neutrality, failure to understand adolescents, poor service, systemic problems (long queues), and administrative problems. Positive themes included believing that clinics could help prevent pregnancy, provide information, create a safe space, and help with moral support. Moreover, some interviewees reported that services were good and that they provided products and support that were not available from home. However, many said they had to attend public clinics because they could not afford private alternatives. Some said the clinics offered a safe space and staff have positive attitudes. In the absence of discussions about sex at home, the clinics ultimately perform an important function, but systemic problems remain. More can be done by schools and households to reduce the stigma associated with sex and HIV. [ABSTRACT FROM AUTHOR]

Purpose: The current study aimed to understand the clinical decision-making skills of school-based speech-language pathologists (SLPs) using narrative and expository discourse information from three sources: perception of language through listening to language alone, standardized criterion-referenced narrative assessment data, and word- and morpheme-level language sample analysis data. Method: Twenty-eight current school-based SLPs participated in the study. During this study, participants rated language quality and made decisions regarding the provision of language services after being provided information from informal assessment measures. Results: SLPs' ratings of language quality and complexity varied across the story retell, wordless picture book generation, and expository samples. There was a lack of consistency in ratings within each context across areas of clarity, sample complexity, language complexity, and vocabulary across all SLPs. Self-reported factors that influenced SLPs' ratings included components of structure, syntax, and semantics. SLPs did not indicate a need for services after listening alone. When provided with criterion-referenced narrative assessment scores and word- and morpheme-level language sample data, more SLPs made a recommendation for services. Conclusions: The study demonstrates the need for objective language measure data during diagnostic decision making. Additionally, SLPs may not realize the information obtained from real-time perception, and analysis of language samples may be an unreliable and inconsistent picture of a child's language abilities. The results of this study highlight the need to continue to rely on multiple sources of assessment data. SLPs should continue to incorporate systematic methods to minimize variability of perceptions in the process of making diagnostic decisions. [ABSTRACT FROM AUTHOR]

Objectives: Since 2018, the World Health Organization has recommended dolutegravir (DTG)‐containing antiretroviral therapy (ART) for most people living with HIV. Country programmes across Africa have subsequently transitioned from other, mostly nonnucleoside reverse transcriptase inhibitor (NNRTI)‐based ART to DTG‐based ART. This study aims to assess the virological impact of programmatic transitioning to DTG‐based ART in Lesotho. Methods: The prospective Dolutegravir in Real‐Life in Lesotho (DO‐REAL) cohort enrols people living with HIV initiating or transitioning to DTG‐based ART in Lesotho. Here, we present data from participants who transitioned from NNRTI‐ to DTG‐based ART between February and December 2020. Blood samples collected at transition and at 16 weeks' follow‐up (window 8–32 weeks) were used for viral load (VL) and resistance testing. Results: Among 1347 participants, follow‐up data was available for 1225. The majority (60%) were female, median age at transition was 47 years [interquartile range (IQR): 38–56], and median (IQR) time since ART initiation was 5.9 (3.5–9.0) years. Among those with complete VL data, the rate of viral suppression to < 100 copies/mL was 1093/1116 (98%) before, 1073/1116 (96%) at, and 1098/1116 (98%) after transition. Even among those with a VL ≥ 100 copies/mL at transition, 42/44 (95%) achieved suppression to < 100 copies/mL at follow‐up. Seven participants had a VL ≥ 1000 copies/mL at follow‐up and did not harbour any integrase mutations associated with resistance to DTG. Conclusions: The high levels of viral suppression observed are encouraging regarding virological outcomes upon programmatic transitioning from NNRTI‐ to DTG‐based ART. [ABSTRACT FROM AUTHOR]

Psychology has an interest in the ways in which religion can aid coping with life's adverse events, as most, perhaps all, individuals will face trauma or adversity at some point in life. The COVID19 pandemic has created adversity for individuals and societies globally and has for many been the cause of traumatic events. Religious coping in the face of crisis is not merely a contemporary phenomenon. This paper argues that several religious coping mechanisms can be found within the texts of Psalms 90, 91 and 92 of the Hebrew Bible. These psalms may represent a community's attempt to cope with the aftermath of a society-wide traumatic event, such as the 6th Century BCE Exile to Babylon. This paper reads these psalms through the lens of coping theory, explores how a traumatic event may have influenced their composition, and considers ways in which they might be used in pastoral situations today. [ABSTRACT FROM AUTHOR]

Religion is often understood to play a positive role in shaping moral attitudes among believers. We assessed the relationship between church members' levels of felt connectedness to their respective congregations and perceived similarity in personal and congregational moral values, and whether there was a relationship between these and the amount of time spent in synchronous movement or singing during worship. The similarity between personal and perceived congregational moral importance (the importance assigned to different moral items) was correlated with feelings of closeness to one's congregation but not by the amount of time spent in synchronous movement or singing. Differences in moral foundations scores and in moral importance of specific issues were found between different theological traditions. These findings demonstrate that, for churchgoers, there is a relationship between the use of music or synchronous movement in a church service and feelings of social bonding and there is also a relationship between the degree to which churchgoers identify with their church community and the degree to which they believe their priorities match those of their church. Furthermore, differences in theological tradition appear to be reflected in differences in moral values. [ABSTRACT FROM AUTHOR]

Policies of dispersal are increasingly favoured internationally for the resettlement of refugees and asylum seekers. With forty percent of the world’s forcibly displaced people being school-aged children, the dispersal of refugee-background people into regional areas means that rural schools are central sites of community response to refugees. Little is known in published research about how rural schools engage in refugee education within the policy context of ‘dispersal’. This review of relevant literature examines the educational dimensions of dispersal policies, drawing on research in Australia, Canada, the United Kingdom, the United States and Sweden. Research linking refugee resettlement, refugee education and rurality shows a complex interplay between histories of exclusion and contemporary challenges in both the construction of rural spaces, and the deployment of humanitarian dispersal policies at national and international levels. This literature is thematically organised to show that in refugee education within a policyscape of dispersal, rural schools may be 1) operating in racialised community contexts; 2) working within poorly resourced infrastructure; 3) unfamiliar with refugee-background students; and, despite these challenges, they may become 4) key sites of resistance, creativity and support for refugee-background students and their families. [ABSTRACT FROM AUTHOR]

Progress-monitoring data collection is an essential skill for teachers serving children for whom the general curriculum is insufficient. As the field of early childhood education moves toward tiered service provision models, the importance of routine data collection is heightened. Therefore, we evaluated the effects of a training package on preschool teachers' implementation of progress-monitoring strategies to collect data on children in need of supports beyond those provided through the general curriculum. This study employed a single-case experimental design in which generalized teacher behavior was collected within the context of the design. In addition, masked reliability data collectors were used throughout the study and an analysis of bias was conducted by a researcher unaffiliated with the study. Social and ecological validity data were collected using a multi-method approach. [ABSTRACT FROM AUTHOR]

Multitiered systems of support provide a framework for matching the needs of a struggling student with an appropriate intervention. Experimental evaluations of tiered support systems in grade schools have been conducted for decades but have been less frequently examined in early childhood contexts. A recent meta-analysis of multitiered systems of support in preschool settings exclusively synthesized outcomes from group design studies. Our current review extends this review by synthesizing single-case research examining interventions implemented within tiered support system frameworks in preschool settings. Our data indicate that single-case evaluations of tiered support systems do not frequently meet contemporary standards for rigor or consistently identify functional relations. Recommendations and considerations for future research are discussed. [ABSTRACT FROM AUTHOR]

This online survey (N = 2365) examined the experiences of (non-sworn/non-warranted) staff serving in police forces in England and Wales during the March to July COVID-19 virus lockdown in the UK. Particular attention was paid to staff working from home, those able to partially work from home and those who remained at work in their usual police location. Home working staff were generally less stressed than those remaining partially or totally at their work location. Public interacting staff were particularly stressed. Regression analyses found that for all staff, irrespective of location, tiredness and finding work more difficult were implicated in increased stress. For those remaining at their place of work homeschooling and lacking preparedness for another lockdown were additional stressors. The importance of feeling valued is discussed. Some recommendations are offered in the light of these findings including the concept of moral injury repair. [ABSTRACT FROM AUTHOR]

We examine the choices of undergraduate students at a French university who are competing for seats at foreign universities to fulfill a mandatory exchange program requirement. We find that average- and high-ability female students request universities that are worse-ranked than their male peers. A survey eliciting students' preferences suggests that male students prioritize the academic characteristics of exchange universities, whereas similar female students consider both the academic and non-academic characteristics of exchange destinations. We explore the consequences of these differing preferences using a simulation that assigns students to exchange seats solely on university ranking and students' academic performance. [ABSTRACT FROM AUTHOR]

Anaerobic fungi and methanogenic archaea are two classes of microorganisms found in the rumen microbiome that metabolically interact during lignocellulose breakdown. Here, stable synthetic co-cultures of the anaerobic fungus Caecomyces churrovis and the methanogen Methanobacterium bryantii (not native to the rumen) were formed, demonstrating that microbes from different environments can be paired based on metabolic ties. Transcriptional and metabolic changes induced by methanogen co-culture were evaluated in C. churrovis across a variety of substrates to identify mechanisms that impact biomass breakdown and sugar uptake. A high-quality genome of C. churrovis was obtained and annotated, which is the first sequenced genome of a non-rhizoid-forming anaerobic fungus. C. churrovis possess an abundance of CAZymes and carbohydrate binding modules and, in agreement with previous studies of early-diverging fungal lineages, N6-methyldeoxyadenine (6mA) was associated with transcriptionally active genes. Co-culture with the methanogen increased overall transcription of CAZymes, carbohydrate binding modules, and dockerin domains in co-cultures grown on both lignocellulose and cellulose and caused upregulation of genes coding associated enzymatic machinery including carbohydrate binding modules in family 18 and dockerin domains across multiple growth substrates relative to C. churrovis monoculture. Two other fungal strains grown on a reed canary grass substrate in co-culture with the same methanogen also exhibited high log2-fold change values for upregulation of genes encoding carbohydrate binding modules in families 1 and 18. Transcriptional upregulation indicated that co-culture of the C. churrovis strain with a methanogen may enhance pyruvate formate lyase (PFL) function for growth on xylan and fructose and production of bottleneck enzymes in sugar utilization pathways, further supporting the hypothesis that co-culture with a methanogen may enhance certain fungal metabolic functions. Upregulation of CBM18 may play a role in fungal–methanogen physical associations and fungal cell wall development and remodeling. [ABSTRACT FROM AUTHOR]

Observational studies describing the impact of transport duration on weaned piglet welfare are limited. Current Canadian transport regulations are heavily informed by studies involving market hogs. Due to physiological differences between weaned piglets and market hogs, additional data on their response to transport are needed for age-specific evidence-based recommendations. A cohort study was conducted to describe and compare mortality, injury, weight change, hematological or biochemical changes in hydration, muscle injury and stress response observed in weaned piglets undergoing short duration (SD, <3 h), or long duration (LD, >30 h) commercial summertime transport events. Data collection on 440 of 11,434 transported piglets occurred the morning of the day before transport (T0), at arrival (T1) and approximately 3 to 4 d (78 to 93 h) after arrival at the nursery barn (T2). Low mortality occurred over all transport events (0.06%) with no association observed between transport duration and odds of death during transport (P = 0.62). The incidence of lameness between T0 and T1 was low (1.84% of the 435 focal piglets scored) with all lameness cases identified as mild in severity. Lesions on ears and skin were more prevalent than other injury types after transport (T1) and may have been related to mixing aggression associated with weaning rather than transport alone. LD piglets weighed 0.39 kg less than SD piglets at T1 (P < 0.01), but no difference in group weight was observed at T2 (P = 0.17). Hematological and biochemical differences were present between groups at T1. LD piglets had increased hematocrit levels compared with SD piglets (P = 0.01), suggesting increased body water losses. SD piglets showed greater levels of muscle injury compared with LD piglets including elevated aspartate aminotransferase (P < 0.01) and creatine kinase (P < 0.01). However, these parameters were within normal reference ranges for piglets of this age group. Indicators of physiological stress response including cortisol and neutrophil to lymphocyte ratios were elevated in SD piglets compared with LD piglets (P = 0.02 and P < 0.01, respectively). The results of this study demonstrate that both short and long transport durations can result in detectable physiological changes in weaned piglets. The overall impact of these durations on piglet welfare should be further explored by analyzing behavioral time budgets during and after transport. [ABSTRACT FROM AUTHOR]

Despite concerns and debates about the policy of using extended solitary confinement for managing individuals deemed to be too violent or disruptive to be controlled any other way—for the broader goal of system order and safety—empirical assessments of disparities in placements into this form of incarceration are limited. Prior studies typically have not compared extended solitary management (ESM) populations to general prison populations or dimensions along which disparities in ESM placements may arise. This paper identifies groups that may be more likely to be placed in ESM and policy concerns unique to each. Drawing on a study of one large state prison system, we examine disparities in ESM placement, including multiple, early, and longer duration placements. Implications of these disparities and the possibility that there may be differential experiences in and effects of ESM are discussed. [ABSTRACT FROM AUTHOR]

Objectives: Affective and psychotic features overlap considerably in bipolar I disorder, complicating efforts to determine its etiology and develop targeted treatments. In order to clarify whether mechanisms are similar or divergent for bipolar disorder with psychosis (BDP) and bipolar disorder with no psychosis (BDNP), neurobiological profiles for both the groups must first be established. This study examines white matter structure in the BDP and BDNP groups, in an effort to identify portions of white matter that may differ between the bipolar and healthy groups or between the bipolar subgroups themselves. Methods: Diffusion‐weighted imaging data were acquired from participants with BDP (n = 45), BDNP (n = 40), and healthy comparisons (HC) (n = 66). Fractional anisotropy (FA), radial diffusivity (RD), and spin distribution function (SDF) values indexing white matter diffusivity or spin density were calculated and compared between the groups. Results: In comparisons between both the bipolar groups and HC, FA (FDR < 0.00001) and RD (FDR = 0.0037) differed minimally, in localized portions of the left cingulum and corpus callosum, while reductions in SDF (FDR = 0.0002) were more widespread. The bipolar subgroups did not differ from each other on FA, RD, or SDF metrics. Conclusions: Together, these results demonstrate a novel profile of white matter differences in bipolar disorder and suggest that this white matter pathology is associated with the affective disturbance common to those with bipolar disorder rather than the psychotic features unique to some. The white matter alterations identified in this study may provide substrates for future studies examining specific mechanisms that target affective domains of illness. [ABSTRACT FROM AUTHOR]

Public libraries understand the importance of conducting needs assessments, however there is a paucity in the literature about how to conduct a needs assessment. Those articles that mention their methodology only mention the use of surveys to obtain valuable information that will inform the development of library programs, services, and resources. The following article describes a six-step process for designing and developing a needs assessment and includes multiple qualitative and quantitative assessment strategies. [ABSTRACT FROM AUTHOR]

Immune cell function varies tremendously between individuals, posing a major challenge to emerging cellular immunotherapies. This report pursues the use of cell morphology as an indicator of high-level T cell function. Short-term spreading of T cells on planar, elastic surfaces was quantified by 11 morphological parameters and analyzed to identify effects of both intrinsic and extrinsic factors. Our findings identified morphological features that varied between T cells isolated from healthy donors and those from patients being treated for Chronic Lymphocytic Leukemia (CLL). This approach also identified differences between cell responses to substrates of different elastic modulus. Combining multiple features through a machine learning approach such as Decision Tree or Random Forest provided an effective means for identifying whether T cells came from healthy or CLL donors. Further development of this approach could lead to a rapid assay of T cell function to guide cellular immunotherapy. [ABSTRACT FROM AUTHOR]

Policing is a high-stress occupation requiring emotional management when facing job-related violence, threats to safety and well-being, work-life disruption, and unpredictable hours. A national health pandemic coupled with public order and restraint imperatives has compounded the levels of stress in policing. In the UK, new working patterns have been negotiated to manage the constraints of a different working environment during COVID-19. Using a self-administered survey, this article explores the experiences of 473 female police officers working during the first lockdown in 2020. The article shows that the COVID-19 preventative measures forced police services to navigate new and varied working patterns for their employees. Previous resistance to flexible working practices in policing was put aside as police services sought to manage the virus in its own ranks as well as policing the public. Preliminary findings suggest that officers working from home were more likely to feel satisfied with management responses compared with those working on the front line, although negative attitudes from colleagues and management towards those working from home were present. Those not working from home reported higher levels of stress related to their Force's lack of communication with them about their welfare. [ABSTRACT FROM AUTHOR]

The article reports on the legislative expansion of the pharmacists' duty of care in the U.S. and the expected adoption of negligence liability amidst the opioid epidemic. Other topics include the judicial application of the learned intermediary doctrine to pharmacists, and the responsibilities of the Food and Drug Administration (FDA) and the Drug Enforcement Administration (DEA) in regulating the practice of pharmacy.

Background: Although colorectal cancer screening has contributed to decreased incidence and mortality, disparities are present by race/ethnicity. The Citywide Colon Cancer Control Coalition (C5) and NYC Department of Health and Mental Hygiene (DOHMH) promoted screening colonoscopy from 2003 on, and hypothesized future reductions in CRC incidence, mortality and racial/ethnic disparities.Methods: We assessed annual percent change (APC) in NYC CRC incidence, stage and mortality rates through 2016 in a longitudinal cross-sectional study of NY State Cancer Registry, NYC Vital Statistics, and NYC Community Health Survey (CHS) data. Linear regression tested associations between CRC mortality rates and risk factors.Results: Overall CRC incidence rates from 2000 decreased 2.8% yearly from 54.1 to 37.3/100,000 population in 2016, and mortality rates from 2003 decreased 2.9% yearly from 21.0 to 13.9 in 2016 at similar rates for all racial/ethnic groups. Local stage disease decreased overall with a transient increase from 2002 to 2007. In 2016, CRC incidence was higher among Blacks (42.5 per 100,000) than Whites (38.0), Latinos (31.7) and Asians (30.0). In 2016, Blacks had higher mortality rates (17.9), than Whites (15.2), Latinos (10.4) and Asians (8.8). In 2016, colonoscopy rates among Blacks were 72.2%, Latinos 71.1%, Whites 67.2%, and Asians, 60.9%. CRC mortality rates varied by neighborhood and were independently associated with Black race, CRC risk factors and access to care.Conclusions: In a diverse urban population, a citywide campaign to increase screening colonoscopy was associated with decreased incidence and mortality among all ethnic/racial groups. Higher CRC burden among the Black population demonstrate more interventions are needed to improve equity. [ABSTRACT FROM AUTHOR]

Species and habitats are the subjects of legislation that mandates reporting of information on ecosystem conditions. Improvements in sensors, sampling platforms, information systems, and collaborations among experts and information users now enables more effective and up-to-date information to meet regional and national needs. Specifically, advances in environmental DNA (eDNA)-based assessments of biodiversity, community science data, various underwater imaging devices, and environmental, behavioral, and physiology observations from animal telemetry provide new opportunities to address multiple requirements for reporting status and trends, including insights into life in the deep ocean. Passive and active acoustic sensors help monitor marine life, boat traffic, and noise pollution. Satellites provide repeated, frequent, and long-term records of many relevant variables from global to local scales and, when combined with numerical computer simulations, allow planning for future scenarios. Metadata standards facilitate the transfer of data from machine to machine, thus streamlining assessments and forecasting and providing knowledge directly to the public. The Marine Biodiversity Observation Network (MBON) facilitates this exchange of information on life in the sea. The collaborative efforts of the Central and Northern California Ocean Observing System (CeNCOOS) of the US Integrated Ocean Observing System and its partners provide an example of a regional MBON process for information delivery. This includes linking policy and management needs, prioritizing observing data from various platforms and methods, streamlining data handling practices, and delivering information for management such as for the Monterey Bay National Marine Sanctuary and the California Current Large Marine Ecosystem, with iterative process adaptation. [ABSTRACT FROM AUTHOR]

Background In resource-limited settings, the World Health Organization recommends enhanced adherence counseling (EAC) for individuals with an unsuppressed human immunodeficiency virus (HIV)-1 viral load (VL) and to remeasure VL after 3 months to avoid unnecessary regimen switches. In cases in which this follow-up VL remains unsuppressed, a regimen switch is indicated. We aimed to assess levels of HIV-1 drug resistance before and after the EAC period among people with ongoing viremia (≥80 c/mL) after EAC. Methods We included adult participants of the CART-1 cohort study conducted in Lesotho who had a VL ≥80 c/mL after EAC. Paired plasma samples (before and after EAC) were analyzed by next-generation sequencing. We assessed the prevalence of resistance-associated mutations and viral susceptibility scores to each participant's antiretroviral therapy (ART) regimen (range, 0–3; 3 indicates complete susceptibility). Results Among 93 participants taking nonnucleoside reverse-transcriptase inhibitor-based ART with an initial VL ≥1000 copies/mL who received a follow-up VL test after EAC, 76 still had a VL ≥80 copies/mL after EAC, and paired samples were available for 57 of 76. The number of individuals without full susceptibility to any drug in their regimen increased from 31 of 57 (54.4%) before to 36 of 57 (63.2%) after EAC. Median susceptibility scores dropped from 0.5 (interquartile range [IQR] = 0.25–) to 0.25 (IQR = 0.25–1) during the EAC period (P  = .16). Conclusions Despite high levels of resistance before EAC, we observed a slight decline in susceptibility scores after EAC. The risk of further accumulation of resistance during EAC has to be balanced against the benefit of avoiding unnecessary switches in those with spontaneous resuppression after EAC. [ABSTRACT FROM AUTHOR]

Objectives: WHO guidelines on ART define the HIV-1 viral load (VL) threshold for treatment failure at 1000 copies/mL. The Switch Either near Suppression Or THOusand (SESOTHO) trial, conducted in Lesotho from 2017 to 2020, found that patients with persistent viraemia below this threshold (100-999 copies/mL) benefit from switching to second-line ART. This pre-planned nested study assesses the prevalence of resistance-associated mutations (RAMs) in SESOTHO trial participants.Methods: The SESOTHO trial [registered at ClinicalTrials.gov (NCT03088241)] enrolled 80 persons taking NNRTI-based first-line ART with low-level HIV-1 viraemia (100-999 copies/mL) and randomized them (1:1) to switch to a PI-based second-line regimen (switch) or continue on first-line therapy (control). We sequenced relevant regions of the viral pol gene using plasma samples obtained at enrolment and 36 weeks. RAMs were classified with the Stanford HIV Drug Resistance Database.Results: Sequencing data were obtained for 37/80 (46%) participants at baseline and 26/48 (54%) participants without viral suppression to <50 copies/mL at 36 weeks (21 control participants and 5 switch participants). At baseline, 31/37 (84%) participants harboured high-level resistance to at least two drugs of their current regimen. At 36 weeks, 17/21 (81%) control participants harboured resistance to at least two drugs of their current regimen, while no PI-associated resistance was detected in the 5 switch participants with ongoing viraemia.Conclusions: Among persons with low-level viraemia while taking NNRTI-based first-line ART enrolled in the SESOTHO trial, the majority harboured HIV-1 with RAMs that necessitate ART modification. These findings support lowering the VL threshold triggering a switch to second-line ART in future WHO guidelines. [ABSTRACT FROM AUTHOR]

Tear gases, or chemical demonstration control agents (DCA), were originally created as weapons that could severely disable or kill enemy troops. Though banned in war, these chemicals are still used in domestic policing. Here we review the available scientific literature on tear gas, summarizing findings from animal and environmental studies as well describing data from new human studies. We find a lack of scientific evidence supporting the safety of tear gas, especially regarding its long-term impacts on human health and the environment. Many of the available studies were published decades ago, and do not parse data by variables such as chemical type and exposure time, nor do they account for the diversity of individuals who are exposed to tear gas in real-life situations. Due to the dearth of scientific research and the misinterpretation of some of the available studies, we conclude that a serious reevaluation of chemical DCA safety and more comprehensive exposure follow-up studies are necessary. [ABSTRACT FROM AUTHOR]

We systematically reviewed the literature to understand the associations between state-level reproductive health policies and reproductive health care outcomes and describe policy impacts on reproductive health outcomes among women aged 18 and older. We focused on research conducted after the implementation of the Patient Protection and Affordable Care Act to understand the influence of state-level policies in the context of existing federal policy. Standard search terms were used to search PubMed for studies published between March 10, 2010, and August 31, 2019. Studies were included that reflected original U.S.-based research testing associations between state-level policies (i.e., laws related to family planning, maternity care, and abortion) and reproductive health outcomes related to those services (e.g., prenatal care use) among adults. Reference lists of systematic reviews were searched to improve the identification of relevant studies. Studies were excluded if they were reviews, qualitative or mixed-methods studies, or descriptive studies, or if a state was not the unit of analysis. After dual review, agreement on inclusion of studies was 100%. Search results returned 1,529 articles; 56 (3.59%) met the inclusion criteria for a full review based on title and abstract review. After dual independent review, eight were selected for inclusion. Two included all 50 states and Washington, DC; one included Oregon and Washington; and the remaining studies included single states (Texas, Arizona, Ohio, and Utah). One-half of the studies (n = 4) focused solely on restrictive abortion legislation. Restricting access to family planning and abortion services (e.g., mandatory waiting periods) were associated with negative outcomes (e.g., additional interventions for medication abortion). Expanding maternity care through Medicaid reform and autonomous midwifery laws were associated with positive outcomes (e.g., prenatal care use). Our review identified eight studies that were largely focused on only one key aspect of reproductive health policy. Findings suggest that state-level legislation could have considerable impact on the reproductive health care that women have access to and receive, as well as the related outcomes. Research in this area remains limited. Rigorous evaluations of the relationship between the breadth of reproductive health policies and related health outcomes are needed, as is an exploration of barriers to the conduct of this type of research. [ABSTRACT FROM AUTHOR]

Background: Russia has a high prevalence of human immunodeficiency virus (HIV) infections. In 2018, over one million persons were living with HIV (PLWH); over a third were women. A high proportion of HIV-infected women are co-infected with hepatitis C virus (HCV), and many consume alcohol, which adversely affects HIV and HCV treatment and prognosis. Despite the triple epidemics of alcohol use, HIV and HCV, and the need for interventions to reduce alcohol use among HIV/HCV co-infected women, evidence-based alcohol reduction interventions for this vulnerable population are limited. To address this gap, we developed a clinical trial to evaluate the efficacy of a computer-based intervention to reduce alcohol consumption among HIV/HCV co-infected women in clinical care.Methods: In this two-arm parallel randomized controlled trial, we propose to evaluate the efficacy of a culturally adapted alcohol reduction intervention delivered via a computer for HIV/HCV co-infected Russian women. The study population consists of women 21-45 years old with confirmed HIV/HCV co-infection who currently use alcohol. Intervention efficacy is assessed by a novel alcohol biomarker, ethyl glucuronide (EtG), and biomarkers of HIV and HCV disease progression. Women are randomized to trial conditions in a 1:1 allocation ratio, using a computer-generated algorithm to develop the assignment sequence and concealment of allocation techniques to minimize assignment bias. Women are randomized to either (1) the computer-based alcohol reduction intervention or (2) the standard-of-care control condition. We will use an intent-to-treat analysis and logistic and linear generalized estimating equations to evaluate intervention efficacy, relative to the standard of care, in enhancing the proportion of women with a laboratory-confirmed negative EtG at each research study visit over the 9-month follow-up period. Additional analyses will evaluate intervention effects on HIV (viral load and CD4+ levels) and HCV markers of disease progression (FibroScan).Discussion: The proposed trial design and analysis provides an appropriate conceptual and methodological framework to assess the efficacy of the computer-based intervention. We propose to recruit 200 participants. The intervention, if efficacious, may be an efficient and cost-effective alcohol reduction strategy that is scalable and can be readily disseminated and integrated into clinical care in Russia to reduce women's alcohol consumption and enhance HIV/HCV prognosis.Trial Registration: ClinicalTrials.gov NCT03362476 . Registered on 5 December 2017. [ABSTRACT FROM AUTHOR]